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Chapter 38: Gout Medications Test Bank

Chapter 38: Gout Medications Test Bank

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Chapter 38: Gout Medications
Test Bank
MULTIPLE CHOICE
1.   A patient who has hypertension is taking a thiazide diuretic. The patient has a serum uric acid level of 8 mg/dL. The primary care nurse practitioner (NP) caring for this patient should:
a.

prescribe colchicine.

b.

discontinue the thiazide diuretic.

c.

order a 24-hour urine collection.

d.

refer the patient to a rheumatologist.

2.   A patient comes to the clinic reporting sudden pain and swelling of one knee joint. The primary care NP suspects gout. When preparing to order diagnostic tests, the most important initial test the primary care NP should order is:
a.

renal function tests.

b.

serum uric acid levels.

c.

24-hour urine collection.

d.

synovial fluid aspirate for Gram stain and culture.

3.   Gout is diagnosed in a patient, and tests show the cause to be an underexcretion of uric acid. The primary care NP should prescribe:
a.

febuxostat (Uloric).

b.

colchicine (Colcrys).

c.

allopurinol (Zyloprim).

d.

probenecid (Benemid).

4.   A primary care NP prescribes probenecid to treat a patient who has gout. The patient comes to the clinic 2 weeks later with severe flank pain. The NP should:
a.

ask the patient about fluid intake.

b.

order a urinalysis and urine culture.

c.

change the medication to allopurinol.

d.

recommend nonsteroidal antiinflammatory drugs (NSAIDs) to treat flank pain.

5.   A patient who is obese and has hypertension is taking a thiazide diuretic and develops gouty arthritis, which is treated with probenecid. At a follow-up visit, the patient’s serum uric acid level is 7 mg/dL, and the patient denies any current symptoms. The primary care NP should discontinue the probenecid and:
a.

prescribe colchicine.

b.

prescribe febuxostat.

c.

tell the patient to use an NSAID if symptoms recur.

d.

counsel the patient to report recurrence of symptoms.

6.   A patient with a history of gouty arthritis comes to the clinic with acute pain and swelling of the great toe. The patient is not currently taking any medications. The primary care NP should prescribe:
a.

naproxen.

b.

colchicine.

c.

probenecid.

d.

allopurinol.

7.   A patient who is taking colchicine for gout is in the clinic 1 week after beginning the medication. The patient reports decreased appetite and nausea. The primary care NP should:
a.

suspect worsening of gouty arthritis.

b.

order vitamin B12 levels to assess for vitamin deficiency.

c.

discontinue the colchicine for 48 hours until symptoms subside.

d.

reassure the patient that these are common, temporary side effects.

8.   A patient who has a previous history of renal stones will begin taking probenecid for gout. The primary care NP should:
a.

add colchicine to the patient’s drug regimen.

b.

counsel the patient to use high-dose aspirin for pain.

c.

teach the patient to drink plenty of acidic fluids such as juice.

d.

tell the patient to stop taking the medication when symptoms subside.


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