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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An older woman who is cared for by a concerned family is particularly likely to suffer from which of the following complications after an episode of gastroenteritis?
- A. Immobility related to overconcern
- B. Continued vomiting caused by too-rapid feeding
- C. Diarrhea resulting from administration of milk products
- D. Constipation related to overtreatment of diarrhea
Correct Answer: D
Rationale: Overtreatment of diarrhea can lead to constipation, especially in older adults.
A 67-year-old woman with a history of A-fib and an ejection fraction of 48% has had normal digoxin levels. Which can cause a decrease in digoxin level?
- A. Decrease creatinine clearance
- B. Weight loss
- C. Increase exercise
- D. Regular use of antacid
Correct Answer: D
Rationale: Regular use of antacids can decrease the absorption of digoxin, potentially lowering its levels.
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.
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.
Which immunization reduces a patient’s risk for infection with the virus that causes painful localized blistering rash?
- A. Smallpox vaccine
- B. Varicella vaccine (chicken pox)
- C. Shingles (herpes zoster) vaccine
- D. Meningococcal vaccine
Correct Answer: C
Rationale: Shingles vaccine reduces the risk of herpes zoster, which causes painful rash.