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Certain drug classes may cause harm in patients with symptomatic (NYHA classes II-IV) reduced ejection Heart failure (HFrEF), and thus should be avoided. If they are strongly indicated, they are to be used with caution, and with close monitoring. Such drugs include all of the following except:
- A. Thiazolidinediones (glitazones, e.g., pioglitazone, rosiglitazone)
- B. Nonsteroidal anti-inflammatory drugs and COX-2 inhibitors
- C. Nutritional supplements (e.g., coenzyme Q10, carnitine, taurine, and antioxidants)
- D. Non-dihydropyridine calcium-channel blockers (verapamil, diltiazem)
Correct Answer: C
Rationale: HFrEF hates fluid and strain glitazones swell, NSAIDs tank kidneys, verapamil/diltiazem slow too much, trastuzumab trashes hearts. Supplements like CoQ10? Neutral or helpful, not harmful, a safe outlier. Clinicians dodge the rest, easing chronic pump woes, not this add-on.
You may also like to solve these questions
The physician tells the patient that there will be an initial course of treatment with continued maintenance treatments and ongoing observation for signs and symptoms over a prolonged period of time. You can help the patient by reinforcing that the primary goal for this type of treatment is:
- A. Cure
- B. Control
- C. Palliation
- D. Permanent remission
Correct Answer: B
Rationale: The physician's plan initial treatment, maintenance, and long-term monitoring suggests a chronic cancer unamenable to cure, aiming instead to control growth and spread. Control stabilizes disease, extending life and quality, unlike cure, which eradicates cancer, or permanent remission, implying no recurrence both unfeasible here. Palliation focuses on symptom relief, not longevity, misaligning with ongoing treatments. Reinforcing control clarifies expectations, reducing anxiety by framing therapy as proactive management, not defeat. Nurses bolster this by explaining observation's role in adjusting care, aligning patient understanding with realistic goals, vital for adherence and emotional resilience in prolonged cancer battles.
Traditionally, nurses have been involved with tertiary cancer prevention. However, an increasing emphasis is being placed on both primary and secondary prevention. What would be an example of primary prevention?
- A. Yearly Pap tests
- B. Testicular self-examination
- C. Teaching patients to wear sunscreen
- D. Screening mammograms
Correct Answer: C
Rationale: Primary prevention stops cancer before it starts by reducing risk factors in healthy folks. Teaching sunscreen use blocks UV radiation a prime cause of skin cancer like melanoma fitting this category perfectly. Pap tests and mammograms are secondary prevention, detecting cervical and breast cancer early for treatment. Testicular self-exams also fall under secondary, aiming to catch testicular cancer sooner. The shift to primary efforts, like sun protection, reflects a proactive stance, cutting UV-induced DNA damage that kicks off carcinogenesis. Nurses pushing this can slash skin cancer rates, especially in fair-skinned populations, by fostering habits that shield against environmental triggers, unlike reactive screening or post-diagnosis care.
What is an independent risk factor for the development of type 2 diabetes mellitus?
- A. Age
- B. Waist circumference
- C. Smoking
- D. All three options above
Correct Answer: D
Rationale: Type 2 diabetes brews from age cells tire; waist fat resists insulin; smoking inflammation tweaks glucose. All hit independently, stacking odds, a chronic trio nurses flag in every patient check, not just one picking off the list.
Which antibiotic is not recommended as first line therapy for the associated bug?
- A. legionella - erythromycin
- B. chlamydia psittaci - doxycycline
- C. chlamydia pneumoniae - doxycycline
- D. mycoplasma pneumoniae - roxithromycin
Correct Answer: C
Rationale: Chlamydia pneumoniae doxycycline's gold, not erythromycin, roxi, or others mispaired. Nurses tweak this chronic lung fix.
The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breathe and the nurse's rapid assessment reveals that the patient's jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct Answer: B
Rationale: Dyspnea plus distended jugulars scream SVCS breast cancer's mets can squeeze the vena cava, blocking venous return from the head and chest. It's an oncology emergency, fast-tracking to edema and airway issues if unchecked. Intracranial pressure needs brain involvement less likely here. Spinal compression hits legs and bladder, not breathing. Neck tumors might press locally, but SVCS fits this picture. Nurses jump on this, pushing for steroids or stenting, knowing seconds count.