NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+, Exams of Nursing

Download NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ and more Exams Nursing in PDF only on Docsity! 1 d) Peptic ulcer disease 2 d) Midepigastric pain that is not reproducible with palpation 3 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Which of the following is the most common cause of heartburn-type epigastric pain? Question 1 options: a) Decreased lower esophageal sphincter tone b) Helicobacter pylori infection of stomach c) Esophageal spasm Save Question 2 (1 point) An older patient reports burning pain after ingestion of many foods and large meals. What assessment would assist the nurse practitioner in making a diagnosis of GERD? Question 2 options: a) Identification of a fluid wave b) Positive Murphy’s sign c) Palpable spleen Save Question 3 (1 point) b) Colon cancer 4 c) Pelvic examination 5 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ 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: Question 3 options: a) Diverticulitis c) Appendicitis d) Peptic ulcer disease Save Question 4 (1 point) A 22-year-old female comes to your office with complaints of right lower quadrant abdominal pain, which has been worsening over the last 24 hours. On examination of the abdomen, there is a palpable mass and rebound tenderness over the right lower quadrant. The clinician should recognize the importance of: Question 4 options: a) Digital rectal examination b) Endoscopy d) Urinalysis Save Question 5 (1 point) c) Gastric ulcer 10 b) Do not use for possible infectious diarrhea 11 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Question 9 options: a) Mallory-Weiss tear b) Esophageal varices d) Colon cancer Save Question 10 (1 point) When counseling clients regarding the use of antidiarrheal drugs such as Imodium anti-diarrheal and Kaopectate, the nurse practitioner advises patients to: Question 10 options: a) Use all the medication c) Use should exceed one week for effectiveness d) These drugs provide exactly the same pharmaceutical effects Save Question 11 (1 point) When teaching a group of older adults regarding prevention of gastroesophageal reflux disease symptoms, the nurse practitioner will include which of the following instructions? Question 11 options: d) Avoid food intolerances, raise head of bed on blocks, and take a proton pump inhibitor before a meal. 12 c) Left lower quadrant 13 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ a) Raise the head of the bed with pillows at night and chew peppermints when symptoms of heartburn begins. b) Raise the head of the bed on blocks and take the proton pump inhibitor medication at bedtime. c) Sit up for an hour after taking any medication and restrict fluid intake. Save Question 12 (1 point) In a patient presenting with suspected recurrence of diverticulitis, abdominal pain usually presents where in the abdomen? Question 12 options: a) Left upper quadrant b) Right upper quadrant d) Right lower quadrant Save Question 13 (1 point) Helicobacter pylori is implicated as a causative agent in the development of duodenal or gastric ulcers. What teaching should the nurse practitioner plan for a patient who has a positive Helicobacter pylori test? Question 13 options: c) Treatment regimen is multiple medications taken daily for a few weeks. 14 c) Gastroesophageal reflux 15 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ a) It is highly contagious and a mask should be worn at home. b) Treatment regimen is multiple lifetime medications. d) Treatment regimen is complicated and is not indicated unless the patient is symptomatic. Save Question 14 (1 point) An obese middle-aged client presents with a month of nonproductive irritating cough without fever. He also reports occasional morning hoarseness. What should the differential include? Question 14 options: a) Atypical pneumonia b) Peptic ulcer disease d) Mononucleosis (Epstein-Barr) Save Question 15 (1 point) Which of the following findings would indicate a need for another endoscopy in clients with peptic ulcer disease? Question 15 options: a) Cases of dyspepsia with constipation Serum amylase level of 145 U/L 20 a) Increased gastric emptying time 21 d) All of the above NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Direct serum bilirubin level of 0.3 mg/dl Save Question 20 (1 point) Which of the following is not a contributing factor to the development of esophagitis in older adults? Question 20 options: b) Regular ingestion of NSAIDs c) Decreased salivation d) Fungal infections such as Candida Save Question 21 (1 point) The major impact of the physiological changes that occur with aging is: Question 21 options: a) Reduced physiological reserve b) Reduced homeostatic mechanisms c) Impaired immunological response Save 22 c) More testosterone than women 23 c) Inhibited or induced by drugs NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Question 22 (1 point) Men have faster and more efficient biotransformation of drugs and this is thought to be due to: Question 22 options: a) Less obesity rates than women b) Prostate enlargement d) Less estrogen than women Save Question 23 (1 point) The cytochrome p system involves enzymes that are generally: Question 23 options: a) Inhibited by drugs b) Induced by drugs d) Associated with decreased liver perfusion Save Question 24 (1 point) 24 b) Observed assessment of function 25 c) Hemoglobin >8 g/dl, MCV decreased, MCH decreased 26 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Functional abilities are best assessed by: Question 24 options: a) Self-report of function c) A comprehensive head-to-toe examination d) Family report of function Save Question 25 (1 point) When interpreting laboratory data, you would expect to see the following in a patient with Anemia of Chronic Disease (ACD): Question 25 options: a) Hemoglobin >8 g/dl, MCV increased, MCH increased b) Hemoglobin >12 g/dl, MCV increased, MCH increased d) Hemoglobin >12 g/dl, MCV decreased, MCH increased Save Question 26 (1 point) Iron Deficiency Anemia (IDA) is classified as a microcytic, hypochromic anemia. This classification refers to which of the following laboratory data? 31 c) Current vital signs 32 b) Clinical decision rule NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ d) Headache Save Question 31 (1 point) Essential parts of a health history include all of the following except: Question 31 options: a) Chief complaint b) History of the present illness d) All of the above are essential history components Save Question 32 (1 point) Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or patients? Question 32 options: a) Clinical practice guideline c) Clinical algorithm d) Clinical recommendation Save 33 a) Family history 34 c) Two mutated genes to acquire the disease NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Question 33 (1 point) The first step in the genomic assessment of a patient is obtaining information regarding: Question 33 options: b) Environmental exposures c) Lifestyle and behaviors d) Current medications Save Question 34 (1 point) In autosomal recessive (AR) disorders, individuals need: Question 34 options: a) Only one mutated gene on the sex chromosomes to acquire the disease b) Only one mutated gene to acquire the disease d) Two mutated genes to become carriers Save Question 35 (1 point) 35 d) One copy of a gene mutation but not the disease 36 b) Transmit the disorder to 50% of her offspring (male or female) 37 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ In AR disorders, carriers have: Question 35 options: a) Two mutated genes; one from each parent that cause disease b) A mutation on a sex chromosome that causes a disease c) A single gene mutation that causes the disease Save Question 36 (1 point) A woman with an X-linked dominant disorder will: Question 36 options: a) Not be affected by the disorder herself c) Not transmit the disorder to her daughters d) Transmit the disorder to only her daughters Save Question 37 (1 point) According to the Genetic Information Nondiscrimination Act (GINA): Question 37 options: 42 b) Allergic rhinitis 43 a) Bulging tympanic membrane NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ d) Ménière’s disease Save Question 42 (1 point) In examination of the nose, the clinician observes gray, pale mucous membranes with clear, serous discharge. This is most likely indicative of: Question 42 options: a) Bacterial sinusitis c) Drug abuse d) Skull fracture Save Question 43 (1 point) Which of the following symptoms is common with acute otitis media? Question 43 options: b) Bright light reflex of tympanic membrane c) Increased tympanic membrane mobility d) All of the above Save 44 a) Physiologic aging 45 d) All of the above NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Question 44 (1 point) Presbycusis is the hearing impairment that is associated with: Question 44 options: b) Ménière’s disease c) Cerumen impaction d) Herpes zoster Save Question 45 (1 point) Epistaxis can be a symptom of: Question 45 options: a) Over-anticoagulation b) Hematologic malignancy c) Cocaine abuse Save Question 46 (1 point) 46 b) Squamous cell carcinoma 47 b) Laryngeal cancer 48 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Your patient has been using chewing tobacco for 10 years. On physical examination, you observe a white ulceration surrounded by erythematous base on the side of his tongue. The clinician should recognize that very often this is: Question 46 options: a) Malignant melanoma c) Aphthous ulceration d) Behcet’s syndrome Save Question 47 (1 point) 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: Question 47 options: a) Thrush c) Carotidynia d) Thyroiditis Save Question 48 (1 point) 53 d) Viral conjunctivitis 54 b) Grossly visible corneal defect NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Save Question 53 (1 point) A patient presents with eye redness, scant discharge, and a gritty sensation. Your examination reveals the palpable preauricular nodes, which are most likely with: Question 53 options: a) Bacterial conjunctivitis b) Allergic conjunctivitis c) Chemical conjunctivitis Save Question 54 (1 point) In assessing the eyes, which of the following is considered a “red flag” finding when associated with eye redness? Question 54 options: a) History of prior red-eye episodes c) Exophthalmos d) Photophobia Save Question 55 (1 point) 55 b) Allergen 56 b) Bronchospasm, vascular permeability, and vasodilatation NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ A 64-year-old male presents with erythema of the sclera, tearing, and bilateral pruritus of the eyes. The symptoms occur intermittently throughout the year and he has associated clear nasal discharge. Which of the following is most likely because of the inflammation? Question 55 options: a) Bacterium c) Virus d) Fungi Save Question 56 (1 point) Patients that have atopic disorders are mediated by the production of Immunoglobulin E (IgE) will have histamine stimulated as an immediate phase response. This release of histamine results in which of the following? Question 56 options: a) Sinus pain, increased vascular permeability, and bronchodilation c) Contraction of smooth muscle, decreased vascular permeability, and vasoconstriction d) Vasodilatation, bronchodilation, and increased vascular permeability Save Question 57 (1 point) 57 a) Ménière’s disease 58 d) Leukoplakia NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ 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? Question 57 options: b) Benign paroxysmal positional vertigo c) Transient ischemic attack (TIA) d) Migraine Save Question 58 (1 point) 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? Question 58 options: a) Fictional keratosis b) Keratoacanthoma c) Lichen planus Save Question 59 (1 point) c) Increased anterior-posterior diameter 64 a) No palpable vibration is felt 65 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Emphysematous changes in the lungs produce the following characteristic in COPD patients? Question 63 options: a) Asymmetric chest expansion b) Increased lateral diameter d) Pectus excavatum Save Question 64 (1 point) When palpating the posterior chest, the clinician notes increased tactile fremitus over the left lower lobe. This can be indicative of pneumonia. Areas of increased fremitus should raise the suspicion of conditions resulting in increased solidity or consolidation in the underlying lung tissue, such as in pneumonia, tumor, or pulmonary fibrosis. In the instance of an extensive bronchial obstruction: Question 64 options: b) Decreased fremitus is felt c) Increased fremitus is felt d) Vibration is referred to the non-obstructed lobe Save Question 65 (1 point) During physical examination of a patient, you note resonance on percussion in the upper lung fields. This is consistent with: c) A normal finding 66 a) Computed tomography (CT) scan 67 a) Pneumothorax NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Question 65 options: a) COPD b) Pneumothorax d) Pleural effusion Save Question 66 (1 point) Which of the following imaging studies should be considered if a pulmonary malignancy is suspected? Question 66 options: b) Chest X-ray with PA, lateral, and lordotic views c) Ultrasound d) Positron emission tomography (PET) scan Save Question 67 (1 point) Upon assessment of respiratory excursion, the clinician notes asymmetric expansion of the chest. One side expands greater than the other. This could be due to: Question 67 options: 68 c) Pulmonary embolism 69 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ b) Pleural effusion c) Pneumonia d) Pulmonary embolism Save Question 68 (1 point) A 72-year-old woman and her husband are on a cross-country driving vacation. After a long day of driving, they stop for dinner. Midway through the meal, the woman becomes very short of breath, with chest pain and a feeling of panic. Which of the following problems is most likely? Question 68 options: a) Pulmonary edema b) Heart failure d) Pneumonia Save Question 69 (1 point) A 26-year-old, non-smoker, male presented to your clinic with SOB with exertion. This could be due to: Question 69 options: a) Exercise-induced cough b) Bronchiectasis 74 a) Streptococcus pneumoniae 75 b) Requires hospitalization for treatment NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ The most common etiologic organism for community-acquired pneumonia is: Question 74 options: b) Beta hemolytic streptococcus c) Mycoplasma d) Methicillin resistant staphylococcus Save Question 75 (1 point) A 75-year-old patient with community-acquired pneumonia presents with chills, productive cough, temperature of 102.1, pulse 100, respiration 18, BP 90/52, WBC 12,000, and blood urea nitrogen (BUN) 22 mg/dl. He has a history of mild dementia and his mental status is unchanged from his last visit. These findings indicate that the patient: Question 75 options: a) Can be treated as an outpatient c) Requires a high dose of parenteral antibiotic d) Can be treated with oral antibiotics Save Question 76 (1 point) 76 c) Pleural effusion on chest X-ray 77 b) Clubbing 78 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Which of the following is considered a “red flag” when diagnosing a patient with pneumonia? Question 76 options: a) Fever of 102 b) Infiltrates on chest X-ray d) Elevated white blood cell count Save Question 77 (1 point) A 23-year-old patient who has had bronchiectasis since childhood is likely to have which of the following: Question 77 options: a) Barrel-shaped chest c) Pectus excavatum d) Prolonged capillary refill Save Question 78 (1 point) c) Tuberculosis 79 a) Lung cancer 80 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Your patient has just returned from a 6-month missionary trip to Southeast Asia. He reports unremitting cough, hemoptysis, and an unintentional weight loss of 10 pounds over the last month. These symptoms should prompt the clinician to suspect: Question 78 options: a) Legionnaires' disease b) Malaria d) Pneumonia Save Question 79 (1 point) A 76-year-old patient with a 200-pack year smoking history presents with complaints of chronic cough, dyspnea, fatigue, hemoptysis, and weight loss over the past 2 months. The physical exam reveals decreased breath sounds and dullness to percussion over the left lower lung field. The chest X-ray demonstrates shift of the mediastinum and trachea to the left. These are classic signs of: Question 79 options: b) Tuberculosis c) Pneumonia d) COPD Save Question 80 (1 point) ASA, ACE/ARB, beta-blocker, aldosterone blockade 85 b) Exercise stress test 86 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ ACE, ARB, Calcium channel blocker, ASA Long-acting nitrates, warfarin, ACE, and ARB ASA, clopidogrel, nitrates Save Question 85 (1 point) A 55-year-old post-menopausal woman with a history of hypertension complains of jaw pain on heavy exertion. There were no complaints of chest pain. Her ECG indicates normal sinus rhythm without ST segment abnormalities. Your plan may include: Question 85 options: a) Echocardiogram c) Cardiac catheterization d) Myocardial perfusion imaging Save Question 86 (1 point) Jenny is a 24 year old graduate student that presents to the clinic today with complaints of fever, midsternal chest pain and generalized fatigue for the past two days. She denies any cough or sputum production. She states that when she takes Ibuprofen and rest that the chest pain does seem to ease off. Upon examination the patient presents looking very ill. She is leaning forward and states that this is the most comfortable position for her. Temp is 102. BP= 100/70. Heart rate is 120/min and regular. Upon c) Pericarditis 87 b) Pain tends to occur with movement, stretching or palpation 88 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ auscultation a friction rub is audible. Her lung sounds are clear. With these presenting symptoms your initial diagnosis would be: Question 86 options: a) Mitral Valve Prolapse b) Referred Pain from Cholecystitis d) Pulmonary Embolus Save Question 87 (1 point) Which symptom is more characteristic of Non-Cardiac chest pain? Question 87 options: a) Pain often radiates to the neck, jaw, epigastrium, shoulder, or arm c) Pain usually lasts less than 10 minutes and is relieved by nitroglycerine d) Pain is aggravated by exertion or stress Save Question 88 (1 point) What is the most common valvular heart disease in the older adult? Question 88 options: b) Aortic stenosis 89 d) Angina 90 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ a) Aortic regurgitation c) Mitral regurgitation d) Mitral stenosis Save Question 89 (1 point) Mr. A presents to your office complaining of chest pain, mid-sternal and radiating to his back. He was mowing his lawn. He reports the pain lasting for about 8 minutes and went away after sitting down. What is his most likely diagnosis based on his presenting symptoms? Question 89 options: a) Acute MI b) GERD c) Pneumonia Save Question 90 (1 point) Jeff, 48 years old, presents to the clinic complaining of fleeting chest pain, fatigue, palpitations, lightheadedness, and shortness of breath. The pain comes and goes and is not associated with activity or exertion. Food does not exacerbate or relieve the pain. The pain is usually located under the left nipple. Jeff is concerned because his father has cardiac disease and underwent a CABG at age 65. The ANP examines Jeff and hears a mid-systolic click at the 4th ICS mid-clavicular area. The ANP knows that this is a hallmark sign of: d) Coronary artery disease with angina pectoris 95 b) S3 gallop rhythm 96 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ a) Musculoskeletal chest wall syndrome with radiation b) Esophageal motor disorder with radiation c) Acute cholecystitis with cholelithiasis Save Question 95 (1 point) A common auscultatory finding in advanced CHF is: Question 95 options: a) Systolic ejection murmur c) Friction rub d) Bradycardia Save Question 96 (1 point) Your 35-year-old female patient complains of feeling palpitations on occasion. The clinician should recognize that palpitations are often a sign of: Question 96 options: a) Anemia b) Anxiety d) All of the above 97 c) Echocardiogram 98 a) Pneumonia NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ c) Hyperthyroidism Save Question 97 (1 point) The best way to diagnose structural heart disease/dysfunction non-invasively is: Question 97 options: a) Chest X-ray b) EKG d) Heart catheterization Save Question 98 (1 point) During auscultation of the chest, your exam reveals a loud grating sound at the lower anterolateral lung fields, at full inspiration and early expiration. This finding is consistent with: Question 98 options: b) Pleuritis c) Pneumothorax d) A and B 99 a) Arterial insufficiency 100 c) Venous insufficiency NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Save Question 99 (1 point) 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? Question 99 options: b) Femoral vein thrombus c) Venous insufficiency d) Peripheral neuropathy Save Question 100 (1 point) Your patient complains of a feeling of heaviness in the lower legs daily. You note varicosities, edema, and dusky color of both ankles and feet. Which of the following is the most likely cause for these symptoms? Question 100 options: a) Femoral vein thrombosis b) Femoral artery thrombus d) Musculoskeletal injury Save d) HIDA scan 104 d) Murphy’s sign 105 d) Cholecystitis NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Save Question 104 (1 point) A specific exam used to evaluate the gall bladder is: Question 104 options: a) Psoas sign b) Obturator sign c) Cullens sign Save Question 105 (1 point) Which disease process typically causes episodic right upper quadrant pain, epigastric pain or chest pain that can last 4-6 hours or less, often radiates to the back (classically under the right shoulder blade) and is often accompanied by nausea or vomiting and often follows a heavy, fatty meal. Question 105 options: a) Acute pancreatitis b) Duodenal ulcer c) Biliary colic Save NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ 1. Question : 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: Student Answer: Acoustic neuroma Cerumen impaction Otitis media Ménière’s disease Instructor Explanation: Elderly clients frequently present with complaints of hardened cerumen and decreased hearing resulting from cerumen impaction aggravated by hearing aid wear. (Goolsby 137-138) Conductive hearing loss is caused by a lesion involving the outer and middle ear to the level of the oval window. Various structural abnormalities, cerumen impaction, perforation of the tympanic membrane, middle ear fluid, damage to the ossicles from trauma or infection, otosclerosis, tympanosclerosis, cholesteatoma, middle ear tumors, temporal bone fractures, injuries related to trauma, and congenital problems are some of the causes. (Kennedy-Malone 170-171) Points Received: 2 of 2 Comments: Question 2. Question : In examination of the nose, the clinician observes gray, pale mucous membranes with clear, serous discharge. This is most likely indicative of: NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Student Answer: Bacterial sinusitis Allergic rhinitis Drug abuse Skull fracture Instructor Explanation: When examining the nose, assess the mucosa for integrity, color, moistness, and edema/lesions and the nasal septum for patency. The turbinates should be assessed for color and size. Pale, boggy turbinates suggest allergies; erythematous, swollen turbinates are often seen with infection. Any discharge should be noted. Clear, profuse discharge is often associated with allergies. (Goolsby 128-129) Patients with seasonal allergic rhinitis report rhinorrhea, sneezing, obstructed nasal passages, and pruritic eyes, nose, and oropharynx during the spring and fall. Patients with perennial allergic rhinitis have similar symptoms associated with exposure to environmental allergens typically in their homes. Physical examination may reveal a pale, boggy nasal mucosa, injected conjunctiva, enlarged turbinates, dark discoloration or bags under the eyes, and mouth breathing; absence of pale, boggy nasal mucosa does not rule out allergic rhinitis. (Kennedy-Malone 182-183) Points Received: 2 of 2 Comments: Question 3. Question : A 45 year old patient presents with ‘sore throat’ and fever for one week. After a quick strep screen you determine the patient has Strep throat. You know that streptococcal pharyngitis should be treated with antibiotics to prevent complications and to shorten the course of disease. Which of the following antibiotics should be considered when a patient is allergic to Penicillin? Student Answer: Amoxicillin NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Question 6. Question : Your patient has been using chewing tobacco for 10 years. On physical examination, you observe a white ulceration surrounded by erythematous base on the side of his tongue. The clinician should recognize that very often this is: Student Answer: Malignant melanoma Squamous cell carcinoma Aphthous ulceration Behcet’s syndrome Instructor Explanation: Most oral malignancies are painless until quite advanced, so patients are often unaware of the lesion unless the lip or anterior portion of the tongue is involved. The patient may become aware of the lesion if it bleeds. Squamous cell cancer lesions vary in appearance, from the reddened patches of erythroplakia to areas of induration/thickening, ulceration, or necrotic lesions. Lesions of malignant melanoma have varied pigmentation, including brown, blue, and black. Even lesions that appear flat and smooth may be nodular, indurated, or fixed to adjacent tissue on palpation. Even though patients with squamous cell malignancies often have a history of heavy alcohol and/or tobacco use or poor dentition, these are not risk factors for malignant melanoma. In Behcet’s syndrome, the patient complains of recurrent episodes of oral lesions that are consistent with aphthous ulcers. The number of lesions ranges from one to several; the size of the ulcers varies from less than to greater than 1 cm. Like aphthous ulcers, the lesions are well defined, with a pale yellow or gray base surrounded by erythema. The majority of patients also develop lesions on the genitals and eyes. (Goolsby 153) Tobacco use and heavy alcohol consumption, alone or synergistically, are strongly related to the development of oral cancer. Pipe smoking and sun exposure have been implicated in lip cancer. Leukoplakia and erythroplasia are often precursors to oral cancer. Relationships between oral cancer and Epstein-Barr virus, HPV, herpes simplex virus, and immunodeficiency states also have been found (Stenson, 2011). (Kennedy-Malone 177). Points Received: 2 of 2 Comments: NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Question 7. Question : A 26 year old patient presents with cough and general malaise for 3 days. They note that their eyes have been watering clear fluid and a ‘runny nose’ since yesterday. They note they ‘feel miserable’ and demand something to make them feel better. What would be the best first plan of treatment? Student Answer: Saline nasal spray for congestion and acetaminophen as needed for pain. Z-pack (azithromycin) for infection and Cromolyn nasal for congestion Hydrococone/acetaminophen as needed for pain and Guaifensin for congestion Cephalexin for infection and Cromolyn ophthalmic for congestion Instructor Explanation: MedU Card #4 Points Received: (not graded) Comments: Question 8. Question : Which of the following findings should trigger an urgent referral to a cardiologist or neurologist? NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Student Answer: History of bright flash of light followed by significantly blurred vision History of transient and painless monocular loss of vision History of monocular severe eye pain, blurred vision, and ciliary flush All of the above Instructor Explanation: Amaurosis fugax is a monocular, transient loss of vision. It stems from transient ischemia of the retina and presents an important warning sign for impending stroke. Depending on the circumstances reported, the patient should be immediately referred to either a cardiovascular or neurological specialist. (Goolsby 108) Points Received: 0 of 2 Comments: Question 9. Question : Dizziness that is described as "lightheaded" or, "like I'm going to faint," is usually caused by inadequate cerebral perfusion and is classified as? Student Answer: Presyncope Disequilibrium Vertigo Syncope Instructor Explanation: MedU Card #5 NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ A 45-year-old man with recurrent episodes of brief intense vertigo every time he turns his head rapidly. He has no other neurologic signs or symptoms. He has a positive Dix- Hallpike maneuver. A 66-year-old man with recurrent episodes of vertigo associated with tinnitus and hearing loss. His head thrust test is positive. A 28-year-old otherwise well woman with new onset constant vertigo with no other neurologic symptoms. On physical exam, she has unidirectional nystagmus that disappears when her gaze is fixed. Instructor Explanation: MedU Card #11. There are multiple reasons to be concerned about a central lesion and possible infarct in this patient. Her age puts her at risk as does her hypertension. Her physical exam shows nystagmus that changes direction and that does not inhibit with focus. Both of these findings are consistent with a central lesion. She needs an urgent MRI. Points Received: 0 of 2 Comments: Question 13. Question : A patient presents with eye redness, scant discharge, and a gritty sensation. Your examination reveals the palpable preauricular nodes, which are most likely with: Student Answer: Bacterial conjunctivitis Allergic conjunctivitis Chemical conjunctivitis Viral conjunctivitis Instructor Explanation: Preauricular nodes are nonpalpable and nontender in allergic conjunctivitis, usually nonpalpable in bacterial conjunctivitis, and palpable in viral conjunctivitis. (Goolsby 112) NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Points Received: 0 of 2 Comments: Question 14. Question : In assessing the eyes, which of the following is considered a “red flag” finding when associated with eye redness? Student Answer: History of prior red-eye episodes Grossly visible corneal defect Exophthalmos Photophobia Instructor Explanation: Red flag warnings for eye redness include pain (not discomfort or irritation), decreased vision, profuse discharge, and corneal defect grossly visible. (Goolsby 112) Points Received: 2 of 2 Comments: NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Question 15. Question : A 64-year-old male presents with erythema of the sclera, tearing, and bilateral pruritus of the eyes. The symptoms occur intermittently throughout the year and he has associated clear nasal discharge. Which of the following is most likely because of the inflammation? Student Answer: Bacterium Allergen Virus Fungi Instructor Explanation: Patients with seasonal allergic rhinitis report rhinorrhea, sneezing, obstructed nasal passages, and pruritic eyes, nose, and oropharynx during the spring and fall. Patients with perennial allergic rhinitis have similar symptoms associated with exposure to environmental allergens typically in their homes. Physical examination may reveal a pale, boggy nasal mucosa, injected conjunctiva, enlarged turbinates, dark discoloration or bags under the eyes, and mouth breathing; absence of pale, boggy nasal mucosa does not rule out allergic rhinitis. (Kennedy-Malone 182-183) Points Received: 2 of 2 Comments: Question 16. Question : Patients that have atopic disorders are mediated by the production of Immunoglobulin E (IgE) will have histamine stimulated as an immediate phase response. This release of histamine results in which of the following? Student Answer: Sinus pain, increased vascular permeability, and bronchodilation How to provide individuals and families with genetic counseling appropriate to your practice setting. The appearance in which common diseases may presenting individuals with genetic disorders. What secondary disease(s) the individual may be likely to develop. How an individual's primary genetic disease(s) may affect their overall health. NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Points Received: 2 of 2 Comments: As a nurse practitioner it is important for you to know (select all that apply): Question 2 options: Question 19. Question : Rheumatic heart disease is a complication that can arise from which type of infection? Student Answer: Epstein-Barr virus Diphtheria Group A beta hemolytic streptococcus Streptococcus pneumoniae Instructor Explanation: Group A beta-hemolytic streptococcal (GABHS) pharyngitis is a bacterial infection of the pharynx, commonly called strep throat. Complications of GABHS pharyngitis, although rare, include rheumatic heart disease and glomerulonephritis, and the condition requires prompt How to provide individuals and families with genetic counseling appropriate to your practice setting. The appearance in which common diseases may presenting individuals with genetic disorders. What secondary disease(s) the individual may be likely to develop. How an individual's primary genetic disease(s) may affect their overall health. None of the above Immune mediated response cell-mediated response antibody-mediated response NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ diagnosis and definitive treatment. Most patients with GABHS pharyngitis are children and youths. Other bacterial causes of pharyngitis include mycoplasmal pneumonia, gonorrhea, and diphtheria. (Goolsby 156) Question 2 (1 point) As a nurse practitioner it is important for you to know (select all that apply): Question 2 options: Which of the following are types of immune responses? (check all that apply) Question 3 options: Question 4 (1 point) Slow walking speed, and low physical activity Lynch syndrome has no life time risk associated with colon cancer. NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Frailty can be defined as a clinical syndrome which the following criteria is present (check all that apply) Question 4 options: Unintentional weight loss of 10lb in the last year Self-reported exhaustion Weakness based on grip strength Which of the following is true regarding Lync syndrome: Question 5 options: Individuals with Lynch syndrome have an 80% lifetime risk of developing colon cancer Lych syndrome is an autosomal recessive genetic condition Individuals with Lynch syndrome have 90% lifetime risk of developing colon cancer Points Received: 2 of 2 Comments: What is the anticipated onset of symptom relief with the use of nasal corticosteroid sprays? Question 4 options: 6-7 hours 2-4 hours 1 to 2 days 4-5 days Cataracts Glaucoma NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Points Received: (not graded) Which of the following conditions is the leading cause of blindness in the United States? Question 5 options: Macular degeneration Diabetic retinopathy NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ NSG6420 QUIZ 3 1. Question : Susan P., a 60-year-old woman with a 30 pack year history, presents to your primary care practice for evaluation of a persistent, daily cough with increased sputum production, worse in the morning, occurring over the past three months. She tells you, “I have the same thing, year after year.” Which of the following choices would you consider strongly in your critical thinking process? Student Answer: Seasonal allergies Acute bronchitis Bronchial asthma Chronic bronchitis Instructor Explanation: The pulmonary component includes an abnormal inflammatory response to noxious stimuli, principally tobacco, but also occupational and environmental pollutants. The hallmark of chronic bronchitis is a daily chronic cough with increased sputum production lasting for at least 3 consecutive months in at least 2 consecutive years, usually worse on awakening; this may or may not be associated with COPD (GOLD, 2011). Emphysema is characterized by obstruction to airflow caused by abnormal airspace enlargement distal to terminal bronchioles. Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-01-14. VitalBook file. (page 206) & Goolsby, Mary J., Laurie Grubbs. Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses, 3rd Edition. F.A. Davis Company, 11/2014. VitalBook file. (page 213) Points Received: 2 of 2 Comments: Points Received: 2 of 2 Comments: NURS 6420 EXAM QUESTIONS AND ANSWERS 100% CORRECT 2023A+ Question 2 . Question : A patient presents complaining of a 5 day history of upper respiratory symptoms including nasal congestion and drainage. On the day the symptoms began he had a low-grade fever that has now resolved. His nasal congestion persisted and he has had yellow nasal drainage for three days associated with mild headaches. On exam he is afebrile and in no distress. Examination of his tympanic membranes and throat are normal. Examination of his nose is unremarkable although a slight yellowish-clear drainage is noted. There is tenderness when you lightly percuss his maxillary sinus. What would your treatment plan for this patient be? Student Answer: Observation and reassurance Treatment with an antibiotic such as amoxicillin Treatment with an antibiotic such as a fluoroquinoline or amoxicillin- clavulanate Combination of a low dose inhaled corticosteroid and a long acting beta2 agonist inhaler. Instructor Explanation: MedU Card #4. According to the American Academy of Ortolaryngology—Head and Neck Surgery Foundation guidelines (2007) on sinusitis, making the distinction between a lingering viral upper respiratory infection that affects the nose and sinuses (viral rhinosinusitis) or early acute bacterial sinusitis can be difficult. It is more likely to be a viral rhinosinusitis if the duration of symptoms is less than ten days and they are not worsening. In this case, you can continue to observe the patient and reassure him that antibiotics are not necessary at this time. Question 3 Question : Emphysematous changes in the lungs produce the following characteristic in