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In the ACC/AHA 2017 Guideline for Hypertension, what is the cut off for hypertension diagnosis?
- A. 120/70 mmHg
- B. 130/80 mmHg
- C. 135/85 mmHg
- D. 140/90 mmHg
Correct Answer: B
Rationale: ACC/AHA 2017 130/80 tags hypertension, not old 140/90 or looser. Nurses gauge this chronic pressure shift.
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A nurse is caring for a client who has recently diagnosed with left ventricular heart failure. What is an early sign the client is most likely to report?
- A. Dyspnea on exertion
- B. Abdominal distention
- C. Swollen legs
- D. Weight gain
Correct Answer: A
Rationale: Left ventricular failure backs blood into lungs dyspnea on exertion hits early as fluid seeps, taxing breathing during activity, a telltale sign before systemic effects. Abdominal distention or leg swelling marks right-sided or late failure. Weight gain tracks fluid, not initial. Nurses catch dyspnea, educating clients to report it, key to early management in this progressive pump failure.
Which of the following interventions would be best for the child who has developed mucositis as a side effect of chemotherapy?
- A. Using lemon glycerin swabs for oral hygiene.
- B. Keeping the child NPO until all sores are healed.
- C. Having the child swish and swallow viscous lidocaine.
- D. Giving the child pudding for breakfast.
Correct Answer: D
Rationale: Mucositis, a painful chemotherapy side effect, involves inflamed, ulcerated mucous membranes, often in the mouth, complicating eating and hygiene. Offering pudding a soft, bland, cool food is the best intervention, as it minimizes irritation and pain, encouraging nutrition without exacerbating sores. Lemon glycerin swabs are harsh, with citric acid and chemicals worsening discomfort and delaying healing. Keeping the child NPO (nothing by mouth) for weeks until sores heal is impractical and risks malnutrition, as mucositis can persist throughout chemotherapy. Viscous lidocaine might numb pain but is a last resort if the child refuses all intake, not a first-line comfort measure. Pudding supports hydration and calorie intake safely, aligning with nursing's goal to maintain nutrition and comfort in pediatric oncology, reducing mucositis-related distress effectively.
Which of the following patients would probably not benefit from a >5-10% weight loss?
- A. A 28-year-old female with BMI 37 kg/m² and oligomenorrhea but planning for fertility in the future
- B. A 40-year-old man with BMI 26 kg/m², who has a strong family history of diabetes, recently diagnosed with prediabetes
- C. A 21-year-old man with BMI 42 kg/m² with no known medical problems and a family history of T2DM
- D. A 70-year-old female, BMI 26 kg/m², with well-controlled T2DM on two oral anti-diabetic medications and osteoporosis
Correct Answer: D
Rationale: A 5-10% weight loss benefits most with obesity-related conditions improving fertility (BMI 37), prediabetes (BMI 26), or T2DM risk (BMI 42). The 70-year-old with BMI 26, well-controlled T2DM, and osteoporosis may not benefit significantly; weight loss could worsen bone density, and her diabetes is managed, reducing urgency. Her age and comorbidities shift focus to stability, not weight reduction, guiding physicians in chronic care prioritization.
Glycaemic profiles of people with diabetes varies with all EXCEPT:
- A. Diet
- B. Exercise
- C. Stress
- D. Monitoring of blood glucose
Correct Answer: C
Rationale: Sugar swings food, sweat, drugs, checks shift it; dress' is a typo for stress, but stress fits, not fabric. Nurses track this chronic dance, not wardrobe.
In Europe and the USA, drugs licensed for use in intrathecal drug delivery systems include:
- A. Diamorphine.
- B. Methadone.
- C. Morphine.
- D. Ziconotide.
Correct Answer: C
Rationale: Intrathecal drug delivery systems (IDDS) use specific licensed drugs in Europe and the USA. Morphine is widely approved for its efficacy in cancer and chronic pain, binding spinal opioid receptors with a strong evidence base. Ziconotide, a non-opioid, is also licensed, targeting calcium channels for refractory cases. Diamorphine (heroin) isn't licensed intrathecally; it's used epidurally or systemically in some regions (e.g., UK palliative care) but lacks IDDS approval. Methadone's long half-life and oral efficacy preclude intrathecal use; it's not licensed. Ketamine has experimental use but no formal approval. Morphine's prominence stems from its pharmacokinetic suitability high potency and spinal receptor affinity making it a cornerstone of IDDS therapy alongside ziconotide.