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Exam (elaborations)

Exam (solved) NR565 Nursing

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This post covers NUR 565 exam questions with verified solutions.

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  • October 13, 2024
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  • 2024/2025
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NR 565 Midterm 2024 exam questions

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 - 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 - 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 - weeks-months
women>men
common hands, feet, & wrists
>60 min in AM
local & sys.

OA Characteristics

Onset
Affected population
Location
Joint stiffness duration
SxS - 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 - Mild leukocytes

What might you expect to find in the synovial fluid of a pt with RA - Cloudy with leukocytes

Goals of Tx for RA - Sxs relief (pain, stiffness, inflammation,
maintaining joint fxn and ROM
minimize systemic involvement
delay progression

Typical pharm Txs for RA - NSAIDs, systemic steroids, antimalarials, antimetabolites, and
biologics

Baseline assessment data before starting DMARD - Liver, PG, serum creatinine, CBC with diff,
sxs of infxn (TB & hepatits), Hx & physical, renal status, & malignancies

Significant baseline data for Sulfasalazine - CXR, pulmonary and neuro status

Significant baseline data for Leflunomide - CXR, BP & pulmonary status

Significant baseline data for Mehtotrexate - CXR, Pulmonary and GI status

Significant baseline data for hydroxychloroquine - Ophthalmologic & cardiac exam (ECG if
indicated)

Conventional DMARDs- examples - Methotrexate, hydroxychloroquine, sulfsalazine

Biologic DMARDS- examples - adalimumab, etanercept, golimumab

"-mab"s

MOA of methotrexate - folic acid antagonist ->inhibits lymphocyte proliferation

Within how many months of RA diagnosis should Methotrexate be started and why? - 3 months
of diagnosis

delay joint degeneration

What routine monitoring is needed for Methotrexate? - Periodic liver & renal fxn

What blood level do we expect to see elevated in a patient with gout? - Uric acid

First line Tx for gout - Corticosteroids, NSAIDs, or Colchicine

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