Download NR511 FINAL ACTUAL EXAM COMPLETE QUESTIONS AND DETAILED ANSWERS|ALREADY GRADED and more Exams Nursing in PDF only on Docsity!
NR511 FINAL ACTUAL EXAM COMPLETE
QUESTIONS AND DETAILED ANSWERS|ALREADY
GRADED
.....something about the oral mucosa membranes Correct Answers vincents stomatitis ...responded to antibiotic therapy. Which of the following actions should be taken next? Correct Answers send a urine specimen for microscopy looking for fungal colonies (+) sign of appendicitis Correct Answers Obturator sign: pain over RLQ- when R hip & knee are flexed A 14yo is seen w/ complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action? Correct Answers send the patient to the ER A 22 year old male is seen b/c he found a hard lump in his testicle during a TSE. Which of the following should be included in the D DX? Correct Answers ALL the above: testicular Ca, inguinal hernia, varicocele A 22yo is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? Correct Answers very early A 23 yo sexually active man is seen in the clinic with unilateral painful testicular swelling & diagnosed w/ epididymitis. In order to prescribe the
correct drug, the clinician understands that which of these is the most common causative organism? Correct Answers chlamydia ttrachomatis A 25 yo presents w/ fatigue, cold intolerance, wt gain & constipation for 3 mo. On PE, the clinician notices a sinus bradycardia, muscular stiffness, coarse dry hair and a delay in relaxation in DTR's. Which of the following tests should be ordered next? Correct Answers TSH A 27 yo F presents w/ a CC of burning and pain on urination. She has no previous Hx of UTI. What are some addt'l symptoms consistent w/ a lower UTI? Correct Answers blood in urine & frequency A 28 yo patient is seen in the office w/ colicky abd pain, particularly w/ meals. SHe has frequent constipation, flatulence and abd distention. Which of the data makes a diagnosis of diverticulitis unlikely? Correct Answers age A 28yo patient is seen w/ complaints of diarrhea. Which of the following Qs would help the clinician est. the Dx of IBS? Correct Answers ALL the above: relief after BM, occasional constipation, does not defecate in the middle of the night A 30yo patient presents w/ pain on urination. The urine microscopy of unspin urine showed greater than 10 leukocytes/ml & a dipstick was possible for nitrates. What is the probable diagnosis? Correct Answers chlamydia infection
A four-year-old boy with undescended testes presents to the clinic with his mother who has questions about his condition. What should the NP tell the mother to ease her concerns? Correct Answers Orchiopexy needs to be performed before age 6 to promote normal spermatogenesis and hormone production. A patient has acute pancreatitis w/ 7 of the diagnostic criteria from Ranson's Criteria. To plan care, the clinician understands that this criteria score has which of the following meanings? Correct Answers a High mortality rate. A patient is diagnosed w/ gardia after backpacking in the mountains. Which of the following would be the appropriate treatment? Correct Answers Metronidazole A patient is seen with a sudden onset of flank pain accompanied by N/V & diaphoresis. In addition to nephrolithasis, which of the following should be added to the D DX list? Correct Answers All the above: pancreatitis, PUD, diverticulitis A patient is seen with RUQ pain that is radiating to the middle of the back. The clinical suspects acute cholelithasis. The clinician should expect which of the following lab findings? Correct Answers Elevated alkaline phosphate
A pt is seen in the clinic w/ hematuria confirmed on a microscopic exam. The clinician should inquire about the ingestion of which of these substances that may cause hematuria. Correct Answers NSAIDs After 6 mo of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? Correct Answers normal TSH An 82 yo man is seen in the primary care ofc w/ c/o dribbling urine & difficulty starting his stream. Which of the following should be included in the list of differentials? Correct Answers All the above: BPH, Prostate Ca, UTI Anemia of Chronic Dz Correct Answers decreased iron serum, saturation, TIBC & INCREASED ferritin Anterior Drawer Test (ankle) Correct Answers used in assessment of suspected rupture of the cruciate ligaments in the knee. Bacterial Prostatitis is always associated with UTIs and is Correct Answers Caused by E. Coli. Prostatic massage is contraindicated. *in younger males check for STIs C-Diff (infection of the Lrg intestine) Correct Answers HC facility, LT hospitalization, LT anti-biotic use, LT use of meds that reduce GI acidity (PPI, omeprazole), Contaminated food/water, Touching infected soil, objects & surfaces.
Gold standard sickle-cell anemia test Correct Answers Hgb electrophoresis which determines Hgb S. How to assess for Peripheral Neuropathy Correct Answers Characterized by "stocking-glove" or distal sensorimotor paresthesia with diminished or variable DTRs Hyposadias Correct Answers opening of the penis is on the underside of the organ. Common in infants w/ FH. Janet is a 30 yo recently diagnosed w/ a herniated disc at L4 & L5-S1. She is currently in the ER w/suspicion of cauda equna compression, Which of the following is a s/s of cauda equina compression? Correct Answers Paresthesia of the perineum & buttocks Jennifer is an 18-year-old girl 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 range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation? Correct Answers There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses John is a 16yo boy who presents to the ER 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? Correct Answers McMurray circumduction test Joyce is seen in the clinic c/o vague symptoms of nervousness and irritability. She says that her hair will not hold a permanent wave anymore. On physical exam, the clinician finds an irregular heartbeat and brisk reflexes. The differential dx should include which of the following conditions? Correct Answers Thyrotoxicosis Knee pain- patellar dysfunction Correct Answers overuse; treat w/ NSAIDs and quad-strengthening exercises. lumbar spinal stenosis presentation Correct Answers prolonged standing discomfort leaning on shopping cart pseudo claudication improves with rest bilat leg numb, weak Most common cause of Appendicitis Correct Answers Fecalith stone made of feces typically found in the colon Most nosocomial pneumonias are caused by Correct Answers Gram- negative bacteria
Phimosis Correct Answers usually long foreskin or foreskin cannot be retracted in uncircumcised males. Common in infancy, refer to a urologist if older. Priaprism Correct Answers prologned ereaction w/o sexual arousal; managed with T-Phenylephrine Prostate Cancer is associated with _______________ and symptoms include__________________. Correct Answers human cytomegalovirus bone pain, wt. loss, anemia, SOB, lymphedema, lymphadenopathy PUD treatment Correct Answers Amoxicillin, clarithromycin, and omeprazole for 2 wks Reuben, aged 24 years, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate? Correct Answers a favorable diagnostic/prognostic trend Risk factors for IDA Correct Answers >60, poverty, recent illness: ulcer, diverticulitis, colitis, hemorrhoids, GI tumors Rotavirus Correct Answers common in children <3yo S: low-grade fever, loss of appetite, copious watery diarrhea, flatulence, vomiting & stomach cramps T: fluids, supportive care, antiemetics
S/S of appendicitis include... Correct Answers - rebound tenderness over the right lower quadrant of the abdomen (McBurneys point)
- N/V, followed by pain; diarrhea
- low grade fever, chills, decreased appetite
- elevated white count
- slightly rigid abd
- normal, hyperactive, or absent bowel sounds. S/S of H. Pylori Correct Answers 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? Correct Answers Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain Sickle cell anemia parent teaching includes Correct Answers splenic sequestration, recognizing abd girth and how to palpate the spleen Sickle-cell anemia (autosomal recessive) & G6PD (x-link) are Correct Answers genetic deficiencies
The clinician as instructed Sam, a 25 yo patient w/ low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate within teaching Sam about the ised of NSAIDs to manage his pain? Correct Answers Start w/ the lowest does that is effective in managing pain b/c LT use of NSAIDs cab result in GI disorderd such as ulcers & hemmorhage. The clinician is caring for Diane, a 22 yo woman who presents with an injured ankle. Diane asks 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 radiography is dependent on the exam and injury description. Which of the following cues in Diane's exam or Hx would alert the clinician to the need for obtaining radiographs? Correct Answers ALL the above: if she was not able to bear wt immediately afte the injury, if the ankle developed marked swelling & discoloration after the injury, if crepitation occurs w/ palpation or ankle movement. The clinician sees a pt who is 5 feet tall and weighs 150lbs (BMI 29.3). How would the clinician classify this pt? Correct Answers Mild obesity - often associated with GERD The clinician suspects that a client has patellar instability. In order to test this, the client is seated w/ the quadriceps relaxed & the knee is placed in extension. Next the patella is displaced laterally and the knee is flexed to 30 degrees. If instability is present, this maneuver displaces the patella to an abn position on the lateral femoral condyle, & the client will perceive pain. Testing for patellar instability in this way is known as Correct Answers apprehension sign
The clinician suspects that a patient seen in the office has hyperthyroidism. Which test should the clinician order on the initial visit? Correct Answers thyroid stimulating hormone (TSH) & free T The differential diagnosis for vertigo can be classified into which of the following categories? Correct Answers All the above: peripheral vestibular dz, CNS disorders & systemic disorders The most cost effective screening test to determine HIV status is which of the following? Correct Answers ELISA- enzyme-linked immunosorbent assay The patient is diagnosed with overactive bladder. Which of the following instructions should be given? Correct Answers Eliminate caffeine The patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication? Correct Answers closed-angle glaucoma The presence of hairy leukoplakia in a person w/ no other symptoms of immune suppression is strongly suggestive of which type of infection? Correct Answers HIV
What can cause ED? Correct Answers medication Hx is important: antihypertensives: BB, antipsychotics, CNS depressants, alcohol, anti- androgens, tobacco What can cause H. Pylori Correct Answers What imaging modality should be ordered for a patient with GERD that does not respond to 6wks of omeprazole & diet modification? Correct Answers Endoscopy What is the Best management for diverticulitis? Correct Answers High- fiber diet What is the difference between cervical spondylosis and cervical myelopathy Correct Answers C.S. aka degenerative arthritis affects the vertebrae and facet joints causing pain and stiffness C.M. is a pinched nerve with symptoms including UE wkns, leg wkns, gait disturbances, loss of bowel and bladder What is the most common cause of anemia? Correct Answers IDA- iron deficiency anemia What is the most common condition associated with vertebral fracture in susceptible individuals? Correct Answers Osteoporosis; primarily thin women
What is the recommended calcium intake for adults over 50 with low bone mass? Correct Answers 1500mg/day What should the NP prescribe for the 26 yo young man with a strain injury? Correct Answers NSAIDs and strengthening exercises Which causes the greatest percentage of mammalian bites? Correct Answers Dogs Which is most prevalent in the U.S. & older adults- CLL or ALL Correct Answers CLL- chronic lymphocytic leukemia Which is the differentiating symptom btwn labyrinthitis & vestibukar neuritis? Correct Answers a hearing loss may be associated w/ labyrinthitis but NOT vesitbular neuritis. Which of the following are predisposing factors for pyelonephritis? Correct Answers alkaline urine Which of the following are risk factors associated with obesity? Correct Answers ALL the above: DM, skin infections, arthritis Which of the following data are indicative of testicular torsion? Correct Answers absent cremasteric reflux
Which of the following statements is true concerning the mngmnt of the client w/ a herniated disc? Correct Answers intolerable pain for >3mo is an indication for surgical intervention. Which of the following statements is true regarding the treatment of carpal tunnel? Correct Answers ALL the above: the goal of treatment is to prevent flexion & extension movements of the wrist, splints are used in carpal tunnel syndrome b/c they allow free mvmnt of the fingers & thumb while maintaining the wrist in a neutral position, corticosteroid injections are discouraged in the treatment b/c of the risks for median nerve damage, scarring and infection. NSAIDs are a treatment as well. Which statement about HIV post-exposure prophylaxis (PRP) for HC workers is most accurate? Correct Answers a PEP should be started w/in hrs after exposure You are performing muscle strength testing on a patient presenting with musculoskeletal pain & find the patient has complete range of motion with gravity eliminated. Which numeric grade of muscle strength would give you this patient? Correct Answers 2 You have detected the presence of crepitus on exam of a patient w/ musculoskeletal complaint. Additionally, there is limited ROM w/ both active & passive movement. These findings suggest that the origin of the musculoskeletal complaint is Correct Answers Articular
