NR511 Final Exam 2 Questions with Answers, Exams of Nursing

Download NR511 Final Exam 2 Questions with Answers and more Exams Nursing in PDF only on Docsity! NR511 FINAL EXAM 2 QUESTIONS WITH ANSWERS TESTED AND VERIFIED ANSWERS Janet is a 30 year old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspician of cauda equna compression. Which of the following is a sign or symptom of cauda equina compression? a. gastrocnemius weakness b. reduced or absent ankle refles c. numbness of the lateral foot d. paresthesia of the perineum and buttocks d. paresthesia of the perineum and buttocks The patient has acute pancreatitis with 7 of the diagnostic criteria from Ranson's Criteria. In order to plan care, the clinician understands that this criteria score has which of the following meanings? a. a high mortality rate b. an increased chance of recurrence c. 7% chance of the disease becoming chronic d. all of the above a. a high mortality rate Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load What does this indicate a. a favorable diagnostic trend b. disease progression c. the need to be more aggressive with Reuben's medications d. the eradication of the HIV a. a favorable diagnostic trend Which is the differentiating symptom mbetween labyrinthitis and vestibular neuritis? a. symptoms with vestibular neuritis are usually acute in onset, whereas with labyrinthitis the onet is more gradual b. hearing loss may be associated with vestibular neuritis, but not with labyrinthitis c. symptoms with labyrinthitis are usually acute in onset, ,whereas with vesticular neuritis the onset is more gradual d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis. d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis. A 27 year old female presents with a chief complaint of burning and pain on urination. She has no previous history of urinary tract infection. what are some additional symptoms consistant with a diagnosis of lower UTI? a. back and abdominal pain b. fever, chills, costovertebral angle (CVA) tenderness c. blood in urine and frequency d. foul-smelling discharge, perineal itch c. blood in urine and frequency The differential diagnosis for vertigo can be classified into which of the following categories: a. peripheral vestibular disease b. CNS disorders c. Systemic disorders d. all of the above d. all of the above Sam is a 25-year-old man 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? 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 Preceptors must always see the patients that the students see in the clinical setting a. true b. false a. true An 82 year old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differentials? 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 3 months is an indication for surgical intervention d. all of the above c. intolerable pain for more than 3 months is an indication for surgical intervention After 6 months of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? a. elevated TSH b. normal TSH c. low TSH d. undetectable TSH b. normal TSH The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit? a. thryoid stimulating hormone (TSH) and free T4 b. TSH and thyrotoxin antibodies •High sensitivity thyroid stimulating hormone TSH and free T4 • Free T4 and serum calcium a. thryoid stimulating hormone (TSH) and free T4 Cat bites are commonly associated with which of the following pathogens? a. pasteurella multocida b. vibri vulnificus c. group B streptococcus d. Group A beta hemolytic streptococcus a. pasteurella multocida The 56 year old man with chronic prostatitis should be treated with trimethoprim 80mg- sulfamethoxazole 400 (TMP-SMX, Bactrim) for how long? a. 3-7 days b. 14-21 days c. 3-6 weeks d 6-12 weeks d 6-12 weeks The A in SNAPPS stands for Assessment a. true b. false b. false A patient is diagnosed with Giardia after backpacking trip in the mountains. Which of the following would be the appropriate treatement? a. Vancomycin b. Penicillin c. Metronidazole d. Bactrim c. Metronidazole The most cost effective screening test to determine HIV status is which of the following? a. western blot b. enzyme-linked immunosorbent assay (ELISA) c. venereal disease research laboratory test (VDRL) d. Viral load b. enzyme-linked immunosorbent assay (ELISA) The clinician sees a patient who is 5 feet tall and weighs 150 pounds (:BMI 29.3). How would the clinician classify this patient? a. overweight b. Mild Obesity c. Moderate Obesity d. morbid obesity b. Mild Obesity One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular srtucture? A. Fascia B. Bone C. Synovium D. Tendons C. Synovium 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? 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 b. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses Which of the following types of cellulitis is a streptococcal infection of the superficial layers of the skin which does not involve the subcutaneous layers? a. necrotizing fascitis b. periorbital cellulitis c. erysipelas d. flesh eating bacteria c. erysipelas A 76 year old man is seen in the office for complaints of urinary incontinence. The clinican should suspect which of these causes of incontinence in men? a. urethral polyps b,. urinary tract infection (UTI) c. anticholinergic medications d. all of the above d. all of the above Sally, aged 25, presents with impetigo that has been diagnosed as infected with staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. She has not been adequately treated recently. Which type of impetigo is this? a. Bullous impetigo b. Staphylococcal scalded skin syndrome (SSSS) c. Nonbullous impetigo d. Ecthyma d. Ecthyma A 42 year old woman is seen in the clinic with fever, chills, vomiting and severe dysuria. She is diagnosed with acute pyelonepritis. How should this patient be managed? a. 3 day course of oral antibiotics b. hospitalization b. eliminate caffeine from your diet A 28 year old patient is seen in the office with colicky abdominal pain, particularly with meals. She has frequent constipation, flatulence and abdominal distention. Which of the data makes a diagnosis of diverticulitis unlikely? a. her age b. frequent constipation c. flatulence d. colicky abdominal pain a. her age Treatment for epididymitis includes which of the following? a. warm sitz baths b. scrotal elevation c. masturbation d. all of the above b. scrotal elevation Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition? a. there are round hypopigmented macules on his back b. there are red papules on his face c. there are crusted placques in Josh's groin area d. there are white streaks on his neck a. there are round hypopigmented macules on his back The clinican has instructed Sam, a 25 year old patient with low back strain, to use NSAID's to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate withn teaching sam about the use of NSAID' to manage his pain 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 hemmorhage b. you should start with the lowest dose that is effective in managing your pain in order to avoid developing tolerance to the medication c. you should take the maximum recommended dose of NSAID's so that you will not need to take narcotics to control your pain 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 hemmorhage Which of the following patients are at risk for developing urinary tract cancer? a. the 45 year old woman who is 100 pounds overweight b. the 78 year old man who smokes three packs of cigarettes a day c. the 84 year old man who worked in the asbestos mines d. all of the above d. all of the above SNAPPS pneumonic used to describe a technique in orally presenting a patient. A. true b. false A. true The clinician is caring for Diane, a 22 year old 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 Diane's description of the injury. Which of the following clues in Diane exam or history would alert the clinician to the need for obtaining radiographs a. if she was not able to bear weight immediately after the injury b. if the ankle developed marked swelling and discoloration after the injury c. if crepitation occurs with palpation or movement of the ankle d. all of the above d. all of the above A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting and diaphoresis. In addition to nephrolithasis, which of the following should be added to the list of differential diagnosis a. Pancreatitis' b. peptic ulcer disease c. diverticulitis d all of the above d all of the above Acute angle-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure a. 0 to 7 mmHg b 8 to 21 mmHg c. 22 to 40 mmHg d. 40-80mmHg b 8 to 21 mmHg A 28 year old patient is seen with complaints of diarrhea. Which of the following questions would help the clinician establish the diagnosis of irratible bowel syndrome? a. Feels relief after a bowel movement b. sometimes is constipated c. does not defecate in the middle of the night d. all of the above d. all of the above The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection? a. HSV Type 2 b HIV c Pneumonia d. Syphilis b HIV Mrs. Gary 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 exam reveals a 75% reduction in both active and passive range of motion of the right shoulder. Mrs. Gray is also experiencing tenderness with motion and pain at the deltoid insertion. HEr medical history is significant for type 1 DMm and HTN. HEr social history reveals that she is a secretary ant that she is right handed. Based on her exam and medical history, you suspect adhesive capulitis or "frozen shoulder" Which clue in Mrs. Grays history supports the diagnosis? a. history of hypertension b. her affected shoulder is also her dominant hand c. her history of diabetes c. her history of diabetes A 63 year old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis? a. Psychogenic nocturia b. Urethral polyp c. Irritative posterior urethral lesion d. Benign prostatic hypertrophy d. Benign prostatic hypertrophy Joyce is seen in the clinic complaining of vague symptoms of feeling nervous and irritable, and that her hair will not hold a curl anymore. On physical exam, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis could be which of the following? What is the most common cause of anemia a. anemia of chronic disease b. sideroblastic anemia c. iron deficiency anemia c. iron deficiency anemia The clinical 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 degrees. 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: a. apprehension sign b. bulge sign c. thumb sign d. none of the above a. apprehension sign If your preceptor is out ill on a day that you are scheduled to be in the clinical setting, another preceptor can supervise you as long as they are willing to take you on as a student and they meet the minimum preceptor qualifications. a. true a. false a. false Which of the following should be considered in a patient presenting with erectile dysfunction a. diabetes mellitus b. hypertension c. atherosclerosis d. all of the above d. all of the above A 23 year old sexually active man is seen in the clinic with unilateral painful testicular swelling and diagnosed with epididymitis. In order to prescribe the correct drub, the clinician understands that which of these is them most common causative organism? a. escheichia coli b. staphylococcus aureus c. chlamydia trachomatis d. pseudomonas aerugonisa c. chlamydia trachomatis The most common offending agents for medication induces resting tremor are: a. selective serotonin reuptake inhibitore (SSRIs) b. Beta-Blockers c. Floroquinolone antibiotics d. anti-psychotics d. anti-psychotics Which of the following type of tremor is characterized by an increase in amplitude when the patient attemps voluntary movements a. resting tremor b. postural tremor c. intention tremor d. medication-induced tremor c. intention tremor Ian, age 62, presents with a wide, diffuse area of erythematous skin on his left lower leg that is warm and tender to palpation. There is some edema involved. You suspect: a. Necrotizing fasciitis. b. Kaposi's sarcoma. c. Cellulitis. d. A diabetic ulcer. c. Cellulitis. Parkinsons disease is a progressive neurological disorder that is associated with which type of tremor? a. resting tremor b. postural tremor c. intention tremor d. medication induced tremor a. resting tremor Which information should be included when you are teaching your patient about the use of nicotine gum? a. the gum must be correctly chewed to a softened state then placed in the buccal mucosa b. patients should not eat for 30 minutes prior to or during the use of the gum c. initially, one piece is chewed every 30 minutes while awake d. acidic foods and beverages should be encouraged during nicotine therapy a. the gum must be correctly chewed to a softened state then placed in the buccal mucosa Severe pain associated with acute otitis media signifies perforation of the tympanic membrane. a. true b. false b. false Jason, aged 62, has obstructive sleep apnea. What do you think is one of his contributing factors? a. He is a recovering alcoholic of 6 years. b. His collar size is 19 inches. c. He is the only person in his family who has this. d. He is extremely thin. b. His collar size is 19 inches. The "B" in the ABCDEs of assessing skin cancer represents: a. biopsy b. best practice c. boundary d. border irregularity d. border irregularity 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? a. diarrhea b. Parkinson's disease c. closed-angle Glaucoma d. Breast cancer c. closed-angle Glaucoma A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinican expect as a manifestation of the disease? a. sinus bradycardia b. atrial fibrillation c. supraventricular tachycardia d. U-waves a. sinus bradycardia d. all of the above Heart valve damage resulting from acute rheumatic fever is a long-term sequelae resulting from infection with which of the following pathogens? a. coxsackievirus b. cytomegalovirus c. francisella tularensis d. group A streptococcus d. group A streptococcus What is the recommended calcium intake for adults over the age of 50 with low bone mass? a. 1200mg/day b 1000mg/day c. 1300mg/day d. 1500mg/day d. 1500mg/day A 14 year old is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action? a. obtain a scrotal ultrasound b. obtain a computed tomography scan (CT) c. instruct the patient to elevate the scrotum d. send the patient to the Emergency room c. instruct the patient to elevate the scrotum d. send the patient to the Emergency room All students are subject to review of clinical logs to ensure that they have received a well- rounded experience a. true b. false a. true A 30 year old patient presents with pain on urination. The urine microscopy of unspun urine showed greater than 10 leukocytes/ml and a dipstick was possible for nitrates. What is the probable diagnosis? a. lower urinary tract infection b. chlamydia infection c. candidiasis d. pyelonephritis b. chlamydia infection Fluctuations and reductions in estrogen may be a contributing factor in which type of rhinitis? a. vasomotor rhinitis b. rhinitis medicamentosum c. atophic rhinitis d. viral rhinitis a. vasomotor rhinitis 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? a. valgus stress test b. McMurray circumduction test c. Lachman's test d. Varus stress test b. McMurray circumduction test Your patient has decided to give Chantix a try to quit smoking. YOu are discussing his quit date, and he will begin taking the medication starting tomorrow. When should he plan to quit smoking? a. he should stop smoking today b. he should stop smoking tomorrow c. his quit date should be in one week d. he will be ready to quit after the first 30 days c. his quit date should be in one week The patient is prescribed radioactive iodine (RAI) and asks the clinician how this drug works. The clinicans response should include which of the following data? a. RAI prevents the peripheral conversion of T4 to T3 b. RAI binds to free T4 c. RAI destroys thyroid tissue d. RAI reduces freely circulating iodine c. RAI destroys thyroid tissue Not sure of the question...something about the oral mucosa membranes a. vincents stomatitis b. allergic stomatitis c. apthous stomatitis d. herpetic stomatitis a. vincents stomatitis