NURS 6531 Final Exam Latest Update 2022/2023(Solved by Exprt), Exams of Nursing

Download NURS 6531 Final Exam Latest Update 2022/2023(Solved by Exprt) and more Exams Nursing in PDF only on Docsity! 2 NURS 6531 Final Exam Latest Update 2022/2023(Solved by Exprt) Question 1 Patient report of bladder dysfunction, saddle anesthesia, and motor weakness of limbs. History of significant trauma relative to the patient’s age. Decreased reflexes, strength, and sensation in the lower extremities. Patient report of pain with the crossed straight leg raise. Question 2. Which of the following is a potential acquired cause of thrombophilia? Question 3 Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of: Ulnar tunnel syndrome Carpal tunnel syndrome P a g e 1 | 42 The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are): Homocysteinuria Protein C deficiency Factor V Leiden Antiphospholipid antibodies 2 Tarsal tunnel syndrome Myofascial pain syndrome Question 4 Which patient would benefit most from screening for type 2 diabetes? A 30 year old female with unintended weight loss. A 25 year old male with family history of type 1 diabetes An obese female with recurrent vaginitis A 50 year old hyperlipidemic male Question 5 P a g e 2 | 42 2 Question 11 Routinely after 3 weeks of low back pain symptoms. To screen for spondylolithiasis in patients less than 20 years of age with 2 weeks of more of low back pain. When there is a suspicion of a space-occupying lesion, fracture, cauda equina, or infection. As a part of a pre-employment physical when heavy lifting is included in the job description. Question 12 An enzyme-linked immunosorbent assay titer A urea breath test A rapid urease test A repeat endoscopy Question 13 MMSE CAGE questionnaire FAQ – Functional Activities Questionnaire Holmes and Rahe social readjustment scale Question 14 P a g e 5 | 42 Diagnostic radiological studies are indicated for low back pain: After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been cured? Which appropriate test for the initial assessment of Alzheimer’s disease provides the performance ratings on 10 complex, higher order activities? 2 P a g e 6 | 42 Major depression occurs most often in which of the following conditions? 2 A. Myocardial infarction Parkinson’s disease Stroke Alzheimer’s disease Question 15 Which of the following statements about multiple sclerosis (MS) is correct? MS is a chronic, untreatable illness that is almost always fatal. MS is a disease of steadily progressive and unrelenting neurologic deterioration. MS is a chronic, treatable illness with unknown cause and a variable course. Patients with MS who take active steps to improve their health have the best cure rate. Question 16 Diagnostic evaluation of hypothyroidism reveals: Elevated TSH and decreased T4 Decreased TSH and increased T4 Decreased TSH and decreased T3 Elevated TSH and increased T4 P a g e 7 | 42 2 P a g e 10 | 42 2 insomnia or hypersomnia diminished ability to think or concentrate grandiose delusions Question 21 Central obesity, “moon” face, and dorsocervical fat pad are associated with: Metabolic syndrome Unilateral pheochromocytoma Cushing’s syndrome None of the above Question 22 Which of the following is the most common cause of low back pain? Lumbar disc disease Spinal stenosis Traumati c fracture Osteoporosis Question 23 Infection Toxoplasmosis P a g e 11 | 42 A middle-aged female presents complaining of recent weight loss. The physical exam reveals an enlarged painless cervical lymph node. The differential diagnosis for this patient’s problem includes: 2 Mononucleo si s All of the above None of the above Question 24 Weigh t gain Fractur e risk Hypoglyce mia Weight loss Question 25 cryptococco si s toxoplasmo si s cryptospori di osis cytomegalo vi ru P a g e 12 | 42 An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects? A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is: 2 1–4 red blood cells per high- powered field Specific gravity 1.012 Urobilinogen 10- white blood cells per high- powered field Question 30 Radial tunnel syndrome Ulnar collateral ligament sprain Olecranon bursitis Lateral epicondylitis Question 31 Depression Panic disorder Anxiety Post-traumatic stress disorder Question 32 P a g e 15 | 42 A 21-year-old female presents to the office complaining of urinary frequency and urinary burning. The nurse practitioner suspects a urinary tract infection when the urinalysis reveals A 26 year old female presents with elbow pain that is described as aching and burning. There is point tenderness along the lateral aspect of the elbow and painful passive flexion and extension. She reports she has been playing tennis almost daily for the past month. The most likely diagnosis is: Maria, age 17, was raped when she was 13 year old. She is now experiencing sleeping problems, flashbacks, and depression. What is your initial diagnosis? 2 Trauma Tight shoes Arthritis flare Hydrochloroth ia zide Question 33 Which of the following is a contraindication for metformin therapy? Insulin therap y Creatinine > 1.5 Edema None of the above Question 34 A positive drawer sign supports a diagnosis of: Sciatica Cruciate ligament injury Meniscal injury Patellar ligament injury P a g e 16 | 42 An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days later, he returns to the office complaining of left great toe pain. On exam, the nurse practitioner notes an edematous, erythematous tender left great toe. The likely precipitant of this patient’s pain is: 2 Question 35 Apples Pepper m int Cucum b ers Popsicles Question 36 A patient taking levothyroxine is being over-replaced. What condition is he at risk for? Osteopor o sis Constipa ti on Depressi o n Exopth al mia Question 37 HbA1C 2-hour 75 gram oral glucose tolerance test C-peptide level A and B P a g e 17 | 42 Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid? Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following: 2 Meningitis Question 44 You must initiate the plan of care for the patient The physician must be on-site and engaged in patient care You must be employed as an independent contractor You must be the main health care provider who sees the patient Question 45 Digital rectal examination (DRE) plus prostate specific antigen (PSA) Prostate specific antigen (PSA) alone Transrectal ultrasound (TRUS) alone Prostate specific antigen (PSA) and transrectal ultrasound (TRUS) Question 46 The primary goals of treatment for patients with alcohol abuse disorder are: Reduction in withdrawal symptoms and reduction in desire for alcohol Psychotherapeutic and pharmacological interventions to decrease desire for and effects of alcohol Abstinence or reduction in use, relapse prevention, and rehabilitation P a g e 20 | 42 What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare? The most commonly recommended method for prostate cancer screening in a 55 year old male is: 2 Marital satisfaction, improvement in family functioning, and reduction in psychiatric impairment Question 47 Lateral meniscus Cruciate ligament Medical menisc us Collateral ligament Question 48 Musculoskeletal pain Difficulty sleeping Depression Fatigue Question 49 Differential diagnosis of proteinuria includes which of the following? Orthostati c proteinuria Nephroti c syndrom P a g e 21 | 42 You are assessing a patient after a sports injury to his right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to the: Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? 2 e P a g e 22 | 42 Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class Ulnar neuritis Septic arthritis Olecrano n bursitis Question 54 Establishment of a definitive diagnosis of osteomyelitis requires: A known causative injury such as a puncture wound, bite, or decubitus ulcer. Biopsy of culture of the pathogen from blood or bone aspirate. Visualization of purulent material draining into soft tissue. Lucent areas identified on plain x-ray. Question 55 The most accurate measure of diabetes control is: Avoidance of micro- and macro-vascular complications. Insulin sensitivity. Early morning glucose levels. HgbA1c Question 56 Alprazolam or diazepam P a g e 25 | 42 A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder? Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class Venlafaxine or buspirone Trazodone or sertraline Venlafaxine or hydroxyzine pamoate Question 57 The most common presentation of thyroid cancer is: Generalized enlargement of the thyroid gland. A solitary thyroid nodule. A multinodular goiter. Abnormal thyroid function tests. Question 58 Cigarette smoke, both active and passive inhalation Chemicals from plastic and rubber Chronic use of phenacetin- containing analgesic agents Working long hours and not voiding often Question 59 Sjogren’s syndrome Pancreatic cancer P a g e 26 | 42 Which of the following accounts for half of the bladder tumors among men and one- third in women? You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of: Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class Disseminated malignancy of the hematologic system Cancer of the liver Question 60 Refer her to a hand surgeon Take a more complete history Try neutral position wrist splinting and oral NSAID Order a nerve conduction study such as am electromyography Question 61 Corticosteroids Inhaled beta-2 agonist bronchodilators Inhaled anticholinergic bronchodilators Xanthines Question 62 Potential causes of septic arthritis include which of the following? Lyme disease Prosthetic joint infection P a g e 27 | 42 Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to: Which drug category contains the drugs that are the first line Gold standard therapy for COPD? h y we a Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class Acetaminophen or an NSAID A muscle relaxant as an adjunct to an NSAID An oral corticosteroid and diazepam (Valium) Colchicine and an opioid analgesic Question 69 Legal authority for advanced practice nursing rests with: The Health Care Financing Administration Federal statutes State laws and regulations Certifying bodies Question 70 Superficial and deep heat Application of cold Transcutaneous electrical nerve stimulation (TENS) Exercise Question 71 A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals ponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks later with the same symptoms of hyperpigmentation, kness, anorexia, fatigue, and weight loss. What action(s) should the nurse P a g e 30 | 42 Which of the following physical modalities recommended for treatment of rheumatoid arthritis provides the most effective long term pain relief? Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class practitioner take? Obtain a thorough history and physical, and check serum cortisol and ACTH levels. Obtain a diet history and check CBC and FBS. Provide nutritional guidance and have the patient return in 1 month. Consult home health for intravenous administration of fluids and electrolytes. Question 72 Start him on an ACE Inhibitor Start him on a diuretic Have him monitor his blood pressure at home Try nonpharmacological methods and have him monitor his blood pressure at home Martin is complaining of erectile dysfunction. He also has a condition that has reduced arterial blood flow to his penis. The most common cause of this condition is: Question 74 P a g e 31 | 42 Parkinson’s disease Epilepsy Multiple sclerosis Diabetes mellitus Jack, age 55, comes to the office with a blood pressure of 144/98 mm Hg. He states that he did not know if it was ever elevated before. When you retake his blood pressure at the end of the exam, it remains at 144/98. What should your next action be? Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class P a g e 32 | 42 th e Th e exp l Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class Emotional stress resulting in hypertension, tachycardia, and increased venous return. Question 80 Thiazid e diuretic Insulin Famotidin e (Pepcid) Albuterol Question 81 Affected joint is painful at rest, with movement and weight bearing Rapid onset that wakes the patient during the night Long history of severe pain with associated joint swelling None of the above Question 82 Primary hyperparathyroidism is treated with Vitamin D restriction Primary hyperparathyroidism is treated with parathyroidectomy P a g e 35 | 42 A 60 year old male patient with multiple health problems presents with a complaint of erectile dysfunction (ED). Of the following, which medication is most likely to be causing problem? cardinal sign of infectious arthritis is: A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class Primary hyperparathyroidism is treated with daily magnesium Primary hyperparathyroidism is treated with parenteral parathyroid hormone (PTH) Question 83 Doxycycline 100 mg qd Nitrofurantoin 100 mg qd Bactrim DS qd Erythromycin qd Question 84 Who is at a higher risk for developing nephrolithiasis? Jack, who exercises every day and drinks copious amounts of water Mary, who watches her weight and eats a low- sodium diet Harvey, a “couch potato” who drinks a lot of no- sodium soda Bill, who runs every day and takes excessive amounts of vitamin C Question 85 Potential side effects of levofloxacin include which of the following? Confusion Hypoglycemia P a g e 36 | 42 Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis? Qu A Qu m m Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class Achilles tendon rupture All of the above Although most of your symptoms will disappear, some will remain but can usually be camouflaged by altering your hairstyle or growing a beard Unfortunately there is no cure but you have a mild case The condition is self-limiting and most likely complete recovery will occur With suppressive drug therapy you can minimize the symptoms Change to a different class of antihypertensive medication to get better control. Increase the dosage of the current BP medication. Continue the current medication and dosage for 4 more weeks. Add a beta-blocker to the current medication regimen. Question 88 P a g e 37 | 42 Retinopathy Hypertension resistant to treatment Peripheral neuropathy Accelerated atherogenesis What diabetic complications result from hyperglycemia? estion 86 tient has just been diagnosed with Bell’s palsy. He is understandably upset and has questions about the prognosis. You response should be: estion 87 A diabetic patient is taking low-dose enalapril for hypertension. A record of the patient’s blood pressure over 4 weeks ranges from 130 to 142 mmHg systolic and 75 to 85 Hg diastolic. How should the nurse practitioner respond? Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class The initial clinical sign of Dupuytren’s contracture is: Pain with ulnar deviation Painless nodule on palmer fascia Pain and numbness in the ring finger Inability to passively extend finger Question 95 Fatigue Cardiomyop a thy Falls Bleeding Question 96 Buy good walking shoes with support and a flexible sole. Exercise at least 5 days per week. Snack before exercise. Do not exercise if your blood sugar is greater than 180 mg/dL Question 97 P a g e 40 | 42 Which of the following is the most common complication of the myelodysplastic syndromes? What information should a 42 year old patient with newly diagnosed diabetes receive about exercise? Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class What is the most commonly abused substance? Heroin Cocaine Alcohol Mariju a na Question 98 “You’re right; it seems like your diabetes is improving.” “Because your kidneys are not functioning well, your insulin is not being metabolized and excreted as it should, so you need less of it.” “You have watched your diet for all these years and as a result, your body is using less insulin.” “I will have to change your oral hyperglycemic agents as it seems your body is making more insulin.” Question 99 Decrease the evening insulin dose and check capillary blood glucose (CBG) at 2:00 am. Instruct the child’s parents on physical activities to help weight loss. Increase the evening insulin dose and check CBG at 2:00 am. Refer the child for instruction on a strict diabetic diet. P a g e 41 | 42 Sam, age 67, is a diabetic with worsening renal function. He has frequent hypoglycemic episodes, which he believes means that his diabetes is getting “better.” How do you respond? A child with type 1 diabetes mellitus has experienced excessive hunger, weight gain and increasing hyperglycemia. The Somogyi effect is suspected. What steps should be taken to diagnose and treat this condition? Scored a 76% on the answers selected. This is the Final for Aug 2020 Moussa Class Question 100 At what age is screening most likely to detect scoliosis? 4 to 6 years 8 to 10 years 12 to 14 years 18 to 20 year s Question 101 Patient report of bladder dysfunction, saddle anesthesia, and motor weakness of limbs. History of significant trauma relative to the patient’s age. Decreased reflexes, strength, and sensation in the lower extremities. Patient report of pain with the crossed straight leg raise. P a g e 42 | 42 The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are):