NR 565 MIDTERM EXAM NEWEST 2024
QUESTIONS AND DETAILED CORRECT
ANSWERS INCLUDING RATIONALES
(GRADED A+)
An 82 yo male visits the clinic complaining that his pain meds "take forever" to work
after he takes his pill. What are possible reasons you can explain to him as to why this
may be happening.
A. Perhaps we need to increase your dose
B. Sometimes as you get older, absorption may be slower resulting in a delayed
response
C. As we get older, the gastric acid decreases and may delay absorption - ANSWER-B.
Sometimes as you get older, absorption may be slower resulting in a delayed response
C. As we get older, the gastric acid decreases and may delay absorption
RA Characteristics
Onset
Affected population
Location
Joint stiffness duration
SxS - ANSWER-weeks-months
women>men
common hands, feet, & wrists
>60 min in AM
local & sys.
OA Characteristics
Onset
Affected population
Location
Joint stiffness duration
SxS - ANSWER-years
men & Women equally
Hands & weight baring joints
<30min in AM
typically local
What might you expect to find in the synovial fluid of a pt with OA - ANSWER-Mild
leukocytes
What might you expect to find in the synovial fluid of a pt with RA - ANSWER-Cloudy
with leukocytes
Goals of Tx for RA - ANSWER-Sxs relief (pain, stiffness, inflammation,
maintaining joint fxn and ROM
minimize systemic involvement
delay progression
When prescribing Medications, we must understand that the liver function declines with
age d/t what?
A. Enlarged Liver
B. Decreased blood flow to liver
C. Increased activity of the hepatic enzymes - ANSWER-B. Decreased blood flow to
liver
Typical pharm Txs for RA - ANSWER-NSAIDs, systemic steroids, antimalarials,
antimetabolites, and biologics
Baseline assessment data before starting DMARD - ANSWER-Liver, PG, serum
creatinine, CBC with diff, sxs of infxn (TB & hepatits), Hx & physical, renal status, &
malignancies
Significant baseline data for Sulfasalazine - ANSWER-CXR, pulmonary and neuro
status
Significant baseline data for Leflunomide - ANSWER-CXR, BP & pulmonary status
Significant baseline data for Mehtotrexate - ANSWER-CXR, Pulmonary and GI status
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