NURS-6531-Advanced Practice Care of Adults, Exams of Nursing

Download NURS-6531-Advanced Practice Care of Adults and more Exams Nursing in PDF only on Docsity! NURS-6531-Advanced Practice Care of Adults • Question 1 0 out of 0 points When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? • Question 2 0 out of 1 points A patient complains of generalized joint pain and stiffness associated with activity and relieved with rest. This patient history is consistent with which of the following disorders? Osteoarthritis • Question 3 What diabetic complications result from hyperglycemia? 1. Retinopathy 2. Hypertension resistant to treatment 3. Peripheral neuropathy 4. Accelerated atherogenesis • Question 4 0 out of 1 points 0 out of 1 points Which factors are associated with high risk for foot complications in a patient with diabetes mellitus? Obesity Abnormal nails Abnormal gait Poorly controlled lipids • Question 5 1 out of 1 points Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)? What are common early signs of BPH – frequency, urgency, nocturia TX with alpha adrenergic Terazosin and doxazosin • Question 6 1 out of 1 points A 63-year-old man presents to the office with hematuria, hesitancy, and dribbling. Digital rectal exam (DRE) reveals a moderately enlarged prostate that is smooth. The PSA is 1.2. What is the most appropriate management strategy for you to follow at this time? Prescribe an alpha adrenergic blocker • Question 7 0 out of 1 points A 30 year old female patient presents to the clinic with heat intolerance, tremors, nervousness, and weight loss inconsistent with increased appetite. Which test would be most likely to confirm the suspected diagnosis? Graves hyperthyroid • Question 8 1 out of 1 points Which history is commonly found in a patient with glomerulonephritis? Ask about recent infections (skin or upper respiratory); recent travel (possible exposure to viruses, bacteria, fungi, or parasites); recent illnesses, surgery, or invasive procedures (possible infection); any systemic diseases (Systemic Lupus Erythematosus -SLE) • Question 9 1 out of 1 points A 60 year old male patient with multiple health problems presents with a complaint of erectile dysfunction (ED). Of the following, which medication is most likely to be causing the problem? diabetes • Question 10 0 out of 1 points Which of the following is not a characteristic of type 2 diabetes mellitus? characterized by high blood sugar, insulin resistance, and relative • Question 17 1 out of 1 points Which of the following is the most common causative organism of nongonococcal urethritis? which of the following does not cause nongonococcal urethritis a chlamydia – most common b. mycoplasma c. neisseria d. ureaplasma • Question 18 1 out of 1 points Which appropriate test for the initial assessment of Alzheimer’s disease provides the performance ratings on 10 complex, higher order activities? FAQ • Question 19 0 out of 1 points What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare? the physician must be on-site and engaged in client care. • Question 20 Diagnostic evaluation for urinary calculi includes: A. Urinalysis and culture B. Non contrast CT C. Serum calcium D. All of the above • Question 21 1 out of 1 points 1 out of 1 points Reed-Sternberg B lymphocytes are associated with which of the following disorders: Hodgkin’s lymphoma • Question 22 0 out of 1 points Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? Musculoskeletal pain is not characteristic of chronic fatigue syndrome; rather, it is characteristic of • Question 28 The most common cause of elevated liver function tests is: Chronic alcohol abuse. • Question 29 0 out of 1 points 1 out of 1 points A 14 year old female cheerleader reports gradual and progressive dull anterior knee pain, exacerbated by kneeling. The nurse practitioner notes swelling and point tenderness at the tibial tuberosity. X-ray is negative. What is the most likely diagnosis? Osgood The most likely diagnosis based on the reports of gradual progressive dull anterior knee pain cause of kneeling and the complains of sore lump on the patient’s knee which the result of the assessment notes were swelling and point tenderness is likely Arthritis or gout. It is the symptoms of Arthritis or gouts usually complaining having knee pain and swelling. • Question 30 Which of the following is a contraindication for metformin therapy? Creatinine > 1.5 Renal dysfunction. Congestive cardiac failure needing drug treatment. Hypersensitivity to metformin. Acute or chronic metabolic acidosis. Impaired hepatic function. • Question 31 1 out of 1 points 0 out of 1 points The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy: albumin-to-creatinine ratio with a spot urine • Question 32 1 out of 1 points Which is the most common cause of end-stage renal disease in the United States? Diabetic Neuropahty, hypertenson, glomerulonephritis, systemic lupus, cystic kidney disease • Question 33 0 out of 1 points A middle-aged female presents complaining of recent weight loss. The physical exam reveals an enlarged painless cervical lymph node. The differential diagnosis for this patient’s problem includes: All of the above (mono, toxoplasmosis, and infection) • Question 34 1 out of 1 points Risk factors for prostate cancer include all of the following except: History of genital trauma and bph • Question 35 1 out of 1 points Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of: carpal tunnels • Question 36 1 out of 1 points The most effective intervention(s) to prevent stroke is (are): smoking cessation and treatment of hypertension • Question 37 1 out of 1 points A diabetic patient is taking low-dose enalapril for hypertension. A record of the patient’s blood pressure over 4 weeks ranges from 130 to 142 mmHg systolic and 75 to 85 mmHg diastolic. How should the nurse practitioner respond? increase the dosage of the current BP medication 1 out of 1 points Which of the following medications increase the risk for metabolic syndrome? Antihistamine and protease inhibitor • Question 43 The most accurate measure of diabetes control is: a1c • Question 44 1 out of 1 points 0 out of 1 points The 4 classic features of Parkinson’s disease are: shaking (tremor) of the hands, arms, legs and face; stiffness; slow movement (bradykinesia); and difficulty with balance and coordination. • Question 45 0 out of 1 points A child with type 1 diabetes mellitus has experienced excessive hunger, weight gain and increasing hyperglycemia. The Somogyi effect is suspected. What steps should be taken to diagnose and treat this condition? Testing blood sugar levels at 3.00 a.m. and again in the morning can help distinguish between the Somogyi effect and the dawn phenomenon. ’s relatively easy to test for the Somogyi effect. For several consecutive nights: • Check your blood sugar just before bed. • Set an alarm to check it again around 3:00 a.m. • Test it again upon waking. If your blood glucose is low when you check it at 3:00 a.m., it’s likely the Somogyi effect. • Question 46 1 out of 1 points A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness, anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take? the correct next step is to measure baseline serum Trimethoprim-sulfamethoxazole - less effective but still an option Other antibiotics - doxycycline, cephalexin, erythromycin Treat for 4 weeks minimum • Question 53 0 out of 1 points Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to: try neutral position wrist splinting and order an oral NSAID • Question 54 0 out of 1 points Urine cultures should be obtained for which of the following patients? All of the above (pregnant females, males, and febrile patients) • Question 55 1 out of 1 points Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse? • Question 56 0 out of 1 points The diagnosis which must be considered in a patient who presents with a severe headache of sudden onset, with neck stiffness and fever, is: migrane or meningitis • Question 57 0 out of 1 points An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects? hypogyclemia • Question 58 0 out of 1 points Which patient would benefit most from screening for type 2 diabetes? Gdma, black, htn, pcos, black, family hx • Question 59 0 out of 1 points The intervention known to be most effective in the treatment of severe depression, with or without psychosis, is: electroconvulsive therapy (ECT). • Question 60 0 out of 1 points Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond? The effect of caffeine in causing osteoporosis is controversial, but it is postulated to result from caffeine ' s diuretic effect that causes calcium to be excreted more rapidly • Question 61 0 out of 1 points Which of the following patients most warrants screening for hypothyroidism? Screening whole populations for hypothyroidism is not warranted. There is a high prevalence of hypothyroidism among the elderly with cognitive impairment. • Question 62 0 out of 1 points Successful management of a patient with attention deficit hyperactivity disorder (ADHD) may be achieved with: psychostimulant Ritalin ii. Dexedrine iii. Focalin iv. Adderall v. Concerta vi. Strattera • Question 63 0 out of 1 includes which of the following? A. Orthostatic proteinuria 0 out of 1 points B. Nephrotic syndrome C. Infection D. Trauma E. A and B • Question 69 0 out of 1 points You are assessing a patient after a sports injury to his right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to the: cruciatanklee ligament • Question 70 A positive drawer sign supports a diagnosis of: cruciate ligament • Question 71 0 out of 1 points 0 out of 1 points A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as: overweight • Question 72 0 out of 1 points A patient has been taking fluoxetine (Prozac) since being diagnosed with major depression, first episode, 2 months ago. She reports considerable improvement in her symptoms and her intention to discontinue the medication. What should be the nurse practitioner’s recommendation? Recommend that the patient continue the antidepressant medication for at least 4 more months. • Question 73 Diagnostic radiological studies are indicated for low back pain: Xray • Question 74 0 out of 1 points 0 out of 1 points A 32 year old female patient presents with fever, chills, right flank pain, right costovertebral angle tenderness, and hematuria. Her urinalysis is positive for leukocytes and red blood cells. The nurse practitioner diagnoses pyelonephritis. The most appropriate management is: Cipro if symptoms does not go away within 2 days hospitalization • Question 75 0 out of 1 points L5-S1 • Question 82 0 out of 1 points A 25 year old overweight patient presents with a complaint of dull achiness in his groin and history of a palpable lump in his scrotum that “comes and goes”. On physical examination, the nurse practitioner does not detect a scrotal mass. There is no tenderness, edema, or erythema of the scrotum, the scrotum does not transilluminate. What is the most likely diagnosis? Inguinal hernia • Question 83 0 out of 1 points Which of the following characteristics are associated with prepatellar bursitis? Repetitive knee trauma • Question 84 0 out of 1 points Which drug category contains the drugs that are the first line Gold standard therapy for COPD? anticholenergic • Question 85 0 out of 1 points Which of the following physical modalities recommended for treatment of rheumatoid arthritis provides the most effective long term pain relief? Physiotherapy • Question 86 0 out of 1 points Which of the following accounts for half of the bladder tumors among men and one- third in women? Cigarette smoke, both active and passive inhalation Cigarette smoke, both active and passive inhalation • Question 87 0 out of 1 points A 35 year old male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency, and reduced force of stream. The nurse practitioner suspects acute bacterial prostatitis. Which of the following specimens would be least helpful for diagnosis? Post void Ordered test – that are helpful Midstream urine specimens for culture and sensitivity CBC and differential Blood urea nitrogen Creatinine Imaging • Question 88 0 out of 1 points In which of the following presentations is further diagnostic testing not warranted? Bilateral gynecomastia in a pre-pubertal • Question 89 0 out of 1 points Martin is complaining of erectile dysfunction. He also has a condition that has reduced arterial blood flow to his penis. The most common cause of this condition is: htn dm • Question 90 0 out of 1 points Which of the following is the most common complication of the myelodysplastic syndromes? Fatigue • Question 91 0 out of 1 points You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of: A. Infection B. Malignancy C. Inflammation D. Drug E. Endocrine B. A. Infection - Viral: infectious mononucleosis (CMV, EBP), HIV - Bacterial: skin infection, TB - Fungal: cryptococcal B. Malignancy - Hematological: lymphoma, leukemia - Solid tumour LN met up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Martin receive today regarding the care if his feet? See a podiatrist yearly; wash your feet daily with warm, soapy water and towel dry between the toes; inspect your feet daily for any lesions; and apply lotion to any dry areas. • Question 97 0 out of 1 points Which of the following is a potential acquired cause of thrombophilia? 1. Lupus anticoagulant 2. antiphospholipid antibody syndrome --antibody to phospholipids • Question 98 0 out of 1 points Deficiency of which nutritional source usually presents with an insidious onset of paresthesias of the hands and feet that are usually painful? B 12 • Question 99 0 out of 1 points What information should patients with diabetes and their families receive about hypoglycemia? Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly. • Question 100 0 out of 1 points Josh, age 22, is a stock boy and has an acute episode of low back pain. You order and NSAID and tell him which of the following? 3200mg max dose alternate with Tylenol if needed • Question 101 0 out of 1 points A 28-year-old female presents to the office requesting testing for diagnosis of hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her risk factors. The nurse practitioner explains that: A. The patient should start anticoagulant therapy immediately. B. Hereditary thrombophilia does not always require anticoagulation therapy. C. Women of childbearing age cannot take anticoagulant therapy. D. Genetic and risk management counseling are recommended. E. B and D  Question 1 1 out of 1 points Which of the following is the most common cause of low back pain? Lumbar disc disease  Question 2 1 out of 1 points The cardinal sign of infectious arthritis is: Affected joint is painful at rest, with movement, and weight bearing  Question 3 1 out of 1 points Which of the following best reflects the National Osteoporosis Foundation daily calcium recommendations for adults? 1000-1200 mg of calcium daily  Question 4 0 out of 1 points Risk factors for osteoporosis include: having RA is (page 960 in Buttaro et al., 2017) Difficulty initiating a urine stream Nocturia Urinary retention Increased force of urine flow Accelerated venous return and increased stroke volume resulting in deactivation of the parasympathetic nervous system. A cycle of inappropriate vasodilation, bradycardia, and hypotension. A sudden rise in blood pressure due to overly efficient vasoconstriction. Emotional stress resulting in hypertension, tachycardia, and increased venous return. Sjogren’s syndrome Pancreatic cancer Disseminated malignancy of the hematologic system ALL Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)? The physiological explanation of syncope is: A 65-year-old patient complains of a recurrent bilateral temporal headaches, malaise, muscle aches, and low grade fever. The headache is described as superficial tenderness rather than deep pain. Giant cell arteritis is suspected. Appropriate treatment is: refer for temporal artery biopsy and initiation of oral prednisone You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of: Cancer of the liver Order and intravenous pyelogram Admit Sam to the hospital Schedule extensive blood work Have Sam collect one urine specimen on first arising and then another 2 hours later A dipstick strip done during routine urinalysis in the office A 24-hour urine collection An early morning spot urine collection Which history is commonly found in a patient with glomerulonephritis? Beta-hemolytic strep infection Frequent urinary tract infections Kidney stones Hypotension Sam, age 42, has had persistent proteinuria on the previous two office visits. Which action is warranted next? The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy: A serum albumin test Periorbital pain, sudden onset, often explosive in quality, and associated with nasal stuffiness, lacrimation, red eye, and nausea. Bilateral, occipital, or frontal tightness or fullness, with waves of aching pain. Hemicranial pain that is accompanied by vomiting and photophobia. Steadily worsening pain that interrupts sleep, is exacerbated by orthostatic changes, and may be preceded by nausea and vomiting. Erythromycin 4 times daily for 7 to 10 days Doxycycline twice daily for 7 to 10 days A fluoroquinolone daily for 3 weeks to 4 months Bactrim DS daily for 4 to 16 weeks Progressive, genetic myopathy with degeneration and death of muscle fibers Asymmetric overgrowth of extremities, angiomas, thickening of bones, and excessive muscle growth Hypotonia that persists into adulthood, and recurrent joint dislocation Hypotonicity, developmental delay, and symmetric congenital absence of A typical description of a tension headache is: The treatment of choice for chronic bacterial prostatitis (CBP) is: The obligatory criteria for diagnosis of muscular dystrophy (MD) are: