The nurse is caring for a client who was recently diagnosed with hemophilia. Which of the following laboratory tests is consistent with that diagnosis?
- A. Prolonged activated partial thromboplastin time
- B. Prolonged prothrombin time
- C. Decreased platelet count
- D. Decreased bleeding time
Correct Answer: A
Rationale: Hemophilia factor VIII or IX lack stretches aPTT, as intrinsic clotting lags, a lab fit for this X-linked bleed fest. PT stays normal extrinsic path's fine. Platelets don't drop; bleeding time's off-base. Nurses spot prolonged aPTT, confirming hemophilia's clotting chaos, guiding factor therapy in this bloody diagnosis.
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Which of the following diseases has the highest proportion of chronic illness deaths in Canada?
- A. Cancer
- B. Diabetes
- C. Cardiovascular disease
- D. Chronic respiratory disease
Correct Answer: C
Rationale: Cardiovascular disease tops Canada's chronic death chart 37% globally in 2012 outpacing cancer's 27%, respiratory's 8%, and diabetes' 4%. Heart attacks and strokes dominate, fueled by aging and lifestyle, a stat nurses lean on for prevention focus. Cancer's big, breathing woes and sugar issues trail, but heart's the killer king, a chronic burden demanding vigilance.
A study by Epstein & Sowers found that hypertension was X times as prevalent in patients with diabetes compared to the general population. What is X?
- A. Two
- B. Three
- C. Four
- D. Five
Correct Answer: A
Rationale: Diabetes doubles hypertension's odds Epstein & Sowers peg it at two times higher, as insulin resistance and vascular stiffness team up, amplifying prevalence over the general crowd. Three, four, five, or six inflate the risk beyond data, skewing the synergy. This duo's frequent dance tied to shared pathways like RAAS pushes clinicians to screen harder, tackling both to cut cardiovascular and renal doom, a chronic combo grounded in solid stats.
A 79 year old woman is told by his GP that she has postural hypertension. Which of the following BP is she likely to be having?
- A. A drop of 15 mmHg/10 mmHg within 3 minutes of standing
- B. A drop of 17 mmHg/10 mmHg within 3 minutes of standing
- C. A drop of 21 mmHg/10 mmHg within 3 minutes of standing
- D. A rise of 5 mmHg/10 mmHg within 3 minutes of standing
Correct Answer: C
Rationale: Postural hypotension 21/10 drop flags, not rises or mild dips. Nurses catch this chronic stand slip (assuming typo meant hypotension).
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.
The best way to prevent chronic complications of diabetes is to:
- A. Take medications as prescribed and remove sugar from the diet completely.
- B. Check feet daily for cuts, long toe nails and infections between the toes.
- C. Maintain a BGL that is as close to normal as possible.
- D. Undertake daily exercise to burn up the excess glucose in the system.
Correct Answer: C
Rationale: Preventing diabetes complications (e.g., neuropathy, retinopathy) hinges on glycemic control. Medications and sugar elimination help, but total sugar removal is impractical carbohydrates are broader, and control, not absence, matters. Daily foot checks prevent ulcers but address consequences, not root causes. Maintaining blood glucose levels (BGL) near normal (e.g., HbA1c <7%) via diet, exercise, and drugs prevents microvascular (kidney, eye) and macrovascular (heart) damage, per ADA guidelines. Exercise burns glucose, aiding control, but isn't singularly best' it's part of a triad. Tight BGL management reduces oxidative stress, glycation, and vascular injury, evidenced by trials (e.g., DCCT), making it the cornerstone strategy over isolated tactics, ensuring long-term organ protection.
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