NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023, Exams of Nursing

Download NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 and more Exams Nursing in PDF only on Docsity! NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 B. No a. It assesses numeracy skills. It enhances patient–provider b. communication. *c It evaluates medical word recognition. . d. It measures technology knowledge. *a Bonuses based on achievement of . benchmarks b. Care coordination for chronic diseases c. Standards for minimum cash reserves Strict requirements for financial d. reporting Angie is a new NP who just finished her FNP program. She is having a difficult time finding an FNP position in the rural area where she lives. So, since she was an ER nurse prior to her graduate program she decides to go back to the ER as an APRN. Does she meet the competency requirements for such a position? *A Ye . s What is the main reason for using the REALM-SF instrument to evaluate health literacy? 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? Question 4 The Consensus Model identifies 3 core courses that all ANPs must take. All the following are Advanced core courses except: *A Public Health . B. Physiology C. Pharmacology Physical D. Assessment The care provided by APRNs is not limited by setting but by patient care needs. *True NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 Epidemiological a. studies b. Experimental design *c Qualitative studies . Randomized clinical d. trials Associations with area a. hospitals b. Costs of ambulatory care *c Ease of access to care . The ratio of providers to d. patients Mandates for communication among primary caregivers and a. hospitalists Penalties for failure to perform medication reconciliations at time b. of discharge *c Reduction of payments for patients readmitted within 30 days . after discharge Requirements for written discharge instructions for patients and d. caregivers A. CNM B. CRNA C. APN D. CNS False Which is the most appropriate research design for a Level III research study? What was an important finding of the Advisory Board survey of 2014 about primary care preferences of patients? To reduce adverse events associated with care transitions, the Centers for Medicare and Medicaid Service have implemented which policy? The Consensus Model for APRN regulation consists of which of the following roles? NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 *A First degree . burn Second degree B. burn Third degree C. burn Fourth degree D. burn A. Nevi Acanthosis B. Nigricans * Acrochordon C. D. Cherry Angioma The most common type of melanoma in African Americans and Asians is: A. Basal Cell carcinoma B. Actinic Keratosis * Acral Lentiginous C. Melanoma Toxic Epidermal D. Necrolysis Olga was making French fries for her kids and gets splashed with hot oil. At the clinic the NP notes that she has red colored skin with superficial blisters and pain where the oil splashed. The most likely diagnosis is: Patty comes to the clinic with these soft fatty cystic lesions on her neck, trunk and arms. The most likely diagnosis is: During a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient’s nose. What will the provider do? keratoses *B Urticaria . C. Xanthelasma D. Melasma NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 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? C. Penicillin Azithromyci D. n * A. Amoxicillin B. Doxycycline Oral Consider prescribing a topical mast cell a. stabilizer. *b Determine the duration of treatment with this . medication. c. Prescribe a non-sedating oral antihistamine. d. Refer the patient to an ophthalmologist for Mikey is a 19 y/o male who is brought to the clinic because he has a fever, sore throat, pain on swallowing and mildly enlarged submandibular nodes First line pharmacological treatment for Mikey would include: a. Normal physiologic variant *b Ocular disease requiring . referral Potential infection in the c. “red” eye Potential vision loss in one d. eye A patient diagnosed with allergic conjunctivitis and prescribed a topical antihistamine- vasoconstrictor medication reports worsening symptoms. What is the provider’s next step in managing this patient’s symptoms? Consult with a dermatologist about possible a. melanoma. b. Reassure the patient that this is a benign lesion. *c Refer the patient for possible electrodessication and . curettage. Tell the patient this is likely a squamous cell d. carcinoma. NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 a. Antibiotic eye drops Nasolacrimal duct b. probing c. Systemic antibiotics *d Warm compresses . *a Examination of scalp scrapings with potassium . hydroxide (KOH) b. Grasping and pulling on a few dozen hairs c. Serum iron studies and a complete blood count d. Venereal Disease Research Laboratory (VDRL) test a. Anthralin Cyclospori b. ne c. Finasteride *d Minoxidil . *A Streptococcus . pyogenes B. Streptococcus pneumonia C. Streptococcus mutans D. Streptomyces 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? A patient diagnosed with alopecia is noted to have scaling on the affected areas of the scalp. Which confirmatory test(s) will the provider order? A female patient is diagnosed with androgenetic alopecia. Which medication will the primary health care provider prescribe? Mikey is a 19 y/o male who is brought to the clinic because he has a fever, sore throat, pain on swallowing and mildly enlarged submandibular nodes The most likely organism causing Mikey’s infection is: further care. NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 *A Acute otitis . media Bullous B. Myringitis C. Otitis externa D. Swimmer’s ear True * False A. Flu B. Peritonsillar abscess Streptococcal * C. Pharyngitis Administration of antibiotic eye a. drops *b Application of topical fluorescein . dye Instillation of cycloplegic eye c. drops Irrigation of the eye with normal d. saline Bryce is a 17 y/o male who comes to the clinic with chief complaint of ear sudden onset of pain, popping noises, and muffled hearing. During the ear exam the NP notices that the TM has ruptured. The most likely diagnosis is: Koplik spots on the buccal mucosa are pathognomonic for mumps. Mikey is a 19 y/o male who is brought to the clinic because he has a fever, sore throat, pain on swallowing and mildly enlarged submandibular nodes. The most likely diagnosis for Mikey is: A patient who works in a furniture manufacturing shop reports a sudden onset of severe eye pain while sanding a piece of wood and now has copious tearing, redness, and light sensitivity in the affected eye. On examination, the conjunctiva appears injected, but no foreign body is visualized. What is the practitioner’s next step? A patient is seen in the clinic for 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? *a Alopecia areata NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 Add a beta blocker to the patient’s A. regimen. *B Admit to the hospital for evaluation and . treatment. Increase the dose of the thiazide C. medication. D. Prescribe a calcium channel blocker. Admit the patient to the hospital for evaluation and a. treatment. *b Consult with the cardiologist to determine appropriate . diagnostic tests. c. Continue to monitor the patient every 3 years. *<140/9 0 <130/8 0 <150/9 0 <150/8 0 An African-American patient who is being treated with a thiazide diuretic for chronic hypertension reports blurred vision and shortness of breath. The provider notes a blood pressure of 185/115. What is the recommended action for this patient? A young adult patient is diagnosed with a mitral valve prolapse. During a routine 3-year health maintenance exam, the provider notes an apical systolic murmur and a mid-systolic click on auscultation. The patient denies chest pain, syncope, or palpitations. What action will the provider take? According to the JNC 8 guidelines the hypertension treatment goal for patients 60 years and younger should be: . Anagen b. effluvium Cicatricial c. alopecia Telogen d. effluvium NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 Autoimmune a. disorder b. Bacterial infection c. Protozoal infection *d Viral infection . a. Daily aspirin therapy to prevent clotting b. Statin therapy with clopidogrel Walking slowly for 15 to 20 minutes c. twice daily *d Walking to the point of pain each day . *True False *True False True * False A. Normal *B Prehypertensi . on A previously healthy patient presents with sudden onset of dyspnea, fatigue, and orthopnea. A family history is negative. The provider suspects myocarditis. What is the most likely etiology for this patient? A patient is diagnosed with peripheral arterial disease (PAD) and elects not to have angioplasty after an angiogram reveals partial obstruction in lower extremity arteries. What will the provider recommend to help manage this patient’s symptoms? A split S2 is best heard at the upper left sternum. In coarctation of the aorta the BP of the arms is higher than the BP of the legs. Pulsus paradoxus is a phenomenon in which the radial pulse can be palpated even though the apical pulse can’t be heard. Juan is a known patient to the NP. He comes in for his quarterly check on his blood pressure. His blood pressure is 125/85. According to JNC 8 his BP falls into the category of: d. Reassure the patient that these findings are expected. NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 Cotton wool A. spots Silver wire B. vessels * Retinal C. hemorrhages D. A & B only Vitamin A Vitamin C *Vitamin K Vitamin D *A Bronchitis . Guy is a 65 y/o male who comes to the clinic with the following chief complaint: “I have been feeling feverish, have chills, and am tired all the time. My heart also makes a funny sound. In the physical exam the NP auscultates a heart murmur, and notices that he patient has subungual hemorrhages, petechiae on the palate, violet colored nodes on the fingers and feet, and nontender red nodes on the palms and soles of his feet. In a patient with Guy’s diagnosis, on funduscopic exam one might see: Ashley is a 47 y/o female who comes to the clinic with a chief complaint of sudden onset of palpitations and a feeling of weakness and dizziness. Additionally she notes that she has dyspnea on exertion. On the physical exam the NP notes that he HR is 120 bpm and her BP drops to 98/60. Her EKG shows no discrete p waves and irregularly irregular rhythm. If Ashley were to start bleeding she would go to the ER and they would initiate which intervention below to reverse the effects of her warfarin: Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some rhinitis and low-grade fever. His likely diagnosis is: A. Copper wire arterioles B. Silver wire arterioles C. Atriovenous nicking *D Optic disc with blurred . margins NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 A. Strep pneumonia *B Pneumococcal . pneumonia C. Mycoplasma pneumonia D. Moraxella catarrhalis True *False A. Pneumonia B. Sinusitis C. COPD All the D. Above *E A & B only . *a ACE inhibitor medication use . b. Chronic obstructive pulmonary Mike is a 56 y/o male who lives in an abandoned building. With about 40 other street people. He comes to the clinic with a social worker who describes his symptoms as: a cough, dyspnea, pleuritic chest pain, fever and tachypnea. Your physical exam notes that he has some consolidation in the lower lobes with an audible friction rub. Given Mike’s diagnosis the most likely causative agent is: Artie is a 21 y/o male who comes to the clinic with a chief complaint of paroxysmal coughing without an apparent cause. He states that this has been going on for about 15 days. He initially had a mild fever, and a runny nose. First line treatment for Artie would include macrolides. Mike is a 22 y/o male who comes to your clinic with a 5-day history of cough without sputum production. He states that his cough is worse in the morning and he has some hoarseness, post-nasal drip and a low- grade fever. Mike has otherwise been healthy Differentials for Mike might include which of the following: A nonsmoking adult with a history of cardiovascular disease reports having a chronic cough without fever or upper airway symptoms. A chest radiograph is normal. What will the provider consider initially as the cause of this patient’s cough? Atypical Pneumonia (Walking B. pneumonia) C. Allergic Rhinitis Community acquired bacterial D. pneumonia NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 a. Chest radiograph b. Complete blood count Computerized c. tomography *d Spirometry . A. Albuterol B. Salmeterol C. Levalbuterol *D metaprotere . nol Surgical resection will improve survival chances a. dramatically. *b That relapse is likely with a 2-year overall survival . of 50%. c. There is an 80% chance of 5-year survival. d. Treatment will proceed with curative intent. A young adult patient without a previous history of lung disease has an increased respiratory rate and reports a feeling of “not getting enough air.” The provider auscultates clear breath sounds and notes no signs of increased respiratory effort. Which diagnostic test will the provider perform initially? Martin is a 73 y/o male who has a 50 year/pack history of smoking and comes to the clinic for his annual physical. As you are leading him back to the exam room you note that he has dyspnea with minimal cough, a barrel chest, and appears to have lost weight since his last visit. Your physical exam confirms a 20 lb. weight loss, and a more noticeable pursed lip breathing. Given Martin’s condition the first line treatment would be all the following except: A patient with limited stage small cell lung cancer (SCLC) has undergone chemotherapy with a good initial response to therapy. What will the provider tell this patient about the prognosis for treating this disease? Which test is the most diagnostic for chronic obstructive pulmonary disease (COPD)? a. COPD Assessment Test disease c. Gastroesophageal reflux disease d. Psychogenic cough NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 a. Bisacodyl Docusate b. sodium *c Methylcellulos . e d. Mineral oil A. CBC B. UA C. CT scan D. KUB *E All the . Above A, C & D F. only Debulking the A. liver B. Chemotherapy C. Liver transplant *D All the Above . E. A & B only A patient has recurrent constipation which improves with laxative use but returns when laxatives are discontinued. Which pharmacologic treatment will the provider recommend for long-term management? Jeremy is an 18 y/o male who comes to the clinic with a chief complaint of periumbilical pain. Over the past 24 hours he has had bouts of nausea and diarrhea and pain at McBurney’s point. Which of the following diagnostic studies would be appropriate for Jeremy’s diagnosis? Danny is a 37 y/o male who returns to the clinic for review of lab results. When he came in a week ago he complained of a “sour” taste when he belched, and severe pain in his stomach. A serum fasting gastrin level was drawn and sent to the lab. The results were 300 pg/ml. Treatment for Danny would include which of the following: hemorrhoid d. Referral for possible surgical intervention NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 *a H. . pylori infection b. NSAID use Parasite c. infestation Viral d. gastroenteritis *a Alcoholism . b. Hepatitis C Hepatocellular c. carcinoma Right-sided heart d. failure Acute A. cholecystitis Acute B. Diverticulitis * Acute C. Appendicitis Acute D. Pancreatitis Irritable bowel A. syndrome *B Duodenal ulcer . A 50-year-old, previously healthy patient has developed gastritis. What is the most likely cause of this condition? A patient is diagnosed with fibrotic liver disease; a liver biopsy shows micronodular cirrhosis. What is the most common cause of this form of cirrhosis? Jeremy is an 18 y/o male who comes to the clinic with a chief complaint of periumbilical pain. Over the past 24 hours he has had bouts of nausea and diarrhea and pain at McBurney’s point. The NP diagnoses him as having: Jeremiah, a 47 y/o male presents to the clinic with episodic gastric pain he describes as gnawing and burning. He notes that the pain is temporarily relieved by food or antacids but return in full force after a couple of hours. He notes that his stools are “tarry” and he sometimes has coffee colored vomit. On this basis the NP provides a diagnosis of: NRNP 6531 MIDTERM EXAMINATION STUDY GUIDE LATEST UPDATED VERSION 2023 Surface electrical a. stimulation b. Teaching head rotation *c Thickened liquids . d. Thinning liquids *a Ordering a CBC and stool for occult . blood Prescribing an antispasmodic b. medication Referring the patient for a lower c. endoscopy Reminding the patient to eat a high- d. fiber diet Cephalospor a. in b. Furosemide c. Lactulose *d Spironolacto . ne Chemical dissolution of the a. gallstone b. Lithotripsy A patient experiences a feeding disorder after a stroke that causes disordered tongue function and impaired laryngeal closure. What intervention will be helpful to reduce complications in this patient? A patient with a history of diverticular disease experiences left-sided pain and reports seeing blood in the stool. What is an important intervention for these symptoms? A patient diagnosed with cirrhosis develops ascites. Which medication will be ordered initially to improve symptoms? A patient with a previous history of liver disease is diagnosed with a bile duct obstruction. Which procedure will be prescribed for this patient? C. GERD D. Acute Diverticulitis