MN 566 FINAL EXAM 2023 ANSWERED, Exams of Nursing

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Question 1 (2 points)

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The clinician is assessing a patient complaining of hearing

loss. The clinician places a tuning fork over the patient’s

mastoid process, and when the sound fades away, the fork is

placed without restriking it over the external auditory meatus.

The patient is asked to let the clinician know when the sound

fades away. This is an example of which type of test?

Question 1 options:

a) (^) Weber test b) (^) Schwabach test c) (^) Rinne test d) (^) Auditory brainstem response (ABR) test

Question 2 (2 points)

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Fluctuations and reductions in estrogen may be a contributing

factor in which type of rhinitis?

Question 2 options:

a) (^) Vasomotor rhinitis b) (^) Rhinitis medicamentosa c) (^) Atrophic rhinitis d) (^) Viral rhinitis

Question 3 (2 points)

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You have a patient who is a positive for strep on rapid antigen

testing (rapid strep test). You order amoxicillin after checking

for drug allergies (patient is negative) but he returns 3 days

later, reporting that his temperature has gone up, not down

(101.5°F in office). You also note significant lymphadenopathy,

most notably in the posterior and anterior cervical chains,

some hepatosplenomegaly, and a diffuse rash. You decide:

Question 3 options:

a) (^) To refer the patient b) (^) That he is having an allergic response and needs to be changed to a macrolide antibiotic c) (^) That his antibiotic dosage is not sufficient and should be changed d) (^) That he possibly has mononucleosis concurrent with his strep infection

Question 4 (2 points)

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A patient presents with nonvesicular lesions that are 2 to 10

mm, symmetrical, and scattered on the oropharynx and

mouth. What is their most likely diagnosis?

Question 4 options:

a) (^) Corynebacterium diphtheriae b) (^) Primary syphilis c) (^) Candida infection d) (^) Secondary syphilis

Question 5 (2 points)

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Jean has acute otitis externa with fluid that is black and

malodorous. Which of the following is responsible for the

infection?

Question 5 options:

a) (^) Fungal infection b) (^) Staphylococcus infection c) (^) Pseudomonas infection d) (^) Allergic reaction

Question 6 (2 points)

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Which of the following medications for temporomandibular

disorder has the warning that patients should NOT drive while

taking it?

Question 6 options:

a) (^) Flexeril b) (^) Naprosyn c) (^) Tylenol d) (^) Elavil

Question 7 (2 points)

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Which type of stomatitis is caused by continual exposure to

chewing tobacco?

Question 7 options:

a) (^) Aphthous stomatitis b) (^) Herpetic stomatitis c) (^) Nicotinic stomatitis d) (^) Allergic stomatitis

Question 8 (2 points)

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What is the initial treatment for uncomplicated anterior

epistaxis?

Question 8 options:

a) (^) Tilting the head back so the blood does not run out of the nose b) (^) Applying firm and continuous pressure superior to the nasal alar cartilages for 10 to 15 minutes c) (^) Applying firm and continuous pressure to the nostril for 5 minutes d) (^) Letting the nose bleed clot and leaning the head forward

Question 9 (2 points)

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Which of the following is an example of sensorineural hearing

loss?

Question 9 options:

a) (^) Perforation of the tympanic membrane b) (^) Otosclerosis c) Cholesteatoma

d) (^) Presbycusis

Question 10 (2 points)

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A provider is examining a patient with temporomandibular

joint disease (TMJ). Which of the following results would the

provider expect from the exam?

Question 10 options:

a) (^) The mandibular opening is 40 mm. b) (^) There are no sounds elicited from the exam. c) (^) The mandible deviates to the left side. d) (^) The patient is able to open the mouth without pain or sound.

Question 11 (2 points)

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A patient presents to the clinician complaining of ear pain. On

examination, the clinician finds that the patient has

tenderness on traction of the pinna as well as when applying

pressure over the tragus. These findings are classic signs of

which condition?

Question 11 options:

a) (^) Otitis media b) (^) Ménière’s disease c) (^) Tinnitus

d) (^) Otitis externa

Question 12 (2 points)

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Peter presents with complaints of right hearing loss that has

been getting worse and a congruent headache. What is the

most likely diagnosis?

Question 12 options:

a) (^) Acoustic neuroma b) (^) Presbycusis c) (^) Ménière’s disease d) (^) Sensorineural hearing loss

Question 13 (2 points)

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You are performing muscle strength testing on a patient

presenting with musculoskeletal pain and find that the patient

has complete ROM but cannot move it above gravity. Which

numeric grade of muscle strength would you give this patient?

Question 13 options:

a) (^1) b) (^2) c) (^3) d) (^4)

Question 14 (2 points)

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Which of the following would lead the clinician to suspect a

tumor when paired with low back pain?

Question 14 options:

a) (^) Minor trauma with sneezing in elderly with osteoporosis b) (^) History of spinal procedure c) (^) Sudden loss of bowel or bladder function d) (^) Unintended weight loss >10% of body weight in 6 months

Question 15 (2 points)

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Which of the following signs or symptoms indicate an

inflammatory etiology to musculoskeletal pain?

Question 15 options:

a) (^) Decreased C-reactive protein b) (^) Hyperalbuminemia c) (^) Morning stiffness d) (^) Weight gain

Question 16 (2 points)

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Which of the following is a risk factor for overuse syndrome

with tendonitis?

Question 16 options:

a) (^) Body mass index < b) (^) Hypothyroidism c) (^) Rheumatoid arthritis d) (^) Cardiac disease

Question 17 (2 points)

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What is the recommended daily calcium intake for men 70

years and younger?

Question 17 options:

a) (^) 500 mg/day b) (^) 750 mg/day c) (^) 1,000 mg/day d) (^) 1,500 mg/day

Question 18 (2 points)

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Fred has been diagnosed with a trigger finger of the ring

finger. Which of the following management strategies is

appropriate?

Question 18 options:

a) (^) Surgical removal of the tendon sheath b) (^) NSAIDs

c) (^) Local anesthetic injection into the tendon sheath d) (^) Splinting

Question 19 (2 points)

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Debbie is a 43-year-old female being evaluated for a wrist

injury. The clinician is assessing for median nerve compression

by having Debbie maintain forced flexion of her wrist for 1

minute with the dorsal surface of each hand pressed together.

Which of these tests did the clinician just perform?

Question 19 options:

a) (^) Allen’s test b) (^) Phalen’s test c) (^) Tinel’s sign d) (^) Finkelstein’s test

Question 20 (2 points)

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Which of the following medications is appropriate to treat

Paget’s disease?

Question 20 options:

a) (^) Boniva b) (^) Fosamax c) (^) Reclast

d) (^) Forteo

Question 21 (2 points)

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A clinician is examining a vertebral fracture, and the

examination and diagnostic findings have shown a

compression of the anterior column that includes both

endplates. What type and subtype are these?

Question 21 options:

a) (^) Compression fracture, type A b) (^) Burst fracture, type B c) (^) Seat-belt type injury, level two d) (^) Fracture-dislocation, shear

Question 22 (2 points)

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Mrs. Allen is a 60-year-old woman who has been diagnosed

with osteoporosis. She is very concerned about the risk of

breast cancer associated with hormone replacement therapy

and is wondering what other treatments are available to her.

The clinician explains that bisphosphonates are another class

of drugs used in the prevention and treatment of osteoporosis.

What teaching should the clinician give Mrs. Allen in regard to

taking bisphosphonates?

Question 22 options:

a) Taking bisphosphonates can result in hypercalcemia, so calcium intake should be decreased while taking this class of drugs. b) There is potential for upper GI irritation, so these medications are contraindicated in people with abnormalities of the esophagus or delayed esophageal emptying.

c) This class of drugs can be taken at any time of the day without regard to meals. D.This class of drugs should be taken with orange juice to increase absorption.

Question 23 (2 points)

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The clinician suspects that a client has patellar instability. In

order to test for this, the client is seated with the quadriceps

relaxed, and the knee is placed in extension. Next the patella

is displaced laterally, and the knee flexed to 30°. If instability

is present, this maneuver displaces the patella to an abnormal

position on the lateral femoral condyle, and the client will

perceive pain. Testing for patellar instability in this way is

known as:

Question 23 options:

a) (^) Apprehension sign b) (^) Bulge sign c) (^) Thumb sign d) (^) Lachman sign

Question 24 (2 points)

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The clinician is caring for Diane, a 22-year-old woman who

presents with an injured ankle. Diane asks the clinician if she

will need an x-ray. The clinician explains to Diane that an x-ray

is not always necessary for an injured ankle and that the

decision to obtain radiographs is dependent on the

examination and Diane’s description of her injury. Which of the

following clues in Diane’s examination or history would alert

the clinician to the need for obtaining radiographs?

Question 24 options:

a) (^) Ability to bear weight immediately after the injury b) (^) Development of minor ankle swelling after the injury c) (^) Slight bruising over the injury site 2 days after injury d) (^) Crepitation with palpation or movement of the ankle

Question 25 (2 points)

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What is the presentation of a complex motor tic?

Question 25 options:

a) (^) Simultaneous shoulder shrugs and head turns b) (^) Eye blinks and extension of extremities c) (^) Throat clearing and finger raising d) (^) Barking, screaming, and snorting

Question 26 (2 points)

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Which of the following is considered first-line treatment for

panic disorders?

Question 26 options:

a) (^) Benzodiazepines b) (^) Selective serotonin reuptake inhibitors (SSRIs) c) (^) Tricyclic antidepressants

d) (^) Cognitive behavioral therapy

Question 27 (2 points)

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Rapid eye movement (REM) sleep occurs how frequently

during non-REM sleep?

Question 27 options:

a) (^) Every 30 to 40 minutes b) (^) Every 60 to 80 minutes c) (^) Every 90 to 100 minutes d) (^) Every 180 to 200 minutes

Question 28 (2 points)

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Which is the most prevalent psychiatric condition in the United

States?

Question 28 options:

a) (^) Depression b) (^) Anxiety c) (^) Substance-related addictions d) (^) Gambling addiction

Question 29 (2 points)

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The effectiveness of benzodiazepines in treating anxiety

disorders suggests that which of the following

neurotransmitters plays a role in anxiety?

Question 29 options:

a) (^) Acetylcholine b) (^) Gamma-aminobutyric acid (GABA) c) (^) Dopamine d) (^) Serotonin

Question 30 (2 points)

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It is important for the clinician to discuss the long-term effects

of sexual assault with survivors. Which of the following is the

most common long-term effect of sexual assault?

Question 30 options:

a) (^) Depression b) (^) Obsessive-compulsive disorder c) (^) Substance abuse d) (^) PTSD

Question 31 (2 points)

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Which of the following neuroendocrine abnormalities is

implicated in depression?

Question 31 options:

a) (^) Decrease in adrenal size b) (^) Hypersecretion of cortisol c) (^) An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing hormone d) (^) Increased inhibitory response of glucocorticoids to dexamethasone

Question 32 (2 points)

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What prenatal factor could increase risk for ADHD?

Question 32 options:

a) (^) Exposure to lead b) (^) Zinc deficiency c) (^) Maternal allergies d) (^) Central nervous system (CNS) infections

Question 33 (2 points)

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What is the median reduction in life expectancy among those

with mental illness?

Question 33 options:

a) (^) 15.4 years b) (^) 10.1 years c) (^) 5.7 years

d) (^) 9.2 years

Question 34 (2 points)

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Bipolar disorder requires differential diagnosis from all of the

following except?

Question 34 options:

a) (^) Substance abuse and medication effects b) (^) Medical and neurological disorders c) (^) Cluster B personality disorders and depression d) (^) Obsessive-compulsive disorder

Question 35 (2 points)

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What is the likely result of the over-prescription, over-supply,

and over-production of opioids?

Question 35 options:

a) (^) Opioid use b) (^) Opioid abuse c) (^) Opioid dependence d) (^) Opioid resistance

Question 36 (2 points)

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Instead of reporting symptoms of body dysmorphic disorder

(BDD) to the primary-care provider, patients often request

which of the following?

Question 36 options:

a) (^) Referrals to plastic surgeons, orthodontists, or dermatologists b) (^) Antidepressant medications c) (^) Nutritional counseling services d) (^) Unnecessary laboratory tests

Question 37 (2 points)

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A 35-year-old female patient is seen in the clinic complaining

of abdominal pain. Which of the following should be included

in the examination?

Question 37 options:

a) (^) Lumbar puncture b) (^) Family history of cardiac problems c) (^) Contrast venography d) (^) Pelvic exam

Question 38 (2 points)

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Which of these is one of the most common dietary triggers of

IBS?

Question 38 options:

a) (^) Gluten-free items b) (^) Lactose c) (^) Honey d) (^) Meat

Question 39 (2 points)

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Which of the following is a condition that results in colicky

abdominal pain?

Question 39 options:

a) (^) Peptic ulcers b) (^) Glisson’s capsule around the liver c) (^) Peritoneum irritation d) (^) Gallstones

Question 40 (2 points)

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Which of the following causes of gastrointestinal bleeding is

found in the lower gastrointestinal tract?

Question 40 options:

a) (^) Erosive esophagitis b) (^) Duodenal ulcer c) Meckel’s diverticulum

d) (^) Gastric ulcer

Question 41 (2 points)

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On further questioning, the 21-year-old patient with

complaints of fatigue, headache, anorexia, and a runny nose

explains that she is sexually active only with her boyfriend,

does not use injectable drugs, and works as an aide in a day-

care center. Which of the following tests would be most helpful

in confirming your diagnosis?

Question 41 options:

a) (^) Anti-HAV IgM b) (^) HAV IgG c) (^) Anti-HCV d) (^) IgM anti-HBs

Question 42 (2 points)

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A 29-year-old is seen in the office with complaints of pain in

his chest and belly. He quit smoking 6 months ago. He has

been suffering the pain for 2 weeks and gets temporary relief

from Alka-Seltzer® and Pepto-Bismol

®

. The burning pain

wakes him at night and radiates up to his chest. Which factor

favors a diagnosis of gastric ulcer?

Question 42 options:

a) (^) His use of Pepto-Bismol

b) (^) His age c) (^) His use of Alka-Seltzer d) (^) His smoking cessation

Question 43 (2 points)

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A 45-year-old patient presents with a chief complaint of

generalized abdominal pain. Her physical examination is

remarkable for left lower quadrant tenderness. At this time,

which of the following should be considered in the differential

diagnosis?

Question 43 options:

a) (^) Endometriosis b) (^) Yersinia enterocolitica infection c) (^) Appendicitis d) (^) GERD

Question 44 (2 points)

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Which of the following patients should be referred to a

hepatologist?

Question 44 options:

a) (^) Patient with persistent elevation of HBsAg b) (^) Patient with anti-HAV IgG

c) (^) Patient with IgG anti-HBs d) (^) Patient with anti-HEV

Question 45 (2 points)

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A 21-year-old student presents with complaints of fatigue,

headache, anorexia, and a runny nose, all of which began

about 2 weeks ago. She started taking vitamins and over-the-

counter cold preparations but feels worse. The smell of food

makes her nauseated. Her boyfriend had mononucleosis about

1 month ago, and she wonders if she might have it also.

Examination reveals cervical adenopathy and an enlarged

liver and spleen. Which of the following labs would be most

helpful in the differential diagnosis at this point?

Question 45 options:

a) (^) Stool culture b) (^) Liver enzymes c) (^) Antihepatitis D virus d) (^) Thyroid-stimulating hormone test

Question 46 (2 points)

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Which of the following dietary instructions should be given to

a patient with GERD?

Question 46 options:

a) (^) Eliminate coffee. b) Drink hot toddies to relieve stomach distress.

c) (^) Recline and rest after meals. d) (^) Increase the amount of spicy foods.

Question 47 (2 points)

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Robin is a 57-year-old female presenting with diffuse

abdominal pain. Which of the following statements from the

provider to Robin is correct?

Question 47 options:

a) (^) “It does not matter that you feel pain not only in your stomach but also in your shoulder.” b) (^) “Does moving around change the nature of your pain?” c) (^) “All causes of abdominal pain do not necessitate a surgical referral.” d) “I noticed on examination that your stomach is rigid, and you stated your pain is quite severe. It is only necessary for a nurse to see you concerning this problem.”

Question 48 (2 points)

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Which of the following is part of the treatment plan for the

patient with IBS?

Question 48 options:

a) (^) High-fiber diet b) (^) A discussion that the goal of treatment is to cure their disease c) (^) Daily laxatives

d) (^) A conversation about their expected shorter life span

Question 49 (2 points)

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Which of the following patients has an increased risk of

epigastric hernia?

Question 49 options:

a) (^) Mark, a 45-year-old African American male with chronic obstructive pulmonary disease b) (^) Gladys, a 93-year-old Hispanic female with dyslipidemia c) (^) Tony, a 33-year-old Asian male with hypertension d) (^) Whitney, a 22-year-old Caucasian female with anemia

Question 50 (2 points)

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A patient is diagnosed with GERD, and his endoscopic report

reveals the presence of Barrett’s epithelium. Which of the

following should the PCP include in the explanation of the

pathology report?

Question 50 options:

a) (^) This is not premalignant tissue. b) (^) This tissue is not resistant to gastric acid. c) (^) This tissue supports healing of the esophagus. d) (^) This tissue does not have an increased risk of developing esophageal adenocarcinoma.

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