Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 51-year-old woman is diagnosed with primary osteoarthritis (OA) of the knee. The NP will educate the woman that which of the following could have contributed to or might worsen her OA?
A. Diabetes mellitus, a congenital abnormality, obesity
Diabetes mellitus is a metabolic disorder and is not a primary contributor to OA; congenital abnormalities alone are less commonly a major factor.
B. Overuse of joints, obesity, diabetes mellitus
While overuse and obesity contribute to OA, diabetes mellitus is not considered a key causal factor.
C. Overuse of joints, obesity, aging
OA risk increases with mechanical stress on joints, cumulative overuse, obesity that increases joint load, and aging-related degeneration of cartilage, making this the most accurate combination of contributing factors.
D. Overuse of joints, obesity, a congenital abnormality
Congenital abnormalities can predispose to OA in some cases, but aging is a far more common contributing factor overall.
This question is an excerpt from Nurse Dive's nursing test bank - Mental Health Northern Kentucky University Proctored Exam 6. Take the full exam now
Full Explanation
Choice A reason: Diabetes mellitus is a metabolic disorder and is not a primary contributor to OA; congenital abnormalities alone are less commonly a major factor.
Choice B reason: While overuse and obesity contribute to OA, diabetes mellitus is not considered a key causal factor.
Choice C reason: OA risk increases with mechanical stress on joints, cumulative overuse, obesity that increases joint load, and aging-related degeneration of cartilage, making this the most accurate combination of contributing factors.
Choice D reason: Congenital abnormalities can predispose to OA in some cases, but aging is a far more common contributing factor overall.
Similar Questions
The psychiatric-mental health nurse practitioner has just diagnosed a 23-year-old man with bipolar disorder. He has had one manic episode with suicidal ideation and no depressive episodes to date. Which of the following is the most appropriate at this time?
A. Divalproex (Depakote)
Divalproex is an effective mood stabilizer, especially for rapid cycling or mixed episodes, but lithium is generally first-line for classic mania with suicidal ideation.
B. Lamotrigine (Lamictal)
Lamotrigine is more effective for bipolar depression than mania and is not ideal for initial treatment of a first manic episode.
C. Carbamazepine (Tegretol)
Carbamazepine is an alternative mood stabilizer but has more drug interactions and is not the preferred first-line for initial mania.
D. Lithium (Eskalith)
Lithium is considered first-line treatment for acute mania in bipolar disorder and provides prophylactic benefits; it is particularly indicated for patients with suicidal ideation.
Full Explanation
Choice A reason: Divalproex is an effective mood stabilizer, especially for rapid cycling or mixed episodes, but lithium is generally first-line for classic mania with suicidal ideation.
Choice B reason: Lamotrigine is more effective for bipolar depression than mania and is not ideal for initial treatment of a first manic episode.
Choice C reason: Carbamazepine is an alternative mood stabilizer but has more drug interactions and is not the preferred first-line for initial mania.
Choice D reason: Lithium is considered first-line treatment for acute mania in bipolar disorder and provides prophylactic benefits; it is particularly indicated for patients with suicidal ideation.
Which of the following aspects of bipolar disorder predicts a favorable response to lithium treatment?
A. Rapid cycling
Rapid cycling is associated with a poorer response to lithium, often requiring alternative or adjunctive therapies.
B. Euthymic intervals
Clear euthymic intervals between episodes are associated with classic bipolar disorder, which predicts a favorable response to lithium treatment.
C. Psychotic symptoms
Psychotic symptoms do not reliably predict lithium response; these patients may require additional antipsychotic therapy.
D. Mixed episodes
Mixed episodes often respond less predictably to lithium alone and may need combination therapy.
Full Explanation
Choice A reason: Rapid cycling is associated with a poorer response to lithium, often requiring alternative or adjunctive therapies.
Choice B reason: Clear euthymic intervals between episodes are associated with classic bipolar disorder, which predicts a favorable response to lithium treatment.
Choice C reason: Psychotic symptoms do not reliably predict lithium response; these patients may require additional antipsychotic therapy.
Choice D reason: Mixed episodes often respond less predictably to lithium alone and may need combination therapy.
A 2-year-old boy presents to the nurse practitioner with new onset seizures and a history of a port-wine stain at birth. Which of the following is not a clinical feature of Sturge-Weber syndrome (SWS)?
A. Sturge-Weber syndrome (SWS) is a rare disorder affecting the skin and nervous system
SWS is indeed a rare neurocutaneous disorder affecting the skin (port-wine stains) and central nervous system, making this a true clinical feature.
B. Symptoms of SWS may include seizures, muscle weakness, and developmental and intellectual disability
Neurologic manifestations, including seizures, hemiparesis, and intellectual disability, are characteristic features of SWS.
C. Treatment may include anti-seizure medications, medications and/or surgery for glaucoma, and low-dose aspirin to reduce the pressure in the eyes and brain
Management often involves anticonvulsants, glaucoma treatment, and sometimes low-dose aspirin to reduce vascular complications, confirming these are accurate features.
D. The prognosis for SWS is usually poor, with an average lifespan of 30 years
The prognosis of SWS varies widely; many patients live well into adulthood, making the statement of an average lifespan of 30 years inaccurate.
Full Explanation
Choice A reason: SWS is indeed a rare neurocutaneous disorder affecting the skin (port-wine stains) and central nervous system, making this a true clinical feature.
Choice B reason: Neurologic manifestations, including seizures, hemiparesis, and intellectual disability, are characteristic features of SWS.
Choice C reason: Management often involves anticonvulsants, glaucoma treatment, and sometimes low-dose aspirin to reduce vascular complications, confirming these are accurate features.
Choice D reason: The prognosis of SWS varies widely; many patients live well into adulthood, making the statement of an average lifespan of 30 years inaccurate.