NURSING 6531 Final Examination Test Questions, Exams of Nursing

Download NURSING 6531 Final Examination Test Questions and more Exams Nursing in PDF only on Docsity! NURSING 6531 Final Examination test 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 Myelodyspla stic 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 Musculoskel etal pain Difficulty sleeping Depression Fatigue Question 6 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- Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? 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? Cefuroxime Levofloxacin Question 11 Which is the most common cause of end-stage renal disease in the United States? Diabetic nephropathy Chronic renal failure secondary to vascular disorders Acute tubular necrosis Kidney trauma Question 12 A typical description of a tension headache is: Periorbital pain, sudden onset, often explosive in quality, and associated with nasal stuffiness, lacrimation, red eye, and nausea. Bilateral, occipital, or frontal tightness or fullness, with waves of aching pain. Hemicranial pain that is accompanied by vomiting and photophobia. Steadily worsening pain that interrupts sleep, is exacerbated by orthostatic changes, and may be preceded by nausea and vomiting. Question 13 A patient taking levothyroxine is being over-replaced. What condition is he at risk for? Osteopo ro sis Constip ati on Depression Exoptha lmi 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 Lateral meniscus Cruciate ligament Medic al menis cus Collater al ligament Question 16 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: 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. Range of motion is full The most likely cause of this patient’s pain is: 7 Depression 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 1. 1. 1. Retinopathy 2. Hypertension resistant to treatment 3. Peripheral neuropathy 4. Accelerated atherogenesis 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 23 Underwe igh t Norm al weig ht Overweight Obese Question 24 “Caffeine has not effect on osteoporosis.” “A high caffeine intake has a diuretic effect that may cause calcium to be excreted more rapidly.” “Caffeine affects bone metabolism by altering intestinal absorption of calcium and assimilation of calcium into the bone matrix.” “Caffeine increase bone resorption.” The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are): A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as: Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond? 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 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 An enzyme-linked immunosorbent assay titer A urea breath test A rapid urease test 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: A patient has just been diagnosed with Bell’s palsy. He is understandably upset and has questions about the prognosis. You response should be: After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been cured? c A repeat endoscopy Question 31 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 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) should the nurse practitioner take? pain. Question 37 Thiazide diuretic Insulin Famotid ine (Pepcid) Albuterol Question 38 HbA1C 2-hour 75 gram oral glucose tolerance test C-peptide level A and B All of the above Question 39 Diagnostic evaluation of hypothyroidism reveals: Elevated TSH and decreased T4 Decreased TSH and 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 the problem? Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following: increased T4 Decreased TSH and decreased T3 Elevated TSH and increased T4 Question 40 The most effective intervention(s) to prevent stroke is (are): 81 mg of aspirin daily Carotid endarterectomy for patients with high- grade carotid lesions Routine screening for carotid artery stenosis with auscultation for bruits Smoking cessation and treatment of hypertension Question 41 Maintain moderate bed rest for 3-4 days Call the office for narcotics if there is no relief with the NSAID in 24-48 hours Begin lower back strengthening exercises depending on pain tolerance Wear a Boston brace at night Question 42 The cardinal sign of infectious arthritis is: 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 Josh, age 22, is a stock boy and has an acute episode of low back pain. You order and NSAID and tell him which of the following? 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 Scoliosis Osteoarthritis Spinal stenosis Herniated nucleus pulposus Question 48 Acute otitis media Chronic otitis media 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: 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? Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect? External otitis Tempomandibula r 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 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 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: failure (CHF) Dyslipidemia Erectile dysfunction (ED) Diabetes mellitus (DM) Question 55 drug fever upper respiratory infection nothing specific, this is a systemic disease manifestation urinary tract infection Question 56 The patient should start anticoagulant therapy immediately. Hereditary thrombophilia does not always require anticoagulation therapy. Women of childbearing age cannot take anticoagulant therapy. Genetic and risk management counseling are recommended. B and D A patient with HIV infection has a fever of unknown origin (FUO). Which of the following is a possible cause of FUO in a patient with HIV? A 28-year-old female presents to the office requesting testing for diagnosis of hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her risk factors. The nurse practitioner explains that: 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 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. How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout? c 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 Prescribe an alpha adrenergic A 63-year-old man presents to the office with hematuria, hesitancy, and dribbling. Digital rectal exam (DRE) reveals a moderately enlarged prostate that is smooth. The PSA is 1.2. What is the most appropriate management strategy 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 Arthritis Ulnar neuritis Septic arthritis Olecran on bursitis Question 73 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: 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 Apples Pepper mi nt Cucum be rs Popsicles Question 75 Corticosteroids Inhaled beta-2 agonist bronchodilators What information should patients with diabetes and their families receive about hypoglycemia? 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? Which drug category contains the drugs that are the first line Gold standard therapy for COPD? alcohol Psychotherapeutic and pharmacological interventions to decrease desire for and effects of alcohol Abstinence or reduction in use, relapse prevention, and rehabilitation Marital satisfaction, improvement in family functioning, and reduction in psychiatric impairment Question 79 Making sure the environment is free of all pollutants Eliminating all pets from the environment Engaging in moderate to high levels of physical activity Remaining indoors with air conditioning as much as possible Question 80 cryptococcosis toxoplasmosis cryptospor idio sis cytomegal ovir us Other than smoking cessation, which of the following slows the progression of COPD in smokers? A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is: Question 81 Central obesity, “moon” face, and dorsocervical fat pad are associated with: Metabolic syndrome Unilateral pheochromocyt oma Cushing’s syndrome None of the above Question 82 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 Oral ciprofloxacin (Cipro) Oral doxycycline (Virbamycin) plus intramuscular ceftriaxone 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 feet? The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is: Radial tunnel syndrome 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: Ulnar collateral ligament sprain Olecranon bursitis Lateral epicondylitis Question 87 Potential causes of hypocalcemia include which of the following? Vitamin D deficie ncy 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? adjunct to an NSAID An oral corticosteroid and diazepam (Valium) Colchicine and an opioid analgesic Question 95 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 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 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains: What information should a 42 year old patient with newly diagnosed diabetes receive about exercise? 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 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 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 Which of the following accounts for half of the bladder tumors among men and one- third in women?