NR511 Final Exam Study Guide- Chamberlain College of Nursing LATEST UPDATED., Exams of Nursing

Download NR511 Final Exam Study Guide- Chamberlain College of Nursing LATEST UPDATED. and more Exams Nursing in PDF only on Docsity! 1. Signs and symptoms and management of musculoskeletal sprains/strains/dislocations 16-15 When Maxwell, age 12, slid into home plate while playing baseball, he injured his ankle. The nurse practitioner is trying to differentiate between a sprain and a strain. A sprain A. is an injury to the ligaments that attach to bones in a joint. B. is an injury to the tendons that attach to the muscles in a joint. C. is an injury resulting in extensive tears of the muscles. D. is an injury th 16-98 Alexander, age 12, sprained his ankle playing ice hockey. He is confused as to whether to apply heat or cold. What should the nurse practitioner tell him? A. “Use continuous heat for the fi rst 12 hours and then use heat or cold to your own preference.” B. “Use continuous cold for the fi rst 12 hours and then use heat or cold to your own preference.” D. “Alternate between cold and heat for 20 minutes each for the fi rst 24 to 48 hours.” 16°69 Ankylosis is defi ned as A. muscle shortening. B. joint stiffness. C. malposition of a joint. D. dislocation of a joint. 16-108 Jill, age 49, has recently begun a rigorous weight- lifting regimen. She presents to the primary care offi ce with a shoulder dislocation. Which of the following clinical manifestations lead the nurse practitioner to suspect an anterior shoulder dislocation over a posterior dislocation? A. Inability to shrug the shoulder B. Absence of pain C. Inability to rotate the shoulder externally D. Shortening of the arm 16-123 In assessing an infant for developmental dysplasia of the hip (DDH), the practitioner places the infant supine, fl exes the knees by holding the thumbs on the inner mid- thighs, with fi ngers outside on the hips touching the greater trochanters, stabilizes one hip, and abducts and gently pulls anteriorly on the other thigh. If this external rotation feels smooth with no sound present, there is no hip dislocation. This is A. the Allis test. B. Las¢gue’s sign. C. the McMurray test. D. the Ortolani maneuver. 16-124 Emily, age 12, presents to the clinic with another muscle strain from one of her many sports activities. The nurse practitioner thinks that the patient was probably never taught about health promotion and maintenance regarding physical activity. What information should be included in patient teaching? A. “After an activity, if any part hurts, apply ice for 20 minutes.” B. “You must fi rst get in shape with a rigorous schedule of weight training, and then you can participate in any activity once you are physically fi t.” C. “After any strenuous activity, you must completely rest your muscles before beginning your next activity.” Upon assessment, the nurse practitioner notes unilateral back pain that had an acute onset and increases when standing and bending. A straight- leg test is negative. The most likely differential diagnosis is . B. muscle strain. C. osteoarthritis. D. spondylolisthesis. June, age 67, presents with back pain with no precipitating event. The pain is located over her lower back and muscles without sciatica, and it is aggravated by sitting, standing, and certain movements. It is alleviated with rest. Palpation localizes the pain, and muscle spasms are felt. There was an insidious onset with progressive improvement. 16-16 Which of the following is NOT a management principal for an acute musculoskeletal injury that does not require emergent treatment? A. RICE B. NSAIDs or acetaminophen C. Imaging studies D. Skeletal muscle relaxants. 16-86 James, age 17, has been complaining of a painful knob below his right knee that has prevented him from actively participating in sports. He has recently been given a diagnosis of Osgood-Schlatter disease and asks you about his treatment options. The nurse practitioner should tell him that the initial treatment is B. immobilization; a long- leg knee immobilizer is recommended. C. surgical intervention; removal of the bony fragments is necessary. D. bedrest for 1 week.. 16-124 Emily, age 12, presents to the clinic with another muscle strain from one of her many sports activities. The nurse practitioner thinks that the patient was probably never taught about health promotion and maintenance regarding physical activity. What information should be included in patient teaching? A. “After an activity, if any part hurts, apply ice for 20 minutes.” B. “You must fi rst get in shape with a rigorous schedule of weight training, and then you can participate in any activity once you are physically fi t.” C. “After any strenuous activity, you must completely rest your muscles before beginning your next activity.” 16-15 When Maxwell, age 12, slid into home plate while playing baseball, he injured his ankle. The nurse practitioner is trying to differentiate between a sprain and a strain. A sprain A. is an injury to the ligaments that attach to bones in a joint. B. is an injury to the tendons that attach to the muscles in a joint. C. is an injury resulting in extensive tears of the muscles. D. is an injury that does not result in joint instability.. 16-98 Alexander, age 12, sprained his ankle playing ice hockey. He is confused as to whether to apply heat or cold. What should the nurse practitioner tell him? A. “Use continuous heat for the fi rst 12 hours and then use heat or cold to your own preference.” B. “Use continuous cold for the fi rst 12 hours and then use heat or cold to your own preference.” D. “Alternate between cold and heat for 20 minutes each for the fi rst 24 to 48 hours.” 8. Osteopenia 6-87 Shelley, 65 years old, sees you for the fi rst time. She has demonstrated osteopenia ona bone density test, and you have prescribed the appropriate medication for her. What additional lifestyle changes should you counsel for this client? A. She should begin a rigorous swimming program to actively build bone. B. She should cut down on coffee, but tea is okay. C. She needs to take a multivitamin every day. D 12-51 Marisa, age 42, has celiac disease. She is prone to osteopenic bone disease as a result of impaired calcium absorption because of A. increased calcium absorption by the small intestine. B. increased absorption of the fat-soluble vitamin D. decreased magnesium absorption.. 15-90 Mrs. Thomas, age 69, comes to your offi ce for the results of her DEXA scan. She reports that her mother had osteopenia before she died. The DEXA scan result shows a T score of -2.7 in the hip and -2.8 in the spine. You explain to her that her results show A. normal bone density. B. osteopenia. C. 16-72 Hilda, age 73, presents with a complaint of low back pain. Red fl ags in her history of a minor fall, osteopenia, and prolonged steroid use for systemic lupus erythematosus suggest the possibility of which of the following serious underlying conditions as the cause of her low back pain? A. Cancer B. Cauda equina syndrome C. Neurological compromise D. . 16-18 Lillian, age 70, was told that she has osteoporosis. When she asks you what this is, you respond that osteoporosis A B. is a degenerative joint disease characterized by loss of cartilage in certain joints.. 16-40 Black men have a relatively low incidence of osteoporosis because they have A. increased bone resorption. B. a higher bone mass. C. wide and thick long bones. D. decreased bone deposition... 16-45 Joan, age 76, has been given a diagnosis of osteoporosis confi rmed with a dual- energy x- ray absorptiometry (DEXA) scan. The nurse practitioner has educated her about the importance of increasing calcium and vitamin D in her diet and starting a low- impact, weight- bearing exercise program. The nurse practitioner is also going to start the patient on medial management. Joan asks about a drug called a “SERM” that she has heard has been shown in studies to prevent vertebral fractures. Which of the following pharmacological therapies for osteoporosis is classifi ed as a selective estrogen receptor modulator (SERM)? A. Alendronate (Fosamax) B. Risedronate (Actonel) C. Salmon calcitonin 16-32 Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond? A. “Caffeine has no effect on osteoporosis.” 16-89 Which of the following is a modifi able risk factor for osteoporosis? A. Low alcohol intake B. Low caffeine intake C. Smoking D. Excessive exercise 16-121 Bone mineral density (BMD) testing is recommended by the National Osteoporosis Foundation for which of the following client populations to assess whether they are at high risk for osteoporosis? B. All men age 65 and older regardless of risk factors C. All women in their 30s for a baseline D. All women of menopausal age. 72 Jillis perimenopausal and asks you about the relationship between exercise and preventing osteoporosis. You tell her that A. exercise has no effect; she should take calcium supplements. B. weight-bearing exercise prevents bone mass loss. C. all types of exercise assist in preventing osteoporosis. D. since she was very athletic during her formative years, her bones will maintain their bone mass. 9. Assessment and management of gout. 8-40 Eric, age 52, has gout. What do you suggest? A. Using salicylates for an acute attack C. Testing his uric acid level every 6 months D. Decreasing fl uid intake 8-92 Gouty pain in the great toe is A. toe gout. B. hyperuricemia of the toe. Podagra 16-82 The nurse practitioner is considering a diagnosis of calcium pyrophosphate dihydrate (CPPD) crystal deposition disease or pseudogout in a 72- year- old man who presents with complaints of pain and stiffness in his wrists and knees. The most useful diagnostic test to assist in confi rming this diagnosis would be 16-118 Gout is caused by urate crystals being deposited in certain joints leading to acute pain, erythema and edema. Gout typically occurs most often in the joint of the A B. wrist. C. elbow. D. fi nger. 17-24 Which of the following medications can increase uric acid and lead to an acute gouty attack? A. HCTZ B. Beta blockers C. Calcium channel blocker D. ACE inhibitors Medication management for acute vs. chronic gout 17-4 What is the medication of choice for an initial acute attack of gout? A. An NSAID 116-2 Colchicine may be used to terminate an acute attack of gouty arthritis as well as to prevent recurrent episodes. The mechanism of action is to A. interrupt the cycle of urate crystal deposition and inf | ammatory response. B. increase serum uric acid levels. C. potentiate the excretion of uric acid. D. inhibit the tubular reabsorption of urate, promoting the excretion of uric acid. 16-7 Bursitis is an infl ammatory process that may be caused by infection, trauma, repetitive movement disorders, gout, or neoplastic disease. The most common cause of septic bursitis due to infection is from which of the following? 10. Dietary restrictions for gout 6-96 You are teaching a client about his gout. Which of the following should you include in your teaching? A. Once gout is treated, there is no danger of permanent damage. B. Diet and alcohol consumption may remain the same. C. Drink at least 1 quart of fl uid per day. 17-85 Joy has gout. In teaching her about her disease, which food do you tell her is allowed on the diet? A. Asparagus B. Beans C. Broccoli D. Mushrooms 11. Signs and symptoms and management of thyroid disorders 5-80 You are seeing Minnie, a 15-year-old girl. You suspect that Minnie is suffering from bulimia, based on your physical exam. When assessing Minnie you observe the following. A. An absence of bowel sounds, epigastric rumbling, and halitosis B. Hyperactive bowel sounds, an enlarged thyroid, and tachycardia D. Clear evidence of dehydration, sore gums, and subjective complaints of stomach pain 12. Thyroid screening tests, confirmatory tests and monitoring 17-11 An elderly client with hyperthyroidism may present with atypical symptoms. Which of the following manifestations are commonly seen in the elderly with hyperthyroidism? A. Adrenergic fi ndings such as tachycardia B. Weight gain, depression, and heat intolerance C. Atrial f i brillation, depression, and weight loss D. Heat intolerance, hyperrefl exia, and anorexia 16. 17. 18. 18-94 Your client, Shirley, has an elevated mean cell volume (MCV). What should you be considering in terms of diagnosis? A. Iron-defi ciency anemia B. Hemolytic anemias C. Lead poisoning X-linked disorders in African American males 18-84 Which of the following is an X-linked recessive disorder commonly seen in African American males? A. Sickle cell anemia C. Pyruvate kinase defi ciency D. Bernard-Soulier syndrome Signs and symptoms of splenic sequestration 18-5 Mindy, age 6, recently was discharged from the hospital after a sickle cell crisis. You are teaching her parents to be alert to the manifestations of splenic sequestration and tell them to be alert to A. vomiting and diarrhea. B. decreased mental acuity. C. D. abdominal pain and vomiting. Most accurate diagnostic testing for sickle cell anemia 18-5 Mindy, age 6, recently was discharged from the hospital after a sickle cell crisis. You are teaching her parents to be alert to the manifestations of splenic sequestration and tell them to be alert to A. vomiting and diarrhea. B. decreased mental acuity. C. . D. abdominal pain and vomiting. 18-2 Sickle cell anemia affects African Americans. Approximately 1 in 400 African Americans in the United States has sickle cell disease (SCD). Advances in treatment have been made, but life expectancy is still limited. The mean survival time for men with the disease is approximately A. 24 years. B. 34 years. C. 42 years. D. 52 years. 18-11 Jimmy, age 6 months, is newly diagnosed with sickle cell disease. His mother brings him to the clinic for a well-baby visit. Which of the following should you do on this visit? A. Tell the parents that Jimmy will not be immunized because of his diagnosis. B. Tell the parents that Jimmy should not go to day care. D. Immunize Jimmy with measles, mumps, a 18-22 Which of the following situations might precipitate a sickle cell crisis in an infant? A. Taking the infant to visit a relative B. Hepatitis B immunization D. Increasing fl uid intake 18-28 Sue has sickle cell anemia. In regulating her and monitoring her hemoglobin and hematocrit levels, you want to maintain them A. slightly below normal. B. strictly at normal. C. slightly above normal. D. around normal with only minor fl uctuations. 18-47 The gold standard for defi nitive diagnosis of sickle cell anemia is A. a reticulocyte count. B. the sickle cell test. C. a hemoglobin electrophoresis. D. a peripheral blood smear. 18-56 Health maintenance in adults with sickle cell anemia includes which of the following? A. Early sterilization to prevent transmission of the disease B. Getting the hepatitis A vaccine C. Avoiding the use of oral contraceptives because of increased risk of clotting 18-68 The primary reason for newborn screening for sickle cell disease is to A. present the parents with the option for genetic screening in the future. B. test siblings if it is proven that the newborn has sickle cell disease. D. prevent a sickle cell crisis. 19. 20. 21. 18-88 Hemolytic anemia may be an inherited condition. Which of the following is not an inherited condition related to hemolytic anemia? A. Hereditary spherocytosis B. C. Glucose-6-phosphate dehydrogenase defi ciency D. Sickle cell anemia 18-95 Sickle cell anemia is an autosomal recessive disorder caused by the hemoglobin S$ gene. An abnormal hemoglobin leads to chronic hemolytic anemia with numerous clinical manifestations and becomes a chronic multisystem disease, with death from organ failure, usually between ages 40 and 50. The hemoglobin S gene is carried by A. approximately 4% of the U.S. population. B. approximately 8% of African Americans. c. approximately 4% of Latinos. D. approximately 12% of Native Americans. Patient education for iron supplementation administration to improve efficacy 18-70 Tina, age 2, had a complete blood count (CBC) drawn at her last visit. It indicates that she has a microcytic hypochromic anemia. What should you do now at this visit? A. B. Instruct Tina’s parents to increase the amount of milk in her diet C. Start Tina on ferrous sulfate (Feosol) and check the CBC in 6 weeks D. Recheck the CBC on this visit. 98 Food sources rich in iron include A. potatoes; bananas; and green, leafy vegetables. B. enriched grain cereals, cabbage, and sweet potatoes. D. enriched grain cereals, strawberries, watermelon, and honeydew melons.. 18-57 Sandra, age 19, is pregnant. She is complaining of breathlessness, tiredness, weakness, and is pale. After diagnosing anemia, you order medication and tell her to take it A. only with meals because it can be irritating to the stomach. B. in the morning if she experiences morning sickness. C. D. at bedtime. Risks, diagnosis and treatment of hematological disorders 18-36 You have a new client, Robert, age 67, who presents with a generalized lymphadenopathy. You know that this is indicative of . B. cancer of the liver. C. Sj6gren’s syndrome. D. pancreatic cancer. 18-51 Systemic lupus erythematosus (SLE) is diagnosed on the basis of A. positive B. positive ANA, weight loss, and night sweats. C. negative ANA, photosensitivity, and renal disease. D. leukopenia, negative ANA, and photosensitivity. 18-91 Mandy, age 18, has infectious mononucleosis. What might you expect her blood work to refl ect? A. Thrombocytopenia and elevated transaminase B. Elevated white blood cells (WBCs) C. Decreased WBCs D. Decreased serum globulins Common types of leukemia 6-39 Which of the following conditions, which may be detected by a complete blood count, has suffi cient prevalence to make early detection benefi cial? A. Anemia B. Leukocytosis C. Thrombocytopenia D. Leukemia 10-60 Which of the following individuals most likely will have a false-negative reaction to the Mantoux test? A. Marvin, age 57 B. Jane, who is on a short course of corticosteroid therapy for an acute exacerbation of asthma D. Mary, who recently was exposed to someone coughing 22. 23. 24. 18-7 Samantha is being given platelets because of acute leukemia. One “pack” of platelets should raise her count by how much? A. 2,000 to 4,000 mm mm 3C. 9,000 to 12,000 mm 3 D. About 15,000 mm 18-58 Which type of leukemia produces symptoms with an insidious onset including weakness, fatigue, massive lymphadenopathy, pruritic vesicular skin lesions, anemia, and thrombocytopenia? A. Acute lymphocytic leukemia B. Acute myelogenous leukemia D. Chronic myelogenous leukemia 18-78 Which of the following cancers is associated with Epstein-Barr virus? B. Kaposi’s sarcoma C. Lymphoma D. Adult T-cell leukemia 18-97 Samuel, age 5, is receiving radiation therapy for his acute lymphocytic leukemia. He is at increased risk of developing which type of cancer as a secondary malignancy when he becomes an adult? A. Chronic lymphocytic leukemia B. Brain tumor C. Liver cancer D. Esophageal cancer 18-12 Your client, Ms. Jones, has an elevated platelet count. You suspect A. systemic lupus erythematosus. B. infectious mononucleosis. C. disseminated intravascular coagulation (DIC). Stages of chronic lymphocytic leukemia (CLL) 18-26 Julie’s brother has chronic lymphatic leukemia. She overheard that he was in stage IV and asks what this means. According to the Rai classifi - cation system, stage IV is a stage A. at which the lymphocytes are greater than 10,000 mm 3. B. with an absolute lymphocytosis, in which the client may live 7 to 10 years or more. D. of anemia. Acute lymphoblastic leukemia (ALL) treatment in children and correlation with subsequent cancers in adulthood 18-85 Skip, age 4, is brought to the offi ce by his mother. His symptoms are pallor, fatigue, bleeding, fever, bone pain, adenopathy, arthralgias, and hepatosplenomegaly. You refer him to a specialist. Which of the following tests do you expect the specialist to perform to confirm a diagnosis? A. An enzyme-linked immunosorbent assay B. A monospot test C. A prothrombin time, partial thromboplastin time, bleeding time, complete blood count, and peripheral smear 18-97 Samuel, age 5, is receiving radiation therapy for his acute lymphocytic leukemia. He is at increased risk of developing which type of cancer as a secondary malignancy when he becomes an adult? A. Chronic lymphocytic leukemia B. Brain tumor C. Liver cancer D. Esophageal cancer 18-15 Allie, age 5, is being treated with radiation for cancer. Her mother asks about the effect radiation will have on Allie’s future growth. Although she knows that a specialist will be handling Allie’s care, her mother asks for your opinion. How do you respond? A. “Let’s worry about the cancer fi rst, then see how her growth is affected.” B. “Chemotherapy may affect her future growth, but radiation will not.” D. “That’s the least of your worries now; everything will turn out okay.” Animal bites 4-90 Sidney, age 72, presents to the clinic with complaints of a weak urine stream, hesitancy, and painful ejaculation. On digital rectal examination, you note that his prostate is boggy. The most common cause of his symptoms is A. acute bacterial prostatitis. . C. chronic nonbacterial prostatitis with chronic pelvic pain syndrome. D. noninfl ammatory prostatitis. 14-408 Jeff, age 20, presents to the college health clinic with complaints of diffi culty passing his urine and a discharge from his penis. Upon further investigation, you note that the discharge is urethral in origin. The most common cause of these symptoms in the young adult male population is A. chronic prostatitis. B. prostatic abscess. D. prostatic hypertrophy. 33. Management and intervention for BPH 14-82 What differentiates prostate cancer symptoms from benign prostatic hypertrophy (BPH) symptoms? A. Urinary frequency, hesitancy, and intermittency are much worse with prostate cancer. B. Nocturia is worse with BPH. C. Dribbling and a weak stream are more indicative of BPH. D. In older adult males, which of the following is the most common cause of nocturia? A. Benign prostatic hyperplasia (BPH) B. Diminished bladder capacity C. Habit D. Overfl ow incontinence 44-2 Benign prostatic hypertrophy is a common fi nding as men age. Classically, this condition may begin with diffi culty initiating the urinary stream, hesitancy, urgency, postvoid dribbling, urinary frequency, nocturia, urinary retention, sensation of a full bladder immediately after voiding, and incontinence. These preceding symptoms would also cause the nurse practitioner to consider what other condition as a differential diagnosis? A. Epididymitis B. Testicular cancer C. Cancer of the prostate D. Balanitis 14-18 Milton, a 72- year- old unmarried, sexually active white man, presents to your clinic with complaints of hesitancy, urgency, and occasional uncontrolled dribbling. Although the nurse practitioner suspects benign prostatic hypertrophy, what else should the differential diagnosis list include? A. Antihistamine use B. Urethral stricture on Detrusor hyperrefl exia D. Renal calculi 14-84 If a patient presents with symptoms of benign prostatic hypertrophy, a digital rectal examination is indicated in order to A. Be evaluate for hypospadias. C. rule out any neurological problems that may cause the symptoms. D. detect the presence of urethritis. 34. Assessment and management of prostate cancer 3-43 When should an African American man start to be screened for prostate cancer by a digital rectal exam? A. Age 60 and then yearly B. Age 40 and then every 2 years C. Never 3-18 Which tumor marker is specifi cally elevated in prostate cancer? A. Prostate cancer tumor marker (PCTM) B. Cancer antigen (CA) 125 C. Carcinoembryonic antigen (CEA) D. 14-39 The U.S. Preventive Services Task Force (USPSTF) recommends against prostate- specifi c antigen (PSA)-based screening for prostate cancer. They grade the evidence related to PSA screening as A. AB. BC. C D.D 14-408 You are referring a 73- year- old client for management of his prostate cancer with hormonal therapy. It is understood that goserelin acetate (Zoladex) acts as a method of androgen ablation by Mr. Hughes is a 46-year-old African American man who is in your primary care offi ce for a physical examination. You recommend which of the following as screening for prostate cancer? A. A digital rectal examination (DRE)