Evidence-Based Practice in Nursing, Exams of Nursing

Download Evidence-Based Practice in Nursing and more Exams Nursing in PDF only on Docsity! NURS 620 Exam 3 Questions and Complete Solutions Graded A+ [Document subtitle] Denning [Date] [Course title] Vertigo - Answer: Symptom of vestibular dysfunction, illusion of motion. Can be caused by lesion, trauma, MS, brainstem ischemia, infarction or hemorrhage, Meniere disease, or aggravated by inner ear problems. Treatment for Bell's palsy - Answer: Surgical decompression, Prednisolone, Acyclovir, nerve stimulation. Trigeminal neuralgia - Answer: Recurrent brief episodes of unilateral shock like pains in the fifth cranial nerve. Diagnosed with MRI or CT if MRI not indicated. Treated with carbamazepine, oxcarbazepine, Baclofen, or Lamotrigine. Surgery can decompress or ablative procedures can block. Myasthenia gravis symptoms - Answer: Fluctuating, localized, skeletal muscle weakness and fatigue. Autoimmune dysfunction. Myasthenia gravis test - Answer: Positive acetylcholine receptor antibody assay. Nystagmus - Answer: Rhythmic oscillation of the eyes Diagnostics for vertigo - Answer: CT, MRI, MR angiography, electronystagmography, video nystagmography, vestibular evoked myogenic potentials, Migraine - Answer: Recurrent, often unilateral, throbbing, has photophobia Tension headache - Answer: Bilateral, non-throbbing Cluster headache - Answer: Unilateral, temporal or behind orbital, intense Which of the following are parts of Evidence-Based Practice? a. Clinician c. Evidence b. Patient d. All of the above - Answer: d. All of the above What is the important question to ask in nursing research? c. Systematic reviews of descriptive or qualitative studies d. Single descriptive or qualitative study - Answer: c. Systematic reviews of descriptive or qualitative studies 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 - Answer: c. Well-designed case control or cohort studies 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 - Answer: b. Opinion of authorities and expert committees Which statement about confusion is true? - Answer: Polypharmacy is a major contributor in older adults Sondra has peripheral vestibular disease causing dizziness and vertigo. Which of the following medications will help to decrease the edema in the labyrinth of the ear? a. Meclizine b. Diphenhydramine c. Diamox d. Promethazine - Answer: C. Diamox 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. - Answer: B. A blank stare 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 - Answer: B. Every 6 months 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 - Answer: C. A 25-year-old female 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. - Answer: D. There is no specific test 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 - Answer: A. Cholinesterase inhibitors 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 - Answer: A. Epidural hematoma Which cranial nerve is affected in a patient with a cerebrovascular accident (CVA) who has difficulty chewing? a. CN 5 b. CN 7 c. CN 9 d. CN 10 - Answer: A. CN 5 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. - Answer: D. The higher the pitch of the bruit, the higher the degree of stenosis 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 - Answer: D. A 45-year-old male awakened at night Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines? a. Propranolol b. Timolol c. Ergotamine a. Greater than 25% b. Greater than 50% c. Greater than 75% d. Only for 100% occlusion - Answer: B. Greater than 50% What antiplatelet agent is most widely used for secondary prevention of stroke? a. Aspirin b. Ticlopidine c. Clopidogrel d. Aspirin and clopidogrel - Answer: A. Aspirin Which adjunctive diagnostic test should be used in the work-up of a patient with suspected Creutzfeldt- Jakob disease or transient epileptic amnesia? a. Magnetic resonance imaging (MRI) b. Noncontrast computed tomography (CT) c. Cerebrospinal fluid (CSF) analysis d. Electroencephalogram (EEG) - Answer: D. Electroencephalogram (EEG) Which herbal preparation may cause delirium and should be avoided in an elderly patient? a. Sam-e b. Saint John's Wort c. Melatonin d. Saw Palmetto - Answer: B. Saint John's Wort Which of the following activities is part of the functional activities questionnaire (FAQ)? a. Asking the patient to unravel a Rubik's cube b. Determining if the patient can drive on the highway c. Asking the patient about a news event from the current week d. Seeing if the patient can keep his or her home clean - Answer: C. Asking the patient about a news event from the current week 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 - Answer: A. Human papillomavirus (HPV) A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea? a. Ceftriaxone b. Doxycycline c. Acyclovir d. Metronidazole - Answer: A. Ceftriaxone 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 - Answer: C. Chlamydia 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) - Answer: B. Bacterial vaginosis Which of the following medications is the treatment of choice for trichomonas? a. Metranidazole b. Ceftriaxone c. Diflucan d. Doxycycline - Answer: A. Metranidazole 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, because that is the most common breast mass." b. "We will order a mammogram and ultrasound to help establish a diagnosis." c. "We will go ahead and schedule you for a biopsy because that is the only way to know for sure." d. "Because your lump is painful, it is most likely not cancer." - Answer: B. "We will order a mammogram and ultrasound to help establish a diagnosis." 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 - Answer: A. Pregnancy test A 42-year-old woman presents to the clinic with complaints of painful intercourse for the last month. Which of the following should be explored as the most likely cause for her dyspareunia? a. Menopause b. Dehydration c. Excess progesterone d. Sexual trauma as a child - Answer: A. Menopause a. At least 4 cups of green tea daily b. Regular exercise c. Take vitamin A supplements d. Eat a diet high in iron - Answer: B. Regular exercise A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which of the following pelvic pathologies is the most common cause of dysmenorrhea? a. Pelvic inflammatory disease b. Endometriosis c. Sexually transmitted infections d. Ovarian cyst - Answer: B. Endometriosis A 26-year-old woman tells the clinician that she has endometriosis because she has frequent pelvic pain. The clinician should also consider which of these differential diagnoses? a. Diverticulitis b. Cholelithiasis c. Kidney stones d. Ovarian cysts - Answer: D. Ovarian cysts Which of the following would be appropriate treatment for a woman with mild endometriosis? a. Oral contraceptives b. Leuprolide acetate injections c. Nafarelin nasal spray d. Hysterectomy - Answer: A. Oral contraceptives A 45-year-old woman is seen in the clinic with abnormal uterine bleeding and pain during intercourse. The clinician should consider which of the following diagnoses? a. Leiomyoma b. Pregnancy c. Ovarian cancer d. All of the above - Answer: D. All of the above A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first? a. Transvaginal ultrasound b. Endometrial biopsy c. Magnetic resonance imaging (MRI) d. Abdominal computed tomography (CT) scan - Answer: A. Transvaginal ultrasound A 45-year-old woman is seen because of irregular menstrual periods. Her follicle-stimulating hormone (FSH) level is 48 mIU/mL, and her luteinizing hormone (LH) level is elevated. She asks the clinician what this means. Which would be the best response? a. "You are approaching menopause." b. "You have a hormone imbalance." c. "Your FSH is normal, but your pituitary is making too much LH." d. "There is an imbalance between your ovaries and pituitary." - Answer: A. "You are approaching menopause." Which of the following tests is essential for a 46-year-old woman who the clinician suspects is perimenopausal? a. Pregnancy test b. Estrogen level c. Progesterone level d. Luteinizing hormone (LH) level - Answer: A. Pregnancy test A 60-year-old woman is seen for an annual checkup. Her obstetric history reveals para 6, gravida 6. She reports that she went through menopause at age 45. Her grandmother died at the age of 80 of colon cancer, and her father died of lung cancer. What in her history would be a risk factor for ovarian cancer? a. Her numerous pregnancies b. Her age at menopause c. Her father's history of lung cancer d. Her grandmother's history of colon cancer - Answer: D. Her grandmother's history of colon cancer 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 - Answer: B. Estradiol 7.5 mcg/24 hr vaginal ring Oral contraceptive pills - Answer: Do not cause endometrial cancer A woman taking estradiol is at risk for developing - Answer: endometrial cancer