Nokea
During a physical examination, a patient presents with swollen lymph nodes. How should you adjust your palpation technique based on the findings?
- A. Increase the pressure to assess for tenderness
- B. Use a firmer grip to ensure you can feel the nodes
- C. Continue using soft finger pads but apply a more vigorous motion
- D. Maintain the light circular motion but focus on the areas of swelling
Correct Answer: A
Rationale: Increased pressure helps assess tenderness and the degree of swelling or possible infection in swollen lymph nodes.
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Which of the following is true about tolterodine?
- A. It should be avoided in men with prostatic hypertrophy.
- B. It increases the risk of constipation compared with oral oxybutynin.
- C. It acts by ablating detrusor spasms.
- D. It has greater risk of adverse effects with its twice-daily formulation.
Correct Answer: C
Rationale: Tolterodine is an anticholinergic that reduces detrusor spasms to alleviate symptoms of overactive bladder.
Barriers to detecting elder mistreatment include all except:
- A. The tendency for many older adults to falsely claim they are being abused
- B. The fear that one might be institutionalized if one admits to being abused
- C. The shame that older adults feel if they have been a victim of abuse
- D. The difficulty that healthcare providers have making a determination regarding abuse if the victim has dementia
Correct Answer: A
Rationale: Many older adults do not falsely claim abuse, so this is not a significant barrier.
What is the most appropriate first step in treating a patient with acute asthma exacerbation?
- A. Administer oral corticosteroids
- B. Provide oxygen therapy
- C. Administer a short-acting beta-agonist (SABA)
- D. Give intravenous fluids
Correct Answer: C
Rationale: The first line treatment for acute asthma exacerbation is a short-acting beta-agonist to relieve bronchoconstriction
A 40-year-old admits to multiple sex partners and presents with several lesions over his body. Findings reveal hemorrhagic vesiculopustular lesions over the hands and feet. These lesions are most likely associated with:
- A. Gonococcemia
- B. Infective endocarditis
- C. Hyperthyroidism
- D. Peripheral vascular disease
Correct Answer: A
Rationale: Hemorrhagic vesiculopustular lesions, particularly on the hands and feet, are associated with gonococcemia.
During an acute attack of gout, the nurse practitioner knows NOT to prescribe:
- A. Colchicine (Colcrys)
- B. Allopurinol (Zyloprim)
- C. Steroids
- D. NSAIDs
Correct Answer: B
Rationale: Allopurinol should not be used during an acute gout attack as it may worsen symptoms.