NRNP 6531 Midterm Exam / NRNP6531 Midterm Exam (V1)(100 Q & A)(Latest, 2024):Walden, Exams of Nursing

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B.

No

a. It assesses numeracy skills.

It enhances patient–provider

b.

communication.

*c It evaluates medical word

recognition.

.

d.

It measures technology

*a Bonuses based on achievement of

.

benchmarks

Care coordination for chronic diseases

Standards for minimum cash reserves Strict requirements for financial

reporting

NRNP 6531 Midterm Exam

Angie is a new NP who just finished her FNP program. She is having a difficult time

finding an FNP position in the rural area where she lives. So, since she was an ER

nurse prior to her graduate program she decides to go back to the ER as an APRN.

Does she meet the competency requirements for such a position?

*A

Ye

.

s

What is the main reason for using the REALM-SF instrument to evaluate health

literacy?

A small, rural hospital is part of an Accountable Care Organization (ACO) and is

designated

as a Level 1 ACO. What is part of this designation?

Question 4

The Consensus Model identifies 3 core courses that all ANPs must take. All the

following are Advanced core courses except:

*A Public Health

.

B.

Physiology

C. Pharmacolo

gy Physical

D.

Assessment

The care provided by APRNs is not limited by setting but by patient care needs.

*True

Epidemiological

a.

studies

b. Experimental

design

*c

Qualitative studies

.

Randomized clinical

d.

trials

Associations with area

a.

hospitals

b. Costs of ambulatory care

*c Ease of access to care

.

The ratio of providers to

d.

patients

A.

CNM

B.

CRNA

C.

APN

D.

CNS

Mandates for communication among primary caregivers and

hospitalists

Penalties for failure to perform medication reconciliations at time

of discharge

*c Reduction of payments for patients readmitted within 30 days

.

after discharge

Requirements for written discharge instructions for patients and

d. caregivers

False

Which is the most appropriate research design for a Level III research study?

What was an important finding of the Advisory Board survey of 2014 about primary

care

preferences of patients?

To reduce adverse events associated with care transitions, the Centers for Medicare

and

Medicaid Service have implemented which policy?

The Consensus Model for APRN regulation consists of which of the following roles?

*Tru

e

*Tru

e

Apply a thick layer of medication over the affected

a.

area.

A solution spray preparation will be more effective

on

b.

hairy areas.

*E All the

.

Above

A, B & C

F. only

When assisting with a skin biopsy of a patient suspected of having bullous pemphigoid (BP) lesions, what

Punch biopsy

Shave biopsy

Wide excision

biopsy

.

*a Excisional

Rules proposed by the various State Boards of Nursing must be approved by the

state

Legislatures.

In reviewing the Total Percentage of Body surface area for adult burn patients each,

leg, arm

and head are noted evaluated at 9%.

What is the initial approach when obtaining a biopsy of a potential malignant

melanoma

lesion?

a. Avoid contact with the infected lesions.

Elicit a positive Nikolsky sign to confirm the

b.

diagnosis.

*c

Perform direct immunofluorescence

.

microscopy.

Prevent spread of the lesions to other areas of

d.

the skin.

When recommending an over-the-counter topical medication to treat a

dermatologic condition, which instruction to the patient is important to enhance

absorption of the drug?

*Tru

e

*Tru

e

*Tru

e

a.

Clean and dress the burn wounds.

*b Order a CBC, glucose, and electrolytes.

.

c.

Perform a chest radiograph.

Refer the patient to the emergency

d.

department (ED).

*c Put cool compresses over the affected area after

.

application.

Use a lotion or cream instead of an ointment

d. preparation.

A progesterone-only contraceptive is most beneficial for treating

acne.

Combined oral contraceptives are effective for non-inflammatory

acne only.

Oral contraceptives are effective because of their androgen

enhancing effects.

*d Yaz, Ortho Tri-Cyclen, and Estrostep, are approved for acne

.

treatment.

Carbuncles are typically treated with systemic antibiotics.

Mild acne is treated only with topicals.

Steroids should be avoided in cases of suspected fungal etiology.

A patient comes to the clinic after being splashed with boiling water while cooking.

The

patient has partial thickness burns on both forearms, the neck, and the chin. What

will the provider do?

A provider is considering an oral contraceptive medication to treat acne in an

adolescent

female. Which is an important consideration when prescribing this drug?

Ashley a 24 y/o female comes to the clinic with the following chief complaint: “I have

these

reddish/purple raised patches all over my skin. On physical exam the NP notes that

the lesions are erythematous with discrete borders that are irregular, oval or round.

The most likely diagnosis based on the physical exam is:

A.

Seborrheic

A. Nevi

Acanthosis

B.

Nigricans

*

Acrochordon

C.

D.

Cherry

Angioma

*A First degree

.

burn

Second degree

B. burn

Third degree

C. burn

Fourth degree

D. burn

keratoses

*B Urticaria

.

C.

Xanthelasma

D.

Melasma

The most common type of melanoma in African Americans and Asians is:

A.

Basal Cell carcinoma

B. Actinic Keratosis

*

Acral Lentiginous

C. Melanoma

Toxic Epidermal

D.

Necrolysis

Olga was making French fries for her kids and gets splashed with hot oil. At the

clinic the NP notes that she has red colored skin with superficial blisters and pain

where the oil splashed. The most likely diagnosis is:

Patty comes to the clinic with these soft fatty cystic lesions on her neck, trunk and

arms. The

most likely diagnosis is:

During a total body skin examination for skin cancer, the provider notes a raised,

shiny,

slightly pigmented lesion on the patient’s nose. What will the provider do?

Consult with a dermatologist about possible

melanoma.

Reassure the patient that this is a benign lesion.

*c Refer the patient for possible electrodessication and

.

curettage.

Tell the patient this is likely a squamous cell

d. carcinoma.

During an eye examination, the provider notes a red-light reflex in one eye but not the other. What is the si

C. Penicillin

Azithromyci

D. n

*

Amoxicillin

Doxycycline Oral

Consider prescribing a topical mast cell

a. stabilizer.

*b Determine the duration of treatment with this

.

medication.

c. Prescribe a non-sedating oral antihistamine.

d. Refer the patient to an ophthalmologist for

Mikey is a 19 y/o male who is brought to the clinic because he has a fever, sore throat, pain

on

swallowing and mildly enlarged submandibular nodes

First line pharmacological treatment for Mikey would include:

a.

Normal physiologic variant

*b

Ocular disease requiring

.

referral

Potential infection in the

c.

“red” eye

Potential vision loss in one

d.

eye

A patient diagnosed with allergic conjunctivitis and prescribed a topical

antihistamine- vasoconstrictor medication reports worsening symptoms. What is

the provider’s next step in managing this patient’s symptoms?

a. Antibiotic eye

drops

Nasolacrimal duct

b.

probing

c. Systemic antibiotics

*d

Warm compresses

.

a. Anthralin

Cyclospo

ri

b.

ne

c. Finasterid

e

*d Minoxidil

*a Examination of scalp scrapings with potassium

.

hydroxide (KOH)

Grasping and pulling on a few dozen hairs

Serum iron studies and a complete blood count

Venereal Disease Research Laboratory (VDRL) test

*A Streptococcus

.

pyogenes

B. Streptococcus

pneumonia

C. Streptococcus

mutans

D. Streptomyces

further care.

An adult patient with a history of recurrent sinusitis and allergic rhinitis reports

chronic

tearing in one eye, ocular discharge, and eyelid crusting. The provider suspects

nasolacrimal duct obstruction. Which initial treatment will the provider recommend?

A patient diagnosed with alopecia is noted to have scaling on the affected areas of

the scalp.

Which confirmatory test(s) will the provider order?

A female patient is diagnosed with androgenetic alopecia. Which medication will the

primary

health care provider prescribe?

Mikey is a 19 y/o male who is brought to the clinic because he has a fever, sore throat, pain

on

swallowing and mildly enlarged submandibular nodes

The most likely organism causing Mikey’s infection is:

A.

Lateralization to the good ear

*B Lateralization to the bad ear

.

Lateralization would be equal to

C.

either ear.

*a

Allergic

.

Bacteri

b.

al

Chemi

c

c.

al

*a Aqueous

.

deficiency

b. Corneal abrasion Evaporative

c. disorder

Poor eyelid

d. closure

Bacteremic spread from remote

infections

Inoculation from local trauma or

bug bites

*c Local spread from the ethmoid

.

sinus

d. Paranasal sinus inoculation

Audrey is a 16 y/o female who comes to the clinic because her teacher says that she is

having a hard time hearing in class. The NP examines her ears and notes that she has

otitis media.

If the NP performed a Weber test on Audrey she would discover that there would be:

A patient experiencing chronically dry eyes reports having a foreign body sensation,

burning,

and itching. A Schirmer test is abnormal. What is the suspected cause of this

patient’s symptoms based on this test finding?

Which is the most common cause of orbital cellulitis in all age groups?

A patient reports bilateral burning and itching eyes for several days. The provider

notes a

boggy appearance to the conjunctivae, along with clear, watery discharge. The

patient’s eyelids are thickened and discolored. There are no other symptoms. Which

type of conjunctivitis is most likely?

*Tru

e

Good hand

A.

washing

B. Adequate rest

C. Zinc Lozenges

*D All the above

.

E.

A & B only

Artificial tear drops are

contraindicated.

Spontaneous bleeding is likely.

*c UVB eye protection is especially

.

important.

Visine may be used for symptomatic

d. relief.

*a Asymmetric red

.

reflex

Corneal

b. opacification

c. Excessive tearing

Injection of

d. conjunctiva

d.

Viral

A retinal detachment would be identified by a shower of floaters with the addition of

sudden flashes of light.

A patient has an elevated, yellowish-white lesion adjacent to the cornea at the 3

o’clock

position of the right eye. The provider notes pinkish inflammation with dilated blood

vessels surrounding the lesion. What information will the provider provide the

patient about this lesion?

A primary care provider may suspect cataract formation in a patient with which

finding?

Aaron an 18 y/o male comes to the clinic with the following symptoms: nasal stuffiness,

sneezing,

scratchy irritated throat and hoarseness. He also complains of a low-grade fever and a

cough that he has had for the past 4 days.

Prevention of Aaron’s condition would include which of the following:

True

* False

*A Acute otitis

.

media

Bullous

Myringitis

Otitis externa

Swimmer’s ear

Flu

Peritonsillar abscess Streptococcal

*

C. Pharyngitis

Administration of antibiotic eye

a. drops

*b Application of topical fluorescein

.

dye

Instillation of cycloplegic eye

c. drops

Irrigation of the eye with normal

d. saline

Bryce is a 17 y/o male who comes to the clinic with chief complaint of ear sudden

onset of pain, popping noises, and muffled hearing. During the ear exam the NP

notices that the TM has ruptured. The most likely diagnosis is:

Koplik spots on the buccal mucosa are pathognomonic for mumps.

Mikey is a 19 y/o male who is brought to the clinic because he has a fever, sore

throat, pain

on swallowing and mildly enlarged submandibular nodes. The most likely diagnosis

for Mikey is:

A patient who works in a furniture manufacturing shop reports a sudden onset of

severe eye

pain while sanding a piece of wood and now has copious tearing, redness, and

light sensitivity in the affected eye. On examination, the conjunctiva appears

injected, but no foreign body is visualized. What is the practitioner’s next step?

A patient is seen in the clinic for patches of hair loss. The provider notes several well-

demarcated patches on the scalp and eyebrows without areas of inflammation

and several hairs within the patch with thinner shafts near the scalp. Based on

these findings, which type of alopecia is most likely?

*a

Alopecia areata

According to the JNC 8 guidelines the hypertension treatment goal for patients 60 years and younger sho

.

Anagen

effluvium

Cicatricial

alopecia

Telogen

effluvium

Add a beta blocker to the patient’s

A. regimen.

*B Admit to the hospital for evaluation and

.

treatment.

Increase the dose of the thiazide

C. medication.

D. Prescribe a calcium channel blocker.

Admit the patient to the hospital for evaluation and

a. treatment.

*b Consult with the cardiologist to determine appropriate

.

diagnostic tests.

c. Continue to monitor the patient every 3 years.

*< 14

0 / 9 0

< 130

/ 8 0

< 150

/ 9 0

< 150

/ 8 0

An African-American patient who is being treated with a thiazide diuretic for chronic

hypertension reports blurred vision and shortness of breath. The provider notes a

blood pressure of 185/115. What is the recommended action for this patient?

A young adult patient is diagnosed with a mitral valve prolapse. During a routine 3-

year

health maintenance exam, the provider notes an apical systolic murmur and a

mid-systolic click on auscultation. The patient denies chest pain, syncope, or

palpitations. What action will the provider take?

Autoimmune

a.

disorder

b. Bacterial

infection

c. Protozoal

infection

*d Viral infection

.

a. Daily aspirin therapy to prevent

clotting

b. Statin therapy with clopidogrel

Walking slowly for 15 to 20

minutes

c.

twice daily

*d

Walking to the point of pain each

*Tru

e

*Tru

e

True

* False

A. Normal

*B Prehypertensi

.

on

d.

Reassure the patient that these findings are expected.

A previously healthy patient presents with sudden onset of dyspnea, fatigue, and

orthopnea.

A family history is negative. The provider suspects myocarditis. What is the most

likely etiology for this patient?

A patient is diagnosed with peripheral arterial disease (PAD) and elects not to have

angioplasty after an angiogram reveals partial obstruction in lower extremity

arteries. What will the provider recommend to help manage this patient’s

symptoms?

A split S2 is best heard at the upper left sternum.

In coarctation of the aorta the BP of the arms is higher than the BP of the legs.

Pulsus paradoxus is a phenomenon in which the radial pulse can be palpated

even though

the apical pulse can’t be heard.

Juan is a known patient to the NP. He comes in for his quarterly check on his blood

pressure.

His blood pressure is 125/85. According to JNC 8 his BP falls into the category of:

a.

Digital subtraction

angiography

*b Doppler ankle, arm index

.

c.

Magnetic resonance

angiography Segmental limb

pressure

Ventricular Tachycardia

Pulsus paradoxus Atrial Fibrillation\ Atrial

*

C. Flutter

D. None of the above

*A Mitral

.

Regurgitation

Aortic Stenosis

Mitral Stenosis Aortic

Regurgitation

C.

Stage I

D.

Stage II

An elderly adult patient without prior history of cardiovascular disease reports lower

leg

soreness and fatigue when shopping or walking in the neighborhood. The primary

care provider notes decreased pedal pulses bilaterally. Which test will the provider

order initially to evaluate for peripheral arterial disease based on these

symptoms?

Ashley is a 47 y/o female who comes to the clinic with a chief complaint of sudden

onset of

palpitations and a feeling of weakness and dizziness. Additionally she notes that

she has dyspnea on exertion. On the physical exam the NP notes that he HR is 120

bpm and her BP drops to 98/60. The NP after running an EKG and noting no

discrete p waves and irregularly irregular rhythm diagnoses her as having:

I n performing a follow-up exam on a patient the NP discovers that the patient has a new

murmur. The

murmur is best heard at the apex of the heart, radiates to the axilla, and is a loud blowing

and high- pitched murmur.

This type of murmur is associated with which of the following conditions:

Angus is a 73 y/o male who comes to the clinic with the chief complaint of: chest

pain,

palpitations, exercise intolerance, intermittent periods of dizziness. Past medical

records indicate that he has an enlarged heart. His diagnosis is:

a. Exercise is contraindicated for life.

Exercise may resume when

symptoms

b.

subside.

*c He may resume exercise in 6

months.

.

d.

He must be symptom-free for 1

*a Echocardiogram

.

b. Electrocardiogram

c. Endomyocardial

biopsy Magnetic

resonance

d.

imaging

Dorsiflexion of the foot that produces lower leg pain is termed Homan’s Sign.

*True False

surgical consult.

.

Order a CBC, type and crossmatch, electrolytes, and renal

function tests.

Perform an ultrasound examination to evaluate the cause.

Schedule the patient for an aortic angiogram.

*d Transfer the patient to the emergency department for a

*A CHF

.

Left Ventricular

Hypertrophy

B.

(LVH)

C. Right sided heart failure

D. None of the above

A patient who is an avid long-distant runner is diagnosed with viral myocarditis.

What will

the provider tell this patient when asked when resuming exercising is permitted?

A patient is in clinic for evaluation of sudden onset of abdominal pain. The provider

palpates

a pulsatile, painful mass between the xiphoid process and the umbilicus. What is

the initial action?

Which test is diagnostic for diagnosing myocarditis?

Patients with hypertensive retinopathy will have all of the following except:

Vitami

n A

Vitami

n C

*Vitami

n K

Vitami

n D

*A

Bronchitis

.

Copper wire arterioles

Silver wire arterioles

Atriovenous nicking

*D Optic disc with blurred

.

margins

Cotton wool

spots

Silver wire

vessels

*

Retinal

C. hemorrhages

D. A & B only

Guy is a 65 y/o male who comes to the clinic with the following chief complaint: “I have been

feeling

feverish, have chills, and am tired all the time. My heart also makes a funny sound. In the

physical exam the NP auscultates a heart murmur, and notices that he patient has

subungual hemorrhages, petechiae on the palate, violet colored nodes on the fingers and

feet, and nontender red nodes on the palms and soles of his feet.

In a patient with Guy’s diagnosis, on funduscopic exam one might see:

Ashley is a 47 y/o female who comes to the clinic with a chief complaint of sudden onset of

palpitations

and a feeling of weakness and dizziness. Additionally she notes that she has dyspnea on

exertion. On the physical exam the NP notes that he HR is 120 bpm and her BP drops to

98/60. Her EKG shows no discrete p waves and irregularly irregular rhythm.

If Ashley were to start bleeding she would go to the ER and they would initiate

which intervention below to reverse the effects of her warfarin:

Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks

of

fatigue and non-productive paroxysmal coughing. He initially had a sore throat,

some rhinitis and low-grade fever. His likely diagnosis is:

True

*False

A.

Pneumoni

a

B. Sinusitis

C.

COPD

All the

D.

Abov

e

*E A & B

only

A. Strep pneumonia

*B Pneumococcal

.

pneumonia

C. Mycoplasma

pneumonia

D. Moraxella catarrhalis

*a ACE inhibitor medication use

.

b. Chronic obstructive pulmonary

Atypical Pneumonia (Walking

B.

pneumonia)

C. Allergic Rhinitis

Community acquired bacterial

D.

pneumonia

Mike is a 56 y/o male who lives in an abandoned building. With about 40 other street people.

He comes to

the clinic with a social worker who describes his symptoms as: a cough, dyspnea, pleuritic

chest pain, fever and tachypnea. Your physical exam notes that he has some consolidation

in the lower lobes with an audible friction rub.

Given Mike’s diagnosis the most likely causative agent is:

Artie is a 21 y/o male who comes to the clinic with a chief complaint of paroxysmal coughing

without an

apparent cause. He states that this has been going on for about 15 days. He initially had a

mild fever, and a runny nose.

First line treatment for Artie would include macrolides.

Mike is a 22 y/o male who comes to your clinic with a 5-day history of cough without sputum

production.

He states that his cough is worse in the morning and he has some hoarseness, post-nasal

drip and a low- grade fever. Mike has otherwise been healthy

Differentials for Mike might include which of the following:

A nonsmoking adult with a history of cardiovascular disease reports having a

chronic cough

without fever or upper airway symptoms. A chest radiograph is normal. What will

the provider consider initially as the cause of this patient’s cough?

a.

Chest radiograph

b. Complete blood

count

Computerized

c.

tomography

*d Spirometry

.

Albuterol

Salmeterol

Levalbuterol

*D metaprotere

.

nol

Surgical resection will improve survival chances

a. dramatically.

*b That relapse is likely with a 2-year overall survival

.

of 50%.

c. There is an 80% chance of 5-year survival.

d. Treatment will proceed with curative intent.

disease

c.

Gastroesophageal reflux

disease

d.

Psychogenic cough

A young adult patient without a previous history of lung disease has an increased

respiratory

rate and reports a feeling of “not getting enough air.” The provider auscultates clear

breath sounds and notes no signs of increased respiratory effort. Which diagnostic

test will the provider perform initially?

Martin is a 73 y/o male who has a 50 year/pack history of smoking and comes to the clinic for

his annual

physical. As you are leading him back to the exam room you note that he has dyspnea with

minimal cough, a barrel chest, and appears to have lost weight since his last visit. Your

physical exam confirms a 20 lb. weight loss, and a more noticeable pursed lip breathing.

Given Martin’s condition the first line treatment would be all the following except:

A patient with limited stage small cell lung cancer (SCLC) has undergone

chemotherapy with

a good initial response to therapy. What will the provider tell this patient about the

prognosis for treating this disease?

Which test is the most diagnostic for chronic obstructive pulmonary disease

(COPD)?

a.

COPD Assessment Test

A. Rest

B. Mucolytics

* Antibiotics

C.

Increased fluid

D.

intake.

Forced expiratory time

b. maneuver

c. Lung radiograph

*d Spirometry for FVC and

.

FEV

a. Damage to the alveolar wall

*b Destruction of alveolar

.

architecture

Mild alteration in lung tissue

c. compliance

Mismatch of ventilation and

d. perfusion

*a Ipratropium

.

bromide

b. Pirbuterol acetate Salmeterol

c. xinafoate

d. Theophylline

Mike is a 22 y/o male who comes to your clinic with a 5-day history of cough without sputum

production.

He states that his cough is worse in the morning and he has some hoarseness, post-nasal

drip and a low- grade fever. Mike has otherwise been healthy

Treatment for Mike’s condition would include all the following except:

Which is characteristic of obstructive bronchitis and not emphysema?

A patient diagnosed with chronic obstructive pulmonary disease reports daily

symptoms of

dyspnea and cough. Which medication will the primary health care provider

prescribe?

A young adult patient develops a cough persisting longer than 2 months. The

provider

prescribes pulmonary function tests and a chest radiograph, which are normal. The

patient

*a Infection

.

b. Lung abscess

c. Malignancy

Thromboemb

oli

d.

sm

*a A high-fiber diet and increased fluid

intake

.

Daily laxatives to prevent straining with

b.

stools

c.

Infiltration of a local anesthetic into the

24-hour esophageal pH

a. monitoring

*b Methacholine challenge

.

test

c. Sputum culture

d. Tuberculosis testing

a. Coagulation studies

*b Computed tomography

.

(CT)

Fiberoptic

c. bronchoscopy

d. Needle biopsy

denies abdominal complaints. There are no signs of rhinitis or sinusitis and the

patient does not take any medications. What will the provider evaluate next to

help determine the cause of this cough?

A patient with a smoking history of 35 pack years reports having a chronic cough

with recent

symptoms of pink, frothy blood on a tissue. The chest radiograph shows a possible

nodule in the right upper lobe. Which diagnostic test is indicated?

A patient reports coughing up a small amount of blood after a week of cough and

fever. The

patient has been previously healthy and does not smoke or work around pollutants

or irritants. What will the provider suspect as the most likely cause of this patient’s

symptoms?

A patient reports anal pruritis and occasional bleeding with defecation. An

examination of

the perianal area reveals external hemorrhoids around the anal orifice as the

patient is bearing down. The provider orders a colonoscopy to further evaluate

this patient. What is the treatment for this patient’s symptoms?

Debulking the

A.

liver

B. Chemotherap

y

C. Liver

transplant

*D All the Above

.

E.

A & B only

Bisacodyl

Docusate

sodium

*c Methylcellulos

.

e

d. Mineral oil

CBC

UA

CT scan

KUB

*E All the

.

Above

A, C & D

F. only

hemorrhoid

d.

Referral for possible surgical

intervention A patient has recurrent constipation which improves with laxative use but returns

when

laxatives are discontinued. Which pharmacologic treatment will the provider

recommend for long-term management?

Jeremy is an 18 y/o male who comes to the clinic with a chief complaint of periumbilical pain.

Over the

past 24 hours he has had bouts of nausea and diarrhea and pain at McBurney’s point.

Which of the following diagnostic studies would be appropriate for Jeremy’s

diagnosis?

Danny is a 37 y/o male who returns to the clinic for review of lab results. When he came in a

week ago he

complained of a “sour” taste when he belched, and severe pain in his stomach. A serum

fasting gastrin level was drawn and sent to the lab. The results were 300 pg/ml.

Treatment for Danny would include which of the following:

*a Alcoholism

.

b. Hepatitis C

Hepatocellul

ar

c.

carcinoma

Right-sided heart

d.

failure

Irritable bowel

A.

syndrome

*B Duodenal ulcer

.

*a H.

.

pylori infection

NSAID use

Parasite

infestation

Viral

gastroenteritis

Acute

cholecystitis

Acute

Diverticulitis

*

Acute

C. Appendicitis

Acute

D. Pancreatitis

A 50-year-old, previously healthy patient has developed gastritis. What is the most

likely cause of this condition?

A patient is diagnosed with fibrotic liver disease; a liver biopsy shows micronodular

cirrhosis.

What is the most common cause of this form of cirrhosis?

Jeremy is an 18 y/o male who comes to the clinic with a chief complaint of

periumbilical pain.

Over the past 24 hours he has had bouts of nausea and diarrhea and pain at

McBurney’s point. The NP diagnoses him as having:

Jeremiah, a 47 y/o male presents to the clinic with episodic gastric pain he describes

as

gnawing and burning. He notes that the pain is temporarily relieved by food or

antacids but return in full force after a couple of hours. He notes that his stools are

“tarry” and he sometimes has coffee colored vomit. On this basis the NP provides a

diagnosis of:

Surface electrical

a.

stimulation

b. Teaching head

rotation

*c

Thickened liquids

.

d.

Thinning liquids

Chemical dissolution of the

a.

gallstone

b. Lithotripsy

*a Ordering a CBC and stool for occult

.

blood

Prescribing an antispasmodic

b. medication

Referring the patient for a lower

c. endoscopy

Reminding the patient to eat a high-

d. fiber diet

Cephalospor

in

Furosemide

Lactulose

*d Spironolacto

.

ne

C.

GERD

D.

Acute Diverticulitis

A patient experiences a feeding disorder after a stroke that causes disordered

tongue

function and impaired laryngeal closure. What intervention will be helpful

to reduce complications in this patient?

A patient with a history of diverticular disease experiences left-sided pain and

reports seeing

blood in the stool. What is an important intervention for these symptoms?

A patient diagnosed with cirrhosis develops ascites. Which medication will be

ordered

initially to improve symptoms?

A patient with a previous history of liver disease is diagnosed with a bile duct

obstruction.

Which procedure will be prescribed for this patient?

*Tru

e

Avoiding saturated fats and

red

a.

meat

*b Consuming a diet high in

fiber

.

Taking an anticholinergic

c.

medication

Using bran to replace high-

fiber

Empirical treatment

with antibiotics

*Hospitalization for

emergent treatment

Prescribing ursodeoxycholic

acid Supportive care with

Single Therapy of Ranitidine

Single Therapy of Omeprazole Triple therapy of: Clarithromycin,

*

C. amoxicillin, PPI

D. None of the above

c.

Open cholecystectomy

*d

Laparoscopic

cholecystectomy

.

Amylase and Lipase are sensitive tests used to assess for pancreatitis.

A patient with a history of diverticular disease asks what can be done to minimize

acute

symptoms. What will the provider recommend to this patient?

Jeremiah, a 47 y/o male presents to the clinic with episodic gastric pain he describes as

gnawing and

burning. He notes that the pain is temporarily relieved by food or antacids but return in full

force after a couple of hours. He notes that his stools are “tarry” and he sometimes has

coffee colored vomit.

Jeremiah is determined to have H. pylori positive ulcers which treatment would be

indicated?

A patient presents with fever, nausea, vomiting, anorexia, and right upper quadrant

abdominal pain. An ultrasound is negative for gallstones. Which action is necessary

to treat this patient’s symptoms?

Admit the patient to the hospital for consultation with

a

a.

surgeon

*b Obtain upright and supine radiologic views of the

abdomen

.

Prescribe an antiemetic and recommend a clear liquid

diet

c.

for 24 hours

Increase the dose of

polyethylene

a.

glycol

*b

Obtain radiographic

Serology

Urea Breath Test

Upper endoscopy and biopsy of

*

C. tissue

D. Stool antigen

Acute acalculous

cholecystitis

Chronic cholelithiasis

*c Common bile duct

.

obstruction

d. Infectious cholecystitis

up

Jeremiah, a 47 y/o male presents to the clinic with episodic gastric pain he describes as

gnawing and

burning. He notes that the pain is temporarily relieved by food or antacids but return in full

force after a couple of hours. He notes that his stools are “tarry” and he sometimes has

coffee colored vomit.

The Gold Standard for diagnosing Jeremiah’s problem is:

A patient has sudden onset of right upper quadrant (URQ) and epigastric abdominal

pain

with fever, nausea, and vomiting. The emergency department provider notes

yellowing of the sclerae. What is the probable cause of these findings?

An adult patient reports intermittent, crampy abdominal pain with vomiting. The

provider

notes marked abdominal distention and hyperactive bowel sounds. What will the

provider do initially?

A patient diagnosed with chronic constipation uses polyethylene glycol and reports

increased abdominal discomfort with nausea and vomiting. What is the initial action

by the provider?

.

studies

Perform a stool culture and occult

c. blood

Refer to a specialist for

d. colonoscopy