Question

• write a sample test questions on each of the topics.
• Each question will use a part of the nursing process. For example, you will provide a question utilizing Assessment, Planning, Interventions, and Evaluating.
• The questions all must be multiple choice with at LEAST four answer choices, must include a rationale for the why your answer choice is right, and the others are wrong. Give the correct answers to these three questions along with the rationale for the correct answer.

1) Gout

2) Anti-Malarials

3) Uric Acid Biosynthesis Inhibitors

4) Uricosurics

Answer 1

1. Gout

Based on assessment phase

Q. A client has history of gout. While performing a head-to-toe assessment the nurses have to identify that gout tends to start at what site?

A. Big toe

B. Knee

C. Thumb or index finger

D. Elbow

Answer: A Big toe

Rationale

Gout commonly occurs in the big toe

Uric acid is sensitive to temperature changes.

At cooler temperatures, uric acid turns into crystals.

Toe is the coolest part of the body as it is farthest from the heart and is the most likely target of gout.

Acute attack of gout that begins in the big toe.

Therefore, the nurse should assess the patient for this during the head-to-toe assessment.

Other choices are invalid because it is specific to gout

During hospitalization due to physical excertion there may be chance of an acute attack.

2) Anti-Malarials

Phase: Intervention : Medication administration

Q. Which among the following is a dihydrofolate reductase inhibitor.

A) Chloroquine

B) Chloroguanide

C) Pyrimethamine

D) Both B and C

Answer : Both B and C

Rationale

Chloroquine is a synthetic 4-aminoquinoline is the drug of choice in the treatment of erythrocytic P. falciparum malaria. It inhibit the formation of hemozoin (Hz) from the heme released by the digestion of hemoglobin (Hb)

Dihydrofolate inhibitors have antimalarials action.  Dihydro folate , whose role is to regenerate folic acid into its reduced form tetrahydrofolate, is necessary for bacteria, Plasmodium and normal and cancerous human cells.

3.Uric Acid Biosynthesis Inhibitors

Question is based on intervention phase - Client education on Gout medication.

Q. A client Mr. X , who diagnosed with Gout prescribed to administer Allopurinol 100 mg , OD, after meal. Which among the following is  incorrect while giving health education to the client.

A. Client needed annual eye check up

B. Allopurinol relieve the inflammation and pain during an acute attack

C. Allopurinol decreases the production of uric acid.

D. Avoid large consumption of Vitamin C rich food.

Answer is B

Rationale

B.Allopurinol is in a class of medications called xanthine oxidase inhibitor( decrease levels of uric acid ) used to prevent gout attacks not to treat an acute attack.

Colchicine and Nonsteroidal anti-inflammatory drugs are effective in treating the inflammation and pain during a gout attack.

A. Allopurinol can cause vision changes, therefore the client instructed for annual eye exams

C. Allopurinol inhibit the enzyme xanthine oxidase. Xanthine oxidase converts oxypurines to uric acid.

D. Large ge doses of vitamin C increases the risk of renal calculi formation.

4. Uricosurics

Q. While administering which among the following Nurses have to monitor an uricosuric action

A. Losartan

B. Allopurinol

C. Rifampicin

D. Ethambutol

Rationale

Phase : Intervention

Answer is A Lozartan

Losartan is an angiotensin receptor blocker which has an uricosuric action

Allopurinol is a xanthine oxidase inhibitor which reduces the synthesis of uric acid

Rifampicin and ethambutol are first line anti tuberculosis drugs.