Nursing 6531 Final Exam Questions with Answers, Exams of Nursing

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Nursing 6531 Final Exam Questions with Answers

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Question 1

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 2

In the outpatient office setting, the most common reason for a malpractice suit is failure to: Properly refer Diagnose correctly in a timely fashion Obtain informed consent Manage fractures and trauma correctly

Question 3

Reed-Sternberg B lymphocytes are associated with which of the following disorders: Aplastic anemia Hodgkin’s lymphoma Non Hodgkin’s lymphoma Which of the following accounts for half of the bladder tumors among men and one- third in women?

Myelodysplasti c syndromes

Question 4

The initial clinical sign of Dupuytren’s contracture is: Pain with ulnar deviation Painless nodule on palmer fascia Pain and numbness in the ring finger Inability to passively extend finger

Question 5

Musculoskeleta l pain Difficulty sleeping Depression Fatigue

Question 6

Decrease the evening insulin dose and check capillary blood glucose (CBG) at 2:00 am. Instruct the child’s parents on physical activities to help weight loss. Increase the evening insulin dose and check CBG at 2:00 am. Refer the child for instruction on a strict diabetic diet. Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? 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?

Which of the following antibiotics should not be prescribed for a pregnant woman

Question 7

The 4 classic features of Parkinson’s disease are: 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 8

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 9

The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is: Rest from activities which may further stress the bone. Daily passive range of motion exercises. Continuation of the patient’s routine physical activities. Application of ice after activity.

Question 10

What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?

Trimethoprim- sulfamethoxazole Erythromycin

Cefuroxime Levofloxacin

Question 11

Which is the most common cause of end-stage renal disease in the United States? Diabetic nephropathy Chronic renal failure secondary to vascular disorders Acute tubular necrosis Kidney trauma

Question 12

A typical description of a tension headache is: Periorbital pain, sudden onset, often explosive in quality, and associated with nasal stuffiness, lacrimation, red eye, and nausea. Bilateral, occipital, or frontal tightness or fullness, with waves of aching pain. Hemicranial pain that is accompanied by vomiting and photophobia. Steadily worsening pain that interrupts sleep, is exacerbated by orthostatic changes, and may be preceded by nausea and vomiting.

Question 13

A patient taking levothyroxine is being over-replaced. What condition is he at risk for? Osteopor o sis Constipa ti on Depression

Exopthal mi a

Question 14

Which of the following medications increase the risk for metabolic syndrome? Antihistamines Proton pump inhibitors Protease inhibitors A and C All of the above

Question 15

Lateral meniscus Cruciate ligament Medical menisc us Collateral ligament

Question 16

Gout Epicondyliti You are assessing a patient after a sports injury to his right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to A middle-aged man presents to urgent care complaining of pain of the medial condyle of the lower humerus. The man works as a carpenter and describes a gradual onset of pain. On exam, the medial epicondyle is tender and pain is increased with flexion and pronation.

s Osteoarth ri tis Lyme disease

Question 17

The organism most often associated with prostatitis is: Klebsiella Neiserria gonorrhoa es Chlamydia trachomatis E.Coli

Question 18

Prescribe systemic antibiotics Prescribe antibiotic ear drops Prescribe nasal steroids and oral decongestants Refer him to an ear, nose, and throat specialist

Question 19

Depression 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? Maria, age 17, was raped when she was 13 year old. She is now experiencing sleeping problems, flashbacks, and depression. What is your initial diagnosis?

.

1. Retinopathy
2. Hypertension resistant to treatment
3. Peripheral neuropathy
4. Accelerated atherogenesis Panic disorder Anxiety Post-traumatic stress disorder

Question 20

What diabetic complications result from hyperglycemia? 1, 2, 3 2, 3, 4 1, 3, 4 1, 2, 4

Question 21

Prolonged PT suggests: Platelet abnormality Abnormality in intrinsic coagulation pathway Abnormality in extrinsic coagulation pathway None of the above

Question 22

Patient report of bladder dysfunction, saddle anesthesia, and motor weakness of limbs. History of significant trauma relative to the patient’s age. Decreased reflexes, strength, and sensation in the lower extremities. Patient report of pain with the crossed straight leg raise.

Question 23

Underweig h t Norm al weigh t Overweight Obese

Question 24

“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 25

The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are): A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as: Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond?

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

Question 26

Diagnostic radiological studies are indicated for low back pain: 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 27

Risk factors for Addison’s disease include which of the following? Tuberculosis Autoimmune disease AIDS All of the above

Question 28

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

Consult with a physician A 14 day course of ciprofloxacin To obtain blood cultures from separate site Obtain urine cultures, CBC, and initiate antibiotic therapy

Question 29

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 30

An enzyme-linked immunosorbent assay titer A urea breath test A rapid urease test A repeat endoscopy

Question 31

A 32 year old female patient presents with fever, chills, right flank pain, right costovertebral angle tenderness, and hematuria. Her urinalysis is positive for leukocytes and red blood cells. The nurse practitioner diagnoses pyelonephritis. A patient has just been diagnosed with Bell’s palsy. He is understandably upset and has questions about the prognosis. You response should be: After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been cured?

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 32

The most common symptoms of transient ischemic attack (TIA) include: 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 33

Which patient would benefit most from screening for type 2 diabetes? 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 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

Question 34

An obese hyperlipidemic patient, newly diagnosed with type 2 diabetes mellitus, has fasting glucose values 180 to 250 mg/Dl. What is the most appropriate initial treatment to consider? A low-calorie diet and exercise Sliding-scale NPH insulin every 12 hours An oral hypoglycemic agent Sliding-scale regular insulin every 6 hours

Question 35

Trimethoprim-sulfamethoxazole for 3 days Ciprofloxacin for 7-10 days Trimethoprim-sulfamethoxazole for 14 days Ciprofloxacin for 3 days

Question 36

The most reliable diagnostic indicator of gout is: Monosodium urate (MSU) crystals in the synovial fluid. Tophi visible over joints or in connective tissue. Elevated serum uric acid level. Abrupt onset of single joint inflammation and 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:

pain.

Question 37

Thiazide diuretic Insulin Famotidin e (Pepcid) Albuterol

Question 38

HbA1C 2-hour 75 gram oral glucose tolerance test C-peptide level A and B All of the above

Question 39

Diagnostic evaluation of hypothyroidism reveals: Elevated TSH and decreased T Decreased TSH and increased T Decreased TSH and decreased T 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 screening recommendations for asymptomatic adults age 45 and over include which of the following:

Elevated TSH and increased T

Question 40

The most effective intervention(s) to prevent stroke is (are): 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 41

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 42

The cardinal sign of infectious arthritis is: 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 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?

None of the above

Question 43

MMSE

CAGE questionnaire FAQ – Functional Activities Questionnaire Holmes and Rahe social readjustment scale

Question 44

Akathisia Dystonia Parkinson is m Hallucinati o ns

Question 45

Urine cultures should be obtained for which of the following patients? Suspected urinary tract infection in pregnancy Febrile patients Young men Which appropriate test for the initial assessment of Alzheimer’s disease provides the performance ratings on 10 complex, higher order activities? A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the following symptoms would lead you to look for another diagnosis?

A 65 year old patient complains of recurrent bilateral temporal headaches, malaise, muscle aches, and low grade fever. The headache is described as superficial tenderness rather than deep pain. Giant cell arteritis is suspected. All of the above Refer for temporal artery biopsy and initiation of oral prednisone. Aspirin or acetaminophen every 4 hours as needed for pain and fever. A daily β-blocker such as propranolol. CT scan of the head and lumbar puncture for CSF evaluation.

Question 47

Scoliosis Osteoarthritis Spinal stenosis Herniated nucleus pulposus

Question 48

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

Tempomandibular joint syndrome

Question 49

Which history is commonly found in a patient with glomerulonephritis? Beta-hemolytic strep infection Frequent urinary tract infections Kidney stones Hypotension

Question 50

The effectiveness of an oral contraceptive may be reduced. She should use a very low dose estrogen oral contraceptive. She should use another anticonvulsant along with the phenytoin. Bilateral tubal ligation is recommended.

Question 51

Which of the following is a contraindication for metformin therapy? Insulin therapy Creatinine

A 27 year old female patient with epilepsy is well controlled with phenytoin (Dilantin). She requests information about contraception. The nurse practitioner should instruct her that while taking phenytoin:

Edema None of the above

Question 52

Microalbuminuria is a measure of: Total urinary protein. Late renal compromise in a diabetic patient. Early glycemic abnormality. Protein lost into the urine.

Question 53

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 54

Congestive heart failure (CHF) The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy: A nurse practitioner diagnoses a 60 year old male with balanitis. Which disease is commonly associated with balanitis?

Dyslipidemia Erectile dysfunction (ED) Diabetes mellitus (DM)

Question 55

drug fever upper respiratory infection nothing specific, this is a systemic disease manifestation urinary tract infection

Question 56

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 A patient with HIV infection has a fever of unknown origin (FUO). Which of the following is a possible cause of FUO in a patient with HIV? 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:

Question 57

In which of the following presentations is further diagnostic testing not warranted? Bilateral gynecomastia in a pre-pubertal male of average weight; Tanner stage 1 Bilateral gynecomastia in a 13 year old male with normal testicular size and volume Recent onset gynecomastia in a 20 year old male with breast tenderness Unilateral breast mass which is 5 centimeters in diameter

Question 58

Exercising for at least 30 minutes every day Exercising a total of 2 hours per week Exercising for at least 20 minutes, 3 or more days per week Exercising for at least 30 minutes, 5 days per week

Question 59

The most accurate measure of diabetes control is: Avoidance of micro- and macro-vascular complications. Insulin sensitivity. How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout?

Early morning glucose levels. HgbA1c

Question 60

Which of the following statements about multiple sclerosis (MS) is correct? MS is a chronic, untreatable illness that is almost always fatal. MS is a disease of steadily progressive and unrelenting neurologic deterioration. MS is a chronic, treatable illness with unknown cause and a variable course. Patients with MS who take active steps to improve their health have the best cure rate.

Question 61

Risk factors for prostate cancer include all of the following except: Family history Benign prostatic hypertrophy African American race Age

Question 62

Which of the following symptoms suggests a more serious cause of back pain? Pain associated with coughing or sneezing

Pain associated with muscle spasm Pain associated with lying down at night Pain associated with negative straight leg raise

Question 63

Potential side effects of levofloxacin include which of the following? Confusion Hypoglycemia Achilles tendon rupture All of the above

Question 64

Diagnostic evaluation for urinary calculi includes: Urinalysis and culture Non contrast CT Serum calcium All of the above

Question 65

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 66

Establishment of a definitive diagnosis of osteomyelitis requires: 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 67

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

Discuss with the patient the need to take the antidepressant medication indefinitely

Question 68

week 2 weeks 4 weeks 8 weeks

Question 69

Which of the following is the most common complication of the myelodysplastic syndromes? Fatigue Cardiomyopa t hy Falls Bleeding

Question 70

Prescribe an alpha adrenergic 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? 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