Nokea
The nurse educates the client that besides an echocardiogram, which of the following tests is the best tool for diagnosing heart failure?
- A. Pulmonary artery catheter
- B. Mitigated angiographic (MUGA) scan
- C. B-type natriuretic peptide (BNP)
- D. Radionuclide studies
Correct Answer: C
Rationale: BNP, a blood test, spikes with heart stretch heart failure's calling card, outshining invasive tools for diagnosis. Pulmonary catheters measure pressures, not routine. MUGA scans ejection fraction, less direct. Radionuclide's vague here. Nurses teach BNP's ease and accuracy, a biomarker gold standard, syncing with echo to nail heart failure's fluid tale.
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A 45 year old man, BMI 35 but otherwise healthy and normotensive has an urinary albumin excretion of 30 mg in 24 hours. Which is the correct action to take?
- A. Reduce weight
- B. It can be observed over 3 months for improvement
- C. Refer him to a nephrologist
- D. Treatment is required
Correct Answer: A
Rationale: Albumin 30 microalbuminuria's dawn, weight loss curbs it; watch, refer, treat, ignore lag. Nurses nudge this chronic kidney shield.
Which of the following is a characteristic of health-related hardiness known as 'challenge'?
- A. Confidence to appraise a health stressor
- B. Ability to modify responses to health stressors
- C. Viewing a health stressor as an opportunity for growth
- D. Optimal psychosocial adaptation to a health stressor
Correct Answer: C
Rationale: Hardiness' challenge sees stressors as growth shots not just sizing up, tweaking, or adapting a mindset nurses foster in chronic fights. It's flipping pain to gain, a resilient twist.
Which of the following health determinants is NOT a component of Lalonde's model?
- A. Biological factors
- B. Physical environment
- C. Health care
- D. Attitude to life
Correct Answer: D
Rationale: Lalonde's grid biology, environment, care, not attitude shapes health, not mindsets. Nurses map this, a chronic model cut.
Which of the following is a treatment option for a client with sickle cell disease?
- A. NPO diet
- B. Blood product administration
- C. Pain management with nonsteroidal anti-inflammatory drugs (NSAIDs) only
- D. Arthrocentesis
Correct Answer: B
Rationale: Sickle cell's vaso-occlusion and anemia crave blood transfusions boost oxygen, unsickling cells, a go-to fix. NPO starves, NSAIDs alone weak for crisis pain, arthrocentesis irrelevant. Nurses bank on blood, easing hypoxia, a lifeline in this hemoglobin havoc, trumping lesser aids.
A 59-year-old lady with type 2 diabetes mellitus (T2DM), heart failure from coronary artery disease, and an ejection fraction of 60 percent attends your practice for a routine follow-up. She has mild dyspnea while climbing stairs but reports no other limitations in her usual activities. Her HbA1c was 7.2 percent. She is compliant to extended-release metformin 2,000 mg OD, Rosuvastatin 10 mg ON, Telmisartan 40 mg OD, carvedilol 25 mg BD, and aspirin 100 mg OD. Her vital signs reveal stable body weight at 88 kg, a blood pressure of 126/78 mmHg, a heart rate of 68 bpm and regular, and a respiratory rate of 18 breaths/min. Her examination is otherwise normal. What would be the most appropriate next step in management?
- A. Increase carvedilol to 50 mg BD
- B. Add an SGLT2-inhibitor to her regimen
- C. Add basal insulin to her regimen
- D. Add dipeptidyl peptidase-4 (DPP-4) inhibitor to her regimen
Correct Answer: B
Rationale: HFpEF (EF 60%) with T2DM and dyspnea SGLT2 inhibitors cut heart failure risk and aid sugar, a dual win over carvedilol's max-out, insulin's glucose-only hit, DPP-4's weak HF edge, or unneeded frusemide (no edema). Clinicians add this, boosting chronic outcomes, a smart next step.