Identifying and Managing Common Medical Conditions, Exams of Nursing

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NSG 6420 EXAM 2 QUESTIONS AND

ANSWERS | 100% VERIFIED

SOLUTIONS 2024/

1 Which of the following is the most common cause of heartburn-type epigastric pain? Question 1 options: a) Decreased lower esophageal sphincter tone b) Helicobacter pylori infection of stomach c) Esophageal spasm d) Peptic ulcer disease Save Question 2 (1 point) 2 An older patient reports burning pain after ingestion of many foods and large meals. What assessment would assist the nurse practitioner in making a diagnosis of GERD? Question 2 options: a) Identification of a fluid wave b) Positive Murphy’s sign c) Palpable spleen d) Midepigastric pain that is not reproducible with palpation Save

Question 3 (1 point) 3 Your patient complains of lower abdominal pain, anorexia, extreme fatigue, unintentional weight loss of 10 pounds in last 3 weeks, and you find a positive hemoccult on digital rectal examination. Laboratory tests show iron deficiency anemia. The clinician needs to consider: Question 3 options: a) Diverticulitis b) Colon cancer c) Appendicitis d) Peptic ulcer disease Save Question 4 (1 point) 4 A 22-year-old female comes to your office with complaints of right lower quadrant abdominal pain, which has been worsening over the last 24 hours. On examination of the abdomen, there is a palpable mass and rebound tenderness over the right lower quadrant. The clinician should recognize the importance of: Question 4 options: a) Digital rectal examination b) Endoscopy c) Pelvic examination d) Urinalysis

NSG 6420 EXAM 2 QUESTIONS AND

ANSWERS | 100% VERIFIED

SOLUTIONS 2024/

Save Question 5 (1 point) 5 A nurse practitioner reports that your patient’s abdominal X-ray demonstrates multiple air-fluid levels in the bowel. This is a diagnostic finding found in: Question 5 options: a) Appendicitis b) Cholecystitis c) Bowel Obstruction d) Diverticulitis Save Question 6 (1 point) 6 Which of the following conditions is the most common cause of nausea, vomiting, and diarrhea? Question 6 options: a) Viral gastroenteritis b) Staphylococcal food poisoning

c) Acute hepatitis A d) E coli gastroenteritis Save Question 7 (1 point) 7 A 56-year-old male complains of anorexia, changes in bowel habits, extreme fatigue, and unintentional weight loss. At times he is constipated and other times he has episodes of diarrhea. His physical examination is unremarkable. It is important for the clinician to recognize the importance of: Question 7 options: a) CBC with differential b) Stool culture and sensitivity c) Abdominal X-ray d) Colonoscopy Save Question 8 (1 point) 8 A 59-year-old patient with history of alcohol abuse comes to your office because of ‘throwing up blood”. On physical examination, you note ascites and caput medusa. A likely cause for the hematemesis is: Question 8 options: a) Peptic ulcer disease b) Barrett’s esophagus

NSG 6420 EXAM 2 QUESTIONS AND

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SOLUTIONS 2024/

c) Esophageal varices d) Pancreatitis Save Question 9 (1 point) 9 An 82-year-old female presents to the emergency department with epigastric pain and weakness. She admits to having dark, tarry stools for the last few days. She reports a long history of pain due to osteoarthritis. She self-medicates daily with ibuprofen, naprosyn, and aspirin for joint pain. On physical examination, she has orthostatic hypotension and pallor. Fecal occult blood test is positive. A likely etiology of the patient’s problem is: Question 9 options: a) Mallory-Weiss tear b) Esophageal varices c) Gastric ulcer d) Colon cancer Save Question 10 (1 point) 10

When counseling clients regarding the use of antidiarrheal drugs such as Imodium anti-diarrheal and Kaopectate, the nurse practitioner advises patients to: Question 10 options: a) Use all the medication b) Do not use for possible infectious diarrhea c) Use should exceed one week for effectiveness d) These drugs provide exactly the same pharmaceutical effects Save Question 11 (1 point) 11 When teaching a group of older adults regarding prevention of gastroesophageal reflux disease symptoms, the nurse practitioner will include which of the following instructions? Question 11 options: a) Raise the head of the bed with pillows at night and chew peppermints when symptoms of heartburn begins. b) Raise the head of the bed on blocks and take the proton pump inhibitor medication at bedtime. c) Sit up for an hour after taking any medication and restrict fluid intake. d) Avoid food intolerances, raise head of bed on blocks, and take a proton pump inhibitor before a meal. Save Question 12 (1 point) 12

NSG 6420 EXAM 2 QUESTIONS AND

ANSWERS | 100% VERIFIED

SOLUTIONS 2024/

In a patient presenting with suspected recurrence of diverticulitis, abdominal pain usually presents where in the abdomen? Question 12 options: a) Left upper quadrant b) Right upper quadrant c) Left lower quadrant d) Right lower quadrant Save Question 13 (1 point) 13 Helicobacter pylori is implicated as a causative agent in the development of duodenal or gastric ulcers. What teaching should the nurse practitioner plan for a patient who has a positive Helicobacter pylori test? Question 13 options:

a) It is highly contagious and a mask should be worn at home. b) Treatment regimen is multiple lifetime medications. c) Treatment regimen is multiple medications taken daily for a few weeks. d) Treatment regimen is complicated and is not indicated unless the patient is symptomatic. Save Question 14 (1 point) 14 An obese middle-aged client presents with a month of nonproductive irritating cough without fever. He also reports occasional morning hoarseness. What should the differential include? Question 14 options: a) Atypical pneumonia b) Peptic ulcer disease c) Gastroesophageal reflux d) Mononucleosis (Epstein-Barr) Save Question 15 (1 point) 15 Which of the following findings would indicate a need for another endoscopy in clients with peptic ulcer disease? Question 15 options:

a) Cases of dyspepsia with constipation b) Symptoms persisting after six to eight weeks of therapy c) All clients with dyspepsia who smoke and drink alcohol d) When a therapeutic response to empiric treatment is obtained Save Question 16 (1 point) 16 A 20 - year-old engineering student complains of episodes of abdominal discomfort, bloating, and episodes of diarrhea. The symptoms usually occur after eating, and pain is frequently relieved with bowel movement. She is on a “celiac diet” and the episodic symptoms persist. Physical examination and diagnostic tests are negative. Colonoscopy is negative for any abnormalities. This is a history and physical consistent with: Question 16 options: a) Inflammatory bowel disease b) Irritable bowel syndrome c) Giardiasis d) Norovirus gastroenteritis Save Question 17 (1 point) 17

What test is used to confirm the diagnosis of appendicitis? Question 17 options: a) CBC b) Flat plate of abdomen c) Rectal exam d) CT of abdomen with attention to appendix Save Question 18 (1 point) 18 If it has been determined a patient has esophageal reflux, you should tell them: Question 18 options: a) They probably have a hiatal hernia causing reflux b) They probably need surgery c) They should avoid all fruit juices d) Smoking, alcohol, and caffeine can aggravate their problem Save Question 19 (1 point) 19

A 74-year-old obese female presents complaining of persistent right upper quadrant pain. She reports that she has not had any prior abdominal surgeries. Which of the following laboratory studies would be most indicative of acute cholecystitis? Question 19 options: C-reactive protein level of 3 mg White blood cell count of 11,

Direct serum bilirubin level of 0.3 mg/dl Serum amylase level of 145 U/L Save Question 20 (1 point) 20 Which of the following is not a contributing factor to the development of esophagitis in older adults? Question 20 options: a) Increased gastric emptying time b) Regular ingestion of NSAIDs c) Decreased salivation d) Fungal infections such as Candida Save Question 21 (1 point) 21 The major impact of the physiological changes that occur with aging is: Question 21 options: a) Reduced physiological reserve b) Reduced homeostatic mechanisms c) Impaired immunological response d) All of the above

Save Question 22 (1 point) 22 Men have faster and more efficient biotransformation of drugs and this is thought to be due to: Question 22 options: a) Less obesity rates than women b) Prostate enlargement c) More testosterone than women d) Less estrogen than women Save Question 23 (1 point) 23 The cytochrome p system involves enzymes that are generally: Question 23 options: a) Inhibited by drugs b) Induced by drugs c) Inhibited or induced by drugs d) Associated with decreased liver perfusion Save Question 24 (1 point)

24 Functional abilities are best assessed by: Question 24 options: a) Self-report of function b) Observed assessment of function c) A comprehensive head-to-toe examination d) Family report of function Save Question 25 (1 point) 25 When interpreting laboratory data, you would expect to see the following in a patient with Anemia of Chronic Disease (ACD): Question 25 options: a) Hemoglobin >8 g/dl, MCV increased, MCH increased b) Hemoglobin >12 g/dl, MCV increased, MCH increased c) Hemoglobin >8 g/dl, MCV decreased, MCH decreased d) Hemoglobin >12 g/dl, MCV decreased, MCH increased Save Question 26 (1 point) 26

Iron Deficiency Anemia (IDA) is classified as a microcytic, hypochromic anemia. This classification refers to which of the following laboratory data? Question 26 options: a) Hemoglobin and Hematocrit b) Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH) c) Serum ferritin and Serum iron d) Total iron binding capacity and transferrin saturation Save Question 27 (1 point) 27 The pathophysiological hallmark of ACD is: Question 27 options: a) Depleted iron stores b) Impaired ability to use iron stores c) Chronic uncorrectable bleeding d) Reduced intestinal absorption of iron Save Question 28 (1 point) 28 The main focus of treatment of patients with ACD is: Question 28 options:

a) Replenishing iron stores b) Providing for adequate nutrition high in iron c) Management of the underlying disorder d) Administration of monthly vitamin B12 injections Save Question 29 (1 point) 29 In addition to the complete blood count (CBC) with differential, which of the following laboratory tests is considered to be most useful in diagnosing ACD and IDA? Question 29 options: a) Serum iron b) Total iron binding capacity c) Transferrin saturation d) Serum ferritin Save Question 30 (1 point) 30 Symptoms in the initial human immunodeficiency virus (HIV) infection include all of the following except: Question 30 options: a) Sore throat

b) Fever c) Weight loss d) Headache Save Question 31 (1 point) 31 Essential parts of a health history include all of the following except: Question 31 options: a) Chief complaint b) History of the present illness c) Current vital signs d) All of the above are essential history components Save Question 32 (1 point) 32 Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or patients? Question 32 options: a) Clinical practice guideline b) Clinical decision rule c) Clinical algorithm

d) Clinical recommendation Save Question 33 (1 point) 33 The first step in the genomic assessment of a patient is obtaining information regarding: Question 33 options: a) Family history b) Environmental exposures c) Lifestyle and behaviors d) Current medications Save Question 34 (1 point) 34 In autosomal recessive (AR) disorders, individuals need: Question 34 options: a) Only one mutated gene on the sex chromosomes to acquire the disease b) Only one mutated gene to acquire the disease c) Two mutated genes to acquire the disease d) Two mutated genes to become carriers Save Question 35 (1 point)

35 In AR disorders, carriers have: Question 35 options: a) Two mutated genes; one from each parent that cause disease b) A mutation on a sex chromosome that causes a disease c) A single gene mutation that causes the disease d) One copy of a gene mutation but not the disease Save Question 36 (1 point) 36 A woman with an X-linked dominant disorder will: Question 36 options: a) Not be affected by the disorder herself b) Transmit the disorder to 50% of her offspring (male or female) c) Not transmit the disorder to her daughters d) Transmit the disorder to only her daughters Save Question 37 (1 point) 37 According to the Genetic Information Nondiscrimination Act (GINA):

Question 37 options: a) Nurse Practitioners (NPs) should keep all genetic information of patients confidential b) NPs must obtain informed consent prior to genetic testing of all patients c) Employers cannot inquire about an employee’s genetic information d) All of the above Save Question 38 (1 point) 38 Which of the following would be considered a “red flag” that requires more investigation in a patient assessment? Question 38 options: a) Colon cancer in family member at age 70 b) Breast cancer in family member at age 75 c) Myocardial infarction in family member at age 35 d) All of the above Save Question 39 (1 point) 39 Your 2-year-old patient shows facial features, such as epicanthal folds, up-slanted palpebral fissures, single transverse palmar crease, and a low nasal bridge. These are referred to as: Question 39 options:

a) Variable expressivity related to inherited disease b) Dysmorphic features related to genetic disease c) De novo mutations of genetic disease d) Different penetrant signs of genetic disease Save Question 40 (1 point) 40 In order to provide a comprehensive genetic history of a patient, the NP should: Question 40 options: a) Ask patients to complete a family history worksheet b) Seek out pathology reports related to the patient’s disorder c) Interview family members regarding genetic disorders d) All of the above Save Question 41 (1 point) 41 An 86-year-old patient who wears a hearing aid complains of poor hearing in the affected ear. In addition to possible hearing aid malfunction, this condition is often due to: Question 41 options: a) Acoustic neuroma

b) Cerumen impaction c) Otitis media d) Ménière’s disease Save Question 42 (1 point) 42 In examination of the nose, the clinician observes gray, pale mucous membranes with clear, serous discharge. This is most likely indicative of: Question 42 options: a) Bacterial sinusitis b) Allergic rhinitis c) Drug abuse d) Skull fracture Save Question 43 (1 point) 43 Which of the following symptoms is common with acute otitis media? Question 43 options: a) Bulging tympanic membrane b) Bright light reflex of tympanic membrane c) Increased tympanic membrane mobility

d) All of the above Save Question 44 (1 point) 44 Presbycusis is the hearing impairment that is associated with: Question 44 options: a) Physiologic aging b) Ménière’s disease c) Cerumen impaction d) Herpes zoster Save Question 45 (1 point) 45 Epistaxis can be a symptom of: Question 45 options: a) Over-anticoagulation b) Hematologic malignancy c) Cocaine abuse d) All of the above Save

Question 46 (1 point) 46 Your patient has been using chewing tobacco for 10 years. On physical examination, you observe a white ulceration surrounded by erythematous base on the side of his tongue. The clinician should recognize that very often this is: Question 46 options: a) Malignant melanoma b) Squamous cell carcinoma c) Aphthous ulceration d) Behcet’s syndrome Save Question 47 (1 point) 47 Your patient is a 78-year-old female with a smoking history of 120-pack years. She complains of hoarseness that has developed over the last few months. It is important to exclude the possibility of: Question 47 options: a) Thrush b) Laryngeal cancer c) Carotidynia d) Thyroiditis Save Question 48 (1 point)

48 Which of the following findings should trigger an urgent referral to a cardiologist or neurologist? Question 48 options: a) History of bright flash of light followed by significantly blurred vision b) History of transient and painless monocular loss of vision c) History of monocular severe eye pain, blurred vision, and ciliary flush d) All of the above Save Question 49 (1 point) 49 The first assessment to complete related to the eyes is: Question 49 options: a) Eye lids b) Visual acuity c) Extraocular movements d) Peripheral vision 50 It is important to not dilate the eye if ____ is suspected. Question 50 options: a) Cataract