NURS-6531D-1-NURS-6531N-1-Adv. Practice Care of Adults2018 Fall Quarter 08/27-11/18-PT27., Exams of Nursing

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NURS- 6531 D- 1 - NURS- 6531 N- 1 -

Adv. Practice Care of Adults

Fall Quarter 08/27-11/18-PT27.

• 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

lack of insulin. Common symptoms include increased thirst, frequent

urination, and unexplained weight loss.

- Question (^11) 1 out of 1

points

A patient has been diagnosed with hypothyroidism and thyroid hormone replacement therapy is prescribed. How long should the nurse practitioner

wait before checking the patient’s TSH? Six to 8 weeks

- Question (^12) 0 out of 1

points

A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety

disorder? Treatment may include counseling and medications, such as

antidepressants. Selective Serotonin Reuptake Inhibitor (SSRI),

Anxiolytic, and Antidepressant

Paxil Effexor Lexapro and cymbalta

- Question (^13) 0 out of 1

points

What is the most common cause of Cushing’s syndrome? Pituitary-

dependent/ACTH- dependent (Cushing's disease), one is a pituitary form, which results

from excessive production of ACTH by a tumor of the pituitary gland,

- Question 14 Which of the following is the most cause of low back pain?

Lumbar disc disease

- Question 15

1 out of 1

points

1 out of 1

points

Warfarin (Coumadin) is prescribed for a frail, elderly male with new onset atrial fibrillation. The goal INR for this patient should be: 2.0 to 3.

- Question (^16) 1 out of 1

points

A 72 year old patient exhibits sudden onset of fluctuating restlessness, agitation, confusion, and impaired attention. This is accompanied by visual hallucinations and sleep disturbance. What is the most likely cause of this behavior? delirium

- 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

fibromyalgia

- Question (^23) 1 out of 1

points

Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within normal limits. Which of the following diagnoses do you explore further?

herniated nucleus pulposus.

- Question 24

0 out of 1

points

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?

avoid chocolate, alcohol, carbonated drinks, peppermint, coffee, citrus, onion, and garlic.

And weight loss

- Question (^25) 1 out of 1

points

The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is:

Rest the affected part of the body

• Once pain free, the person can gradually begin the sporting activity again
• Air splinting can reduce pain and decrease the time until return to full participation or

intensity of exercise.

• NSAIDs to reduce pain and inflammation - Question (^26) 0 out of 1

points

Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus?

Post-prandial hypoglycemia

- Question 27

1 out of 1

points

A thymectomy is usually recommended in the early treatment of which disease?

Thymectomy is an important treatment option for Myasthenia Gravis

- 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.

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

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

• Question

(^38) 0 out of 1

points

Microalbuminuria is a measure of: endothelial dysfunction, dm neuropathy, diabetic

kidney disease and end organ damage r/t htn

- Question (^39) 0 out of 1

points

Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect?

External otitis

- Question 40

1 out of 1

points

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:

: cipro or Levaquin fluoroquinolones 10 to 14 days

trimethoprim sulfamethoxazole for 14 days

UTI in males should be treated with fluoroquinolones for 10 to 14 days. Acute bacterial prostatitis requires 2 weeks of oral antibiotic treatment with trimethoprim- sulfamethoxazole (TMP-SMX) or fluoroquinolones. Chronic bacterial prostatitis may require 4 to 6 weeks of treatment.

- Question 41

0 out of 1

points

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

10 WBC/ HP

Pyuria (neutrophils in the urine)

Bacteriuria

Hematuria

Positive leukocyte esterase and/or nitrite dipstick

(Leukocyte esterase = indicates presence of WBCs; suggests bacterial cause)

(Positive nitrite = indicates gram - organism)

Urine culture indicated in symtpoms and negative urinalysis

- Question 42

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

cortisol, to test ACTH levels, and to order an ACTH stimulation test with

cosyntropin.Primary adrenocortical insufficiency work up for

- Question (^47) 0 out of 1

points

Other than smoking cessation, which of the following slows the progression of

COPD in smokers? Engaging in moderate-to-high levels of physical activity

- Question 48

1 out of 1

points

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: Primary hyperparathyroidism is treated with

parathyroidectomy

- Question (^49) 0 out of 1

points

The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in almost 100% of patients is:

- Question (^50) 0 out of 1

points

A patient has HIV infection and is having a problem with massive diarrhea.

You suspect the cause is:. Cryptosporidiosis

• When patients with HIV infection have massive diarrhea, a

protozoa of the cryptosporidium genus is the most likely cause.

- Question (^51) 0 out of 1

points

How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout?

Exercising for at least 20 minutes 3 or more days per week.

Café au lait spots

- Question 52

1 out of 1

points

The treatment of choice for chronic bacterial prostatitis (CBP) is: Fluoroquinolones

(Ciprofloxacin, levofloxacin, others)- antibiotics of choice

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

points

Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following:

A HbA1C

.

B. 2-hour 75 gram oral glucose tolerance test

C. C-peptide level

D A and B

.

E. All of the above

- Question 64

0 out of 1

points

Prolonged PT suggests: Liver disease, DIC (early)Warfarin, Factor VII deficiency

- Question 65

0 out of 1

points

Diagnostic confirmation of acute leukemia is based on: Bone marrow aspiration

and biopsy

- Question 66

0 out of 1

points

Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis?

- Question (^67) 0 out of 1

points

The most effective treatment of non-infectious bursitis includes: Need options

rest, cold and heat treatments, elevation, administration of nonsteroidal anti-

inflammatory drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections

(with or without local anesthetic agents).

- Question 68 Differential diagnosis of proteinuria includes which of the following?

Differential

diagnosis of

proteinuria

includes which of the following?

A. Orthostatic proteinuria

0 out of 1

points