NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Scor, Exams of Nursing

Download NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Scor and more Exams Nursing in PDF only on Docsity! NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Score Guide A 35-year-old female with a history of migraines presents to the clinic with worsening symptoms for the past few weeks. She reports waking up at night with headaches and nausea. Her only medication history is oral contraceptive pills (OCPs). Otherwise, she states she is healthy. Which of the following actions if taken by the NP is the best next step? - correct answers Take a further history and perform a very careful neurological exam A grandmother is accompanying her 9-year-old granddaughter during a routine physical examination. She asks you privately if her granddaughter has started puberty yet. During the examination, the NP notes asymmetric projection of the areola and nipple of the right chest to form a secondary mound above the level of the breast. The left breast is underdeveloped. These assessment findings are consistent with which Tanner Stage of development? - correct answers IV Primary prevention is defined as which of the following? - correct answers Interventions designed to prevent disease Based on the U.S. Preventive Services Task Force (USPSTF) recommendations, which of the following statements is true about screening for breast cancer in average-risk women? - correct answers Mammography is recommended every 2 years for women aged 50-74 with insufficient evidence for screening women over the age of 75. Which of the following statements is true regarding recommendations by the eighth Joint National Committee (JNC8) for adults aged 60 and older? Select all that apply. - correct answers Target blood pressure should be </= 150/90 mmHg but notes that if treatment results in SBP <140 and is "well tolerated and without adverse effects to health or quality of live, treatment does not need to be adjusted." NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Score Guide In those aged 80 or older, blood pressure targets of 140 to <150/70 to 80 appear optimal for notable reductions in stroke, cardiovascular events, and all-cause mortality. Which of the following is a useful strategy when examining young children between the ages of 1 and 4? - correct answers Have the parent facilitate the exam (e.g., removing clothes, holding the child on lap). The NP is completing the review of systems on a 4-month-old female during a routine encounter. Which statement from the parent may indicate a cardiac problem in the infant and require a more thorough subjective history? - correct answers "It often takes the baby more than 30 minutes to finish a bottle." A 16-year-old male presents to the clinic with a history of a congenital right upper eyelid drooping as represented in this image. He has no complaints and denies injury or trauma. Which cranial nerve (CN) is involved in this condition? Patient with eyelid drooping - correct answers CNIII Which cranial nerve (CN) innervates the muscles of the pharynx and provides sensory fibers to portions of the tympanic membrane, auditory canal, pharynx, and the posterior third of the tongue? - correct answers CN IX The NP should suspect injury to which cranial nerve (CN) if a patient presents with complaints of photosensitivity and uneven pupils after being struck in the eye with a baseball? - correct answers CNIII NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Score Guide are being assessed when the patient is asked to extend, flex, and rotate the neck, EXCEPT? - correct answers Sacrospinalis A 58-year-old male complains of lower back pain for many years. He denies a recent injury. On examination, the NP finds that the patient has tenderness to palpation over the sacroiliac joint. Which of the following conditions is most consistent with this physical sign? - correct answers ankylosing spondylitis Which of the following statements is true regarding prostate cancer screening? - correct answers Setting normal cut-offs for prostate-specific antigen (PSA) testing relies on balancing A 53-year-old African American male presents for discussion of his prostate cancer risk and possible screening for this disease. His father was diagnosed at age 82 years with prostate cancer but died recently at age 87 years from a myocardial infarction before the disease progressed. Family history also reveals that his mother died of ovarian cancer when he was age 10 years, and two of his maternal aunts had breast cancer. Which of the following is true about prostate cancer risk for this patient and subsequent screening? - correct answers This patient is at an elevated risk of prostate cancer due to his family history; thus, screening modalities should be discussed between the patient and provider. A 34-year-old female presents to primary care for follow-up regarding anal pain with defecation. A recent referral to GI for anoscopic examination revealed anal fissures that appear to be her source of pain. In addition, today she reports that she has developed episodic abdominal discomfort and sores in her mouth. Which of the following underlying conditions is the NP most likely to find? - correct answers Inflammatory bowel disease A 45-year-old female presents to the primary care clinic. She complains of recently experiencing a change in the patterns of her bowel movements. Her NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Score Guide PMH is significant for bleeding ulcers as well as Crohn's disease. Her family medical history includes a maternal aunt who died of colon cancer at age 49 years. Which of the following historical elements would be most concerning for colon cancer in this patient? - correct answers recent onset of small- caliber stools A 67-year-old female presents to the office for an annual check-up. She retired as a police captain at age 66. Now she enjoys gardening and water aerobics several days a week. She states, "staying active keeps me limber". After a careful history and physical examination, the NP documents the following musculoskeletal system findings: Full range of motion in all joints. Hands with Heberden nodes at the DIP joints, Bouchard nodes at PIP joints. Mild pain with flexion, extension, and rotation of both hips. Full range of motion in the knees, with moderate crepitus. No effusion but bony enlargement along the tibiofemoral joint line bilaterally. Both feet with hallux valgus at the first MTP joints. Which of the following is the most accurate interpretation of these findings? - correct answers These findings suggest osteoarthritis A 50-year-old male presents to the office for a routine physical examination. He has no complaints. His PMH is significant for non-alcoholic fatty liver disease and high cholesterol for which he is taking fenofibrate. On the social history intake form, he reported consuming 8 ounces of malt liquor daily for 20 years. After a careful history and physical examination, the NP documents the following nervous system findings: Mental Status: Alert, relaxed, and cooperative. Thought process coherent. Oriented to person, place, and time. Speech is fluent, follows commands. Detailed cognitive testing deferred. Cranial Nerves: I—not tested; II through XII intact. Motor: Normal muscle bulk and tone. Strength 5/5 throughout. No pronator drift. Cerebellar—Rapid alternating movements (RAMs), finger-to-nose (F→N), heel-to-shin (H→S) intact. Gait with normal stance and stride. Sensory: Pinprick, light touch, position, and vi - correct answers These findings suggest no abdnormalities NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Score Guide Which cranial nerve (CN) is being assessed by the examiner in this image? ADA Description: Examiner's hands placed on anterior shoulders while patient shrugs both shoulders upward against hands. - correct answers CNXI What assessment test is being performed in this image? ADA Description: Tuning fork on top of the head. - correct answers Weber test A 74-year-old man presents to the clinic for a scheduled annual examination. He has a history of hypertension and diabetes, both controlled with medication. He denies any complaints. The NP performed a fundoscopic examination. Identify the abnormal assessment findings in this image. ADA Description: Accumulations of axoplasmic debris within adjacent bundles of unmyelinated ganglion cell axons of the retina. - correct answers Cotton wool spots A 66-year-old female presents to the office for a focused visit to discuss hypertension management strategies. During the interview, the patient asks the NP if she could be screened today for cervical cancer/HPV. Review of her medical record reveals she was screened at ages 57, 60, and 63, with no abnormal findings, and no history of cancer. What is the best action the NP should take regarding the patient's request for screening? - correct answers Deny her request, inform the patient that she has had three negative screenings in the last 10 years and no longer requires screening, and focus on the reason for the visit. Of the following statements, which is true regarding the human papillomavirus (HPV) vaccine? - correct answers The vaccine can protect against anogenital lesions A 21-year-old female presents for her first annual exam. She reports concern because her female partner was recently diagnosed with condyloma NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Score Guide examination of the abdominal wall or inguinal region? - correct answers Internal inguinal rings What are the most predominant risk factors for prostate cancer? - correct answers Age Ethnicity Family history A patient presents with right-upper quadrant (RUQ) pain but does not have any tenderness on palpation in the RUQ. The NP is suspicious of acute cholecystitis. The NP knows to perform which assessment test next? - correct answers Murphy Sign Pain in the right-lower quadrant (RLQ) during deep, even palpation of the left-lower quadrant (LLQ) then quickly withdrawing your fingers indicates what positive assessment finding? - correct answers Blumberg sign The NP suspects a patient has appendicitis. Identify the physical examination maneuver done by applying pressure halfway between the umbilicus and the anterior spine of the ilium? - correct answers McBurney Sign Which assessment finding would be most suggestive of a diagnosis of biliary colic? - correct answers Associated right shoulder pain Which of the following physical assessment finding is most suggestive of peritonitis secondary to a ruptured appendix? - correct answers Pressing down onto the abdomen firmly and quickly withdrawals the hand produces pain NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Score Guide A 76-year-old female presents to the office for an annual physical. Upon reviewing her history, she had a positive FOBT on one occasion at age 66 years. Subsequent colonoscopy revealed internal hemorrhoids and sigmoid diverticuli only. She has no firstdegree relatives with a history of colorectal cancer or adenomatous polyps. What is the U.S. Preventive Services Task Force (USPSTF) screening recommendation for this particular patient? - correct answers Do not screen routinely A 30-year-old male is admitted to the hospital for abdominal pain. He reports steady, aching pain that began suddenly around his naval and now involves the lower abdomen. He also reports a decreased appetite with nausea but no vomiting. After a careful history and physical examination, the NP documents the following abdominal findings: The abdomen is flat, firm, and rigid, with increased tenderness and guarding in the right lower quadrant. No bowel sounds heard. Liver percusses to 7 cm in the midclavicular line; edge not felt. Spleen and kidneys not felt. No palpable masses. No CVA tenderness. Psoas sign positive. Blumberg sign positive. Which of the following is the most accurate interpretation of these findings? - correct answers These findings suggest acute peritonitis The NP student is precepting with a provider in a geriatric-based clinic. The provider asks the student if he is familiar with the 10-Minute Geriatric Screener. Which of the following statements best demonstrates that the NP understands this assessment tool? - correct answers The tool assesses for functional deficits which are strong predictors of patient outcomes in the elderly. The NP conducted a physical assessment on a 79-year-old male who lives independently in subsidized housing. The documentation for the Head, Eyes, Ears, Nose, Throat (HEENT) findings are as follows: Scalp without lesions. Skull NC/AT. Conjunctiva pink, sclera muddy. Pupils 2 mm constricting to 1 mm, round, regular, equally reactive to light and accommodation. Extraocular movements intact. Disc margins sharp, without hemorrhages or exudates. Mild arteriolar narrowing. TMs with good cone of light. Weber NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Score Guide midline. AC > BC. Nasal mucosa erythematous, septum deviated to the right, turbinates mildly enlarged. No sinus tenderness. Oral mucosa pink. Dentition fair. Caries present. Tongue midline, slight beefy redness. Pharynx is mildly erythematous with cobblestoning. Which of the following is the most accurate interpretation of the findings? - correct answers The patient has chronic allergies The staff NP in a nursing home is conducting a physical assessment on an 84-year-old male resident who is pleasant, active, and cooperative. The skin findings in this image are observed during the examination. The staff and patient deny any known injury or trauma. The NP should document these findings as consistent with which of the following? ADA Description: Extensor surface of the right forearm with emphasis on well-demarcated vividly purple macules and patches - correct answers Actinic purpura An 80-year-old woman who lives alone at home presents with concerns about maintaining her independent living status. She continues to drive and care for herself and her pet dog but reports two falls over the past 4 months. During one fall, she struck her head, causing a contusion over the right eye. She attributes these episodes to environmental factors. Once she tripped over a rug, and once she misjudged the depth of the curb while crossing the street. Which of the following would be the best approach to this patient? - correct answers Perform a comprehensive assessment of fall risk and plan preventive interventions Concerning alcohol consumption in older adults, which of the following is true? - correct answers The CAGE screening for alcohol abuse retains the same sensitivity and specificity it has for younger populations NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Score Guide The NP is conducting a physical assessment on a woman in her 26th week of pregnancy. Which of the examination finding is worrisome for a potential, emergent condition? - correct answers Facial edema The NP is documenting the obstetric history of a patient. Her history includes two spontaneous miscarriages at 16- and 24-weeks' gestation, four living children (one set of twins) who were delivered at term, and a current pregnancy. How would this be documented? - correct answers G6P3024 An 11-month-old infant male is accompanied to the clinic by his father. The father is concerned about the skin rash on this son's arms represented in this image. Family history is significant for a 4-year-old sibling with atopic dermatitis and asthma. Which of the following is the best documentation of the integument findings? - correct answers Erythematous, patches and plaques involving the extensor surfaces of the bilateral antecubital fossa. Mild, secondary excoriations present with serous exudate. No streaking. Scant purulent drainage A mother brings her 15-day-old female infant to the outpatient clinic for evaluation of a rash that appeared suddenly after visiting family in Florida. It is August and the house did not have air conditioning. The infant is afebrile, eating and drinking well, and does not appear to be in distress. The physical assessment findings are represented in this image. Based on the history and examination findings, what is the likely etiology? ADA Description: Infant with a red, facial rash. - correct answers miliaria rubra The NP assesses for the Moro Reflex as part of an infant routine physical examination. The NP should suspect a neurologic disease if the reflex has not disappeared by what specific timeframe? - correct answers 16 weeks A 2-month-old female is accompanied by her parents for her first visit to the practice. When reviewing the hospital medical records of her birth, the NP NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Score Guide notes documentation regarding significantly edematous hands and feet present at birth. Upon physical examination of the infant, the NP finds skin folds that run along the sides of the neck down to the shoulders. Which of the following should be assessed and monitored by the NP and parents related to these findings? Select all that apply. - correct answers The infant's growth chart with concern for height and length. The infant's ability to properly latch during breastfeeding. The infant's fluid gain or loss. The NP is observing a female pediatric patient during a routine physical. She can jump in place and balance on one foot. She speaks in full sentences and her mother states that she can feed herself. Based on your observations and the history, determine her developmental age - correct answers 4 years The NP is observing a full-term infant male. He can pull to a stand, use "mama" and "dada" specifically, and indicates his wants by vocalization and pointing. Based on your observations, determine his developmental age. - correct answers 12 months Of the following statements, which is accurate regarding growth and assessment charts published by the National Center for Health Statistics? Select all that apply. - correct answers All charts include height, weight, and head circumference for children up to 36 months. Growth charts are available for children with specific conditions such as Down syndrome or Turner syndrome. Growth charts are available for use in infants born prematurely. NR509 Final Exam 88Questions & Answers all answers 100%Verified: Updated 2023/2024 A+ Score Guide A 25-year-old male presents to the clinic with a complaint of severe rectal pain during defecation. The pain is so severe he waits several days before having a bowel movement. He has a history of ulcerative colitis (UC). He also reports being in an active sexual new relationship with a male partner. After conducting a history and physical exam, the NP documents the following anorectal findings: Perirectal area inflamed; no ulcerations, open sores, fissures, or verruca. Scant, whiteyellow, mucoid, rectal discharge noted. Unable to examine external sphincter, rectal vault, or prostate because of spasm of the external sphincter and marked inflammation and tenderness of anal canal. Which of the following is the most accurate interpretation of these findings? - correct answers These findings suggest infectious proctitis A 54-year-old female with a history of migraines since childhood presents to the clinic with chronic intermittent, progressive pulsatile headaches which are similar in nature to prior attacks and precipitated by current life stressors. The headaches are accompanied by nausea and vomiting. She denies constitutional symptoms. On examination, she has elevated blood pressure but otherwise a normal cardiovascular, neurologic, and fundoscopic examination. Based on the history and physical examination findings, which diagnoses are appropriate for the differential diagnosis (DDx) list? Select all that apply. - correct answers Migraine Tension A 50-year-old female presents to the clinic for evaluation of neck stiffness and aching pain. She was a restrained driver in a low-speed, rear-end, motor vehicle collision 1 day ago. The pain started several hours after the accident. On physical examination, you note muscle spasms over the paraspinous muscles on the left side of the neck, as well as pain reported during active range of motion of the cervical spine. No neurological deficits are noted. Which of the following is the most accurate interpretation of these findings? - correct answers These findings suggest cervical strain