HIV Testing, Inflammatory Process Evaluation, and Other Clinical Scenarios, Exams of Nursing

Download HIV Testing, Inflammatory Process Evaluation, and Other Clinical Scenarios and more Exams Nursing in PDF only on Docsity! NR 511 Week 8 Final Exam NR 511 Final Exam Question1. The most cost-effective screening test for determining HIV status is which of the following? a. Western blot b. Enzyme-linked immunosorbent assay c. Venereal Disease Research Laboratory test d. Viral load Question2. Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process? a. Erythrocyte sedimentation rate b. White blood cell count c. Polymorphonuclear cells d. C-reactive protein (CRP) Question3. Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter? a. GABA b. Acetylcholine c. Dopamine d. Serotonin Question4. Mrs. Thomas was seen in the oMce complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that di fferenti ates the di agnosi s and is most consi stent wi th lateral epi condyl i ti s rentiates the diagnosis and is most consistent with lateral epicondylitis (tenniselbow)is: a. Ecchymosis,edema,anderythemaoverthelateralepicondyle A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next? a. Serum calcium b. TSH c. Electrolytes d. Urine specific gravity Question11. Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy? a. Insulin b. Metformin c. Glucotrol d. Precose Question12. During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? a. An enlarged rubbery gland b. A hard irregular gland c. A tender gland d. A boggy gland Question13. Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step? a. Remove the insect with tweezers. b. Immobilize the insect with 2% lidocaine. c. Sedate Eddie with diazepam. d. Shine a light in the ear for the insect to “find its way out.” Question14. What is the most common cause of microcytic anemia? a. Anemia of chronic disease b. Sideroblastic anemia c. Iron-deficiency anemia d. Thalassemia Question15. An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses? a. Benign prostatic hyperplasia (BPH) b. Parkinson’s disease c. Prostate cancer d. All of the above Question16. Early rheumatoid disease is characterized by: a. Pain and swelling in both small and large peripheral joints b. Rigid joints with diminished range of motion c. Joint swelling and immobility on rising d. A cardiac rub or pulmonary friction rub Question17. A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do? a. Make an immediate referral for an orthopedic evaluation without further assessment. b. Tell her that it takes time for these bruises to improve, so she should be patient. c. Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint. d. Send her to the emergency room for reduction of this obvious wrist fracture. Question18. The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least: a. 1 month b. 3 months c. 6 months d. 12 months Question19. A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find? a. The scrotum will be dark. b. The scrotum will appear light pink or yellow. c. The scrotum will appear milky white. d. The internal structures will be clearly visible. A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination? a. Human papillomavirus (HPV) b. Endometrial hyperplasia c. Vagismus d. Polycystic ovarian syndrome Question28. As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin? a. Two b. Three c. Four d. Five Question29. Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? a. Morning stiffness and limited mobility of the lumbar spine b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain c. Fever, chills, and elevated erythrocyte sedimentation rate d. Pathologic fractures, severe night pain, weight loss, and fatigue Question30. A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis? a. Testosterone level b. Prostate-specific antigen c. Nocturnal penile tumescence and rigidity d. Prolactin level Question31. The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective? a. “I’ll take my pill at least 30 minutes before breakfast.” b. “I’ll take my Glucotrol before bedtime.” c. “It is important to take my medication right after I eat.” d. “Since I only like to eat two meals a day, I can take the pill between my meals.” Question32. In the United States, what is the second most common connective tissue disease and the most destructive to the joints? a. Osteoarthritis b. Systemic lupus erythematosus (SLE) c. Rheumatoid arthritis d. Sjögren’s syndrome Question33. The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety? a. Acetylcholine b. Gamma-aminobutyric acid (GABA) c. Dopamine d. Serotonin Question34. A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action? a. Refer to a urologist immediately. b. Obtain a computed tomography (CT) scan. c. Instruct the patient to elevate the scrotum. d. Prescribe ibuprofen. Question35. Which of the following medications can cause hyperglycemia? a. Prednisone b. Metformin c. Synthroid d. Cephalexin Question36. During treatment for anaphylaxis, what site is used for the initial injection of epinephrine? a. IV b. Abdomen c. Upper lateral thigh d. Deltoid Question37. It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period? a. Before the initiation of treatment b. 1 to 2 weeks after the initiation of treatment c. When switching to a different medication d. 1 to 2 weeks after tapering off medications Question38. What is the most common cause of secondary amenorrhea? a. Pregnancy b. Pituitary dysfunction c. Inadequate estrogen levels d. Genetic disorders Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? a. Gastrocnemius weakness b. A reduced or absent ankle reflex c. Numbness in the lateral foot d. Paresthesia of the perineum and buttocks Question46. A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the following tests is essential before prescribing any oral contraceptive? a. Pregnancy test b. Complete blood cell count c. Thyroid-stimulating hormone d. Urine dip for protein Question47. A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin? a. Ketoacidosis b. Cirrhosis c. Hypoglycemic episodes d. All of the above Question48. The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants? a. SSRIs are more effective than TCAs. b. SSRIs take less time to work than TCAs. c. SSRIs have a more favorable side-effect profile than TCAs. d. SSRIs are not lethal in overdose. Question49. Which type of bone marrow transplant is obtained from an identical twin? a. Autogenic b. Autologous c. Allogeneic d. Syngeneic Question50. Pink, cherry red tissues and skin may result from which type of poisoning? a. Arsenic b. Lead c. Carbon monoxide d. Strychnine Question51. Basic human needs are identified as: a. Autonomy and feeling valued by others b. Exhilaration and productivity c. Spirituality d. Career success and material rewards Question52. The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient? a. Overweight b. Mild obesity c. Moderate obesity d. Morbid obesity Question53. A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnoses? a. Testicular cancer b. Inguinal hernia c. Varicocele d. All of the above Question54. What is the treatment of choice for a patient diagnosed with testicular cancer? a. Radical orchidectomy b. Lumpectomy c. Radiation implants d. All of the above Question55. Which method is used to remove heavy metals, such as lead, that are ingested as poisons? a. Chelation b. Dialysis c. Gastric lavage d. Bowel irrigation Question56. A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate? a. “It is probably just a cyst because that is the most common breast mass.” b. “We will order a mammogram and ultrasound to help establish a diagnosis.” c. “We will go ahead and schedule you for a biopsy because that is the only way to know for sure.” d. “Because your lump is painful, it is most likely not cancer.” Question57. Question64. A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expect as a manifestation of the disease? a. Sinus bradycardia b. Atrial fibrillation c. Supraventricular tachycardia d. U waves Question65. Which of the following tests is essential for a 46-year-old woman who the clinician suspects is perimenopausal? a. Pregnancy b. Estrogen level c. Progesterone level d. LH level Question66. After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? a. Elevated TSH b. Normal TSH c. Low TSH d. Undetectable TSH Question67. A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment? a. No treatment at this time b. Diet and exercise for 6-week trial c. Diet, exercise, and oral medication d. Diet, exercise, and exogenous insulin Question68. Which of the following should be considered in a patient presenting with erectile dysfunction? a. Diabetes mellitus b. Hypertension c. Atherosclerosis d. All of the above Question69. Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome? a. Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel. b. Only people with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel. c. An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel. d. Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance. Question70. A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea? a. Ceftriaxone b. Doxycycline c. Acyclovir d. Metronidazole Question71. Which of the following statements is true regarding the treatment of carpal tunnel syndrome? a. The goal of treatment is to prevent flexion and extension movements of the wrist. b. Splints are used in carpal tunnel syndrome, because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position. c. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection. d. All of the above Question72. Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this patient? a. Elevated uric acid level b. Elevated blood urea nitrogen c. Decreased urine pH d. Decreased C-reactive protein Question73. Which of the following data is indicative of testicular torsion? a. Absent cremasteric reflex b. Pain relieved on testicular elevation c. Testicle very low in the scrotum d. Swollen scrotum with “red dot sign” Question74. A patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer her, the clinician must understand that exercise has what effect on the patient with type 2 diabetes? a. Reduces postprandial blood glucose d. The friend must have his or her own bathroom. Question82. Sandra is 42 years old and has just been diagnosed with leukemia. She is complaining of bone and joint pain. Which type of leukemia is most likely the culprit? a. Acute lymphocytic leukemia b. Acute myelogenous leukemia c. Chronic myelogenous leukemia d. Chronic lymphocytic leukemia Question83. Which of the following is identified as an eating disorder in which a person craves food substitutes, such as clay, ice chips, and cotton, and is considered an objective finding associated with severe iron deficiency? a. Ferritin b. Porter’s syndrome c. Hypochromasia d. Pica Question84. The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit? a. High sensitivity thyroid-stimulating hormone (TSH) and free T4 b. Free T4 and serum calcium c. Free T3 and T4 d. TSH and thyroxin antibodies Question85. The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been effective? a. “As long as I don’t need glasses, I don’t have to worry about going blind.” b. “I know I need to have my eyes checked every year.” c. “My optometrist checks my eyes.” d. “I will see my eye doctor when my vision gets blurry.” Question86. Triggering factors for acute exacerbations of which of the following conditions include exposure to ultraviolet (UV)-B and UV-A rays? a. Rheumatoid arthritis b. Scleroderma c. SLE d. Sjögren’s syndrome Question87. Which of the following characteristics separates anaphylaxis from a vasovagal reaction? a. Bradycardia b. Extreme diaphoresis c. Severe bronchoconstriction d. Hypotension Question88. Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The clinician has explained to Mr. Jackson that the goals for managing osteoarthritis include controlling pain, maximizing functional independence and mobility, minimizing disability, and preserving quality of life. Mr. Jackson explains to the clinician that his first choice would be to use complementary therapies to control his condition and asks what therapies are most effective in treating osteoarthritis. What would be the most appropriate response from the clinician? a. “Complementary therapies should be considered only if surgical interventions are not successful.” b. “I am unfamiliar with the available complementary therapies for osteoarthritis and prefer to discuss more mainstream treatments, such as NSAIDs and physical therapy, to manage your condition.” c. “I would be happy to discuss all the treatment options available to you. Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being studied for use in the treatment of osteoarthritis and have shown promise when used with standard medical therapy.” d. “It would be crazy to use complementary therapies to treat such a serious condition.” Question89. One benefit of motivational interviewing (MI) is: a. It assumes that ambivalence is a normal part of the change process. b. It can be utilized during routine office visits. c. It is a therapeutic technique which is not necessarily time intensive. d. All are benefits of MI. Question90. What percentage of burns is involved using the rule of nines if both front legs are burned? a. 9% b. 18% c. 24% d. 36% Question91. Women are at the highest risk for developing postpartum depression for up to how long after childbirth? a. 2 weeks b. 1 month c. 3 months d. 6 months Question92. Which statement about HIV postexposure prophylaxis (PEP) for health-care workers is the most accurate? a. PEP should be started within hours of exposure. b. PEP should be started within 72 hours of exposure. c. Renal and hepatic function tests should be done 6 weeks after beginning PEP.