College of Nursing NR 601 Final Exam – Question with Answers (Latest, Graded A)2023, Exams of Nursing

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College of Nursing NR 601 Final Exam

– Question with Answers (Latest, Graded

A) 2023

1. Which of the following statements is NOT true about palliative care teams? - A: Provide weekly home visits
2. A 55-year-old women has type 2 DM she had three UTIs in the last 9 months and she is concerned about her kidneys. She has no report of dysuria, frequency or urgency at this time. Which of the following is the best action to follow? - A: Recheck UA dipstick today
3. According to the sexuality presentation, atrophic vaginitis (AV) - A: Is a contributing factor for frequent UTIs
4. Ms. L 55-year-old women with BMI of 28, has 20-year hx of primary HTN and has been on hydrochlorothiazide 25 mg daily for years with excellent response. During follow up visit Mrs L reports that for the last 6 months she has felt thirsty all of the time even though she drinks at least 10 glasses of water a day. Upon chart review the N notes that the last two fasting blood glucose levels have been 136 mg/dl and 165 mg/dl. The NP checks a random blood glucose, which is 210 mg/dl. What is the next appropriate test? - A: Prescribe Metformin 500 mg PO BID
5. A patient has been prescribed Metformin (Glucophage). One week later he returns with lowered blood sugars but complaints of some loose stools during the week. How should the NP respond? - A: Reassure the patient that this is an anticipated side effect
6. A 60-year-old obese male client has type 2 DM and a lipid panel of TC= 250, HDL = 32, LDL= 165. The NP teaches

the patient about his modifiable cardiac risk factors which include:

• A: Diabetes, obesity, and hyperlipidemia

7. Lifestyle approaches to postmenopausal symptom management include

• A: avoiding sugar, coffee, chocolate and alcoho l

8. When treating depression associated with dementia, which of the following would be a poor choice and should not be prescribed? - A: Amitriptyline
9. How does women’s anatomy make them more susceptible to UTIs? - A: the urethra is shorter

18. The comorbid psychiatric problem with the highest frequency in dementia is: - A: Anxiety
19. All of the following are true statements regarding elder abuse EXCEPT: - A : common signs of abuse include decreased anxiety and depression
20. Which of the following is a role of the advanced nurse in? - A: All of the above
21. The proposed mechanism by which diphenhydramine causes delirium is: - A: Anticholinergic effect

22. A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea) is : - A : Morphine
23. According to the Palliative Care presentation, hospice care may be provided to: - A: those with a life expectancy < 6 months
24. A 68-year-old women is being worked up for stress incontinence. UA reveals positive leukocyte esterase, positive nitrites, 15 WBCs, no RBS, no protein, no casts. She denies frequency, urgency, suprapubic pressure or urgency. What is the first treatment for her US results? - A: no treatment is necessary
25. The elderly are at higher risk for delirium because of: - A: All of the above
26. A 63-year-old man is seen in the clinic with a c/o nocturia. Which of the following should be included in the differential diagnosis? - A: Benign prostatic hypertrophy (BPH)
27. A 75-year-old man is being treated as an outpatient for metastatic prostate cancer. Which of the following statements is true regarding the management of pain with opioids in the elderly? - A: none of the above
28. The highest level of evidence with the use of adjuvant analgesics is with: - A: neuropathic pain patients are candidates for adjuvant analgesia
29. The 56-year-old man with chronic prostatis should initially be treated with antibiotics for how long? - A: 14 days
30. A 50-year-old female patient screened for diabetes has a fasting plasma glucose level of 124 mg/dl. The NP plan includes: - A: repeat fasting plasma glucose in one year

- A: Ageist attitudes

34. Mrs. Smith a 65-year-old women presents to the clinic for the first time and c/o UI and dyspareunia, she went through menopause 10 years ago without any hormone replacement therapy and had a hysterectomy for fibroid. Her mother had a hip fracture at 82, pt had mammogram 5 years ago and no known fam hx of breast cancer……you decide to begin topical hormone replacement therapy. Which of the following evaluations would be necessary prior initiating hormone replacement therapy? - A: Mammogram
35. Mr. A experienced a brief onset of right-sided weakness, slurred speech and confusion yesterday. The symptom has resolved. What should the NP do? - A: identify modifiable cardiovascular risk factors
36. Any women with a complicated cystitis or symptoms of upper tract disease needs a urine culture and - A: sensitivity test
37. All of the following patients have a risk of adverse reaction from Metformin except: - A: patients with BMI >
38. A middle-aged patient has been diagnosed with Parkinson’s disease. What influences the NP’s decision to begin pharmacological treatment for this patient? - A : symptom interfering with functional ability
39. Which of the following medications can blunt the signs of hypoglycemia in diabetes? - A: beta blockers
40. The Mini-cog is a short screening tool used to assess cognition. Which of the following statements pertaining to the test is a true statement? - A: A score of 0-2 is a positive screen for dementia

41. What is a sign of insulin resistance that can present in African American patients? - A: Acanthosis Nigricans
42. Age related changes in bladder, urethra and ureters include all of the following in older women except:
    • A: increased estrogen production’s influence on the bladder and ureter
43. The majority of patients enrolled in hospice care die: - A : at home

53. Acanthosis nigrans is associated with all of the following conditions except: - A: tinea versicolor
54. Which of the following statements is true regarding pain? - A: pain is subjective experience related to actual or potential tissue damage

55. A 51-year-old male pt screened for diabetes has a fasting plasma glucose level of 98 mg/dl. The NP plan includes: - A: repeat fasting plasma glucose in 3 years
56. Increased risk factors for erectile dysfunction include all EXCEPT:
    • A: dominant personality
57. When assessing an elderly client who reports a tremor, which assessment findings would be most reliable in identifying Parkinson’s disease? - A: Resting tremor, slow unsteady gait, and cogwheel resistance
58. Which of the following is the most appropriate screening tool for delirium? - A: Confusion Assessment Method
59. An 82-year-old man is seen in the primary care office with complaints of dribbling urine, difficulty starting his stream. Which of the following should be included in the list of differential diagnosis?
    • A: all of the above (BPH, Parkinson’s disease, prostate cancer)
60. The patient with BPH is seen for follow up. He has been taking finasteride (Proscar) for 6 months. The clinician should assess this patient for which of the side effects? - A: Erectile dysfunction
61. Hospice care differs from palliative care in that:
    • A: supports patients and families through both the dying and the bereavement process
62. According to the genitourinary presentation, the number 1 risk factor for urinary incontinence is: - A: AGING
63. The firs step in treating delirium is to: - A: identify the cause
64. Which of the listed conditions is most likely to cause delirium?

- A: lisinopril

67. Delirium is typically characterized by all of the following except: - A: Hyperactive level of psychomotor activity
68. An 80-year-old female widow asks her NP about hospice enrolment. Her diagnosis includes congestive HF, HTN and DM2. She has noticed that in the last month she has lower extremity edema and she is finding it difficult to walk to the grocery store and church, she does not use oxygen. She is able to maintain her home but requires more frequent rest after vacuuming. She does not wish to be admitted to the hospital again in the future but if admitted wants to remain full code status. Why is this patient NOT appropriate for hospice? - A: her prognosis is > 6 months
69. Jean a 42-year-old, presents to the clinic with c/o dysuria, frequency and strong odor of her urine for 5 days. This is the second occurrence this year. What is the appropriate next step to this patient? - A: order UA and urine culture and sensitivity and treat the patient with antibiotics today
70. All of the following patients should be screened for diabetes EXCEPT:

• A: 44-year-old Caucasian with HTN

71. A male patient with a BMI of 33 presents to the office with c/o fatique, excessive hunger and excessive thirst. You suspect type 2 DM. initial testing to confirm diagnosis can include: - A: all of the above
72. An 87-year-old tells the NP that his grandson locks him in his bedroom when he goes out. The grandson withholds food if the patient does not give him money every week. The patient appears frail, ungroomed, and his clothes are visibly dirty and smell of urine. Which of the following is the best

action for NP?

- A: report the grandson to your state’s protective services

73. The leading cause of death in elderly travelers worldwide is: - A: accidents
74. The majority of depressed older adults remain untreated because of : - A: All of the above (misdiagnosis, social stigma, environmental…)
75. When examining the spine of an older adult you notice a curvature with a sharp angle. This is referred to as a: - A: scoliosis
76. Which of the following patients has the highest risk for the development of osteoporosis? - A: A 5’4” Asian female weighing 95 lbs

often used for treatment of:

• A : Diabetic neuropathy

85. Which of the following statements about OA is true? - A: It affects primarily weight bearing joints
86. MJ presents to the clinic with the following hx and presentation: hx of structural damage with current s/s of HF. Treatment will be based on MJs stage of HF which is: - A: Stage C

87. Dietary supplements such as Omega 3 (fish oils) are often taken for cardioprotective benefit. The NP knows regarding Omega 3 consumption:
    • A: randomized control trials have found no reduction in morbidity or mortality
88. A 55-year-old Caucasian male pt follows up with you after referral to a cardiologist. The pt reports he thinks the medication is causing cough and sometimes he has difficulty breathing, which of the following medication was most likely prescribed? - A: Lisinopril
89. The prevalence of depression in nursing home residents is greater than adults living in the community: - A: 3-4 times
90. The NP orders bilateral wrist Xrays on a 69-year-old gentleman c/o of pain in both wrists for the past 6 weeks not related to any known trauma. The NP suspects elderly onset RA. The initial radiographic finding in a patient with elderly onset RA would be: - A: soft tissue swelling
91. The NP knows that the goal of treatment for anxiety should:
    • A: reduce symptoms and improve function
92. All of the following statements are true regarding anxiety EXCEPT:
    • A: is a normal part of aging
93. Which of the following best describes the pain associated with OA?
    • A: Begins upon arising and after prolonged weight bearing and/or use of the joint
94. Which organism that can be prevented by immunization is most often responsible for infectious outbreak in the nursing home setting? - A : Influenza A

97. PG is a 58-year-old Caucasian man with stable mental health diagnosis of schizophrenia who presents for a yearly physical. PG is prescribed aripiprazole for treatment of his schizophrenia. The NP knows the following labs should be ordered to assess for cardiometabolic changes related to his medication EXCEPT: - A: AST/ALT