Nokea
In order to reduce cardiovascular, renal and all-cause mortality, the American Heart Association (AHA) and the American College of Cardiology (ACC) has set the definition of hypertension as a BP of X in 2017. What is X?
- A. 120/70 mmHg
- B. 125/75 mmHg
- C. 130/80 mmHg
- D. 135/85 mmHg
Correct Answer: C
Rationale: Hypertension's threshold shifted in 2017 when the AHA and ACC pegged it at 130/80 mmHg, aiming to catch cardiovascular and renal risks earlier, slashing mortality via tighter control. Lower cutoffs like 120/70 or 125/75 flag normal or elevated, not yet disease. Higher ones 135/85 or 140/90 stick to older, laxer standards, missing early intervention's benefit. This pivot reflects evidence tying 130/80 to doubled event risk versus <120, pushing clinicians to act sooner with lifestyle or meds, a proactive stance in chronic disease's long game.
You may also like to solve these questions
Which of the following has been shown to be useful in managing fatty liver?
- A. Insulin injection
- B. Metformin
- C. Vitamin E
- D. Exercises
Correct Answer: C
Rationale: Vitamin E, an antioxidant, reduces hepatic inflammation in non-alcoholic steatohepatitis (NASH), per AASLD guidelines, aiding NAFLD management. Insulin treats diabetes, not NAFLD directly. Metformin improves insulin sensitivity but lacks strong evidence for NAFLD reversal. Exercise and diet are key but split here; exercise aids weight loss, indirectly helping. Vitamin E's specific benefit makes it notable in chronic liver disease care.
A 7-year-old child with osteosarcoma is being treated with chemotherapy. Which medication would the nurse expect the physician to order most commonly as a prophylaxis against Pneumocystis jirovecii?
- A. Trimethoprim-sulfamethoxazole
- B. Ketoconazole
- C. Filgastim
- D. Prednisone
Correct Answer: A
Rationale: Osteosarcoma chemotherapy compromises the immune system, increasing susceptibility to opportunistic infections like Pneumocystis jirovecii pneumonia (PCP), a serious risk in immunocompromised children. Trimethoprim-sulfamethoxazole (TMP-SMX) is the most common prophylactic antibiotic for PCP, effectively preventing this lung infection by targeting its causative organism. Ketoconazole treats fungal infections but not PCP, which is caused by a fungus-like organism requiring specific therapy. Filgrastim stimulates neutrophil production to combat neutropenia, not PCP directly. Prednisone, a corticosteroid, suppresses immunity and reduces tumor-related edema but doesn't prevent infections and may increase risk. The nurse anticipates TMP-SMX due to its established role in pediatric oncology protocols, ensuring protection against a preventable, potentially fatal complication during chemotherapy.
According to Johnson and Chang (2014), people living with chronic illness are more likely than the general population to:
- A. Have significantly reduced activity and subsequent loss of independence
- B. Be required to see their doctor more regularly
- C. Experience periods of hospitalisation as a consequence of acute flare-ups of their underlying chronic disease
- D. Stay home and reduce their activity and social interactions
Correct Answer: A
Rationale: Chronic illness curbs activity arthritis, COPD slash mobility, stealing independence, a standout hit over frequent doctor visits, hospital stays from flares, or self-imposed isolation. Those ripple too, but reduced function's the core burden, reshaping daily life. Nurses prioritize this, boosting support, a chronic truth where physical loss leads.
The nurse should suggest which food choice when providing dietary teaching for a patient scheduled to receive external-beam radiation for abdominal cancer?
- A. Fruit salad
- B. Baked chicken
- C. Creamed broccoli
- D. Toasted wheat bread
Correct Answer: B
Rationale: Abdominal radiation zaps the gut, sparking diarrhea from irritated bowels baked chicken's lean protein fuels healing without roughage to rile things up. Fruit salad's fiber and whole-grain toast's bulk worsen diarrhea; dairy in creamed broccoli risks lactose issues post-radiation. Nurses steer patients here to low-residue diets, dodging raw fruits and grains that scrape an already tender GI tract. In oncology, it's about balancing nutrition with symptom control chicken keeps strength up without the bowel chaos, key for tolerating treatment.
Mr XYZ, a 60-year-old, smoker with DM, hypertension and CKD Stage 3 sees you for routine chronic review. He reports recurrent gout flares past five weeks of increasing intensity and duration which he assumes is due to frequent travel and lack of exercise. His current laboratory results are creatinine 106, eGFR 56, uric acid 400, HbA1c 7.3%, random hypocount 8.5 mmol/L. He is currently taking glipizide 5 mg BD, Metformin 250 mg BD, Amlodipine 5 mg OM. What is the most appropriate management in this patient?
- A. Offer dietary advice
- B. Prescribe NSAIDs and medical certificate (MC)
- C. Increased exercise frequency (e.g. jogging at least 3 times per week)
- D. Initiate urate lowering therapy using allopurinol with colchicine prophylaxis
Correct Answer: D
Rationale: Gout flares, uric acid 400, CKD 3 allopurinol with colchicine tames crystals, not just diet, NSAIDs, jogging, or smoke quit. Nurses start this chronic uric brake.