Nokea
Which of the following statements regarding weight regulation is FALSE?
- A. Functional MRI (fMRI) studies have shown overactivation of reward-encoding brain regions and/or deficiency in cortical inhibitory networks in obese people
- B. The homeostatic weight regulation circuitry centres around the corticolimbic structures of the brain
- C. Liking and wanting of food are subconscious processes
- D. The reward system of weight regulation is nonhomeostatic in nature
Correct Answer: B
Rationale: Weight regulation involves homeostatic (hypothalamic) and nonhomeostatic (reward-driven) systems. fMRI studies showing reward region overactivation in obesity, subconscious liking/wanting, and the reward system's nonhomeostatic nature are true. However, homeostatic regulation centers on the hypothalamus, not corticolimbic structures (involved in reward/emotion), making this false. Understanding this distinction aids physicians in addressing both physiological and behavioral drivers in chronic obesity management.
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Mr Tan, a 50-year-old with hypertension, sees you for a routine review. He reports three gout flares in the past two months, relieved with three days of Arcoxia for each episode. You perform some blood tests, which result in the following returns: Creatinine 95 umol/L, eGFR >90 mL/min, Uric acid 460 mmol/L, HbA1c 5.4 percent, Random hypo-count 7.5 mmol/L. He is currently on Amlodipine 10 mg OM. He does not drink alcohol except one glass of wine once or twice a year on special occasions. His BMI is 20.5 kg/m². Which is the most appropriate next step?
- A. Prescribe NSAIDs standby for gout flare
- B. Offer dietary advice and advise regular exercise only
- C. Discuss urate lowering therapy as he has had >2 gout flares in the past year, ideally with colchicine prophylaxis
- D. Offer exercise and dietary advice
Correct Answer: C
Rationale: Three gout flares in two months uric acid 460 beg for urate-lowering therapy like allopurinol, with colchicine to dodge attacks, fitting >2 flares yearly guideline. NSAIDs or steroids treat, not prevent; diet and exercise tweak, not tame, this level. Clinicians push this combo, curbing chronic gout's fire, a proactive leap.
The BMI that does NOT INCREASE the risk of renal disease and CKD is X. What is X?
- A. 25 or more
- B. 30 or more
- C. 35 or more
- D. 40 or more
Correct Answer: A
Rationale: Body Mass Index (BMI) correlates with chronic kidney disease (CKD) risk, with higher values linked to increased incidence due to obesity-related glomerular hypertension and inflammation. A BMI of 25 or more defines overweight and obesity, elevating CKD risk, though 18.5-24.9 is the range typically not increasing risk. The question's phrasing implies the threshold where risk begins, making 25 or more the level where renal disease risk rises, per studies like the Framingham Heart Study. Higher BMIs (30+, 35+, 40+) progressively worsen risk, with 30 marking obesity. Thus, 25 or more is the correct cutoff, guiding family physicians in counseling patients on weight management to prevent CKD onset.
Rehabilitation utilises two types of rehabilitation interventions. The goal of the intervention support is to
- A. Maintaining existing abilities
- B. Restoring function
- C. Preventing deterioration and further disability
- D. Maintaining existing abilities while preventing new or further disabilities
Correct Answer: D
Rationale: Rehab's dual play hold steady, fend off worse blends maintenance and prevention, a chronic balance. Nurses aim here, a full guard.
Which of the following assessment findings are consistent with aortic stenosis?
- A. Systolic click
- B. Pitting edema
- C. Harsh systolic crescendo decrescendo murmur
- D. Atrial fibrillation
Correct Answer: C
Rationale: Aortic stenosis narrows the valve, obstructing outflow producing a harsh systolic crescendo-decrescendo murmur, loudest at the aortic area, a classic sign from turbulent flow. Systolic clicks tie to mitral prolapse, not stenosis. Pitting edema reflects heart failure, a late complication, not direct. Atrial fibrillation may coexist but isn't specific. Nurses expect this murmur, auscultating for its distinct pattern, key to spotting stenosis early, guiding diagnostics like echocardiography to prevent progression to failure.
Effective management of CHF has elements that are common to most programs. These do not include:
- A. Involvement of a multidisciplinary team across the health care sectors
- B. The use of evidence based management guidelines, including both pharmacological and nonpharmacological therapy
- C. Regular hospitalisation for monitoring of cardiac function and change in haemodynamic status
- D. Inclusion of patients and their family in care planning and development of individualised selfmanagement plans
Correct Answer: C
Rationale: CHF management leans on teams, guidelines, patient-family plans smart, evidence-based wins. Routine hospital stays? Nope home care's goal, not ward loops. Nurses push this, a chronic stay-out strategy.