Nokea
The movement patterns of 80 students who participated in a training programme have been measured. One of the measurement variables is the number of hours the student plays sports per week. This variable is measured both after and before the training programme. Subsequently, the average number of hours the student played sports before the training programme is compared with the number of hours the student plays sports after the training programme. Question: Which test is suitable to compare these two average values?
- A. Chi-square test
- B. Fisher's exact test
- C. Two-sample t-test
- D. Paired t-test
Correct Answer: D
Rationale: Same kids, before-after sports hours paired t-test ties each shift, not chi-square's counts, Fisher's tables, or two-sample splits. Nurses stat this, a chronic match check.
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Strategies to overcome barriers and challenges faced in insulin therapy include the following EXCEPT:
- A. Close supervision for the patient's first jab
- B. Threaten patient into adherence with insulin therapy
- C. Engage patient from the start
- D. Offer the least painful options currently available in the market
Correct Answer: B
Rationale: Insulin wins guide first shots, engage early, ease pain, set sharp goals; threats flop, breed resentment. Nurses coach this chronic game, not bully.
Mr Yee, 45 years old, reports three recent gout attacks in the ankle or knee. You notice a small tophus over his left elbow. He says that two years ago he took allopurinol 100 mg for one month followed by 200 mg OM for one month, but stopped as it 'did not help his gout and there was no improvement'. When you probe, he states that he was not very adherent to allopurinol either then as it was some years ago. He says he took it likely 'once or twice a week'. He states that he did not experience any rashes or other side effects to it then. He did not go back to see his previous GP as he has moved house and your clinic is nearer to his home. He does not drink alcohol except one glass of wine once or twice a year on special occasions. Two weeks ago, he was admitted to the hospital for a gout flare. He had blood tests done, which returned the results below. He is asking you to give him Arcoxia standby as it usually works for his gout flare. Uric acid 620 mmol/L, Creatinine 96 umol/L, eGFR >90 mL/min, BP 144/94 mmHg. He has HTN on HCTZ long-term. Which is incorrect advice?
- A. Offer to restart allopurinol and explain that it does not work immediately. You may wish to discuss HLA B5801 testing particularly as it is unclear how frequent and for how long he was taking allopurinol previously
- B. Advise that he will need stepwise up-titration of a urate lowering agent to reach uric acid target. Regular blood tests will allow this to be done safely
- C. Advice that colchicine prophylaxis is helpful to prevent gout attacks, as it takes time for a urate lowering agent to reach uric acid target
- D. Advise him that allopurinol is ineffective. Offer to initiate febuxostat or probenecid immediately
Correct Answer: D
Rationale: Tophus and 620 uric acid yell chronic gout allopurinol's not bunk; past spotty use tanked it, not the drug. Restarting with titration, colchicine cover, and allergy watch fits; HLA testing flags risk. Swapping to febuxostat or probenecid skips allopurinol's shot wrong call when adherence, not efficacy, flopped. Clinicians correct this, steering chronic control right.
What is essential in an ecological approach to health behaviour?
- A. People should be approached in their natural environment
- B. People learn behaviour in a layered environment
- C. People aim to find a balance between risk and health
- D. If it is beneficial to one's health, it is also sustainable
Correct Answer: B
Rationale: Ecological health layered worlds shape acts, not just spots, balance, or green wins. Nurses weave this, a chronic context web.
Mdm Koh, a 55-year-old housewife with hypertensive nephropathy was recently started on allopurinol 50 mg per day with prophylactic colchicine 500 mg OM 3 weeks ago in your clinic. She is on Lasix 20 mg OM, nifedipine LA 30 mg OM, aspirin 100 mg OM and renalvite 1 tab OM. She came down with flu like symptoms 4 days ago and developed rashes after being given Amoxil by another General Physician. Today, she returns to your clinic. What should be the next step?
- A. Stop Amoxil and continue the chronic medications
- B. Prescribe paracetamol for pain relief and switch to clarithromycin 500 mg BD instead
- C. Continue medications and check for Dengue serology
- D. Stop all medications and refer for possible SJS
Correct Answer: D
Rationale: Rash post-Amoxil, allopurinol new SJS looms, stop all, refer fast; not just Amoxil, clarithro, dengue, or colchicine tweaks. Nurses flag this chronic skin scare.
A 75-year-old female presented to the emergency department with shortness of breath. The client's daughter is at the bedside and shares that the client has a history of heart failure. The nurse places the client on the cardiac monitor and finds that the client is in atrial fibrillation at a rate of 180 beats per minute. Which is a likely finding?
- A. Bounding pulses
- B. Lethargy
- C. Hypotension
- D. Edema
Correct Answer: C
Rationale: Atrial fibrillation at 180 beats/minute in heart failure loses atrial kick, slashing output hypotension follows as rapid, erratic beats fail to fill ventricles, a likely finding with this tachycardic chaos. Bounding pulses need strong ejection, not here. Lethargy or edema might emerge, but BP drop's immediate, tied to poor perfusion. Nurses expect this, anticipating rate control or fluids, a critical catch in this acute decompensation.