Download NR 568 FINAL ACTUAL EXAM QUESTIONS AND VERIFIED ANSWERS and more Exams Nursing in PDF only on Docsity! NR 568 FINAL EXAM After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? Question options: a) Elevated TSH b) Normal TSH c) Low TSH d) Undetectable TSH b) normal TSH Which of the following is diagnostic for diabetes mellitus? Question options: a) A1C 7.0 on one occasion b) Fasting blood sugar (FBS) of 100 mg/dL on two occasions c) Random plasma glucose greater than or equal to 200 in a person with symptoms of hyperglycemia d) Two-hour post-load plasma glucose of 300 mg/dL on one occasion c) Random plasma glucose greater than or equal to 200 in a person with symptoms of hyperglycemia Which of the following statements is true regarding the treatment of carpal tunnel syndrome? Question options: a) The goal of treatment is to prevent flexion and extension movements of the wrist. b) Splints are used in carpal tunnel syndrome, because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position. c) Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection. d) All of the above d) All of the above What is the recommended daily calcium intake for adults over the age of 50 with low bone mass? Question options: a) 1,200 mg/day b) 1,000 mg/day c) 1,300 mg/day d) 1,500 mg/day d) 1,500 mg/day The clinician finds numerous nodules on the thyroid of a 65-year-old woman. The clinician suspects thyroid cancer. Which of the following data would be most significant for this patient? Question options: a) A history of tonsillectomy in the 1940s Question options: a) Elevated uric acid level b) Elevated blood urea nitrogen c) Decreased urine pH d) Decreased C-reactive protein a) Elevated uric acid level A patient with type 1 diabetes comes to the clinic complaining of feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first? Question options: a) Check his blood sugar. b) Have him drink 4 ounces of juice. c) Call 911. d) Ask him about his usual eating habits. b) Have him drink 4 ounces of juice. A BMI of 29 kg/m2 is considered obesity. Question options: a) True b) False b) false Joyce is seen in the clinic complaining of vague symptoms of nervousness and irritability. She says that her hair will not hold a permanent wave anymore. On physical examination, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis should include which of the following conditions? Question options: a) Myxedema b) Thyrotoxicosis c) Cushing's syndrome d) Pan-hypopituitarism b) Thyrotoxicosis A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment? Question options: a) No treatment at this time b) Diet and exercise for 6-week trial c) Diet, exercise, and oral medication d) Diet, exercise, and exogenous insulin b) Diet and exercise for 6-week trial Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and limited movement in her right shoulder. She denies any history of trauma. Her examination reveals a 75% reduction in both active and passive ROM of the right shoulder. Mrs. Gray also is experiencing tenderness with motion and pain at the deltoid insertion. Her medical history is significant for type 1 diabetes mellitus and hypertension. Her social history reveals that she is a secretary and that she is right-handed. Based on her examination and medical history, you suspect adhesive capsulitis, or "frozen shoulder." Which clue in Mrs. Gray's history supports this diagnosis? Question options: a) History of hypertension b) Her affected shoulder is also her dominant arm. c) Her history of diabetes mellitus d) Her work as a secretary predisposes her to repetitive motions. c) Her history of diabetes mellitus Question 16 0 / 2 points Which of the following laboratory findings should the clinician expect in a patient with untreated Graves' disease? Question options: a) Elevated TSH b) Elevated T4 c) Elevated thyrotropin-releasing hormone (TRH) d) All of the above d) all of the above a) RAI prevents the peripheral conversion of T4 to T3. b) RAI binds free T4. c) RAI destroys thyroid tissue. d) RAI reduces freely circulating iodine. c) RAI destroys thyroid tissue Urine-free cortisol is one of four diagnostic tests recommended for Cushing's syndrome. Question options: a) True b) False a) True The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective? Question options: a) "I'll take my pill at least 30 minutes before breakfast." b) "I'll take my Glucotrol before bedtime." c) "It is important to take my medication right after I eat." d) "Since I only like to eat two meals a day, I can take the pill between my meals." a) "I'll take my pill at least 30 minutes before breakfast Which of the following statements concerning the treatment of fibromyalgia syndrome is true? Question options: a) There is currently no cure for the disorder; however, patients should be made aware that symptom relief is possible. b) Treatment is directed toward controlling discomfort, improving sleep, and maintaining function. c) Fibromyalgia syndrome can be difficult to manage, requiring a variety of approaches and multiple medications. d) All of the above d) All of the above A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do? Question options: a) Make an immediate referral for an orthopedic evaluation without further assessment. b) Tell her that it takes time for these bruises to improve, so she should be patient. c) Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint. d) Send her to the emergency room for reduction of this obvious wrist fracture. c) Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint. Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? Question options: a) Morning stiffness and limited mobility of the lumbar spine b) Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain c) Fever, chills, and elevated erythrocyte sedimentation rate d) Pathologic fractures, severe night pain, weight loss, and fatigue b) Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome? Question options: a) Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel. Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The clinician has explained to Mr. Jackson that the goals for managing osteoarthritis include controlling pain, maximizing functional independence and mobility, minimizing disability, and preserving quality of life. Mr. Jackson explains to the clinician that his first choice would be to use complementary therapies to control his condition and asks what therapies are most effective in treating osteoarthritis. What would be the most appropriate response from the clinician? Question options: a) "Complementary therapies should be considered only if surgical interventions are not successful." b) "I am unfamiliar with the available complementary therapies for osteoarthritis and prefer to discuss more mainstream treatments, such as NSAIDs and physical therapy, to manage your condition." c) "I would be happy to discuss all the treatment options available to you. Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being studied for use in the treatment of osteoarthritis and have shown promise when used with standard medical therapy." d) "It would be crazy to use complementary therapies to treat such a serious condition." c) "I would be happy to discuss all the treatment options available to you. Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being studied for use in the treatment of osteoarthritis and have shown promise when used with standard medical therapy." Metformin is the first line of pharmacologic treatment for type 2 DM. Question options: a) True b) False a) True A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next? Question options: a) Serum calcium b) TSH c) Electrolytes d) Urine specific gravity b) TSH 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 options: a) Inability to bear weight immediately after the injury b) Development of marked ankle swelling and discoloration after the injury c) Crepitation with palpation or movement of the ankle d) All of the above d) All of the above One of the most frequent presenting signs/symptoms of osteoporosis is: Question options: a) Goiter b) Abnormal serum calcium c) Elevated urine biochemical markers d) Bony fracture d) Bony fracture Lifestyle modification is the treatment of choice for metabolic syndrome. Question options: a) True b) False a) True Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is: Question options: a) Ecchymosis, edema, and erythema over the lateral epicondyle b) Pain at the elbow with resisted movements at the wrist and forearm d) Elevated HDL cholesterol b) Recurrent yeast infection Which of the following statements is true concerning the management of the client with a herniated disc? Question options: a) Muscle relaxants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use. b) An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred. c) Intolerable pain for more than a 3-month period is an indication for surgical intervention. d) All of the above c) Intolerable pain for more than a 3-month period is an indication for surgical intervention. Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? Question options: a) Gastrocnemius weakness b) A reduced or absent ankle reflex c) Numbness in the lateral foot d) Paresthesia of the perineum and buttocks d) Paresthesia of the perineum and buttocks The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs? Question options: a) "You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage." b) "You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication." c) "You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain." d) "It is important to take NSAIDs on an empty stomach in order to increase absorption." a) "You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage." Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? Question options: a) Decreased C-reactive protein b) Hyperalbuminemia c) Morning stiffness d) Weight gain c) Morning stiffness The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient? Question options: a) Overweight b) Mild obesity c) Moderate obesity d) Morbid obesity a) Overweight John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear? Question options: a) Valgus stress test b) McMurray circumduction test c) Lachman test and a tack embedded in his left heel. Which of the following would be an appropriate treatment? a. Tricyclic antidepressants b. Capsaicin cream c. Vitamin B12 injections d. Insulin a. Tricyclic antidepressants Which of the following is diagnostic for diabetes mellitus? a. A1C 7.0 on one occasion b. Fasting blood sugar (FBS) of 100 mg/dL on two occasions c. Random glucose of 200 mg/dL on two occasions d. Two-hour post-load plasma glucose of 300 mg/dL on one occasion c. Random glucose of 200 mg/dL on two occasions A 35-year-old woman presents with symptoms of hypoglycemia. There is no history of diabetes mellitus. Which of the following should be included in the differential diagnosis? a. Anxiety disorder b. Pheochromocytoma c. Psychosis d. All of the above b. Pheochromocytoma The clinician should question the patient with suspected gout about use of which of these medications? Question options: a) Low-dose aspirin b) Thiazide diuretics c) Ethambutol d) All of the above d) All of the above Jennifer is an 18-year-old who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited ROM in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation? Question options: a) Posterior dislocations are more common than anterior dislocations. b) There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses. c) Recurrent dislocations are uncommon and would require great force to result in injury. d) Surgery is most commonly the treatment of choice. b) There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses. Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is: Question options: a) Ecchymosis, edema, and erythema over the lateral epicondyle b) Pain at the elbow with resisted movements at the wrist and forearm c) Inability to supinate and pronate the arm d) Inability to flex or extend the elbow against resistance b) Pain at the elbow with resisted movements at the wrist and forearm ... ... Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy? Question options: a) Insulin b) Metformin c) Glucotrol d) Precose c) Glucotrol Normal estrogen function is important for preventing osteoporosis in both men and women. Estrogen works to prevent osteoporosis in which of the following ways? Question options: a) By decreasing the erosive activity of osteoclasts