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D120 NURS 6840
Special Populations Primary Care
Comprehensive Final OA Guide
Q & S
2024
- A 78-year-old male patient with a history of Type II diabetes
- Prescribe antibiotics and schedule a follow-up in one week.
- Refer to a wound care specialist for debridement.
- Order a lower extremity arterial Doppler study.
- Advise immediate admission for intravenous antibiotic
and hypertension presents with a non-healing ulcer on his left foot. Which of the following is the most appropriate initial intervention?
therapy.Answer: C. Rationale: A lower extremity arterial Doppler study will help determine if there is adequate blood flow to the area, which is crucial for healing. Poor circulation is a common issue in diabetic patients and can impede wound healing.
- A 55-year-old female patient with rheumatoid arthritis reports
- Increase the dose of methotrexate.
- Add a biologic agent to her treatment regimen.
- Prescribe a short course of oral corticosteroids.
- Recommend physical therapy.
increased joint pain and stiffness. She is currently taking methotrexate. What is the next best step in managing her symptoms?
Answer: B. Rationale: Adding a biologic agent can be beneficial for patients who have an inadequate response to methotrexate alone. Biologics target specific components of the immune system and can reduce inflammation and halt disease progression.
- A 22-year-old pregnant woman at 28 weeks' gestation is
- Immediate insulin therapy.
- Dietary modifications and exercise.
diagnosed with gestational diabetes. What is the most important aspect of management?
- Oral hypoglycemic agents.
- Frequent blood glucose monitoring.
Answer: B. Rationale: Dietary modifications and exercise are the first-line treatments for gestational diabetes. These interventions can help control blood glucose levels and reduce the risk of complications.
- A 65-year-old patient with chronic kidney disease stage 3
- Amlodipine
- Lisinopril
- Hydrochlorothiazide
- Metoprolol
presents with a blood pressure of 160/100 mmHg. Which antihypertensive medication is preferred in this patient?
Answer: B. Rationale: ACE inhibitors like lisinopril are preferred in chronic kidney disease due to their protective effects on the kidneys and ability to slow the progression of kidney damage.
- A 30-year-old patient presents with a sudden onset of severe
- Prescribe analgesics and antiemetics.
- Perform a lumbar puncture.
- Order a CT scan of the head.
- Advise bed rest and hydration.
headache, photophobia, and neck stiffness. Which of the following is the most appropriate action?
Answer: B. Rationale: The patient's symptoms are suggestive of meningitis, and a lumbar puncture is necessary to obtain cerebrospinal fluid for analysis to confirm the diagnosis and guide treatment.
Question: A 65-year-old male patient with a history of type 2
diabetes presents with complaints of blurry vision and tingling in his feet. Which of the following conditions should the nurse practitioner suspect as a complication of diabetes in this patient?
- Diabetic nephropathy
- Diabetic retinopathy
- Diabetic neuropathy
- Diabetic ketoacidosis
Answer: B) Diabetic retinopathy
Rationale: Blurry vision and neuropathy symptoms are
indicative of diabetic retinopathy, a common complication of diabetes affecting the eyes and nerves.
Question: A pregnant patient with a history of hypertension is
prescribed antihypertensive medication. Which class of antihypertensive drugs is generally contraindicated in pregnancy due to potential teratogenic effects?
- ACE Inhibitors
- Beta Blockers
- Calcium Channel Blockers
- Diuretics
Answer: A) ACE Inhibitors
Rationale: ACE Inhibitors are contraindicated in pregnancy due
to their potential to cause birth defects and other adverse effects on the fetus.
Question: An elderly patient is admitted to the hospital with
confusion, dehydration, and electrolyte imbalances. Which condition should the nurse consider as a common cause of these symptoms in the elderly population?
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