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quickmaster (1)3.6 (5)ChatNR 508 Final Exam
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Question 1
2 / 2 pts
A patient who has diabetes reports intense discomfort when needing to void. A urinalysis is normal. To treat this, the primary care NP should consider prescribing:
flavoxate (Urispas).
bethanechol (Urecholine).
phenazopyridine (Pyridium).
oxybutynin chloride (Ditropan XL).
Question 2
2 / 2 pts
A patient reports difficulty returning to sleep after getting up to go to the bathroom every night. A physical examination and a sleep hygiene history are noncontributory. The primary care NP should prescribe:
zaleplon.
ZolpiMist.
ramelteon.
chloral hydrate.
Question 3
2 / 2 pts
A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100° F. The primary care NP visualizes bilateral erythematous, nonbulging, intact tympanic membranes. The child is taking fluids well and is playing with toys in the examination room.The NP should:
prescribe azithromycin once daily for 5 days.
prescribe amoxicillin twice daily for 10 days.
prescribe amoxicillin-clavulanate twice daily for 10 days.
initiate antibiotic therapy if the child’s condition worsens.
Question 4
2 / 2 pts
An 80-year-old patient with congestive heart failure has a viral upper respiratory infection. The patient asks the primary care NP about treating the fever, which is 38.5° C. The NP should:
recommend acetaminophen.
recommend high-dose acetaminophen.
tell the patient that antibiotics are needed with a fever that high.
tell the patient a fever less than 40° C does not need to be treated.
Question 5
2 / 2 pts
A patient who takes levodopa and carbidopa for Parkinson’s disease reports experiencing freezing episodes between doses. The primary care NP should consider using:
selegiline.
amantadine.
apomorphine.
modified-release levodopa.
Question 6
2 / 2 pts
A patient is being tapered from long-term therapy with prednisolone and reports weight loss and fatigue. The primary care NP should counsel this patient to:
consume foods high in vitamin D and calcium.
begin taking dexamethasone because it has longer effects.
expect these side effects to occur as the medication is tapered.
increase the dose of prednisolone to the most recent amount taken.
Question 7
2 / 2 pts
The primary care nurse practitioner (NP) sees a 50-year-old woman who reports frequent leakage of urine. The NP learns that this occurs when she laughs or sneezes. She also reports having an increased urge to void even when her bladder is not full. She is not taking any medications. The NP should:
perform a dipstick urinalysis.
prescribe desmopressin (DDAVP).
prescribe oxybutynin chloride (Ditropan XL).
teach exercises to strengthen the pelvic muscles.
Question 8
2 / 2 pts
A 7-year-old patient who has severe asthma takes oral prednisone daily. At a well-child examination, the primary care NP notes a decrease in the child’s linear growth rate. The NP should consult the child’s asthma specialist about:
gradually tapering the child off the prednisone.
a referral for possible growth hormone therapy.
giving a double dose of prednisone every other day.
dividing the prednisone dose into twice-daily dosing.
Question 9
2 / 2 pts
A patient who is taking isoniazid and rifampin for latent TB is seen by the primary care NP for a routine follow-up visit. The patient reports having nausea, vomiting, and a decreased appetite. The NP should:
ask about alcohol intake.
suggest taking the medications with food.
reassure the patient that these side effects are common.
order liver and renal function tests and serum glucose.
Question 10
2 / 2 pts
A primary care NP sees a child with asthma to evaluate the child’s response to the prescribed therapy. The child uses an ICS twice daily and an albuterol metered-dose inhaler as needed. The child’s symptoms are well controlled. The NP notes slowing of the child’s linear growth on a standardized growth chart. The NP should change this child’s medication regimen to a:
combination ICS/LABA inhaler twice daily.
short-acting 2-agonist (SABA) with oral corticosteroids when symptomatic.
combination ipratropium/albuterol inhaler twice daily.
SABA as needed plus a leukotriene modifier once daily.
Question 11
2 / 2 pts
A patient is newly diagnosed with Alzheimer’s disease stage 6 on the Global Deterioration Scale. The primary care NP should prescribe:
donepezil (Aricept).
rivastigmine (Exelon).
memantine (Namenda).
galantamine (Razadyne).
Question 12
2 / 2 pts
The primary care NP sees a 12-month-old infant who needs the MMR, Varivax, influenza, and hepatitis A vaccines. The child’s mother tells the NP that she is pregnant. The NP should:
administer all of these vaccines today.
give the hepatitis A and influenza vaccines.
give the Varivax, hepatitis A, and influenza vaccines.
withhold all of these vaccines until after the baby is born.
Question 13
2 / 2 pts
A parent brings a 5-year-old child to a clinic for a hospital follow-up appointment. The child is taking a medication at a dose equal to an adult dose.The parent reports that the medication is not producing the desired effects. The NP should:
order renal function tests.
prescribe another medication to treat this child’s symptoms.
discontinue the drug and observe the child for toxic side effects.
obtain a serum drug level and consider increasing the drug dose.
Question 14
2 / 2 pts
An NP orders an inhaled corticosteroid 2 puffs twice daily and an albuterol metered-dose inhaler 2 puffs every 4 hours as needed for cough or wheezing for a 65-year-old patient with recent onset of reactive airways disease who reports symptoms occurring every 1 or 2 weeks. At a follow-up appointment several months later, the patient reports no change in frequency of symptoms. The NP’s initial action should be to:
order spirometry to evaluate pulmonary function.
prescribe a systemic corticosteroid to help with symptoms.
ask the patient to describe how the medications are taken each day.
give the patient detailed information about the use of metered-dose inhalers.
Question 15
2 / 2 pts
A patient is diagnosed with a condition that causes chronic pain. The primary care NP prescribes an opioid analgesic and should instruct the patient to:
wait until the pain is at a moderate level before taking the medication.
take the medication at regular intervals and not just when pain is present.
start the medication at higher doses initially and taper down gradually.
take the minimum amount needed even when pain is severe to avoid dependency.
Question 16
2 / 2 pts
A patient tells the primary care NP that he has difficulty getting and maintaining an erection. The NP’s initial response should be to:
prescribe sildenafil (Viagra).
perform a medication history.
evaluate his cardiovascular status.
order a papaverine injection test to screen for erectile dysfunction.
Question 17
2 / 2 pts
A 55-year-old patient develops Parkinson’s disease characterized by unilateral tremors only. The primary care NP will refer the patient to a neurologist and should expect initial treatment to be:
levodopa.
carbidopa.
pramipexole.
carbidopa/levodopa.
Question 18
2 / 2 pts
A patient who has migraine headaches without an aura reports difficulty treating the migraines in time because they come on so suddenly. The patient has been using over-the-counter NSAIDs. The primary care NP should prescribe:
frovatriptan (Frova).
sumatriptan (Imitrex).
cyproheptadine (Periactin).
dihydroergotamine (D.H.E. 45).
Question 19
2 / 2 pts
A woman tells a primary care NP that she is considering getting pregnant. During a health history, the NP learns that the patient has seasonal allergies, asthma, and epilepsy, all of which are well controlled with a second-generation antihistamine daily, an inhaled steroid daily with albuterol as needed, and an antiepileptic medication daily. The NP should counsel this patient to:
take her asthma medications only when she is having an acute exacerbation.
avoid using antihistamine medications during her first trimester of pregnancy.
discontinue her seizure medications at least 6 months before becoming pregnant.
use only oral corticosteroids and not inhaled steroids while pregnant for improved asthma control.
Question 20
2 / 2 pts
A patient who has partial seizures has been taking phenytoin (Dilantin). The patient has recently developed thrombocytopenia. The primary care nurse practitioner (NP) should contact the patient’s neurologist to discuss changing the patient’s medication to:
topiramate (Topamax).
levetiracetam (Keppra).
zonisamide (Zonegran).
carbamazepine (Tegretol).
Question 21
2 / 2 pts
A patient is taking dicloxacillin (Dynapen) 500 mg every 6 hours to treat a severe penicillinase-resistant infection. At a 1-week follow-up appointment, the patient reports nausea, vomiting, and epigastric discomfort. The primary care NP should:
change the medication to a cephalosporin.
decrease the dose to 250 mg every 6 hours.
reassure the patient that these are normal adverse effects of this drug.
order blood cultures, a white blood cell (WBC) count with differential, and liver function tests (LFTs).
Question 22
2 / 2 pts
A 75-year-old patient who lives alone will begin taking a narcotic analgesic for pain. To help ensure patient safety, the NP prescribing this medication should:
assess this patient’s usual sleeping patterns.
ask the patient about problems with constipation.
obtain a baseline creatinine clearance test before the first dose.
perform a thorough evaluation of cognitive and motor abilities.
Question 23
2 / 2 pts
A patient has been taking intramuscular (IM) meperidine 75 mg every 6 hours for 3 days after surgery. When the patient is discharged from the hospital, the primary care NP should expect the patient to receive a prescription for _____ mg orally every _____ hours.
hydrocodone 30; 6
hydrocodone 75; 6
meperidine 300;12
meperidine 75; 6
Question 24
2 / 2 pts
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:
prescribe colchicine.
prescribe febuxostat.
tell the patient to use an NSAID if symptoms recur.
counsel the patient to report recurrence of symptoms.
Question 25
2 / 2 pts
A mother brings her a college-age son to the primary care NP and asks the NP to talk to him about alcohol use. He reports binge drinking on occasion and drinking only beer on weekends. The NP notes diaphoresis, tachycardia, and an easy startle reflex. The NP should:
admit him to the hospital for detoxification.
ask him how much he had to drink last night.
prescribe lorazepam (Ativan) to help with symptoms.
suggest that he talk to a counselor about alcohol abuse.
Question 26
2 / 2 pts
A primary care NP sees a patient who has fever, flank pain, and dysuria. The patient has a history of recurrent urinary tract infections (UTIs) and completed a course of trimethoprim-sulfamethoxazole (TMP/SMX) the week before. A urine test is positive for leukocyte esterase. The NP sends the urine for culture and should treat this patient empirically with:
gemifloxacin.
ciprofloxacin.
azithromycin.
TMP/SMX.
Question 27
2 / 2 pts
A patient who takes carbamazepine (Tegretol) has been seizure-free for 2 years and asks the primary care NP about stopping the medication. The NP should:
order an electroencephalogram (EEG).
prescribe a tapering regimen of the drug.
inform the patient that antiepileptic drug (AED) therapy is lifelong.
tell the patient to stop the drug and use only as needed.
Question 28
2 / 2 pts
A primary care NP has been working with a young woman who wants to quit smoking before she begins having children. She has made several attempts to quit using nicotine replacement therapy and is feeling discouraged. She does not want to take medication at this time. The NP should:
discuss the effects of smoking on fetal development.
ask her to write down any factors that triggered her relapses.
give her information about the long-term effects of smoking.
convince her that taking medication will be essential in her case.
Question 29
2 / 2 pts
A primary care NP prescribes a nonselective NSAID for a patient who has osteoarthritis. The patient expresses concerns about possible side effects of this medication. When counseling the patient about the medication, the NP should tell this patient:
to avoid taking antacids while taking the NSAID.
to take each dose of the NSAID with a full glass of water.
that a few glasses of wine each day are allowed while taking the NSAID.
to decrease the dose of the NSAID if GI symptoms occur.
Question 30
2 / 2 pts
A patient has been taking a COX-2 selective NSAID to treat pain associated with a recent onset of RA. The patient tells the primary care NP that the pain and joint swelling are becoming worse. The patient does not have synovitis or extraarticular manifestations of the disease. The NP will refer the patient to a rheumatologist and should expect the specialist to prescribe:
methotrexate.
corticosteroids.
opioid analgesics.
hydroxychloroquine.
Question 31
2 / 2 pts
A patient has been taking an opioid analgesic for 2 weeks after a minor outpatient procedure. At a follow-up clinic visit, the patient tells the primary care NP that he took extra doses for the past 2 days because of increased pain and wants an early refill of the medication. The NP should suspect:
dependence.
drug addiction.
possible misuse.
increasing pain.
Question 32
2 / 2 pts
An elderly patient with dementia exhibits hostility and uncooperativeness. The primary care NP prescribes clozapine (Clozaril) and should counsel the family about:
a decreased risk of extrapyramidal symptoms.
improved cognitive function.
the need for long-term use of the medication.
a possible increased risk of heart disease and stroke.
Question 33
2 / 2 pts
A patient who was hospitalized for an infection was treated with an aminoglycoside antibiotic. The patient asks the primary care nurse practitioner (NP) why outpatient treatment wasn’t an option. The NP should tell the patient that aminoglycoside antibiotics:
are more likely to be toxic.
cause serious adverse effects.
carry more risk for serious allergic reactions.
must be given intramuscularly or intravenously.
Question 34
2 / 2 pts
A woman who is pregnant tells an NP that she has been taking sertraline for depression for several years but is worried about the effects of this drug on her fetus. The NP will consult with this patient’s psychiatrist and will recommend that she:
stop taking the sertraline now.
continue taking the antidepressant.
change to a monoamine oxidase inhibitor (MAOI).
discontinue the sertraline a week before delivery.
Question 35
2 / 2 pts
A patient who has HIV is being treated with Emtriva. The patient develops hepatitis B. The primary care NP should contact the patient’s infectious disease specialist to discuss:
adding zidovudine.
changing to Truvada.
changing to tenofovir.
ordering Combivir and tenofovir.
Question 36
2 / 2 pts
A patient who was in a motor vehicle accident has been treated for lower back muscle spasms with metaxalone (Skelaxin) for 1 week and reports decreased but persistent pain. A computed tomography scan is normal. The primary care NP should:
suggest ice and rest.
order physical therapy.
prescribe diazepam (Valium).
add an opioid analgesic medication.
Question 37
2 / 2 pts
A primary care NP sees a patient who has dysuria, fever, and urinary frequency. The NP orders a urine dipstick, which is positive for nitrates and leukocyte esterase, and sends the urine to the laboratory for a culture. The patient is allergic to sulfa drugs. The NP should:
order cefaclor (Ceclor).
prescribe cefixime (Suprax).
administer intramuscular ceftriaxone (Rocephin).
wait for culture results before ordering an antibiotic.
Question 38
2 / 2 pts
A patient comes to the clinic several days after an outpatient surgical procedure complaining of swelling and pain at the surgical site. The primary care NP notes a small area of erythema but no abscess or induration. The NP should:
prescribe TMP-SMX.
prescribe topical mupirocin four times daily.
suggest that the patient apply warm soaks three times daily.
refer the patient to the surgeon for further evaluation.
Question 39
2 / 2 pts
A patient who has genital herpes has frequent outbreaks. The patient asks the primary care NP why it is necessary to take oral acyclovir all the time and not just for acute outbreaks. The NP should explain that oral acyclovir may:
prevent the virus from developing resistance.
cause episodes to be shorter and less frequent.
actually eradicate the virus and cure the disease.
reduce the chance of transmitting the virus to others.
Question 40
2 / 2 pts
A patient is taking isoniazid, pyrazinamide, rifampin, and streptomycin to treat TB. The primary care NP should routinely perform:
serum glucose and liver function tests (LFTs).
bone marrow density and ophthalmologic tests.
ophthalmologic, hearing, and serum glucose tests.
color vision, serum glucose, and LFTs.
Question 41
2 / 2 pts
A primary care NP sees a patient who was recently hospitalized for infection and treated with gentamicin for 10 days. The patient tells the NP that the drug was discontinued early because “my blood level was too high.” The NP should order:
a serial audiometric test.
a serum blood urea nitrogen (BUN) and creatinine.
a urinalysis and complete blood count.
serum calcium, magnesium, and sodium.
Question 42
2 / 2 pts
A 40-year-old woman asks the primary care NP what she can do to minimize her risk of osteoporosis. She takes 800 mg of calcium and drinks 2 cups of skim milk each day. The NP should recommend that she:
decrease dietary fat.
limit her caffeine intake.
consume a high-protein diet.
drink diet instead of sugary sodas.
Question 43
2 / 2 pts
A patient has a sore throat with fever. The primary care NP observes erythematous 4+ tonsils with white exudate. A rapid antigen strep test is negative, and a culture is pending. The NP orders amoxicillin as empiric treatment. The patient calls the next day to report a rash. The NP should suspect:
penicillin drug allergy.
a viral cause for the patient’s symptoms.
a serum sickness reaction to the penicillin.
scarlatiniform rash from the streptococcal infection.
Question 44
2 / 2 pts
A patient is taking sulfisoxazole. The patient calls the primary care NP to report abdominal pain, nausea, and insomnia. The NP should:
change to TMP/SMX.
tell the patient to stop taking the drug immediately.
reassure the patient that these are minor adverse effects of this drug.
order a CBC with differential, platelets, and a stool culture.
Question 45
2 / 2 pts
A patient is in the clinic with acute symptoms of anxiety. The patient is restless and has not slept in 3 days. The primary care NP observes that the patient is irritable and has moderate muscle tension. The patient’s spouse reports that similar symptoms have occurred before in varying degrees for several years. The NP should refer the patient to a psychologist and should prescribe which drug for short-term use?
Alprazolam
Buspirone
Melatonin
Zolpidem
Question 46
2 / 2 pts
A woman who takes oral contraceptive pills develops vaginal candidiasis. The primary care NP prescribes a single dose of fluconazole. When counseling the patient about this drug, the NP should tell her:
that the drug is safe if she were to become pregnant.
that she may consume alcohol while taking this medication.
to use a backup contraceptive method for the next 2 months.
that she may need a lower dose of fluconazole because she takes oral contraceptive pills.
Question 47
2 / 2 pts
A patient in the clinic reports taking a handful of acetaminophen extra-strength tablets about 12 hours prior. The patient has nausea, vomiting, malaise, and drowsiness. The patient’s aspartate aminotransferase and alanine aminotransferase are mildly elevated. The primary care NP should:
expect the patient to sustain permanent liver damage.
reassure the patient that these symptoms are reversible.
tell the patient that acetylcysteine cannot be given this late.
administer activated charcoal to remove acetaminophen from the body.
Question 48
2 / 2 pts
An NP sees a preschooler in clinic for the first time. When obtaining a medication history, the NP notes that the child is taking a medication for which safety and effectiveness in children has not been established in drug information literature. The NP should:
discontinue the medication.
order serum drug levels to evaluate toxicity.
report the prescribing provider to the Food and Drug Administration (FDA).
ask the parent about the drug’s use and side effects.
Question 49
2 / 2 pts
A patient who has Parkinson’s disease who takes levodopa and carbidopa reports having drooling episodes that are increasing in frequency. The primary care NP should order:
benztropine.
amantadine.
apomorphine.
modified-release levodopa.
Question 50
2 / 2 pts
The primary care NP sees a 6-month-old infant for a routine physical examination and notes that the infant has a runny nose and a cough. The parents report a 2-day history of a temperature of 99° F to 100° F and two to three loose stools per day. Other family members have similar symptoms. The infant has had two sets of immunizations at 2 and 4 months of age. The NP should:
administer the 6-month immunizations at this visit today.
schedule an appointment in 2 weeks for 6-month immunizations.
administer DTaP, Hib, IPV, hepatitis B, and PCV13 today and RV in 2 weeks.
withhold all immunizations until the infant’s temperature returns to normal and the cough is gone.
Question 51
2 / 2 pts
A patient who was recently hospitalized and treated with gentamicin tells the primary care NP, “My kidney function test was abnormal and they stopped the medication.” The patient is worried about long-term effects. The NP should:
monitor renal function for several months.
reassure the patient that complete recovery should occur.
refer the patient to a nephrologist for follow-up evaluation.
monitor serum electrolytes and serum creatinine and BUN.
Question 52
2 / 2 pts
A patient has begun treatment for HIV. The primary care NP should monitor the patient’s complete blood count (CBC) at least every _____ months.
1 to 3
3 to 6
6 to 9
9 to 12
Question 53
2 / 2 pts
A patient who was recently diagnosed with COPD comes to the clinic for a follow-up evaluation after beginning therapy with a SABA as needed for dyspnea. The patient reports occasional mild exertional dyspnea but is able to sleep well. The patient’s FEV1 in the clinic is 85% of predicted, and oxygen saturation is 96%. The primary care NP should recommend:
a combination LABA/ICS twice daily.
influenza and pneumococcal vaccines.
ipratropium bromide (Atrovent) twice daily.
home oxygen therapy as needed for dyspnea.
Question 54
2 / 2 pts
A patient who takes 150 mg of clozapine (Clozaril) twice daily calls the primary care NP at 10:00 AM one day to report forgetting to take the 8:00 AM dose. The NP should counsel the patient to:
take the missed dose now.
take 75 mg of clozapine now.
wait and take the evening dose at the usual time.
take the evening dose 2 hours earlier than usual.
Question 55
2 / 2 pts
A patient has been taking fluoxetine 20 mg every morning for 5 days and calls the primary care NP to report decreased appetite, nausea, and insomnia. The NP should:
suggest taking a sedative at bedtime.
change the medication to bupropion.
add trazodone to the patient’s regimen.
reassure the patient that these effects will subside.
Question 56
2 / 2 pts
A female patient presents with grayish, odorous vaginal discharge. The primary care NP performs a gynecologic examination and notes vulvar and vaginal erythema. Testing of the discharge reveals a pH of 5.2 and a fishy odor when mixed with a solution of 10% potassium hydroxide. The NP should:
order topical fluconazole.
order metronidazole 500 mg twice daily for 7 days.
withhold treatment until culture results are available.
prescribe a clotrimazole vaginal suppository for 7 days.
Question 57
2 / 2 pts
An 80-year-old patient has a diagnosis of glaucoma, and the ophthalmologist has prescribed timolol (Timoptic) and pilocarpine eye drops. The primary care NP should counsel this patient:
that systemic side effects of these medications may be severe.
that the combination of these two drugs may cause drowsiness.
to begin an exercise program to improve cardiovascular health.
that a higher dose of one or both of these medications may be needed.
Question 58
2 / 2 pts
An 18-month-old child who attends day care has head lice and has been treated with permethrin 1% (Nix). The parent brings the child to the clinic 1 week later, and the primary care NP notes live bugs on the child’s scalp. The NP should order:
lindane.
malathion.
ivermectin.
permethrin 5%.
Question 59
2 / 2 pts
An adult patient who has a viral upper respiratory infection asks the primary care nurse practitioner (NP) about taking acetaminophen for fever and muscle aches. To help ensure against possible drug toxicity, the NP should first:
determine the patient’s height and weight.
ask the patient how high the temperature has been.
tell the patient to take 325 mg initially and increase as needed.
ask the patient about any other over-the-counter (OTC) cold medications being used.
Question 60
2 / 2 pts
The primary care NP follows a patient who is being treated for RA with methotrexate. The patient asks the NP why the medication does not seem to alleviate pain. The NP tells the patient that:
an immunomodulator may be needed to control pain.
a higher dose of methotrexate may be needed to achieve pain control.
if methotrexate does not control pain, an opioid analgesic may be necessary.
methotrexate is used to slow disease progression and preserve joint function.
Question 61
2 / 2 pts
A patient has a UTI and will begin treat
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and an intranasal corticosteroid. The NP would be concerned about which adverse effects?
/in Uncategorized /by developerLiver toxicity
Excessive drowsiness
Rebound congestion
Tremor
restlessness
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Liver toxicity
Excessive drowsiness
Rebound congestion
Tremor
Nr 508 Final Exam
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Question
Question 1
2 / 2 pts
A patient who has diabetes reports intense discomfort when needing to void. A urinalysis is normal. To treat this, the primary care NP should consider prescribing:
flavoxate (Urispas).
bethanechol (Urecholine).
phenazopyridine (Pyridium).
oxybutynin chloride (Ditropan XL).
Question 2
2 / 2 pts
A patient reports difficulty returning to sleep after getting up to go to the bathroom every night. A physical examination and a sleep hygiene history are noncontributory. The primary care NP should prescribe:
zaleplon.
ZolpiMist.
ramelteon.
chloral hydrate.
Question 3
2 / 2 pts
A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100° F. The primary care NP visualizes bilateral erythematous, nonbulging, intact tympanic membranes. The child is taking fluids well and is playing with toys in the examination room.The NP should:
prescribe azithromycin once daily for 5 days.
prescribe amoxicillin twice daily for 10 days.
prescribe amoxicillin-clavulanate twice daily for 10 days.
initiate antibiotic therapy if the child’s condition worsens.
Question 4
2 / 2 pts
An 80-year-old patient with congestive heart failure has a viral upper respiratory infection. The patient asks the primary care NP about treating the fever, which is 38.5° C. The NP should:
recommend acetaminophen.
recommend high-dose acetaminophen.
tell the patient that antibiotics are needed with a fever that high.
tell the patient a fever less than 40° C does not need to be treated.
Question 5
2 / 2 pts
A patient who takes levodopa and carbidopa for Parkinson’s disease reports experiencing freezing episodes between doses. The primary care NP should consider using:
selegiline.
amantadine.
apomorphine.
modified-release levodopa.
Question 6
2 / 2 pts
A patient is being tapered from long-term therapy with prednisolone and reports weight loss and fatigue. The primary care NP should counsel this patient to:
consume foods high in vitamin D and calcium.
begin taking dexamethasone because it has longer effects.
expect these side effects to occur as the medication is tapered.
increase the dose of prednisolone to the most recent amount taken.
Question 7
2 / 2 pts
The primary care nurse practitioner (NP) sees a 50-year-old woman who reports frequent leakage of urine. The NP learns that this occurs when she laughs or sneezes. She also reports having an increased urge to void even when her bladder is not full. She is not taking any medications. The NP should:
perform a dipstick urinalysis.
prescribe desmopressin (DDAVP).
prescribe oxybutynin chloride (Ditropan XL).
teach exercises to strengthen the pelvic muscles.
Question 8
2 / 2 pts
A 7-year-old patient who has severe asthma takes oral prednisone daily. At a well-child examination, the primary care NP notes a decrease in the child’s linear growth rate. The NP should consult the child’s asthma specialist about:
gradually tapering the child off the prednisone.
a referral for possible growth hormone therapy.
giving a double dose of prednisone every other day.
dividing the prednisone dose into twice-daily dosing.
Question 9
2 / 2 pts
A patient who is taking isoniazid and rifampin for latent TB is seen by the primary care NP for a routine follow-up visit. The patient reports having nausea, vomiting, and a decreased appetite. The NP should:
ask about alcohol intake.
suggest taking the medications with food.
reassure the patient that these side effects are common.
order liver and renal function tests and serum glucose.
Question 10
2 / 2 pts
A primary care NP sees a child with asthma to evaluate the child’s response to the prescribed therapy. The child uses an ICS twice daily and an albuterol metered-dose inhaler as needed. The child’s symptoms are well controlled. The NP notes slowing of the child’s linear growth on a standardized growth chart. The NP should change this child’s medication regimen to a:
combination ICS/LABA inhaler twice daily.
short-acting 2-agonist (SABA) with oral corticosteroids when symptomatic.
combination ipratropium/albuterol inhaler twice daily.
SABA as needed plus a leukotriene modifier once daily.
Question 11
2 / 2 pts
A patient is newly diagnosed with Alzheimer’s disease stage 6 on the Global Deterioration Scale. The primary care NP should prescribe:
donepezil (Aricept).
rivastigmine (Exelon).
memantine (Namenda).
galantamine (Razadyne).
Question 12
2 / 2 pts
The primary care NP sees a 12-month-old infant who needs the MMR, Varivax, influenza, and hepatitis A vaccines. The child’s mother tells the NP that she is pregnant. The NP should:
administer all of these vaccines today.
give the hepatitis A and influenza vaccines.
give the Varivax, hepatitis A, and influenza vaccines.
withhold all of these vaccines until after the baby is born.
Question 13
2 / 2 pts
A parent brings a 5-year-old child to a clinic for a hospital follow-up appointment. The child is taking a medication at a dose equal to an adult dose.The parent reports that the medication is not producing the desired effects. The NP should:
order renal function tests.
prescribe another medication to treat this child’s symptoms.
discontinue the drug and observe the child for toxic side effects.
obtain a serum drug level and consider increasing the drug dose.
Question 14
2 / 2 pts
An NP orders an inhaled corticosteroid 2 puffs twice daily and an albuterol metered-dose inhaler 2 puffs every 4 hours as needed for cough or wheezing for a 65-year-old patient with recent onset of reactive airways disease who reports symptoms occurring every 1 or 2 weeks. At a follow-up appointment several months later, the patient reports no change in frequency of symptoms. The NP’s initial action should be to:
order spirometry to evaluate pulmonary function.
prescribe a systemic corticosteroid to help with symptoms.
ask the patient to describe how the medications are taken each day.
give the patient detailed information about the use of metered-dose inhalers.
Question 15
2 / 2 pts
A patient is diagnosed with a condition that causes chronic pain. The primary care NP prescribes an opioid analgesic and should instruct the patient to:
wait until the pain is at a moderate level before taking the medication.
take the medication at regular intervals and not just when pain is present.
start the medication at higher doses initially and taper down gradually.
take the minimum amount needed even when pain is severe to avoid dependency.
Question 16
2 / 2 pts
A patient tells the primary care NP that he has difficulty getting and maintaining an erection. The NP’s initial response should be to:
prescribe sildenafil (Viagra).
perform a medication history.
evaluate his cardiovascular status.
order a papaverine injection test to screen for erectile dysfunction.
Question 17
2 / 2 pts
A 55-year-old patient develops Parkinson’s disease characterized by unilateral tremors only. The primary care NP will refer the patient to a neurologist and should expect initial treatment to be:
levodopa.
carbidopa.
pramipexole.
carbidopa/levodopa.
Question 18
2 / 2 pts
A patient who has migraine headaches without an aura reports difficulty treating the migraines in time because they come on so suddenly. The patient has been using over-the-counter NSAIDs. The primary care NP should prescribe:
frovatriptan (Frova).
sumatriptan (Imitrex).
cyproheptadine (Periactin).
dihydroergotamine (D.H.E. 45).
Question 19
2 / 2 pts
A woman tells a primary care NP that she is considering getting pregnant. During a health history, the NP learns that the patient has seasonal allergies, asthma, and epilepsy, all of which are well controlled with a second-generation antihistamine daily, an inhaled steroid daily with albuterol as needed, and an antiepileptic medication daily. The NP should counsel this patient to:
take her asthma medications only when she is having an acute exacerbation.
avoid using antihistamine medications during her first trimester of pregnancy.
discontinue her seizure medications at least 6 months before becoming pregnant.
use only oral corticosteroids and not inhaled steroids while pregnant for improved asthma control.
Question 20
2 / 2 pts
A patient who has partial seizures has been taking phenytoin (Dilantin). The patient has recently developed thrombocytopenia. The primary care nurse practitioner (NP) should contact the patient’s neurologist to discuss changing the patient’s medication to:
topiramate (Topamax).
levetiracetam (Keppra).
zonisamide (Zonegran).
carbamazepine (Tegretol).
Question 21
2 / 2 pts
A patient is taking dicloxacillin (Dynapen) 500 mg every 6 hours to treat a severe penicillinase-resistant infection. At a 1-week follow-up appointment, the patient reports nausea, vomiting, and epigastric discomfort. The primary care NP should:
change the medication to a cephalosporin.
decrease the dose to 250 mg every 6 hours.
reassure the patient that these are normal adverse effects of this drug.
order blood cultures, a white blood cell (WBC) count with differential, and liver function tests (LFTs).
Question 22
2 / 2 pts
A 75-year-old patient who lives alone will begin taking a narcotic analgesic for pain. To help ensure patient safety, the NP prescribing this medication should:
assess this patient’s usual sleeping patterns.
ask the patient about problems with constipation.
obtain a baseline creatinine clearance test before the first dose.
perform a thorough evaluation of cognitive and motor abilities.
Question 23
2 / 2 pts
A patient has been taking intramuscular (IM) meperidine 75 mg every 6 hours for 3 days after surgery. When the patient is discharged from the hospital, the primary care NP should expect the patient to receive a prescription for _____ mg orally every _____ hours.
hydrocodone 30; 6
hydrocodone 75; 6
meperidine 300;12
meperidine 75; 6
Question 24
2 / 2 pts
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:
prescribe colchicine.
prescribe febuxostat.
tell the patient to use an NSAID if symptoms recur.
counsel the patient to report recurrence of symptoms.
Question 25
2 / 2 pts
A mother brings her a college-age son to the primary care NP and asks the NP to talk to him about alcohol use. He reports binge drinking on occasion and drinking only beer on weekends. The NP notes diaphoresis, tachycardia, and an easy startle reflex. The NP should:
admit him to the hospital for detoxification.
ask him how much he had to drink last night.
prescribe lorazepam (Ativan) to help with symptoms.
suggest that he talk to a counselor about alcohol abuse.
Question 26
2 / 2 pts
A primary care NP sees a patient who has fever, flank pain, and dysuria. The patient has a history of recurrent urinary tract infections (UTIs) and completed a course of trimethoprim-sulfamethoxazole (TMP/SMX) the week before. A urine test is positive for leukocyte esterase. The NP sends the urine for culture and should treat this patient empirically with:
gemifloxacin.
ciprofloxacin.
azithromycin.
TMP/SMX.
Question 27
2 / 2 pts
A patient who takes carbamazepine (Tegretol) has been seizure-free for 2 years and asks the primary care NP about stopping the medication. The NP should:
order an electroencephalogram (EEG).
prescribe a tapering regimen of the drug.
inform the patient that antiepileptic drug (AED) therapy is lifelong.
tell the patient to stop the drug and use only as needed.
Question 28
2 / 2 pts
A primary care NP has been working with a young woman who wants to quit smoking before she begins having children. She has made several attempts to quit using nicotine replacement therapy and is feeling discouraged. She does not want to take medication at this time. The NP should:
discuss the effects of smoking on fetal development.
ask her to write down any factors that triggered her relapses.
give her information about the long-term effects of smoking.
convince her that taking medication will be essential in her case.
Question 29
2 / 2 pts
A primary care NP prescribes a nonselective NSAID for a patient who has osteoarthritis. The patient expresses concerns about possible side effects of this medication. When counseling the patient about the medication, the NP should tell this patient:
to avoid taking antacids while taking the NSAID.
to take each dose of the NSAID with a full glass of water.
that a few glasses of wine each day are allowed while taking the NSAID.
to decrease the dose of the NSAID if GI symptoms occur.
Question 30
2 / 2 pts
A patient has been taking a COX-2 selective NSAID to treat pain associated with a recent onset of RA. The patient tells the primary care NP that the pain and joint swelling are becoming worse. The patient does not have synovitis or extraarticular manifestations of the disease. The NP will refer the patient to a rheumatologist and should expect the specialist to prescribe:
methotrexate.
corticosteroids.
opioid analgesics.
hydroxychloroquine.
Question 31
2 / 2 pts
A patient has been taking an opioid analgesic for 2 weeks after a minor outpatient procedure. At a follow-up clinic visit, the patient tells the primary care NP that he took extra doses for the past 2 days because of increased pain and wants an early refill of the medication. The NP should suspect:
dependence.
drug addiction.
possible misuse.
increasing pain.
Question 32
2 / 2 pts
An elderly patient with dementia exhibits hostility and uncooperativeness. The primary care NP prescribes clozapine (Clozaril) and should counsel the family about:
a decreased risk of extrapyramidal symptoms.
improved cognitive function.
the need for long-term use of the medication.
a possible increased risk of heart disease and stroke.
Question 33
2 / 2 pts
A patient who was hospitalized for an infection was treated with an aminoglycoside antibiotic. The patient asks the primary care nurse practitioner (NP) why outpatient treatment wasn’t an option. The NP should tell the patient that aminoglycoside antibiotics:
are more likely to be toxic.
cause serious adverse effects.
carry more risk for serious allergic reactions.
must be given intramuscularly or intravenously.
Question 34
2 / 2 pts
A woman who is pregnant tells an NP that she has been taking sertraline for depression for several years but is worried about the effects of this drug on her fetus. The NP will consult with this patient’s psychiatrist and will recommend that she:
stop taking the sertraline now.
continue taking the antidepressant.
change to a monoamine oxidase inhibitor (MAOI).
discontinue the sertraline a week before delivery.
Question 35
2 / 2 pts
A patient who has HIV is being treated with Emtriva. The patient develops hepatitis B. The primary care NP should contact the patient’s infectious disease specialist to discuss:
adding zidovudine.
changing to Truvada.
changing to tenofovir.
ordering Combivir and tenofovir.
Question 36
2 / 2 pts
A patient who was in a motor vehicle accident has been treated for lower back muscle spasms with metaxalone (Skelaxin) for 1 week and reports decreased but persistent pain. A computed tomography scan is normal. The primary care NP should:
suggest ice and rest.
order physical therapy.
prescribe diazepam (Valium).
add an opioid analgesic medication.
Question 37
2 / 2 pts
A primary care NP sees a patient who has dysuria, fever, and urinary frequency. The NP orders a urine dipstick, which is positive for nitrates and leukocyte esterase, and sends the urine to the laboratory for a culture. The patient is allergic to sulfa drugs. The NP should:
order cefaclor (Ceclor).
prescribe cefixime (Suprax).
administer intramuscular ceftriaxone (Rocephin).
wait for culture results before ordering an antibiotic.
Question 38
2 / 2 pts
A patient comes to the clinic several days after an outpatient surgical procedure complaining of swelling and pain at the surgical site. The primary care NP notes a small area of erythema but no abscess or induration. The NP should:
prescribe TMP-SMX.
prescribe topical mupirocin four times daily.
suggest that the patient apply warm soaks three times daily.
refer the patient to the surgeon for further evaluation.
Question 39
2 / 2 pts
A patient who has genital herpes has frequent outbreaks. The patient asks the primary care NP why it is necessary to take oral acyclovir all the time and not just for acute outbreaks. The NP should explain that oral acyclovir may:
prevent the virus from developing resistance.
cause episodes to be shorter and less frequent.
actually eradicate the virus and cure the disease.
reduce the chance of transmitting the virus to others.
Question 40
2 / 2 pts
A patient is taking isoniazid, pyrazinamide, rifampin, and streptomycin to treat TB. The primary care NP should routinely perform:
serum glucose and liver function tests (LFTs).
bone marrow density and ophthalmologic tests.
ophthalmologic, hearing, and serum glucose tests.
color vision, serum glucose, and LFTs.
Question 41
2 / 2 pts
A primary care NP sees a patient who was recently hospitalized for infection and treated with gentamicin for 10 days. The patient tells the NP that the drug was discontinued early because “my blood level was too high.” The NP should order:
a serial audiometric test.
a serum blood urea nitrogen (BUN) and creatinine.
a urinalysis and complete blood count.
serum calcium, magnesium, and sodium.
Question 42
2 / 2 pts
A 40-year-old woman asks the primary care NP what she can do to minimize her risk of osteoporosis. She takes 800 mg of calcium and drinks 2 cups of skim milk each day. The NP should recommend that she:
decrease dietary fat.
limit her caffeine intake.
consume a high-protein diet.
drink diet instead of sugary sodas.
Question 43
2 / 2 pts
A patient has a sore throat with fever. The primary care NP observes erythematous 4+ tonsils with white exudate. A rapid antigen strep test is negative, and a culture is pending. The NP orders amoxicillin as empiric treatment. The patient calls the next day to report a rash. The NP should suspect:
penicillin drug allergy.
a viral cause for the patient’s symptoms.
a serum sickness reaction to the penicillin.
scarlatiniform rash from the streptococcal infection.
Question 44
2 / 2 pts
A patient is taking sulfisoxazole. The patient calls the primary care NP to report abdominal pain, nausea, and insomnia. The NP should:
change to TMP/SMX.
tell the patient to stop taking the drug immediately.
reassure the patient that these are minor adverse effects of this drug.
order a CBC with differential, platelets, and a stool culture.
Question 45
2 / 2 pts
A patient is in the clinic with acute symptoms of anxiety. The patient is restless and has not slept in 3 days. The primary care NP observes that the patient is irritable and has moderate muscle tension. The patient’s spouse reports that similar symptoms have occurred before in varying degrees for several years. The NP should refer the patient to a psychologist and should prescribe which drug for short-term use?
Alprazolam
Buspirone
Melatonin
Zolpidem
Question 46
2 / 2 pts
A woman who takes oral contraceptive pills develops vaginal candidiasis. The primary care NP prescribes a single dose of fluconazole. When counseling the patient about this drug, the NP should tell her:
that the drug is safe if she were to become pregnant.
that she may consume alcohol while taking this medication.
to use a backup contraceptive method for the next 2 months.
that she may need a lower dose of fluconazole because she takes oral contraceptive pills.
Question 47
2 / 2 pts
A patient in the clinic reports taking a handful of acetaminophen extra-strength tablets about 12 hours prior. The patient has nausea, vomiting, malaise, and drowsiness. The patient’s aspartate aminotransferase and alanine aminotransferase are mildly elevated. The primary care NP should:
expect the patient to sustain permanent liver damage.
reassure the patient that these symptoms are reversible.
tell the patient that acetylcysteine cannot be given this late.
administer activated charcoal to remove acetaminophen from the body.
Question 48
2 / 2 pts
An NP sees a preschooler in clinic for the first time. When obtaining a medication history, the NP notes that the child is taking a medication for which safety and effectiveness in children has not been established in drug information literature. The NP should:
discontinue the medication.
order serum drug levels to evaluate toxicity.
report the prescribing provider to the Food and Drug Administration (FDA).
ask the parent about the drug’s use and side effects.
Question 49
2 / 2 pts
A patient who has Parkinson’s disease who takes levodopa and carbidopa reports having drooling episodes that are increasing in frequency. The primary care NP should order:
benztropine.
amantadine.
apomorphine.
modified-release levodopa.
Question 50
2 / 2 pts
The primary care NP sees a 6-month-old infant for a routine physical examination and notes that the infant has a runny nose and a cough. The parents report a 2-day history of a temperature of 99° F to 100° F and two to three loose stools per day. Other family members have similar symptoms. The infant has had two sets of immunizations at 2 and 4 months of age. The NP should:
administer the 6-month immunizations at this visit today.
schedule an appointment in 2 weeks for 6-month immunizations.
administer DTaP, Hib, IPV, hepatitis B, and PCV13 today and RV in 2 weeks.
withhold all immunizations until the infant’s temperature returns to normal and the cough is gone.
Question 51
2 / 2 pts
A patient who was recently hospitalized and treated with gentamicin tells the primary care NP, “My kidney function test was abnormal and they stopped the medication.” The patient is worried about long-term effects. The NP should:
monitor renal function for several months.
reassure the patient that complete recovery should occur.
refer the patient to a nephrologist for follow-up evaluation.
monitor serum electrolytes and serum creatinine and BUN.
Question 52
2 / 2 pts
A patient has begun treatment for HIV. The primary care NP should monitor the patient’s complete blood count (CBC) at least every _____ months.
1 to 3
3 to 6
6 to 9
9 to 12
Question 53
2 / 2 pts
A patient who was recently diagnosed with COPD comes to the clinic for a follow-up evaluation after beginning therapy with a SABA as needed for dyspnea. The patient reports occasional mild exertional dyspnea but is able to sleep well. The patient’s FEV1 in the clinic is 85% of predicted, and oxygen saturation is 96%. The primary care NP should recommend:
a combination LABA/ICS twice daily.
influenza and pneumococcal vaccines.
ipratropium bromide (Atrovent) twice daily.
home oxygen therapy as needed for dyspnea.
Question 54
2 / 2 pts
A patient who takes 150 mg of clozapine (Clozaril) twice daily calls the primary care NP at 10:00 AM one day to report forgetting to take the 8:00 AM dose. The NP should counsel the patient to:
take the missed dose now.
take 75 mg of clozapine now.
wait and take the evening dose at the usual time.
take the evening dose 2 hours earlier than usual.
Question 55
2 / 2 pts
A patient has been taking fluoxetine 20 mg every morning for 5 days and calls the primary care NP to report decreased appetite, nausea, and insomnia. The NP should:
suggest taking a sedative at bedtime.
change the medication to bupropion.
add trazodone to the patient’s regimen.
reassure the patient that these effects will subside.
Question 56
2 / 2 pts
A female patient presents with grayish, odorous vaginal discharge. The primary care NP performs a gynecologic examination and notes vulvar and vaginal erythema. Testing of the discharge reveals a pH of 5.2 and a fishy odor when mixed with a solution of 10% potassium hydroxide. The NP should:
order topical fluconazole.
order metronidazole 500 mg twice daily for 7 days.
withhold treatment until culture results are available.
prescribe a clotrimazole vaginal suppository for 7 days.
Question 57
2 / 2 pts
An 80-year-old patient has a diagnosis of glaucoma, and the ophthalmologist has prescribed timolol (Timoptic) and pilocarpine eye drops. The primary care NP should counsel this patient:
that systemic side effects of these medications may be severe.
that the combination of these two drugs may cause drowsiness.
to begin an exercise program to improve cardiovascular health.
that a higher dose of one or both of these medications may be needed.
Question 58
2 / 2 pts
An 18-month-old child who attends day care has head lice and has been treated with permethrin 1% (Nix). The parent brings the child to the clinic 1 week later, and the primary care NP notes live bugs on the child’s scalp. The NP should order:
lindane.
malathion.
ivermectin.
permethrin 5%.
Question 59
2 / 2 pts
An adult patient who has a viral upper respiratory infection asks the primary care nurse practitioner (NP) about taking acetaminophen for fever and muscle aches. To help ensure against possible drug toxicity, the NP should first:
determine the patient’s height and weight.
ask the patient how high the temperature has been.
tell the patient to take 325 mg initially and increase as needed.
ask the patient about any other over-the-counter (OTC) cold medications being used.
Question 60
2 / 2 pts
The primary care NP follows a patient who is being treated for RA with methotrexate. The patient asks the NP why the medication does not seem to alleviate pain. The NP tells the patient that:
an immunomodulator may be needed to control pain.
a higher dose of methotrexate may be needed to achieve pain control.
if methotrexate does not control pain, an opioid analgesic may be necessary.
methotrexate is used to slow disease progression and preserve joint function.
Question 61
2 / 2 pts
A patient has a UTI and will begin treat
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Nr 509 Week4 Quiz Advanced Physical Assessment Chamberlain 2018 Guaranteed A Answers Good Luck
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1. A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the FNP expect to see during an assessment of this patient?
a. Hard and fixed cervical nodes
b. Enlarged and tender inguinal nodes
c. Bilateral enlargement of the popliteal nodes
d. Pelletlike nodes in the supraclavicular region
2. The direction of blood flow through the heart is best described by which of these
a. Vena cava right atrium right ventricle lungs pulmonary artery left atrium left ventricle
b. Right atrium right ventricle pulmonary artery lungs pulmonary vein left atrium left ventricle
c. Aorta right atrium right ventricle lungs pulmonary vein left atrium left ventricle vena cava
d. Right atrium right ventricle pulmonary vein lungs pulmonary artery left atrium left ventricle
3. In assessing the carotid arteries of an older patient with cardiovascular disease, the FNP would
a. Palpate the artery in the upper one third of the neck.
b. Listen with the bell of the stethoscope to assess for bruits.
c. Simultaneously palpate both arteries to compare amplitude.
d. Instruct the patient to take slow deep breaths during auscultation.
4. When listening to heart sounds the FNP knows that the valve closures that can be heard best at the base of the heart are
a. mitral, tricuspid.
b. tricuspid, aortic.
c. aortic, pulmonic.
d. mitral, pulmonic.
5. The sack that surrounds and protects the heart is called the
a. pericardium.
b. myocardium.
c. endocardium.
d. pleural space.
6. When assessing a newborn infant who is five minutes old the FNP knows that which of these statements would be true?
a. The left ventricle is larger and weighs more than the right.
b. The circulation of a newborn is identical to that of an adult.
c. There is an opening in the atrial septum where blood can flow into the left side of the heart.
d. The foramen ovale closes just minutes before birth and the ductus arteriosus closes immediately after.
7. The FNP is performing an assessment on an adult. The adults vital signs are normal and capillary refill is five seconds. What should the FNP do next?
a. ask the parent if the child has had frostbite in the past.
b. suspect that the child has a venous insufficiency problem.
c. consider this a delayed capillary refill time and investigate further.
d. consider this a normal capillary refill time that requires no further assessment.
8. During an assessment of an older adult the FNP should expect to notice which finding as normal physiologic change associated with aging process?
a. Hormonal changes causing vasodilation and a resulting drop in blood pressure
b. Progressive atrophy of the intramuscular calf veins, causing venous insufficiency
c. Peripheral blood vessels growing more rigid with age, producing a rise in systolic blood pressure
d. Narrowing of the inferior vena cava, causing low blood flow and increases in venous pressure resulting in varicosities
9. The mother of a three month old infant states that her baby has not been gaining weight. With further questioning the FNP finds that the infant falls asleep after nursing and wakes up after a short amount of time hungry again. What other information with the FNP want to have?
a. The position that baby sleeps in
b. Sibling history of eating disorders
c. Amount of background noise when eating
d. Presence of dyspnea or diaphoresis when sucking
10. In assessing a patient’s major risk factors for heart disease which would the FNP want to include when taking a history?
a. Family history, hypertension, stress, age
b. Personality type, high cholesterol, diabetes, smoking
c. Smoking, hypertension, obesity, diabetes, high cholesterol
d. Alcohol consumption, obesity, diabetes, stress, high cholesterol
11. The FNP is assessing… the pulses of a patient who has been admitted for untreated hyperthyroidism. The FNP should expect to find a—— pulse
a. normal
b. absent
c. bounding
d. weak, thread
12. A patient complains of leg pain that wakes him at night. He states that he has been having problems with his legs. He has pain in his legs his legs when they are elevated, which disappears when he dangles them. He recently noticed a sore on the inner aspect of his right ankle. On the basis of this history information the FNP interprets that the patient is most likely experiencing
a. pain related to lymphatic abnormalities.
b. problems related to arterial insufficiency.
c. problems related to venous insufficiency.
d. pain related to musculoskeletal abnormalities.
13. During an assessment the FNP uses the profile sign to detect
a. Pitting edema.
b. Early clubbing.
c. Symmetry of the fingers.
d. Insufficient capillary refill.
14. Which of these statements describes the closure of the valves in a normal cardiac cycle?
a. The aortic valve closes slightly before the tricuspid valve.
b. The pulmonic valve closes slightly before the aortic valve.
c. The tricuspid valve closes slightly later than the mitral valve.
d. Both the tricuspid and pulmonic valves close at the same time.
15. When performing a peripheral vascular assessment on a patient the FNP is unable to palpate the ulnar pulses. The patient skin is warm and capillary refill is normal. The FNP should next
a. check for the presence of claudication.
b. refer the individual for further evaluation.
c. consider this a normal finding and proceed with the peripheral vascular evaluation.
d. ask the patient if he or she has experienced any unusual cramping or tingling in the arm.
16. A 67-year-old patient states that he “recently began have pain in his left calf when climbing the 10 stairs to his apartment”. This pain is relieved by sitting for about two minutes then he’s able to resume activities. The FNP interprets this patient is most likely experiencing
a. Claudication.
b. Sore muscles.
c. Muscle cramps.
d. Venous insufficiency.
17. In assessing a 70-year-old man the FNP finds the following blood pressure 140/100 mmHg, heart rate 104 and slightly irregular, split S2. Which of these findings can… by expected hemodynamic changes related to age?
a. Increase in resting heart rate
b. Increase in systolic blood pressure
c. Decrease in diastolic blood pressure
d. Increase in diastolic blood pressure
18. The FNP is examining the lymphatic system of a healthy three year old child. Which finding should the FNP expect?
a. Excessive swelling of the lymph nodes
b. The presence of palpable lymph nodes
c. No nodes palpable because of the immature immune system of a child
d. Fewer numbers and a decrease in size of lymph nodes compared with those of an adult
19. The FNP is preparing to perform modified Allen test. Which is an appropriate reason for this test?
a. To measure the rate of lymphatic drainage
b. To evaluate the adequacy of capillary patency before venous blood draws
c. To evaluate the adequacy of collateral circulation before cannulating the radial artery
d. To evaluate the venous refill rate that occurs after the ulnar and radial arteries are temporarily occluded
20. A 25-year-old woman is in her fifth month of pregnancy has a blood pressure of 100/70 mmHg. In reviewing her previous exam the FNP notes that her blood pressure in her second month was 124/80 mmHg. When evaluating this change what does the FNP know to be true?
a. This is the result of peripheral vasodilatation and is an expected change.
b. Because of increased cardiac output, the blood pressure should be higher this time.
c. This is not an expected finding because it would mean a decreased cardiac output.
d. This would mean a decrease in circulating blood volume, which is dangerous for the fetus
21. Findings from an assessment of a 70-year-old patient with swelling in his ankles include jugular venous pusations, 5 cm above the sternal angle when the head of his bed is eleveted 45°. The FNP knows that this finding indicate:
a. Decreased fluid volume.
b. Increased cardiac output.
c. Narrowing of jugular veins.
d. Elevated pressure related to heart failure.
22. The component of the conduction system referred to as the pacemaker of the heart is the
a. Atrioventricular (AV) node.
b. Sinoatrial (SA) node.
c. Bundle of His.
d. Bundle branches.
23. The FNP is reviewing anatomy and physiology of the heart. Which statement best describes by atrial kick?
a. The atria contract during systole and attempt to push against closed valves.
b. Contraction of the atria at the beginning of diastole can be felt as a palpitation.
c. Atrial kick is the pressure exerted against the atria as the ventricles contract during systole.
d. The atria contract toward the end of diastole and push the remaining blood into the ventricles.
24. A 45-year-old man is in the clinic for a routine physical. During history the patient states he has been having difficulty sleeping. I’ll be sleeping great and then I wake up and feel like I can’t catch my breath. The FNP‘s best response to this would be
a. “When was your last electrocardiogram?”
b. “It’s probably because it’s been so hot at night.”
c. “Do you have any history of problems with your heart?”
d. “Have you had a recent sinus infection or upper respiratory infection?”
25. When assessing a patient the FNP notes that the left femoral pulse as diminished 1 /4 . What should the FNP do next?
Auscultate the site for a bruit.
NR 509 Week4 Quiz Advanced Physical Assessment Chamberlain (2018)…GUARANTEED A+ ANSWERS! GOOD LUCK
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NR 509 Week 4 Quiz Advanced Physical Assessment Chamberlain (Spring 2018)…GUARANTEED A+ ANSWERS! GOOD LUCK
1. A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the FNP expect to see during an assessment of this patient?
a. Hard and fixed …
NR 509 Week4 Quiz Advanced Physical Assessment Chamberlain (2018)…GUARANTEED A+
1. A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the FNP expect to see during an assessment of this patient?
a. Hard and fixed …
NR 509 Week 4 Quiz Advanced Physical Assessment Chamberlain (Spring 2018)
1. A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the FNP expect to see during an assessment of this patient?
a. Hard and …
NR 509 Week 4 Quiz Advanced Physical Assessment(Spring 2018)…GUARANTEED A+
1. A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the FNP expect to see during an assessment of this patient?
a. Hard and fixed …
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Nr 511 Week 4 Midterm Exam Version 1 18749337
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NR 511 Week 4 Midterm Exam Version 1
Question 1: Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the literature with ratings of available evidence
c. Conducting an external review of a guideline
d. Developing evidence-based tables
Question 2: African American patients seem to have a negative reaction to which of the following asthma medications?
a. Inhaled corticosteroids
b. Long-term beta-agonist bronchodilators
c. Leukotriene receptor agonist
d. Oral corticosteroid
Question 3: Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?
a. The tumor size cannot be evaluated, the cancer has not spread to the lymph nodes, and the distant spread cannot be evaluated.
b. The cancer is in situ, it is spreading into the lymph nodes, but the spread otherwise cannot be evaluated.
c. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.
d. The cancer is about 5 cm in size, nearby lymph nodes cannot be evaluated, and there is no evidence of distant spreading.
Question 4: Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?
a. Meclizine
b. Diphenhydramine
c. Diamox
d. Promethazine
Question 5: Mandy presents with a cauliflower-like wart that is in her anogenital region. You suspect it was sexually transmitted and document this as a:
a. Filiform/digitate wart.
b. Dysplastic cervical lesion.
c. Condyloma accuminata.
d. Koilocytosis.
Question 6: Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?
a. Dementia
b. Alzheimer’s disease
c. Parkinson’s disease
d. Delirium
Question 7: You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?
a. “Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow.”
b. “Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow.”
c. “Drive to the emergency room (ER) now.”
d. “Call 911.”
Question 8: A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
a. NSAIDs
b. Beets
c. Vitamin A
d. Red meat
Question 9: Which of the following is an example of tertiary prevention in a patient with chronic renal failure?
a. Fluid restriction
b. Hemodialysis 4 days a week
c. High-protein diet
d. Maintain blood pressure at 120/80
Question 10: Which of the following conditions is associated with cigarette smoking?
a. Glaucoma
b. Increased sperm quality
c. Bladder cancer
d. Eczema
Question 11: A chronic cough lasts longer than:
a. 3 weeks
b. 1 month
c. 6 months
d. 1 year
Question 12: The ‘freezing phenomenon’ is a cardinal feature of?
a.Parkinson’s disease
b. Alzheimer’s disease
c. A CVA
d. Bell’s palsy
Question 13: When administered at the beginning of an attack, oxygen therapy may help this kind of headache?
a. Tension
b. Migraine
c. Cluster
d. Stress
Question 14: Which ethnic group has the highest lung cancer incidence and mortality rates?
a. African American men
b. Scandinavian men and women
c. Caucasian women
d. Asian men
Question 15: The most significant precipitating event leading to otitis media with effusion is:
a. Pharyngitis
b. Allergies
c. Viral upper respiratory infection (URI)
d. Perforation of the eardrum
Question 16: Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:
a. Severe asthma.
b. A common valvular lesion.
c. Severe hypertension.
d. A previous coronary artery bypass graft (CABG).
Question 17: A 34-year-old patient was treated for a urinary tract infection (UTI) and has not responded to antibiotic therapy. Which of the following actions should be taken next?
a. Send a urine specimen for microscopy looking for fungal colonies.
b. Increase the dose of antibiotic.
c. Order a cytoscopy.
d. Order a different antibiotic.
Question 18: Which statement best describes a carotid bruit?
a. It is felt with the middle three fingers over the carotid artery.
b. A bruit becomes audible when the lumen is narrowed to 1 mm or less.
c. A low-pitched bruit is a medical emergency.
d. The higher the pitch of the bruit, the higher the degree of stenosis.
Question 19: Which statement is true regarding chloasma, the ‘mask of pregnancy’?
a. It is caused by a decrease in the melanocyte-stimulating hormone duringpregnancy.
b. This condition only occurs on the face.
c. Exposure to sunlight will even out the discoloration.
d. It is caused by increased levels of estrogen and progesterone.
Question 20: Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?
a. “You must be under a lot of stress lately.”
b. “It is hereditary. Did your father experience this also?”
c. “The cause is unknown, but we suspect it is due to an immunologic mechanism.”
d. “We’ll have to do some tests.”
Question 21: A blood pressure (BP) of 150/90 is considered:
a. Stage 2 hypertension
b. Hypertensive
c. Normal in healthy older adults
d. Acceptable if the patient has DM
Question 22: When teaching post MI patients about their NTG tablets, theclinician should stress that the tablets should remain in thelight-resistant bottle in which they are packaged and shouldnot be put in another pill box or remain in areas that are orcould become warm and humid. Once opened, the bottlemust be dated and discarded after how many months?
a. 1 month
b. 3 months
c. 6 months
d. As long as the tablets are kept in this special bottle, they will last forever
Question 23: Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?
a. He should stop smoking today.
b. He should stop smoking tomorrow.
c. His quit date should be in 1 week.
d. He will be ready to quit after the Frst 30 days
Question 24: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?
a. Spores
c. Pseudohyphae
b. Leukocytes
d. Epithelial cells
Question 25: The hallmark of an absence seizure is:
a. No activity at all.
b. A blank stare.
c. Urine is usually voided involuntarily.
d. The attack usually lasts several minutes.
Question 26: Which medication used for scabies is safe for children 2 months and older?
a. Permethrin cream
b. Lindane
c. Crotamiton lotion and cream
d. Ivermectin
Question 27: The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?
a. Viral conjunctivitis
b. Keratoconjunctivitis
c. Bacterial conjunctivitis
d. Allergic conjunctivitis
Question 28: Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?
a. “Most patients have complete recovery in a few weeks to a few months.”
b. “Unfortunately, you’ll probably have a small amount of residual damage.”
c. “Don’t worry, I’ll take care of everything.”
d. “You may have a few more episodes over the course of your lifetime but no permanent damage.”
Question 29: How often should drug levels be monitored when a seizure medication has controlled the seizures and the drug level is adequate
a. Every 3 months
b. Every 6 months
c. Annually
d. Whenever there is a problem
Question 30: Immunizations are an example of which type of prevention?
a. Primary
b. Secondary
c. Tertiary
Question 31: The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?
a. Repeat the test.
b. Refer to a nephrologist.
c. Measure the serum protein.
d. Obtain a blood urea nitrogen (BUN) and creatinine.
Question 32: Which cranial nerve is afected in a patient with acerebrovascular accident who has difficulty chewing?
a. CN V
b. CN VII
c. CN IX
d. CN X
Question 33: Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer?
a. KUB (kidneys, ureter, bladder) x-ray
b. Cystoscopy with biopsy
c. Magnetic resonance imaging (MRI)
d. Urine tumor marker (NMP22)
Question 34: The “B” in the ABCDEs of assessing skin cancer represents:
a. Biopsy.
b. Best practice.
c. Boundary.
d. Border irregularity.
Question 35: Which statement is true regarding driving and patients with a seizure disorder?
a. Once diagnosed with a seizure disorder, patients mustnever drive again.
b. After being seizure free for 6 months, patients may drive.
c. Each state has diferent laws governing driving forindividuals with a seizure disorder.
d. These persons may drive but never alone.
Question 36: Which high-density lipoprotein (HDL) level is considered cardioprotective?
a. Greater than 30
b. Greater than 40
c. Greater than 50
d. Greater than 60
Question 37: The most common etiologic organism for community-acquired pneumonia is:
A. Streptococcus pneumoniae
B. Beta hemolytic streptococcus
C. Mycoplasma
D. Methicillin resistant staphylococcus
Question 38: Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?
a. Serum calcium
b. Electrocardiogram (ECG)
c. Thyroid-stimulating hormone test
d. Complete blood cell count
Question 39: A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?
a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.
b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.
c. A throat culture should be performed to confirm the results of the rapid strep test.
d. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.
Question 40: Patients with acute otitis media should be referred to a specialist in which of the following situations?
a. Concurrent vertigo or ataxia
b. Failed closure of a ruptured tympanic membrane
c. If symptoms worsen after 3 or 4 days of treatment
d. All of the above
Question 41: Which of the following tests is most useful in determining renal function in a patient suspected of chronic renal failure (CRF)?
a. Blood urea nitrogen (BUN) and creatinine
b. Electrolytes
c. Creatinine clearance
d. Urinalysis
Question 42: Marci has a wart on her hand. She says she heard something about “silver duct tape therapy.” What do you tell her about his?
a. It is an old wives’ tale.
b. It is used as a last resort.
c. Salicylic acid is more effective.
d. It is a simple treatment that should be tried first.
Question 43: What is the first-line recommended treatment against Group A b-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?
a. Penicillin
b. Quinolone
c. Cephalosporin
d. Macrolide
Question 44: Which of the following is an example of sensorineural hearing loss?
a. Perforation of the tympanic membrane
b. Otosclerosis
c. Cholesteatoma
d. Presbycusis
Question 45: Which of the following is “a linear crack extending from the epidermis to the dermis?”
a. An ulcer
b. A fissure
c. Lichenification
d. An excoriation
Question 46: A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night visio0n, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?
a. The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.
b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.
c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist.
d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.
Question 47: The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?
a. IgA
b. IgE
c. IgG
d. IgM
Question 48: A patient is seen with a sudden onset of ±ank painaccompanied by nausea, vomiting, and diaphoresis. Inaddition to nephrolithiasis, which of the following should beadded to the list of diferential diagnoses?
a. Pancreatitis
b. Peptic ulcer disease
c. Diverticulitis
d. All of the above
Question 49: Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?
a. B-type natriuretic peptide
b. C-reactive protein
c. Serum albumin
d. Erythrocyte sedimentation rate
Question 50: You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?
a. Baker phenomenon
b. Arnold reflex
c. cough reflex
d. Tragus reflex
Perfect answer to all questions
Purchase the answer to view it
Try it first(plagiarism check)Buy tutorial $25Save time and money!
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NR 511 Week 4 Midterm Exam Version 1
NR 511 Week 4 Midterm Exam Version 1
Question 1: Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the …
NR 511 Week 4 Midterm (Exam Version 1)
Question 1: Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the literature with ratings of available …
Blog ArchiveCopyright © 2019 HomeworkMarket.com Read More
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
Nr 511 Week 4 Midterm Exam Version 1 18749341
/in Uncategorized /by developerReport Issue
NR 511 Week 4 Midterm Exam Version 1
Question 1: Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the literature with ratings of available evidence
c. Conducting an external review of a guideline
d. Developing evidence-based tables
Question 2: African American patients seem to have a negative reaction to which of the following asthma medications?
a. Inhaled corticosteroids
b. Long-term beta-agonist bronchodilators
c. Leukotriene receptor agonist
d. Oral corticosteroid
Question 3: Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?
a. The tumor size cannot be evaluated, the cancer has not spread to the lymph nodes, and the distant spread cannot be evaluated.
b. The cancer is in situ, it is spreading into the lymph nodes, but the spread otherwise cannot be evaluated.
c. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.
d. The cancer is about 5 cm in size, nearby lymph nodes cannot be evaluated, and there is no evidence of distant spreading.
Question 4: Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?
a. Meclizine
b. Diphenhydramine
c. Diamox
d. Promethazine
Question 5: Mandy presents with a cauliflower-like wart that is in her anogenital region. You suspect it was sexually transmitted and document this as a:
a. Filiform/digitate wart.
b. Dysplastic cervical lesion.
c. Condyloma accuminata.
d. Koilocytosis.
Question 6: Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?
a. Dementia
b. Alzheimer’s disease
c. Parkinson’s disease
d. Delirium
Question 7: You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?
a. “Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow.”
b. “Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow.”
c. “Drive to the emergency room (ER) now.”
d. “Call 911.”
Question 8: A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
a. NSAIDs
b. Beets
c. Vitamin A
d. Red meat
Question 9: Which of the following is an example of tertiary prevention in a patient with chronic renal failure?
a. Fluid restriction
b. Hemodialysis 4 days a week
c. High-protein diet
d. Maintain blood pressure at 120/80
Question 10: Which of the following conditions is associated with cigarette smoking?
a. Glaucoma
b. Increased sperm quality
c. Bladder cancer
d. Eczema
Question 11: A chronic cough lasts longer than:
a. 3 weeks
b. 1 month
c. 6 months
d. 1 year
Question 12: The ‘freezing phenomenon’ is a cardinal feature of?
a.Parkinson’s disease
b. Alzheimer’s disease
c. A CVA
d. Bell’s palsy
Question 13: When administered at the beginning of an attack, oxygen therapy may help this kind of headache?
a. Tension
b. Migraine
c. Cluster
d. Stress
Question 14: Which ethnic group has the highest lung cancer incidence and mortality rates?
a. African American men
b. Scandinavian men and women
c. Caucasian women
d. Asian men
Question 15: The most significant precipitating event leading to otitis media with effusion is:
a. Pharyngitis
b. Allergies
c. Viral upper respiratory infection (URI)
d. Perforation of the eardrum
Question 16: Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:
a. Severe asthma.
b. A common valvular lesion.
c. Severe hypertension.
d. A previous coronary artery bypass graft (CABG).
Question 17: A 34-year-old patient was treated for a urinary tract infection (UTI) and has not responded to antibiotic therapy. Which of the following actions should be taken next?
a. Send a urine specimen for microscopy looking for fungal colonies.
b. Increase the dose of antibiotic.
c. Order a cytoscopy.
d. Order a different antibiotic.
Question 18: Which statement best describes a carotid bruit?
a. It is felt with the middle three fingers over the carotid artery.
b. A bruit becomes audible when the lumen is narrowed to 1 mm or less.
c. A low-pitched bruit is a medical emergency.
d. The higher the pitch of the bruit, the higher the degree of stenosis.
Question 19: Which statement is true regarding chloasma, the ‘mask of pregnancy’?
a. It is caused by a decrease in the melanocyte-stimulating hormone duringpregnancy.
b. This condition only occurs on the face.
c. Exposure to sunlight will even out the discoloration.
d. It is caused by increased levels of estrogen and progesterone.
Question 20: Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?
a. “You must be under a lot of stress lately.”
b. “It is hereditary. Did your father experience this also?”
c. “The cause is unknown, but we suspect it is due to an immunologic mechanism.”
d. “We’ll have to do some tests.”
Question 21: A blood pressure (BP) of 150/90 is considered:
a. Stage 2 hypertension
b. Hypertensive
c. Normal in healthy older adults
d. Acceptable if the patient has DM
Question 22: When teaching post MI patients about their NTG tablets, theclinician should stress that the tablets should remain in thelight-resistant bottle in which they are packaged and shouldnot be put in another pill box or remain in areas that are orcould become warm and humid. Once opened, the bottlemust be dated and discarded after how many months?
a. 1 month
b. 3 months
c. 6 months
d. As long as the tablets are kept in this special bottle, they will last forever
Question 23: Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?
a. He should stop smoking today.
b. He should stop smoking tomorrow.
c. His quit date should be in 1 week.
d. He will be ready to quit after the Frst 30 days
Question 24: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?
a. Spores
c. Pseudohyphae
b. Leukocytes
d. Epithelial cells
Question 25: The hallmark of an absence seizure is:
a. No activity at all.
b. A blank stare.
c. Urine is usually voided involuntarily.
d. The attack usually lasts several minutes.
Question 26: Which medication used for scabies is safe for children 2 months and older?
a. Permethrin cream
b. Lindane
c. Crotamiton lotion and cream
d. Ivermectin
Question 27: The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?
a. Viral conjunctivitis
b. Keratoconjunctivitis
c. Bacterial conjunctivitis
d. Allergic conjunctivitis
Question 28: Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?
a. “Most patients have complete recovery in a few weeks to a few months.”
b. “Unfortunately, you’ll probably have a small amount of residual damage.”
c. “Don’t worry, I’ll take care of everything.”
d. “You may have a few more episodes over the course of your lifetime but no permanent damage.”
Question 29: How often should drug levels be monitored when a seizure medication has controlled the seizures and the drug level is adequate
a. Every 3 months
b. Every 6 months
c. Annually
d. Whenever there is a problem
Question 30: Immunizations are an example of which type of prevention?
a. Primary
b. Secondary
c. Tertiary
Question 31: The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?
a. Repeat the test.
b. Refer to a nephrologist.
c. Measure the serum protein.
d. Obtain a blood urea nitrogen (BUN) and creatinine.
Question 32: Which cranial nerve is afected in a patient with acerebrovascular accident who has difficulty chewing?
a. CN V
b. CN VII
c. CN IX
d. CN X
Question 33: Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer?
a. KUB (kidneys, ureter, bladder) x-ray
b. Cystoscopy with biopsy
c. Magnetic resonance imaging (MRI)
d. Urine tumor marker (NMP22)
Question 34: The “B” in the ABCDEs of assessing skin cancer represents:
a. Biopsy.
b. Best practice.
c. Boundary.
d. Border irregularity.
Question 35: Which statement is true regarding driving and patients with a seizure disorder?
a. Once diagnosed with a seizure disorder, patients mustnever drive again.
b. After being seizure free for 6 months, patients may drive.
c. Each state has diferent laws governing driving forindividuals with a seizure disorder.
d. These persons may drive but never alone.
Question 36: Which high-density lipoprotein (HDL) level is considered cardioprotective?
a. Greater than 30
b. Greater than 40
c. Greater than 50
d. Greater than 60
Question 37: The most common etiologic organism for community-acquired pneumonia is:
A. Streptococcus pneumoniae
B. Beta hemolytic streptococcus
C. Mycoplasma
D. Methicillin resistant staphylococcus
Question 38: Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?
a. Serum calcium
b. Electrocardiogram (ECG)
c. Thyroid-stimulating hormone test
d. Complete blood cell count
Question 39: A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?
a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.
b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.
c. A throat culture should be performed to confirm the results of the rapid strep test.
d. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.
Question 40: Patients with acute otitis media should be referred to a specialist in which of the following situations?
a. Concurrent vertigo or ataxia
b. Failed closure of a ruptured tympanic membrane
c. If symptoms worsen after 3 or 4 days of treatment
d. All of the above
Question 41: Which of the following tests is most useful in determining renal function in a patient suspected of chronic renal failure (CRF)?
a. Blood urea nitrogen (BUN) and creatinine
b. Electrolytes
c. Creatinine clearance
d. Urinalysis
Question 42: Marci has a wart on her hand. She says she heard something about “silver duct tape therapy.” What do you tell her about his?
a. It is an old wives’ tale.
b. It is used as a last resort.
c. Salicylic acid is more effective.
d. It is a simple treatment that should be tried first.
Question 43: What is the first-line recommended treatment against Group A b-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?
a. Penicillin
b. Quinolone
c. Cephalosporin
d. Macrolide
Question 44: Which of the following is an example of sensorineural hearing loss?
a. Perforation of the tympanic membrane
b. Otosclerosis
c. Cholesteatoma
d. Presbycusis
Question 45: Which of the following is “a linear crack extending from the epidermis to the dermis?”
a. An ulcer
b. A fissure
c. Lichenification
d. An excoriation
Question 46: A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night visio0n, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?
a. The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.
b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.
c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist.
d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.
Question 47: The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?
a. IgA
b. IgE
c. IgG
d. IgM
Question 48: A patient is seen with a sudden onset of ±ank painaccompanied by nausea, vomiting, and diaphoresis. Inaddition to nephrolithiasis, which of the following should beadded to the list of diferential diagnoses?
a. Pancreatitis
b. Peptic ulcer disease
c. Diverticulitis
d. All of the above
Question 49: Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?
a. B-type natriuretic peptide
b. C-reactive protein
c. Serum albumin
d. Erythrocyte sedimentation rate
Question 50: You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?
a. Baker phenomenon
b. Arnold reflex
c. cough reflex
d. Tragus reflex
Perfect answer to all questions
Purchase the answer to view it
Try it first(plagiarism check)Buy tutorial $30Save time and money!
Our teachers already did such homework, use it as a reference!
NR 511 Week 4 Midterm Exam Version 1
NR 511 Week 4 Midterm Exam Version 1
Question 1: Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the …
NR 511 Week 4 Midterm (Exam Version 1)
Question 1: Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the literature with ratings of available …
Blog ArchiveCopyright © 2019 HomeworkMarket.com Read More
"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"
Nr 511 Week 4 Midterm Exam Version 1 2 3 And 5 18749343
/in Uncategorized /by developerReport Issue
NR 511 Week 4 Midterm Exam Version 1, 2, 3 & 5
Version 1
Question 1: Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the literature with ratings of available evidence
c. Conducting an external review of a guideline
d. Developing evidence-based tables
Question 2: African American patients seem to have a negative reaction to which of the following asthma medications?
a. Inhaled corticosteroids
b. Long-term beta-agonist bronchodilators
c. Leukotriene receptor agonist
d. Oral corticosteroid
Question 3: Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?
a. The tumor size cannot be evaluated, the cancer has not spread to the lymph nodes, and the distant spread cannot be evaluated.
b. The cancer is in situ, it is spreading into the lymph nodes, but the spread otherwise cannot be evaluated.
c. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.
d. The cancer is about 5 cm in size, nearby lymph nodes cannot be evaluated, and there is no evidence of distant spreading.
Question 4: Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?
a. Meclizine
b. Diphenhydramine
c. Diamox
d. Promethazine
Question 5: Mandy presents with a cauliflower-like wart that is in her anogenital region. You suspect it was sexually transmitted and document this as a:
a. Filiform/digitate wart.
b. Dysplastic cervical lesion.
c. Condyloma accuminata.
d. Koilocytosis.
Question 6: Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?
a. Dementia
b. Alzheimer’s disease
c. Parkinson’s disease
d. Delirium
Question 7: You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?
a. “Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow.”
b. “Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow.”
c. “Drive to the emergency room (ER) now.”
d. “Call 911.”
Question 8: A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
a. NSAIDs
b. Beets
c. Vitamin A
d. Red meat
Question 9: Which of the following is an example of tertiary prevention in a patient with chronic renal failure?
a. Fluid restriction
b. Hemodialysis 4 days a week
c. High-protein diet
d. Maintain blood pressure at 120/80
Question 10: Which of the following conditions is associated with cigarette smoking?
a. Glaucoma
b. Increased sperm quality
c. Bladder cancer
d. Eczema
Question 11: A chronic cough lasts longer than:
a. 3 weeks
b. 1 month
c. 6 months
d. 1 year
Question 12: The ‘freezing phenomenon’ is a cardinal feature of?
a.Parkinson’s disease
b. Alzheimer’s disease
c. A CVA
d. Bell’s palsy
Question 13: When administered at the beginning of an attack, oxygen therapy may help this kind of headache?
a. Tension
b. Migraine
c. Cluster
d. Stress
Question 14: Which ethnic group has the highest lung cancer incidence and mortality rates?
a. African American men
b. Scandinavian men and women
c. Caucasian women
d. Asian men
Question 15: The most significant precipitating event leading to otitis media with effusion is:
a. Pharyngitis
b. Allergies
c. Viral upper respiratory infection (URI)
d. Perforation of the eardrum
Question 16: Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:
a. Severe asthma.
b. A common valvular lesion.
c. Severe hypertension.
d. A previous coronary artery bypass graft (CABG).
Question 17: A 34-year-old patient was treated for a urinary tract infection (UTI) and has not responded to antibiotic therapy. Which of the following actions should be taken next?
a. Send a urine specimen for microscopy looking for fungal colonies.
b. Increase the dose of antibiotic.
c. Order a cytoscopy.
d. Order a different antibiotic.
Question 18: Which statement best describes a carotid bruit?
a. It is felt with the middle three fingers over the carotid artery.
b. A bruit becomes audible when the lumen is narrowed to 1 mm or less.
c. A low-pitched bruit is a medical emergency.
d. The higher the pitch of the bruit, the higher the degree of stenosis.
Question 19: Which statement is true regarding chloasma, the ‘mask of pregnancy’?
a. It is caused by a decrease in the melanocyte-stimulating hormone duringpregnancy.
b. This condition only occurs on the face.
c. Exposure to sunlight will even out the discoloration.
d. It is caused by increased levels of estrogen and progesterone.
Question 20: Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?
a. “You must be under a lot of stress lately.”
b. “It is hereditary. Did your father experience this also?”
c. “The cause is unknown, but we suspect it is due to an immunologic mechanism.”
d. “We’ll have to do some tests.”
Question 21: A blood pressure (BP) of 150/90 is considered:
a. Stage 2 hypertension
b. Hypertensive
c. Normal in healthy older adults
d. Acceptable if the patient has DM
Question 22: When teaching post MI patients about their NTG tablets, theclinician should stress that the tablets should remain in thelight-resistant bottle in which they are packaged and shouldnot be put in another pill box or remain in areas that are orcould become warm and humid. Once opened, the bottlemust be dated and discarded after how many months?
a. 1 month
b. 3 months
c. 6 months
d. As long as the tablets are kept in this special bottle, they will last forever
Question 23: Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?
a. He should stop smoking today.
b. He should stop smoking tomorrow.
c. His quit date should be in 1 week.
d. He will be ready to quit after the Frst 30 days
Question 24: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?
a. Spores
c. Pseudohyphae
b. Leukocytes
d. Epithelial cells
Question 25: The hallmark of an absence seizure is:
a. No activity at all.
b. A blank stare.
c. Urine is usually voided involuntarily.
d. The attack usually lasts several minutes.
Question 26: Which medication used for scabies is safe for children 2 months and older?
a. Permethrin cream
b. Lindane
c. Crotamiton lotion and cream
d. Ivermectin
Question 27: The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?
a. Viral conjunctivitis
b. Keratoconjunctivitis
c. Bacterial conjunctivitis
d. Allergic conjunctivitis
Question 28: Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?
a. “Most patients have complete recovery in a few weeks to a few months.”
b. “Unfortunately, you’ll probably have a small amount of residual damage.”
c. “Don’t worry, I’ll take care of everything.”
d. “You may have a few more episodes over the course of your lifetime but no permanent damage.”
Question 29: How often should drug levels be monitored when a seizure medication has controlled the seizures and the drug level is adequate
a. Every 3 months
b. Every 6 months
c. Annually
d. Whenever there is a problem
Question 30: Immunizations are an example of which type of prevention?
a. Primary
b. Secondary
c. Tertiary
Question 31: The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?
a. Repeat the test.
b. Refer to a nephrologist.
c. Measure the serum protein.
d. Obtain a blood urea nitrogen (BUN) and creatinine.
Question 32: Which cranial nerve is afected in a patient with acerebrovascular accident who has difficulty chewing?
a. CN V
b. CN VII
c. CN IX
d. CN X
Question 33: Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer?
a. KUB (kidneys, ureter, bladder) x-ray
b. Cystoscopy with biopsy
c. Magnetic resonance imaging (MRI)
d. Urine tumor marker (NMP22)
Question 34: The “B” in the ABCDEs of assessing skin cancer represents:
a. Biopsy.
b. Best practice.
c. Boundary.
d. Border irregularity.
Question 35: Which statement is true regarding driving and patients with a seizure disorder?
a. Once diagnosed with a seizure disorder, patients mustnever drive again.
b. After being seizure free for 6 months, patients may drive.
c. Each state has diferent laws governing driving forindividuals with a seizure disorder.
d. These persons may drive but never alone.
Question 36: Which high-density lipoprotein (HDL) level is considered cardioprotective?
a. Greater than 30
b. Greater than 40
c. Greater than 50
d. Greater than 60
Question 37: The most common etiologic organism for community-acquired pneumonia is:
A. Streptococcus pneumoniae
B. Beta hemolytic streptococcus
C. Mycoplasma
D. Methicillin resistant staphylococcus
Question 38: Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?
a. Serum calcium
b. Electrocardiogram (ECG)
c. Thyroid-stimulating hormone test
d. Complete blood cell count
Question 39: A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?
a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.
b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.
c. A throat culture should be performed to confirm the results of the rapid strep test.
d. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.
Question 40: Patients with acute otitis media should be referred to a specialist in which of the following situations?
a. Concurrent vertigo or ataxia
b. Failed closure of a ruptured tympanic membrane
c. If symptoms worsen after 3 or 4 days of treatment
d. All of the above
Question 41: Which of the following tests is most useful in determining renal function in a patient suspected of chronic renal failure (CRF)?
a. Blood urea nitrogen (BUN) and creatinine
b. Electrolytes
c. Creatinine clearance
d. Urinalysis
Question 42: Marci has a wart on her hand. She says she heard something about “silver duct tape therapy.” What do you tell her about his?
a. It is an old wives’ tale.
b. It is used as a last resort.
c. Salicylic acid is more effective.
d. It is a simple treatment that should be tried first.
Question 43: What is the first-line recommended treatment against Group A b-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?
a. Penicillin
b. Quinolone
c. Cephalosporin
d. Macrolide
Question 44: Which of the following is an example of sensorineural hearing loss?
a. Perforation of the tympanic membrane
b. Otosclerosis
c. Cholesteatoma
d. Presbycusis
Question 45: Which of the following is “a linear crack extending from the epidermis to the dermis?”
a. An ulcer
b. A fissure
c. Lichenification
d. An excoriation
Question 46: A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night visio0n, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?
a. The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.
b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.
c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist.
d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.
Question 47: The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?
a. IgA
b. IgE
c. IgG
d. IgM
Question 48: A patient is seen with a sudden onset of ±ank painaccompanied by nausea, vomiting, and diaphoresis. Inaddition to nephrolithiasis, which of the following should beadded to the list of diferential diagnoses?
a. Pancreatitis
b. Peptic ulcer disease
c. Diverticulitis
d. All of the above
Question 49: Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?
a. B-type natriuretic peptide
b. C-reactive protein
c. Serum albumin
d. Erythrocyte sedimentation rate
Question 50: You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?
a. Baker phenomenon
b. Arnold reflex
c. cough reflex
d. Tragus reflex
Version 2
Question 1: Women are at the highest risk for developing postpartum depression for up to how long after childbirth?
2 weeks
1 month
3 months
6 months
Question 2: CPT coding offers the uniformed language used for reporting medical services and procedures performed by physician and nonphysician practitioners. Clinicians are paid based on calculated resource costs that are calculated based on practice components.
a. Clinician education loans
b. Clinician practice liability and malpractice expense
c. Clinician reported cost reduction efforts
d. Clinician volume of patients treated
Question 3: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression.
Which of the following is a sign or symptom of cauda equina compression?
a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks
Question 4: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?
a. Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral
Question 5: Which of the following is a specific test for multiple sclerosis (MS)?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.
Question 6: Most adult poisonings are:
a. intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.
Question 7: A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?
a. The scrotum will be dark.
b. The scrotum will appear light pink or yellow.
c. The scrotum will appear milky white.
d. The internal structures will be clearly visible.
Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?What is the normal number for the Glascow Coma Scale?
a. 7
b. 9
c. 10
d. 15
Question 9: S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician suspect in the initial test results for this patient?
a. Elevated uric acid level
b. Elevated blood urea nitrogen (BUN)
c. Decreased urine pH
d. Decreased C-reactive protein (CRP)
Question 10: Which solution should be used when irrigating lacerated tissue over a wound on the arm?
a. Dilute povidone-iodine solution
b. Hydrogen peroxide (H2O2)
c. Saline solution infused with an antibiotic
d. Saline irrigation or soapy water
Question 11: Which ethical principle reflects respect for all persons and their self-determination?
a. Autonomy
b. Beneficence
c. Justice
d. Veracity
Question 12: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?
a. An enlarged rubbery gland
b. A hard irregular gland
c. A tender gland
d. A boggy gland
Question 13: How often should the clinician examine the feet of a person with diabetes?
a. Once a year
b. Every 6 months
c. Every 3 months
d. Every visit
Question 14: Which of the following medications is the treatment of choice for trichomonas? (Points: 2)
a. Metranidazole
b. Ceftriaxone
c. Diflucan
d. Doxycycline
Question 15: Immunizations are an example of which type of prevention? (Points: 2)
a. Primary
b. Secondary
c. Tertiary
Question 16: What is the treatment of choice for a patient diagnosed with testicular cancer?
a. Radical orchidectomy
b. Lumpectomy
c. Radiation implants
d. All of the above
Question 17: George, aged 59, complains of a flulike illness, including fever, chills, and myalgia after returning from visiting his grandchildren in New England. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?
a. A viral syndromes
b. Lyme disease
c. Rocky Mountain spotted fever
d. Relapsing fever
Question 18: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?
a. Gonorrhea
b. Human papillomavirus (HPV)
c. Chlamydia
d. Trichomonas
Question 19: What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?
a. A stabbing type of pain on one small area of the body
b. A vesicular skin lesion on one side of the body
c. A pain that is worse upon awakening
d. A lesion on the exterior ear canal
Question 20: Which drug commonly prescribed for burns is active against a wide spectrum of microbial pathogens and is the most frequently used agent for partial- and full-thickness thermal injuries?
a. Clotrimazole cream (Lotrimen)
b. Mafenide acetate (Sulfamylon)
c. Silver nitrate
d. Silver sulfadiazine (Silvadene)
Question 21: Which of the following is a role of the advanced practice nurse in palliative cancer care?
a. Detecting cancer in asymptomatic patients or those with specific symptoms
b. Arranging for follow-up care, including psychosocial and spiritual support
c. Identifying and managing complications of care
d. All of the above
Question 22: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?
a. Superficial burns
b. Superficial partial-thickness burns
c. Deep partial-thickness burns
d. Full-thickness burns
Question 23: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:
a. 1 month.
b. 3 months.
c. 6 months.
d. 12 months.
Question 24: In the United States, what is the second most common connective tissue disease and the most destructive to the joints?
a. Osteoarthritis
b. Systemic lupus erythematosus (SLE)
c. Rheumatoid arthritis (RA)
d. Sjogren’s syndrome
Question 25: A sunscreen with a sun-protection factor (SPF) of at least what number will block most harmful ultraviolet (UV) radiation?
a. 4
b. 8
c. 10
d. 15
Question 26: The hallmark of an absence seizure is:
a. No activity at all.
b. A blank stare.
c. Urine is usually voided involuntarily.
d. The attack usually lasts several minutes.
Question 27: The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?
a. Acetylcholine
b. Gamma-aminobutyric acid (GABA)
c. Dopamine
d. Serotonin
Question 28: Which characteristic of delirium helps to distinguish delirium from dementia?
a. Abrupt onset
b. Impaired attention
c. Affective changes
d. Delusions
Question 29: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?
a. Pregnancy test
b. Pelvic ultrasound
c. Endometrial biopsy
d. Platelet count
Question 30: The clinician should question the patient with suspected gout about use of which of these medications that may be a risk factor?
a. Low-dose aspirin
b. Thiazide diuretics
c. Ethambutol
d. All of the above
Question 31: A bulla is:
a. A vesicle larger than 1 cm in diameter.
b. An elevated solid mass with a hard texture, and the shape and borders can be regular or irregular.
c. A superficial elevated lesion filled with purulent fluid.
d. Thinning of the skin (epidermis and dermis) that appears white or translucent.
Question 32: Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination.
As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?
a. Morning stiffness and limited mobility of the lumbar spine
b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
c. Fever, chills, and elevated erythrocyte sedimentation rate
d. Pathologic fractures, severe night pain, weight loss, and fatigue
Question 33: Which of the following statements is true concerning the musculoskeletal exam?
a. The uninvolved side should be examined initially and compared to the involved side.
b. The part of the body that is causing the patient pain should be examined first.
c. The patient should not be asked to perform active range-of-motion (ROM) exercises whenever possible to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.
Question 34: The current goal of treatment for a patient with HIV infection is which of the following?
a. Viral suppression of HIV to undetectable levels in the peripheral blood
b. Compete eradication of the virus
c. Encouraging the person to have no contact with uninfected individuals
d. Complete abstinence
Question 35: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?
a. Benzodiazepines
b. Antipsychotics
c. Anticonvulsants
d. Antidepressants
Question 36: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?
a. Suggest she use a heating pad to improve circulation
b. Refer to a podiatrist for a foot care treatment plan
c. Send her for acupuncture treatments
d. All of the above
Question 37: Which of the following statements is true concerning the management of the client with a herniated disc?
a. Muscle relaxants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use.
b. An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred.
c. Intolerable pain for more than a 3-month period is an indication for surgical intervention.
d. All of the above
Question 38: Which patient is more likely to have a cluster headache?
a. A female in her reproductive years
b. A 40-year-old African American male
c. A 55-year-old female who drinks 10 cups of coffee daily
d. A 45-year-old male awakened at night
Question 39: The main mechanism for avoiding a lawsuit involves:
a. Good liability insurance
b. A collaborating physician
c. Good documentation
d. Open communication skills
Question 40: A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding?
a. Trichomonas
b. Bacterial vaginosis
c. Human papillomavirus (HPV)
d. Herpes simplex virus (HSV)
Question 41: Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease?
a. Elevated thyroid-stimulating hormone (TSH)
b. Elevated T4
c. Elevated TRH
d. All of the above
Question 42: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?
a. Human papillomavirus (HPV)
b. Endometrial hyperplasia
c. Vagismus
d. Polycystic ovarian syndrome
Question 43: When may confidentiality be overridden?
a. When personal information is available on the computer
b. W
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the “C” of LACE represents?
/in Uncategorized /by developera. Commitment
b. Consensus
c. Certification
d. Collaboration
Question 50: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?
a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain
Version 3
Question 1: In an outpatient setting
what is the most common reason for a malpractice suit?
a. Failure to treat a condition
b. Failure to diagnose correctly
c. Ordering the wrong medication
d. Failure to manage care
Question 2: How often should the clinician examine the feet of a person with diabetes?
a. Once a year
b. Every 6 months
c. Every 3 months
d. Every visit
Question 3: Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?
a. Cholinesterase inhibitors
b. Anxiolytics
c. Antidepressants
d. Atypical antipsychotics
Question 4: Which of the following medications is the treatment of choice for trichomonas?
a. Metranidazole
b. Ceftriaxone
c. Diflucan
d. Doxycycline
Question 5: Most adult poisonings are:
a. intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.
Question 6: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?
a. “”It is probably just a cyst
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a. Commitment
b. Consensus
c. Certification
d. Collaboration
Question 50: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?
a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain
Version 3
Question 1: In an outpatient setting
Nr 511 Week 4 Midterm Exam Version 1 2 3 And 5 18749349
/in Uncategorized /by developerReport Issue
NR 511 Week 4 Midterm Exam Version 1, 2, 3 & 5
Version 1
Question 1: Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the literature with ratings of available evidence
c. Conducting an external review of a guideline
d. Developing evidence-based tables
Question 2: African American patients seem to have a negative reaction to which of the following asthma medications?
a. Inhaled corticosteroids
b. Long-term beta-agonist bronchodilators
c. Leukotriene receptor agonist
d. Oral corticosteroid
Question 3: Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?
a. The tumor size cannot be evaluated, the cancer has not spread to the lymph nodes, and the distant spread cannot be evaluated.
b. The cancer is in situ, it is spreading into the lymph nodes, but the spread otherwise cannot be evaluated.
c. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.
d. The cancer is about 5 cm in size, nearby lymph nodes cannot be evaluated, and there is no evidence of distant spreading.
Question 4: Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?
a. Meclizine
b. Diphenhydramine
c. Diamox
d. Promethazine
Question 5: Mandy presents with a cauliflower-like wart that is in her anogenital region. You suspect it was sexually transmitted and document this as a:
a. Filiform/digitate wart.
b. Dysplastic cervical lesion.
c. Condyloma accuminata.
d. Koilocytosis.
Question 6: Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?
a. Dementia
b. Alzheimer’s disease
c. Parkinson’s disease
d. Delirium
Question 7: You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?
a. “Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow.”
b. “Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow.”
c. “Drive to the emergency room (ER) now.”
d. “Call 911.”
Question 8: A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
a. NSAIDs
b. Beets
c. Vitamin A
d. Red meat
Question 9: Which of the following is an example of tertiary prevention in a patient with chronic renal failure?
a. Fluid restriction
b. Hemodialysis 4 days a week
c. High-protein diet
d. Maintain blood pressure at 120/80
Question 10: Which of the following conditions is associated with cigarette smoking?
a. Glaucoma
b. Increased sperm quality
c. Bladder cancer
d. Eczema
Question 11: A chronic cough lasts longer than:
a. 3 weeks
b. 1 month
c. 6 months
d. 1 year
Question 12: The ‘freezing phenomenon’ is a cardinal feature of?
a.Parkinson’s disease
b. Alzheimer’s disease
c. A CVA
d. Bell’s palsy
Question 13: When administered at the beginning of an attack, oxygen therapy may help this kind of headache?
a. Tension
b. Migraine
c. Cluster
d. Stress
Question 14: Which ethnic group has the highest lung cancer incidence and mortality rates?
a. African American men
b. Scandinavian men and women
c. Caucasian women
d. Asian men
Question 15: The most significant precipitating event leading to otitis media with effusion is:
a. Pharyngitis
b. Allergies
c. Viral upper respiratory infection (URI)
d. Perforation of the eardrum
Question 16: Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:
a. Severe asthma.
b. A common valvular lesion.
c. Severe hypertension.
d. A previous coronary artery bypass graft (CABG).
Question 17: A 34-year-old patient was treated for a urinary tract infection (UTI) and has not responded to antibiotic therapy. Which of the following actions should be taken next?
a. Send a urine specimen for microscopy looking for fungal colonies.
b. Increase the dose of antibiotic.
c. Order a cytoscopy.
d. Order a different antibiotic.
Question 18: Which statement best describes a carotid bruit?
a. It is felt with the middle three fingers over the carotid artery.
b. A bruit becomes audible when the lumen is narrowed to 1 mm or less.
c. A low-pitched bruit is a medical emergency.
d. The higher the pitch of the bruit, the higher the degree of stenosis.
Question 19: Which statement is true regarding chloasma, the ‘mask of pregnancy’?
a. It is caused by a decrease in the melanocyte-stimulating hormone duringpregnancy.
b. This condition only occurs on the face.
c. Exposure to sunlight will even out the discoloration.
d. It is caused by increased levels of estrogen and progesterone.
Question 20: Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?
a. “You must be under a lot of stress lately.”
b. “It is hereditary. Did your father experience this also?”
c. “The cause is unknown, but we suspect it is due to an immunologic mechanism.”
d. “We’ll have to do some tests.”
Question 21: A blood pressure (BP) of 150/90 is considered:
a. Stage 2 hypertension
b. Hypertensive
c. Normal in healthy older adults
d. Acceptable if the patient has DM
Question 22: When teaching post MI patients about their NTG tablets, theclinician should stress that the tablets should remain in thelight-resistant bottle in which they are packaged and shouldnot be put in another pill box or remain in areas that are orcould become warm and humid. Once opened, the bottlemust be dated and discarded after how many months?
a. 1 month
b. 3 months
c. 6 months
d. As long as the tablets are kept in this special bottle, they will last forever
Question 23: Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?
a. He should stop smoking today.
b. He should stop smoking tomorrow.
c. His quit date should be in 1 week.
d. He will be ready to quit after the Frst 30 days
Question 24: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?
a. Spores
c. Pseudohyphae
b. Leukocytes
d. Epithelial cells
Question 25: The hallmark of an absence seizure is:
a. No activity at all.
b. A blank stare.
c. Urine is usually voided involuntarily.
d. The attack usually lasts several minutes.
Question 26: Which medication used for scabies is safe for children 2 months and older?
a. Permethrin cream
b. Lindane
c. Crotamiton lotion and cream
d. Ivermectin
Question 27: The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?
a. Viral conjunctivitis
b. Keratoconjunctivitis
c. Bacterial conjunctivitis
d. Allergic conjunctivitis
Question 28: Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?
a. “Most patients have complete recovery in a few weeks to a few months.”
b. “Unfortunately, you’ll probably have a small amount of residual damage.”
c. “Don’t worry, I’ll take care of everything.”
d. “You may have a few more episodes over the course of your lifetime but no permanent damage.”
Question 29: How often should drug levels be monitored when a seizure medication has controlled the seizures and the drug level is adequate
a. Every 3 months
b. Every 6 months
c. Annually
d. Whenever there is a problem
Question 30: Immunizations are an example of which type of prevention?
a. Primary
b. Secondary
c. Tertiary
Question 31: The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?
a. Repeat the test.
b. Refer to a nephrologist.
c. Measure the serum protein.
d. Obtain a blood urea nitrogen (BUN) and creatinine.
Question 32: Which cranial nerve is afected in a patient with acerebrovascular accident who has difficulty chewing?
a. CN V
b. CN VII
c. CN IX
d. CN X
Question 33: Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer?
a. KUB (kidneys, ureter, bladder) x-ray
b. Cystoscopy with biopsy
c. Magnetic resonance imaging (MRI)
d. Urine tumor marker (NMP22)
Question 34: The “B” in the ABCDEs of assessing skin cancer represents:
a. Biopsy.
b. Best practice.
c. Boundary.
d. Border irregularity.
Question 35: Which statement is true regarding driving and patients with a seizure disorder?
a. Once diagnosed with a seizure disorder, patients mustnever drive again.
b. After being seizure free for 6 months, patients may drive.
c. Each state has diferent laws governing driving forindividuals with a seizure disorder.
d. These persons may drive but never alone.
Question 36: Which high-density lipoprotein (HDL) level is considered cardioprotective?
a. Greater than 30
b. Greater than 40
c. Greater than 50
d. Greater than 60
Question 37: The most common etiologic organism for community-acquired pneumonia is:
A. Streptococcus pneumoniae
B. Beta hemolytic streptococcus
C. Mycoplasma
D. Methicillin resistant staphylococcus
Question 38: Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?
a. Serum calcium
b. Electrocardiogram (ECG)
c. Thyroid-stimulating hormone test
d. Complete blood cell count
Question 39: A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?
a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.
b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.
c. A throat culture should be performed to confirm the results of the rapid strep test.
d. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.
Question 40: Patients with acute otitis media should be referred to a specialist in which of the following situations?
a. Concurrent vertigo or ataxia
b. Failed closure of a ruptured tympanic membrane
c. If symptoms worsen after 3 or 4 days of treatment
d. All of the above
Question 41: Which of the following tests is most useful in determining renal function in a patient suspected of chronic renal failure (CRF)?
a. Blood urea nitrogen (BUN) and creatinine
b. Electrolytes
c. Creatinine clearance
d. Urinalysis
Question 42: Marci has a wart on her hand. She says she heard something about “silver duct tape therapy.” What do you tell her about his?
a. It is an old wives’ tale.
b. It is used as a last resort.
c. Salicylic acid is more effective.
d. It is a simple treatment that should be tried first.
Question 43: What is the first-line recommended treatment against Group A b-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?
a. Penicillin
b. Quinolone
c. Cephalosporin
d. Macrolide
Question 44: Which of the following is an example of sensorineural hearing loss?
a. Perforation of the tympanic membrane
b. Otosclerosis
c. Cholesteatoma
d. Presbycusis
Question 45: Which of the following is “a linear crack extending from the epidermis to the dermis?”
a. An ulcer
b. A fissure
c. Lichenification
d. An excoriation
Question 46: A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night visio0n, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?
a. The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.
b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.
c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist.
d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.
Question 47: The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?
a. IgA
b. IgE
c. IgG
d. IgM
Question 48: A patient is seen with a sudden onset of ±ank painaccompanied by nausea, vomiting, and diaphoresis. Inaddition to nephrolithiasis, which of the following should beadded to the list of diferential diagnoses?
a. Pancreatitis
b. Peptic ulcer disease
c. Diverticulitis
d. All of the above
Question 49: Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?
a. B-type natriuretic peptide
b. C-reactive protein
c. Serum albumin
d. Erythrocyte sedimentation rate
Question 50: You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?
a. Baker phenomenon
b. Arnold reflex
c. cough reflex
d. Tragus reflex
Version 2
Question 1: Women are at the highest risk for developing postpartum depression for up to how long after childbirth?
2 weeks
1 month
3 months
6 months
Question 2: CPT coding offers the uniformed language used for reporting medical services and procedures performed by physician and nonphysician practitioners. Clinicians are paid based on calculated resource costs that are calculated based on practice components.
a. Clinician education loans
b. Clinician practice liability and malpractice expense
c. Clinician reported cost reduction efforts
d. Clinician volume of patients treated
Question 3: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression.
Which of the following is a sign or symptom of cauda equina compression?
a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks
Question 4: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?
a. Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral
Question 5: Which of the following is a specific test for multiple sclerosis (MS)?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.
Question 6: Most adult poisonings are:
a. intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.
Question 7: A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?
a. The scrotum will be dark.
b. The scrotum will appear light pink or yellow.
c. The scrotum will appear milky white.
d. The internal structures will be clearly visible.
Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?What is the normal number for the Glascow Coma Scale?
a. 7
b. 9
c. 10
d. 15
Question 9: S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician suspect in the initial test results for this patient?
a. Elevated uric acid level
b. Elevated blood urea nitrogen (BUN)
c. Decreased urine pH
d. Decreased C-reactive protein (CRP)
Question 10: Which solution should be used when irrigating lacerated tissue over a wound on the arm?
a. Dilute povidone-iodine solution
b. Hydrogen peroxide (H2O2)
c. Saline solution infused with an antibiotic
d. Saline irrigation or soapy water
Question 11: Which ethical principle reflects respect for all persons and their self-determination?
a. Autonomy
b. Beneficence
c. Justice
d. Veracity
Question 12: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?
a. An enlarged rubbery gland
b. A hard irregular gland
c. A tender gland
d. A boggy gland
Question 13: How often should the clinician examine the feet of a person with diabetes?
a. Once a year
b. Every 6 months
c. Every 3 months
d. Every visit
Question 14: Which of the following medications is the treatment of choice for trichomonas? (Points: 2)
a. Metranidazole
b. Ceftriaxone
c. Diflucan
d. Doxycycline
Question 15: Immunizations are an example of which type of prevention? (Points: 2)
a. Primary
b. Secondary
c. Tertiary
Question 16: What is the treatment of choice for a patient diagnosed with testicular cancer?
a. Radical orchidectomy
b. Lumpectomy
c. Radiation implants
d. All of the above
Question 17: George, aged 59, complains of a flulike illness, including fever, chills, and myalgia after returning from visiting his grandchildren in New England. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?
a. A viral syndromes
b. Lyme disease
c. Rocky Mountain spotted fever
d. Relapsing fever
Question 18: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?
a. Gonorrhea
b. Human papillomavirus (HPV)
c. Chlamydia
d. Trichomonas
Question 19: What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?
a. A stabbing type of pain on one small area of the body
b. A vesicular skin lesion on one side of the body
c. A pain that is worse upon awakening
d. A lesion on the exterior ear canal
Question 20: Which drug commonly prescribed for burns is active against a wide spectrum of microbial pathogens and is the most frequently used agent for partial- and full-thickness thermal injuries?
a. Clotrimazole cream (Lotrimen)
b. Mafenide acetate (Sulfamylon)
c. Silver nitrate
d. Silver sulfadiazine (Silvadene)
Question 21: Which of the following is a role of the advanced practice nurse in palliative cancer care?
a. Detecting cancer in asymptomatic patients or those with specific symptoms
b. Arranging for follow-up care, including psychosocial and spiritual support
c. Identifying and managing complications of care
d. All of the above
Question 22: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?
a. Superficial burns
b. Superficial partial-thickness burns
c. Deep partial-thickness burns
d. Full-thickness burns
Question 23: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:
a. 1 month.
b. 3 months.
c. 6 months.
d. 12 months.
Question 24: In the United States, what is the second most common connective tissue disease and the most destructive to the joints?
a. Osteoarthritis
b. Systemic lupus erythematosus (SLE)
c. Rheumatoid arthritis (RA)
d. Sjogren’s syndrome
Question 25: A sunscreen with a sun-protection factor (SPF) of at least what number will block most harmful ultraviolet (UV) radiation?
a. 4
b. 8
c. 10
d. 15
Question 26: The hallmark of an absence seizure is:
a. No activity at all.
b. A blank stare.
c. Urine is usually voided involuntarily.
d. The attack usually lasts several minutes.
Question 27: The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?
a. Acetylcholine
b. Gamma-aminobutyric acid (GABA)
c. Dopamine
d. Serotonin
Question 28: Which characteristic of delirium helps to distinguish delirium from dementia?
a. Abrupt onset
b. Impaired attention
c. Affective changes
d. Delusions
Question 29: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?
a. Pregnancy test
b. Pelvic ultrasound
c. Endometrial biopsy
d. Platelet count
Question 30: The clinician should question the patient with suspected gout about use of which of these medications that may be a risk factor?
a. Low-dose aspirin
b. Thiazide diuretics
c. Ethambutol
d. All of the above
Question 31: A bulla is:
a. A vesicle larger than 1 cm in diameter.
b. An elevated solid mass with a hard texture, and the shape and borders can be regular or irregular.
c. A superficial elevated lesion filled with purulent fluid.
d. Thinning of the skin (epidermis and dermis) that appears white or translucent.
Question 32: Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination.
As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?
a. Morning stiffness and limited mobility of the lumbar spine
b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
c. Fever, chills, and elevated erythrocyte sedimentation rate
d. Pathologic fractures, severe night pain, weight loss, and fatigue
Question 33: Which of the following statements is true concerning the musculoskeletal exam?
a. The uninvolved side should be examined initially and compared to the involved side.
b. The part of the body that is causing the patient pain should be examined first.
c. The patient should not be asked to perform active range-of-motion (ROM) exercises whenever possible to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.
Question 34: The current goal of treatment for a patient with HIV infection is which of the following?
a. Viral suppression of HIV to undetectable levels in the peripheral blood
b. Compete eradication of the virus
c. Encouraging the person to have no contact with uninfected individuals
d. Complete abstinence
Question 35: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?
a. Benzodiazepines
b. Antipsychotics
c. Anticonvulsants
d. Antidepressants
Question 36: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?
a. Suggest she use a heating pad to improve circulation
b. Refer to a podiatrist for a foot care treatment plan
c. Send her for acupuncture treatments
d. All of the above
Question 37: Which of the following statements is true concerning the management of the client with a herniated disc?
a. Muscle relaxants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use.
b. An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred.
c. Intolerable pain for more than a 3-month period is an indication for surgical intervention.
d. All of the above
Question 38: Which patient is more likely to have a cluster headache?
a. A female in her reproductive years
b. A 40-year-old African American male
c. A 55-year-old female who drinks 10 cups of coffee daily
d. A 45-year-old male awakened at night
Question 39: The main mechanism for avoiding a lawsuit involves:
a. Good liability insurance
b. A collaborating physician
c. Good documentation
d. Open communication skills
Question 40: A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding?
a. Trichomonas
b. Bacterial vaginosis
c. Human papillomavirus (HPV)
d. Herpes simplex virus (HSV)
Question 41: Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease?
a. Elevated thyroid-stimulating hormone (TSH)
b. Elevated T4
c. Elevated TRH
d. All of the above
Question 42: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?
a. Human papillomavirus (HPV)
b. Endometrial hyperplasia
c. Vagismus
d. Polycystic ovarian syndrome
Question 43: When may confidentiality be overridden?
a. When personal information is available on the computer
b. W
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Nr 511 Week 4 Midterm Exam Version 1
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Question 1: Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the literature with ratings of available evidence
c. Conducting an external review of a guideline
d. Developing evidence-based tables
Question 2: African American patients seem to have a negative reaction to which of the following asthma medications?
a. Inhaled corticosteroids
b. Long-term beta-agonist bronchodilators
c. Leukotriene receptor agonist
d. Oral corticosteroid
Question 3: Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?
a. The tumor size cannot be evaluated, the cancer has not spread to the lymph nodes, and the distant spread cannot be evaluated.
b. The cancer is in situ, it is spreading into the lymph nodes, but the spread otherwise cannot be evaluated.
c. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.
d. The cancer is about 5 cm in size, nearby lymph nodes cannot be evaluated, and there is no evidence of distant spreading.
Question 4: Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?
a. Meclizine
b. Diphenhydramine
c. Diamox
d. Promethazine
Question 5: Mandy presents with a cauliflower-like wart that is in her anogenital region. You suspect it was sexually transmitted and document this as a:
a. Filiform/digitate wart.
b. Dysplastic cervical lesion.
c. Condyloma accuminata.
d. Koilocytosis.
Question 6: Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?
a. Dementia
b. Alzheimer’s disease
c. Parkinson’s disease
d. Delirium
Question 7: You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?
a. “Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow.”
b. “Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow.”
c. “Drive to the emergency room (ER) now.”
d. “Call 911.”
Question 8: A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
a. NSAIDs
b. Beets
c. Vitamin A
d. Red meat
Question 9: Which of the following is an example of tertiary prevention in a patient with chronic renal failure?
a. Fluid restriction
b. Hemodialysis 4 days a week
c. High-protein diet
d. Maintain blood pressure at 120/80
Question 10: Which of the following conditions is associated with cigarette smoking?
a. Glaucoma
b. Increased sperm quality
c. Bladder cancer
d. Eczema
Question 11: A chronic cough lasts longer than:
a. 3 weeks
b. 1 month
c. 6 months
d. 1 year
Question 12: The ‘freezing phenomenon’ is a cardinal feature of?
a.Parkinson’s disease
b. Alzheimer’s disease
c. A CVA
d. Bell’s palsy
Question 13: When administered at the beginning of an attack, oxygen therapy may help this kind of headache?
a. Tension
b. Migraine
c. Cluster
d. Stress
Question 14: Which ethnic group has the highest lung cancer incidence and mortality rates?
a. African American men
b. Scandinavian men and women
c. Caucasian women
d. Asian men
Question 15: The most significant precipitating event leading to otitis media with effusion is:
a. Pharyngitis
b. Allergies
c. Viral upper respiratory infection (URI)
d. Perforation of the eardrum
Question 16: Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:
a. Severe asthma.
b. A common valvular lesion.
c. Severe hypertension.
d. A previous coronary artery bypass graft (CABG).
Question 17: A 34-year-old patient was treated for a urinary tract infection (UTI) and has not responded to antibiotic therapy. Which of the following actions should be taken next?
a. Send a urine specimen for microscopy looking for fungal colonies.
b. Increase the dose of antibiotic.
c. Order a cytoscopy.
d. Order a different antibiotic.
Question 18: Which statement best describes a carotid bruit?
a. It is felt with the middle three fingers over the carotid artery.
b. A bruit becomes audible when the lumen is narrowed to 1 mm or less.
c. A low-pitched bruit is a medical emergency.
d. The higher the pitch of the bruit, the higher the degree of stenosis.
Question 19: Which statement is true regarding chloasma, the ‘mask of pregnancy’?
a. It is caused by a decrease in the melanocyte-stimulating hormone duringpregnancy.
b. This condition only occurs on the face.
c. Exposure to sunlight will even out the discoloration.
d. It is caused by increased levels of estrogen and progesterone.
Question 20: Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?
a. “You must be under a lot of stress lately.”
b. “It is hereditary. Did your father experience this also?”
c. “The cause is unknown, but we suspect it is due to an immunologic mechanism.”
d. “We’ll have to do some tests.”
Question 21: A blood pressure (BP) of 150/90 is considered:
a. Stage 2 hypertension
b. Hypertensive
c. Normal in healthy older adults
d. Acceptable if the patient has DM
Question 22: When teaching post MI patients about their NTG tablets, theclinician should stress that the tablets should remain in thelight-resistant bottle in which they are packaged and shouldnot be put in another pill box or remain in areas that are orcould become warm and humid. Once opened, the bottlemust be dated and discarded after how many months?
a. 1 month
b. 3 months
c. 6 months
d. As long as the tablets are kept in this special bottle, they will last forever
Question 23: Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?
a. He should stop smoking today.
b. He should stop smoking tomorrow.
c. His quit date should be in 1 week.
d. He will be ready to quit after the Frst 30 days
Question 24: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?
a. Spores
c. Pseudohyphae
b. Leukocytes
d. Epithelial cells
Question 25: The hallmark of an absence seizure is:
a. No activity at all.
b. A blank stare.
c. Urine is usually voided involuntarily.
d. The attack usually lasts several minutes.
Question 26: Which medication used for scabies is safe for children 2 months and older?
a. Permethrin cream
b. Lindane
c. Crotamiton lotion and cream
d. Ivermectin
Question 27: The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?
a. Viral conjunctivitis
b. Keratoconjunctivitis
c. Bacterial conjunctivitis
d. Allergic conjunctivitis
Question 28: Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?
a. “Most patients have complete recovery in a few weeks to a few months.”
b. “Unfortunately, you’ll probably have a small amount of residual damage.”
c. “Don’t worry, I’ll take care of everything.”
d. “You may have a few more episodes over the course of your lifetime but no permanent damage.”
Question 29: How often should drug levels be monitored when a seizure medication has controlled the seizures and the drug level is adequate
a. Every 3 months
b. Every 6 months
c. Annually
d. Whenever there is a problem
Question 30: Immunizations are an example of which type of prevention?
a. Primary
b. Secondary
c. Tertiary
Question 31: The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?
a. Repeat the test.
b. Refer to a nephrologist.
c. Measure the serum protein.
d. Obtain a blood urea nitrogen (BUN) and creatinine.
Question 32: Which cranial nerve is afected in a patient with acerebrovascular accident who has difficulty chewing?
a. CN V
b. CN VII
c. CN IX
d. CN X
Question 33: Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer?
a. KUB (kidneys, ureter, bladder) x-ray
b. Cystoscopy with biopsy
c. Magnetic resonance imaging (MRI)
d. Urine tumor marker (NMP22)
b
Question 34: The “B” in the ABCDEs of assessing skin cancer represents:
a. Biopsy. c. Boundary.
b. Best practice. d. Border irregularity.
Question 35: Which statement is true regarding driving and patients with a seizure disorder?
a. Once diagnosed with a seizure disorder, patients mustnever drive again.
b. After being seizure free for 6 months, patients may drive.
c. Each state has diferent laws governing driving forindividuals with a seizure disorder.
d. These persons may drive but never alone.
Question 36: Which high-density lipoprotein (HDL) level is considered cardioprotective?
a. Greater than 30
b. Greater than 40
c. Greater than 50
d. Greater than 60
Question 37: The most common cause of CAP is?
a. Incorrect octane gasoline
b. A loose gas cap
c. A clogged muffler
d. A bad spark plug
Question 38: Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?
a. Serum calcium
b. Electrocardiogram (ECG)
c. Thyroid-stimulating hormone test
d. Complete blood cell count
Question 39: A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?
a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.
b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.
c. A throat culture should be performed to confirm the results of the rapid strep test.
d. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.
Question 40: Patients with acute otitis media should be referred to a specialist in which of the following situations?
a. Concurrent vertigo or ataxia
b. Failed closure of a ruptured tympanic membrane
c. If symptoms worsen after 3 or 4 days of treatment
d. All of the above
Question 41: Which of the following tests is most useful in determining renal function in a patient suspected of chronic renal failure (CRF)?
a. Blood urea nitrogen (BUN) and creatinine
b. Electrolytes
c. Creatinine clearance
d. Urinalysis
Question 42: Marci has a wart on her hand. She says she heard something about “silver duct tape therapy.” What do you tell her about his?
a. It is an old wives’ tale.
b. It is used as a last resort.
c. Salicylic acid is more effective.
d. It is a simple treatment that should be tried first.
Question 43: What is the first-line recommended treatment against Group A b-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?
a. Penicillin
b. Quinolone
c. Cephalosporin
d. Macrolide
Question 44: Which of the following is an example of sensorineural hearing loss?
a. Perforation of the tympanic membrane
b. Otosclerosis
c. Cholesteatoma
d. Presbycusis
Question 45: Which of the following is “a linear crack extending from the epidermis to the dermis?”
a. An ulcer
b. A fissure
c. Lichenification
d. An excoriation
Question 46: A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night visio0n, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?
a. The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.
b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.
c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist.
d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.
Question 47: The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?
a. IgA
b. IgE
c. IgG
d. IgM
Question 48: A patient is seen with a sudden onset of ±ank painaccompanied by nausea, vomiting, and diaphoresis. Inaddition to nephrolithiasis, which of the following should beadded to the list of diferential diagnoses?
a. Pancreatitis
b. Peptic ulcer disease
c. Diverticulitis
d. All of the above
Question 49: Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?
a. B-type natriuretic peptide
b. C-reactive protein
c. Serum albumin
d. Erythrocyte sedimentation rate
Question 50: You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?
a. Baker phenomenon
b. Arnold reflex
c. cough reflex
d. Tragus reflex
NR 511 Week 4 Midterm (Exam Version 1)
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NR 511 Week 4 Midterm Exam Version 1
NR 511 Week 4 Midterm Exam Version 1
Question 1: Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the …
NR 511 Week 4 Midterm Exam Version 1
NR 511 Week 4 Midterm Exam Version 1
Question 1: Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the …
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Nr 511 Week 4 Midterm Exam Version 2 18749351
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NR 511 Week 4 Midterm Exam Version 2
Question 1: Women are at the highest risk for developing postpartum depression for up to how long after childbirth?
2 weeks
1 month
3 months
6 months
Question 2: CPT coding offers the uniformed language used for reporting medical services and procedures performed by physician and nonphysician practitioners. Clinicians are paid based on calculated resource costs that are calculated based on practice components.
a. Clinician education loans
b. Clinician practice liability and malpractice expense
c. Clinician reported cost reduction efforts
d. Clinician volume of patients treated
Question 3: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression.
Which of the following is a sign or symptom of cauda equina compression?
a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks
Question 4: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?
a. Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral
Question 5: Which of the following is a specific test for multiple sclerosis (MS)?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.
Question 6: Most adult poisonings are:
a. intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.
Question 7: A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?
a. The scrotum will be dark.
b. The scrotum will appear light pink or yellow.
c. The scrotum will appear milky white.
d. The internal structures will be clearly visible.
Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?What is the normal number for the Glascow Coma Scale?
a. 7
b. 9
c. 10
d. 15
Question 9: S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician suspect in the initial test results for this patient?
a. Elevated uric acid level
b. Elevated blood urea nitrogen (BUN)
c. Decreased urine pH
d. Decreased C-reactive protein (CRP)
Question 10: Which solution should be used when irrigating lacerated tissue over a wound on the arm?
a. Dilute povidone-iodine solution
b. Hydrogen peroxide (H2O2)
c. Saline solution infused with an antibiotic
d. Saline irrigation or soapy water
Question 11: Which ethical principle reflects respect for all persons and their self-determination?
a. Autonomy
b. Beneficence
c. Justice
d. Veracity
Question 12: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?
a. An enlarged rubbery gland
b. A hard irregular gland
c. A tender gland
d. A boggy gland
Question 13: How often should the clinician examine the feet of a person with diabetes?
a. Once a year
b. Every 6 months
c. Every 3 months
d. Every visit
Question 14: Which of the following medications is the treatment of choice for trichomonas? (Points: 2)
a. Metranidazole
b. Ceftriaxone
c. Diflucan
d. Doxycycline
Question 15: Immunizations are an example of which type of prevention? (Points: 2)
a. Primary
b. Secondary
c. Tertiary
Question 16: What is the treatment of choice for a patient diagnosed with testicular cancer?
a. Radical orchidectomy
b. Lumpectomy
c. Radiation implants
d. All of the above
Question 17: George, aged 59, complains of a flulike illness, including fever, chills, and myalgia after returning from visiting his grandchildren in New England. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?
a. A viral syndromes
b. Lyme disease
c. Rocky Mountain spotted fever
d. Relapsing fever
Question 18: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?
a. Gonorrhea
b. Human papillomavirus (HPV)
c. Chlamydia
d. Trichomonas
Question 19: What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?
a. A stabbing type of pain on one small area of the body
b. A vesicular skin lesion on one side of the body
c. A pain that is worse upon awakening
d. A lesion on the exterior ear canal
Question 20: Which drug commonly prescribed for burns is active against a wide spectrum of microbial pathogens and is the most frequently used agent for partial- and full-thickness thermal injuries?
a. Clotrimazole cream (Lotrimen)
b. Mafenide acetate (Sulfamylon)
c. Silver nitrate
d. Silver sulfadiazine (Silvadene)
Question 21: Which of the following is a role of the advanced practice nurse in palliative cancer care?
a. Detecting cancer in asymptomatic patients or those with specific symptoms
b. Arranging for follow-up care, including psychosocial and spiritual support
c. Identifying and managing complications of care
d. All of the above
Question 22: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?
a. Superficial burns
b. Superficial partial-thickness burns
c. Deep partial-thickness burns
d. Full-thickness burns
Question 23: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:
a. 1 month.
b. 3 months.
c. 6 months.
d. 12 months.
Question 24: In the United States, what is the second most common connective tissue disease and the most destructive to the joints?
a. Osteoarthritis
b. Systemic lupus erythematosus (SLE)
c. Rheumatoid arthritis (RA)
d. Sjogren’s syndrome
Question 25: A sunscreen with a sun-protection factor (SPF) of at least what number will block most harmful ultraviolet (UV) radiation?
a. 4
b. 8
c. 10
d. 15
Question 26: The hallmark of an absence seizure is:
a. No activity at all.
b. A blank stare.
c. Urine is usually voided involuntarily.
d. The attack usually lasts several minutes.
Question 27: The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?
a. Acetylcholine
b. Gamma-aminobutyric acid (GABA)
c. Dopamine
d. Serotonin
Question 28: Which characteristic of delirium helps to distinguish delirium from dementia?
a. Abrupt onset
b. Impaired attention
c. Affective changes
d. Delusions
Question 29: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?
a. Pregnancy test
b. Pelvic ultrasound
c. Endometrial biopsy
d. Platelet count
Question 30: The clinician should question the patient with suspected gout about use of which of these medications that may be a risk factor?
a. Low-dose aspirin
b. Thiazide diuretics
c. Ethambutol
d. All of the above
Question 31: A bulla is:
a. A vesicle larger than 1 cm in diameter.
b. An elevated solid mass with a hard texture, and the shape and borders can be regular or irregular.
c. A superficial elevated lesion filled with purulent fluid.
d. Thinning of the skin (epidermis and dermis) that appears white or translucent.
Question 32: Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination.
As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?
a. Morning stiffness and limited mobility of the lumbar spine
b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
c. Fever, chills, and elevated erythrocyte sedimentation rate
d. Pathologic fractures, severe night pain, weight loss, and fatigue
Question 33: Which of the following statements is true concerning the musculoskeletal exam?
a. The uninvolved side should be examined initially and compared to the involved side.
b. The part of the body that is causing the patient pain should be examined first.
c. The patient should not be asked to perform active range-of-motion (ROM) exercises whenever possible to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.
Question 34: The current goal of treatment for a patient with HIV infection is which of the following?
a. Viral suppression of HIV to undetectable levels in the peripheral blood
b. Compete eradication of the virus
c. Encouraging the person to have no contact with uninfected individuals
d. Complete abstinence
Question 35: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?
a. Benzodiazepines
b. Antipsychotics
c. Anticonvulsants
d. Antidepressants
Question 36: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?
a. Suggest she use a heating pad to improve circulation
b. Refer to a podiatrist for a foot care treatment plan
c. Send her for acupuncture treatments
d. All of the above
Question 37: Which of the following statements is true concerning the management of the client with a herniated disc?
a. Muscle relaxants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use.
b. An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred.
c. Intolerable pain for more than a 3-month period is an indication for surgical intervention.
d. All of the above
Question 38: Which patient is more likely to have a cluster headache?
a. A female in her reproductive years
b. A 40-year-old African American male
c. A 55-year-old female who drinks 10 cups of coffee daily
d. A 45-year-old male awakened at night
Question 39: The main mechanism for avoiding a lawsuit involves:
a. Good liability insurance
b. A collaborating physician
c. Good documentation
d. Open communication skills
Question 40: A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding?
a. Trichomonas
b. Bacterial vaginosis
c. Human papillomavirus (HPV)
d. Herpes simplex virus (HSV)
Question 41: Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease?
a. Elevated thyroid-stimulating hormone (TSH)
b. Elevated T4
c. Elevated TRH
d. All of the above
Question 42: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?
a. Human papillomavirus (HPV)
b. Endometrial hyperplasia
c. Vagismus
d. Polycystic ovarian syndrome
Question 43: When may confidentiality be overridden?
a. When personal information is available on the computer
b. When a clinician needs to share information with a billing company
c. When an insurance company wants to know the results of a breast cancer gene test
d. When a patient has a communicable disease
Question 44: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?
a. Sinus bradycardia
b. Atrial fibrillation
c. Supraventricular tachycardia
d. U waves
Question 45: The most cost-effective screening test to determine HIV status is which of the following?
a. Western Blot
b. Enzyme-linked immunosorbent assay (ELISA)
c. Venereal Disease Research Laboratory (VDRL) test
d. Viral load
Question 46: After 6 months of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?
a. Elevated thyroid-stimulating hormone (TSH)
b. Normal TSH
c. Low TSH
d. Undetectable TSH
Question 47: The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods?
a. Rice
b. Carrots
c. Spinach
d. Potatoes
Question 48: A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment?
a. Tricyclic antidepressants
b. Capsacin cream
c. Vitamin B12 injections
d. Insulin
Question 49 : In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the “C” of LACE represents?
a. Commitment
b. Consensus
c. Certification
d. Collaboration
Question 50: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?
a. Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain
Perfect answer to all questions
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NR 511 Week 4 Midterm (Exam Version 2)
Question 1: Women are at the highest risk for developing postpartum depression for up to how long after childbirth?
2 weeks
1 month
3 months
6 months
Question 2: CPT coding offers the …
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"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"