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,A 72-year-old woman has been on hydrochlorothiazide 12.5 mg
for many years to control her Stage II hypertension. Her blood
pressure (BP) at this visit is 168/96. She is currently complaining
of pain on her right hip and on both knees. She has increased
her dose of ibuprofen (Motrin) from 400 mg 3 times day (TID)
to 800 mg TID. She is still in pain and would like something
stronger. Which of the following statements is the best
explanation of the effects of ibuprofen (Motrin) on her disease?
A) It increases the chances of adverse effects to her health
B) It inhibits the effect of renal prostaglandins and blunts the
effectiveness of the diuretic
C) It prolongs the therapeutic effects of hydrochlorothiazide
and other diuretics
D) None of the statements are true - Answer: B) It inhibits the
effect of renal prostaglandins and blunts the effectiveness of
the diuretic.
NSAIDs and ASA inhibit the vasodilatory effects of
prostaglandins, which predisposes the kidney to ischemia.
NSAIDs and diuretics can cause acute prerenal failure by
decreasing renal blood flow.
,2. All of the following are infections that affect mostly the labia
and vagina except:
A) Bacterialvaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis - Answer: D) Chlamydia trachomatis
Infections that commonly affect the labia and vagina include
bacterial vaginosis, candidiasis, and trichomoniasis. Chlamydia
trachomatis commonly affects the cervix, endometrial lining ,
fallopian tubes, and pelvic cavity.
The nurse practitioner would test the obturator and iliopsoas
muscle to evaluate for:
A) Cholecystitis
B) Acute appendicitis
C) Inguinal hernia
D) Gastriculcer - Answer: B) Acute appendicitis.
, Signs and symptoms of an acute abdomen include invol- untary
guarding, rebound tenderness, boardlike abdomen, and a
positive obtu- rator and psoas sign. A positive obturator sign
occurs when pain is elicted by internal rotation of the right hip
from 90 degrees hip/knee flexion. The psoas sign is positive
when pain occurs with passive extension of the thigh while the
patient is lying on his/her side with knees extended, or when
pain occurs with active flexion of his/her thigh at the hip.
Treatment for mild preeclampsia includes all of the following
except:
A) Bed rest except for bathroom privileges
B) Close monitoring of weight and blood pressure
C) Close follow-up of urinary protein, serum creatinine, and
platelet count
D) A prescription of methyldopa (Aldomet) to control blood
pressure - Answer: D) A prescription of methyldopa (Aldomet)
to control blood pressure
Recommended care for women diagnosed with preeclampsia
includes bed rest with bath- room privileges, weight and BP
monitoring, and closely following urine protein and serum