Nokea
Which of the following test(s) is/are routinely used in the assessment of heart failure?
- A. Holter monitoring
- B. ECG and echocardiography
- C. Ambulatory blood pressure monitoring
- D. Echocardiography
Correct Answer: B
Rationale: ECG and echocardiography are routine in heart failure assessment ECG detects ischemia/arrhythmias, echocardiography confirms ejection fraction and structure, per ESC guidelines. Holter monitoring targets arrhythmias, not routine. Ambulatory BP aids hypertension, not HF directly. Trans-oesophageal echo is specialized. This pair ensures comprehensive chronic HF evaluation.
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A parent of a child with Wilms tumor asks the nurse about surgery. Which statement concerning the type of surgery for Wilms tumor is most accurate?
- A. Surgery is only done if chemotherapy and radiation fail.
- B. Surgery is usually performed within 24 to 48 hours of admission.
- C. Surgery is the least favorable therapy for the treatment of Wilms tumor.
- D. Surgery will be delayed until the child's overall health status improves.
Correct Answer: B
Rationale: Wilms tumor, a kidney cancer in children, is primarily treated with surgical resection (nephrectomy) as the cornerstone of therapy, typically performed within 24 to 48 hours of diagnosis to remove the tumor before it spreads. This urgency stems from its responsiveness to surgery and the need to stage the cancer accurately, guiding subsequent chemotherapy or radiation. Delaying surgery until chemotherapy or radiation fails is incorrect surgery is the initial step, not a last resort. It's not the least favorable option; rather, it's the preferred first-line treatment due to high cure rates when combined with adjuvant therapies. Waiting for health improvement isn't standard unless the child is critically unstable, which isn't typical at diagnosis. The nurse's accurate explanation reassures parents and underscores surgery's role, aligning with pediatric oncology protocols to optimize outcomes in Wilms tumor management.
A 72 years old man is diagnosed to have Type 2 DM, hypertension and hyperlipidemia with stage 3 chronic kidney disease. He is otherwise well and asymptomatic. He is referred to you for follow-up care. His blood pressure is 142/70 mmHg with HbA1c 6.5%. You would continue his following medications EXCEPT
- A. Hydrochlorothiazide 12.5 mg OD
- B. Simvastatin 40 mg ON
- C. Aspirin 100 mg OD
- D. Glibenclamide 10 mg bid
Correct Answer: D
Rationale: Stage 3 CKD eGFR 30-59 means glibenclamide's out; it piles up, risking hypoglycemia in shaky kidneys. Thiazide holds BP, simvastatin guards lipids, aspirin shields heart, irbesartan protects kidneys all stay. Nurses swap sulphonylureas here, dodging chronic sugar crashes in fragile renal states.
A nurse is caring for a client diagnosed with atherosclerosis. Which of the following is considered a risk factor for the development of this disorder?
- A. Diet high in vitamin K
- B. Low HDL-C/High LDL-C
- C. High HDL-C/Low LDL-C
- D. Vegan diet
Correct Answer: B
Rationale: Atherosclerosis loves lipids low HDL (good cholesterol) and high LDL (bad cholesterol) pile plaque, a prime risk factor driving vessel narrowing. Vitamin K aids clotting, not plaque. High HDL/low LDL protects. Vegan diets cut fats, lowering risk. Nurses flag lipid imbalance, pushing statins or diet shifts, a cholesterol-fueled root of this vascular scourge.
Obesity is associated with an increased incidence of which of the following disorders?
- A. Dyslipidaemia
- B. Hypertension
- C. Cancer
- D. All disorders mentioned above
Correct Answer: D
Rationale: Obesity hauls dyslipidaemia, hypertension, cancer fat's a triple threat, no dodge. Nurses see this, a chronic disease bundle.
Which vaccination should not be given to HIV sufferers?
- A. ADT
- B. Pneumococcal
- C. MMR
- D. DPT
Correct Answer: C
Rationale: MMR's live HIV's immune slump says no, unlike ADT, pneumococcal, DPT, or dead polio's safety. Nurses nix live shots, a chronic viral risk dodge.