Nokea
Lenore White is an 80-year-old woman who smokes two packs of cigarettes per day. What two ethical principles are in conflict?
- A. Beneficence and community
- B. Nonmaleficence and justice
- C. Autonomy and justice
- D. Autonomy and nonmaleficence
Correct Answer: D
Rationale: The nurse faces a dilemma between respecting autonomy (the patient’s choice to smoke) and preventing harm (nonmaleficence).
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A nurse practitioner examines the skin of an elderly patient. Which finding below is NOT a benign lesion associated with the aging process?
- A. Xerosis
- B. Cherry angiomas and senile purpura
- C. Senile keratosis and senile lentigines
- D. Dermatophytosis
Correct Answer: D
Rationale: Dermatophytosis is a fungal infection and is not a normal aging change.
Which of the following is the most appropriate treatment for trichomoniasis in a non-pregnant woman?
- A. Metronidazole (Flagyl)
- B. Doxycycline (Vibramycin)
- C. Clindamycin (Cleocin)
- D. Clotrimazole (Lotrimin)
Correct Answer: A
Rationale: Metronidazole is the first-line treatment for trichomoniasis.
Several years later, Mr. Hunter, who is now 75 years old, seeks additional intervention for his urinary symptoms that have progressed further. He now experiences slow urinary stream, hesitancy, straining, and a feeling of incomplete emptying in addition to the previous urinary urgency and frequency. At times, he has noted blood in his urine. He has had five urinary tract infections (UTIs) in the past 2 years. His current IPSS is 24, with a bother score of 5 indicating severe voiding symptoms with high impact on his quality of life. Mr. Hunter’s updated medical history includes hypertension, coronary artery disease, benign prostatic hyperplasia, cataract surgery 4 years ago, and two falls within the past year while rushing to the bathroom during the night. Current medications are aspirin, metoprolol, finasteride, and tamsulosin. Physical examination reveals an enlarged, nontender prostate, about 50 g in size without discrete nodules. Upon further evaluation, the intermittent hematuria is attributed to BPH. Postvoid residual volume is 110 mL. Uroflowmetry reveals urinary flow rate of 12 mL/s. Which of the following is the best next step in management?
- A. Start tadalafil.
- B. Switch from tamsulosin to silodosin.
- C. Switch from finasteride to dutasteride.
- D. Perform surgical resection of prostate.
Correct Answer: D
Rationale: Given the severity of his symptoms and the failure of medical therapy, surgical resection of the prostate is the best option.
A nurse is working with an older adult who is at risk for malnutrition. Which of the following interventions is the most appropriate?
- A. Administer high-calorie supplements.
- B. Encourage intake of a variety of foods rich in vitamins and minerals.
- C. Restrict caloric intake to prevent weight gain.
- D. Focus on protein supplements exclusively.
Correct Answer: B
Rationale: A balanced diet with a variety of foods helps ensure adequate nutrition, including vitamins and minerals, in older adults.
The most common treatment for Helicobacter pylori is a triple therapy, interpreted as
- A. 2 antibiotics and proton pump inhibitor for 7-14 days
- B. 3 different antibiotics for 7-20 days
- C. 3 rounds of the same antibiotic over 3 weeks
- D. 2 proton pump inhibitors and 1 antibiotic for 7-14 days
Correct Answer: A
Rationale: Triple therapy for H. pylori typically includes 2 antibiotics and a proton pump inhibitor for 7-14 days.