Medicare Patient Care Costs and Satisfaction: A Review, Exercises of Nursing

Download Medicare Patient Care Costs and Satisfaction: A Review and more Exercises Nursing in PDF only on Docsity! ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Primary Care 5th ED Sample items Chapter 1 1.A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated as a Level 1 ACO. What is part of this designation? Bonuses based on achievement of benchmarks 2. What was an important finding of the Advisory Board survey of 2014 about primary care preferences of patients? Ease of access to care. 3. Which assessments of care providers are performed as part of the Value Based Purchasing initiative? (Select all that apply.) Appraising costs per case of care for Medicare patients Assessing patients’ satisfaction with hospital care Monitoring mortality rates of all patients with pneumonia Chapter 002 1. To reduce adverse events associated with care transitions, the Centers for Medicare and Medicaid Service have implemented which policy? Reduction of payments for patients readmitted within 30 days after discharge 2. According to Naylor’s transitional care model, which intervention has resulted in lower costs and fewer re-hospitalizations in high-risk older patients? Coordination of post-hospital care by advanced practice nurses 3. Which approaches are among those recommended by the Agency for Healthcare Research and Quality to improve health literacy in patients? (Select all that apply.) Empowering patients and families Correct Repeating the instructions Correct Supplementing teaching with visual aids Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Chapter 003 1. What is the purpose of Level II research? To describe relationships among characteristics or variables 2.Which is the most appropriate research design for a Level III research study? Experimental design 3.What is the purpose of clinical research trials in the spectrum of translational research? Examination of safety and effectiveness of various interventions Chapter 004 1. The provider learns that a patient is taking herbal supplements for a variety of reasons. What is an important point to discuss with this patient about taking such supplements? Many supplements lack clear clinical evidence of efficacy Correct 2. A patient takes glucosamine chondroitin to help control osteoarthritis pain. Which medications, taken in conjunction with this medication, are of concern? Blood-thinning agents Correct 3. Which dietary supplements have shown some effectiveness in reducing blood pressure in patients with hypertension? (Select all that apply.) CoQ10 Correct Garlic extract Correct L-arginine Correct Test Bank - Chapter 005 ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A 1. Which is the most important factor limiting access to health care for sexual and gender minorities? Laws prohibiting full marriage equality 2. What is the medical diagnostic term used to identify transgender patients? Gender dysphoria Correct Test Bank - Chapter 011 1. A woman who is currently pregnant reports that she has had three previous pregnancies: twins delivered at 35 weeks gestation (both living), one at 38 weeks gestation (living), and one miscarriage at 16 weeks gestation. How will this be recorded as her G/TPAL in her electronic medical record? G4P:1113 2. A pregnant woman who is overweight has no previous history of hypertension or diabetes. Her initial screening exam reveals a blood pressure of 140/90 and a fasting blood glucose of 128 mg/dL. What will the practitioner do? Monitor blood pressure and fasting blood glucose closely 3. A pregnant woman reports not having had any vaccinations as a child but requests vaccines during her pregnancy. Which vaccines may be given? (Select all that apply.) HPV Correct Inactivated influenza Correct Tdap Correct Test Bank - Chapter 012 1. The mother of a 3-day-old newborn reports that her infant nurses every 4 hours during the day and sleeps 6 hours at night. What will the provider recommend? Awakening the baby every 3 hours to nurse 2. An infant who has just begun nursing develops hyperbilirubinemia. What will the provider tell the mother? To use a breast pump to increase her milk supply 3. A mother who has been breastfeeding her infant for several weeks develops a fever, breast warmth, and breast tenderness. What will the provider recommend? Warm packs and increased frequency of nursing Test Bank - Chapter 013 ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A 1. When prescribing medications to an 80-year-old patient, the provider will consult the Beers list to help identify potentially problematic drugs. Correct 2. An 80-year-old woman who lives alone is noted to have a recent weight loss of 5 pounds. She appears somewhat confused, according to her daughter, who is concerned that she is developing dementia. The provider learns that the woman still drives, volunteers at the local hospital, and attends a book club with several friends once a month. What is the initial step in evaluating this patient? Obtain a CBC, serum electrolytes, BUN, and glucose Correct 3. The practitioner is establishing a plan for routine health maintenance for a new female client who is 80 years old. The client has never smoked and has been in good health. What will the practitioner include in routine care for this patient? (Select all that apply.) Pneumovax vaccine if not previously given Correct Yearly influenza vaccine Correct Test Bank - Chapter 014 1. When should palliative care be initiated by a primary care provider? As part of routine health maintenance Correct 2. When using the “Five Wishes” approach to documenting patient preferences for end-of- life care, the provider will document which types of preferences? (Select all that apply.) How much information to give various family members Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A The level of sedation versus alertness the patient desires Correct The people designated to make care decisions for the patient Correct 3. A patient who is near death is exhibiting signs of agitation, anxiety, and intractable pain. When discussing palliative sedation with this patient’s family, what will be discussed? (Select all that apply.) The fact that this is an intervention of last resort Correct The need for informed consent from the patient and family Correct The possibility that this measure may hasten death Correct Test Bank - Chapter 015 1. A woman who is obese has a neck circumference of 16.5 cm. Which test is necessary to assess for complications of obesity in this patient based on this finding? Polysomnography Correct 2. Which medications are associated with weight gain? (Select all that apply.) Antidepressants Correct Antihistamines Correct Insulin analogs Correct Seizure medications Correct Test Bank - Chapter 016 1. Routine screening blood tests at an annual physical exam reveal a fasting glucose level of 125 mg/dL and a hemoglobin A1C of 6.2%. What will the provider do, based on these results? Evaluate the patient for impaired glucose tolerance Correct 2. A 60-year-old patient who leads a sedentary lifestyle has expressed an interest in beginning an aerobic exercise program. What will the provider include when counseling this patient about this program? Stretching should be performed prior to activity Correct 3. The primary care provider is screening a patient using the CAGE criteria. What will the provider include in this assessment? (Select all that apply.) Number of times per week eaten in restaurants ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Patient’s comorbidities Correct Surgeon’s preference Correct Type of anesthetic agent planned Correct Test Bank - Chapter 022 1. During a pre-participation sports physical, the examiner notes a difference in strength of the patient’s radial and femoral pulses with the femoral pulses being weaker. What will the provider do? Refer the patient for a cardiologic exam Correct 2.A high-school adolescent is being screened for fitness before participating in sports. The adolescent has a normal examination and the examiner notes S1 and S2 heart sounds without murmur, normal blood pressure, and equal pulses. The parent reports that the adolescent’s father has a history or Wolff- Parkinson-White syndrome, which has been treated. What will the provider do? Refer the adolescent to a cardiologist Correct 2. An overweight adolescent who takes metformin has type 2 diabetes with a HgA1c of 8.5% and asks about sports participation. What will the provider recommend? Referral to the endocrinologist for sports clearance Correct Test Bank - Chapter 023 1. What is included in the mitigation phase of emergency management? Identification of risks Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A 2. A primary care office develops a plan for what to do in case of a fire in the building. As part of the plan, two people are to take charge in case of this emergency. Which phase of emergency planning does this represent? Response Correct Test Bank - Chapter 024 1. A patient with asthma has been given three bronchodilator treatments but continues to have wheezing and shortness of breath. The nurse caring for the patient notes an oxygen saturation of 90% on room air. What action is indicated? Notify the patient’s physician immediately Correct 2. Which symptom in a patient with asthma indicates severe bronchospasm? Pausing to breathe while attempting to talk Correct 3. Which clinical findings are worrisome in a patient experiencing acute bronchospasm, requiring immediate treatment? (Select all that apply.) A silent chest after previously wheezing Correct Decreasing blood pressure Correct Presence of an urticarial rash Correct Test Bank - Chapter 025 1. A child with no previous history of asthma is brought to the emergency department with wheezing, stridor, and shortness of breath. When the child is started on oxygen and given a nebulized bronchodilator treatment, the treatment team notes a wheal and flare rash on the child’s trunk. What medication will be given immediately? Intramuscular epinephrine Correct 2. A man self-administers epinephrine using an Epi-Pen after experiencing a bee sting and developing angioedema and wheezing. What should the man do next? Obtain transport to an emergency department immediately Correct Test Bank - Chapter 026 1. A child experiences a snake bite while camping and is seen in the emergency department. The child’s parents are not able to identify the type of snake. An inspection of the site reveals two puncture wounds on the child’s arm with no swelling or erythema at the site. The child has normal vital signs. Which treatment is indicated? ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Cleaning the wound, giving tetanus prophylaxis, and observing for 12 hours Correct 3. A patient is seen in the emergency department after experiencing a spider bite. The spider is in a jar and is less than one inch in size, yellow-brown, and has a violin-shaped marking on its back. Depending on the patient’s symptoms, which treatments and diagnostic evaluations may be ordered? (Select all that apply.) CBC, BUN, electrolytes, and creatinine Correct Coagulation studies Correct Tetanus prophylaxis Correct Test Bank - Chapter 027 1. A patient who takes a beta blocker medication is in the emergency department with syncope, shortness of breath, and hypotension. A cardiac monitor reveals a heart rate of 35 beats per minute. Which medication may be used to stabilize this patient? Epinephrine Correct 2. A patient reports heart palpitations but no other symptoms and has no prior history of cardiovascular disease. The clinic provider performs an electrocardiogram and notes atrial fibrillation and a heart rate of 120 beats per minute. Which is the initial course of action in treating this patient? Refer the patient to a cardiologist Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Egg allergy Correct Milk allergy Correct Test Bank - Chapter 032 1. A patient is brought to the emergency department after being hit in the head with a baseball. The patient is awake and talking, but is confused and disoriented and does not obey simple commands. The patient is able to point to the area of pain and opens eyes only when commanded to do so. Bystanders report a period of unconsciousness lasting almost 5 minutes. Which severity of traumatic brain injury is likely? Moderate Correct 2. A patient is in the emergency department after sustaining a blow to the head in a motor vehicle accident. The patient’s Glasgow Coma score is 14 and the patient is drowsy. The patient has a small amount of blood in one external auditory canal. Which is a priority in diagnosing the extent of injury in this patient? Non-enhanced computed tomography of the head Correct 3. A patient who sustained a head injury has a Glasgow Coma score of 14. The patient’s spouse reported that the patient lost consciousness for approximately 7 minutes after falling down the stairs. A head CT does not reveal brain lesions. Which treatment is indicated? Admission to the hospital with a neurosurgical evaluation Correct Test Bank - Chapter 033 1. A young adult patient is being treated for hypertension and is noted to have a resting blood pressure of 135/88 mm Hg just after finishing a meal. After standing, the patient has a blood pressure of 115/70 mm Hg. What is the likely cause of this change in blood pressure? Antihypertensive medications Correct 2. An elderly patient who has orthostatic hypotension secondary to antihypertensive medications is noted to have a drop in systolic blood pressure of 25 mm Hg. Which intervention is important for this patient? Initiation of a fall risk protocol Correct 3. An older patient develops orthostatic hypotension secondary to an antihypertensive ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A medication and asks what measures can be taken to minimize this condition. What will the provider recommend? (Select all that apply.) Crossing the legs when standing up Correct Custom-fitted elastic stockings Correct Increased physical activity Correct Test Bank - Chapter 034 1. Several groups of college students arrive in the emergency department reporting severe gastrointestinal symptoms after leaving a fraternity party. After stabilizing these patients, a priority for the emergency department personnel is to contact the fraternity to determine whether others are affected. Correct 2. A patient who ingested a bottle of acetaminophen tablets is brought to the emergency department. Which treatment is indicated? N-acetylcysteine Correct 3. What is the first priority in emergency management of a biological terrorism attack? Containing the exposures Correct Test Bank - Chapter 035 1. When beginning a health maintenance exam, the health care provider learns that an adult patient has been sexually assaulted the previous day. What is the initial responsibility of the provider? ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Refer the patient to the emergency department for a forensic examination Correct 2. A patient who was sexually assaulted one month prior tells her provider that she is concerned about contracting HIV. When is it appropriate to perform testing? In two weeks and then 3 to 6 months after the assault Correct 3. During a health maintenance examination, 17-year-old female reports having been raped repeatedly at a college party during the previous semester and tells the practitioner that she did not seek help at the time. Which action is a priority for the primary care provider? Reporting the alleged assault to law enforcement Correct Test Bank - Chapter 036 A healthy 20-year-old patient reports having had 1 or 2 episodes of syncope without loss of consciousness. Which is the most likely type of syncope in this patient? Reflex syncope Correct 3. An elderly patient reports experiencing syncope each morning when getting out of bed. Which assessment will the health care provider perform first to evaluate this patient’s symptoms? Orthostatic blood pressures Correct 4. Which tests are indicated as part of the initial evaluation for women of childbearing age who report syncope? (Select all that apply.) 12-lead electrocardiogram Correct Complete blood count Correct Serum glucose testing Correct Test Bank - Chapter 037 1. A provider attending a soccer match on a hot day is assisting a player who feels hot and appears dehydrated, but who is alert and oriented. What does the provider suspect? Heat exhaustion Correct 2. A patient is brought to a clinic after fainting while working outdoors on a hot day. The patient has slurred speech and headache and has a temperature of 104° F. What will the provider do? Transport the patient to the emergency department Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A provider may recommend (Select all that apply.) avoiding oil-based products. Correct eliminating spicy foods. Correct using topical antibiotics. Correct Test Bank - Chapter 043 1. A patient is in the clinic with patches of hair loss. The provider notes several well- demarcated patches on the scalp and eyebrows without areas of inflammation and several hairs within the patch with thinner shafts near the scalp. Based on these findings, which type of alopecia is most likely? Alopecia areata Correct 2. A patient with alopecia is noted to have scaling on the affected areas of the scalp. Which confirmatory test(s) will the provider order? Examination of scalp scrapings with potassium hydroxide Correct 3. A female patient is diagnosed with androgenetic alopecia. Which medication will the provider order? Minoxidil Correct Test Bank - Chapter 044 1. A patient has been bitten by a dog and has sustained several puncture wounds near the thumb of one hand. The patient is able to move all fingers and the bleeding has stopped. What is the correct treatment for this patient? ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Obtain a physician consultation for evaluation and treatment Correct 2. A patient has sustained a human bite on his hand during a fist fight. Which is especially concerning with this type of bite injury? Potential septic arthritis or osteomyelitis Correct 3. Which type of bite is generally closed by delayed primary closure? (Select all that apply.) Bites to the hand Correct Deep puncture wounds Correct Wounds 8 hours old Correct Test Bank - Chapter 045 1. When assisting with a skin biopsy of a patient suspected of having bullous pemphigoid lesions, the practitioner will perform direct immunofluorescence microscopy. Correct 2. An elderly adult patient with bullous pemphigoid is prescribed oral prednisone and hydroxyzine to manage symptoms. Which medication side effect is of immediate concern for this patient? Sedation Correct 3. A patient is newly diagnosed with bullous pemphigoid and has moderate to severe itching. The provider orders a topical corticosteroid will discuss which potential complication with this patient? Secondary infection Correct Test Bank - Chapter 046 1. A patient comes to the clinic after being splashed by boiling water while cooking. The patient has partial thickness burns on both forearms, the neck, and the chin. What will the provider do? Refer the patient to the emergency department Correct 2. A patient suffers chemical burns on both arms after a spill at work. What is the initial action by the providers in the emergency department? Remove the offending chemical and garments Correct Test Bank - Chapter 047 1. A previously healthy patient has an area of inflammation on one leg which has well- ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection? Amoxicillin-clavulanate Correct 2. A child has vesiculopustular lesions around the nose and mouth with areas of honey- colored crusts. The provider notes a few similar lesions on the child’s hands and legs. Which treatment is appropriate for this child? Amoxicillin-clavulanate Correct 3. A patient with a purulent skin and soft tissue infection (SSTI). A history reveals a previous MRSA infection in a family member. The clinician performs an incision and drainage of the lesion and sends a sample to the lab for culture. What is the next step in treating this patient? Prescribe oral clindamycin Correct Test Bank - Chapter 048 1. A patient who has been exposed to poison ivy presents with inflammation and a vesicular rash on one arm. The provider recommends a topical steroid, but the next day the patient calls to report similar lesions appearing on the face. What will the provider tell this patient? The vesicles may continue to develop for up to 2 weeks. Correct 2. A child has irritant contact dermatitis with lesions on the extremities and face. Which treatment is recommended for this patient? Oral corticosteroids Correct Test Bank - Chapter 049 ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Test Bank - Chapter 054 1. When collecting a specimen to determine a diagnosis of tinea corporis, the provider will scrape which portion of the lesion? The active, leading border Correct 2. When evaluating scalp lesions in a patient suspected of having tinea capitis, the provider uses a Wood’s lamp and is unable to elicit fluorescence. What is the significance of this finding? The patient may have tinea capitis. Correct 3. Which medication will the provider prescribe as first-line therapy to treat tinea capitis? Oral griseofulvin Correct Test Bank - Chapter 055 1. An older patient experiences a herpes zoster outbreak and asks the provider if she is contagious because she is going to be around her grandchild who is too young to be immunized for varicella. What will the provider tell her? Contagion is possible until all of her lesions are crusted. Correct 2. A patient has a unilateral vesicular eruption which is described as burning and stabbing in intensity. To differentiate between herpes simplex and herpes zoster, which test will the provider order? Polymerase chain reaction analysis Correct 3. A patient who has had a previous herpes zoster outbreak experiences a second outbreak and asks the provider about treatment to reduce the duration and severity of symptoms. What will the provider recommend? Acyclovir Correct Test Bank - Chapter 056 1. A female patient is diagnosed with hidradenitis suppurativa and has multiple areas of swelling, pain, and erythema, along with several abscesses in the right femoral area. When counseling the patient about this disorder, the practitioner will include which information? It is often progressive with relapses and permanent scarring. Correct 2. Which medications may be used as part of the treatment for a patient with hidradenitis suppurativa? (Select all that apply.) Erythromycin ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Correct Infliximab Correct Isotretinoin Correct Prednisone Correct Test Bank - Chapter 057 1. A patient has excessive sweating of the palms, soles, and axillae. The provider understands that this presentation is often due to which cause? Anxiety Correct 2. A patient reports generalized excessive sweating and states that night sweats are present. Which diagnostic test is a priority for this patient to determine the underlying cause? Purified protein derivative test Correct 3. A patient is newly diagnosed with hyperhidrosis with excessive sweating on the palms and soles. What will the provider recommend to treat this condition? Aluminum chloride hexahydrate Correct Test Bank - Chapter 058 1. A patient with intertrigo shows no improvement and persistent redness after treatment with drying agents and antifungal medications. The patient reports an onset of odor associated with a low- grade fever. What will the provider do next to manage this condition? Culture the lesions to determine the cause Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A 2. When recommending ongoing treatment for a patient who has recurrent intertrigo, what will the provider suggest? (Select all that apply.) Aluminum sulfate solution Correct Burow’s solution compresses Correct 3. An overweight patient has intertrigo, with recurrent fungal infections. In addition to medication therapy, what will the provider recommend to treat the condition? (Select all that apply.) Expose areas to light and air Correct Use a hand-held dryer to dry the area Correct Wear natural-fiber clothing Correct Test Bank - Chapter 059 1. A patient is diagnosed with herpetic whitlow and in a follow-up evaluation, is noted to have paronychial inflammation of the tendon sheath in one finger. What is a priority treatment for this patient? Refer the patient to the emergency department Correct 2. A patient with recurrent herpetic whitlow is counseled about management of symptoms and prevention of complications. What will be included in this teaching? (Select all that apply.) Contact the provider if symptoms persist longer than 3 weeks Correct Cool compresses may help with comfort and decrease erythema Correct Keep hands away from the mouth and eyes to prevent inoculation Correct 3. A female patient who works with caustic chemicals has developed acute paronychia. What will he provider include when teaching this patient about her condition? (Select all that apply.) Analgesics may be necessary for comfort Correct Use protective gloves while working Correct Wear waterproof gloves when washing dishes ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A determine a diagnosis of scabies? Intra-epidermal burrows on the interdigital spaces of the hands Correct 2. The provider is prescribing 5% permethrin cream for an adolescent patient who has scabies. What will the provider include in education for this patient? Stuffed animals and pillows should be placed in plastic bags for 1 week. Correct 3. An adult patient has greasy, scaling patches on the forehead and eyebrows suggestive of seborrheic dermatitis. What is included in assessment and management of this condition? (Select all that apply.) Begin first-line treatment with a topical antifungal medication Correct Evaluate the scalp for dry, flaky scales and treat with selenium sulfide shampoo Correct Test Bank - Chapter 065 1. A patient with chronic seborrheic dermatitis reports having difficulty remembering to use the twice daily ketoconazole cream prescribed by the provider. What will the provider order for this patient? Oral itraconazole (Sporanox) Correct 2. An adult patient has greasy, scaling patches on the forehead and eyebrows suggestive of seborrheic dermatitis. What is included in assessment and management of this condition? (Select all that apply.) Begin first-line treatment with a topical antifungal medication Correct Evaluate the scalp for dry, flaky scales and treat with selenium sulfide shampoo Correct Test Bank - Chapter 066 1. A patient who has stasis dermatitis is instructed to apply an emollient to the skin around the ankles. What is the reason for this recommendation? ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A To maintain optimum skin integrity Correct 2. Which treatment is most important in long-term management of stasis dermatitis? Compression therapy Correct 3. Which are elements of patient education when counseling a client who has stasis dermatitis about preventing complications associated with this disease? (Select all that apply.) Applying emollients daily Correct Keeping legs elevated when seated Correct Weight reduction Correct Test Bank - Chapter 067 1. A patient describes a wheal and flare type rash that recurs frequently with hives that appear and then fade within an hour. The provider notes that the patient demonstrates a wheal and flare reaction when the skin is stroked with a pen. What will the provider ask the patient to help determine the cause of this rash? Whether the patient is exposed to cold or water prior to the rash Correct 2. A patient with chronic urticaria is taking a high dose non-sedating H1 blocker medication but reports minimal relief from itching. What will the provider prescribe to help alleviate this symptom? An H2 blocker Correct Test Bank - Chapter 068 1.An adolescent patient has several warts on one hand. Which action by the provider is indicated? Reassure the patient that these lesions will regress spontaneously Correct 2. A pregnant woman has a history of human papillomavirus (HPV) and asks what she should do to prevent spread of this disease to her newborn. What will the provider recommend? Elective caesarean section Correct Test Bank - Chapter 069 1. A patient has a pressure ulcer that has been treated with topical medications. During a follow-up visit, the provider notes an area of red bumps in the lesion. What does this indicate? Healing tissue Correct 2. A patient has an ulcer on one lower leg just above the medial malleolus. The ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A provider notes irregular wound edges with granulation tissue and moderate exudate, with ankle edema in that leg. What is the initial treatment to help treat this wound? Compression therapy Correct 3. A patient with a wound containing necrotic tissue requires debridement. The practitioner notes an area of erythema and exudate in the wound. Which type of debridement will most likely be used? Mechanical debridement Correct Test Bank - Chapter 070 1. A provider performs an eye examination during a health maintenance visit and notes a difference of 0.5 mm in size between the patient’s pupils. What does this finding indicate? Probable benign, physiologic anisocoria Correct 2. A patient comes to clinic with diffuse erythema in one eye without pain or history of trauma. The examination reveals a deep red, confluent hemorrhage in the conjunctiva of that eye. What is the most likely treatment for this condition? Reassure the patient that this will resolve Correct 3. During an eye examination, the provider notes a red light reflex in one eye but not the other. What is the significance of this finding? Ocular disease requiring referral Correct Test Bank - Chapter 071 1. A primary care provider may suspect cataract formation in a patient with which finding? Asymmetric red reflex Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Apply over-the-counter artificial tears as needed Correct Avoid direct exposure to air conditioning Correct Use non-tearing baby shampoo to gently scrub the eyelids Correct Test Bank - Chapter 076 1. An adult patient with a history of recurrent sinusitis and allergic rhinitis reports chronic tearing in one eye, ocular discharge, and eyelid crusting. The provider suspects nasolacrimal duct obstruction. Which initial treatment will the provider recommend? Warm compresses Correct 2. A patient has dacryocystitis. The provider notes a painful lacrimal sac abscess that appears to be coming to a head. Which treatment will be useful initially? Incision and drainage Correct Test Bank - Chapter 077 1. Which is the most common cause of orbital cellulitis in all age groups? Local spread from the ethmoid sinus Correct 2. A child has unilateral eyelid edema, warmth and erythema and does not exhibit pain with ocular movement. Which is most likely true about this child’s infection? The eye is typically spared without conjunctivitis Correct 3. A patient has eyelid swelling with erythema and warmth and reports pain with eye movement. Which diagnostic tests will be performed to confirm a diagnosis of orbital cellulitis? (Select all that apply.) Complete blood count Correct CT scan of orbits Correct Test Bank - Chapter 078 1. A patient has an elevated, yellowish-white lesion adjacent to the cornea at the 3 o’clock position of the right eye. The provider notes pinkish inflammation with dilated blood vessels surrounding the lesion. What will the provider tell the patient about this lesion? UVB eye protection is especially important Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A 2. A patient who has an inflamed pterygia lesion has been using loteprednol topical steroid drops for 7 days. The patient shows no improvement in symptoms. What is the next course of action? Consult with an ophthalmologist Correct Test Bank - Chapter 079 1. A child sustains an ocular injury in which a shard of glass from a bottle penetrated into the eye wall. The emergency department provider notes that the shard has remained in the eye. Which best describes this type of injury? Intraocular foreign body Correct 2. A patient suffers a penetrating injury to one eye caused by scissors. The provider notes a single laceration away from the iris that involves the anterior but not the posterior segment. What is the prognosis for this injury? Because the posterior segment is not involved, the prognosis is good Correct 3. Which is an important protective precaution in a metal fabrication workshop? Polycarbonate goggles Correct Test Bank - Chapter 080 1. A primary care provider notes painless, hard lesions on a patient’s external ears that expel a white crystalline substance when pressed. What diagnostic test is indicated? Uric acid chemical profile Correct 2. During a routine physical examination, a provider notes a shiny, irregular, painless lesion on the top of one ear auricle and suspects skin cancer. What will the provider tell the patient about this lesion? A biopsy should be performed. Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Test Bank - Chapter 081 1. A child has recurrent impaction of cerumen in both ears and the parent asks what can be done to help prevent this. What will the provider recommend? Clean the outer ear and canal with a soft cloth Correct 2. A patient complains of otalgia and difficulty hearing from one ear. The provider performs an otoscopic exam and notes a dark brown mass in the lower portion of the external canal blocking the patient’s tympanic membrane. What is the initial action? Ask the patient about previous problems with that ear Correct 3. A provider is recommending a cerumenolytic for a patient who has chronic cerumen buildup. The provider notes that the patient has dry skin in the ear canal. Which preparation is FDA approved for this use? Carbamide peroxide Correct Test Bank - Chapter 082 1. A young child has a pale, whitish discoloration behind the tympanic membrane. The provider notes no scarring on the TM and no retraction of the pars flaccida. The parent states that the child has never had an ear infection. What do these findings most likely represent? Congenital cholesteatoma Correct 2. A child is diagnosed as having a congenital cholesteatoma. What is included in management of this condition? (Select all that apply.) Antibacterial treatment Correct Removal of debris from the ear canal Correct Surgery to remove the lesion Correct Test Bank - Chapter 083 1. A child who has recurrent otitis media fails a hearing screen at school. The provider suspects which type of hearing loss in this child? Conductive Correct 2. A screening audiogram on a patient is abnormal. Which test may the primary provider perform next to further evaluate the cause of this finding? ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Refer the patient to an otolaryngologist for evaluation Correct Test Bank - Chapter 088 1. A patient reports persistent nasal blockage, nasal discharge, and facial pain lasting on the right side for the past 4 months. There is no history of sneezing or eye involvement. The patient has a history of seasonal allergies and takes a non-sedating antihistamine. What does the provider suspect is the cause of these symptoms? Chronic rhinosinusitis Correct 2. A provider determines that a patient has chronic rhinosinusitis without nasal polyps. What is the first-line treatment for this condition? Intranasal corticosteroids Correct 3. A pregnant woman develops nasal congestion with chronic nasal discharge. What is the recommended treatment for this patient? Saline lavage Correct Test Bank - Chapter 089 1. A patient has bilateral bleeding from the nose with bleeding into the pharynx. What is the initial intervention for this patient? Assess airway safety and vital signs Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A 2. A patient is in the emergency department with unilateral epistaxis that continues to bleed after 15 minutes of pressure on the anterior septum and application of a topical nasal decongestant. The provider is unable to visualize the site of the bleeding. What is the next measure for this patient? Nasal packing Correct 3. A patient has recurrent epistaxis without localized signs of irritation. Which laboratory tests may be performed to evaluate this condition? (Select all that apply.) CBC with platelets Correct PT and PTT Correct PT/INR Correct Test Bank - Chapter 090 1. A child is hit with a baseball bat during a game and sustains an injury to the nose, along with a transient loss of consciousness. A health care provider at the game notes bleeding from the child’s nose and displacement of the septum. What is the most important intervention at this time? Immobilize the child’s head and neck and call 911 Correct 2. A provider performs a nasal speculum examination on a patient who sustained nasal trauma in a motor vehicle accident. The provider notes marked swelling of the nose, instability and crepitus of the nasal septum with no other facial bony abnormalities and observes a rounded bluish mass against the nasal septum. Which action is necessary at this time? Urgent drainage of the mass Correct 3. An alert, irritable 12-month-old child is brought to the emergency department by a parent who reports that the child fell into a coffee table. The child has epistaxis, periorbital ecchymosis, and nasal edema. Nares are patent and the examiner palpates instability and point tenderness of the nasal septum. The orbital structures appear intact. What is an urgent action for this patient? Involvement of social services Correct Test Bank - Chapter 091 1. A patient has recurrent sneezing, alterations in taste and smell, watery, itchy eyes, and ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A thin, clear nasal secretions. The provider notes puffiness around the eyes. The patient’s vital signs are normal. What is the most likely diagnosis for this patient? Allergic rhinitis Correct 2. A patient has seasonal rhinitis symptoms and allergy testing reveals sensitivity to various trees and grasses. What is the first-line treatment for this patient? Intranasal steroids Correct 3. A patient is concerned about frequent nasal stuffiness and congestion that begins shortly after getting out of bed in the morning. The patient denies itching and sneezing. A physical examination reveals erythematous nasal mucosa with scant watery discharge. What treatment will the provider recommend for this patient? Daily intranasal steroids Correct Test Bank - Chapter 092 1. A patient has nasal congestion, fever, purulent nasal discharge, headache, and facial pain and begins treatment with amoxicillin-clavulanate. At a follow-up visit 10 days after initiation of treatment, the patient continues to have purulent discharge, congestion, and facial pain without fever. What is the next course of action for this patient? A second course of amoxicillin-clavulanate Correct 2. A patient with allergic rhinitis develops acute sinusitis and begins treatment with an antibiotic. Which measure may help with symptomatic relief for patients with underlying allergic rhinitis? Intranasal steroids Correct 3. Which are potential complications of chronic or recurrent sinusitis? (Select all that apply.) Meningitis Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Fiberoptic nasopharyngoscopy Correct 3. An adult patient has epiglottitis secondary to a chemical burn. Which medication will be given initially to prevent complications? Dexamethasone Correct Test Bank - Chapter 098 1. A patient reports painful oral lesions 3 days after feeling pain and tingling in the mouth. The provider notes vesicles and ulcerative lesions on the buccal mucosa. What is the most likely cause of these symptoms? Herpes simplex virus Correct 2. A patient has gingival inflammation with several areas of ulceration and a small amount of purulent discharge. What is required to diagnose this condition? Physical examination Correct 3. A patient has painful oral lesions and the provider notes several white, verrucous lesions in clusters throughout the mouth. What is the recommended treatment for this patient? Surgical excision Correct Test Bank - Chapter 099 1. Which physical examination finding suggests viral rather than bacterial parotitis? Clear discharge from Stensen’s duct Correct 2. A patient who has acute suppurative parotitis has been taking amoxicillin-clavulanate for 4 days without improvement in symptoms. The provider will order an antibiotic for Methicillin-resistant S. aureus. Which other measure may be helpful? Surgical drainage Correct 3. What are factors associated with acute suppurative parotitis? (Select all that apply.) Anticholinergic medications Correct Diabetes mellitus Correct Radiotherapy Correct ADV NUR PR NSG 6001 PRIMARY CARE 5TH EDITION SAMPLE ITEMS/2023. DOWNLOAD TO SCORE A Test Bank - Chapter 100 1. An adolescent has fever, chills, and a severe sore throat. On exam, the provider notes foul- smelling breath and a muffled voice with marked edema and erythema of the peritonsillar tissue. What will the primary care provider do? Refer the patient to an otolaryngologist Correct 2. A patient is diagnoses with peritonsillar abscess and will be hospitalized for intravenous antibiotics. What additional treatment will be required? Needle aspiration of the abscess Correct