PN EXIT EXAM QUESTION AND ANSWERS 100% PASS 2024 LATEST UPDATED GRADED A+, Exams of Nursing

Download PN EXIT EXAM QUESTION AND ANSWERS 100% PASS 2024 LATEST UPDATED GRADED A+ and more Exams Nursing in PDF only on Docsity!

PN EXIT EXAM

QUESTION AND

ANSWERS 100%

PASS 2024

LATEST

UPDATED

GRADED A+

1 Yousee a 73-year-old woman with a 40 pack year smoking history, chronic

obstruction pulmonary disease and peripheral artery disease who presents with an ulcer on the soul of her left foot. The also has an irregular edge and pale face and punched out appearance, with the surrounding skin white and shiny. The patient states that the pain is worse at night in bed and when the legs are elevated. The most likely diagnosis is:

• arterial ulcer

2. Hey 75-year-old man presents with chief complaints of headache, Nausea, and muscle weakness. His creatinine level is 2.1 MG/DLNGFR is 30 ML/MIN/1.73 m2. He currently takes a thiazides diuretic for the management of hypertension. Which of the following statements is false regarding the use of diuretics in the elderly?

• loop diuretics are contraindicated when GFR is <40 ml/min/1.73 m

3. All of the following practices are recommended when prescribing medication with confusing or similar-sounding names except:

• including either the generic or brand name on the prescription order, but not both

4. A 19-year-old is diagnosed with meningococcal meningitis. In order to prevent secondary infections among adults who had close contact with the patient, all of the following are recommended except:

• Prophylaxis with acyclovir (Zovirax)

5. A 38-year-old woman comes to the emergency department complaining of a rapid heartbeat, tremors, and chest tightness. She reports early in the day she was feeling a migraine starting so she took a pill giving to her by her friend who also experience migraines. Her medical history reveals that she is currently taking a monoamine oxidase inhibitor for depression. Which

migraine medication did see most likely take?

• Almotriptan ( alert)

6. 826-year-old woman presents with uncomplicated UTI. She is otherwise healthy, has not received any systematic anti microbials in the past year and it’s not taking any medications. She is currently not pregnant and is using etonogestrel/ estradiol vaginal ring for contraception. The local E. Coli resistance rate to TMP/SMX is about 12%. The preferred therapy for this patient is:

• Trimethoprim-sulfamethoxazole

7. As part of the Deficit reduction act of 2005, Medicare will incorporate quality payment adjustments for certain hospitals-acquired conditions, including all of the following except:

• Myocardial ischemic

8. Which of the following example describes a potential malpractice scenario?

• A post-myocardial infraction patient is prescribed an inappropriate dose clopidogrel and experience a severe blessing episode.

9. A 57-year-old woman presents for a flu shot as she has heard reports that it will be “a bad flu season’. She has had no primary care for more than 10 years she like health insurance. She admits to a 30 pack here cigarette smoking history, currently smoking one pack for a day. Her history and examination are unremarkable. Which screening test would you recommend?

• Mammography

10. A 28-year-old woman presents who complains of tugging chest pain unrelated to physical activity. She is generally in good health and non-smoker has a BMI of 23 KG/M2, and denies dyspnea of dizziness. Physical examination reveals a grade 2/6 late systolic murmur that follows a midsystoloc click at the 5th intercostal space, mid-clavicular line. An echocardiogram Fails to reveal mitral valve tissue redundancy. This can you go presentation is most consistent with:

• Mitral Valve prolapse

11. A quality improvement plan characterized by Limiting variability and removing defects in a process best describes:

• six sigma

12. Laboratory findings of a 28-year-old male suspected of a heart stroke can include all of the following except:

• Hypermatremia

13. A 42-year-old male presents with a sudden onset of inability to tightly close the eye lid, frown, or smile on the right side. His examination is otherwise unremarkable and past medical history is unremarkable. This likely represent paralysis of cranial nerve:

• VII

14. You see a 71-year-old man with atrial fibrillation and chronic obstructive pulmonary Disease who is diagnosed with community-acquired Pneumonia. His medical history does not show any drug allergies and he completed a course of respiratory fluoroquindore for the treatment of acute bacterial sinuses within the past month. Which of the following would you consider The most appropriate choice of anti-microbial?

• High dose amoxicillin

15. According to the Consolidated Omnibus Reconciliation Act ( CORBA), The spouse of an eligible employee will be eligible for COBRA coverage in all of the following circumstances except when the eligible employee:

• is terminated for misconduct

16. A 43-year-old woman presents in the emergency department with a chief complaint of swelling of the ankles, hands, and face. She also reports urine dad is darkly colored and foamy. Her blood pressure is 184/118 mm hg. All of the following urinalysis findings will support a diagnosis of glomerulonephritis except:

• Elevated levels of ketones

17. A 78-year-old male is being treated for hypoglycemia episode. He has a long history of type 2 diabetes mellitus as well as congestive heart failure and COPD. He is currently taking basal insulin with a sulfonylurea. What is the acceptable a A1C goal for this patient?

• <8%

18. Tertiary Prevention activities for a 69-year-old woman with congestive heart failure and type 2 diabetes mellitus include:

• Adjusting therapy to minimize dyspnea

19. A physicians employs an NP to provide service at a satellite acute care clinic. If the physician is never present at the clinic, which of the following statements is true?

• The NP services should be billed under the NP’s provider number.

20. You see a 48-year-old man with a chief complaint of pain during urination. Imaging reveals the presence of a kidney stone in the ureter. Do you consider all of the following management option except:

• Thiazides diuretic use

21. In managing a 58-year-old woman who is admitted for deep vein thrombosis, caution should be used with which of the following medication due to risk of heparin induced thrombocytopenia?

• Enoxaparin (lovenox)

22. You see a 76-year-old woman living at home who is accompanied by her home care provider. She has COPD and type two diabetes mellitus. An example of a secondary prevention strategy is:

• Checking her blood pressure

23. All of the following persons are eligible for Medicare service except:

• A 69-year-old undocumented resident in the US with atrial fibrillation

24. The NP is called to treat a 43-year-old woman for multiple contusions following a domestic violence attack. The NP realizes that one of the best predictors of a subsequent homicide of victims are domestic violence is:

• History of perpetrator attempting to strangle the victim

25. When initiating therapy for a spironolactone for a patient who Is also and ace inhibitor, you advise the patient to return in 5 days to check which of the following laboratory parameters?

• Potassium

26. All of the following are examples of primary prevention strategies except:

• performing a hemoglobin A1C for all patients admitted to the hospital

27. When considering HIPAA regulations, all the following are examples of” individual identifiable health information” except:

• The number of prescriptions of oxycodone written each month by a provider

28. Which of the following statements is false regarding end-of-life decisions making for a patient that is hopelessly and terminally ill?

• Advance directives are legally binding and recognized in all 50 states

29. While evaluating 833 or female with a two day history of dysuria, which of the following findings in urinalysis is most suggestive of urinary tract infection caused by a gram-negative organism?

• Nitrites

30. You are examining a 65-year-old woman with a history of rheumatic heart disease. In assessing the patient for mitral stenosis, you expect to find a heart heart murmur characterized as: -localized low-pitch late diastolic heard best at apex.
31. The privacy rule established by the US health department and human services in 1996 Implemented the requirements for:

• Health insurance portability and accountability act (HIPPA)

32. When managing elderly patients with diminish cognitive function, which of the following statements is true regarding patient’s competence for making in form healthcare decisions?

• only a court can appoint a guardian to make decisions for a patient declared incompetent

33. A 17-year-old male is admitted after experiencing sudden, severe pain in the scrotum during the night. Physical examination reveals swelling of the scrotum and the loss of cremasteric reflex. His heart rate is 110 bpm, Blood pressure 150/80 mm hg, and temperature 99.8 F. There’s most likely represents:

• testicular torsion

34. In considering treatment for Jane in the previous question, which of the following would be most appropriate if she has a history of penicillin allergy?

• amoxicillin

35. All of the following are required Medicare terms and conditions for paying NP service except:

• separate charges are billed for NP services and facility charges

36. The NP is called to evaluate a 57-year-old man who reports episodes of acute angina with physical exertion. He is currently taking an ace inhibitor and low-dose aspirin. The NP considers which of the following approaches at the start of anginal symptoms?

• A dose of nitroglycerin via sublingual spray

37. A 41-year-old woman is diagnosed with hypertension that requires medication. She is otherwise healthy but currently takes drospirenone/ethinyl estradiol for birth control. Which of the following antihypertensive medication would be least preferred for this patient?

• Calcium channel blocker

38. The NP is called to evaluate Jane, a 43-year-old woman, who presents with a diffuse maculopapular rash that began on The trunk but now covers the entire body, including the palms and soles. The rash is not itchy but wart-like sores are present in the mouth and genital area as well as skin folds. Initial evaluation reveals generalize lymphadenopathy And a low-grade fever, and she complains of lethargy and headache. The patient reports that she had a painless genital ulcer that healed on its own about 3 weeks earlier. Which of the following is the most likely diagnosis?

• Genital Herpes

39. Gary is a 63-year-old African-American male who has been treated for hypertension with ace inhibitors her monotherapy for the past six weeks. Despite carries insistence that he is taking his medication as directed, his blood pressure continues to elevated. Gary mentions that he prefers not having to take multiple medications is day due to the cost and convenience. Which of the following is the most appropriate course of action?

• switch to a calcium channel blocker

40. A 15-year-old male is brought into the emergency department by his parents following a 12 hour history of nausea, family, and abdominal pain. Physical examination reveals obturator and psoas signs and a temperature of 102.6 F. Anticipated white blood cell with differential results are as follows:

• Total WBC = 16,500/ mm3, Neutrophils=66%, Bands=8%, Lymphocytes=22%

41. A 27-year-old man presents with a chief concern of an abnormal mass within his left scrotum. He describes it as feeling like a bag of worms in his present when he is standing but disappears when he lies down. His past medical history is unremarkable and his BMI is 29 KG/M2. He has been in a monogamous relationship for the past four months. The most likely diagnosis is:

• Varicocele

42. In a patient diagnosed with infections mononucleosis, the use of amoxicillin should be avoided due to the risk:

• Rash

43. Mrs. Gonzalez is a 53 old female who is being evaluated for routine follow-up care. Her medical history includes dyslipidemia; hypertension, and rheumatoid arthritis. Laboratory animal is reveals elevated serum alanine transaminase and aspartate transaminase. The long-term use of which of the following medications is the most likely cause of this finding?

• Methotrexate

44. A 77 year old woman is accompanied by her husband for evaluation. She is currently being treated for metoprolol for hypertension and digoxin for atrial fibrillation. He reports that his wife is becoming increasingly forgetful over the past year, fell into note in Porten family events such as birthdays sometime to come and confused with driving directions to familiar locations. She has no previous psychiatric history. The most likely diagnosis is:

• Dementia

45. A 22-year-old college student presents with a two day history of severe sore throat and

difficulty eating or drinking due to trouble swallowing. A physical examination reveals exudative pharyngitis and minimally tender anterior and posterior cervical lymphadenopathy. The NP suspects infectious mononucleosis and expects which are the following laboratory findings?

• Lymphocytosis with atypical lymphocytes

46. Phyllis is a 34-year-old woman who presents with a chief complaint of a migraine resulting in nausea and vomiting. She reports that she experiences multiple migraines each month. She has given a prescription for sumatriptan 100-mg tablets orally to treat acute migraine pain. When counseling Phyllis about the medication, the nurse practitioner advises about all of the following adverse effects except:

• Sedation

47. A 27-year-old woman is being evaluated for a seven day history of acute bacterial rhino- sinusitis. She is otherwise healthy and has not received any antimicrobial therapy in the past six months. She also has no history of drug allergy. In considering a first-line antimicrobial treatment, which of the following would be most appropriate?

• Amoxicillin-clavulanate

48. A 21-year-old female student presents at the university clinic with a nose bleed. This is her third bleeding episode in the past week she is otherwise healthy with no history of bleeding disorders. The NP advises that the appropriate first line intervention of anterior epistaxis is: -Firm pressure to the area superior to the nasal alar cartilage
49. A 49-year-old woman presents with a three day history of Burning during urination, a thin and grayish white vaginal discharge in vagina itching. Laboratory examinations common you expect to find all-of the following except:

• pseudohyphae

50. You see a 77-year-old male for treatment in lacerations on his forearm. Upon examination, you notice poor skin turgor what it says on the arms and back of the hands. This is likely a sign of:

• normal age related change

51. A 26-year-old male presents with a chief complaint of bilateral, intermittent itchy eyes accompanied by a rope like discharge. This is most consistent with conjunctivitis caused by:

• Allergen

52. A 32 -year-old woman in her second trimester pregnancy presents with fever, flank pain, and hematuria. The NP suspects pyelonephritis. Which of The following urinalysis results would be most indicative of pyelonephritis? -White blood cell(WBC) casts
53. A 21 year old camp counselor presents for evaluation with a chief complaint of generalized itchiness. He has just returned after a week of summer camp. Physical examination reveals excoriated papules along his axillary folds and at the belt line. The NP

suspects scabies and prescribes permethrin lotion. In counseling the patient on the use of permethrin, the NP mention that:

• itch often persists for a few weeks after successful treatment.

54. Bill is a 46-year-old man who rushed to the emergency department at the experiencing Senate onset of edema of the lips and face and a sensation of the tightness and difficulty breathing following a wasp sting. His blood pressure is 78/52 mm hg, heart rate 120 BPM, and respiratory rate is 32/min. The course of action in caring for Bill is to administer:

• Epinephrine

55. A 32-year-old man requires evaluation for hepatitis infection prior to taking a job as a restaurant cook. He Presents with the following Laboratory results:

• Hepatitis A

56. A 57-year-old woman presents with a six month old numbness of the finger tips and oral irritation. Physical examination reveals pale conjunctiva and the heart murmur. She is otherwise healthy, exercise regularly, has a BMI of 22 kg/m2, and she states she is a vegan. Hemogram results are as follows: Hg= 8. g/dL (12-16 g/dL) Hct =23% (36% - 42%) MCV = 135 fl ( 80 - 96 fL) - Red Blood Cell distribution width =17%, These findings are most consistent with:

• vitamin B12 deficiency

57. A 23-year-old man is admitted after experiencing seizures. A witness to the seizure described how the patient fell to the ground with rigid extension of the arms and legs which was followed by A period of jerking movement and loss of consciousness. This best describes which type seizures?

• Tonic-clonic

58. A 23-year-old male patient is evaluated in the early morning hours for nausea with vomiting. He had eaten some food from the fridge from the night before that “was probably to old”. The NP expects acute gastroenteritis and would expect The course of the disease over the next 48 to 72 hours to involve:

• Resolution of vomiting but onset of diarrhea

59. A 64-year-old woman with chronic kidney disease presents with a chief complaint lethargy. His hemogram is as follows: Hemoglobin (Hg)=9.9 g/dL, Hematocrit (Hct)=30% - Mean cell volume(MCV)=81 fL. These findings are most consistent with: -Anemia if chronic disease
60. There is no number 60
61. A 16-year-old male presents for evaluation after a syncopal Episode at school. He reports that he has recently been experiencing bouts of lightheadedness. His blood pressure is 126/76 episode at school. He reports that he has recently been experiencing bouts of lightheadedness. His blood pressure is 126/76 mm Hg and his BMI=33 kg/m2. You notice velvet-like plaques at the naps of the neck. Laboratory assessment should include which of the following tests?

-Hemoglobin A1C

62. 846-year-old man is rushed to the emergency department while experiencing an acute adrenaline crisis that presents with abdominal pain, severe vomiting, and low blood pressure. He appears cyanotic and confused. The most appropriate treatment for this patient is an injection of:

• Hydrocortisone

63. A 17-year-old male with intermittent asthma presents for routine follow-up. He explains that he experienced asthma symptoms once or twice is weak, usually during physical activity. Symptoms are promptly will leave each time with albuterol per MDI with spacer. He does not report any nighttime awakenings due to his asthma. His act score is 24 and vital signs are all within normal limits. According to the NAEPP EPR-3, what is the next step in the management of his asthma?

• Continued use of SABA on an as needed basis

64. Which of the following electrocardiogram changes do you expect to find in a person with myocardial ischemia?

• T wave inversion in leads I, II, and aVF
  65. Clinical features of Hashimoto’s thyroiditis typically include: -presence of anti-thyroid peroxidase antibody‘s.
  66. Which of the following is the most appropriate antibiotic for a 57-year-old man with acute bacterial rhinosinusitis and who has type 2 Diabetes mellitus, COPD and a beta lactam allergy? -Levaquin
  67. The NP is called to evaluate a 56-year-old man complaining of severe pain in the upper right abdomen that radiates to the right shoulder, nausea and vomiting, which started soon after dinner. The NP suspects a cute cholecystitis. All of the following findings would be consistent with the diagnosis except: -microcytic anemia
  68. The NP is called to evaluate a 34 year old non-pregnant woman who complains of a four week history of anxiety, palpitations, diarrhea, unexplained weight loss, and sensitivity to heat. Her medical history is unremarkable and she is not taking any medications. Physical examination reveals warm moist skin and exaggerated deep tendon reflexes. The NP suspects Graves’ disease. Which of the following laboratory results would best support this diagnosis? -thyroid stimulating hormone=0.05mU/L
  69. A 27-year-old male is rushed to the emergency department after experiencing a series of seizures. He has no history of neurologic disorder. His girlfriend states that he was taking multiple medications for mood disorder but recently stopped taking one of them. The most likely medication the patient discontinue is a: -benzodiazepine

70. A 68-year-old woman who resides in a long-term care facility is being treated for a urinary tract infection. Her medical history includes hypertension, peripheral artery disease, and a 35 pack year smoking history. During the evaluation, she brings to your attention a painless, pearly nodule on the upper lip. This clinical presentation most likely represents: -basal cell carcinoma
71. A 24 year old with a history of major depressive disorder is rushed to the emergency department by his friends after taking an overdose of antidepressant medication. The ingestion of which of the following medications poses the greatest risk of death for this patient? -A two week supply of nortriptyline
72. You see a 24-year-old woman of Asian and Sestri who is being evaluated for a neurologic disorder. A thorough laboratory analysis is conducted in the hemogram results are as follows: hemoglobin 10.4, hematocrit 32%, Mean cell volume (MCV) 71, Red blood cell distribution with (RDW) 13%, Red blood cells 5.5, the most likely condition associated with these hemogram results are: -beta thalassemia minor
73. And 18-year-old man is being evaluated for a severe exacerbation of asthma. He is currently taking an inhaled corticosteroid, a long acting beta agonist, and a short acting beta agonist one and as needed basis. The most important component of the initial assessment includes an: -Peak expiratory flow reading
74. A 19 year old college freshman has been urged by her friends to be evaluated for lethargy, loss of appetite, and hypersomnia over the past two weeks. You administer the Beck Depression inventory assessment and she scores at 22. This would indicate: -moderate depression
75. 35-year-old woman presents with a chief complaint of being unable to close her right eyelid tightly, frown, or Smile on the right side. She is otherwise healthy with no significant prior medical history. Inappropriate diagnostic test for this patient would be: -lyme disease antibody titer
76. The NP is called to evaluate a 72 year old woman with community acquired pneumonia. Her vital signs include temperature 101.6°F, blood pressure 106/68 mmHg, and heart rate 78 BPM, physical examination reveals increased tactile fremitus and donis to percussion at the left lung base. These findings are consistent with: -consolidation
77. The nurse practitioner is evaluating a 19-year-old male suffering from a severe headache. He has a history of headaches that lead to occur in clusters over a few days. He has unsuccessfully tried several therapeutic modalities. A positive response to which of the following interventions supports the diagnosis of cluster headache?

-oxygen therapy

78. When developing a management plan for patients with genitourinary infections, which of the following would you most likely recommend for follow-up imaging following resolution of their infection? -A 43-year-old man with type two diabetes mellitus and recurrent Pyelonephritis.
79. The NP is called to evaluate a 48-year-old man who was brought to the emergency department after experiencing severe low back pain following an attempt to lift heavy furniture. He also reports a coincident loss of bowel and bladder control. This most likely indicates: -Caude equina syndrome
80. A 43-year-old woman is being evaluated in the emergency department with a complaint of a severe headache. She describes a unilateral, pulsing headache that was preceded by a gradual onset of paresthesia affecting the ipsilateral face and arm. The patient stated she noticed a funny smell prior to the symptoms starting. This description is most typical of: -migraine with aura
81. A 20-year-old college student living in a campus dormitory has been diagnosed with Meningococcal meningitis. The NP decides to speak with the University health officials and inform them that: -individuals with household type or more intimate contact or at risk for infection.
82. Mr. Waugh is a 62-year-old man who has been previously diagnosed with Dilated cardiomyopathy and is being evaluated for fatigue, Edina, and shortness of breath. On examination, you expect to find:

• point of maximal impulse at 6th intercostal space 2cm left of midclavicular line.

92. A A 54-year-old man is being evaluated for pain related to acute bacterial prostatitis. In considering the diagnosis and management, the NP realizes that:

• perineal pain with defecation is a common complaint

93. You see a 64-year-old man with an area erythema concentrated on the left side of his neck with clusters of vesicles forming a line. He reported pain in the area a couple of days before the eruption of the lesions. He states that he recently initiated biologic therapy for rheumatoid arthritis. Which of the following is the most likely diagnosis? -herpes zoster
94. While taking the history on a 60-year-old female patient the nurse practitioner learns that she has a 15-year-old history of poorly controlled hypertension. The patient admits that another provider had told her that the high blood pressure had affected her eyes. As a result, the nurse practitioner expects that funduscopic examination will likely reveal:

• General vessel narrowing

95. A 71-year-old male presents to the emergency department. He is complaining of

severe abdominal pain in the right lower quadrant. Diagnostic findings to support a ruptured appendix would include all of the following except:

• leukopenia

96. You are evaluating a 43-year-old woman with community-acquired pneumonia. She has no comorbidities, no reported history of drug allergies, and has not received antimicrobial therapy in the past six months. Which of the following is the most appropriate treatment choice?

• Azithromycin

97. You see a 58-year-old man who complains of a persistent dry, hacking cough. He reports that he recently started taking a medication to treat high blood pressure. He is most likely taking a(n):

• Angiotensin-concerting enzyme (ACE) inhibitor

98. Ms. Wang is a 57-year-old female who was seen 2 weeks ago for evaluation of ongoing abdominal discomfort and nausea. Laboratory assessment reveal H. pylori and she was treated for peptic ucler disease with an appropriate antibiotic/proton-pump inhibitor combination. She returns today and admits to no real change in her symptoms. This suggestion that:

• the patient could have complicated peptic ulcer disease and should be referred for endoscopy.

99. You see a 26-year-old man with moderate persistent asthma who is experiencing a severe exacerbation. Which of the following would you most likely expect when evaluating this patient?

• Expiratory Wheeze

100. A 70-year-old man who lives in a long-term care facility is being evaluated following a fall. He is fairly healthy with no mobility limitations or other obvious risk factors. He is taking simvastatin for dysilpidemia as well aspirin. A caregiver who witnessed the fall reports that the patient did not try to brace himself for the fall but just”fell flat on the ground.” This likely suggests:

• A possible syncopal episode requiring cardiovascular and neurological evaluation

101. Which of the following is most consistent with the hepatic enzyme profile of a person with non-alcoholic fatty liver disease?

• AST=98 U/L, ALT=149 U/L

102. A 40 sexual woman presents with a 12 hour history of fever, severe pain in the upper right abdomen, and positive Murphy’s sign. Her medical history is unremarkable and she is an otherwise good health. The most likely diagnosis is:

• acute cholecystitis

103. You see a 54-year-old man living in subsidize housing with a history of hypertension. He states that he stopped taking his high blood pressure medication about four months ago because of calls. He is concerned because his blood pressure is high

whenever he checks it, though he does not report any symptoms. His BP at this visit is 196/104 mm Hg. Upon examination of his patient, you would expect to detect an S4 sound heard during:

• Late Diastole

104. A 47-year-old woman reports that her long-time boyfriend was recently diagnosed with liver cancer possibly caused by a chronic hepatitis B infection. Though she does not have symptoms, she wants to be checked for hepatitis B. She can’t recall if she has ever been vaccinated for hepatitis B. The laboratory results are as follows: Hepatitis B surface antigen positive, hepatitis B surface antibody negative, total hepatitis B core antibody positive, IgM antibody to hepatitis B core antigen negative. These findings are most consistent with: -Chronic hepatitis B
105. An 84-year-old female patient is admitted from a local long-term care facility(LTCF). The patient is normally awake, alert and oriented. She resides in the LTCF because she has not fully recovered from a broken hip resulting from a fall four months ago, otherwise she is in relatively good health. She can walk short distances with a walker, though she primarily stays in a wheelchair. Today, however, the nursing staff found her to be acutely confused and unable to ambulate without falling. She was transferred to the emergency department for evaluation. Initial laboratory testing must include:

• urinalysis

106. You see a 75-year-old female who complains of dizziness and lightheadedness and nearly fallen a few times over the past couple of days. Hospital evaluation reveals no apparent cardiac or neurological reasons for the symptoms. Her medical history shows that she is taking several medications for various conditions, including hypertension depression; type two diabetes mellitus, and urinary incontinence. In reviewing the medications for fall risk, which of the following changes will likely decrease her fall risk? -Switching her anti-hyperglycemic medication from a sulfonylunrea to a GLP- receptor against
107. A 74-year-old male with asymptomatic atrial electrical cardioversion that successfully restored the heart rhythm. Which of the following medications can be considered for the purpose of maintaining the heart rhythm?

• sotalol

108. Communication skills are critical when interviewing patients to gather information that can be used to diagnose conditions and develop a management plan. IContact and nonverbal cues are examples of ways of the following communication skills? -Active listening
109. A 78-year-old man is brought in by his neighbor who reports that he found him sitting in the front yard. She reports that he mumbled something about waiting for his wife, though she passed away more than 10 years ago. The neighbor says that the patient lives by himself and that this is the first time he has acted in this manner. The patient is calm but has trouble understanding simple directions and is unable to respond

properly to simple questions. Suspecting delirium, The most appropriate first course of action is to:

• identify the underlying illness

110. A 67-year-old man is being evaluated for shortness of breath. His medical history reveals that he experience a myocardial infarction about 2 years A girl and a history of hypertension, which is well controlled by diet. Otherwise, his medical history is unremarkable. Which of the following would you expect to find on electrocardiogram? -Pathologic Q wave
111. Mrs. Yamamoto presents for evaluation of a domino pain. She does not speak English well and wants to use her 16-year-old son to interpret. The NP knows that when evaluating a patient who requires an interpreter, it is best to:

• use an interpreter of similar age and gender

112. Do you see a 74-year-old male who is accompanied by his granddaughter who lives with him. He has hypertension, a prior why myocardial infarction, long-standing type two diabetes, and recently underwent a lower limb Amputation secondary to diabetes. He is currently taking a ace inhibitor, statin, lower dose of aspirin, biguanide and insulin. The granddaughter reports that since the amputation, her grandfather sometimes becomes withdrawn, irritable and moody for no apparent reason, does not want to participate in the typical activity he enjoys, and often does not appear to eat much during the day. She also states that he often complains of being tired but normally wakes up in the early morning hours. The most appropriate action is to evaluate the patient for:

• depression

113. In evaluating a 62-year-old male with ischemic heart disease in mitral incompetency, you expect to find the murmur that is:

• systolic with radiation to the axillae

114. A 77-year-old woman with urinary incontinence is brought in by her caregiver for evaluation are they potential urinary track infection. She is mentally alert and responds clearly to questions. The caregiver waits in the waiting area. While performing a routine comprehensive physical exam, you notice bruises on her right and left upper arms. The most appropriate approach would be to say: -I noticed you have similar bruises on both arms
115. When prioritizing risk factors for bacterial endocarditis, The nurse practitioner knows who among the following patients has the highest risk.

• A 75-year-old woman with non-organic prosthetic aortic valve

116. A 22-year-old woman is being evaluated for an upper respiratory tract infection. As you prepare for auscultation, the patient states quote quotesI have a benign murmur that has been with me my whole life. “ anticipating a physiologic murmur, you would expect which of the following characteristics?

• becomes softer when going from a supine to standing position

117. A 36-year-old man is hospitalized for alcohol poisoning. Do I follow up evaluation the next day, he denies that he has a drinking problem. The best approach to assess for possible alcoholism is conducting with other following questionnaires?

• CAGE

118. A 79-year-old man is brought into the emergency department by his daughter. She reports that her father lives by herself independently and she checks on him several times each week. This morning when she arrived at his home, he was acting confused, did not immediately respond to simple commands, and insisted that he saw his the season wife. He was “perfectly fine“ just a couple of days ago. She is concerned that this may be an early indication of dementia. When differentiating between delirium and dementia, the nurse practitioner knows that: -delirium is associated with a sudden state of rapid change in brain function
119. In considering the use of an inhaled anticholinergic, such as tiotropium bromide, for the treatment of chronic obstructed pulmonary disease the NP recognizes which of the following is the desired therapeutic action?

• bronchodilator

120. You see a 14-year-old soccer player with an ankle sprain. Physical examination reveals complete ankle instability, significant swelling, and moderate to severe ecchymosis. You would grade this sprain as:

• Grade III

121. A 25-year-old male presents who complain of excessive shortness of breath with mild exercise ( walking up a couple of flights of stairs). He denies chest pain shut up to my little friend body mass index (BMI) = 24 kg/m2, denies smoking, and his blood pressure is 128/68 mm Hg. Physical examination reveals a grade 3/6 crescendo- decrescendo systolic murmur at the second intercostal space, right sternal border that radiates to the neck. These findings are most consistent with:

• congenital bicuspid aortic valve

122. A 43-year-old man who smokes one pack per day and has an 18 pack year smoking history presents with a chief complaint of increasing shortness of breath, chronic cough and sputum production. In considering chronic obstruction pulmonary disease, which of the following is required for the diagnosis of COPD?

• FEB1/FBC ratio <0.70>

123. In which of the following situations is parental consent usually needed prior to treatment?

• A 16-year-old request treatment of acne valgaris

124. When a valuate illness symptoms in older patients, the disease will often present differentially from younger adults to:

• Decreased compensatory mechanism in the elderly

125. An 18-year-old female is being evaluated for wheezing that occurs on a intermittent basis. Symptoms occur about 3 to 4 times weekly, but not daily. Nighttime awakening due to wheezing and coughing occurs about once per week. Her FEV1 is 85% predicted and asthma control test score is 22. The patient is diagnosed with mild persistent asthma and initiated on Step 2 treatment, which will include:

• lowered toes inhaled corticosteroids only

126. When considering and end of life decisions for a terminally ill person with Alzheimer-type dementia who can no longer communicate, all of the following can be used as an advance directive except:

• testimony from a family member or close friend

127. You are seeing a 68-year-old woman for treatment of an uncomplicated urinary track infection. She has well-controlled hypertension, type two diabetes mellitus, and dyslipidemia and takes an angiotensin- converting enzyme inhibitor, statin, biguanide, and low-dose aspirin. She understanding conversation, especially in noisy environments. This is likely a:

• normal age-related change in hearing

128. A 28-year-old male with asthma presents with a chief complaint that he has to use his rescue inhaler multiple times his day. Evaluation reveals that he has moderate to severe persistent asthma and Step 4 treatment. And appropriate regimen would included:

• medium dose a CS plus a long acting beta2-agonist

129. The healthcare principle that promotes action that lead to achieving the greatest good for the greatest number is known as:

• Utilitarianism

130. A Forteo male is brought in for an evaluation after he reportedly collapsed doing a tennis match, though he quickly regain consciousness. His medical history is otherwise unremarkable. You suspect hypertrophic cardiomyopathy. Which of the following a heart murmur characteristics would support the diagnosis?

• becomes louder when going from a supine to standing position

131. A 47-year-old man is being evaluated for severe eye pain and sign on set a reduced acuity. The NP suspects acute angle closure glaucoma. Which of the following is most likely to be found on funduscopic examination to support this diagnosis?

• A deeply-cupped optic disc

132. When evaluating the value of a test, the portion of negative results that are truly negative best describes:

• Negative predictive value

133. The NP is called to evaluate a 53-year-old man who acute bacterial rhinosinusitis. He currently smokes in one PPD and has a 30 pack year cigarette smoking history. His medical history shows that he is allergic to penicillin. Two weeks ago, he was treated

with a macrolide for “bronchitis. “ You now prescribe:

134. The ability of a test to identify individuals who truly have a disease with a positive test result best describes:

• sensitivity

135. Which of the following types of clinical studies represent the lowest level of evidence used to guide medical decisions? -clinical experience of renowned expert in field
136. Which of the following represents the highest level of scientific evidence when evaluating clinical research?

• systematic review

138. While conducting an examination of a 15-year-old female accompanied by her mother regarding a potential sexually transmitted disease, The NP knows that the best approach to the visit would be to:

• ask the adolescent if she wishes the mother to be included in the interview and examination

137. Which of the following activities best demonstrates fulfillment of the nursing leadership role?

• collaborating with a local health clinic on strategies to improve adult vaccination rates

139. You see a 68-year-old woman who is being treated for moderate depression. She complains that her medication is causing symptoms of dry mouth and constipation. She most likely taking which of the following medication? -Nortriptyline
140. A 25-year-old landscaper with a six CM abscess on the left upper arm presents one week post incision and drainage for the follow up appointment. The area is most improved, but has some residual erythema and discomfort. The nurse practitioner correctly interpret that:

• The healing process is proceeding normally and he should continue to monitor progress

141. Hey 67-year-old female has a long history of chronic venous insufficiency(CVI) and was seen by the nurse practitioner from brown discoloration on her calves. The nurse practitioner diagnose Hyperpigmentation is due to CVI and present the appropriate treatment plan. When evaluating the patients understanding, the nurse practitioner expects that she will say:

• “I need to elevate my legs as often as I can. “

142. Betty is a 33-year-old mother of two children who presents for treatment of a lower urinary track infection. This is her third episode in the past six months. She is prescribed appropriate antibiotic therapy and is taught strategies to decrease urinary tract infection. Which of the following is recommended for the prevention of recurrent UTI in at risk

patients?

• continuous low-dose antimicrobial prophylaxis

143. A patient who was seen for upper respiratory tract infection has an abnormal blood test results and requires a follow up visit. The patient repeatedly fails to show up for the following visit. Which of the following is the best approach is to inform the patient of the need an urgency for a repeat test?

• a certified letter 144.And NP’s duty of care can be established:
• when the NP gives professional advice or treatment is any setting 145.All of the following are elements of malpractice except:
• charging a patient for a procedure that was not performed 146.Which of the following describes the ethical principle of beneficence?
• The obligation of the healthcare provider to help people in need 147.Which of the following describes the ethical principle of veracity
• The healthcare provider must be truthful and avoid deception

148. The legal authority of an NP’s to perform healthcare service as defined by state law is called: -nurse practice act
149. “Incident-to” Service are defined as those which are “an Integral, although incidental, part of the physicians personal professional service in the course of diagnosis or treatment of an injury or illness.“ as long as certain criteria are met, “incident to“ billing is an option in all of the following settings except:

• hospital

150. A 50-year-old woman presents with a chief complaint of a four day history of unilateral headache with occasional blurred vision. Her medical history is unremarkable. Blood pressure is 146/94 mm Hg, heart rate is 86 bpm, and respiratory rate is 26/minute. Physical examination reveals a tender, pulseless temporal artery. All of the following are true except:

• Sumatriptan is recommended to reduce stood headache