1.Your patient with rheumatoid arthritis has not benefited from…a.Visual acuityb.Type2 diabetesc.Hearing acuity

Question Answered step-by-step 1.Your patient with rheumatoid arthritis has not benefited from…a.Visual acuityb.Type2 diabetesc.Hearing acuity1.Your patient with rheumatoid arthritis has not benefited from NSAIDs, corticosteroids, or methotrexate. The rheumatologist has ordered the initiation of a tumor necrosis factor inhibitor(Humira). The advanced practice nurse anticipates that the patient will be screened for which of the following?d.Latent Tb infection 2.You are seeing a 31-year-old female who comes in with a complaint of nagging, daily headache which usually reaches a pain intensity of 5-6/10. She has a history of migraine headaches for which she takes Excedrin Migraine on average 2-3 times a month. Outside of the headache issues, she is a healthy individual. Based on this patient’s chronic daily headache and migraine headache history which of the following medications would be a reasonable agent for the advanced practice nurse to choose for treatment?a.Losartan(Cozaar)b.Divalproex(Depakote)c.Topiramate(Topamax)d.Verapamil(Calan) 3.An advanced practice nurse wants to execute health maintenance education with a seizure disorder patient.Included in this educationis the recommendation to have dental check ups regularly.Which of the following adverse effects associated with phenytoin(Dilantin)use supports the advanced practice nurse recommendation?a.Development of gingival hyperplasiab.Damage to dental nerve rootsc.Discoloration of dental enameld.Increased risk of dental caries 4.A patient comes on current therapy of sertraline (Zoloft) 100 mg a day for a few years since the traumatic end of a relationship, She reports feeling “fine” currently and is wanting to discuss coming off the Zoloft. The advanced practice nurse advises which of the following?a.Decrease Zoloft and add Celexab.Discontinue of the zoloftc.Change from Zoloft to celexad.Tapering off the zoloft slowly 5.You are seeing Ms.R. who reports challenges with mild anxiety and depression as well as insomnia. She reports being very stressed lately due to a lot of changes in her life. The advanced practice nurse may negotiate with Ms.R a prescription for a medication that it has the potential to positively impact all her complaints and selects which of the following?a.Melatoninb.Buspironec.St.John Wortd.Trazadone 6.You are working with a patient newly diagnosed with migraine headaches. Before initiating therapy with Sumatriptan(Imitrex) you are sure to carefully assess the patient for evidence of?a.hypotensionb.coronary artery diseasec.dissociative disorderd.COPD 7.Mrs.B is presently on 15 mg of Methotrexate for treatment of her rheumatoid arthritis. She has not seen her Rheumatologist for the last 4 months. She reports today with a complaint of feeling fatigue. Understanding the potential adverse effects of this drug which of the following does the advanced practice nurse anticipate should be assessed for this patient?a.Urinalysis with electrolytes monthlyb.Urinalysis with an EKGc.CBC with diff and platelet count monthlyd.CBC with EKG weekly 8.NSAIDS are a reasonable analgesic drug to recommend for pain associated with osteo and rheumatoid arthritis. They provide adequate pain relief and are not overly expensive. Chronic use of NSAIDs for the older adult is not recommended secondary to which of the following except?a.Weight gainb.Increased risk for renal impairmentc.Weight lossd.Increased risk for GI bleeding 9.Your patient with rheumatoid arthritis comes in with exacerbation of pain despite current therapy with Methotrexate.The decision is made to add 5 mg of prednisone daily. When educating the patient about this medication it would be important for the advanced practice nurse to include which of the following?a.She needs to start a physical exercise regimen to improve her staminab.She needs to take the medication about 20-30 min before eatingc.She needs to report signs of illness early as prednisone suppresses immune responsed.She needs to drink 84 ounces of water a day to protect her kidneys 10.You are taking care of a farmer who professes to be a lay herbalist. She wildcrafts for feverfew which she uses to treat her headaches.You query her as to how often she is taking feverfew.She says may be once a month or so.Had she reported that she was taking feverfew on a routine basis which of the following labs would you want to order?a.A PT/INRb.Blood Glucosec.A WBCd.A BUN   11. You are seeing a 7 year old that has been diagnosed with a…11. You are seeing a 7 year old that has been diagnosed with a seizure disorder. Currently the patient is being managed with carbamazepine (Tegretol) suspension. Which of the following statements accurately describes the correct information about administration of this drug?A .The suspension is thick so shake well before usingb. Discontinue immediately if a rash develops and administer Benadryl.c. Add the suspension to a grape flavored liquid antihistamine.D .The suspension is thick so dilute it with OJ. 12. You are seeing sixty nine year old Mr.C today for a wellness check. For almost the last decade he has been taking lorazepam (Ativan) 2mg at HS for sleep and on most days, he takes 1 mg in the morning and 1 mg in the afternoon to help with his anxiety. In the last six months he has been involved in 3 minor car incidents. His wife thinks his in attention and lack of focus has something to do with the Ativan and she wants him to get off it. The advanced practice nurse understands the following related to use of benzodiazepines in the older adult.a. Due to metabolism changes of aging larger doses are needed for anxiety maintenanceb. Withdrawal symptoms can occur within 24 hours of abrupt cessation of the drugc. Adverse events are minimal and not thought to contribute to falls or other injuries.d. Long acting benzodiazepines are preferred over the shorter acting benzodiazepines 13. One of your patients who is on Ambien for her insomnia comes in for follow up.She reports getting 8 hours of sleep at night instead of the 4-5 hours she used to get which is good because she has started a new job. Despite getting more sleep she reports waking up groggy, is more anxious during her awake hours, gained 8 pounds and is experiencing some memory problems. The advanced practice nurse nurse understands the symptoms she is reporting likely relate to which of the following?A. Suppression of REM sleepb. Enhancement of omega brain wavesc. Suppression of alpha brain wavesd. Enhanced REM sleep 14.You are seeing a 43 year old migraine headache patient for a routine follow -up. He reports that he is using his Imitrex to abort a headache about a dozen times a month. He is headache free today and his BP is 171/93.You note his BP to be in a similar range his prior two visits. Understanding pharmacologic approaches to migraine management the advanced practice nurse considers which of the following drugs for his newly diagnosed hypertension?a. Terazosinb. Furosemidec. Verapamild. Hydralazine 15. You are educating a migraine patient about important information related to their current migraine management with Imitrex .which of the following teaching points is accurate?a. Triptans have more adverse effects than ergots.b. Triptans should not be used more than 3 days a monthc. Triptans should not be used for migraine with aurad. Triptans should not be taken within 24 hrs. Of vasoconstrictors 16. Mr.H who is 89 years old, comes in with a complaint of knee pain. He says to you “you think this might be arthritis”?Mr. H has a 2Pk/day smoking history for 69 years .Other than that he has no medical diagnoses and is on no routine medications. The advanced practice nurse knows that the most appropriate medication to use for control of Mr.H osteoarthritic pain is which of the following?a. Misoprostolb. Gold Saltsc. Acetaminophend. Corticosteroids 17.You have a 38 year old single, sexually active paramedic who is changing jobs. She is a healthy individual who does lifestyle coaching on the side. The new employer has a nicotine free work place. The paramedic comes to you feeling depressed about having been laid off in a “Reduction in Force “from their last employer,anxious about the potential new job and quitting smoking. You decide to prescribe Bupropion (Wellbutrin) for all the following reasons except?a. The anti -depressant effect of bupropion will help with smoking cessation.b. Bupropion is prescribed under the brand name of Zyban for smoking cessation.c. The side effect of bupropion is a metallic taste in the mouth with nicotine intake.d. Sexual side effects of Bupropion are virtually absent when compared to SSRIs/SNRIs. 18.Ms.E’s husband of 67 years passed away a couple weeks ago. You are seeing her for a routine follow up of her hypertension that is well controlled on 50 mg losartan .She expresses feelings of sadness and difficulty getting going every day since the loss of her husband. She agrees to short term use of an anti depressant .The preferred anti-depressant for an older adult is which of the following?A .Trazadone (Desyrel)b. Amitriptyline (Elavil)c .Phenelzine (NArdil)d. Citalopram (Celexa)19.You have a pediatric patient taking Lamictal for generalized tonic -clonic seizures.You are educating the parents about this mediation.The development of which of the following indicates a need to stop this medication immediately?a. Onset of polydipsiab. Development of a rashc .Onset of nausea and vomitingd. Development of a UTI 20.You are seeing a migraine patient presently using a triptan medication for abortive therapy.The patient has been hospitalized 3 times over the last 7 months for migraine management. A decision is made to add divalproex sodium(Depakote) .Which of the following will the advanced practice nurse monitor while the patient is on this therapy?a. Pulmonary functions testb. CBC and LFTsc. Electrolytesd. Electrocardiogram  Health Science Science Nursing NU 636 Share QuestionEmailCopy link Comments (0)