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Which of the following statements regarding dietary approaches to obesity treatment is TRUE?
- A. Dietary modifications are generally not sustainable and hence dietary approaches are not as important as pharmacological approaches
- B. There is no Randomised Controlled Trial (RCT) level of evidence regarding decreasing sugar sweetened beverages
- C. Dietary approaches can be broadly categorised into energy-focused, macronutrient-focused, dietary pattern-focused, and dietary timing-focused
- D. Long-term diet trials have shown intermittent fasting to be superior to continuous energy restriction with respect to average weight loss
Correct Answer: C
Rationale: Diet's obesity fight splits smart energy, macros, patterns, and timing frame approaches, a true lens on options like low-carb or fasting. Sustainability varies, RCTs back sugar cuts, fasting ties (not tops) restriction, and proteins sate more than carbs. Clinicians wield this quartet, tailoring chronic plans, a broad truth in food's fat battle.
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Which of the following procedures are performed for a client with a pericardial effusion?
- A. Thoracotomy
- B. Pericardiocentesis
- C. Coronary artery bypass graft
- D. Thoracentesis
Correct Answer: B
Rationale: Pericardial effusion fluid around the heart threatens tamponade, compressing cardiac output. Pericardiocentesis drains this via needle or catheter, relieving pressure, a targeted fix for this diagnosis. Thoracotomy, an open chest surgery, is overkill unless complications escalate. Coronary bypass addresses arterial blockages, unrelated to effusion. Thoracentesis taps pleural fluid, not pericardial. Nurses prep for pericardiocentesis, anticipating its urgency in restoring function, a procedure matching the condition's anatomy and risk, critical for stabilizing clients in this cardiac emergency.
What do you tell patients is the most important risk factor for lung cancer when you are teaching about lung cancer prevention?
- A. Cigarette smoking
- B. Exposure to environmental/occupational carcinogens
- C. Exposure to environmental tobacco smoke (ETS)
- D. Pipe or cigar smoking
Correct Answer: A
Rationale: Cigarette smoking towers as lung cancer's top risk 80-90% of cases tie to its carcinogens like tar and nicotine, a dose-dependent killer dwarfing other factors. Environmental/occupational exposures like asbestos amplify risk, especially with smoking, but lack its prevalence. ETS hikes risk by 35%, significant yet secondary. Pipe or cigar smoking carries risk, less than cigarettes due to inhalation patterns. Teaching smoking as paramount drives home its preventable dominance, urging cessation as the gold-standard defense, a nurse's key message to slash lung cancer odds, backed by epidemiology and public health campaigns.
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.
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.
A 75-year-old lady is listed for an anterior resection to treat a cancer in the descending hemicolon. She has never previously been in hospital. She gives no history of shortness of breath or angina, but admits that she does not take part in strenuous activity. Apart from painkillers, she takes no medications. Appropriate statements regarding preoperative testing include:
- A. Resting echocardiography is a useful test of her functional capacity.
- B. Coronary angiography is indicated.
- C. Cardiopulmonary exercise testing is a useful test of functional capacity.
- D. Brain natriuretic peptide level is a useful test that indicates heart failure.
Correct Answer: C
Rationale: Preoperative assessment evaluates surgical risk. Resting echocardiography assesses cardiac structure, not functional capacity, which requires dynamic testing. Coronary angiography is invasive and unwarranted without symptoms like angina or ischemia evidence. Cardiopulmonary exercise testing (CPET) measures aerobic capacity (e.g., VOâ‚‚ peak), directly assessing functional reserve for surgical stress ideal for this asymptomatic but inactive patient. Brain natriuretic peptide (BNP) indicates heart failure if elevated but doesn't test capacity; it's a biomarker, not a stress test. Dobutamine stress echocardiography detects ischemia, useful but less comprehensive than CPET for overall fitness. CPET's ability to quantify cardiopulmonary reserve makes it the most appropriate choice for optimizing perioperative management in this elderly patient.