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1. For a patient with asthma, what is the primary purpose of prescribing salmeterol?
- A. Relieve acute bronchospasm
- B. Prevent asthma attacks
- C. Suppress cough
- D. Thin respiratory secretions
Correct answer: B
Rationale: Salmeterol is classified as a long-acting beta2-agonist, which is used to prevent asthma attacks by providing extended bronchodilation. It is not typically used for immediate relief of acute bronchospasm or for suppressing cough. Additionally, salmeterol does not have the primary purpose of thinning respiratory secretions.
2. A 56-year-old white male complains of intermittent dysphagia for the past three months, particularly with the ingestion of meat. He has no difficulties swallowing liquids. He has no history of smoking, uses no medications, and has had no weight loss. What test would be best to evaluate him?
- A. Upper endoscopy
- B. Chest/abdominal CT scan
- C. Barium swallow
- D. Esophageal manometry
Correct answer: C
Rationale: For a patient presenting with intermittent dysphagia, especially with solids like meat, a barium swallow is the most appropriate initial test. In this case, the classic presentation suggests a Schatzki’s ring, which is best visualized through a barium study. Upper endoscopy may not always visualize Schatzki’s rings effectively. Chest/abdominal CT scan and esophageal manometry are not the preferred tests for diagnosing Schatzki’s rings. Treatment for Schatzki’s rings often involves bougie dilatation, and no further therapy may be necessary.
3. A patient with glaucoma is prescribed timolol eye drops. What is the primary action of this medication?
- A. Reduce intraocular pressure
- B. Dilate the pupils
- C. Constrict the pupils
- D. Enhance tear production
Correct answer: A
Rationale: Timolol eye drops are prescribed to reduce intraocular pressure in patients with glaucoma. By decreasing the pressure within the eye, timolol helps prevent damage to the optic nerve, which is crucial in managing glaucoma and preserving vision. Dilating or constricting the pupils or enhancing tear production are not the primary actions of timolol eye drops.
4. The sister of a patient diagnosed with BRCA gene-related breast cancer asks the nurse, 'Do you think I should be tested for the gene?' Which response by the nurse is most appropriate?
- A. In most cases, breast cancer is not caused by the BRCA gene.
- B. It depends on how you will feel if the test is positive for the BRCA gene.
- C. There are many things to consider before deciding to have genetic testing.
- D. You should decide first whether you are willing to have a bilateral mastectomy.
Correct answer: C
Rationale: The most appropriate response by the nurse is C: 'There are many things to consider before deciding to have genetic testing.' Genetic testing for BRCA gene mutations is a complex decision that involves various factors such as emotional readiness, potential impact on insurance and employability, and the implications of test results. Option A is incorrect because although most breast cancers are not related to BRCA gene mutations, individuals with these mutations have a significantly higher risk. Option B is not ideal as it oversimplifies the decision-making process by focusing solely on emotional aspects. Option D is incorrect as it implies a predetermined course of action (mastectomy) before even undergoing genetic testing, which is not appropriate.
5. A patient with hyperthyroidism is prescribed propylthiouracil (PTU). What is the primary purpose of this medication?
- A. Increase thyroid hormone production
- B. Suppress thyroid hormone production
- C. Enhance iodine absorption
- D. Stimulate the thyroid gland
Correct answer: B
Rationale: Propylthiouracil (PTU) is a medication used to treat hyperthyroidism by suppressing the production of thyroid hormones. It works by inhibiting the enzyme responsible for the synthesis of thyroid hormones, thereby reducing their levels in the body. This helps to alleviate the symptoms of hyperthyroidism and restore thyroid hormone levels to normal range.
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