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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 - ansnature 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 - ansPepto-Bismol
A patient is seen with complaints of diarrhea. Which of the following should be included in the patient's differential diagnosis? - ansfrequency, 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 - ansHis use of Alka Seltzer
Which of the following is most effective in diagnosing appendicitis - ansHistory 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? - ansUrine 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? - ansObtain 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? - ansHer 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? - ans
Which of the following dietary instructions should be given to a patient with GERD? - ansEliminate coffee
The patient with GERD should be instructed to eliminate which of these activities? - ansWeight lifting
. A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? - ansVery 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?
- ansElevated alkaline phosphatase
Which of the following is part of the treatment plan for the patient with irritable bowel syndrome? - ansHigh fiber diet
The nurse is assessing a client diagnosed with gastroesophageal reflux disease. Which of the following should be included in this assessment? - ansPresence of pyrosis
A client, diagnosed with a hiatal hernia, will experience which of the following symptoms most frequently? - ansHeartburn
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 - ansAvoid lying down after meals
.A client is experiencing water brash. The nurse realizes this symptom is associated with - ansBarretts esophagus
.A client has been prescribed Zantac for gastroesophageal reflux disease. The nurse realizes this medication is classified as a - anshistamine H2-receptor antagonist
A client is diagnosed with peptic ulcer disease caused by NSAID use. Which of the following would be indicated for this client? - ansTreatment similar to a client with peptic ulcer disease
A child care worker complains of flu-like symptoms. On further assessment, hepatitis is suspected. The nurse realizes that this individual is at risk for which type of hepatitis - ansHep A
When the liver is seriously damaged, ammonia levels can rise in the body. One of the treatments for this is - ansgiving lactulose
A client is scheduled for a liver biopsy. The nurse realizes that the most important sign to assess for is:
The nurse realizes that the organ which is a major site for metastases, harboring and growing cancerous cells that originated in some other part of the body, is the - ansliver
Because health care workers are at a greater risk of hepatitis B infection, it is recommended that all health care workers - ansbecome vaccinated
A female client is surprised to learn that she has been diagnosed with hemochromatosis. Which of the following should the nurse respond to this client? - ansFemales often do not experience the effects of the disease until menopause
The nurse, caring for a client recovering from the placement of a shunt to treat portal hypertension, should assess the client for which of the following complications associated with this surgery? - ansPulmonary edema
A client is diagnosed with macrovesicular fatty liver. Which of the following should the nurse instruct this client?. - ansAvoid all alcohol
A client is being evaluated for a lower urinary tract infection. Which of the following symptoms would the nurse expect to find? - ansCloudy urine
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? - ansRefer 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 - ans
Which of the following would be an appropriate treatment for a patient with mild BPH? - ansReevaluate symptoms in 1 to 3 months.
. A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis? - ansTestosterone level . A 35-year-old man presents with complaints of painful erections, and he notices his penis is crooked when erect. What is the most likely diagnosis? - ansPeyronie's disease
The patient with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6 months. The clinician should assess this patient for which of these side effects? - ansErectile dysfunction
The clinician should prescribe an antibiotic that covers which of these organisms for a patient with acute prostatitis? - ansGram-negative bacillus
. The 56-year-old man with chronic prostatitis should be treated with trimethoprim 80 mgsulfamethoxazole 400 mg (TMP-SMX, Bactrim) for how long? - ans6 to 12 weeks
A 46-year-old man presents with urinary hesitancy and low back pain. He has no history of UTI. Digital rectal examination (DRE) reveals a normal prostate, and a diagnosis of prostatodynia is made. Which is the appropriate treatment? - ansTerazosin 2 mg PO once a day
A 23-year-old sexually active man is seen in the clinic with unilateral painful testicular swelling, and he is diagnosed with epididymitis. In order to prescribe the correct drug, the clinician must understand that which of these is the most common causative organism? - ansChlamydia trachomatis
Which test is used to confirm a diagnosis of epididymitis? - ansUltrasound of the scrotum
Treatment for epididymitis includes which of the following? - ansScrotal elevation
Which of the following data is indicative of testicular torsion? - ansAbsent cremasteric reflex
A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find? - ansThe scrotum will appear light pink or yellow.
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? - ansAn 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? - ansThe 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? - ansshrunken testicles, hot flashes, gynecomastia, erectile dysfunction, osteoporosis, loss of muscle mass
. What is the treatment of choice for a patient diagnosed with testicular cancer - ansRadical 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? - ans
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 - ansEvery 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 - ansSyphilis
A patient is diagnosed with a parasitic infection caused by close contact with another persons genitals. For which infection should the nurse plan care? - ansPhthirus pubis
It is documented in the medical record that a patient has gummas. For which sexually transmitted infection should the nurse plan care - ansSyphilis
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? - anscondoms 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? - ansBlisters
Human papillomavirus (HPV) produces verrucous growths. What term should the nurse use to describe these lesions to the patient? - ansWarts
The nurse is collecting data on a patient with Chlamydia. Which assessment finding should be reported immediately to the RN or physician? - anssharp 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? - ansWet 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? - ansPapanicolaou 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 - ansInterferon 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? - ansHBV-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? - ansPracticing standard precautions
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 - ansPelvic 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? - ansReporting regulations are the same throughout the country
