NR511 Final Exam and Midterm Study Guide, Exams of Nursing

Download NR511 Final Exam and Midterm Study Guide and more Exams Nursing in PDF only on Docsity! NR511 Final exam NR 511 midterm SANNER study Latest Updated 2024/2025 Assesses the clients HPI - Correct Answer OLDCARTS TRUE or FALSE... The history of present illness is a breakdown of the clients chief complaint - Correct AnswerTRUE What is needed to make a sound clinical decision - Correct AnswerEvidence based research clinical practice guidelines published evidence-based algorithms (few false positives) high percentage of healthy people will show a normal result - Correct Answerhigh specificity high number of false positives - Correct Answerlow specificity if a diagnostic study has ____________, then a high number of healthy people will show a normal result - Correct Answerhigh specificity proportion of true positives - Correct Answersensitivity ______________ will lead to positive findings for patients with a disease - Correct Answerhigh sensitivity how clients cover out of pocket expenses when on medicare - Correct Answersecondary insurance to cover 20% out of pocket expense inpatient hospital, skilled nursing care, hospice, home care - Correct AnswerPart A medicare outpatient, provider visits, surgery, labs, medical equipment, preventative exams - Correct AnswerPart B Medicare Wellness services, eye exams, hearing exams, hearing aides, glasses - Correct AnswerPart C Medicare Prescription drugs - Correct AnswerPart D Medicare NP's are reimbursed at _______of the physician fee - Correct Answer85% what is the purpose of medicare advantage plans - Correct Answerlower co payments , add additional benefits Third party payers fall into 7 categories...( name 7) - Correct AnswerMedicare, Medicaid, indemnity, managed care, Workers comp, Veterans admin, auto liability Papular rash, satellite lesions = what kind of skin issue - Correct Answerfungal those at risk for fungal skin infections - Correct Answerimmunocompromised young - diaper rash Diabetic antibiotic therapy Aids corticosteroid treatment chemo flat to slightly elevated brown papules and plaques, scale when rubbed, hypopigmentation, puritic, found on trunk and shoulders - Correct Answertinea vesicolor candidiasis in tip of penis - Correct Answerbalanitis annual lesions with scaly borders, ring shape scaly borders on exposed skin and trunk - Correct Answertinea corporis Athletes foot - Correct Answertinea pedis jock itch - Correct Answertinea cruis white or yellow nail discoloration, thickening of nail, separation from nail bed - Correct Answertinea unguium dry skin teaching - Correct Answeruse tepid water and mild soaps,older adults at risk spreading skin infection of epidermis and subcutaneous tissue,begins after a break in the skin - Correct Answercellulitis bacterial infection characterized by papules - Correct Answerfolliculitis' caused by human papilloma virus, abrading skin can spread virus - Correct Answerwarts easiest types of warts to treat - Correct Answerfiliform, digitate causative organism of viral conjunctivits - Correct Answeradenovirus hallmark symptoms of red, itchy eyes, clear to no drainage, preauricular lymph node swelling and tenderness indicate - Correct Answerviral conjunctivitis red eye, crusted lid, normal visual acuity ,watery, itchy eyes, photophobia indicate - Correct Answerbacterial conjunctivitis gradual, painless, progressive loss of vision - Correct Answercataracts tend to be bilateral in nature, may manifest as blurry/distorted vision, c/o glare with driving - Correct Answerage related cataracts small lump,or swelling which develops in the eye lid as result of blockage in a gland - Correct Answerchalazion/cyst inflammation around eyelid margins,caused by staphylococcal infection at lash base - Correct Answerblepharitis treatment for blepharitis - Correct Answerbacitracin 0.5 ointment treatment for resistant stapylococcal infections - Correct Answerd/c bacitracin, start quinolone ointment/erythromycin when to refer to a chalazion to ophthalmologist - Correct Answerpersist for more than 4 weeks Tests for dry eye include: - Correct Answerslit lamp,shermer test first level education for dry eyes - Correct Answerclient education overflow of tears onto the face - Correct Answerepiphora treatment for epiphora should not include... - Correct Answercorticosteroid or anesthetic eye gtts, may block healing and increase infection red,hot, tender swelling at edge of eyelid, most improve on their own - Correct Answerhordeolum/stye sinus pain felt behind the eye include what sinuses - Correct Answerethmoid sinuses pressure over the cheek include what sinuses, - Correct Answermaxillary sinuses symptoms that confirm diagnosis of sinusitis - Correct AnswerURI x 7 days plus 2 or more of the following colored nasal drainage poor response to decongestants facial/sinus pain/positional headache tender pinna/tragus erythematous ear canal swimming history - Correct Answerotitis externa red bulging tympanic membrane - Correct Answerotitis media standard treatment for otitis media - Correct Answeramoxicillin 40-45 mg/kg/day divided in two doses x 10 days results in increased intraocular pressure, an emergency if left untreated, can cause blindness, occurs suddenly, dramatic onset of symptoms of blurry vision, red eyes, unilateral pain, pressure, headache, seeing halos, photophobia, loss of peripheral vision then central vision - Correct AnswerAcute Angle-Closure glaucoma strategy to relieve middle ear pressure due to barotrauma - Correct Answeroral decongestants and nasal steroids type of hearing loss that occurs due to loud noises - Correct Answersensorineural bone conduction is greater than air conduction, produces high frequency hearing loss that is bilateral and symmetrical - Correct Answerconductive hearing loss/presbycusis is cerumen impaction sensorineural or conductive hearing loss - Correct Answerconductive tests used to determine if hearing loss in conductive or sensorineural - Correct AnswerWeber test & Rinne test if a client has persistent sore throat ,fever, throat pain ,difficulty swallowing, secretions, respiratory difficulty, stridor, but no pharyngeal erythema or cough... - Correct AnswerEpiglottis posterior cervical lymph node swelling ,persistent sore throat, fever , malaise, not responding to treatment - Correct Answertest for mono using monospot test Treatmetn for group A strep pharyngitis - Correct Answerpenicillin V 500mg BID or 250mg 4 x daily x 10 days or benzathine penicillin 1.2 million units IM once infection is almost always unilateral ,located between the tonsil and superior pharyngeal constrictor muscle - Correct Answerperitonsillar abscess Ig3 mediated, type 1 sensitivity. Turbinates pale - Correct Answerrhinitis/hay fever watery rhinorrhea nasal congestion nasal speech, mouth breathing - Correct Answerviral rhinitis atopic triad consists of: - Correct Answerallergic rhinitis, asthma, eczema 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 - Correct Answerd. 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 - Correct Answera. 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 d. Pneumococcal pneumonia. - Correct Answerc. Gram-negative bacteria. A family practice office for all 5 of your clinical rotations will guarantee that you will gain the required pediatric exposure a. true b. false - Correct Answerb. false The most common precancerous skin lesion found in Caucasians is a. skin tags b. actinic keratosis c. melanoma d. basal skin lesion - Correct Answerb. actinic keratosis Which obstructive lung disease is classified as reversible? a. Asthma b. Chronic bronchitis c. Emphysema d. COPD - Correct Answera. Asthma Which of the following is an example of an articular structure a. bone b. synovium c. tendons d. fascia - Correct Answerb. 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 - Correct Answerb. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses Which of the following statements is true concerning the management of the client with a herniated disc? 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 3 months is an indication for surgical intervention d. all of the above - Correct Answerc. 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 - Correct Answerb. 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 - Correct Answera. 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 - Correct Answera. 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 - Correct Answerd 6-12 weeks The A in SNAPPS stands for Assessment a. true b. false - Correct Answerb. 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 - Correct Answerc. 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 - Correct Answerb. 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 - Correct Answerb. 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 - Correct AnswerC. 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 - Correct Answerb. 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. 2 c. 3 d. 4 - Correct Answerb. 2 The patient is diagnosed with overactive bladder (OAB). Which of the following instructions should be given to this woman? a. Limit the amount of water that you drink b. eliminate caffeine from your diet c. wear panty liners d. all of the above - Correct Answerb. 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 - Correct Answera. her age Treatment for epididymitis includes which of the following? a. warm sitz baths b. scrotal elevation c. masturbation d. all of the above - Correct Answerb. 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 - Correct Answera. 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 - Correct Answera. 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 - Correct Answerd. all of the above SNAPPS pneumonic used to describe a technique in orally presenting a patient. A. true b. false - Correct AnswerA. 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 - Correct Answerd. 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 - Correct Answerd 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 - Correct Answerb 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 - Correct Answerd. 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 - Correct Answerb 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 - Correct Answerc. 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 - Correct Answerd. 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? • Myxedema • Cushing's Syndrome b. bulge sign c. thumb sign d. none of the above - Correct Answera. 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 - Correct Answera. 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 - Correct Answerd. 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 - Correct Answerc. 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 - Correct Answerd. 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 - Correct Answerc. 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. - Correct Answerc. 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 - Correct Answera. 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 - Correct Answera. 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 - Correct Answerb. 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. - Correct Answerb. 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 - Correct Answerd. 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 - Correct Answerc. 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 - Correct Answera. sinus bradycardia Tori is on systematic antifungals for a bad tinena infection. You understand that serum labs should be monitored for: a. renal failure b. hepatotoxicity c. electrolyte imbalance d. leukocytosis - Correct Answerb. hepatotoxicity Which of the following signs or symtoms indicate an inflammatory etiology to musculoskeletal pain? a. decreased C-reactive protein b. hyperalbuminemia c. morning stiffness - Correct Answerc. morning stiffness A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? a. very early b 3-4 hours after perforation c. late in inflammation d. appendicitis never presents with vague pain - Correct Answera. very early A patiennt presents to the clinicians office with a sore throat, fever of 100.7 and tender anterior cervical lymphadenopathy. The clinican suspects strep throat and performs a rapid strep test that is negative. What would the next step be? a. the patient should be instructed to rest and increase fluid intake as the infection is most likely viral and resolve without antibiotic therapy a. lower urinary tract infection b. chlamydia infection c. candidiasis d. pyelonephritis - Correct Answerb. 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 - Correct Answera. 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 - Correct Answerb. 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 - Correct Answerc. 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 - Correct Answerc. 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 - Correct Answera. vincents stomatitis