WGU D116 UNIT 8 OA REVIEW FULL
TEST WITH CORRECT ANSWERS
A patient presents with complaint of pain and swelling of the big left toe. The patient has
never experienced this problem before. It is determined that the patient is having an
acute gouty attack. The patient's history is significant for an allergy to ibuprofen that
results in a rash.
Which treatment is appropriate for this patient? - CORRECT ANSWER- colchicine
Used for acute flare ups of gout to act as an anti-inflammatory by reducing swelling and
pain
Allopurinol is an antihyperuricemic
An adult patient with rheumatoid arthritis is being treated with methotrexate, folic acid,
hydroxychloroquine, etanercept, and aspirin. Liver and kidney function tests, complete
blood count (CBC), and platelet count are requested regularly.
Which additional procedure should be included to assess for adverse effects of the drug
regimen? - CORRECT ANSWER- Opthalmic exam
A patient has been diagnosed with rheumatoid arthritis, and the decision has been
made to start the patient on methotrexate and folic acid.
What is an appropriate starting dose of methotrexate for this patient? - CORRECT
ANSWER- 7.5mgbymouthonceweekly
A nursing student asks for clarification on the differences between the mechanisms of
spontaneous mutation and conjugation in acquired resistance of microbes.
Which statement is correct? - CORRECT ANSWER- Spontaneous mutation leads to
resistance to only one antimicrobial agent
A patient receiving a cephalosporin develops a secondary intestinal infection caused by
Clostridium difficile.
What is an appropriate treatment for this patient? - CORRECT ANSWER-
Discontinuing the cephalosporin and beginning flagyl
A patient is diagnosed with a lung infection caused by Pseudomonas aeruginosa. The
culture and sensitivity report shows sensitivity to all aminoglycosides. The provider
knows that the rate of resistance to gentamicin is common in this hospital.
Which medication should the provider be expected to order? - CORRECT ANSWER-
Amikacin
, When resistance to gentamicin and tobramycin is common, amikacin is the drug of
choice for the initial treatment of aminoglycoside-sensitive infections
A child with otitis media has had three ear infections in the past year. The child has just
completed a ten-day course of amoxicillin with no improvement. The parent asks the
provider why this drug is not working because it has worked in the past.
What should the provider tell the patient? - CORRECT ANSWER- "The bacteria
have synthesized penicillinase"
Beta-lactamases are enzymes that cleave the beta-lactam ring and render the PCN
inactive (amoxicillin)
Pt will need to start augmentin
A patient who is taking acetaminophen for pain wants to know why it does not cause
gastrointestinal upset as other over-the-counter pain medications do.
Which property of acetaminophen is the most likely explanation for this? - CORRECT
ANSWER- It has minimal effects at peripheral sites
Tylenol central effects
NSAIDs peripheral effects
A patient who has arthritis has been taking ibuprofen and a glucocorticoid medication.
The patient reports having tarry stools but denies gastric pain.
Which action by the provider is correct? - CORRECT ANSWER- Prescribing an
antiulcer medication
Glucocorticoid therapy, especially when combined with NSAIDs, can increase the risk of
gastric ulcer and possibly bleeding
A patient will begin taking hydroxychloroquine for rheumatoid arthritis. The patient is
currently taking high-dose NSAIDs and methotrexate.
What should the patient be taught about hydroxychloroquine? - CORRECT ANSWER-
An eye exam is necessary at the beginning of therapy with this drug
Can cause retinal damage - eye exam at the onset of treatment as well as every 6
months during treatment
A patient with gout who has increasingly frequent acute gouty attacks will begin
receiving allopurinol and colchicine.
Which statement should be included when teaching the patient about this drug
regimen? - CORRECT ANSWER- "You will take both drugs initially and then stop
taking colchicine"
TEST WITH CORRECT ANSWERS
A patient presents with complaint of pain and swelling of the big left toe. The patient has
never experienced this problem before. It is determined that the patient is having an
acute gouty attack. The patient's history is significant for an allergy to ibuprofen that
results in a rash.
Which treatment is appropriate for this patient? - CORRECT ANSWER- colchicine
Used for acute flare ups of gout to act as an anti-inflammatory by reducing swelling and
pain
Allopurinol is an antihyperuricemic
An adult patient with rheumatoid arthritis is being treated with methotrexate, folic acid,
hydroxychloroquine, etanercept, and aspirin. Liver and kidney function tests, complete
blood count (CBC), and platelet count are requested regularly.
Which additional procedure should be included to assess for adverse effects of the drug
regimen? - CORRECT ANSWER- Opthalmic exam
A patient has been diagnosed with rheumatoid arthritis, and the decision has been
made to start the patient on methotrexate and folic acid.
What is an appropriate starting dose of methotrexate for this patient? - CORRECT
ANSWER- 7.5mgbymouthonceweekly
A nursing student asks for clarification on the differences between the mechanisms of
spontaneous mutation and conjugation in acquired resistance of microbes.
Which statement is correct? - CORRECT ANSWER- Spontaneous mutation leads to
resistance to only one antimicrobial agent
A patient receiving a cephalosporin develops a secondary intestinal infection caused by
Clostridium difficile.
What is an appropriate treatment for this patient? - CORRECT ANSWER-
Discontinuing the cephalosporin and beginning flagyl
A patient is diagnosed with a lung infection caused by Pseudomonas aeruginosa. The
culture and sensitivity report shows sensitivity to all aminoglycosides. The provider
knows that the rate of resistance to gentamicin is common in this hospital.
Which medication should the provider be expected to order? - CORRECT ANSWER-
Amikacin
, When resistance to gentamicin and tobramycin is common, amikacin is the drug of
choice for the initial treatment of aminoglycoside-sensitive infections
A child with otitis media has had three ear infections in the past year. The child has just
completed a ten-day course of amoxicillin with no improvement. The parent asks the
provider why this drug is not working because it has worked in the past.
What should the provider tell the patient? - CORRECT ANSWER- "The bacteria
have synthesized penicillinase"
Beta-lactamases are enzymes that cleave the beta-lactam ring and render the PCN
inactive (amoxicillin)
Pt will need to start augmentin
A patient who is taking acetaminophen for pain wants to know why it does not cause
gastrointestinal upset as other over-the-counter pain medications do.
Which property of acetaminophen is the most likely explanation for this? - CORRECT
ANSWER- It has minimal effects at peripheral sites
Tylenol central effects
NSAIDs peripheral effects
A patient who has arthritis has been taking ibuprofen and a glucocorticoid medication.
The patient reports having tarry stools but denies gastric pain.
Which action by the provider is correct? - CORRECT ANSWER- Prescribing an
antiulcer medication
Glucocorticoid therapy, especially when combined with NSAIDs, can increase the risk of
gastric ulcer and possibly bleeding
A patient will begin taking hydroxychloroquine for rheumatoid arthritis. The patient is
currently taking high-dose NSAIDs and methotrexate.
What should the patient be taught about hydroxychloroquine? - CORRECT ANSWER-
An eye exam is necessary at the beginning of therapy with this drug
Can cause retinal damage - eye exam at the onset of treatment as well as every 6
months during treatment
A patient with gout who has increasingly frequent acute gouty attacks will begin
receiving allopurinol and colchicine.
Which statement should be included when teaching the patient about this drug
regimen? - CORRECT ANSWER- "You will take both drugs initially and then stop
taking colchicine"
