NR 565 MIDTERM 2025 EXAM
QUESTIONS & UPDATED CORRECT
ANSWERS
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 - correct answer ✔✔B. Decreased blood flow to
liver
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 - correct 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 - correct 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 - correct 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 - correct answer ✔✔Mild
leukocytes
What might you expect to find in the synovial fluid of a pt with RA - correct answer ✔✔Cloudy
with leukocytes
Goals of Tx for RA - correct answer ✔✔Sxs relief (pain, stiffness, inflammation,
maintaining joint fxn and ROM
, minimize systemic involvement
delay progression
Typical pharm Txs for RA - correct answer ✔✔NSAIDs, systemic steroids, antimalarials,
antimetabolites, and biologics
Baseline assessment data before starting DMARD - correct answer ✔✔Liver, PG, serum
creatinine, CBC with diff, sxs of infxn (TB & hepatits), Hx & physical, renal status, & malignancies
Significant baseline data for Sulfasalazine - correct answer ✔✔CXR, pulmonary and neuro status
Significant baseline data for Leflunomide - correct answer ✔✔CXR, BP & pulmonary status
Significant baseline data for Mehtotrexate - correct answer ✔✔CXR, Pulmonary and GI status
Significant baseline data for hydroxychloroquine - correct answer ✔✔Ophthalmologic & cardiac
exam (ECG if indicated)
Conventional DMARDs- examples - correct answer ✔✔Methotrexate, hydroxychloroquine,
sulfsalazine
Biologic DMARDS- examples - correct answer ✔✔adalimumab, etanercept, golimumab
"-mab"s
MOA of methotrexate - correct answer ✔✔folic acid antagonist ->inhibits lymphocyte
proliferation
QUESTIONS & UPDATED CORRECT
ANSWERS
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 - correct answer ✔✔B. Decreased blood flow to
liver
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 - correct 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 - correct 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 - correct 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 - correct answer ✔✔Mild
leukocytes
What might you expect to find in the synovial fluid of a pt with RA - correct answer ✔✔Cloudy
with leukocytes
Goals of Tx for RA - correct answer ✔✔Sxs relief (pain, stiffness, inflammation,
maintaining joint fxn and ROM
, minimize systemic involvement
delay progression
Typical pharm Txs for RA - correct answer ✔✔NSAIDs, systemic steroids, antimalarials,
antimetabolites, and biologics
Baseline assessment data before starting DMARD - correct answer ✔✔Liver, PG, serum
creatinine, CBC with diff, sxs of infxn (TB & hepatits), Hx & physical, renal status, & malignancies
Significant baseline data for Sulfasalazine - correct answer ✔✔CXR, pulmonary and neuro status
Significant baseline data for Leflunomide - correct answer ✔✔CXR, BP & pulmonary status
Significant baseline data for Mehtotrexate - correct answer ✔✔CXR, Pulmonary and GI status
Significant baseline data for hydroxychloroquine - correct answer ✔✔Ophthalmologic & cardiac
exam (ECG if indicated)
Conventional DMARDs- examples - correct answer ✔✔Methotrexate, hydroxychloroquine,
sulfsalazine
Biologic DMARDS- examples - correct answer ✔✔adalimumab, etanercept, golimumab
"-mab"s
MOA of methotrexate - correct answer ✔✔folic acid antagonist ->inhibits lymphocyte
proliferation
