Which medication is used to treat an acute flare of gout?
Allopurinol.
Colchicine.
Probenecid.
Sulfinpyrazone.
The Correct Answer is B
Choice A rationale
Allopurinol is a xanthine oxidase inhibitor used for the long-term prophylaxis (prevention) of gout flares by decreasing the production of uric acid, thereby lowering serum uric acid levels. It is not the drug of choice for treating an acute, painful flare-up because it does not rapidly reduce the inflammation caused by existing urate crystal deposition in the joint.
Choice B rationale
Colchicine is an alkaloid used to treat acute gout flares by disrupting microtubule formation, which inhibits the migration of neutrophils to the site of inflammation and interferes with the inflammatory response triggered by urate crystals. It is most effective when administered within 24 hours of the onset of symptoms to reduce pain and inflammation rapidly.
Choice C rationale
Probenecid is a uricosuric agent that works by inhibiting the reabsorption of uric acid in the proximal renal tubules, thereby increasing the excretion of uric acid in the urine. Like allopurinol, it is used for the long-term management of gout in patients who underexcrete uric acid, but it is ineffective for rapid relief during an acute flare.
Choice D rationale
Sulfinpyrazone is another uricosuric agent, similar to probenecid, that promotes the excretion of uric acid through the kidneys. It is indicated for the prophylactic treatment of chronic gout to maintain low serum uric acid levels and prevent recurrent attacks. It is not an appropriate medication for the immediate, symptomatic relief required during an acute gout flare.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Airborne precautions are reserved for diseases with very small particles that remain suspended in the air and travel over long distances, such as tuberculosis, measles, or varicella (chickenpox). Influenza droplets are generally large and do not remain suspended in the air for long periods, falling rapidly, thus requiring droplet precautions instead of the more restrictive airborne type.
Choice B rationale
Contact precautions are used for infections spread by direct or indirect contact with the patient or the patient's environment, such as Clostridium difficile or antibiotic-resistant organisms like MRSA. While contact can spread influenza, the primary route is large respiratory droplets, making droplet precautions the most specific and necessary type of isolation.
Choice C rationale
Influenza is primarily spread by large respiratory droplets expelled when an infected person coughs, sneezes, or talks. These droplets travel a short distance (typically less than 3 to 6 feet) before settling. Droplet precautions, including placing the patient in a private room and requiring staff to wear a surgical mask within the specified distance, are essential to prevent transmission.
Choice D rationale
Universal precautions, now generally referred to as Standard Precautions, involve basic infection control practices like hand hygiene and using personal protective equipment (PPE) for contact with blood, body fluids, non-intact skin, and mucous membranes of all patients. While always used, they are insufficient alone for preventing influenza spread, which requires the added barrier of droplet precautions.
Correct Answer is C
Explanation
Choice A rationale
A patient admitted due to a fall may have various injuries, but without further information indicating impaired organ function (like liver or kidney disease), a fall alone does not specifically suggest a compromised capacity for drug metabolism or elimination, which are the main determinants of drug toxicity risk.
Choice B rationale
A poor appetite can lead to nutritional deficiencies, potentially affecting plasma protein levels (hypoalbuminemia), which could theoretically increase the free (active) fraction of highly protein-bound drugs. However, this is an indirect risk factor, and the direct impact on drug elimination is less immediate than impaired renal function.
Choice C rationale
A low creatinine clearance (normal range 90-130 mL/min/1.73 m) indicates significantly impaired kidney function. The kidneys are the primary route for the excretion of many drugs and their metabolites. Reduced clearance leads to the accumulation of drugs in the body, increasing the plasma concentration and significantly raising the risk of dose-dependent drug toxicity.
Choice D rationale
Dehydration can lead to hemoconcentration, which might increase the drug concentration initially. However, it can also lead to acute kidney injury, which, if present, would be the main concern due to reduced drug excretion. Dehydration itself is less direct a risk factor for drug accumulation than chronic or sustained renal impairment.
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