Nursing 6531 Final Exam Questions With Answers, Exams of Nursing

Download Nursing 6531 Final Exam Questions With Answers and more Exams Nursing in PDF only on Docsity! Nursing 6531 Final Exam Questions With Answers Question 2 In the outpatient office setting, the most common reason for a malpractice suit is failure to: Properly refer Diagnose correctly in a timely fashion Obtain informed consent Manage fractures and trauma correctly Question 3 Reed-Sternberg B lymphocytes are associated with which of the following disorders: Aplastic anemia Hodgkin’s lymphoma Non Hodgkin’s lymphoma Myelodysplasti c syndromes Question 4 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 5 Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? Musculoskeleta l pain Difficulty sleeping Depression Fatigue Question 6 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? 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. Question 7 The 4 classic features of Parkinson’s disease are: Mask-like facies, dysarthria, excessive salivation, and dementia. Tremor at rest, rigidity, bradykinesia, and postural disturbances. Depression, cognitive impairment, constipation and shuffling gait. Tremor with movement, cogwheeling, repetitive movement, and multi- Exopthal mi a Question 14 Which of the following medications increase the risk for metabolic syndrome? Antihistamines Proton pump inhibitors Protease inhibitors A and C All of the above Question 15 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: Lateral meniscus Cruciate ligament Medical menisc us Collateral ligament Question 16 A middle-aged man presents to urgent care complaining of pain of the medial condyle of the lower humerus. The man works as a carpenter and describes a gradual onset of pain. On exam, the medial epicondyle is tender and pain is increased with flexion and pronation. Gout Epicondyliti s Osteoarth ri tis Lyme disease Question 17 The organism most often associated with prostatitis is: Klebsiella Neiserria gonorrhoa es Chlamydia trachomatis E.Coli Question 18 Dave, age 38, states that he thinks he has an ear infection because he just flew back from a business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next action? Prescribe systemic antibiotics Prescribe antibiotic ear drops Prescribe nasal steroids and oral decongestants Refer him to an ear, nose, and throat specialist Question 19 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? Depression 1. 1. 1. Retinopathy 2. Hypertension resistant to treatment 3. Peripheral neuropathy 4. Accelerated atherogenesis Panic disorder Anxiety Post-traumatic stress disorder Question 20 What diabetic complications result from hyperglycemia? 1, 2, 3 2, 3, 4 1, 3, 4 1, 2, 4 Question 21 Prolonged PT suggests: Platelet abnormality Abnormality in intrinsic coagulation pathway Abnormality in extrinsic coagulation pathway None of the above Question 22 A 32 year old female patient presents with fever, chills, right flank pain, right costovertebral angle tenderness, and hematuria. Her urinalysis is positive for leukocytes and red blood cells. The nurse practitioner diagnoses pyelonephritis. The most appropriate management is: Consult with a physician A 14 day course of ciprofloxacin To obtain blood cultures from separate site Obtain urine cultures, CBC, and initiate antibiotic therapy Question 29 A patient has just been diagnosed with Bell’s palsy. He is understandably upset and has questions about the prognosis. You response should be: 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 Question 30 After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been cured? An enzyme-linked immunosorbent assay titer A urea breath test A rapid urease test A repeat endoscopy Question 31 A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness, anorexia, fatigue, and weight loss. What action(s) 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 32 The most common symptoms of transient ischemic attack (TIA) include: Nausea, vomiting, syncope, incontinence, dizziness, and seizure. Weakness in an extremity, abruptly slurred speech, or partial loss of vision, and sudden gait changes. Headache and visual symptoms such as bright spots or sparkles crossing the visual field. Gradual onset of ataxia, vertigo, generalized weakness, or lightheadedness Question 33 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 34 An obese hyperlipidemic patient, newly diagnosed with type 2 diabetes mellitus, has fasting glucose values 180 to 250 mg/Dl. What is the most appropriate initial treatment to consider? A low-calorie diet and exercise Sliding-scale NPH insulin every 12 hours An oral hypoglycemic agent Sliding-scale regular insulin every 6 hours Question 35 A 32 year old male patient complains of urinary frequency and burning on urination for 3 days. Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial treatment should be: Trimethoprim-sulfamethoxazole for 3 days Ciprofloxacin for 7-10 days Trimethoprim-sulfamethoxazole for 14 days Ciprofloxacin for 3 days Question 36 The most reliable diagnostic indicator of gout is: Monosodium urate (MSU) crystals in the synovial fluid. Tophi visible over joints or in connective tissue. Elevated serum uric acid level. Abrupt onset of single joint inflammation and None of the above Question 43 Which appropriate test for the initial assessment of Alzheimer’s disease provides the performance ratings on 10 complex, higher order activities? MMSE CAGE questionnaire FAQ – Functional Activities Questionnaire Holmes and Rahe social readjustment scale Question 44 A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the following symptoms would lead you to look for another diagnosis? Akathisia Dystonia Parkinson is m Hallucinati o ns Question 45 Urine cultures should be obtained for which of the following patients? Suspected urinary tract infection in pregnancy Febrile patients Young men A 65 year old patient complains of recurrent bilateral temporal headaches, malaise, muscle aches, and low grade fever. The headache is described as superficial tenderness rather than deep pain. Giant cell arteritis is suspected. Appropriate treatment is: All of the above Refer for temporal artery biopsy and initiation of oral prednisone. Aspirin or acetaminophen every 4 hours as needed for pain and fever. A daily β-blocker such as propranolol. CT scan of the head and lumbar puncture for CSF evaluation. Question 47 Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within normal limits. Which of the following diagnoses do you explore further? Scoliosis Osteoarthritis Spinal stenosis Herniated nucleus pulposus Question 48 Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect? Acute otitis media Chronic otitis media External otitis Tempomandibular joint syndrome Question 49 Which history is commonly found in a patient with glomerulonephritis? Beta-hemolytic strep infection Frequent urinary tract infections Kidney stones Hypotension Question 50 A 27 year old female patient with epilepsy is well controlled with phenytoin (Dilantin). She requests information about contraception. The nurse practitioner should instruct her that while taking phenytoin: The effectiveness of an oral contraceptive may be reduced. She should use a very low dose estrogen oral contraceptive. She should use another anticonvulsant along with the phenytoin. Bilateral tubal ligation is recommended. Question 51 Which of the following is a contraindication for metformin therapy? Insulin therapy Creatinine > 1.5 Question 57 In which of the following presentations is further diagnostic testing not warranted? Bilateral gynecomastia in a pre-pubertal male of average weight; Tanner stage 1 Bilateral gynecomastia in a 13 year old male with normal testicular size and volume Recent onset gynecomastia in a 20 year old male with breast tenderness Unilateral breast mass which is 5 centimeters in diameter Question 58 How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout? Exercising for at least 30 minutes every day Exercising a total of 2 hours per week Exercising for at least 20 minutes, 3 or more days per week Exercising for at least 30 minutes, 5 days per week Question 59 The most accurate measure of diabetes control is: Avoidance of micro- and macro-vascular complications. Insulin sensitivity. Early morning glucose levels. HgbA1c Question 60 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 61 Risk factors for prostate cancer include all of the following except: Family history Benign prostatic hypertrophy African American race Age Question 62 Which of the following symptoms suggests a more serious cause of back pain? Pain associated with coughing or sneezing Pain associated with muscle spasm Pain associated with lying down at night Pain associated with negative straight leg raise Question 63 Potential side effects of levofloxacin include which of the following? Confusion Hypoglycemia Achilles tendon rupture All of the above Question 64 Diagnostic evaluation for urinary calculi includes: Urinalysis and culture Non contrast CT Serum calcium All of the above Question 65 blocker Recommend saw palmetto Prescribe an antibiotic Refer to urology Question 71 What is the most common cause of Cushing’s syndrome? Excessive ACTH production Administration of a glucocorticoid or ACTH Pituitary adenoma or a non-pituitary ACTH- producing tumor Autonomous cortisol production from adrenal tissue Question 72 A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects: Arthritis Ulnar neuritis Septic arthritis Olecrano n bursitis Question 73 What information should patients with diabetes and their families receive about hypoglycemia? Hypoglycemia is a rare complication. Hypoglycemia requires professional medical treatment. Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly. Hypoglycemia occurs only as a result of insulin overdose. Question 74 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? Apples Pepper mi nt Cucumb e rs Popsicles Question 75 Which drug category contains the drugs that are the first line Gold standard therapy for COPD? Corticosteroids Inhaled beta-2 agonist bronchodilators Inhaled anticholinergic bronchodilators Xanthines Question 76 Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis? Doxycycline 100 mg qd Nitrofurantoin 100 mg qd Bactrim DS qd Erythromycin qd Question 77 Legal authority for advanced practice nursing rests with: The Health Care Financing Administration Federal statutes State laws and regulations Certifying bodies Question 78 The primary goals of treatment for patients with alcohol abuse disorder are: Reduction in withdrawal symptoms and reduction in desire for alcohol Question 81 Central obesity, “moon” face, and dorsocervical fat pad are associated with: Metabolic syndrome Unilateral pheochromocytom a Cushing’s syndrome None of the above Question 82 Martin, a 58 year old male with diabetes, is at your office for his diabetes follow up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Martin receive today regarding the care if his Wash your feet with cold water daily See a podiatrist every 2 years, inspect your own feet monthly, and apply lotion to your feet daily Go to a spa and have a pedicure monthly See a podiatrist yearly; wash your feet daily with warm soapy water and towel dry between the toes; inspect your feet daily for lesions; apply lotion to dry areas Question 83 The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is: Oral ciprofloxacin (Cipro) Oral doxycycline (Virbamycin) plus intramuscular ceftriaxone Oral trimethoprim-sulfamethoxazole (Bactrim DS) Intramuscular penicillin Question 84 What intervention does the American College of Rheumatology recommend as first line therapy for osteoarthritis? Extensive diagnostic work- up NSAIDs at therapeutic doses Early joint replacement Exercise and weight loss Question 85 Which of the following characteristics are associated with prepatellar bursitis? Pain with weight bearing Pain with range of motion of the knee Repetitive knee trauma All of the above Question 86 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: Radial tunnel syndrome Ulnar collateral ligament sprain Olecranon bursitis Lateral epicondylitis Question 87 Potential causes of hypocalcemia include which of the following? Vitamin D deficienc y Chronic kidney disease Malnutrition All of the above Question 88 Diagnostic confirmation of acute leukemia is based on: Bone marrow aspiration and biopsy Pancytopenia Hyperuricemia All of the above Question 89 A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder? Colchicine and an opioid analgesic Question 95 A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse Primary hyperparathyroidism is treated with Vitamin D restriction Primary hyperparathyroidism is treated with parathyroidectomy Primary hyperparathyroidism is treated with daily magnesium Primary hyperparathyroidism is treated with parenteral parathyroid hormone (PTH) Question 96 What information should a 42 year old patient with newly diagnosed diabetes receive about exercise? 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 A 30 year old female patient presents to the clinic with heat intolerance, tremors, nervousness, and weight loss inconsistent with increased appetite. Which test would be most likely to confirm the suspected diagnosis? A serum thyroid stimulating hormone (TSH) level Follicle stimulating hormone (FSH) A urine drug screen The Hamilton Anxiety Scale Question 98 Which of the following set of symptoms should raise suspicion of a brain tumor? Recurrent, severe headaches that awaken the patient and are accompanied by visual disturbances. Vague, dull headaches that are accompanied by a reported sense of impending doom. Periorbital headaches occurring primarily in the evening and accompanied by pupillary dilation and photophobia. Holocranial headaches present in the morning and accompanied by projective vomiting without nausea. Question 99 Which factors are associated with high risk for foot complications in a patient with diabetes mellitus? 1. Obesity 2. Abnormal nails 3. Abnormal gait 4. Poorly controlled lipids 1, 2, 3 2, 3, 4 2, 3 1, 4 Question 100 Which of the following patients most warrants screening for hypothyroidism? A young adult female with postpartum depression lasting 2 weeks. A patient taking thyroid replacement preparation. A 40 year old male with unexplained tremors. An elderly female with recent onset of mental dysfunction. Question 101 Which of the following accounts for half of the bladder tumors among men and one- third in women? 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 FINAL SCORE 83/100