You are treating a patient with acute anxiety and she is having an acute attack in the office. The ANP has knowledge that the fastest relief of symptoms is... [Show More] :
a TCA
a beta-blocker
a benzodizepine
an SSRI
Correct answer:
benzodiazepine
The fastest relief of anxiety symptoms will occur with a benzodiazepine. The other choices list agents that will require multiple doses for results. With daily continued use of benzodiazepines, the anti-anxiety effect may become diminished.
A geriatric patient with cardiovascular disease is in the office being counseled on lifestyle changes. The ANP knows that which of the following is the most important to include in this discussion?
"Control your hypertension, stop smoking, maintain a normal weight, and exercise regularly."
"Have a yearly physical examination, increase fiber in your diet, and exercise regularly."
"Maintain a normal level of serum blood sugar and decrease cholesterol intake."
"Decrease smoking, increase vitamin supplements, and increase protein intake."
Correct answer:
"Control your hypertension, stop smoking, maintain a normal weight, and exercise regularly."
All of these are important for the geriatric patient to decrease cardiovascular risk. Controlling hyperglycemia, high fiber intake, and vitamins all assist in maintaining a healthy lifestyle but do not help to prevent cardiovascular disease.
You are seeing a female with inflammatory bowel disease, known as IBD. The Adult Nurse Practitioner knows that if she orders a hemogram on this patient, which of the following results would be seen if the patient was anemic?
microcytic, hypochromic type
macrocytic, normochromic type
normocytic, normochromic type
macrocytic, hypochromic type
Correct Answer:
normocytic, normochromic type
Anemia is a common problem in IBD. The etiology is often from multiple causes. The anemia of chronic disease, a normocytic, normochromic anemia, is a result of inflammation of the IBD without blood loss. Blood loss would result in a microcytic, hypochromic anemia. The macrocytic anemias are a result of deficiency in vitamin B12 or other causes.
Which of the following is the least likely risk factor for suicide?
physical illness
male
increasing age
black race
Correct answer:
black race
Being of a white race is more likely to be a factor in suicide. Besides the other three choices risk factors include: substance abuse, living alone, and less education.
The healthcare provider's required level of expected conduct as established by custom, law, or professional organizations is called the:
Standard of care.
Breach of duty.
Duty.
Malpractice.
Correct answer:
Standard of care
Standard of care is another term associated with negligence. Standard of care is a healthcare provider's required level of expected conduct as established by custom, law, or professional organizations.
A brief account by the patient of any signs or symptoms he or she is experiencing is one component of:
Review of systems.
Symptom assessment.
Functional assessment.
Objective assessment.
Correct Answer:
Review of systems
In the review of systems, the patient tells the nurse in his or her own words what signs or symptoms he or she has experienced in various body systems. It is important that these be in a patient's own words to perform the most complete and accurate assessment.
All of the following are typical changes to the gastrointestinal system that come with aging EXCEPT:
decreased liver size
decreased muscle tone in bowel
increased absorption of calcium
atrophy of salivary glands
Correct answer:
increased absorption of calcium
Decreased absorption of calcium is a common change that comes with aging, not increased absorption. Other gastrointestinal changes include: less efficient cholesterol stabilization and absorption, atrophy of taste buds, and slowing in esophageal emptying, among others.
A 28-year-old female patient is in the office and is to undergo radioactive iodine treatment for Graves disease. The ANP is counseling her and understands that the mechanism of action of this treatment therapy is:
alter the thyroid metabolic rate
relieve distress caused by increased thyroid size
destroy the overactive thyroid tissue
reduce production of TSH
Correct answer:
destroy the overactive thyroid tissue
Graves disease is the most common form of thyrotoxicosis. Radioactive iodine is used for thyroid ablation to destroy the overactive thyroid tissue that causes the thyroid hormone dysfunction.
Which of the following statements about falls in the elderly is least accurate?
Black women are at higher risk for hip fractures than white women.
The majority of deaths from falls are among people aged 65 years or older.
Injuries from falls include head injuries, pelvic injuries, lacerations, and more.
About 90% of hip fractures are due to falls.
Correct Answer:
Black women are at higher risk for hip fractures than white women.
It is white women, not black women, who are at higher risk for hip fractures. Falls are one of the most common adverse events that threaten the quality of life of older adults. Falls among older adults are not a normal consequence of aging.
Normal age-related changes of the skin may be confused with which of the following clinical abnormalities?
dehydration
vitiligo
scabies
shingles
Correct Answer:
dehydration
Normal age-related changes of the skin may be confused with dehydration. Sebaceous gland activity tends to decrease with age, and the skin's natural hydrators decline over the years. The skin's ability to regenerate lipids compromising the protective lipid barrier layer of the Stratum Corneum also declines with age, as does blood flow to the skin, which may cause a drop in sebum production.
A 29-year old woman who is 6 weeks postpartum reports she is having rectal bleeding that she believes is related to hemorrhoids. The Adult Nurse Practitioner knows that this type of rectal bleeding is usually described as:
dark brown to black blood color with normal-appearing stool
significant amounts of bright red blood
large blood clots and mucus mixed with stool
streaks of bright red blood on the stool
The Correct answer is:
streaks of bright red blood on the stool
Choice D is the right answer. The color of blood related to hemorrhoids is described as bright red, eliminating choice A. Amount of blood with hemorrhoids is usually small or scant, eliminating choices B and C. Internal hemorrhoids can occur during or after childbirth. With chronically protruding or prolapsing hemorrhoids, the patient often reports mucous leaking and staining of the undergarments. Other causes are obesity, constipation, and prolonged sitting.
You have a patient with AIDS. You recognize that a low CD4 T-cell count puts the patient at risk for opportunistic infections. You are reviewing his lab reports and see that his CD4 T-cell count is indeed low. Which of the following is the normal range for CD4 T-cell count?
800 -1400
700 -1400
400 - 1000
600 -1200
Correct answer:
600 -1200
The normal CD4 T-cell count is 600 - 1200. A low CD4 T-cell count is below 600. The destruction of the CD4 T-cell causes depletion in the number of CD4 T-cells and consequently increases the risk of infection. This puts the patient at risk for infection.
ou have an adult patient with diabetes whose blood pressure is 145/95 mm Hg. Which stage of hypertension does this indicate?
normal
pre-hypertension
Stage I
Stage II
Correct Answer:
Stage I
Stage I hypertension is characterized by a systolic pressure of 140 - 159 mm Hg and a diastolic pressure of 90 - 99 mm Hg. The treatment recommendation for this stage is usually a thiazide diuretic and for those with diabetes, either ACE inhibitors or ARBs, because of their renal protective properties. [Show Less]
