Nokea
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.
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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.
Joyce Mitchell is a 73-year-old frail female with a history of frequent falls, presenting with nausea, vomiting, sweating, and horizontal nystagmus. She is diagnosed with vestibular neuritis. What is the best initial course of treatment?
- A. Vestibular rehabilitation
- B. Supportive care with anti-nausea and anti-vertigo medication
- C. Fluids
- D. Epley maneuver
Correct Answer: B
Rationale: Supportive care with anti-nausea and anti-vertigo medication is appropriate for vestibular neuritis.
Headache warning signs that need prompt investigation include all of the following except:
- A. New onset after 50
- B. Aggravated or relieved by change of position
- C. Precipitated by Valsalva maneuver
- D. Headaches relieved with mild recurrent use of analgesics
Correct Answer: D
Rationale: Headaches relieved with mild, infrequent analgesic use typically don’t require urgent investigation.
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.
A 72-year-old woman reports vaginal dryness that interferes with coitus. Her medical history includes type 2 diabetes, hypertension, and osteoarthritis. Medications are glyburide, chlorthalidone, and acetaminophen. What would be your first step in therapy?
- A. Stop glyburide
- B. Stop chlorthalidone
- C. Stop acetaminophen
- D. Start topical vaginal lubricant
Correct Answer: D
Rationale: Topical vaginal lubricants can help alleviate vaginal dryness and improve sexual function.