NURS-611 ADVANCED PATHOPHYSIOLOGY FINAL EXAM 2024: Multiple Choice Questions and Answers, Exams of Nursing

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1. It is important to not dilate the eye if is suspected. Cataract Macular degeneration Acute closed-angle glaucoma Chronic open-angle glaucoma CORRECT ANSWER; Acute closed-angle glaucoma Question 2. 2. An 18-year-old female patient presents with repeated urinary tract infections. She has no risk factors in her history, and her physical examination is unremarkable. She also has a normal pelvic exam. Which of the following should be obtained if anatomic abnormalities are suspected? Ultrasound of the kidneys Intravenous pyelogram Cystoscopy Transvaginal ultrasound of the bladder CORRECT ANSWER; Intravenous pyelogram Question 3. 3. The pathophysiological hallmark of ACD is: Depleted iron stores Impaired ability to use iron stores Chronic uncorrectable bleeding Reduced intestinal absorption of iron CORRECT ANSWER; Impaired ability to use iron stores Question 4. 4. Which of the following is the most important question to ask during cardiovascular health history? Number of offspring Last physical exam Sudden death of a family member Use of caffeine

CORRECT ANSWER; Sudden death of a family member Question 5. 5. A 26-year-old, non-smoker, male presented to your clinic with SOB with exertion. This could be due to: Exercise-induced cough Bronchiectasis Alpha- 1 deficiency Pericarditis CORRECT ANSWER; Alpha- 1 deficiency Question 6. 6. Which of the following dermatological conditionsresults from reactivation of the dormant varicella virus? Tineaversicolor Seborrheic keratosis Verruca Herpes zoster CORRECT ANSWER; Herpes zoster Question 7. 7. Mr. Jones is a 68-year-old retired Air Force pilot that has been diagnosed with prostate cancer in the past week. He has never had a surgical procedure in his life and seeks clarification on the availability of treatments for prostate cancer. He asks the nurse practitioner to tell him the side effects of a radical prostatectomy. Which of the following is not a potential side effect of this procedure? Urinary incontinence Impotence Dribbling urine Selected low back pain CORRECT ANSWER; Selected low back pain Question 8. 8. Presbycusis is the hearing impairment that is associated with: Physiologic aging Ménière's disease

Hispanics African Americans American Indians CORRECT ANSWER; african americans Question 13. 13. A key symptom of ischemic heart disease is chest pain. However, angina equivalents may include exertional dyspnea. Angina equivalents are important because: Women with ischemic heart disease many times do not present with chest pain Some patients may have no symptoms or atypical symptoms; diagnosis may only be made at the time of an actual myocardial infarction Elderly patients have the most severe symptoms A & B only a & b only Question 14. 14. The nurse practitioner is discussing lifestyle changes with a patient diagnosed with gastroesophageal reflux. What are the nonpharmacological management interventions that should be included? Weight reduction and rest 30 minutes after each meal in the supine position Elevation of head of the bed 4 - 6 inches on blocks and weight reduction Encouraged to wear restrictive clothing to add support for diaphragmatic breathing Using oral mints to relieve gastric distress Elevation of head of the bed 4 - 6 inches on blocks and weight reduction Question 15. 15. Which lesions are typically located along the distribution of dermatome? Scabies Herpes zoster Tinea Dyshidrosis Herpes zoster Question 16. 16. Which of the following medications are commonly associated with the side effect of cough? Beta blocker Diuretic ACE inhibitor Calcium antagonist

tension headaches benign intracranial hypertension tension headaches Question 22. 22. A 59-year-old patient with history of alcohol abuse comes to your office because of 'throwing up blood". On physical examination, you note ascites and caput medusa. A likely cause for the hematemesis is: Peptic ulcer disease Barrett's esophagus Esophageal varices Pancreatitis Esophageal varices Question 23. 23. Which of the following is considered a "red flag" when diagnosing a patient with pneumonia? Fever of 102 Infiltrates on chest X-ray Pleural effusion on chest X-ray Elevated white blood cell count Pleural effusion on chest X-ray Question 24. 24. Your patient complains of lower abdominal pain, anorexia, extreme fatigue, unintentional weight loss of 10 pounds in last 3 weeks, and you find a positive hemoccult on digital rectal examination. Laboratory tests show iron deficiency anemia. The clinician needs to consider: Diverticulitis Colon cancer Appendicitis Peptic ulcer disease Colon cancer Question 25. 25. You have a patient complaining of vertigo and want to know what could be the cause. Knowing there are many causes for vertigo, you question the length of time the sensation lasts. She tells you several hours to days and is accompanied by tinnitus and hearing loss. You suspect which of the following conditions? Ménière's disease Benign paroxysmal positional vertigo Transient ischemic attack (TIA) Migraine Ménière's disease

Question 26. 26. In examining the mouth of an older adult with a history of smoking, the nurse practitioner finds a suspicious oral lesion. The patient has been referred for a biopsy to be sent for pathology. Which is the most common oral precancerous lesion? Fictional keratosis Keratoacanthoma Lichen planus Leukoplakia Leukoplakia Question 27. 27. A cough is described as chronic if it has been present for: 2 weeks or more 8 weeks or more 3 months or more 6 months or more 8 weeks or more Question 28. 28. The first assessment to complete related to the eyes is: Eye lids Visual acuity Extraocular movements Peripheral vision Visual acuity Question 29. 29. The Mini-Cog is a short screening tool used to assess cognition. Which of the following statements pertaining to the test is a true statement? The patient will be asked to repeat five words immediately following the directions by the practitioner. The patient is asked to draw the hour and minute hands on a picture of an analog clock. A score of 0 - 2 is a positive screen for dementia. The patient is asked to recall five images from picture cards following the drawing of the clock hands. A score of 0 - 2 is a positive screen for dementia. Question 30. 30. A woman with an X-linked dominant disorder will: Not be affected by the disorder herself Transmit the disorder to 50% of her offspring (male or female) Not transmit the disorder to her daughters Transmit the disorder to only her daughters Transmit the disorder to 50% of her offspring (male or female)

Question 36. 36. Which symptom is more characteristic of Non-Cardiac chest pain? Pain often radiates to the neck, jaw, epigastrium, shoulder, or arm Pain tends to occur with movement, stretching or palpation Pain usually lasts less than 10 minutes and is relieved by nitroglycerine Pain is aggravated by exertion or stress Pain tends to occur with movement, stretching or palpation Question 37. 37. Aortic regurgitation requires medical treatment for early signs of CHF with: Beta blockers ACE inhibitors Surgery Hospitalization ACE inhibitors Question 38. 38. What test is used to confirm the diagnosis of appendicitis? CBC Flat plate of abdomen Rectal exam CT of abdomen with attention to appendix Flat plate of abdomen Question 39. 39. The major impact of the physiological changes that occur with aging is: Reduced physiological reserve Reduced homeostatic mechanisms Impaired immunological response All of the above All of the above Question 40. 40. A smooth round nodule with a pearly gray border and central induration best describes which skin lesion? Seborrheic keratosis Malignant melanoma Herpes zoster Basal cell carcinoma Basal cell carcinoma Question 41. 41. A 20-year-old engineering student complains of episodes of abdominal discomfort, bloating, and episodes of diarrhea. The symptoms usually occur after eating, and pain is frequently relieved with bowel movement. She is on a "celiac diet" and the episodic symptoms persist. Physical examination and diagnostic tests are negative. Colonoscopy is negative for any abnormalities. This is a history and physical consistent with:

Inflammatory bowel disease Irritable bowel syndrome Giardiasis Norovirus gastroenteritis Irritable bowel syndrome Question 42. 42. Which of the following disorders can cause urinary incontinence? Cystocele Overactive bladder Uterine prolapse All of the above All of the above Question 43. 43. Which of the following drugs would be useful for the nurse practitioner to prescribe for an older adult to prevent gastric ulcers when a nonsteroidal anti-inflammatory drug is used for chronic pain management? Misoprostol (Cytotec) Cimetidine (Tagamet) Metronidazole (Flagyl) Bismuth subsalicylate (Peptobismol) Misoprostol (Cytotec) Question 44. 44. Which of the following details are NOT considered while staging asthma? Nighttime awakenings Long-acting beta agonist usage Frequency of symptoms Spirometry findings Long-acting beta agonist usage Question 45. 45. A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The patient reports a smoking history of 2 packs of cigarettes per day since age 16. This would be recorded in the chart as: 50 x 2-pack years 100 - pack years 50 - year, 2-pack history 100 - pack history 100 - pack years Question 46. 46. A clinical clue for suspected renal artery stenosis would be: Decreased urine output Development of resistant hypertension in a previously well-controlled patient

cellulitis Question 52. 52. A 62-year-old client presents with a complaint of fever, pain, and burning on urination. Difficulty urinating with dribbling has been increasing in the past few days. He has a feeling of pressure in his groin. On examination, his prostate is tender, boggy, and warm. A stat urinalysis reveals the presence of leukocytes and bacteria. He is allergic to sulfa drugs. His weight is 70 kg and his last serum creatinine was 1.0. While awaiting the culture and sensitivity, the nurse practitioner begins empiric treatment with which of the following? Trimethoprim/sulfamethoxazole DS bid x 2 weeks Ampicillin 250 mg PO Q day for 10 days Nitrofurantoin 100 mg Q 12 hours for 7 days Ciprofloxacin 500 mg Q 12 hours for 14 days Ciprofloxacin 500 mg Q 12 hours for 14 days Question 53. 53. In teaching an older adult female client with end-stage renal disease her medication regimen, the nurse practitioner must include which of the following pieces of information in the treatment plan? Report any changes in the color of her stool Take iron supplement and elemental calcium with each meal Take iron supplement before meals and the calcium after meals Take calcium with a high phosphorus meal Take iron supplement before meals and the calcium after meals Question 54. 54. A 46-year-old female complains of fatigue, general malaise, and pain and swelling in her hands that has gradually worsened over the last few weeks. She reports that pain, stiffness, and swelling of her hands are most severe in the morning. On physical examination, you note swelling of the metacarpophalangeal joints bilaterally. These are common signs of: Osteoarthritis Rheumatoid arthritis Scleroderma Sarcoidosis Rheumatoid arthritis Question 55. 55. Whenever a patient presents with acute non-traumatic shoulder pain, the clinician should make sure to exclude a: Cardiac origin of symptoms Gastrointestinal condition Cervical spine disorder All of the above All of the above

Question 56. 56. A female patient presents to the clinic with complaints of a severe, throbbing, unilateral headache. She complains of seeing flashes of light prior to the headache. She complains of sound and light sensitivity as well as nausea. The clinician should recognize these as symptoms of: Epilepsy with aura Cluster headache Migraine headache Normal pressure hydrocephalus Migraine headache Question 57. 57. The main focus of treatment of patients with ACD is: Replenishing iron stores Providing for adequate nutrition high in iron Management of the underlying disorder Administration of monthly vitamin B12 injections Management of the underlying disorder Question 58. 58. The most common neurological cause of seizures in an older adult is: Alzheimer's disease Multiple sclerosis Stroke Peripheral neuropathy Stroke Question 59. 59. Your 63-year-old Caucasian woman with polymyalgia rheumatica (PMR) will begin treatment with corticosteroids until the condition has resolved. You look over her records and it has been 2 years since her last physical examination and any laboratory or diagnostic tests as she relocated and had not yet identified a health-care provider. In prioritizing your management plan, your first orders should include: Recommending she increase her dietary intake of Calcium and Vitamin D Ordering once a year bisphosphonate and a proton pump inhibitor Participate in a fall prevention program Dual-energy X-ray (DEXA) scan and updating immunizations Dual-energy X-ray (DEXA) scan and updating immunizations Question 60. 60. Your patient is a 78-year-old female with a smoking history of 120-pack years. She complains of hoarseness that has developed over the last few months. It is important to exclude the possibility of: Thrush Laryngeal cancer

blocker, statin drug, and an ACE inhibitor. On physical examination, you note palpable tenderness over the right side of the forehead. There are no neurological deficits. Vision is 20/20 with lenses. No weakness of extremities. CN II to XII are intact. The history corresponds to which of the following disorders? Drug toxicity Giant cell arteritis Cluster headache Migraine headache Giant cell arteritis Question 66. 66. Which of the following conditions is the most common cause of nausea, vomiting, and diarrhea? Viral gastroenteritis Staphylococcal food poisoning Acute hepatitis A E coli gastroenteritis Viral gastroenteritis Question 67. 67. The nurse practitioner orders bilateral wrist X-rays on a 69-year-old gentleman complaining of pain in both wrists for the past 6 weeks not related to any known trauma. The nurse practitioner suspects elderly onset rheumatoid arthritis. The initial radiographic finding in a patient with elderly onset rheumatoid arthritis would be: Symmetric joint space narrowing Soft tissue swelling Subluxations of the joints Joint erosions soft tissue swelling Question 68. 68. A common auscultatory finding in advanced CHF is: Systolic ejection murmur S3 gallop rhythm Friction rub Bradycardia s3 gallop rub Question 69. 69. The three cardinal features of Parkinson's disease are: Essential tremor, postural rigidity, and infarcts of the basal ganglion Bradykinesia, rigidity, and tremor Shuffling gait, constipation, positional freezing. Dementia, incontinence, and infarcts of the basal ganglion

Bradykinesia, rigidity, and tremor Question 70. 70. In AR disorders, carriers have: Two mutated genes; one from each parent that cause disease A mutation on a sex chromosome that causes a disease A single gene mutation that causes the disease One copy of a gene mutation but not the disease One copy of a gene mutation but not the disease Question 71. 71. A 75-year-old patient complains of pain and paresthesias in the right foot that worsens with exercise and is relieved by rest. On physical examination you note pallor of the right foot, capillary refill of 4 seconds in the right foot, +1 dorsalis pedis pulse in the right foot, and +2 pulse in left foot. Which of the following is a likely cause of the signs and symptoms? Arterial insufficiency Femoral vein thrombus Venous insufficiency Peripheral neuropathy Arterial insufficiency Question 72. 72. Which of the following statements is true concerning anti-arrhythmic drugs? Amiodarone is the only one not associated with increased mortality and it has a very favorable side effect profile. Both long-acting and short-acting calcium channel blockers are associated with an increased risk of cardiovascular morbidity and mortality. Most anti-arrhythmics have a low toxic/therapeutic ratio and some are exceedingly toxic. Anti-arrhythmic therapy should be initiated in the hospital for all patients. Most anti-arrhythmics have a low toxic/therapeutic ratio and some are exceedingly toxic. Question 73. 73. A 23-year-old patient who has had bronchiectasis since childhood is likely to have which of the following: Barrel-shaped chest Clubbing Pectusexcavatum Prolonged capillary refill clubbing Question 74. 74. Which of the following is a common trigger of migraine headache? Missed meals Menses Alcohol All of the above

Question 79. 79. A 43-year-old male patient complains of right-sided abdominal and pain in the back in the right costovertebral angle region, fever, chills, dysuria, and nausea. On physical examination, there is 102 degree fever, tachycardia, and right costovertebral angle tenderness to percussion. The most likely condition is: Lower urinary tract infection Nephrolithiasis Hydronephrosis Pyelonephritis Pyelonephritis Question 80. 80. A careful history of a female client with a chief complaint of intermittent diarrhea reveals that she also experiences bouts of constipation. She has no known allergies and experienced no unintentional weight loss. What is the most likely condition? Inflammatory bowel disease Irritable bowel syndrome Giardiasis Lactose intolerance Irritable bowel syndrome Question 81. 81. A 33-year-old female reports general malaise, fatigue, stiffness, and pain in multiple joints of the body. There is no history of systemic disease and no history of trauma. On physical examination, the patient has no swelling or decreased range of motion in any of the joints. She indicates specific points on the neck and shoulders that are particularly affected. She complains of tenderness upon palpation of the neck, both shoulders, hips, and medial regions of the knees. The clinician should include the following disorder in the list of potential diagnoses: Osteoarthritis Rheumatoid arthritis Fibromyalgia Polymyalgia rheumatica Fibromyalgia Question 82. 82. A 60-year-old female patient complains of pain in both hands that is worse in the morning. On physical examination, the thumb metacarpophalangeal joint is swollen on both hands. There is swelling of the proximal and distal interphalangeal joints bilaterally. These are typical signs of: Osteoarthritis Rheumatoid arthritis Normal aging Gouty arthritis

Osteoarthritis Question 83. 83. A 68-year-old male reports painless rectal bleeding occasionally noted with thin pencil-like stools, but no pain with defection. He has a history of colon polyp removal 10 years ago but was lost to follow-up. The nurse practitioner's appropriate intervention is: Digital rectal exam and send home with 3 hemoccult to return Immediate referral to gastroenterologist and colonoscopy Order a screening sigmoidoscopy Order a colonoscopy and barium enema and refer based on results Immediate referral to gastroenterologist and colonoscopy Question 84. 84. During physical examination of a patient, you note resonance on percussion in the upper lung fields. This is consistent with: COPD Pneumothorax A normal finding Pleural effusion A normal finding Question 85. 85. Your 70-year-old patient has gastroesophageal reflux disease (GERD). After a trial of lifestyle modifications and antacids, the patient continues to have occasional mild heartburn after occasional meals and at night. The most appropriate next action is: Prokinetic agents H2 antagonists Proton pump inhibitors Sucralfate H2 antagonists Question 86. 86. In order to provide a comprehensive genetic history of a patient, the NP should: Ask patients to complete a family history worksheet Seek out pathology reports related to the patient's disorder Interview family members regarding genetic disorders All of the above All of the above Question 87. 87. An 86-year-old patient who wears a hearing aid complains of poor hearing in the affected ear. In addition to possible hearing aid malfunction, this condition is often due to: Acoustic neuroma Cerumen impaction