NURS-6531N-8, Advanced. Practice Care of Adults Questions with answers, Exams of Nursing

Download NURS-6531N-8, Advanced. Practice Care of Adults Questions with answers and more Exams Nursing in PDF only on Docsity! NURS-6531N-8, Advanced. Practice Care of Adults Questions with answers 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: Y e 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: Anticholiner g ics Answers: Xanthines Antihistimin e s Steroids Anticholiner g 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 Answer s: Overweight, cyanosis, and normal or slightly increased respiratory rate Underweight, pink skin, and increased respiratory rate • 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 erythematos us 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 insufficienc y Answers: Congestive heart failure Varicose veins Deep vein thrombos is Arterial insufficiency • Question 17 Which statement below is correct about pertussis? Selected 1 out of 1 points Answer: It is also called whooping cough Answer s: 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 Answer s: Pneum o nia Asthm a Sinusiti s 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: Diverticul it is Answers: Diverticul o sis Diverticula 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 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 regurgitatio n 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 Answer s: 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 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: Scal p Nail s 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 Answer s: Topical steroid use Topical antibiotic use A recent laceratio n 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: Antihista mi nes Answers: Aspiri 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 Nocturn al 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: Doxycyclin e (Vibramyci n) Answers: Erythromycin Clarithromyc in (Biaxin) Doxycyclin e (Vibramyci n) 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: Powd e rs Answer s: Powd e rs Gels Crea m s Selected Answer: Ursodiol Answer s: Ursodiol Ibuprofe n 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 Cr a m pi ng an d ab do mi na l pa in 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 R e s t a n d a l o w s o d i u m d i e t • 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 detachme nt Answers: Cataract s Glaucom a Retinal detachmen t Iritis • Question 57 In order to decrease deaths from lung cancer: 1 out of 1 points An active 65-year-old man under your care has known acquired valvular aortic stenosis and mitral regurgitation. He also has a history of infectious endocarditis. He has recently been told he needs elective replacement of his aortic valve. When he comes into the office you discover that he has 10 remaining teeth in poor repair. Your recommendation would be to: Selected Answer: coordinate with his cardiac and oral surgeons to have the tooth extractions and valve replacement done at the same time to reduce the risk of anesthetic complications. Answers: defer any further dental work until his valve replacement is completed instruct him to have dental extraction done cautiously, having no more than 2 teeth per visit removed. suggest he consult with his oral surgeon about having all the teeth removed at once and receiving appropriate antibiotic prophylaxis coordinate with his cardiac and oral surgeons to have the tooth extractions and valve replacement done at the same time to reduce the risk of anesthetic complications. • Question 63 Appropriate therapy for peptic ulcer disease (PUD) is: Selected Answer: Dependent on cessation of NSAID use Answers: Primarily by eradication of infection Based on etiology Aimed at diminishing prostaglandin synthesis Dependent on cessation of NSAID use • Question 64 0 out of 1 points 1 out of 1 points Shirley, age 58, has been a diabetic for 7 years. Her blood pressure is normal. Other than her diabetes medications, what would you prescribe today during her routine office visit? Selected Answer: An ACE Inhibitor Answers: A calcium channel blocker A beta blocker An ACE Inhibitor No hypertension medication • Question 65 1 out of 1 points Medicare is a federal program administered by the Centers for Medicare and Medicaid Services (CMS). The CMS has developed guidelines for Evaluation and Management coding, which all providers are expected to follow when coding patient visits for reimbursement. Which of the following is an important consideration regarding billing practices? Selected Answer: Failing to bill for billable services will lead to unnecessarily low revenues Answers: It is important to “undercode” so that one does not get charged with Medicare fraud The practice of “overcoding” is essential in this age of decreasing reimbursements Failing to bill for billable services will lead to unnecessarily low revenues Time spent with the patient is a very important determinant of billing • Question 66 1 out of 1 points A 2 year old presents with a white pupillary reflex. What is the most likely cause of this finding? Selected Answer: Retinoblasto m a Answers: Viral conjunctiviti s Glaucoma Cornea l abrasio n Retinoblasto m a • Question 67 0 out of 1 points Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo? Selected Answer: A labyrinthectomy Answers: Pharmacological therapy A labyrinthectomy A vestibular neurectomy Wearing an earplug in the ear with the most hearing loss • Question 68 Which of the following is not a risk factor for coronary arterial insufficiency? Selected Answer: Hyperhomocyste in emia Answers: Hyperhomocyste in emia Smoking Genetic factors 0 out of 1 points Alcohol ingestion • Que Answer s: Group A Streptococcus Staphlococcus areus Β-hemolytic Streptococcus Streptococcu s pyogenes • Question 72 0 out of 1 points A 60 year old male diabetic patient presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which “is better.” His temperature is 100°F and pulse is 102 bpm. The most appropriate initial action is to: Selected Answer: Start an oral antibiotic, mouth swishes with an oral anti- infective, and an analgesic Answers: Start an oral antibiotic, refer the patient to a dentist immediately, and follow up within 3 days Order mandibular x-rays and question the patient about physical abuse Start an oral antibiotic, mouth swishes with an oral anti- infective, and an analgesic Initiate a parenteral antibiotic and consider hospital admission • Question 73 1 out of 1 points If a patient presents with a deep aching, red eye and there is no discharge, you should suspect: Selected Answer: Iritis Answer s: Iritis Allergic conjunctiviti s Viral conjunctivitis Bacterial conjunctiviti s • Question 74 1 out of 1 points The National Cholesterol Education Program’s Adult Treatment Panel III recommends that the goal for low density lipoproteins in high risk patients be less than: Selected Answer: 100 mg/dL Answers: 160 mg/dL 130 mg/dL 100 mg/dL 70 mg/dL • Question 75 1 out of 1 points A patient presents with classic symptoms of gastroesophageal reflux disease (GERD). He is instructed on life style modifications and drug therapy for 8 weeks. Three months later he returns, reporting that he was “fine” as long as he took the medication. The most appropriate next step is: Selected Answer: Investigation with endoscopy, manometry, and/or pH testing Answers: Referral for surgical intervention such as a partial or complete fundoplication Dependent upon how sever the practitioner believes the condition To repeat the 8 week course of drug therapy while continuing lifestyle modifications Investigation with endoscopy, manometry, and/or pH testing • Question 76 0 out of 1 points Group A β-hemolytic streptococcal (GABHS) pharyngitis is most common in which age group? Selected Answer: Under 3 years of age Answers: Under 3 years of age Prescho ol children 6 to 12 years of age Adolescents • Question 77 The most appropriate treatment for a child with mild croup is: Selected Answer: A decongestant Answers: A bronchodilator An antibiotic A decongestant 0 out of 1 points A cool mist vaporizer • Question 78 0 out of 1 points A child complains that his “throat hurts” with swallowing. His voice is very “throaty” and he is hyperextending his neck to talk. Examination reveals Stool softeners Laxatives Osmotic agents • Question 81 1 out of 1 points A 40 year old presents with a hordeolum. The nurse practitioner teaches the patient to: Selected Answer: Apply a topical antibiotic and warm compresses. Answer s: Apply a topical antibiotic and warm compresses. Apply cool compresses and avoid touching the hordeolum. Use an oral antibiotic and eye flushes. Apply light palpation to facilitate drainage. • Question 82 1 out of 1 points Sarah has allergic rhinitis and is currently being bothered by nasal congestion. Which of the following meds ordered for allergic rhinitis would be most appropriate? Selected Answer: A decongestant nasal spray Answers: An antihistamine intranasal spray A decongestant nasal spray Ipratropium Omalizuma b • Question 83 What is the Gold standard for the diagnosis of asthma? Selected Answer: Spirometry Answers: Patient’s perception of clogged airways Validated quality-of-life questionnaires Bronchoscopy 1 out of 1 points Spirometry • Question 84 0 out of 1 points A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough? Selected Answer: Methyldopa Answers: Methyldopa Enalapril Amlodipin e Hydrochloroth ia zide • Question 85 1 out of 1 points Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by: Selected Answer: Candidiasis Answers: A p t e r y g i u m • Question 88 0 out of 1 points What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare? Selected Answer: You must initiate the plan of care for the patient Answers: 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 89 Of the following choices, the least likely cause of cough is: Selected Answer: Acute pharyngitis Answers: Asthma Gastroesophageal reflux 1 out of 1 points Acute pharyngitis Allergic rhinitis • Question 90 1 out of 1 points The most common correlate(s) with chronic bronchitis and emphysema is(are): Selected Answer: Cigarette smoking Answers: Familial and genetic factors Cigarette smoking Air pollution Occupation al environmen t • Question 91 0 out of 1 points Which choice below is least effective for alleviating symptoms of the common cold? Selected Answer: Topical decongestan ts Answer s: Antihistamines Oral decongestants Topical decongestants Antipyretics • Question 92 0 out of 1 points When teaching a patient with hypertension about restricting sodium, you would include which of the following instructions? Selected Answer: Diets with markedly reduced intakes of sodium may be associated with other beneficial effects beyond blood pressure control Answers: Diets with markedly reduced intakes of sodium may be associated with other beneficial effects beyond blood pressure control Sodium restriction can cause serious adverse effects A goal of 3 g of sodium chloride or 1.2 g of sodium per day is easily achievable Seventy-five of sodium intake is derived from processed foods • Question 93 Selected a Answer: Inferio r wall Answer s: Inferior wall Anterior wall Apical wall Lateral wall • Question 96 0 out of 1 points The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The least likely diagnosis for this patient is: Selected Answer: Otitis media with effusion Answer s: Acute otitis media (AOM) Otitis media with effusion Mucoid otitis media Serous otitis media • Question 97 0 out of 1 points Alan, age 54, notices a bulge in his midline every time he rises from bed in the morning. You tell him it is a ventral hernia, also known as: Selected Answer: incision al hernia Answers: inguin al hernia 9