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NUR 654 Midterm Study Guide
1. A patient has rapid weight gain, amenorrhea without pregnancy, and mild hypertension.
Once confirmatory tests are performed, what is a possible treat- ment for this patient?: Pituitary tumor resection
2. A patient has unexplained weight loss and the provider notes increased skin pigmentation
on light-exposed skin folds along with darkened palmar creases. Which laboratory tests will the provider order vs NOT order: ORDER: Serum ACTH, Serum electrolytes, TB skin testing NOT: Serum cortisol
3. T or F
Patient wishes related to palliative care should be discussed at the initial visit and updated at preventive visits: T
4. T or F
A patient on chemo has a high temperature and absolute neutropenic count >500,000 needs immediate ER workup: T
5. Radiation therapy can be used for all of the following in cancer treatment EXCEPT:
Treatment of side effects of chemo
6. T or F
SIADH is an oncological emergency requiring urgent oncologic care: T
7. What is an effective pharmacologic medication to treat non-cancer chronic pain?:
Ibuprofen
8. T or F
The most common sites for breast CA metastasis include lymph, lungs, liver, bone, and brain: T
9. What is an FDA approved treatment for osteoporosis?: Biphosphonate therapy
10. T or F
Bone density improvement is the primary goal of biphosphonate treatment?: F (it is to slow the progression of disease)
11. An elevated serum alkaline phosphate (SAP) may include all of the following EXCEPT:
Hypothyroidism
12. T or F
Xray findings associated with Paget's disease can show enlargement of bone and specific deformities (long bone bowing): T
13. Symptoms of Cushing's Syndrome include: Amenorrhea
14. T or F
Pituitary tumor resection may be first line treatment for Cushing's Syndrome if inidicated: T
15. Addison's Disease may cause which of the following lab abnormalities?: Ele- vated ACTH
(not hypokalemia, hypernatremia, or elevated cortisol)
16. T or F
A patient with suspected hirsutism should be referred to endocrinology for an evaluation: T
17. A positive Trousseau's sign occurs with which serum abnormality?: HYPOcalcemia
18. Which of the following can cause hypocalcemia?: Vit D deficiency, hypomagnesemia
27. T or F
Herbal OTC remedies for menopausal women with vasomotor symptoms have not been proven effective and may be harmful: T
28. Neuropathic pain may be characterized by: poorly localized, shooting or stabbing pain
29. T or F
Naproxen is recommended for moderate pain or dysmenorrhea and should be dosed: 500mg initially then 250mg q12 hours: T
30. The medical diagnosis associated with a transgender patient is: Gender dysphoria
31. T or F
Diminished testosterone may be a possible cause of decreased arousal, libido, and orgasm in postmenopausal women: T
32. Causes of primary amenorrhea in a 17 year old may include all EXCEPT: en-
dometriosis
33. Lab work for a primary amenorrhea includes: Thyroid panel, pregnancy test, prolactin
34. T or F
A Bartholin Gland cyst is always infectious: F
35. Differential diagnosis to consider in a case of mastitis that is worsening despite
a course of cephalosporin antibiotics: inflammatory breast carcinoma
36. Diagnostic work-up for unilateral breast pain in a postmenopausal woman should
include: bilateral mammogram
37. T or F
Female patient found to have BRCA1 and BRCA2 mutation may be offered prophylactic mastectomy and oophorectomy: T
38. Chronic pelvic pain in women may be related to all EXCEPT: Hepatitis (faulty posture,
interstitial cystitis, physical abuse are causes)
39. Severe primary dysmenorrhea in a young adult may be treated with: Combina- tion oral
contraceptives
40. Most common cause of dyspareunia in the premenopausal patient: endometrio- sis
41. Follow-up for abnormal pap involving a low grade intraepithelial lesion will include:
Colposcopy with biopsy
42. T or F
Outpatient management of PID with fever will include administration of Ro- cephin IM, Doxycycline and metronidazole for 14 days: T
43. Risk factors for PID include all EXCEPT: Tubal sterilization (it includes age under 25, smoking, and vaginal
douching)
44. T or F
BV presents with white non-inflammatory discharge, clue cells, and a positive KOH whiff test: T
45. Treatment for asymptomatic gonorrhea exposure includes: Empiric ceftriaxone and
azithromycin
46. T or F
Men under 50 years with erectile dysfunction are at higher risk for CV disease: T
47. Benefit of a liquid based medium in performing the pap includes: Allowing for testing
56. T or F
Physical manifestation of GAD often includes HA or IBS: T
57. Bell's Palsy presentation may include all of the following EXCEPT: Unilateral
weakness in arms and legs
58. Most important role of the PCP in cancer management: Counseling about healthy
practices to reduce risk
59. T or F
Hand preference before one year of age is suspect of cerebral palsy and may indicate decreased function in the other hand: T
60. The purpose of conducting an interview prior to beginning neuropsycholog- ical
evaluation in an older adult that may have dementia: to assess ability to cooperate with testing
61. Which medication is NOT useful in treating a tension HA?: Lithium
62. What is recommended to prevent ophthalmic complication in patients with Bell's
Palsy: Lubricating eye drops
63. A patient reports 2 episodes of visual disturbances and eye pain 1-2 days every
2 months - which diagnostic will you order initially?: MRI (think MS)
64. Toddler of recently divorced mother with difficulty sleeping with angry out- bursts and
tantrums - NP learns that child refuses to play with playmates and sits quietly alone - what will NP initially do?: Ask about child's relationship with father
65. Well child check on a 4 month old infant evaluates mental health issues - what
states indicates potential problem with relationship of infant-mother?: I let my baby cry a while to learn to be patient
66. 14 year old female with amenorrhea for 3 months - pregnancy test negative, body
weight is at 82% for height and age - often throws up and refuses to eat
- what condition do you suspect?: Anorexia nervosa
67. Toddler with hitting and biting at daycare and tantrums at home shortly after sibling born
- what will NP do?: Engage patient in positive parenting strategies to facilitate appropriate child coping
68. Which drug to treat focal epilepsy and complex partial seizures: Carbamazepine
69. A patient reports restlessness, fatigue, difficulty concentrating - what other things to
ask about?: HA and bowel habits
70. Patient reports recurrent HA 1-2 times per month - weather changes, or
changes in sleep patterns: Triptans - migraines
71. School aged with frustration doing tasks: GAD
72. Conducting interview before doing neuropsych test: Determine if they are able to
concentrate and answer question
73. Patient the Alzheimers taking Donezepil to treat - increased social withdraw- al -
initial step to manage?: Encourage activity and exercise
74. NP performing emotional health check of an 18 month old through: Observation of the
child with the caretakers in structured vs unstructured situations
75. A patient with Parkinson's Disease has been taking Sinemet with increased
dyskinesia - what medication to take: Amantadine
76. A patient with dementia has agitation and visual hallucinations and is given
88. An obese adolescent female patients reports irregular periods and excessive acne.
The provider notes an increased amount of hair on her upper back, shoulder, and upper abdomen. What will the provider do based upon these findings?: Refer to an endocrinologist for evaluation
89. A patient being treated for cancer has had chemotherapy within the past two weeks
and comes to the primary care clinic with a fever of 38 degrees C. What is the initial action?: obtain a STAT CBC with ditterential
90. A patient with cancer is expected to require long term pain medication to
manage cancer pain. which agent will be best for this patient?: Morphine
91. A patient with breast cancer has been symptom-free for 6 months and reports a
new onset of lower back pain rated as an 8 on a 1 to 10 pain rating scale to the primary provider. What is most important when evaluating this patient's pain?: Obtaining an MRI of the spinal cord
92. What is the purpose of radiation treatment prior to surgical resection of a tumor?:
to debulk the tumor mass
93. A patient has new-onset hypertension with a systolic blood pressure of 180 mm
Hg. Which test will the provider order to diagnose this patient?: Fractionated metanephrine levels
94. A woman who has stopped having menstrual periods has vasomotor symp- toms but
does not want to use hormone replacement therapy. What measures will the provider recommend?: keeping the house cool, use of personal fans
95. A 45 year old woman has gone 120 days without a menstrual period. A preg- nancy
test is negative. What will the provider do based on this symptom?: Evaluate the various causes of amenorrhea
96. Which of the following is NOT considered an oncologic emergency in a patient
with cancer requiring urgent referral for an oncologist?: bone marrow sup- pression (SIADH, tumor lysis syndrome, and superior vena cava syndrome are emergencies)
97. Which laboratory values representing parathyroid hormone (PTH) and serum
calcium are consistent with a diagnosis of primary hyperparathy- roidism?: Inappropriate secretion of PTH along with hypercalcemia
98. An adolescent female reports moderate dysmenorrhea with periods and tells the
primary care NP that 400mg of ibuprofen every 6-8 hours is not controlling her pain. What will the NP recommend?: taking naproxen 500mg initially, then 250mg every 6-8 hours
99. A woman who is taking oral contraceptive pills (OCPs) to prevent pregnancy calls
the provider to report forgetting to take the pills for 4 days. She has not had sexual intercourse during that time. What will the provider recommend?- : Resume the pills and use a backup method the remainder of the cycle
100. A patient with normal renal function has a potassium level of 6.0 mEq/L. Which
underlying cause is possible in this patient?: adrenocortical deficiency
101. A 40-year-old patient with primary hyperparathyroidism has increased serum
calcium 0.5 mg/dL above normal without signs of nephrolithiasis. What is the recommended treatment for this patient?: Annual monitoring of calcium, creatinine, and bone density
102. a patient has low serum calcium associated with low serum albumin. what is the
recommended treatment for this patient: vitamin D and calcium supplementation
103. a patient has bone pain and laboratory testing reveals an elevated serum
alkaline phosphate. which test can help distinguish paget's from malignant bone disease: bone radiography
