Which of the following statements is INCORRECT about the pharmacologic treatment of Crohn's disease?
Metronidazole is effective in the treatment of Crohn's disease.
Sulfasalazine is effective in the treatment of mild Crohn's disease.
Thiopurines can be used in the treatment of Crohn's disease for their steroid-sparing effects.
Avoid NSAIDs in the treatment of Crohn's disease because they may exacerbate disease.
The Correct Answer is B
Choice A reason: Metronidazole has shown efficacy in treating perianal Crohn’s disease and mild-to-moderate disease activity, particularly when infection or abscess is suspected. It is often used as adjunct therapy.
Choice B reason: Sulfasalazine is more effective in ulcerative colitis than in Crohn’s disease. Its benefit in Crohn’s is limited and not considered first-line, especially for small bowel involvement. This makes the statement incorrect.
Choice C reason: Thiopurines such as azathioprine and 6-mercaptopurine are immunomodulators used to maintain remission and reduce steroid dependence. They are effective in long-term management of Crohn’s disease.
Choice D reason: NSAIDs can exacerbate Crohn’s disease by increasing intestinal permeability and promoting inflammation. Their use is generally avoided in patients with inflammatory bowel disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Carcinomas are typically hard, irregular, immobile, and may be associated with skin changes or nipple retraction. While breast cancer must always be ruled out, the described mass lacks the suspicious features of malignancy.
Choice B reason: A clogged duct is usually painful and associated with lactation. It presents as a tender, localized area of swelling and is not typically rubbery or mobile. This patient is nulligravid and not lactating, making this diagnosis unlikely.
Choice C reason: Fibroadenomas are common benign breast tumors in young women. They are typically smooth, round, rubbery, mobile, and nontender. The location in the upper outer quadrant and the described characteristics strongly suggest a fibroadenoma.
Choice D reason: Duct ectasia involves dilation of the milk ducts and may present with nipple discharge, tenderness, or inflammation. It is more common in older women and does not typically present as a discrete, mobile mass.
Correct Answer is C
Explanation
Choice A reason: Pseudobulbar affect is characterized by sudden, uncontrollable episodes of laughing or crying that are disproportionate or unrelated to the situation. It does not involve loss of muscle tone or cataplexy and is typically associated with neurological conditions such as multiple sclerosis or traumatic brain injury.
Choice B reason: Secondary narcolepsy occurs due to identifiable causes such as brain injury, tumors, or infections affecting the hypothalamus. While it can present with excessive daytime sleepiness, cataplexy is not a defining feature unless hypocretin deficiency is present. The presence of cataplexy in this case points more specifically to Type 1 narcolepsy.
Choice C reason: Type 1 narcolepsy is characterized by excessive daytime sleepiness and cataplexy—sudden loss of muscle tone triggered by strong emotions such as laughter, while consciousness is preserved. This presentation is classic for Type 1 narcolepsy and is associated with low cerebrospinal fluid hypocretin levels.
Choice D reason: Type 2 narcolepsy also presents with excessive daytime sleepiness but lacks cataplexy. Since the patient experiences muscle tone loss triggered by laughter, Type 2 narcolepsy is ruled out.
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