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NSG 6001 WEEK 3 MIDTERM EXAM 2023-2024 ACTUAL
EXAM TEST BANK 150 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES |ALREADY
GRADED A+
A 35 year old female patient is seen in the clinic complaining of abdominal pain. Which of the following should be included in the history and physical - ANSWER-nature of the pain, timing of the pain, palliative and provocative aspects, associated symptoms (n/v). A patient comes to the office complaining of constipation. The patient lists all of the following medications. Which drug could be responsible for the contipation - ANSWER-Pepto-Bismol A patient is seen with complaints of diarrhea. Which of the following should be included in the patient's differential diagnosis? - ANSWER-frequency, amount and fluidity, color and characteristics. Diet history, recent travel, medication use, source of drinking water A 29 year old Englishman is seen in the office with complaints of pain in his chest and belly. He has been suffering the pain for 2 weeks and gets temporary relief from Alka-Seltzer. The burning wakes him at night and radiates up to his chest. Which factor favors a diagnosis of gastric ulcer - ANSWER-His use of Alka Seltzer Which of the following is most effective in diagnosing appendicitis - ANSWER-History and physical A 46-year-old patient is seen in the clinic with abdominal pain. Which of the following tests is essential for this patient? - ANSWER-Urine human chorionic gonadotropin
. A 25-year-old accountant is seen in the clinic complaining of crampy abdominal pain after meals. She is often constipated and takes laxatives, which are followed by a couple of days of diarrhea. She temporarily feels better after a bowel movement. She states she is embarrassed by flatulence and has abdominal distension. She has had no weight loss or blood in her stool. This problem has gone on for about 6 months. What should the next step be? - ANSWER-Obtain a complete history A 28-year-old patient is seen in the clinic with colicky abdominal pain particular with meals. She has frequent constipation, flatulence, and abdominal distension. Which of the data make a diagnosis of diverticulitis unlikely? - ANSWER-Her age
A 28-year-old patient is seen with complaints of diarrhea. Which of the following responses to the history questions would help the primary care physician (PCP) establish the diagnosis of irritable bowel syndrome? - ANSWER- Which of the following dietary instructions should be given to a patient with GERD? - ANSWER-Eliminate coffee The patient with GERD should be instructed to eliminate which of these activities? - ANSWER-Weight lifting
. A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? - ANSWER-Very early . A patient is seen in the clinic with right upper quadrant pain that is radiating to the middle of the back. The NP suspects acute cholelithiasis. The NP should expect which of the following laboratory findings? - ANSWER-Elevated alkaline phosphatase Which of the following is part of the treatment plan for the patient with irritable bowel syndrome? - ANSWER-High fiber diet The nurse is assessing a client diagnosed with gastroesophageal reflux disease. Which of the following should be included in this assessment? - ANSWER-Presence of pyrosis A client, diagnosed with a hiatal hernia, will experience which of the following symptoms most frequently? - ANSWER-Heartburn The nurse is instructing a client diagnosed with a hiatal hernia on ways to reduce the symptoms. Which of the following should be included in these instructions - ANSWER-Avoid lying down after meals .A client is experiencing water brash. The nurse realizes this symptom is associated with - ANSWER- Barretts esophagus
A client is being evaluated for a lower urinary tract infection. Which of the following symptoms would the nurse expect to find? - ANSWER-Cloudy urine An elderly client is diagnosed with a urinary tract infection. Which of the following will the nurse most likely assess in this client? - ANSWER-Change in mental status A client is prescribed trimethoprim-sulfamethoxazole for a urinary tract infection. Which of the following instructions would not be appropriate for this medication?. - ANSWER-Take with an antacid A client with a urinary tract infection is being discharged with a prescription for ciprofloxacin. The nurse should include which of the following discharge instructions? - ANSWER-. Do not take within 2 hours of antacid use A male client asks the nurse about the purpose of the prostate gland. The nurse should respond that it is a structure that:. - ANSWER-provides a milky alkaline substance that neutralizes the acidity of the male urethra and the female vagina A 50-year-old male client has had a prostate-specific antigen test. The nurse realizes that the normal range for this test would be: - ANSWER- 3 - 4 ng/ml A male client, having difficulty voiding, tells the nurse that he thinks something is wrong with his penis. The nurse reviews the structures of the penis with the client and explains that the structure that surrounds the urethra is the - ANSWER-corpus spongiosum During the examination of the male testes, the nurse should instruct the client on - ANSWER-monthly testicular self-examinations .A male client has a prostate specific antigen level of 22 nanograms. The nurse realizes that this client will most likely be scheduled for a(n): - ANSWER-bone scan A female clients Pap test revealed atypical results. The nurse realizes that this client will most likely be scheduled for a(n): - ANSWER-colposcopy
A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea? - ANSWER-Ceftriaxone A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease has she most probably been exposed to? - ANSWER-Chlamydia A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding? - ANSWER-Bacterial vaginosis Which of the following medications is the treatment of choice for trichomonas - ANSWER-Metronidazole A 42-year-old woman presents to the clinic with complaints of painful intercourse for the last month. Which of the following should be explored as the likely cause of her dyspareunia? - ANSWER- Menopause
. 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? - ANSWER-Benign prostatic hypertrophy A 76-year-old man is seen in the office for complaints of urinary incontinence. The clinician should explore which of these causes of incontinence in men? - ANSWER-UTI A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action? - ANSWER-Refer to a urologist immediately 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 differential diagnoses - ANSWER- Which of the following would be an appropriate treatment for a patient with mild BPH? - ANSWER- Reevaluate symptoms in 1 to 3 months.
During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? - ANSWER-An enlarged rubbery gland A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system? - ANSWER-The cancer involves the seminal vesicles
. A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects? - ANSWER-shrunken testicles, hot flashes, gynecomastia, erectile dysfunction, osteoporosis, loss of muscle mass . What is the treatment of choice for a patient diagnosed with testicular cancer - ANSWER-Radical orchidectomy A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnoses? - ANSWER- A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan - ANSWER-Every 3 to 4 months During data collection the nurse notes the presence of a chancre on a male patients penis. For which sexually transmitted infection should the nurse focus additional data collection - ANSWER-Syphilis A patient is diagnosed with a parasitic infection caused by close contact with another persons genitals. For which infection should the nurse plan care? - ANSWER-Phthirus pubis It is documented in the medical record that a patient has gummas. For which sexually transmitted infection should the nurse plan care - ANSWER-Syphilis The nurse is assisting with teaching a 22-year-old female patient who is diagnosed with a sexually transmitted infection (STI). She says, I dont understand. My boyfriend always wears a condom. Which
understanding by the nurse should guide teaching in this situation? - ANSWER-condoms can decrease the risk of STIs, but they are not foolproof The nurse is providing care for a patient with genital herpes who has vesicular lesions. What term should the nurse use to describe these lesions to the patient? - ANSWER-Blisters Human papillomavirus (HPV) produces verrucous growths. What term should the nurse use to describe these lesions to the patient? - ANSWER-Warts The nurse is collecting data on a patient with Chlamydia. Which assessment finding should be reported immediately to the RN or physician? - ANSWER-sharp pain at the base of the ribs Because Trichomonas is relatively large, unusually shaped, and diagnosed quickly, the nurse is asked to assist the physician obtain which type of specimen? - ANSWER-Wet mount A patient diagnosed with Trichomonas asks the nurse how the diagnosis will affect her risk for cervical cancer. Which response by the nurse is best? - ANSWER-Papanicolaou smears should be done more frequently because results may be altered by Trichomonas. A patient asks why the physician has recommended systemic interferon treatment for genital warts. Which explanation should the nurse provide to the patient - ANSWER-Interferon therapy can attack warts all over the body at the same time
. A patient with hepatitis B virus (HBV) delivers a 6-pound 2-ounce baby boy. Which action should the nurse anticipate will be needed for the infant? - ANSWER-HBV-immune globulin less than 12 hours after birth and then HBV vaccine series The nurse must bathe a patient with herpes. What is the nurses best protection against contracting sexually transmitted infections (STIs) from patients while providing perineal hygiene? - ANSWER- Practicing standard precautions . The nurse is caring for a pregnant woman who is fearful that her unborn child will be born blind because of having a sexually transmitted infection (STI). For which STI should the nurse plan care to prevent ophthalmia neonatorum in the newborn? - ANSWER-Gonorrhea
A patient is undergoing treatment that involves the burning of lesions with heat or chemical agents. The nurse recognizes that this patient most likely has which condition? - ANSWER-Genital warts
. The nurse is providing care for a newborn. Which intervention should the nurse make to prevent development of ophthalmia neonatorum? - ANSWER-Antibiotic eyedrops While reviewing a medical record the nurse notes that patient has a strawberry cervix. For which sexually transmitted infection (STI) would the nurse plan care? - ANSWER-Trichomoniasis The nurse is preparing a poster presentation identifying the frequency of sexually transmitted infections (STIs) in the United States. Which STI should the nurse highlight as being the most commonly diagnosed? - ANSWER-Chlamydia While assisting a health care provider (HCP) conduct a pelvic examination, the patient complains of severe pain during the bimanual examination. For which health problem should the nurse suspect this patient is going to need care - ANSWER-Pelvic inflammatory disease While assisting with care, the nurse counsels the patient diagnosed with a sexually transmitted infection (STI) about notification of sexual partners. Which patient statement indicates the need for further teaching? - ANSWER-Reporting regulations are the same throughout the country Factors that place a patient at risk of developing an antimicrobial-resistant organism include: - ANSWER- Inappropriate use of antimicrobials Infants and young children are at higher risk of developing antibiotic- resistant infections due to: - ANSWER-the fact that children this age are more likely to be in daycare and exposed to pathogens from other children Providers should use an antibiogram when prescribing. An antibiogram is: - ANSWER-A chart of the local resistance patterns to antibiotics developed by laboratories there is often cross-sensitivity and cross-resistance between penicillin's and cephalosporin's because: - ANSWER-both drugs classes contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms
Jonathan has been diagnosed with strep throat and needs a prescription for an antibiotic. He says the last time he had penicillin he developed a red, blotchy rash. An appropriate antibiotic to prescribe would be: - ANSWER-Azithromycin Sarah is a 25-year-old female who is 8 weeks pregnant and has a urinary tract infection. What would be the appropriate antibiotic to prescribe for her? - ANSWER-amoxicillin (Trimox) Pong-tai is a 12-month-old child who is being treated with amoxicillin for acute otitis media. His parents call the clinic and say he has developed diarrhea. The appropriate action would be to: - ANSWER-Advise the parents that some diarrhea is normal with amoxicillin and recommend probiotics daily Lauren is a 13-year-old child who comes to clinic with a 4-day history of cough, low-grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish-yellow. The appropriate antibiotic to prescribe would be: - ANSWER-None Joanna had a small ventricle septal defect (VSD) repaired when she was 3 years old and has no residual cardiac problems. She is now 28 and is requesting prophylactic antibiotics for an upcoming dental visit. The appropriate antibiotic to prescribe according to current American College of Cardiology and American Heart Association guidelines is: - ANSWER-None, no antibiotic is required for dental procedures to prevent further development of antibacterial resistance it is recommended that fluoroquinolones be reserved for treatment of: - ANSWER-community-acquired pneumonia in patients with comorbidities Fluoroquinolones have Black box warning regarding ________ even months after treatment - ANSWER- tendon rupture Janet was recently treated with clindamycin for an infection. She calls the advice nurse because she is having frequent diarrhea that she thinks may have blood in it. What would be the appropriate care for her? - ANSWER-Asses her for pseudomembranous colitis Keng has chronic hepatitis that has led to mildly impaired liver function. He has an infection that would be best treated by a macrolide. Which would be the best choice for a patient with liver dysfunction? - ANSWER-Erythromycin (E-mycin)
when prescribing metronidazole (flagyl) to treat bacterial vaginosis, patient education would include: - ANSWER-consuming alcohol in any for may cause a severe reaction Every antibiotic drug class has resistant organisms that influence prescribing decisions. - ANSWER-True the centers for disease control recommends all newborn infants receive prophylactic administration of ____ within 1 hour of birth - ANSWER-erythromycin ophthalmic ointment conjunctivitis in a child that is accompanied by acute otitis media is treated with - ANSWER-high-dose oral amoxicillin twenty-year-old Annie comes to the clinic complaining of copious yellow-green eye discharge. Gram stain indicates she most likely has gonococcal conjunctivitis. While awaiting the culture results, the plan of care should be: - ANSWER-IM ceftriaxone education of women who are being treated with ophthalmic antibiotics for conjunctivitis includes: - ANSWER-throwing away eye makeup and purchasing new Sadie was prescribed betaxolol ophthalmic drops by her ophthalmologist to treat her glaucoma. Oral beta blockers should be avoided in patients who use ophthalmic beta blockers because: - ANSWER-the additive effects may include bradycardia David presents to the clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eye drops. The education regarding using cromolyn eye drops includes: - ANSWER-He should not wear his soft contacts while using the cromolyn eye drops ciprofloxacin otic drops are contraindicated in: - ANSWER-Patients with a perforated tympanic membrane _______ is/are prescribed to prevent swimmer's ear - ANSWER-Isopropyl ear drops (EarSol)
Patient education regarding the use of ciprofloxacin-hydrocortisone (Cipro HC otic) ear drops - ANSWER- warm the bottle of ears drops I is or her hand before administering Jamie presents to the clinic with hard wax in both ear canals. Instructions regarding home removal of hard cerumen include: - ANSWER-instill carbamide peroxide (debrox) twice daily until canals are clear the goals of treatment when prescribing antiretroviral medication to patients with HIV include: - ANSWER-all of the above a challenge face wit antiretroviral therapy (ART) is: - ANSWER-drug-resistant mutations of HIV Predictors for successful treatment with antiretroviral therapy (ART) in HIV-positive patients include: - ANSWER-the patient is strictly adherent to the ART treatment regime the goal of antiretroviral therapy in HIV-positive patient is: - ANSWER-maximum suppression of HIV replication pregnant women who are HIV positive - ANSWER-are treated with a combination antiretroviral therapy (ART0 regimen antiretroviral therapy is recommended for HIV-positive patients with: - ANSWER-All of the above if considering starting a patient on the nucleoside reverse transcriptase inhibitor abacavir, the following testing is recommended prior to prescribing - ANSWER-HLA B*5701 testing Suzanne is pregnant and has tested HIV positive. Which antiretroviral drug should be avoided in women who are pregnant? - ANSWER-Lopinavir/r the cost of HIV treatment can be prohibitive for any patient. Patients can receive assistance from the: - ANSWER-Ryan White HIV/AIDS treatment modernization act
Diffuse - ANSWER-Which pain characteristic is usually indicative of angina pectoris? About 30% - ANSWER-What % of patients w/angina pectoris have simultaneous dyspnea, caused by transient increase in pulm. venous pressures that accompany ventricular stiffening during an episode of myocardial ischemia? Coronary artery disease associated with heart failure - ANSWER-What is the most common form of heart disease in a patient with atrial fibrillation?
. Kelly, a 25-year-old female with an allergy to bee stings - ANSWER-In which patient do premature ventricular contractions NOT need to be treated? Potassium - ANSWER-What does digitalis compete with at binding sites on the cell membrane? Christa is a 65-year-old female with a history of myocardial infarction (MI) - ANSWER-What of the following patients is a candidate for statins? The gum must be correctly chewed to a softened state and then placed in the buccal mucosa - ANSWER- Which information should be included when you are teaching your patient about the use of nicotine gum? 15 to 20 mg - ANSWER-How much nicotine does an average cigarette contain? Preparation - ANSWER-Madeline is a smoker in a primary-care visit with her provider. After her provider asks if she is willing to quit, she says she has decided to quit, has bought nicotine gum, and is interested in hearing about Chantix. Which of the following steps is Madeline in regarding behavioral changes and her attempts at cessation? Penicillin - ANSWER-What is the first-line recommended treatment against Group A beta-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis? Moderate persistent - ANSWER-Cydney presents with a history of asthma. She has not been treated for a while. She complains of daily but not continual symptoms, greater than 1 week and at nighttime. She
has been using her rescue inhaler. Her FEV1 is 60% to 80% predicted. How would you classify her asthma severity?
. Inhaled corticosteroid - ANSWER-Joyce is taking a long-acting beta agonist for her asthma. What additional medication should she be taking? . 5 to 15 mcg/mL - ANSWER-Your patient is on theophylline for his asthma. You want to maintain his serum levels between: Stage 1 mild COPD - ANSWER-George has COPD and an 80% forced expiratory volume in 1 second. How would you classify the severity of his COPD? Anxiety-related dyspnea - ANSWER-Lisa is a 25-year-old Hispanic female experiencing chest tightness, a feeling of suffocation, and feels like she "can't get air in." She has no current history of heart or lung disease and did not exercise leading up to this attack. Which of the following is the most likely cause for this dyspnea? Most nosocomial pneumonias are caused by: - ANSWER-Most nosocomial pneumonias are caused by: His quit date should be in 1 week - ANSWER-Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking? . Prior cryptorchidism - ANSWER-A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following risk factors leads the clinician to suspect potential testicular cancer? . Radical orchidectomy - ANSWER-What is the treatment of choice for a patient diagnosed with testicular cancer? Every 3 to 4 months - ANSWER-A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?
Nodular and unusually firm gland - ANSWER-During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? The cancer involves the seminal vesicles - ANSWER-A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which understanding of the Jewett rating system? Pelvic exam - ANSWER-A 35-year-old female patient is seen in the clinic complaining of abdominal pain. Which of the following should be included in the examination? Gallstones - ANSWER-Which of the following is a condition that results in colicky abdominal pain?
. Endometriosis - ANSWER-A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her physical examination is remarkable for left lower quadrant tenderness. At this time, which of the following should be considered in the differential diagnosis? "Does moving around change the nature of your pain?" - ANSWER-Robin is a 57-year-old female presenting with diffuse abdominal pain. Which of the following statements from the provider to Robin is correct? Obtain a complete history - ANSWER-A 25-year-old accountant is seen in the clinic complaining of crampy abdominal pain after meals. Often constipated and takes laxatives, followed by a couple days of diarrhea. She temporarily feels better after a bowel movement. She states she is embarrassed by flatulence and has abdom. distension. She has had no weight loss or blood in her stool. This problem has gone on 6 months. What should next step be? Her age - ANSWER-A 28-year-old patient is seen in the clinic with colicky abdominal pain, particularly after meals. She has frequent constipation, flatulence, and abdominal distension. Which of the data make a diagnosis of diverticulitis unlikely? Staphylococcus - ANSWER-Gail, a 35-year-old female patient, is seen in the clinic in the morning. She complains of abrupt onset of nausea, vomiting, colicky abdominal cramps, and profuse watery diarrhea that began last night. Vitals are BP: 110/70, HR: 110, temperature: 99°F, RR: 12. She recently came back from vacation in Switzerland, ate leftovers for dinner, and had a cold 2 weeks ago. Which is the most probable cause of her condition?
Pepto-Bismol® - ANSWER-A patient comes to the office complaining of constipation. The patient lists all of the following medications. Which drug could be responsible for the constipation? Mildly exercise after breakfast - ANSWER-Which of the following is an appropriate strategy to manage constipation?
. Thyroid-stimulating hormone - ANSWER-A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which test should be ordered next? Hard stools - ANSWER-Which of the following is not a cause of secondary constipation? . Pregnancy - ANSWER-What is the most common cause of secondary amenorrhea? "You mentioned on your intake form that you do not feel safe in your home. Why is that?" - ANSWER- The clinician is seeing Jalissa, a 17-year-old patient, for a well woman's exam. She mentions that she has been depressed and has been yo-yo dieting because she feels "so fat." She marked "no" to whether she feels safe in her home on her intake form, and mentions she is worried about getting STIs from her boyfriend of three months. Which of the following is the correct way to interact with the patient, based on her history? Evening primrose oil 250 mg orally up to 3 times daily 2 to 3 days before menses - ANSWER-Which of the following is an alternative treatment for breast tenderness with premenstrual syndrome? Polyp - ANSWER-A 45-year-old woman is seen in the clinic with abnormal uterine bleeding and pain during intercourse. The clinician should consider which of the following diagnoses? Passing six or more stools daily without improvement for at least 3 days - ANSWER-What must be present for a diagnosis of acute diarrhea? . Gastroenteritis - ANSWER-A patient is seen with complaints of diarrhea. Which of the following should be included in the patient's differential diagnosis?
