Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
For a 39-year-old woman with a recent diagnosis of psoriatic arthritis who is treatment-naive with mild disease, which of the following would be considered an appropriate first-line therapy?
A. Intra-articular glucocorticoids
Intra-articular glucocorticoids may be used for flare management in specific joints but are not first-line systemic therapy for mild psoriatic arthritis.
B. NSAIDs
NSAIDs are first-line therapy for mild psoriatic arthritis, providing anti-inflammatory and analgesic effects without the risks associated with immunosuppressants.
C. Opioids
Opioids are not recommended for arthritis management due to risk of dependence and do not address inflammation.
D. Pregabalin (Lyrica)
Pregabalin is indicated for neuropathic pain, not inflammatory arthritis, and is not appropriate for first-line treatment of psoriatic arthritis.
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: Intra-articular glucocorticoids may be used for flare management in specific joints but are not first-line systemic therapy for mild psoriatic arthritis.
Choice B reason: NSAIDs are first-line therapy for mild psoriatic arthritis, providing anti-inflammatory and analgesic effects without the risks associated with immunosuppressants.
Choice C reason: Opioids are not recommended for arthritis management due to risk of dependence and do not address inflammation.
Choice D reason: Pregabalin is indicated for neuropathic pain, not inflammatory arthritis, and is not appropriate for first-line treatment of psoriatic arthritis.
Similar Questions
The PMHNP is evaluating a new client who reports symptoms of one hypomanic episode and at least one major depressive episode. Which psychiatric condition is most closely associated with these experiences?
A. Bipolar I disorder
Bipolar I disorder requires at least one manic episode, not just hypomania, making this inconsistent with the presentation.
B. Bipolar II disorder
Bipolar II disorder is characterized by at least one hypomanic episode and at least one major depressive episode without a history of full mania, matching the client’s symptoms.
C. Cyclothymic disorder
Cyclothymic disorder involves chronic, milder mood fluctuations but does not meet criteria for full hypomanic or major depressive episodes.
D. Schizoaffective disorder
Schizoaffective disorder includes mood episodes along with psychotic symptoms, which are not reported in this client’s history.
Full Explanation
Choice A reason: Bipolar I disorder requires at least one manic episode, not just hypomania, making this inconsistent with the presentation.
Choice B reason: Bipolar II disorder is characterized by at least one hypomanic episode and at least one major depressive episode without a history of full mania, matching the client’s symptoms.
Choice C reason: Cyclothymic disorder involves chronic, milder mood fluctuations but does not meet criteria for full hypomanic or major depressive episodes.
Choice D reason: Schizoaffective disorder includes mood episodes along with psychotic symptoms, which are not reported in this client’s history.
The PMHNP is conducting a mental status exam (MSE) on a new client. He asks her to explain the meaning of the proverb, "A rolling stone gathers no moss." The PMHNP understands that the proverb portion of the MSE tests functioning in which areas of the brain?
A. Temporal lobe
The temporal lobe primarily processes auditory information and is involved in memory formation, but abstract reasoning and proverb interpretation are not localized to this area.
B. Parietal lobe
The parietal lobe integrates sensory information and contributes to spatial awareness, which is unrelated to abstract reasoning or interpretation of proverbs.
C. Occipital lobe
The occipital lobe is mainly responsible for visual processing and does not govern executive functions or abstract thought.
D. Frontal lobe
The frontal lobe, particularly the prefrontal cortex, is critical for executive functioning, abstract reasoning, planning, and judgment. Interpreting proverbs like “A rolling stone gathers no moss” requires conceptualization, abstraction, and insight, making this portion of the MSE a test of frontal lobe functioning.
Full Explanation
Choice A reason: The temporal lobe primarily processes auditory information and is involved in memory formation, but abstract reasoning and proverb interpretation are not localized to this area.
Choice B reason: The parietal lobe integrates sensory information and contributes to spatial awareness, which is unrelated to abstract reasoning or interpretation of proverbs.
Choice C reason: The occipital lobe is mainly responsible for visual processing and does not govern executive functions or abstract thought.
Choice D reason: The frontal lobe, particularly the prefrontal cortex, is critical for executive functioning, abstract reasoning, planning, and judgment. Interpreting proverbs like “A rolling stone gathers no moss” requires conceptualization, abstraction, and insight, making this portion of the MSE a test of frontal lobe functioning.
A 66-year-old man is a long-time client of the PMHNP. He has been taking several vitamins under the supervision of the provider. Recently, he had a transient ischemic attack (TIA) and was placed on warfarin (Coumadin). Which of the following vitamins or supplements will the client need to discontinue?
A. L-methyl folate
L-methyl folate does not significantly affect coagulation or interact with warfarin and can usually be continued safely.
B. Vitamin D3
Vitamin D3 has no major interaction with warfarin and does not influence clotting, so it is generally safe to continue.
C. Melatonin
Melatonin may have minimal effects on blood pressure or sedation but does not interfere with warfarin metabolism.
D. Vitamin E
Vitamin E has anticoagulant properties and can increase the risk of bleeding when combined with warfarin. Discontinuation is recommended to reduce hemorrhagic risk.
Full Explanation
Choice A reason: L-methyl folate does not significantly affect coagulation or interact with warfarin and can usually be continued safely.
Choice B reason: Vitamin D3 has no major interaction with warfarin and does not influence clotting, so it is generally safe to continue.
Choice C reason: Melatonin may have minimal effects on blood pressure or sedation but does not interfere with warfarin metabolism.
Choice D reason: Vitamin E has anticoagulant properties and can increase the risk of bleeding when combined with warfarin. Discontinuation is recommended to reduce hemorrhagic risk.