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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
An oncology nurse educator is providing health education to a patient who has been diagnosed with skin cancer. The patient's wife has asked about the differences between normal cells and cancer cells. What characteristic of a cancer cell should the educator cite?
- A. Malignant cells contain more fibronectin than normal body cells
- B. Malignant cells contain proteins called tumor-specific antigens
- C. Chromosomes contained in cancer cells are more durable and stable than those of normal cells
- D. The nuclei of cancer cells are unusually large, but regularly shaped
Correct Answer: B
Rationale: Cancer cells sport tumor-specific antigens (e.g., CEA) proteins marking them as rogue, unlike normal cells. Fibronectin's less in malignant cells, aiding their slipperiness. Chromosomes are fragile and jumbled (aneuploidy), not stable. Nuclei are big and wonky (pleomorphic), not regular. Nurses in oncology education lean on this antigen trait it's why tests spot cancer and therapies target it, a clear line from normal to malignant.
The thickening of the glomerular basal membrane in an early stage of diabetes mellitus is a consequence of which mechanism?
- A. AGE deposition
- B. Proteinuria
- C. Inflammation
- D. All mechanisms mentioned above
Correct Answer: A
Rationale: Early diabetic kidney AGEs glue GBM thick, not protein spill or inflammation yet. Nurses catch this, a chronic sugar scar.
What is the cut-off of blood pressure for the diagnosis of hypertension that is recommended by MOH Clinical Practice Guideline?
- A. 120/70 mmHg
- B. 125/75 mmHg
- C. 130/70 mmHg
- D. 140/90 mmHg
Correct Answer: D
Rationale: MOH guidelines hold hypertension at 140/90 mmHg, a conventional cutoff balancing sensitivity and specificity for diagnosis in primary care, aligning with global norms like WHO. Lower thresholds 120/70, 125/75, 130/70, 135/80 catch prehypertension or align with newer AHA standards, but MOH sticks to 140/90 for actionable clarity, triggering treatment to curb stroke or heart risks. This higher bar avoids overdiagnosis in resource-stretched settings, ensuring focus on clear disease, a practical call for managing chronic vascular load.
Which of the following would predispose a client to mitral stenosis?
- A. Obesity
- B. Rheumatic fever
- C. Intravenous drug use
- D. Diabetes
Correct Answer: B
Rationale: Mitral stenosis narrows the valve rheumatic fever's scarring, from streptococcal aftermath, is the prime culprit, stiffening leaflets over years. Obesity, IV drug use (tied to endocarditis), or diabetes don't directly scar valves. Nurses link rheumatic history to this, watching for dyspnea or murmurs, a legacy of infection shaping this cardiac bottleneck.
About the mineralocorticoid antagonists (MRAs) which of the following is correct?
- A. Patiromer is a new MRA
- B. Losartan is a MRA
- C. MRAs can cause hypokalemia
- D. Finerenone is a novel nonsteroidal MRA
Correct Answer: D
Rationale: MRAs finerenone's new, not patiromer, losartan; hyperkalemia, albumin cuts fit. Nurses tap this chronic kidney tweak.