NURS-6531N-8,Adv. Practice Care of Adults.2018 SummerQtr 05/29- 08/19-PT27 Test Midterm Ex, Exams of Nursing

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08/19-PT

Test Midterm Exam

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Course NURS-6531N-8,Adv. Practice Care of Adults.2018 Summer

Qtr 05/29-08/19-PT

Test Midterm Exam

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Score

0 out of 100 points

Time Elapsed 1 hour, 53 minutes out of 1 hour and 50 minutes

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All Answers, Submitted Answers, Correct Answers

• 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?

Selected Answer:

Ye s

Answers:

Ye s

No

• Question 2

The most common cancer found on the auricle is:

Selected

Answer: Basal cell carcinoma

Answers: Actinic keratosis

Basal cell carcinoma

Squamous cell carcinoma

Acral-lentiginous melanoma

• Question 3

1 out of 1 points

0 out of 1 points

Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?

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Selected

Answer: Anticholinerg

ics

Answers: Xanthines

Antihistimine s

Steroids

Anticholinerg ics

• Question 4

0 out of 1 points

A 47 year old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On examination, external hemorrhoids are noted. How should the nurse practitioner proceed?

Selected

Answer: Instruct the patient on measures to prevent hemorrhoids such as

bowel habits and diet.

Answers: Instruct the patient on measures to prevent hemorrhoids such as

bowel habits and diet.

Order a topical hemorrhoid cream along with a stool softener.

Refer the patient for a barium enema and sigmoidoscopy.

Refer the patient for a surgical hemorrhoidectomy.

• Question 5

0 out of 1 points

Which of the following patient characteristics are associated with chronic bronchitis?

Selected

Answer: Underweight, pink skin, and increased respiratory rate

Answers:

Overweight, cyanosis, and normal or slightly increased respiratory rate

Underweight, pink skin, and increased respiratory rate

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Overweight, pink skin, and normal or slightly increased respiratory rate

Normal weight, cyanosis, and greatly increased respiratory rate

• Question 6

1 out of 1 points

A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent care with new onset left lower quadrant pain. Her current medications include omeprazole 20 milligrams po daily, lisinopril 20 milligrams po daily, simvastatin 20 milligrams po daily, and prednisone 12 milligrams po daily. The nurse practitioner suspects acute diverticulitis and possibly an abscess. The most appropriate diagnostic test for this patient at this time is:

Selected

Answer: CT scan

Answers: CBC/diff

Erythrocyte sedimentation rate

Abdominal ultrasound

CT scan

• Question 7

1 out of 1 points

A patient reports “something flew in my eye” about an hour ago while he was splitting logs. If there were a foreign body in his eye, the nurse practitioner would expect to find all except:

Selected

Answer: Purulent drainage

Answers:

Purulent drainage

Tearing

Photophobia

A positive fluorescein stain

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• Question 8

1 out of 1 points

A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect:

Selected

Answer: Gonococcal

conjunctivitis

Answers: Viral conjunctivitis

Common pink eye

Gonococcal conjunctivitis

Allergic conjunctivitis

• Question 9

0 out of 1 points

A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 different thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect:

Selected

Answer: A complicated case of shingles and prescribe acyclovir, an analgesic,

and a topical cortisone cream

Answers: A common case of shingles and prescribe an analgesic and an antiviral

agent

A complicated case of shingles and prescribe acyclovir, an analgesic, and a topical cortisone cream

Herpes zoster and consider that this patient may be immunocompromised

A recurrence of chickenpox and treat the patient’s symptoms

• Question 10

0 out of 1 points

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Which type of lung cancer has the poorest prognosis?

Selected

Answer: Adenocarcinoma

Answers: Adenocarcinoma

Epidermoid carcinoma

Small cell carcinoma

Large cell carcinoma

• Question 11

1 out of 1 points

An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3– 4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has:

Selected

Answer: Chronic diarrhea

Answers: Acute diarrhea

Chronic diarrhea

Irritable bowel

Functional bowel disease

• Question 12

1 out of 1 points

Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect?

Selected

Answer: Systemic lupus

erythematosus

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Answers: An allergic reaction

Relapsing polychondritis

Lymphocytoma cutis

Systemic lupus erythematosus

• Question 13

1 out of 1 points

Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes?

Selected

Answer: Acute bronchitis

Answers: Chronic sinusitis

Acute bronchitis

Bacterial pneumonia

Acute exacerbation of chronic bronchitis

• Question 14

0 out of 1 points

Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta- agonist daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in?

Selected

Answer: Mild persistent

Answers: Mild

intermittent

Mild persistent

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Moderate persistent

• Question 15

0 out of 1 points

Which of the following is the most appropriate therapeutic regimen for an adult patient with no known allergies diagnosed with group A B-hemolytic strep?

Selected

Answer: None of the above

Answers:

Penicillin V 500 milligrams PO every 8 hours for 10 days

Ampicillin 250 milligrams PO twice a day for 10 days

Clarithromycin 500 milligrams po daily for 7 days

None of the above

• Question 16

0 out of 1 points

A cashier complains of dull ache and pressure sensation in her lower legs. It is relieved by leg elevation. She occasionally has edema in her lower legs at the end of the day. What is the most likely cause of these problems?

Selected

Answer: Arterial

insufficiency

Answers: Congestive heart

failure

Varicose veins

Deep vein thrombosis

Arterial insufficiency

• Question 17

Which statement below is correct about pertussis?

Selected

1 out of 1 points

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Answer: It is also called whooping cough

Answers:

It is also called whooping cough

It begins with symptoms like strep throat

It lasts about 3 weeks

It occurs most commonly in toddlers and young children

• Question 18

0 out of 1 points

Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis?

Selected

Answer: Asthma

Answers:

Pneumo nia

Asthma

Sinusitis

Pertussis

• Question 19

1 out of 1 points

A 70 year old patient presents with left lower quadrant (LLQ) abdominal pain, a markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition?

Selected

Answer: Diverticulit

is

Answers: Diverticulo

sis

Diverticula

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Diverticulit is

Diverticulu m

• Question 20

1 out of 1 points

Sylvia, age 83, presents with a 3 day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect?

Selected

Answer: Herpes

zoster

Answers: Varicella

Herpes zoster

Syphilis

Rubella

• Question 21

0 out of 1 points

A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is:

Selected

Answer: Medicatio

ns

Answers: Alcohol

Gallstone s

Medicatio ns

Pregnanc y

• Question 22

1 out of 1 points

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When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action?

Selected

Answer: Order an abdominal ultrasound

Answers: Order abdominal x-rays

Order an abdominal ultrasound

Refer the patient to a surgeon for evaluation

Prescribe pain medication

• Question 23

A false-positive result with the fecal occult blood test can result from:

Selected

Answer: stool that has been stored

before testing

Answers: ingestion of large amounts of

vitamin C

0 out of 1 points

a high dietary intake of rare cooked beef

a colonic neoplasm that is not bleeding

stool that has been stored before testing

• Question 24

0 out of 1 points

A 76-year-old male complains of weight loss, nausea, vomiting, abdominal cramping and pain. Physical findings include an abdominal mass and stool positive for occult blood. The nurse practitioner pain suspects a tumor in the small intestine. The best diagnostic test for this patient is:

Selected

Answer: Colonoscopy

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Answers: Colonoscopy

Small bowel follow- through

Barium enema

CT abdomen

• Question 25

1 out of 1 points

A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with:

Selected

Answer: Systolic heart

failure

Answers: Mitral

regurgitation

Systolic heart failure

Cardiac myxoma

Diastolic heart failure

• Question 26

1 out of 1 points

Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized?

Selected

Answer: Multilobar involvement on chest x-ray with the inability to take oral

medications

Answers:

Multilobar involvement on chest x-ray with the inability to take oral medications

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Alert and oriented, slightly high but stable vital signs, and no one to take care of her at home

Sputum and gram positive organisms

A complete blood count showing leukocytosis

• Question 27

0 out of 1 points

A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him:

Selected

Answer: “It^ is the most common cause of death in patients with skin

cancer.”

Answers: “It^ is the most common cause of death in patients with skin

cancer.”

“It can be cured with surgical excision or radiation therapy.”

“It is a slow growing skin cancer that rarely undergoes malignant changes.”

“It can be cured using 5-flurouracil cream twice daily for 2 to 4 weeks.”

• Question 28

1 out of 1 points

Expected spirometry readings when the patient has chronic emphysema include:

Selected

Answer: Increased total lung capacity (TLC)

Answers: Decreased residual volume (RV)

Increased vital capacity (VC)

Increased forced expiratory volume (FEV-1)

Increased total lung capacity (TLC)

• Question 29

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1 out of 1 points

An 80-year-old male admits to difficulty swallowing during the review of systems. The nurse practitioner recognizes the differential diagnosis for this patient’s dysphagia is:

Selected

Answer: A and C

Answers: Esophageal

cancer

Chest pain

GERD

A and C

All of the above

• Question 30

0 out of 1 points

A 40 year old female with history of frequent sun exposure presents with a multicolored lesion on her back. It has irregular borders and is about 11mm in diameter. What should the nurse practitioner suspect?

Selected

Answer: Basal cell

carcinoma

Answers: Squamous cell

carcinoma

Malignant melanoma

A common nevus

Basal cell carcinoma

• Question 31

1 out of 1 points

Which of the following is not a goal of treatment for the patient with cystic fibrosis?

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Selected

Answer: Replace water-soluble

vitamins

Answers: Prevent intestinal

obstruction

Provide adequate nutrition

Promote clearance of secretions

Replace water-soluble vitamins

• Question 32

1 out of 1 points

The nurse practitioner is performing a physical exam on a middle-aged African-American man. Which of the following areas is a common site for melanomas in African-Americans and other dark-skinned individuals?

Selected

Answer: B and C

Answers: Scalp

Nails

Feet

B and C

All of the above

• Question 33

1 out of 1 points

An adult presents with tinea corporis. Which item below is a risk factor for its development?

Selected

Answer: Topical steroid

use

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Answers:

Topical steroid use

Topical antibiotic use

A recent laceration

Cold climates

• Question 34

0 out of 1 points

A patient has experienced nausea and vomiting, headache, malaise, low grade fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is elevated with a shift to the left. He is requesting medication for diarrhea. What is the most appropriate response?

Selected

Answer: Order stool cultures.

Answers: Prescribe loperamide (Immodium) or atropine-diphenoxylate (Lomotil)

and a clear liquid diet for 24 hours.

Prescribe a broad-spectrum antibiotic such as ciprofloxacin (Cipro), and symptom management.

Offer an anti-emetic medication such as ondansetron (Zofran) and provide oral fluid and electrolyte replacement instruction.

Order stool cultures.

• Question 35

1 out of 1 points

Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order?

Selected

Answer: Antihistami

nes

Answers: Aspirin

NSAIDs

Opioids

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Antihistami nes

• Question 36

0 out of 1 points

Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is:

Selected

Answer: Peripheral

edema

Answers: Peripheral

edema

Weight gain

Shortness of breath

Nocturnal dyspnea

• Question 37

1 out of 1 points

A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe?

Selected

Answer: Amoxicillin

Answers: Ibuprofen

Erythromyci n

Amoxicillin

Acetaminop hen

• Question 38

1 out of 1 points

A 70 year old man who walks 2 miles every day complains of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 2 mile walk. What question asked during the history, if answered affirmatively, would

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suggest a diagnosis of arteriosclerosis obliterans?

Selected

Answer: “Is^ your leg pain relieved by^ rest?”

Answers: “Are^ you wearing your usual^ shoes?”

“Do you also have chest pain when you have leg pain?”

“Is your leg pain relieved by rest?”

“Do you ever have the same pain in the other leg?”

• Question 39

Which of the following statements about malignant melanomas is true?

Selected

Answer: They usually occur in older adult males

Answers: They usually occur in older adult males

The patient has no family history of melanoma

They are common in blacks

The prognosis is directly related to the thickness of the lesion

• Question 40

0 out of 1 points

1 out of 1 points

Sheila, age 78, presents with a chief complaint of waking up during the night coughing. You examine her and find an S3 heart sound, pulmonary crackles that do not clear with coughing, and peripheral edema. What do you suspect?

Selected

Answer: Heart failure

Answers: Asthma

Nocturnal allergies

Valvular

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disease

Heart failure

• Question 41

0 out of 1 points

Which antibiotic would be the most effective in treating community acquired pneumonia (CAP) in a young adult without any comorbid conditions?

Selected

Answer: Doxycycline

(Vibramycin)

Answers: Erythromycin

Clarithromycin (Biaxin)

Doxycycline (Vibramycin)

Penicillin

• Question 42

1 out of 1 points

Which of the following dermatologic vehicles are the most effective in absorbing moisture and decreasing friction?

Selected

Answer: Powde

rs

Answers:

Powde rs

Gels

Cream s

Lotion

• Question 43

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1 out of 1 points

A 70 year old patient presents with a slightly raised, scaly, erythematous patch on her forehead. She admits to having been a “sun worshiper.” The nurse practitioner suspects actinic keratosis. This lesion is a precursor to:

Selected

Answer: Squamous cell

carcinoma

Answers:

Squamous cell carcinoma

Basal cell carcinoma

Malignant melanoma

Acne vulgaris

• Question 44

1 out of 1 points

An elderly patient is being seen in the clinic for complaint of “weak spells” relieved by sitting or lying down. How should the nurse practitioner proceed with the physical examination?

Selected

Answer: Compare the patient’s blood pressure lying first, then sitting,

and then standing.

Answers: Assist the patient to a standing position and take her blood

pressure.

Assess the patient’s cranial nerves.

Compare the patient’s blood pressure lying first, then sitting, and then standing.

Compare the amplitude of the patient’s radial and pedal pulses.

• Question 45

1 out of 1 points

What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery?

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Selected

Answer: Ursodiol

Answers:

Ursodiol

Ibuprofen

Prednisone

Surgery is the only answer

• Question 46

0 out of 1 points

A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is:

Selected

Answer: Staphylococcus aureus

Answers: Staphylococcus aureus

Group A beta hemolytic streptococcus

Haemophilus influenza

Pseudomonas aeruginosa

• Question 47

Which of the following is not a symptom of irritable bowel syndrome?

Selected

Answer: Painful diarrhea

Answers: Painful diarrhea

Painful constipation

Cramping and abdominal pain

0 out of 1 points

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Weight loss

• Question 48

1 out of 1 points

A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed?

Selected

Answer: Any recent trauma

Answers:

Any recent trauma

Difficulty swallowing

Stiffness in the right shoulder

Change in sleeping habits

• Question 49

0 out of 1 points

Marvin, age 56, is a smoker with diabetes. He has just been diagnosed as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis?

Selected

Answer: ACE Inhibitor

Answers: ACE Inhibitor

Beta Blocker

Calcium channel blocker

Diuretic

• Question 50

1 out of 1 points

The differential diagnosis for a patient complaining of a sore throat includes which of the following?

Selected

Answer: A, B, and C

Answers: Gonococcal

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infection

Thrush

Leukoplakia

B only

A, B, and C

• Question 51

0 out of 1 points

A patient presents to the primary care provider complaining of a rash on his right forehead that started yesterday and is burning and painful. The physical exam reveals an erythematous, maculopapular rash that extends over the patient’s right eye to his upper right forehead. Based on the history and examination, the most likely cause of this patient’s symptoms is:

Selected

Answer: Rhus

dermatitis

Answers: Rhus

dermatitis

Ophthalmic zoster

Chemosis

Optic neuritis

• Question 52

0 out of 1 points

Before initiating an HMG CoA-reductase inhibitor for hyperlipidemia, the nurse practitioner orders liver function studies. The patient’s aminotransferase (ALT) is elevated. What laboratory test(s) should be ordered?

Selected

Answer: Serum cholesterol with HDL

and LDL

Answers:

Serologic markers for hepatitis

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Serum bilirubin

Serum cholesterol with HDL and LDL

A liver biopsy

• Question 53

1 out of 1 points

A patient with elevated lipids has been started on lovastatin. After 3 weeks of therapy, he calls to report generalized muscle aches. The nurse practitioner should suspect:

Selected

Answer: Rhabdomyolysis

Answers: A drug interaction

Hepatic dysfunction

Hypersensitivity to lovastatin

Rhabdomyolysis

• Question 54

Treatment of acute vertigo includes:

Selected

Answer: Bedrest and an

antihistamine

1 out of 1 points

Answers:

Bedrest and an antihistamine

Fluids and a decongestant

A sedative and decongestant

Rest and a low sodium diet

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• Question 55

Treatment of H.pylori includes which of the following?

Selected

Answer: A, B, and C

Answers: Proton pump

inhibitor

Antibiotic therapy

Bismuth subsalicylate

A and B

1 out of 1 points

A, B, and C

• Question 56

1 out of 1 points

Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect?

Selected

Answer: Retinal

detachment

Answers: Cataracts

Glaucoma

Retinal detachment

Iritis

• Question 57

In order to decrease deaths from lung cancer:

1 out of 1 points

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Selected

Answer: Patients should be counseled to quit

smoking

Answers: All smokers should be screened annually

All patients should be screened annually

Only high risk patients should be screened routinely

Patients should be counseled to quit smoking

• Question 58

1 out of 1 points

John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia?

Selected

Answer: Every 5 years

Answers:

Every 5 years

Every 2 years

Every year

Whenever blood work is done

• Question 59

1 out of 1 points

Mort is hypertensive. Which of the following factors influenced your choice of using an alpha blocker as the antihypertensive medication?

Selected

Answer: Mort has benign prostatic

hyperplasia

Answers: Mort is black

Mort also has congestive heart failure