Evidence-Based Practice in Nursing, Exams of Nursing

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NR 511 Test Bank Solutions (Latest Update)

AANP-FNP lightning round review-#

1. How many sets of Kegels should be done each day to help with urinary incontinence?

-Three sets of 10 a day

2. What is the first line treatment for allergic rhinitis?

• intranasal corticosteroid—ie: Flonase.

3. What is the term used for the loss of high-pitched tones in geriatrics?

-Presbycusis

4. What type of hearing loss does cerumen impaction cause?

• Conductive hearing loss

5. You see an older woman bending over leaving on her shopping cart at the grocery store. What isthe likely diagnosis?

-Spinal stenosis

6. Multiple myeloma is disease of what?

-Plasma cells

7. What test in the office can you use to help diagnose sciatica?

• Straight leg test (Always pick the cheapest, most noninvasive tests first!!)

8. I have heel pain that is worse in the morning. What is my likely diagnosis?

• Plantar fasciitis

9. The Lachman test is used to help diagnose what?

• ACL

10. Other tests for acl include

-anterior and posterior drawer tests

11. What is the treatment for gout and what would be the medication instructions for a flare?

• Colchicine and take 1.2 mg at the first sign of flare, followed in 1 hour with a single dose of 0. mg.

12. What is a sign of colchicine toxicity?

• Diarrhea

13. What is a common cause of posterior knee pain?

• Baker’s cyst

14. Cotton wool spots, neovascularization and microaneurysms are all Eye exam findings in whatcondition? – Diabetes

15. And what about AV nicking and what it is?

• HTN, when an artery crosses over a vein

16. What is the treatment for bacterial sinusitis?

-Augmentin

17. I’m tired, have a sore throat and swollen posterior cervical nodes on exam. What is the likely diagnosis? -Mono--The best thing I can say to help differentiate those two for memory is that P inposterior is closer to M in mono in the alphabet so that’s how I remember!
18. Recall that swollen ANTERIOR cervical nodes are seen in

• strep.

19. What is a common side effect of Pyridium, an anti-spasmodic for dysuria?

-Orange colored urine

20. What would be included in your list of differentials for hematuria?

-Bladder cancer, kidney stones, exercise induced, trauma, medications, infection, and BPH are the most common reasons

21. What is the medication treatment for MRSA?Bactrim
22. What are some symptoms a patient with lupus would complain of?

• Fatigue, malar rash aka butterfly rash, and joint aches.

23.And what is the lab that you would order it to confirm it?

-ANA

24. What is the term used to describe dry, itching skin?

-Xerosis

25. What is the most common kind of skin cancer?

• Basal cell carcinoma reminder that this cancer presents as a pearly domed nodule, pink or fleshcolored and usually has telangiectasia present

26. What medication is used to treat a cat or dog bite?

-Augmentin (dogmantin)

27. What do you think of when you hear a bright beefy red rash and what is the treatment?

• Candidiasis and treatment is topical anti-fungal (e.g diaper rash)

28. How would you describe the prostate in BPH?

• Firm, rubbery, smooth and symmetrically enlarged. NB that prostate cancer on the other hand isasymmetrical

29. A1C> what is considered T2DM?

6.5%

30. My A1C is >10, what would be the medication of choice? Insulin (also first choice medication if fasting glucose is >300!)
31. Hypothyroidism is most common in what population?

• Women >50yrs

32. Your pediatric pt has bloody discharge in his ear, what’s the likely dx?

• Ruptured TM

33. Your patient presents with a burn and blisters are present. What degree burn is this?

-2nd^ degree

34 What is the treatment for pertussis?

• Macrolide (Azithromycin)

35. What bug causes the greatest mortality in community acquired pneumonia?Strep pneumo
36. What would be seen on xray of a pt with TB? A black circle usually in the upper lobes
37. Most common side effect of long-term inhaled corticosteroid use?

-Osteopenia and cataracts

38. S3 heart sound is a sign of what?

-Congestive heart failure (keep in mind they’re normal during pregnancy)

39. What medication do use to treat a fib?

• Beta blockers

40. What is pulsus paradoxus?

• A decrease in systolic pressure with inspiration usually seen in asthmatics...to measure use a bloodpressure cuff and stethoscope

41. The upcoming July 4th holiday reminds you of what diagnosis?

-Raynauds ..red white and blue color changing of the hands. Tx? CCBs

42. Someone with high triglyceride levels is at increased risk of what?

-Pancreatitis

43. Subclinical hypothyroidism is described as what lab readings?

-High TSH with a normal T

44. A positive Markle test is significant of what?

-Appendicitis ...recall that the Markle test is also known as the heel jar in which the patient raises their heels then drop them suddenly and if they experience pain it’s positive for appendicitis

45. What differentials do you think of in someone with left upper quadrant pain?

-Gastritis, pancreatitis, myocardial infarction, and left lower lobe pneumonia.

46. What about left lower quadrant?

-Diverticulitis

47. A positive Murphy’s sign is indicative of what?

-Cholecystitis.

48. What diagnostic test would you order if this were positive?

• An ultrasound

49. What is the first line treatment for GERD?

• H2 blockers

50. I was going to go over hepatitis B markers but I think it’s harder to say that out loud versus seeing it on paper so going to skip that but of course remember to review those for the exam too!
51. What diagnostic test should be done for suspicion of appendicitis?

-CT scan ...you should also do a CT scan for diverticulitis and speaking of diverticulitis what is the treatment? Cipro and Flagyl

52. What is the confirmatory test for HIV? Per Leik 3rd edition,

• Step 1 : Order HIV-1/HIV-2 antibodies and P24 antigen (combination assay) with reflexes. "Reflex" means that if positive, the lab will automatically perform the follow-up test to confirm theresults.

53. What is the treatment for syphilis?

-Pcn G (for all stages of it)

54. And what are some presenting features of syphilis? Rashes on soles of feet and palms of hands,painless lesions (chancre)
55. Gonorrhea treatment? Rocephin (“gone-a-cephin” helps me remember this one!)
56. Cervicitis is seen in which diagnoses?

-Chlamydia and gonorrhea

57. I am a healthy 63-year-old patient, what is my goal BP according to JNC 8?

• <150/90 for 60yrs+. Recall that less than 60yrs is <140/90 in addition to those with DM and CKD

58. What should we keep in mind when prescribing for the elderly population?

-May have to start with half dose and increase slowly, side effects!! Especially anticholinergics

59. A low HDL and high trig level always means what?

-Insulin insufficiency

60. The S1 is the closure of which valves?

-AV valves, and S2 is closure of semilunar valves

61. On exam you feel a weakened peripheral pulse, what diagnosis do you think of?

• PAD

62. An absent red reflex is indicative of what? Cataract
63. During an eye exam you note absent venous pulsations, what is this related to?

-Papilledema

64. The Dix Hallpike maneuver is used to test for what condition?

-Vertigo

65. What is the most well-known medication treatment for Vertigo?

• Meclizine

66. What medication is prescribed for essential tremors?

-BB (propranolol)

67. A young adult patient states that she is experiencing episodes of vision loss and abnormal limbsensations. What would be at the top of your list of differentials?

• MS---and what would you do? REFER TO NEURO

68. When assessing a patient for dementia, what is the FIRST and best thing you should do?

-GET A GOOD HX FROM PT BUT ALSO FAMILY

69. Name a difference between dementia and delirium?

• Dementia is slow progress, delirium happens RAPIDLY

70. What is the MAIN cause of delirium?

-Infection

71. Cranial Nerves review (just going over the MAIN ones I’ve seen in reviews/questions for the exam)

--nose: 1

--vision: 2

--EOM: 3, 4, and 6

--trigeminal: 5 (trigeminal neuralgia)

--facial: 7 (bell’s palsy)—HSV can cause Bell’s Palsy (keep in mind!)

--ears: 8

--shoulders: 11

72. UTI treatment?

• Macrobid

73. What about UTI in a pregnant pt?

-Keflex or Amoxicillin

74. Anxiety…which meds to use for situational?

-Benzos and GAD? SSRIs, SNRIs

75. What about OCD? SSRI, SNRI, TCA
76. Which population has the highest suicide rate?

-Older, white males

77. What symptom is specific to the geriatric population when you think of UTIs? Confusion
78. PNA in Geri’s, how do they present?

-We went over this last round, but felt it was important enough to repeat it. Tachypnea, extreme fatigue, and I didn’t mention last time but another thing to keep in mind with geris and PNA is that they MAY not have a fever with it because of decreased thermoregulation. Also can see delirium and falls.

79. What is the difference between sensitivity and specificity?

• Sen= TRUE positive, they tested POSITIVE and HAVE the DA, whereas Spec= DON’T have theDA, tested NEG

80. What vitamin deficiency can alcohol lead to?

-Thiamine deficiency (vit B1)---and INCREASED GGT levels

81. MMSE, what score indicates dementia?

<24 (0-9 is severe)

82. 10mm+ for PPD is needed for continued investigation of TB for what two populations?

-Healthcare workers and recent migrants. Note 5mm+ “ “-- HIV patients and immunosuppressant

83. What food is advised to try first in infants 4-6 months of age?

-Rice cereal

84. What degree of curvature in scoliosis should warrant bracing?

20 degrees

85. Tanner staging, anyone need a refresher on this?
86. What is the leading cause of death in children?

-ACCIDENTS

87. What sound during the Ortolani maneuver is a positive finding and signifies a possible hipabnormality (hip dysplasia) in infants. –

-The "clunk" sound

88. A newborn's mother is discovered to be HBsAg (hepatitis B surface antigen) positive. Which of the following would you recommend for this infant?

—Give BOTH the Hep B vaccine and immunoglobulin

89. Which method is used to diagnose gonorrheal pharyngitis or proctitis?

—Thayer-Martin culture is recommended for screening to diagnose gonorrheal pharyngitis or proctitis.

90. What is the treatment for a medial tibial stress fracture (aka “shin splints”)

-RICE

Chapter 3. Health

Promotion Multiple

Choice

Identify the choice that best completes the statement or answers the question.

_A 1. Which of the following is a primary prevention measure for a 76-year-old man newly diagnosed with a testosterone deficiency?

a. Calcium supplementation b. Testicular self-examination c. Bone density test d. Digital rectal examination

A 2. Which of the following is an example of secondary prevention in a 50-year-old woman?

a. Yearly mammogram b. Low animal fat diet c. Use of seat belt

d. Daily application of sunscreen

B_ 3. 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. Maintenance of blood pressure at 120/

A 4. Immunizations are an example of which type of prevention?

a. Primary b. Secondary c. Tertiary

True/False

Indicate whether the statement is true or false.

F 1. Prevalence is the number of new cases of a particular disease.

F 2. The number of cases of a particular disease for the past 5 years is an example of the incidence rate.

T 3. “There are 1,185,000 cases of HIV/AIDS in the United States” is an example of the morbidity rate.

T 4. Endemic is the term used when the presence of an event is constant.

F 5. The “bird” flu of 2005 to 2006 is considered a sporadic outbreak.

T_ 6. A pandemic affects many communities in a short period of time.

Chapter 3. Health

Promotion Answer

Section

MULTIPLE CHOICE

1. ANS: A PTS: 1

2. ANS: A PTS: 1

3. ANS: B PTS: 1

4. ANS: A PTS: 1

TRUE/FALSE

1. ANS: F PTS: 1

2. ANS: F PTS: 1

3. ANS: T PTS: 1

4. ANS: T PTS: 1

5. ANS: F PTS: 1

6. ANS: T PTS: 1

Chapter 5. Evidence-Based Care

Multiple Choice Identify the choice that best completes the statement or answers the question.

D_ 1. Which of the following are parts of evidence-based practice?

a. Clinician

b. Patient c. Evidence d. All of the above

B 2. Which is the most important question to ask in nursing research?

a. What findings constitute evidence? b. How will the findings be used? c. Is this a randomized controlled trial? d. What theory is being utilized?

D 3. Nursing research should be utilized by:

a. Nurses at the bedside b. Advanced practice nurses c. Nurse researchers d. Nurses at all levels of practice

A 4. Applying evidence at the point of care requires:

a. Readily available evidence-based resources b. Ability to review research literature c. Single articles in journals d. Current textbooks

C_ 5. Practice guidelines are designed to:

a. Be inflexible b. Be utilized in every circumstance c. Provide a reference point for decision making d. Be created by a professional organization to guide the practice of a profession

B_ 6. 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

B_ 7. Which of the following would be considered the research design for Level I evidence?

a. Single, well-designed randomized clinical trial b. Systematic review of randomized clinical trial studies c. Well-designed controlled trials without randomization d. Systematic reviews of descriptive or qualitative studies

C_ 8. Which of the following would be considered the research design for Level II evidence?

a. Single descriptive or qualitative study b. Well-designed case control or cohort studies c. Single, well-designed, randomized clinical trial d. Systematic review of randomized clinical trial studies

A 9. Which of the following would be considered the research design for Level III evidence?

a. Well-designed controlled trials without randomization b. Systematic reviews of descriptive or qualitative studies

c. Systematic review of randomized clinical trial studies d. Opinion of authorities and expert committees

D 10. Which of the following would be considered the research design for Level IV evidence?

a. Single descriptive or qualitative study b. Opinion of authorities and expert committees c. Systematic review of randomized clinical trial studies d. Well-designed controlled trials without randomization

_C 11. Which of the following would be considered the research design for Level V evidence?

a. Systematic review of randomized clinical trial studies b. Well-designed controlled trials without randomization c. Systematic reviews of descriptive or qualitative studies d. Single descriptive or qualitative study

C 12. Which of the following would be considered the research design for Level VI evidence?

a. Systematic reviews of descriptive or qualitative studies b. Opinion of authorities and expert committees c. Well-designed case control or cohort studies d. Single descriptive or qualitative study

B13. Which of the following would be considered the research design for Level VII evidence?

a. Well-designed controlled trials without randomization b. Opinion of authorities and expert committees c. Well-designed case control or cohort studies d. Single descriptive or qualitative study

Chapter 5. Evidence-

Based Care Answer Section

MULTIPLE CHOICE

1. ANS: D PTS: 1

2. ANS: B PTS: 1

3. ANS: D PTS: 1

4. ANS: A PTS: 1

5. ANS: C PTS: 1

6. ANS: B PTS: 1

7. ANS: B PTS: 1

8. ANS: C PTS: 1

9. ANS: A PTS: 1

10. ANS: D PTS: 1

11. ANS: C PTS: 1

12. ANS: C PTS: 1

13. ANS: B

Chapter 6. Neurological

Problems Multiple

Choice

Identify the choice that best completes the statement or answers the question.

D 1. Which statement about confusion is true?

a. Confusion is a disease process. b. Confusion is always temporary.

c. Age is a reliable predictor of confusion. d. Polypharmacy is a major contributor to confusion in older adults.

C_ 2. 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

B_ 3. 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

B 4. 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

C 5. Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)?

a. A teenage male b. A 65-year-old male c. A 25-year-old female d. A 60-year-old female

D_ 6. Which of the following is a specific test to MS?

a. Magnetic resonance imaging (MRI) b. Computed tomography (CT) scan c. A lumbar puncture d. There is no specific test.

A 7. 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

A 8. Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery?

a. Epidural hematoma b. Subdural hematoma c. Subarachnoid hematoma d. Intraparenchymal hemorrhage

A 9. Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing?

a. CN V b. CN VII c. CN IX d. CN X

D 10. 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.

D_11. 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

D 12. Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?

a. Dementia b. Alzheimer’s disease c. Parkinson’s disease d. Delirium

C_13. Which type of meningitis is more benign, self-limiting, and caused primarily by a virus?

a. Purulent meningitis b. Chronic meningitis c. Aseptic meningitis