Madam Lim 79 years old is functionally independent and lives in the community. She has osteoarthritis of the knee and hypertension. What would you set her target BP to be?
- A. <120/80 mmHg
- B. <130/80 mmHg
- C. <135/85 mmHg
- D. <150/90 mmHg
Correct Answer: D
Rationale: Fit 79 <150/90 balances hypertension, age; tighter risks falls, joints. Nurses set this chronic elder goal.
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Clients with chronic illness want the health care system to provide them with which of the following?
- A. Less information
- B. Less travel time
- C. Ways to adjust to disease consequences
- D. Limited information on ways to cope with their symptoms
Correct Answer: C
Rationale: Chronic folks crave adaptation tools handling fear, sleep woes, or sex shifts not less info or travel ease. Nurses deliver this, a lifeline for illness' long tail, not just quick fixes.
Diabetes is associated with pathophysiological mechanisms that contribute to the development of cardiovascular events. Question: What is the approximate percentage of diabetes patients who also have hypertension?
- A. 25%
- B. 50%
- C. 75%
- D. 100%
Correct Answer: C
Rationale: Diabetes and hypertension 75% overlap, sugar and pressure tag-team hearts. Nurses watch this, a chronic duo hit.
Sodium-glucose-co-transporter-2 (SGLT-2) inhibitors were shown to reduce albuminuria and proteinuria by X%. What is X?
- A. 10--30
- B. 20-40
- C. 30-50
- D. 40-60
Correct Answer: C
Rationale: SGLT-2 inhibitors, used in type 2 diabetes, reduce albuminuria and proteinuria by 30-50%, as evidenced in trials like CREDENCE and DAPA-CKD. They lower glomerular hyperfiltration by inhibiting glucose and sodium reabsorption in the proximal tubule, decreasing intraglomerular pressure and thus protecting kidney function. This 30-50% reduction is significant in slowing chronic kidney disease (CKD) progression, a key benefit beyond glycemic control. Lower ranges (10-30%, 20-40%) underestimate this effect, while higher ranges (40-60%) may apply to specific subgroups but aren't the average. This renal protection makes SGLT-2 inhibitors a cornerstone in managing diabetic nephropathy, vital knowledge for physicians optimizing chronic disease outcomes.
Which of the following is NOT an example of intermittent fasting?
- A. Alternate day fasting
- B. Mediterranean dieting
- C. Modified fasting regimes such as the 5:2 diet'
- D. Time restricted feeding
Correct Answer: B
Rationale: Fasting flips alternate, 5:2, timed, holy skips; Mediterranean's steady, not starved. Nurses clock this chronic fast gap.
A 56 year old lady with Type 2 DM and a BMI of 30 kg/m2 is reviewed by her family doctor due to poor glycaemic control. She is treated with oral gliclazide since she is diagnosed as diabetic and currently she is on 160 mg bid. Her serum creatinine is 110 μmol/L. Which ONE of the following medications should be most appropriately to be added next?
- A. Metformin
- B. Acarbose
- C. Pioglitazone
- D. Insulin
Correct Answer: A
Rationale: Gliclazide maxed, HbA1c off metformin's next, safe at creatinine 110 (eGFR likely 50+), tackling insulin resistance in obesity. Acarbose slows carbs, pioglitazone risks fluid, insulin's later, linagliptin's fine but less foundational. Nurses add this chronic sugar anchor, boosting control without kidney strain.
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