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A collection of multiple-choice questions and answers related to the nurs 6531 course, focusing on the care of adult patients. It covers a range of topics, including thrombophilia, carpal tunnel syndrome, diabetes screening, rheumatoid arthritis, urinary tract infections, alzheimer's disease, hypothyroidism, prostate cancer, hypoglycemia, glomerulonephritis, manic episodes, cushing's syndrome, low back pain, hiv infection, non-gonococcal urethritis, transient ischemic attack, parkinson's disease, urinary tract infections, radial tunnel syndrome, post-traumatic stress disorder, hypertension, metformin therapy, cruciate ligament injury, gastroesophageal reflux disease, levothyroxine therapy, diabetes screening, barotrauma.
Typology: Exams
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Question 2. Which of the following is a potential acquired cause of thrombophilia - Correct Answer-Homocysteinuria Protein C deficiency Factor V Leiden Antiphospholipid antibodies Question 3 Phalen's test, 90°wrist flexion for 60 seconds, reproduces symptoms of: - Correct Answer-Ulnar tunnel syndrome Carpal tunnel syndrome Tarsal tunnel syndrome Myofascial pain syndrome Question 4 Which patient would benefit most from screening for type 2 diabetes? - Correct Answer-A 30 year old female with unintended weight loss. A 25 year old male with family history of type 1 diabetes An obese female with recurrent vaginitis A 50 year old hyperlipidemic male Question 5 A 72 year old female patient reports a 6 month history of gradually progressive swollen and painful distal interphalangeal (DIP) joints of one hand. She has no systemic symptoms but the erythrocyte sedimentation
rate (ESR), antinuclear antibody (ANA), and rheumatoid factor (RF) are all minimally elevated. What is the most likely diagnosis? - Correct Answer- Rheumatoid arthritis (RA) Osteoarthritis (OA) Lupus Peripheral neuropathy Question 6 A 32 year old male patient complains of urinary frequency and burning on urination for 3 days. Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial treatment should be: - Correct Answer-Trimethoprim-sulfamethoxazole for 3 days Ciprofloxacin for 7- 10 days Trimethoprim-sulfamethoxazole for 14 days Ciprofloxacin for 3 days A thymectomy is usually recommended in the early treatment of which disease? - Correct Answer-Parkinson's disease Multiple sclerosis Myasthenia gravis Huntington's chorea Question 8 The diagnosis of human papilloma virus (HPV) infection in males is usually made by - Correct Answer-Clinical appearance Viral culture Tzanck smear KOH prep Question 9
The most effective intervention(s) to prevent stroke is (are): - Correct Answer-81 mg of aspirin daily Carotid endarterectomy for patients with high-grade carotid lesions Routine screening for carotid artery stenosis with auscultation for bruits Smoking cessation and treatment of hypertension Question 10 What is the most common cause of Cushing's syndrome? - Correct Answer-Excessive ACTH production Administration of a glucocorticoid or ACTH Pituitary adenoma or a non-pituitary ACTH-producing tumor Autonomous cortisol production from adrenal tissue Question 11 Diagnostic radiological studies are indicated for low back pain: - Correct Answer-Routinely after 3 weeks of low back pain symptoms. To screen for spondylolithiasis in patients less than 20 years of age with 2 weeks of more of low back pain. When there is a suspicion of a space-occupying lesion, fracture, cauda equina, or infection. As a part of a pre-employment physical when heavy lifting is included in the job description. Question 12 After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been cured? - Correct Answer-An enzyme-linked immunosorbent assay titer A urea breath test A rapid urease test A repeat endoscopy
Question 13 Which appropriate test for the initial assessment of Alzheimer's disease provides the performance ratings on 10 complex, higher order activities? - Correct Answer-MMSE CAGE questionnaire FAQ - Functional Activities Questionnaire Holmes and Rahe social readjustment scale Question 14 Major depression occurs most often in which of the following conditions? - Correct Answer-A. Myocardial infarction Parkinson's disease Stroke Alzheimer's disease Question 15 Which of the following statements about multiple sclerosis (MS) is correct?
Question 17 Risk factors for prostate cancer include all of the following except: - Correct Answer-Family history Benign prostatic hypertrophy African American race Age Question 18 What information should patients with diabetes and their families receive about hypoglycemia? - Correct Answer-Hypoglycemia is a rare complication. Hypoglycemia requires professional medical treatment. Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly. Hypoglycemia occurs only as a result of insulin overdose. Question 19 Which history is commonly found in a patient with glomerulonephritis? - Correct Answer-Beta-hemolytic strep infection Frequent urinary tract infections Kidney stones Hypotension Question 20 Which of the following is characteristic of a manic episode? - Correct Answer-weight loss of gain insomnia or hypersomnia diminished ability to think or concentrate grandiose delusions
Question 21 Central obesity, "moon" face, and dorsocervical fat pad are associated with: - Correct Answer-Metabolic syndrome Unilateral pheochromocytoma Cushing's syndrome None of the above Question 22 Which of the following is the most common cause of low back pain? - Correct Answer-Lumbar disc disease Spinal stenosis Traumatic fracture Osteoporosis Question 23 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: - Correct Answer- Infection Toxoplasmosis Mononucleosis All of the above None of the above Question 24 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? - Correct Answer-Weight gain Fracture risk Hypoglycemia Weight loss
Question 25 A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is - Correct Answer-cryptococcosis toxoplasmosis cryptosporidiosis cytomegalovirus Question 26 Which of the following is the most common causative organism of nongonococcal urethritis? - Correct Answer-Chlamydia trachomatis Ureaplasma urealyticum Mycoplasma hominis Trichonomas vaginalis Question 27 The most common symptoms of transient ischemic attack (TIA) include - Correct Answer-Nausea, vomiting, syncope, incontinence, dizziness, and seizure. Weakness in an extremity, abruptly slurred speech, or partial loss of vision, and sudden gait changes. Headache and visual symptoms such as bright spots or sparkles crossing the visual field. Gradual onset of ataxia, vertigo, generalized weakness, or lightheadedness Question 28 What is the first symptom seen in the majority of patients with Parkinson's disease? - Correct Answer-Rigidity Bradykinesia Rest tremor Flexed posture
Question 29 A 21-year-old female presents to the office complaining of urinary frequency and urinary burning. The nurse practitioner suspects a urinary tract infection when the urinalysis reveals - Correct Answer- 1 - 4 red blood cells per high-powered field Specific gravity 1. Urobilinogen 10 - white blood cells per high-powered field Question 30 A 26 year old female presents with elbow pain that is described as aching and burning. There is point tenderness along the lateral aspect of the elbow and painful passive flexion and extension. She reports she has been playing tennis almost daily for the past month. The most likely diagnosis is:
erythematous tender left great toe. The likely precipitant of this patient's pain is: - Correct Answer-Trauma Tight shoes Arthritis flare Hydrochlorothiazide Question 33 Which of the following is a contraindication for metformin therapy? - Correct Answer-Insulin therapy Creatinine > 1. Edema None of the above Question 34 A positive drawer sign supports a diagnosis of: - Correct Answer-Sciatica Cruciate ligament injury Meniscal injury Patellar ligament injury Question 35 Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid? - Correct Answer- Apples Peppermint Cucumbers Popsicles Question 36 A patient taking levothyroxine is being over-replaced. What condition is he at risk for? - Correct Answer-Osteoporosis
Constipation Depression Exopthalmia Question 37 Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following: - Correct Answer-HbA1C 2 - hour 75 gram oral glucose tolerance test C-peptide level A and B All of the above Question 38 Dave, age 38, states that he thinks he has an ear infection because he just flew back from a business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next action? - Correct Answer- Prescribe systemic antibiotics Prescribe antibiotic ear drops Prescribe nasal steroids and oral decongestants Refer him to an ear, nose, and throat specialist Question 39 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? - Correct Answer-Maintain moderate bed rest for 3-4 days Call the office for narcotics if there is no relief with the NSAID in 24- 48 hours Begin lower back strengthening exercises depending on pain tolerance Wear a Boston brace at night Question 40
Risk factors for Addison's disease include which of the following? - Correct Answer-Tuberculosis Autoimmune disease AIDS All of the above Question 41 Urine cultures should be obtained for which of the following patients? - Correct Answer-Suspected urinary tract infection in pregnancy Febrile patients Young men All of the above Question 42 Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond? - Correct Answer-"Caffeine has not effect on osteoporosis." "A high caffeine intake has a diuretic effect that may cause calcium to be excreted more rapidly." "Caffeine affects bone metabolism by altering intestinal absorption of calcium and assimilation of calcium into the bone matrix." "Caffeine increase bone resorption." Question 43 The diagnosis which must be considered in a patient who presents with a severe headache of sudden onset, with neck stiffness and fever, is: - Correct Answer-Migraine headache Subarachnoid hemorrhage Glaucoma Meningitis
Question 44 What conditions must be met for you to bill "incident to" the physician, receiving 100% reimbursement from Medicare? - Correct Answer-You must initiate the plan of care for the patient The physician must be on-site and engaged in patient care You must be employed as an independent contractor You must be the main health care provider who sees the patient Question 45 The most commonly recommended method for prostate cancer screening in a 55 year old male is: - Correct Answer-Digital rectal examination (DRE) plus prostate specific antigen (PSA) Prostate specific antigen (PSA) alone Transrectal ultrasound (TRUS) alone Prostate specific antigen (PSA) and transrectal ultrasound (TRUS) Question 46 The primary goals of treatment for patients with alcohol abuse disorder are:
Collateral ligament Question 48 Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? - Correct Answer-Musculoskeletal pain Difficulty sleeping Depression Fatigue Question 49 Differential diagnosis of proteinuria includes which of the following? - Correct Answer-Orthostatic proteinuria Nephrotic syndrome Infection Trauma A and B Question 50 A patient presenting for an annual physical exam has a BMI of 25 kg/m This patient would be classified as: - Correct Answer-Underweight Normal weight Overweight Obese Question 51 Reed-Sternberg B lymphocytes are associated with which of the following disorders: - Correct Answer-Aplastic anemia Hodgkin's lymphoma Non Hodgkin's lymphoma Myelodysplastic syndromes
Question 53 A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects: - Correct Answer-Arthritis Ulnar neuritis Septic arthritis Olecranon bursitis Question 54 Establishment of a definitive diagnosis of osteomyelitis requires: - Correct Answer-A known causative injury such as a puncture wound, bite, or decubitus ulcer. Biopsy of culture of the pathogen from blood or bone aspirate. Visualization of purulent material draining into soft tissue. Lucent areas identified on plain x-ray. Question 55 The most accurate measure of diabetes control is: - Correct Answer- Avoidance of micro- and macro-vascular complications. Insulin sensitivity. Early morning glucose levels. HgbA1c Question 56 A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder? - Correct Answer-Alprazolam or diazepam Venlafaxine or buspirone
Trazodone or sertraline Venlafaxine or hydroxyzine pamoate Question 57 The most common presentation of thyroid cancer is: - Correct Answer- Generalized enlargement of the thyroid gland. A solitary thyroid nodule. A multinodular goiter. Abnormal thyroid function tests. Question 58 Which of the following accounts for half of the bladder tumors among men and one-third in women? - Correct Answer-Cigarette smoke, both active and passive inhalation Chemicals from plastic and rubber Chronic use of phenacetin-containing analgesic agents Working long hours and not voiding often Question 59 You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of: - Correct Answer-Sjogren's syndrome Pancreatic cancer Disseminated malignancy of the hematologic system Cancer of the liver Question 60 Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to: - Correct Answer-Refer her to a hand surgeon Take a more complete history Try neutral position wrist splinting and oral NSAID
Order a nerve conduction study such as am electromyography Question 61 Which drug category contains the drugs that are the first line Gold standard therapy for COPD? - Correct Answer-Corticosteroids Inhaled beta-2 agonist bronchodilators Inhaled anticholinergic bronchodilators Xanthines Question 62 Potential causes of septic arthritis include which of the following? - Correct Answer-Lyme disease Prosthetic joint infection Reiter's syndrome A and B All of the above Question 63 The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is: - Correct Answer-Oral ciprofloxacin (Cipro) Oral doxycycline (Virbamycin) plus intramuscular ceftriaxone Oral trimethoprim-sulfamethoxazole (Bactrim DS) Intramuscular penicillin Question 64 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? - Correct Answer-Advise the patient to stop the antidepressant medication
Question the patient to determine if the self-assessment is correct before advising her to discontinue the medication Recommend that the patient continue the antidepressant medication for at least 4 more months Discuss with the patient the need to take the antidepressant medication indefinitely Question 65 Your patient has an elevated mean cell volume (MCV). What should you be considering in terms of diagnosis? - Correct Answer-Iron-deficiency anemia Hemolytic anemia Lead poisoning Liver disease Question 66 Which of the following medications increase the risk for metabolic syndrome? - Correct Answer-Antihistamines Proton pump inhibitors Protease inhibitors A and C All of the above Question 67 The hallmark of neurofibromatosis (von Recklinghausen's disease) present in almost 100% of patients is - Correct Answer-Acoustic neuroma Astrocytoma of the retina Distinctive osseous lesions Café au lait spots Question 68
The most commonly recommended pharmacological treatment regimen for low back pain (LBP) is: - Correct Answer-Acetaminophen or an NSAID A muscle relaxant as an adjunct to an NSAID An oral corticosteroid and diazepam (Valium) Colchicine and an opioid analgesic Question 69 Legal authority for advanced practice nursing rests with: - Correct Answer- The Health Care Financing Administration Federal statutes State laws and regulations Certifying bodies Question 70 Which of the following physical modalities recommended for treatment of rheumatoid arthritis provides the most effective long term pain relief? - Correct Answer-Superficial and deep heat Application of cold Transcutaneous electrical nerve stimulation (TENS) Exercise Question 71 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? - Correct Answer-Obtain a thorough history and physical, and check serum cortisol and ACTH levels. Obtain a diet history and check CBC and FBS. Provide nutritional guidance and have the patient return in 1 month.
Consult home health for intravenous administration of fluids and electrolytes. Question 72 Jack, age 55, comes to the office with a blood pressure of 144/98 mm Hg. He states that he did not know if it was ever elevated before. When you retake his blood pressure at the end of the exam, it remains at 144/98. What should your next action be? - Correct Answer-Start him on an ACE Inhibitor Start him on a diuretic Have him monitor his blood pressure at home Try nonpharmacological methods and have him monitor his blood pressure at home 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: - Correct Answer-Parkinson's disease Epilepsy Multiple sclerosis Diabetes mellitus Question 74 Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus? - Correct Answer- Hypertriglyceridemia and low high-density lipoprotein (HDL) Gestational diabetes and polycystic ovarian syndrome Hispanic, African-American, Native-American, and Pacific Islander ethnicity Postprandial hypoglycemia Question 75
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: - Correct Answer-The patient should start anticoagulant therapy immediately. Hereditary thrombophilia does not always require anticoagulation therapy. Women of childbearing age cannot take anticoagulant therapy. Genetic and risk management counseling are recommended. B and D Question 76 The 4 classic features of Parkinson's disease are - Correct Answer-Mask- like facies, dysarthria, excessive salivation, and dementia. Tremor at rest, rigidity, bradykinesia, and postural disturbances. Depression, cognitive impairment, constipation and shuffling gait. Tremor with movement, cogwheeling, repetitive movement, and multi- system atrophy. Question 77 Which of the following set of symptoms should raise suspicion of a brain tumor? - Correct Answer-Recurrent, severe headaches that awaken the patient and are accompanied by visual disturbances. Vague, dull headaches that are accompanied by a reported sense of impending doom. Periorbital headaches occurring primarily in the evening and accompanied by pupillary dilation and photophobia. Holocranial headaches present in the morning and accompanied by projective vomiting without nausea.
Question 78 The most common cause of elevated liver function tests is: - Correct Answer-Hepatitis Biliary tract obstruction Chronic alcohol abuse A drug-induced injury Question 79 The physiological explanation of syncope is: - Correct Answer-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. Question 80 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? - Correct Answer-Thiazide diuretic Insulin Famotidine (Pepcid) Albuterol Question 81 The cardinal sign of infectious arthritis is: - Correct Answer-Affected joint is painful at rest, with movement and weight bearing Rapid onset that wakes the patient during the night Long history of severe pain with associated joint swelling None of the above
Question 82 A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains: - Correct Answer-Primary hyperparathyroidism is treated with Vitamin D restriction Primary hyperparathyroidism is treated with parathyroidectomy Primary hyperparathyroidism is treated with daily magnesium Primary hyperparathyroidism is treated with parenteral parathyroid hormone (PTH) Question 83 Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis? - Correct Answer-Doxycycline 100 mg qd Nitrofurantoin 100 mg qd Bactrim DS qd Erythromycin qd Question 84 Who is at a higher risk for developing nephrolithiasis? - Correct Answer- Jack, who exercises every day and drinks copious amounts of water Mary, who watches her weight and eats a low-sodium diet Harvey, a "couch potato" who drinks a lot of no-sodium soda Bill, who runs every day and takes excessive amounts of vitamin C Question 85 Potential side effects of levofloxacin include which of the following? - Correct Answer-Confusion Hypoglycemia Achilles tendon rupture All of the above
Question 86 A patient has just been diagnosed with Bell's palsy. He is understandably upset and has questions about the prognosis. You response should be: - Correct Answer-Although most of your symptoms will disappear, some will remain but can usually be camouflaged by altering your hairstyle or growing a beard Unfortunately there is no cure but you have a mild case The condition is self-limiting and most likely complete recovery will occur With suppressive drug therapy you can minimize the symptoms Question 87 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? - Correct Answer-Change to a different class of antihypertensive medication to get better control. Increase the dosage of the current BP medication. Continue the current medication and dosage for 4 more weeks. Add a beta-blocker to the current medication regimen. What diabetic complications result from hyperglycemia?
Question 89 Diagnostic confirmation of acute leukemia is based on: - Correct Answer- Bone marrow aspiration and biopsy Pancytopenia Hyperuricemia All of the above Question 90 The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy: - Correct Answer-A dipstick strip done during routine urinalysis in the office A 24-hour urine collection An early morning spot urine collection A serum albumin test Question 91 Which of the following antibiotics should not be prescribed for a pregnant woman in the 3rd trimester? - Correct Answer-Trimethoprim- sulfamethoxazole Erythromycin Cefuroxime Levofloxacin Question 92 Martin, a 58 year old male with diabetes, is at your office for his diabetes follow 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? - Correct Answer-Wash your feet with cold water daily
See a podiatrist every 2 years, inspect your own feet monthly, and apply lotion to your feet daily Go to a spa and have a pedicure monthly See a podiatrist yearly; wash your feet daily with warm soapy water and towel dry between the toes; inspect your feet daily for lesions; apply lotion to dry areas Question 93 The intervention known to be most effective in the treatment of severe depression, with or without psychosis, is: - Correct Answer-Psychotherapy Electroconvulsive therapy (ECT) A selective serotonin reuptake inhibitor (SSRI) A tricyclic antidepressant (TCA) Question 94 The initial clinical sign of Dupuytren's contracture is: - Correct Answer-Pain with ulnar deviation Painless nodule on palmer fascia Pain and numbness in the ring finger Inability to passively extend finger Question 95 Which of the following is the most common complication of the myelodysplastic syndromes - Correct Answer-Fatigue Cardiomyopathy Falls Bleeding