Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 52-year-old woman with a BMI of 31 is diagnosed with osteoarthritis of the knee. The nurse practitioner (NP) instructs the woman that weight loss will help minimize both pain and functional loss. Which of the following most closely explains the NP's advice to lose weight?
A. Weight loss is encouraged for the overall health of the patient because it reduces the chance of developing diabetes and other cardiometabolic issues
While true, this choice is a general health benefit and does not directly explain the reduction in knee pain or functional loss.
B. Each pound of weight loss can decrease the load across the knee 3 to 6-fold
This choice is correct because mechanical load on the knee joint increases disproportionately with body weight. Even a small amount of weight loss significantly reduces joint stress, thereby improving pain and function in osteoarthritis.
C. Weight loss can reduce cardiovascular strain
Reducing cardiovascular strain is beneficial but does not directly impact knee joint load or osteoarthritis symptoms.
D. Weight loss can reduce the chance for a fall, which might lead to additional damage to the knee joint
Preventing falls is important but is an indirect benefit; the primary mechanism for pain reduction is decreased mechanical load on the joint.
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: While true, this choice is a general health benefit and does not directly explain the reduction in knee pain or functional loss.
Choice B reason: This choice is correct because mechanical load on the knee joint increases disproportionately with body weight. Even a small amount of weight loss significantly reduces joint stress, thereby improving pain and function in osteoarthritis.
Choice C reason: Reducing cardiovascular strain is beneficial but does not directly impact knee joint load or osteoarthritis symptoms.
Choice D reason: Preventing falls is important but is an indirect benefit; the primary mechanism for pain reduction is decreased mechanical load on the joint.
Similar Questions
A 56-year-old man with Type 2 diabetes reports pain in his feet that has a burning quality. Which of the following is the most appropriate treatment?
A. Hydrocodone (Norco)
Hydrocodone is an opioid and is generally not first-line for chronic neuropathic pain, due to dependency risks and limited efficacy for burning neuropathic pain.
B. Gabapentin (Neurontin)
This choice is correct because gabapentin is a first-line treatment for diabetic neuropathic pain. It targets nerve hyperexcitability and reduces burning, tingling, and neuropathic discomfort.
C. Acetaminophen (Tylenol)
Acetaminophen is useful for nociceptive pain but is not effective for neuropathic pain caused by diabetic peripheral neuropathy.
D. Botulinum toxin (Botox)
Botulinum toxin is used for muscle spasticity or localized pain syndromes, not generalized diabetic neuropathy.
Full Explanation
Choice A reason: Hydrocodone is an opioid and is generally not first-line for chronic neuropathic pain, due to dependency risks and limited efficacy for burning neuropathic pain.
Choice B reason: This choice is correct because gabapentin is a first-line treatment for diabetic neuropathic pain. It targets nerve hyperexcitability and reduces burning, tingling, and neuropathic discomfort.
Choice C reason: Acetaminophen is useful for nociceptive pain but is not effective for neuropathic pain caused by diabetic peripheral neuropathy.
Choice D reason: Botulinum toxin is used for muscle spasticity or localized pain syndromes, not generalized diabetic neuropathy.
A 16-year-old girl of South Asian descent presents to the PMHNP accompanied by her father. He reports that since the death of her mother 3 months ago, his daughter has been having episodes of strange behavior. He describes these episodes as beginning with a stomach ache and dizziness. Then she behaves as though her dead mother has taken control of her body. After a few minutes, she is back to herself again. Afterward, the patient states she cannot remember anything about these episodes. Which culture-bound syndrome should the PMHNP include in the differential diagnosis?
A. Amok
Amok is a culture-bound syndrome mostly reported in Southeast Asia characterized by sudden episodes of aggressive or homicidal behavior, usually followed by amnesia. This does not match the described symptoms of dissociation and possession.
B. Khayal
Khayal is a culture-bound syndrome from South Asia involving panic-like symptoms with palpitations, dizziness, and fear of death, often related to wind sensations. While it shares somatic features, it does not involve the sense of a deceased person controlling the body.
C. Possession syndrome
This choice is correct because possession syndrome involves episodes where an individual believes a spirit or supernatural entity has taken control of their body, often accompanied by dissociative amnesia. The patient’s behavior, post-episode memory loss, and cultural context fit this syndrome.
D. Ataque de nervios
Ataque de nervios is commonly reported in Latin American populations and includes intense emotional outbursts such as crying, trembling, and shouting, which are culturally specific and do not align with the presentation described here.
Full Explanation
Choice A reason: Amok is a culture-bound syndrome mostly reported in Southeast Asia characterized by sudden episodes of aggressive or homicidal behavior, usually followed by amnesia. This does not match the described symptoms of dissociation and possession.
Choice B reason: Khayal is a culture-bound syndrome from South Asia involving panic-like symptoms with palpitations, dizziness, and fear of death, often related to wind sensations. While it shares somatic features, it does not involve the sense of a deceased person controlling the body.
Choice C reason: This choice is correct because possession syndrome involves episodes where an individual believes a spirit or supernatural entity has taken control of their body, often accompanied by dissociative amnesia. The patient’s behavior, post-episode memory loss, and cultural context fit this syndrome.
Choice D reason: Ataque de nervios is commonly reported in Latin American populations and includes intense emotional outbursts such as crying, trembling, and shouting, which are culturally specific and do not align with the presentation described here.
A 63-year-old man was recently placed on warfarin (Coumadin) by his nurse practitioner. Which of the following supplements will he need to discontinue?
A. Sam-e
Sam-e is primarily used for depression and joint pain. While it may have mild anticoagulant effects, it is not as significant in potentiating warfarin’s effects as omega-3 fatty acids.
B. Omega-3 fatty acids
This choice is correct because omega-3 fatty acids have antiplatelet properties and can increase the risk of bleeding when combined with warfarin. Patients on anticoagulants are typically advised to limit or discontinue omega-3 supplementation.
C. Melatonin
Melatonin is a sleep-regulating supplement and does not significantly affect coagulation or interact with warfarin to increase bleeding risk.
D. Tryptophan
Tryptophan is an amino acid precursor to serotonin used for sleep or mood regulation. It does not have a clinically significant interaction with warfarin.
Full Explanation
Choice A reason: Sam-e is primarily used for depression and joint pain. While it may have mild anticoagulant effects, it is not as significant in potentiating warfarin’s effects as omega-3 fatty acids.
Choice B reason: This choice is correct because omega-3 fatty acids have antiplatelet properties and can increase the risk of bleeding when combined with warfarin. Patients on anticoagulants are typically advised to limit or discontinue omega-3 supplementation.
Choice C reason: Melatonin is a sleep-regulating supplement and does not significantly affect coagulation or interact with warfarin to increase bleeding risk.
Choice D reason: Tryptophan is an amino acid precursor to serotonin used for sleep or mood regulation. It does not have a clinically significant interaction with warfarin.