A pregnant 30-year-old woman complains of persistent numbness on the palmar surface of her right hand and of pain in her right arm. Her symptoms are more severe in the morning. Neurologic examination reveals a sensory deficit in the right thumb and the index and middle fingers, as well as on the lateral half of the ring finger. The patient has weakness when abducting the thumb. Which of the following is considered first-line treatment?
Gabapentin (Neurontin)
Anti-inflammatories
Corticosteroids
Splinting of the right wrist
The Correct Answer is D
Choice A reason: Gabapentin is used for neuropathic pain but is generally not first-line for mild to moderate carpal tunnel syndrome, especially during pregnancy.
Choice B reason: Anti-inflammatory medications may be limited during pregnancy due to safety concerns and are not the most effective treatment for compressive neuropathy in the wrist.
Choice C reason: Corticosteroids can provide relief but systemic steroids are generally avoided in pregnancy unless necessary; localized corticosteroid injections may be used but are second-line.
Choice D reason: This choice is correct because wrist splinting, particularly at night, is the first-line conservative treatment for carpal tunnel syndrome, especially in pregnant patients. It helps maintain the wrist in a neutral position, reducing pressure on the median nerve and alleviating symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: "None" is incorrect because certain medications can interact with metabolic pathways affected by smoking.
Choice B reason: Galantamine is metabolized by the CYP1A2 enzyme, which is induced by smoking. This induction can reduce therapeutic levels of the drug, potentially making it less effective or requiring dose adjustment, thus contraindicating its use without careful monitoring.
Choice C reason: Donepezil is metabolized primarily by CYP2D6 and CYP3A4 and is not significantly affected by smoking; it remains safe for use in smokers.
Choice D reason: Rivastigmine is metabolized by esterases, not CYP enzymes, so smoking does not alter its metabolism, making it safe in this patient.
Correct Answer is D
Explanation
Choice A reason: Remdesivir is an antiviral and is not commonly associated with mood disturbances such as mania.
Choice B reason: Albuterol can cause mild nervousness or tremor but rarely induces full manic episodes.
Choice C reason: Famotidine is an H2 receptor antagonist and is not associated with mania.
Choice D reason: Dexamethasone is a corticosteroid that can induce psychiatric side effects including mania, agitation, and psychosis, particularly in older adults or those with underlying vulnerabilities.
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