NURS- 6531N-8,Adv. Practice Care of Adults Summer Qtr, Exams of Nursing

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

2018 Summer Qtr 05/29-08/19-PT27 mi

Midterm and

final exams

• 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?

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

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

• 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

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

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- 2 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

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

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

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

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 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

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

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

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

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?

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

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

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

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

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

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?

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

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

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

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

• 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 A, B, and C

• Question 56

1 out of 1 points

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

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