Pre-Predictor Exam Review Certified
and Accurately Defined
Tricyclic antidepressants, like amitriptyline, have anticholinergic
side effects which are especially problematic in the elderly
because they contribute to urinary retention. Hydrochlorothiazide
is a diuretic and may contribute to his incontinence. Cimetidine is
well known to produce adverse reactions such as confusion in
elders. Ramipril, an ACE inhibitor, is unlikely to contribute to this
patient's incontinence or confusion. Toileting may be a
complicated by the anticholinergic medication and/or the diuretic
causing diuresis, urge incontinence, and inability to void at will.
A patient with no significant medical history has varicose veins.
She complains of "aching legs". The intervention that will provide
,the greatest relief for her complaint is to: - Ans>>>elevate her
legs periodically.
The intervention that will provide the greatest relief for this
patient is elevating her legs periodically. This will facilitate venous
return. Use of support stockings will prolong the length of time
she is able to stand in place, but will not provide relief after her
legs begin aching. Support stockings should be applied prior to
getting out of bed.
Stress urinary incontinence is: - Ans>>>may be aggravated by
caffeine or alcohol.
Stress urinary incontinence is not expected as a result of the
normal aging process. The primary problem is sphincter
incompetence. The ingestion of caffeine or alcohol decreases
sphincter control. Anticholinergic and antidepressant medications
are causative factors related to overflow incontinence. Detrusor
muscle instability is the primary underlying problem causing urge
incontinence.
Which commonly used herbal remedy is NOT associated with
anxiety and/or depressive symptom relief? - Ans>>>Ginkgo
biloba
,Ginkgo biloba is a common herbal remedy associated with
enhancement of vascular and cerebral perfusion and memory. The
nurse practitioner should be aware when the patient is taking any
herbal supplement to avoid risk of drug interactions.
Upon ophthalmoscopic examination of a 78-year-old patient, the
nurse practitioner observes dark spots against a red retina. What
diagnosis is this finding most consistent with? - Ans>>>Cataract
A cataract opacity is seen as a dark disruption of the red reflex on
ophthalmoscopic exam.
A 72 year old female patient reports a 6 month history of
progressively more swollen and painful distal interphalangeal
(DIP) joints of one hand. There are no systemic symptoms but the
erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA),
and rheumatoid factor (RF) are all minimally elevated. What is the
most likely diagnosis? - Ans>>>Osteoarthritis
When osteoarthritis affects the hands, the distal interphalangeal
(DIP) joints are usually involved. Rheumatoid arthritis is usually
symmetrical, and the proximal interphalangeal (PIP) joints are
, more often affected. Inflammation often develops quickly, not
gradually. This patient is elderly; therefore, it is expected that the
ESR, ANA, and RF will be only somewhat elevated. Over-
interpretation of laboratory tests without evidence of systemic
inflammation can lead to misdiagnosis.
The nurse practitioner is evaluating a 35-year-old female nurse.
She has a history of hospitalization for hepatitis B infection 2
years ago. Her laboratory tests demonstrate positive HBsAg. The
nurse practitioner would most likely diagnose: - Ans>>>chronic
hepatitis B infection.
Presence of hepatitis B surface antigen at this time indicates
chronic infection with hepatitis B. Lab studies indicating a positive
surface antigen on 2 separate occasions at least 6 months apart
indicate chronic infection. Immunization produces positive
hepatitis B antibodies in most instances. Hepatitis B surface
antigen would not be present in a person who has recovered from
hepatitis B infection. This case would not be an acute episode
because of the history of hepatitis B infection 2 years prior.
One exception to the recommendation to limit dietary fat intake
is: - Ans>>>children under 2 years-of-age.
and Accurately Defined
Tricyclic antidepressants, like amitriptyline, have anticholinergic
side effects which are especially problematic in the elderly
because they contribute to urinary retention. Hydrochlorothiazide
is a diuretic and may contribute to his incontinence. Cimetidine is
well known to produce adverse reactions such as confusion in
elders. Ramipril, an ACE inhibitor, is unlikely to contribute to this
patient's incontinence or confusion. Toileting may be a
complicated by the anticholinergic medication and/or the diuretic
causing diuresis, urge incontinence, and inability to void at will.
A patient with no significant medical history has varicose veins.
She complains of "aching legs". The intervention that will provide
,the greatest relief for her complaint is to: - Ans>>>elevate her
legs periodically.
The intervention that will provide the greatest relief for this
patient is elevating her legs periodically. This will facilitate venous
return. Use of support stockings will prolong the length of time
she is able to stand in place, but will not provide relief after her
legs begin aching. Support stockings should be applied prior to
getting out of bed.
Stress urinary incontinence is: - Ans>>>may be aggravated by
caffeine or alcohol.
Stress urinary incontinence is not expected as a result of the
normal aging process. The primary problem is sphincter
incompetence. The ingestion of caffeine or alcohol decreases
sphincter control. Anticholinergic and antidepressant medications
are causative factors related to overflow incontinence. Detrusor
muscle instability is the primary underlying problem causing urge
incontinence.
Which commonly used herbal remedy is NOT associated with
anxiety and/or depressive symptom relief? - Ans>>>Ginkgo
biloba
,Ginkgo biloba is a common herbal remedy associated with
enhancement of vascular and cerebral perfusion and memory. The
nurse practitioner should be aware when the patient is taking any
herbal supplement to avoid risk of drug interactions.
Upon ophthalmoscopic examination of a 78-year-old patient, the
nurse practitioner observes dark spots against a red retina. What
diagnosis is this finding most consistent with? - Ans>>>Cataract
A cataract opacity is seen as a dark disruption of the red reflex on
ophthalmoscopic exam.
A 72 year old female patient reports a 6 month history of
progressively more swollen and painful distal interphalangeal
(DIP) joints of one hand. There are no systemic symptoms but the
erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA),
and rheumatoid factor (RF) are all minimally elevated. What is the
most likely diagnosis? - Ans>>>Osteoarthritis
When osteoarthritis affects the hands, the distal interphalangeal
(DIP) joints are usually involved. Rheumatoid arthritis is usually
symmetrical, and the proximal interphalangeal (PIP) joints are
, more often affected. Inflammation often develops quickly, not
gradually. This patient is elderly; therefore, it is expected that the
ESR, ANA, and RF will be only somewhat elevated. Over-
interpretation of laboratory tests without evidence of systemic
inflammation can lead to misdiagnosis.
The nurse practitioner is evaluating a 35-year-old female nurse.
She has a history of hospitalization for hepatitis B infection 2
years ago. Her laboratory tests demonstrate positive HBsAg. The
nurse practitioner would most likely diagnose: - Ans>>>chronic
hepatitis B infection.
Presence of hepatitis B surface antigen at this time indicates
chronic infection with hepatitis B. Lab studies indicating a positive
surface antigen on 2 separate occasions at least 6 months apart
indicate chronic infection. Immunization produces positive
hepatitis B antibodies in most instances. Hepatitis B surface
antigen would not be present in a person who has recovered from
hepatitis B infection. This case would not be an acute episode
because of the history of hepatitis B infection 2 years prior.
One exception to the recommendation to limit dietary fat intake
is: - Ans>>>children under 2 years-of-age.
