Nokea
Which of the following condition has low risk of progression to liver cirrhosis:
- A. Hepatic steatosis
- B. Hepatic steatohepatitis
- C. Hepatic steatohepatitis with fibrosis
- D. Chronic hepatitis
Correct Answer: A
Rationale: Steatosis fat sits, low cirrhosis odds; steatohepatitis, fibrosis, chronic, booze burn scar. Nurses mark this chronic liver lite.
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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.
According to the McGinnis model of 2002, what percentage of health differences between people is related to their behaviour?
- A. 10%
- B. 20%
- C. 30%
- D. 40%
Correct Answer: D
Rationale: McGinnis pegs behaviour smoking, eating at 40% of health gaps, big over genes or care. Nurses lean on this, a chronic choice chunk.
The nurse is assessing a client with severe anemia. Which clinical manifestation does the nurse expect to see in this client?
- A. Bradycardia
- B. Pale, cool skin
- C. Hypertension
- D. Warm, flushed skin
Correct Answer: B
Rationale: Severe anemia starves oxygen pale, cool skin reflects shunted flow and low hemoglobin, a classic find as body compensates. Bradycardia's rare; tachycardia revs to pump more. Hypertension doesn't fit BP may drop. Warm, flushed skin suits overload, not anemia. Nurses expect pallor, tying it to blood's oxygen flop, a sign guiding transfusion or iron.
A 30yr NZ man goes to PNG, takes 300 mg chloroquine weekly for 2 weeks prior and 4 weeks post his trip. 3/12 later gets febrile/sweats/maleana with malaria parasites on film. The following is true
- A. He took 1/2 the normal dose of chloroquine
- B. If he took primaquine for 2/52 this wouldn't have happened
- C. Assume chloroquine resistance and treat accordingly
- D. This is probably p. falciparum
Correct Answer: C
Rationale: PNG malaria chloroquine's 250 mg norm, resistance rife, not dose, primaquine, or falciparum lock. Nurses switch this chronic resistant fix.
Spirometry is used to determine the severity of COPD and to monitor disease progression. This test measures
- A. The ratio of volume of air the patient can forcibly exhale in 1 second and forced vital capacity
- B. The ratio of residual volume when patient has fully exhaled and forced vital capacity
- C. The ratio of forced vital capacity and volume of air the patient can forcibly exhale in 6 seconds
- D. The ratio of respiratory effort and respiratory rate
Correct Answer: A
Rationale: Spirometry sizes COPD FEV1/FVC ratio, air blasted in one second versus all-out capacity, pegs obstruction's depth, tracking decline. Residual's post-exhale, not this; 6-second's off; effort-rate's vague. Nurses lean on this, staging chronic airflow's fade.