Nokea
Regarding oxygen consumption by the adult human body:
- A. It is approximately 3 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ at rest in the awake adult patient.
- B. It rises to approximately 11 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ at peak exercise in healthy young adults.
- C. Increases by approximately 5-fold after major surgery.
- D. Peak oxygen consumption is likely to be quantified accurately by cardiopulmonary exercise testing.
Correct Answer: A
Rationale: Oxygen consumption (VOâ‚‚) reflects metabolic demand. At rest, VOâ‚‚ is approximately 3-4 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ in awake adults, aligning with basal energy needs (250-300 ml/min total). During peak exercise, healthy young adults can reach 30-40 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹, far exceeding 11 ml, depending on fitness. Post-major surgery, VOâ‚‚ increases 50-100% (1.5-2-fold), not 5-fold, due to stress and healing, though critical illness may spike higher briefly. Cardiopulmonary exercise testing (CPET) accurately measures peak VOâ‚‚, unlike the Duke Activity Status Index, which estimates it via questionnaire. The resting value of 3 ml Oâ‚‚ kgâ»Â¹ minâ»Â¹ is a physiological constant, foundational to understanding perioperative oxygen delivery and demand.
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The Barker hypothesis describes the relationship between birth weight and the development of diseases. Question: Which relationship is correct?
- A. High birth weight is associated with a reduced risk of obesity, diabetes and/or cardiovascular disease at a later age
- B. High birth weight is associated with an increased risk of obesity, diabetes and/or cardiovascular disease at a later age
- C. Low birth weight is associated with a reduced risk of obesity, diabetes and/or cardiovascular disease at a later age
- D. Low birth weight is associated with an increased risk of obesity, diabetes and/or cardiovascular disease at a later age
Correct Answer: D
Rationale: Barker's call low birth weight scars metabolism, upping later obesity, diabetes, heart woes. High weight leans risky too, but low's the proven chronic link nurses track this fetal echo.
A 72 years old man is diagnosed to have Type 2 DM, hypertension and hyperlipidemia with stage 3 chronic kidney disease. He is otherwise well and asymptomatic. He is referred to you for follow-up care. His blood pressure is 142/70 mmHg with HbA1c 6.5%. You would continue his following medications EXCEPT
- A. Hydrochlorothiazide 12.5 mg OD
- B. Simvastatin 40 mg ON
- C. Aspirin 100 mg OD
- D. Glibenclamide 10 mg bid
Correct Answer: D
Rationale: Stage 3 CKD eGFR 30-59 means glibenclamide's out; it piles up, risking hypoglycemia in shaky kidneys. Thiazide holds BP, simvastatin guards lipids, aspirin shields heart, irbesartan protects kidneys all stay. Nurses swap sulphonylureas here, dodging chronic sugar crashes in fragile renal states.
The Pulmonary rehabilitation program consists of several specific components. Which of the following are not a part of the program?
- A. Education and self-management
- B. Exercise training
- C. Coping measures to relieve anxiety, depression and changes in behaviour
- D. Spirometry
Correct Answer: D
Rationale: Pulmonary rehab builds COPD strength education, exercise, coping tools for mind and mood, all in. Spirometry's a test, not therapy diagnoses, doesn't train. Nurses skip it here, a chronic fix's focus.
Which of the following statements regarding factors leading to obesity is FALSE?
- A. The factors known to cause obesity are complex and multiple
- B. Twin, family and adoption studies show that the rate of heritability of BMI is high, ranging from 40% to 70% demonstrating a major genetic component
- C. More recent studies have identified a potential role for the microbial content of the skin
- D. Emotional factors are well-known to be potent modulators of appetite
Correct Answer: C
Rationale: Obesity's mess genes, emotions, drugs stack up; gut microbes, not skin, tip scales. Nurses sift this chronic cause pile, nixing dermal fluff.
Non modifiable risk factors for developing chronic illness include:
- A. Smoking and hypertension
- B. Sedentary lifestyle and diabetes
- C. Family history and socio-political factors
- D. Working/living conditions and stress
Correct Answer: C
Rationale: Non-modifiable risk factors are inherent traits or circumstances that cannot be changed, unlike modifiable factors tied to behavior or environment. Smoking and hypertension are modifiable through lifestyle changes or medical intervention, not fixed. Sedentary lifestyle is a choice, and diabetes, while influenced by genetics, is often manageable, making them modifiable. Family history, such as genetic predisposition to diseases like cancer or heart disease, is unalterable, and socio-political factors like access to healthcare shaped by policy or socioeconomic status are beyond individual control, fitting the non-modifiable category. Working and living conditions, plus stress, can be adjusted with resources or coping strategies, classifying them as modifiable. The distinction lies in control: family history and socio-political factors remain static, influencing chronic illness risk without personal alteration, as noted in foundational chronic disease literature like Farrell (2017), emphasizing genetics and societal context over mutable habits.