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NURS 6531 Final Exam / NURS6531 Final Exam (Latest): Walden University

Walden NURS 6531 Final Exam / Walden NURS6531 Final Exam (Latest)

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· Question 1

 

When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

· Question 2

 

Central obesity, “moon” face, and dorsocervical fat pad are associated with:

 

A.

 

Metabolic syndrome

 

B.

 

Unilateral pheochromocytoma

 

C.

 

Cushing’s syndrome

 

D.

 

None of the above

 

· Question 3

 

An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days later, he returns to the office complaining of left great toe pain. On exam, the nurse practitioner notes an edematous, erythematous tender left great toe. The likely precipitant of this patient’s pain is:

 

A.

 

Trauma

 

B.

 

Tight shoes

 

C.

 

Arthritis flare

 

D.

 

Hydrochlorothiazide

 

· Question 4

 

The most effective treatment of non-infectious bursitis includes:

 

· Question 5

 

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

 

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 6

 

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

 

· Question 7

 

Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)?

A. Nocturia
B. Urgency incontinence
C. Strong urinary stream flow
D. Straining to void

 

· Question 8

 

Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid?

§ Food that is very hot or very cold

§ Fatty or fried foods

§ Peppermint or spearmint, including flavoring

§ Coffee, tea, and soft drinks that contain caffeine

§ Spicy, highly seasoned foods

§ Fried foodDT caffeine, chocolate and anticholinergics

 

· Question 9

 

Which drug category contains the drugs that are the first line Gold standard therapy for COPD?

 

· Question 10

 

The most commonly recommended pharmacological treatment regimen for low back pain (LBP) is:

 

· Question 11

 

Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis?

 

· Question 12

 

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 action(s) should the nurse practitioner take?

.A Obtain a thorough history and physical, and check serum cortisol and ACTH levels.

B. Perform a diet history and check CBC and FBS.

C. Provide nutritional guidance and have the patient return in one month.

D. Consult home health for intravenous administration

 

· Question 13

The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is:

· Question 14

How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout?

· Question 15

 

The intervention known to be most effective in the treatment of severe depression, with or without psychosis, is:

· Question 16

 

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 the: he
A. lateral meniscus
B. cruciate ligament
C. medial meniscus
D. collateral ligament.

 

· Question 17

 

 

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. The most appropriate management is:

 

· Question 18

 

A 21-year-old female presents to the office complaining of urinary frequency and urinary burning. The nurse practitioner suspects a urinary tract infection when the urinalysis reveals

· Question 19

 

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. Range of motion is full The most likely cause of this patient’s pain is:

 

· Question 20

 

The initial clinical sign of Dupuytren’s contracture is:

·

· Question 21

 

The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy

 

· Question 22

 

What is the first symptom seen in the majority of patients with Parkinson’s disease?

 

· Question 23

 

The most commonly recommended method for prostate cancer screening in a 55 year old male is:

 

· Question 24

 

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

 

· Question 25

 

Which of the following symptoms suggests a more serious cause of back pain?

 

· Question 26

 

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?

· Question 27

 

A 72 year old female patient reports a 6 month history of gradually progressive swollen and painful distal interphalangeal (DIP) joints of one hand. She has no systemic symptoms but the erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), and rheumatoid factor (RF) are all minimally elevated. What is the most likely diagnosis?

· Question 28

 

A patient taking levothyroxine is being over-replaced. What condition is he at risk for?

 

· Question 29

 

Which of the following is the most common cause of low back pain?

 

A.

 

Lumbar disc disease

 

B.

 

Spinal stenosis

 

C.

 

Traumatic fracture

 

D.

 

Osteoporosis

 

· Question 30

 

Which is the most common cause of end-stage renal disease in the United States?

 

· Question 31

 

A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects:

 

A.

 

Arthritis

 

B.

 

Ulnar neuritis

 

C.

 

Septic arthritis

 

D.

 

Olecranon bursitis

 

· Question 32

 

A 60 year old female patient complains of sudden onset unilateral, stabbing, surface pain in the lower part of her face lasting a few minutes, subsiding, and then returning. The pain is triggered by touch or temperature extremes. Physical examination is normal. Which of the following is the most likely diagnosis?

 

· Question 33

 

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?

 

· Question 34

 

A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the following symptoms would lead you to look for another diagnosis?

 

· Question 35

 

Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of:

 

· Question 36

 

Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond?

· Question 37

 

The most common cause of elevated liver function tests is:

 

· Question 38

 

Reed-Sternberg B lymphocytes are associated with which of the following disorders:

 

A.

 

Aplastic anemia

 

B.

 

Hodgkin’s lymphoma

 

C.

 

Non Hodgkin’s lymphoma

 

D.

 

Myelodysplastic syndromes

 

· Question 39

 

Which of the following is a potential acquired cause of thrombophilia?

 

A.

 

Homocysteinuria

 

B.

 

Protein C deficiency

 

C.

 

Factor V Leiden

 

D.

 

Antiphospholipid antibodies

 

· Question 41

 

A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains:

 

Primary hyperparathyroidism is treated with Vitamin D restriction

 

Primary hyperparathyroidism is treated with parathyroidectomy

 

Primary hyperparathyroidism is treated with daily magnesium

 

Primary hyperparathyroidism is treated with parenteral parathyroid hormone (PTH)

 

· Question 42

 

Diagnostic confirmation of acute leukemia is based on:

·

· Question 43

 

A 25 year old overweight patient presents with a complaint of dull achiness in his groin and history of a palpable lump in his scrotum that “comes and goes”. On physical examination, the nurse practitioner does not detect a scrotal mass. There is no tenderness, edema, or erythema of the scrotum, the scrotum does not transilluminate. What is the most likely diagnosis?

A. Testicular torsion

B. Epididymitis

C. Inguinal hernia

D. Varicocele

 

· Question 44

 

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?

A. Prescribe nasal steroids and oral decongestants
B. Prescribe antibiotic eardrops
C. Prescribe systemic eardrops
D. Refer David to an ear, nose, and throat specialist

 

· Question 45

 

Which of the following antibiotics should not be prescribed for a pregnant woman in the 3rd trimester?

· Question 46

 

The physiological explanation of syncope is:

 

· Question 47

 

 

A 20 year old male patient complains of “scrotal swelling.” He states his scrotum feels heavy, but denies pain. On examination, the nurse practitioner notes transillumination of the scrotum. What is the most likely diagnosis?

 

· Question 48

 

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: nclude nitrofurantoin monohydrate/macrocrystals, trimethoprim-sulfamethoxazole (TMP-SMX), or fosfomycin.

 

· Question 49

 

Diagnostic radiological studies are indicated for low back pain:

 

· Question 50

 

 

Who is at a higher risk for developing nephrolithiasis?

·

· Question 51

 

 

An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects?

 

A.

 

Weight gain

 

B.

 

Fracture risk

 

C.

 

Hypoglycemia

 

D.

 

Weight loss

 

· Question 52

 

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 53

 

The diagnosis of human papilloma virus (HPV) infection in males is usually made by:

 

· Question 54

 

Which history is commonly found in a patient with glomerulonephritis?

 

· Question 55

 

A patient complains of generalized joint pain and stiffness associated with activity and relieved with rest. This patient history is consistent with which of the following disorders?

 

· Question 56

 

The most common presentation of thyroid cancer is:

 

· Question 57

 

The obligatory criteria for diagnosis of muscular dystrophy (MD) are:

 

· Question 58

 

The diagnosis which must be considered in a patient who presents with a severe headache of sudden onset, with neck stiffness and fever, is:

 

· Question 59

 

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?

 

· Question 60

 

A 72 year old patient exhibits sudden onset of fluctuating restlessness, agitation, confusion, and impaired attention. This is accompanied by visual hallucinations and sleep disturbance. What is the most likely cause of this behavior?

A. Dementia

C. Parkinson’s disease

D. Depression

 

· Question 61

 

Which of the following set of symptoms should raise suspicion of a brain tumor?

 

· Question 62

 

The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is:

 

· Question 63

 

Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to:

 

· Question 64

 

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. Musculosckeletal pain
B. Difficulty sleeping
C. Depression
D. Fatigue

 

· Question 65

 

The cardinal sign of infectious arthritis is:

 

 

· Question 66

 

Diagnostic evaluation for urinary calculi includes:

 

· Question 67

 

Martin, a 58 year old male with diabetes, is at your office for his diabetes follow up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Martin receive today regarding the care if his feet?

See a podiatrist yearly; wash your feet daily with
warm, soapy water and towel dry between the
toes; inspect your feet daily for any lesions; and
apply lotion to any dry areas.

· Question 68

 

Potential causes of septic arthritis include which of the following?

· Question 69

 

Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse?

· Question 70

 

A 15 year-old female patient is 5 feet tall and weighs 85 pounds. You suspect anorexia and know that the best initial approach is to:

Having the client in view of staff for 90 minutes after each meal

 

· Question 71

 

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 strategy for you to follow at this time?

A. Prescribe an alpha adrenergic blocker.
B. Recommend saw palmetto.
C. Prescribe an antibiotic
D. Refer the client to urology.

 

· Question 72

 

A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder?

· Question 73

 

A positive drawer sign supports a diagnosis of:

 

· Question 74

 

Sam, age 67, is a diabetic with worsening renal function. He has frequent hypoglycemic episodes, which he believes means that his diabetes is getting “better.” How do you respond?

·

· Question 75

 

A 14 year old female cheerleader reports gradual and progressive dull anterior knee pain, exacerbated by kneeling. The nurse practitioner notes swelling and point tenderness at the tibial tuberosity. X-ray is negative. What is the most likely diagnosis?

 

· Question 76

 

A 35 year old male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency, and reduced force of stream. The nurse practitioner suspects acute bacterial prostatitis. Which of the following specimens would be least helpful for diagnosis?

· Question 77

 

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 next action be?

 

· Question 78

 

A patient has just been diagnosed with Bell’s palsy. He is understandably upset and has questions about the prognosis. You response should be:

·

· Question 79

 

Martin is complaining of erectile dysfunction. He also has a condition that has reduced arterial blood flow to his penis. The most common cause of this condition is:

 

· Question 80

 

Successful management of a patient with attention deficit hyperactivity disorder (ADHD) may be achieved with:

 

· Question 81

 

What diabetic complications result from hyperglycemia?

1.

1.

1. Retinopathy

2. Hypertension resistant to treatment

3. Peripheral neuropathy

4. Accelerated atherogenesis

 

· Question 82

 

· Question 83

 

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

 

· Question 84

 

What is the first step in the treatment of uric acid kidney stones?

· Question 85

 

Establishment of a definitive diagnosis of osteomyelitis requires:

 

· Question 86

 

Which of the following is the most common causative organism of nongonococcal urethritis?

 

A.

 

Chlamydia trachomatis

 

B.

 

Ureaplasma urealyticum

 

C.

 

Mycoplasma hominis

 

D.

 

Trichonomas vaginalis

 

· Question 87

 

Urine cultures should be obtained for which of the following patients?

·

· Question 88

 

A 30 year old female patient presents to the clinic with heat intolerance, tremors, nervousness, and weight loss inconsistent with increased appetite. Which test would be most likely to confirm the suspected diagnosis?

 

· Question 89

 

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?

· Question 90

 

Potential causes of hypocalcemia include which of the following?

 

· Question 91

 

Which of the following patients most warrants screening for hypothyroidism?

· Question 92

 

Which of the following is a contraindication for metformin therapy?

 

· Question 93

 

The organism most often associated with prostatitis is:

 

A.

 

Klebsiella

 

B.

 

Neiserria gonorrhoaes

 

C.

 

Chlamydia trachomatis

 

D.

 

Escherichia coli

 

· Question 94

 

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

 

· Question 95

 

What is the most commonly abused substance?

 

· Question 96

 

The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in almost 100% of patients is:

· Question 97

 

Diagnostic evaluation of hypothyroidism reveals:

· Question 98

 

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. A low-calorie diet and exercise
B. Sliding-scale NPH insulin every 12 hours
C. A sulfonylurea and/or metformin (Glucophage® -XR)
D. Sliding-scale regular insulin every 6 hours

 

· Question 99

 

The correct treatment for ankle sprain during the first 48 hours after injury includes:

· Question 100

 

Prolonged PT suggests:

 

A.

 

Platelet abnormality

 

B.

 

Abnormality in intrinsic coagulation pathway

 

C.

 

Abnormality in extrinsic coagulation pathway

 

D.

 

None of the above

 

Question 101

·

A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as:

· Question 102

 

The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are):

· Question 103

 

Risk factors for Addison’s disease include which of the following?

 

· Question 104

 

Major depression occurs most often in which of the following conditions?

 

· Question 105

 

Which of the following medications increase the risk for metabolic syndrome?

 

· Question 106

 

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:

 

· Question 107

 

Risk factors for prostate cancer include all of the following except:

 

· Question 108

 

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?Post-traumatic stress disorder

 

 

NURS 6531 Midterm Exam / NURS6531 Midterm Exam (Latest): Walden University

Walden NURS 6531 Midterm Exam / Walden NURS6531 Midterm Exam (Latest)

· Question 1

 

When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

 

Yes

 

No

· Question 2

 

The most common cancer found on the auricle is:

 

Actinic keratosis

 

Basal cell carcinoma

 

Squamous cell carcinoma

 

Acral-lentiginous melanoma

· Question 3

 

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?

 

Xanthines

 

Antihistimines

 

Steroids

 

Anticholinergics

· Question 4

 

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?

 

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

 

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

 

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

 

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:

 

CBCdiff

 

Erythrocyte sedimentation rate

 

Abdominal ultrasound

 

CT scan

· Question 7

 

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:

 

Purulent drainage

 

Tearing

 

Photophobia

 

A positive fluorescein stain

· Question 8

 

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:

 

Viral conjunctivitis

 

Common pink eye

 

Gonococcal conjunctivitis

 

Allergic conjunctivitis

· Question 9

 

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:

 

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

 

Which type of lung cancer has the poorest prognosis?

 

Adenocarcinoma

 

Epidermoid carcinoma

 

Small cell carcinoma

 

Large cell carcinoma

· Question 11

 

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:

 

Acute diarrhea

 

Chronic diarrhea

 

Irritable bowel

 

Functional bowel disease

· Question 12

 

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?

 

An allergic reaction

 

Relapsing polychondritis

 

Lymphocytoma cutis

 

Systemic lupus erythematosus

· Question 13

 

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

 

Chronic sinusitis

 

Acute bronchitis

 

Bacterial pneumonia

 

Acute exacerbation of chronic bronchitis

· Question 14

 

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?

 

Mild intermittent

 

Mild persistent

 

Moderate persistent

· Question 15

 

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?

 

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

 

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?

 

Congestive heart failure

 

Varicose veins

 

Deep vein thrombosis

 

Arterial insufficiency

· Question 17

 

Which statement below is correct about pertussis?

 

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

 

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

 

Pneumonia

 

Asthma

 

Sinusitis

 

Pertussis

· Question 19

 

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?

 

Diverticulosis

 

Diverticula

 

Diverticulitis

 

Diverticulum

· Question 20

 

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?

 

Varicella

 

Herpes zoster

 

Syphilis

 

Rubella

· Question 21

 

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

 

Alcohol

 

Gallstones

 

Medications

 

Pregnancy

· Question 22

 

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

 

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:

 

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

 

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:

 

Colonoscopy

 

Small bowel follow-through

 

Barium enema

 

CT abdomen

· Question 25

 

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:

 

Mitral regurgitation

 

Systolic heart failure

 

Cardiac myxoma

 

Diastolic heart failure

· Question 26

 

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

 

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

 

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

 

“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

 

Expected spirometry readings when the patient has chronic emphysema include:

 

Decreased residual volume (RV)

 

Increased vital capacity (VC)

 

Increased forced expiratory volume (FEV-1)

 

Increased total lung capacity (TLC)

· Question 29

 

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:

 

Esophageal cancer

 

Chest pain

 

GERD

 

A and C

 

All of the above

· Question 30

 

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?

 

Squamous cell carcinoma

 

Malignant melanoma

 

A common nevus

 

Basal cell carcinoma

· Question 31

 

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

 

Prevent intestinal obstruction

 

Provide adequate nutrition

 

Promote clearance of secretions

 

Replace water-soluble vitamins

· Question 32

 

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?

 

Scalp

 

Nails

 

Feet

 

B and C

 

All of the above

· Question 33

 

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

 

Topical steroid use

 

Topical antibiotic use

 

A recent laceration

 

Cold climates

· Question 34

 

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?

 

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

 

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

 

Aspirin

 

NSAIDs

 

Opioids

 

Antihistamines

· Question 36

 

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

 

Peripheral edema

 

Weight gain

 

Shortness of breath

 

Nocturnal dyspnea

· Question 37

 

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?

 

Ibuprofen

 

Erythromycin

 

Amoxicillin

 

Acetaminophen

· Question 38

 

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?

 

“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?

 

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

 

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?

 

Asthma

 

Nocturnal allergies

 

Valvular disease

 

Heart failure

· Question 41

 

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

 

Erythromycin

 

Clarithromycin (Biaxin)

 

Doxycycline (Vibramycin)

 

Penicillin

· Question 42

 

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

 

Powders

 

Gels

 

Creams

 

Lotion

· Question 43

 

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:

 

Squamous cell carcinoma

 

Basal cell carcinoma

 

Malignant melanoma

 

Acne vulgaris

· Question 44

 

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?

 

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

 

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

 

Ursodiol

 

Ibuprofen

 

Prednisone

 

Surgery is the only answer

· Question 46

 

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:

 

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?

 

Painful diarrhea

 

Painful constipation

 

Cramping and abdominal pain

 

Weight loss

· Question 48

 

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?

 

Any recent trauma

 

Difficulty swallowing

 

Stiffness in the right shoulder

 

Change in sleeping habits

· Question 49

 

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?

 

ACE Inhibitor

 

Beta Blocker

 

Calcium channel blocker

 

Diuretic

· Question 50

 

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

 

Gonococcal infection

 

Thrush

 

Leukoplakia

 

B only

 

A, B, and C

· Question 51

 

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:

 

Rhus dermatitis

 

Ophthalmic zoster

 

Chemosis

 

Optic neuritis

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