Nokea
When treating a patient with asthma who is experiencing acute wheezing, which medication should be given to relieve the symptoms?
- A. Short acting bronchodilator
- B. Long acting bronchodilator
- C. Inhaled corticosteroid
- D. Combination of methylxanthine and long acting bronchodilator
Correct Answer: A
Rationale: The correct answer is A: Short acting bronchodilator. During an acute asthma attack, a short-acting bronchodilator (such as albuterol) is the preferred medication to relieve symptoms quickly by dilating the airways. This medication acts rapidly to open up the airways and provide immediate relief of wheezing and shortness of breath. Long-acting bronchodilators (choice B) are not recommended for acute symptom relief. Inhaled corticosteroids (choice C) are used for long-term control of asthma symptoms and not for immediate relief during an acute attack. Combining methylxanthine and long-acting bronchodilator (choice D) is not the standard treatment for acute wheezing in asthma.
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A 44-year-old male presents for an employment physical and is concerned about testing positive for amphetamines on a drug screen. His current medication list includes metformin, lisinopril, glyburide, and bupropion. The most likely medication cause for a false positive result for amphetamines would be:
- A. Metformin
- B. Lisinopril
- C. Glyburide
- D. Bupropion
Correct Answer: D
Rationale: The correct answer is D, Bupropion. Bupropion is known to potentially cause false-positive results for amphetamines on drug screens due to its structural similarity to amphetamines. Bupropion is a medication commonly used to treat depression and aid in smoking cessation. Metformin (A), Lisinopril (B), and Glyburide (C) are not known to cause false positives for amphetamines. Metformin is used to treat diabetes, Lisinopril is used for hypertension, and Glyburide is used for diabetes. Therefore, the most likely medication cause for a false positive result for amphetamines in this case would be bupropion.
During the breast examination of a perimenopausal woman, the NP detects a bloody spontaneous discharge from the right nipple. This indicates further evaluation:
- A. Fibroadenoma
- B. Polycystic breast disease
- C. An intraductal papilloma
- D. Pituitary prolactinoma
Correct Answer: C
Rationale: The correct answer is C: An intraductal papilloma. Bloody spontaneous discharge from the nipple in a perimenopausal woman is concerning for an intraductal papilloma, which is a benign growth in the milk ducts. Further evaluation with imaging studies and possibly a biopsy is necessary to rule out malignancy.
Choice A: Fibroadenoma is a common benign breast tumor but does not typically present with bloody discharge.
Choice B: Polycystic breast disease is not associated with bloody discharge and is characterized by multiple fluid-filled cysts in the breast tissue.
Choice D: Pituitary prolactinoma is a benign tumor of the pituitary gland that can cause elevated prolactin levels leading to nipple discharge, but it is not typically bloody and would not present with spontaneous discharge from the nipple.
Dr. Smith is obtaining informed consent from Mr. Jones to perform a colonoscopy. Which element of decision-making capacity is impaired in this case?
- A. Understanding
- B. Appreciation
- C. Ability to express a choice
- D. None of the above
Correct Answer: B
Rationale: The correct answer is B: Appreciation. In this scenario, Mr. Jones may understand the information presented about the colonoscopy, but he may not fully appreciate the implications and consequences of undergoing the procedure. Appreciation involves the ability to understand the personal relevance of the information provided. This is crucial in ensuring that the individual can make a truly informed decision.
A: Understanding is not impaired as Mr. Jones may comprehend the information presented.
C: Ability to express a choice is not necessarily impaired in this case, as Mr. Jones may still be able to verbalize his decision.
D: None of the above is incorrect because Appreciation is indeed impaired in this situation.
The medication that blocks the transportation of glucose across the intestines into the bloodstream to target prandial blood glucose is:
- A. Metformin (Glucophage XR)
- B. Acarbose (Precose)
- C. Rosiglitazone (Avandia)
- D. Glipizide (Glucotrol XL)
Correct Answer: B
Rationale: The correct answer is B: Acarbose (Precose). Acarbose is an alpha-glucosidase inhibitor that blocks the breakdown of carbohydrates into glucose in the intestines, reducing glucose absorption and lowering postprandial blood glucose levels. Metformin (A) works by decreasing glucose production in the liver. Rosiglitazone (C) is a thiazolidinedione that improves insulin sensitivity. Glipizide (D) is a sulfonylurea that stimulates insulin release from the pancreas. Acarbose specifically targets postprandial blood glucose by blocking glucose absorption in the intestines.
The assessment of a 72-year-old male causes the NP to have concerns that the pt. is a suicide risk. Risk factors for suicide in the elderly do NOT include
- A. Chronic pain
- B. Comorbid physical illness
- C. Family history of suicide
- D. Retirement
Correct Answer: D
Rationale: The correct answer is D: Retirement. Retirement is not a known risk factor for suicide in the elderly. Here's the rationale:
1. Chronic pain (choice A) and comorbid physical illness (choice B) are risk factors as they can contribute to feelings of hopelessness and despair.
2. Family history of suicide (choice C) is a significant risk factor due to the genetic and environmental influences.
3. Retirement (choice D) does not directly increase the risk of suicide. In fact, many individuals find purpose and fulfillment in retirement.