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NR 511 Week 5 Quiz: Advanced Pharmacology
NR 511 Week 5 Quiz: Advanced Pharmacology Question 1 1 / 1 pts A 48-year-old male presents with acute low back pain in the right that increases when s... [Show More] tanding and bending. Upon physical exam, lower extremity muscle strength is 5/5 and straigh leg raise test is negative. Which of the following is the most likely diagnosis? You Answered Spondylolisthesis. Osteoarthritis. Correct Answer Muscle strain. Herniated nucleus pulposus. Muscle strain is usually located in the low back and is unilateral in location. The onset is acute, and pain increases with standing and bending and decreases with sitting. The straight leg raise test and plain x-ray are both negative. Question 2 1 / 1 pts A 55-year-old patient is able to complete range of motion (ROM) against gravity with some resistance. The nurse practitioner would assign which of the following numerical grades to this manual muscle testing description? Correct! 4 3 2 5 Normal muscle strength and function and complete ROM against gravity with full or normal resistance would be given a numerical grade of 5. Complete ROM against gravity with some resistance is given a numerical grade of 4 and described as good muscle strength. Complete ROM against gravity is indicative of fair muscle strength and function and is given a numerical grade of 3. A grade of 2, denoting poor muscle strength, is given for complete ROM with gravity eliminated. Question 3 1 / 1 pts The valgus stress test, varus stress test, Lachman test, and thumb sign are all considered standard tests to check the integrity of the ligaments of the knee. Which of the following would the clinician choose to assess the anterior cruciate ligament (ACL), which is the most commonly involved structure in severe knee injury? Thumb sign. Correct! Lachman test. Valgus stress test. Varus stress test. The Lachman test assesses the ACL. Question 4 1 / 1 pts A 55-year-old female presents to the clinic with complaints of left hand and wrist pain and swelling after a slip and fall on the ice yesterday. On examination, the clinician notes tenderness at the “anatomical snuffbox.” This finding most likely indicates which of the following? Hamate fracture. You Answered Radial head fracture. Ulnar styloid fracture. Correct Answer Scaphoid fracture. There is tenderness over the “anatomical snuffbox” in a scaphoid (aka navicular) fracture, the most common injury of the carpal bones. Poor blood supply puts the scaphoid bone at risk of avascular necrosis; therefore, wrist pain and tenderness in the anatomical snuffbox, even without history of antecedent trauma, warrant a wrist x-ray. Question 5 1 / 1 pts A 16-year-old male patient presents to the clinic after sustaining a football injury to his right knee. The clinician elicits a positive anterior/posterior drawer sign. This test indicates an injury to the ______? Collateral ligament. Lateral meniscus. Medial meniscus. Correct! Cruciate ligament. Positive anterior and posterior drawer signs indicate injury to the anterior cruciate ligament and posterior cruciate ligament, respectively. The drawer and Lachman tests are utilized to assess for cruciate ligament injury. Question 6 1 / 1 pts A 10-year-old male presents to the clinic after jumping off a 2-foot wall, twisting his foot and ankle upon landing. His ankle x-ray demonstrates a fracture of the distal tibia, over the articular surface, through the epiphysis and physis. Based on the Salter-Harris classification of growth plate injuries, the clinician knows that this is a ______? Salter-Harris IV fracture. Salter-Harris V fracture. Correct! Salter-Harris III fracture. Salter-Harris II fracture. The Salter-Harris classification system of growth plate injuries divides most growth plate injuries into 5 categories based on the damage: A Salter-Harris I fracture travels through the physis. A Salter-Harris II fracture travels through the metaphysis and physis. A Salter-Harris III fracture travels through the epiphysis and physis. A Salter-Harris IV fracture travels through the metaphysis, epiphysis, and physis. A Salter-Harris V fracture involves a compression injury of the physis. Question 7 1 / 1 pts A 13-year-old obese (body mass index [BMI] above the 95th percentile) boy reports low-grade left knee pain for the past 2 months. He denies antecedent trauma but admits to frequent “horseplay” with his friends. The pain has progressively worsened, and he is now unable to bear weight at all on his left leg. His current complaints include left groin, thigh, and medial knee pain and tenderness. His examination demonstrates negative drawer, Lachman, and McMurray tests; left hip with decreased internal rotation and abduction; and external hip rotation with knee flexion. Based on the above scenario, the clinician should suspect which of the following? A left meniscal tear. Osgood-Schlatter disease. A left anterior cruciate ligament (ACL) tear. Correct! A slipped capital femoral epiphysis (SCFE). SCFE is a displacement of the femoral head relative to the femoral neck that occurs through the physis (growth plate) of the femur. The vast majority of clients with this condition are obese, as the added weight increases shear stress across the physis. The mean age at diagnosis is 12 years for females and 13.5 years for males. Surgery is often required via in situ pin fixation (single screw) to stabilize the growth plate to prevent further slippage and avoid complications. Question 8 0 / 1 pts A 49-year-old female presents with low back pain radiating into the right leg,. An x-ray of the lumbosacral spine is within normal limits. Which of the following diagnoses do you explore further? You Answered Osteoarthritis. Correct Answer Herniated nucleus pulposus. Scoliosis. Compression fracture. A plain x-ray will not show a herniated nucleus pulposus or a muscle strain. It will show spondylolisthesis, scoliosis, osteoarthritis, and spinal stenosis. Note that x-rays of the spine are not indicated in low back pain unless the cause of the pain is thought to be bony in origin or traumatic in nature or there is a need to rule out systemic disease. Question 9 1 / 1 pts A 42-year-old professional golfer complains of chronic back pain for many years. His workup reveals that it is not the result of a degenerative disc problem. His back “goes out” about twice per year, and he is out of work for about a week each time. Which of the following should the clinician advise? Make an appointment with a neurosurgeon for a surgical consultation. Correct! Begin a planned exercise program to strengthen back muscles. Consider changing careers to something less physical. Start on a daily low-dose narcotic to take away the pain. In this case, the patient may benefit from a regular planned exercise program to strengthen his back muscles and attempt to reduce the probability of future episodes of back pain. Question 10 0 / 1 pts A 55-year-old female patient presents with complaints of pain and paresthesias in the left ulnar aspect of the forearm, thumb, and middle finger following a C6 & C7 nerve root dermatomal pattern. This is known as ________? Correct Answer Cervical radiculopathy. You Answered Brachial plexus neuritis. Peripheral polyneuropathy. Thoracic outlet syndrome. Cervical nerve root compression of C6 and C7 causes cervical radiculopathy. Brachial plexus neuritis presents with dysfunction ranging from momentary paresthesias to completely flail extremities and is usually caused by injuries to the C5 and C6 nerve roots. Peripheral polyneuropathy is associated with distal sensorimotor paresthesia and diminished deep tendon reflexes. Thoracic outlet syndrome is caused by compression of the brachial plexus and/or subclavian vessels as they exit the space between the superior shoulder girdle and the first rib. Symptoms are color changes in the hand and sensory changes and weakness in the fourth and fifth fingers. Question 11 1 / 1 pts In assessing the skeletal muscles, the clinician turns the patient’s forearm so that the palm is face up. This is called: Eversion. Abduction. Pronation. Correct! Supination. Turning the forearm so that the palm is up is called supination. Question 12 1 / 1 pts A 62-year-old woman presents to the clinic with chronic low back pain. She states she has developed episodes of fecal incontinence and numbness in her right leg over the last week. Upon examination the clinician notes decreased perianal sensation to pinprick. What should the clinician do next? Send the patient for Electromyelography (EMG) testing. Prescribe physical therapy for 6 weeks. Correct! Refer the patient to the Emergency Room (ER). Order a MRI. Cauda equina is characterized by loss of bowel/bladder control or saddle-pattern anesthesia (perineum). If left untreated, compression can cause ischemia and permanent nerve damage leading to incontinence and paralysis. The patient should be immediately referred to the ER. Question 13 1 / 1 pts A conservative approach is recommended in the initial approach to the management of low back pain. Which of the following would be an appropriate treatment plan for a 32-year-old obese male (BMI 33) diagnosed with an acute lumbar strain? Epidural Steroid Injections (ESI). Bedrest. Correct! Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Surgery. It has been proven that rest has little to no effect on the resolution of LBP. Patients should do whatever activities are tolerable. Almost 90% of cases resolve within 1 to 6 weeks thus the initial management should include non-pharmacologic (masage, heat, etc.), pharmacological (NSAIDs, short term use of muscle relaxants) and activity. Surgery and ESI are not indicated in the initial management of LBP. Question 14 0 / 1 pts A 28-year-old male presents to the clinic for follow-up from the emergency department, where he was seen for right forearm pain 3 days ago. He works as a carpenter and is right hand dominant. He states he was diagnosed with right forearm tendinitis and is not sure what this means. As part of teaching, the clinician explains that the condition is caused by inflammation of one or more of the tendons. Which of the following describes tendons? Correct Answer The collagen fibers that connect muscle to bone. You Answered The fibrocartilaginous disks that separate bony surfaces. The ropelike bundles of collagen fibrils that connect bone to bone. The pouches of synovial fluid that cushion bone and other joint structures. Tendons are the collagen fibers that connect muscle to bone. Question 15 1 / 1 pts A 16-year-old boy presents to the office with complaints of low back pain after lifting heavy boxes. In discussing with him proper body mechanics to prevent future injuries, the clinician should advise which of the following? “Hold boxes away from your body at arm’s length.” “Bend and twist simultaneously as you lift.” Correct! “Bend your knees and face the object straight on.” “Keep your feet firmly together.” In discussing with the patient proper body mechanics to prevent future injuries, you tell him to bend his knees and face the object straight on, to hold boxes close to his body and not at arm’s length, and to spread his feet about shoulder width apart. Using legs and arms, facing objects straight on, and keeping a wide stance will provide a broad base of support and allow for use of supporting muscles, relieving stress on the back muscles. Quiz Score: 10 out of 15 PreviousNext Submission Details: [Show Less]
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NR 511 Week 3 Quiz: Advanced Pharmacology
NR 511 Week 3 Quiz: Advanced Pharmacology Question 1 1 / 1 pts A rash that looks like the patient was slapped on the cheeks of the face is the hallma... [Show More] rk characteristic for which disease? Correct! Erythema infectiosum (fifth disease). Rubella. Rocky Mountain spotted fever. Rubeola. Erythema infectiosum (fifth disease) usually starts on the cheeks and spreads to the arms and trunk. Question 2 0 / 1 pts A 3-year-old patient presents to your pediatric office with her mother. She has recently started in day care. Her mother noted slight perioral erythema on the right side of the patient’s mouth last night before bed. The patient awoke today with 3 small, superficial, honey-colored vesicles where the erythema was last night. The patient has no surrounding erythema presently. She had no difficulty eating this morning and is active and energetic and doesn’t appear lethargic or fatigued. She is also afebrile. How would you treat this child? Oral Keflex for 7 days. Topical compress with Burow solution and follow-up in 2 to 3 days.ou Answered Local debridement and topical compress with Burow solution and close follow-up. Correct Answer Local debridement and mupirocin for 5 days. This is the treatment of choice for impetigo. Question 3 1 / 1 pts A 27-year-old female comes in to your primary care office complaining of a perioral rash. The patient noticed burning around her lips a couple days ago that quickly went away. She awoke from sleep yesterday and noticed a group of vesicles with erythematous bases where the burning had been before. There is no burning today. She is afebrile and has no difficulty eating or swallowing. What test would confirm her diagnosis? Exam under a Wood lamp. Sterile culture sent for aerobic and anaerobic bacteria.orrect! Tzanck smear. Potassium hydroxide (KOH) prep. This would show giant cells consistent with herpes simplex virus. KOH and wood's lamp are used to diagnose fungal infections. Cultures can be sent to diagnose bacterial infections but it will not detect HSV. Question 4 0 / 1 pts A 10-year-old male presents to the office with his mother with complaints of itchy and red eyes for 1 day. He reports watery drainage in both eyes, associated with repetitive itching. He has no fever or constitutional symptoms. The patient has a sibling that just started day care recently. Upon examination, vision is 20/20 OU with glasses. He has mild to moderate conjunctival hyperemia with bilateral preauricular lymph nodes that are inflamed. What is the patient’s diagnosis? You Answered Bacterial conjunctivitis. Correct Answer Viral conjunctivitis. Blepharitis. Allergic conjunctivitis. This is the classic presentation of viral conjunctivitis. The patient also has exposure to kids at school and a sibling with day care exposure. Question 5 1 / 1 pts A 22-year-old college student presents to your urgent care clinic complaining of a rash. She was recently on spring break and spent every night in the hot tub at her hotel. On physical exam, she has multiple small areas of 1- to 2-mm erythematous pustules that are present mostly where her bathing suit covered her buttocks. What is the most likely pathogen causing these lesions? Correct! Pseudomonas aeruginosa Klebsiella. Streptococcus. Staphylococcus aureus. This is a common cause of hot tub folliculitis. Staph and Strep can cause folliculitis but it is not the most common pathogens in hot tubs. Klebsiella can cause folliculitis in the immunocompromised patient. Question 6 1 / 1 pts You diagnose 46-year-old Mabel with viral conjunctivitis. Your treatment should include: Oral erythromycin for 14 days. Ciprofloxacin ophthalmic drops. Gentamicin ophthalmic ointment.orrect! Supportive measures and lubricating drops (artificial tears). Viral conjunctivitis is treated with supportive measures, including cold compresses and lubricating eye drops. Preventive measures, such as frequent handwashing, are important, as viral conjunctivitis is highly contagious. Question 7 0 / 1 pts Mrs. Johnson, a 54-year-old accountant, presents to the office with a painful red eye without discharge. You should suspect: Bacterial conjunctivitis. Viral conjunctivitis Correct Answer Iritisou Answered Allergic conjunctivitis. In a client with iritis, there is rarely a discharge. Question 8 0 / 1 pts A 4-year-old male presents to your pediatric clinic with his mother complaining of an itchy rash, mostly between his fingers. This has been going on for multiple days and has been getting worse. The patient recently started at a new day care. On physical exam, the patient is afebrile and has multiple small (1-2 mm) red papules in sets of 3 located in the web spaces between his fingers. He also has signs of excoriation. What is the treatment for this problem? Over-the-counter Benadryl cream. Correct Answer Permethrin lotion for the patient and also his family members.u Answered Cold compresses and hydrocortisone cream 1% twice a day. Ketoconazole cream. This is the treatment for scabies. Question 9 0 / 1 pts A 25-year-old male presents with “bleeding in my eye” for 1 day. He awoke this morning with a dark area of redness in his eye. He has no visual loss or changes. He denies constitutional symptoms, pruritus, drainage, or recent trauma. The redness presents on physical exam as a dark red area in the patient’s sclera of the right eye only and takes up less than 50% of the eye. The patient’s remaining sclera is clear and white. He also notes he was drinking alcohol last night and vomited afterward. What is the best treatment? You Answered Sending the patient to the emergency department for immediate ophthalmology consult. Topical steroids and close follow-up with an ophthalmologist. Cold compresses and frequent handwashing. Correct Answer Reassurance that this lesion will resolve without any treatment in 2 to 4 weeks. This is the classic presentation of a subconjunctival hemorrhage. It will resolve without treatment in 2 to 4 weeks. Vomiting probably caused his hemorrhage. Question 10 0 / 1 pts A 20-year-old male presents to your office in the summer complaining of chest discoloration. He is a lifeguard and has been out in the sun without a shirt on for long periods of time. His physical exam shows small, flat, circular, hypopigmented macules on his chest that he states are mildly pruritic. What is the treatment of choice for this diagnosis? Ketoconazole shampoo. Oral fluconazole.ou Answered Hydrocortisone cream 1%. Correct Answer Selenium sulfide shampoo. Selenium sulfide shampoo is the treatment of choice for tinea versicolor. Ketaconozole is not the treatment for tinea versicolor but it can be used for recurrence prevention in resolved cases. Oral fluconazole is only the treatment in severe cases that are resistant to topical treatments. Question 11 0 / 1 pts Sharon, a 47-year-old bank teller, is seen by the nurse practitioner in the office for a red eye. You are trying to decide between a diagnosis of conjunctivitis and iritis. One distinguishing characteristic between the two is: Eye discomfort. No change in or slightly blurred vision. Correct Answer A ciliary flush.u Answered Slow progression. When trying to decide between a diagnosis of conjunctivitis and iritis, one distinguishing characteristic is the ciliary flush present in iritis. Photophobia is not usually present in conjunctivitis, but it is always present with iritis. Photophobia occurs with corneal inflammation, iritis, and angle-closure glaucoma. Question 12 0 / 1 pts Which of the following patients does not have an increased risk of Candida infection? A patient requiring home antibiotics while recovering from an operation for an infected hernia. A diabetic patient. You Answered A patient using a steroid regimen for asthma control. Correct Answer A patient with a history of coronary artery disease. Coronary artery disease doesn’t increase the risk of Candida infection. Question 13 1 / 1 pts Henry, 64 years old, is having difficulty getting rid of a corneal infection. He asks why. How do you respond? “Because the infection was painless, it was not treated early enough.” Correct! “Because the cornea doesn’t have a blood supply, an infection can’t be fought off as usual.” “Systemic antibiotics have difficulty getting to that area of the eye.” “We can’t determine the causative agent.” Because the cornea is an avascular organ, immune defenses have difficulty fighting off infections. Question 14 0 / 1 pts A 25-year-old male presents to your urgent care clinic complaining of genital pruritus. On physical exam, the patient has small, erythematous, excoriated papules in his pubic hair. No mites are identified. There is no penile discharge, and the patient has no constitutional symptoms. He is sexually active but wears condoms during all sexual experiences. What is the most likely diagnosis? Gonorrhea. Chlamydiaou Answered Scabies. Correct Answer Pediculosis. This is a common presentation of genital lice. Question 15 1 / 1 pts Mary, age 82, presents with several eye problems. She states that her eyes are always dry and look “sunken in.” What do you suspect? Correct! Normal age-related changes. Hypothyroidism. A detached retina. Cushing syndrome. Dryness of the eyes and the appearance of “sunken” eyes are normal age-related changes. [Show Less]
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NR 511 Week 2 Quiz: Advanced Pharmacology
NR 511 Week 2 Quiz: Advanced Pharmacology Question 1 0 / 1 pts A 67-year old female on multiple medications for chronic conditions was just diagnose... [Show More] d with gastroesophageal reflux disease (GERD). In teaching the patient about the disease, what medication should the clinician recommend that the patient refrain from using? Correct Answer Nonsteroidal anti-inflammatory drugs (NSAIDs). Oral contraceptives. Antibiotics. Antifungals. Clients with GERD should avoid taking NSAIDs because they tend to aggravate the already irritated gastric mucosa. Question 2 1 / 1 pts When the Weber test is performed with a tuning fork to assess hearing and there is no lateralization, the clinician should document this finding as: Correct! A normal finding. Perceptive deafness. Nerve damage. Conductive deafness. A Weber test assesses hearing by bone conduction. With normal hearing, sound is heard equally well in both ears, meaning there is no lateralization. Question 3 1 / 1 pts A 26-year-old male recently returned from a camping trip with symptoms of acute gastroenteritis. He reports that he only ate vegetables from his garden that he canned prior to his outing. Which of the following pathogens might be causing his symptoms? Staphylococcus. Campylobacter jejuni. Clostridium perfringens.orrect! Clostridium botulinum. C botulinum is an anaerobic, gram-positive bacillus that produces toxins. It is widely distributed in the soil and vegetation. Improperly processed home-canned low-acid vegetables and contaminated meats are the usual cause of food-borne botulism. Question 4 1 / 1 pts A 29-year-old female just returned from Central America with traveler’s diarrhea and presents to the clinic for evaluation. Which of the following is the best treatment? Metronidazole (Flagyl). Gastric lavage.orrect! Supportive care. Penicillin antibiotics. Enterotoxigenic Escherichia coli (ETEC) is the most common cause of traveler’s diarrhea, which occurs after ingesting contaminated food or water. It is usually self-limiting, requiring no treatment other than supportive care. It is common in developing countries. Traveler’s diarrhea caused by E coli used to be frequently treated with a 3- to 5-day course of a quinolone antibiotic, such as ciprofloxacin (Cipro). Question 5 1 / 1 pts A 75-year-old female presents to your office complaining of dizziness and ringing in both ears for 1 day. She describes the dizziness as feeling like "the room is spinning". On physical exam, the Rinne test reveals that air conduction is greater than bone conduction bilaterally. The Weber test reveals lateralization to the left. She is unable to hear the examiner's whisper on the right side but can hear the whisper on the left side. What is the next step in helping this patient’s symptoms? Refer the patient to the Emergency Room. Start her on high-dose Augmentinect! Start the patient on a low-salt diet, prescribe meclizine for vertigo and refer her to an ENT specialist. Order a computed tomography (CT) scan to rule out acoustic neuroma. Meniere's disease is characterized by vertigo, tinnitus and hearing loss. The patient self-reports vertigo and tinnitus while the results of the Weber, Rinne, and whisper test indicate sensorineural hearing loss on the right. Meniere disease is diagnosed based on history and the exclusion of other conditions as well. Referral to ENT is warranted to rule out other etiologies. The treatment for symptoms of Meniere disease is both dietary and pharmacological. Antibiotics are not indicated, nor is it necessary to send the patient to the Emergency Room. A CT scan would not help to relieve the patient's symptoms. UnansweredQuestion 6 0 / 1 pts In a young child, unilateral purulent rhinitis is most often caused by: A foreign body. An allergic reaction. A bacterial infection. A viral infection. In a young child, unilateral purulent rhinitis is most often caused by a foreign body. The key word here is unilateral. UnansweredQuestion 7 0 / 1 pts A 38-year-old male patient has recently had an ileostomy for ulcerative colitis. Which self-care measures should the clinician teach him about to relieve food blockage? Take a hot shower or tub bath. Lie in a supine position. Drink cold fluids. Massage the peristomal area. Self-care measures to relieve food blockage in a client with an ileostomy include massaging the peristomal area, which may stimulate peristalsis and fecal elimination; assuming a knee-chest position to reduce intra-abdominal pressure; taking a warm shower or tub bath to relax the abdominal muscles; and drinking warm fluids or grape juice to produce a mild cathartic effect. UnansweredQuestion 8 0 / 1 pts A 30-year-old male presents to the clinic with intermittent diarrhea. He is pretty sure that the antacids taken for heartburn are the cause since the loose stools always occur within 30 minutes after taking them. How should the clinician respond? “Antacids contain caffeine, which decreases bowel transit time.” “Antacids contain sorbitol or mannitol, which are sugars that aren’t absorbed and can cause fluid to be drawn into the bowel.” “Antacids contain fructose, which may not be totally absorbed, resulting in fluid being drawn into the bowel.” “Antacids may contain magnesium, which decreases bowel transit time and may contain poorly absorbed salts that draw fluid into the bowel.” Antacids may contain magnesium, which decreases bowel transit time and may contain poorly absorbed salts that result in an osmotic draw of fluid into the bowel resulting in diarrhea. UnansweredQuestion 9 0 / 1 pts A 52-year-old female is suspected of having a gastric ulcer and will undergo an Esophagogastroduodenoscopy (EGD). She is concerned because she heard that gastric ulcers can be malignant. How should the clinician respond? “Don’t worry. Gastric ulcers are not cancerous.” “You have about a 50% chance of having gastric cancer from your ulcer.” “Even if it is cancer, surgery is 100% successful.” “About 95% of gastric ulcers are benign.” About 95% of gastric ulcers are benign even though some of these seem to look malignant on x-ray. Question 10 1 / 1 pts Which medications used to treat nausea and vomiting works by affecting the chemoreceptor trigger zone, thereby stimulating upper gastrointestinal motility and increasing lower esophageal sphincter pressure? Anticholinergics, such as scopolamine (Donnatal). orrect! Antidopaminergic and cholinergic agents, such as metoclopramide (Reglan). Antidopaminergic agents, such as prochlorperazine (Compazine). Tetrahydrocannabinols, such as dronabinol (Marinol). Metoclopramide (Reglan) is used for diabetic gastroparesis and postoperative nausea and vomiting. It works by affecting the chemoreceptor trigger zone, thereby stimulating upper gastrointestinal motility and increasing lower esophageal sphincter pressure. Question 11 1 / 1 pts A 72-year-old male patient presents to the clinic for his annual physical. He states that he is worried because he only has a bowel movement every three days. How should the clinician respond? “You should have at least three stools per week.” “You should defecate once a day.” orrect! “There is no such thing as a ‘normal’ pattern of defecation.” “You should have two to three stools per day.” There is no such thing as a “normal” pattern of defecation. Patterns of defecation vary widely and may in part be affected by dietary habits, fluid intake, bacteria in the stool, psychological stress, or voluntary postponement of defecation. Defecating every third day could be the routine pattern for Simon. He should be questioned if this is routine for him. Question 12 1 / 1 pts Nausea is difficult to discern in a young child. What question should the clinician ask to determine if a child has nausea? “Are you nauseous?” “Are you sick to your tummy?” “Are you eating the way you normally eat?”orrect! “Are you hungry?” To elicit information concerning nausea in a young child, ask the child about hunger because a young child cannot usually differentiate between hunger and mild nausea. Question 13 1 / 1 pts The antibiotic of choice for recurrent acute otitis media (AOM) and/or treatment failure in children is: Correct! Amoxicillin and potassium clavulanate (Augmentin). Amoxicillin (Amoxil) Azithromycin (Zithromax). Prednisone (Deltasone). The antibiotic of choice for recurrent AOM or treatment failure is amoxicillin and potassium clavulanate (Augmentin). Question 14 1 / 1 pts A 21-year-old female patient presents to the clinic for pre-operative tonsillectomy clearance. She has heard about permanent taste changes after a tonsillectomy and is concerned. What should the clinician tell her? “Your ability to recognize sweet from salty taste will be altered for life.” “You will have some alterations, but we’ll have to wait and see how you are affected personally.”Correct! “You may notice a slight difference initially, but there are no lasting changes in taste.” “About half of the patients have some permanent alterations in the sense of taste.” Although some clients report a significant subjective drop in taste function following surgery, none have ongoing taste dysfunction. Question 15 1 / 1 pts An 82-year-old female has been diagnosed with irritable bowel, chronic constipation, and diverticulosis following a colonoscopy. Which pharmacological agent should the clinician recommend? Correct! Bulking agents. Stool softeners. Lubricants. Laxatives. Bulking agents, such as psyllium preparations or methylcellulose preparations, are used for irritable bowel, chronic constipation, and diverticulosis. Quiz Score: 10 out of 15 [Show Less]
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NR 511 Week 1 Quiz: Advanced Pharmacology
NR 511 Week 1 Quiz: Advanced Pharmacology Question 1 1 / 1 pts The phrase usual and customary refers to: The success rate of a specified procedur... [Show More] e. How much an insurer will charge to provide coverage. How charges for a service compares with charges made to other persons receiving similar services and supplies. How an insurer evaluates the need for an ordered diagnostic test. The phrase usual and customary refers to the comparison of charges with other like charges for services and supplies received in the immediate vicinity as well as in a broader geographic area. Question 2 1 / 1 pts What must you do as an advanced practice registered nurse (APRN) before billing for visits? Correct! Obtain a provider number and familiarize yourself with the rules and policies of the third-party payer. Provide evidence of continuing medical education Obtain a Drug Enforcement Administration (DEA) number. Establish a collaborative agreement with a physician. To bill your clients for services, you must obtain a provider number and familiarize yourself with the rules and policies of each payor. Question 3 1 / 1 pts Which one of the following is true regarding the importance of documentation? Correct! It allows you to communicate your findings to other providers and serves as a record for the visit. It is only important in order to bill the patient for your service. It is only important for defending yourself in the event of a law suit. It allows you to communicate your findings with the general public. The purposes of documentation are to record the patient's report of symptoms, PMH, lifestyle and family factors, positive and negative findings on physical exam and the provider's plan. Documentation is important for billing purposes, communication with other providers and in the case litigation. Question 4 0 / 1 pts Which of the following statements does not belong in the past medical history portion of your chart note? Correct Answer Your patient had lab work done at their last appointment; CBC was normal. Your patient’s father passed away from lung cancer. Your patient had a cholecystectomy 3 years prior.ou Answered Your patient has an allergy to penicillin. Allergies, family history and surgical history all belong in the history portion of your note. Test results are objective findings and should be in the diagnostic tests (objective) section of the note. Question 5 1 / 1 pts In relation to writing a patient encounter note, the acronym SOAP stands for which of the following? Correct! Subjective, objective, assessment, plan. Symptoms, observations, assessment, plan. Symptoms, objective findings, assessment, plan. Subjective, outward findings, assessment, plan. The acronym SOAP stands for subjective, objective, assessment and plan. Question 6 0 / 1 pts Most health maintenance organizations (HMOs) use a reimbursement mechanism called capitation. What does this mean?You Answer The HMO reimburses the provider on a fee-for-service basis. The HMO is not responsible for provider reimbursement. The HMO reimburses the provider only if the patient has paid their deductible. Correct Answer The HMO reimburses the provider a predetermined fee per client per month based on the client’s age and sex. The reimbursement mechanism called capitation that some HMOs use is one in which the HMO reimburses the provider a set fee per client per month based on the client's age and sex. HMOs are prepaid, comprehensive systems of health benefits that combine both financing and delivery of services to subscribers. They may pay providers on a capitated or fee-for-service basis. Question 7 1 / 1 pts A screening test identified correctly identified 80 individuals who did not have breast cancer out of 100 individuals that were known to be free of the disease (true negatives). Thus, the test failed to recognize 20 individuals who did not have breast cancer. What is the specificity of the screening test? 40%. 60%. 20%.orrect! 80%. Specificity measures a screening test's ability to recognize individuals who are non-diseased or those with negative reactions (true negatives). It can be represented by a reaction of tested negatives to the total number of known, or true, negatives. In this case, the number of negatives that the test recognized was 80, with the total number of known, or true, negatives being 100. 80 out of 100=80%. Question 8 0 / 1 pts What is an Accountable Care Organization (ACO)? A bundling of pilot organizations.u Answered A payment system for episodes of care to save money for the health care system. Correct Answer A group of providers and suppliers who come together voluntarily to give coordinated, high-quality care to Medicare patients. A risk pool that saves the overall organization money and maximizes reimbursement. ACOs are groups of doctors, hospitals and other health care providersd who come together voluntarily to give coordinated, high-quality care to the Medicare patients they serve. Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeeds in delivering high quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program. Question 9 1 / 1 pts Denial of provider status is something that seriously impedes a nurse practitioner’s ability to practice. If that occurs, some steps one can take include: “Bashing” the organization to others and contacting an attorney.ct! Writing letters to the organization’s president and chief executive officer (CEO), activating others to lobby on your behalf, and reapplying after a 6-month period. Requesting that your clients lobby on your behalf by going to the newspapers. Requesting that your physician colleagues intervene on your behalf by writing critical letters to the organization in question. There are many steps a nurse practitioner can take if denied provider status by a 3rd party reimburser. First, one should ascertain the reasons for this stance and determine whether it is the same across the board regarding nurse practitioners. If it is a consistent policy, attempt to find out why and begin marshaling evidence to overturn this stance in a constructive way. This may include having both clients and physician colleagues “lobby” on your behalf. Find out who the decision maker in the organization is and attempt to communicate directly with that person. Ascertain if there is a law in the state mandating this policy. Be prepared to testify at hearings and speak out at community meetings about this issue. Request language changes that specify “ask your doctor” and lobby to have these changes adopted. Reapplication in 6 months is reasonable. Question 10 1 / 1 pts Which of the following statements about Medicaid is true? Medicaid pays for family planning services, dental care, and eyeglasses. Medicaid is a federal plan created to provide care for indigent persons. Eligibility requirements for Medicaid are mandated by the Health Care Financing Administration.rrect! Medicaid is a program for the indigent financed jointly by the federal and state governments. Financed jointly by the federal and state governments, Medicaid is a program created to pay for health care services for the indigent. Minimally, Medicaid must provide inpatients, skilled nursing facility, and home care; physician services, outpatients care; family planning services; and periodic sreening, detection, and treatment of children under age 12. Question 11 1 / 1 pts Which of the following is the best method for evaluating the efficacy of a new clinical intervention? Correct! A randomized controlled trial. A descriptive study. A correlational study A case report. The best method for evaluating the efficacy of a new clinical intervention is a randomized controlled trial (RCT). Question 12 0 / 1 pts The Affordable Care Act (ACA) which passed in 2010 has a number of provisions, including the establishment of health exchanges. The purpose of a health insurance exchange is to: You Answered Reduce the overall out-of-pocket cost of health insurance to the consumer. Correct Answer Create an online marketplace for the sale and purchase of health insurance for consumers. Reduce the number of consumer health claims to the insurer. Require each state to sell health insurance policies to consumers. The health insurance exchange was created to provide a website for consumers to compare health insurance policies. Therefore, it is a marketplace for the sale and purchase of health insurance for consumers. Question 13 1 / 1 pts Which of the following demonstrates an objective finding? Correct! Respiratory rate. Shortness of breath Ankle pain. Headache. Respiratory rate is the only objective finding which can be measured. Question 14 1 / 1 pts Which of the following demonstrates a subjective finding? Extremity edema. Pulse rate.rrect! Pain level. Eye color. Pain is a subjective finding, as patients self-report their level of pain. All other options are objective findings. Question 15 1 / 1 pts An 81-year-old patient presents for a physical. She recently had a fall and now has problems walking up her stairs. The only restroom in the house is on the second floor. She also has a flight of stairs outside her house she has to navigate in order to reach street level, and this is difficult for her. Where does this information belong in your chart note? Plan.rrect! Functional health problems. Review of systems. Assessment. The patient is having trouble with her normal routine and daily life due to her recent fall, so this information belongs in the functional health patterns section. Quiz Score: 10 out of 15 [Show Less]
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NR 511 Week 7 Quiz: Advanced Pharmacology
NR 511 Week 7 Quiz: Advanced Pharmacology Question 1 1 / 1 pts A patient is being treated for erectile dysfunction. The patient is morbidly obese and... [Show More] is also being treated for a coagulopathy. Which of the following medications would be contraindicated? Subcutaneous pellet testosterone (Testopel). Topical testosterone (AndroGel).orrect! Alprostadil (Caverject). Sildenafil (Viagra). The vasoactive injectable alprostadil (Caverject) should not be used in patients with sickle cell anemia, coagulopathy, severe cardiovascular disease, myeloma, leukemia, morbid obesity, or penile deformity, fibrosis, or implants. Question 2 1 / 1 pts A 32-year-old male appears with a rapid onset of unilateral scrotal pain radiating up to the groin and flank. The nurse practitioner is trying to differentiate between epididymitis and testicular torsion. Which test should be the provider’s first choice? X-ray. Physical examination. Technetium scan.orrect! Ultrasound. If your client has a rapid onset of unilateral scrotal pain radiating up to the groin and flank and you are trying to differentiate between epididymitis and testicular torsion, an ultrasound is useful for determining whether the swelling is in the testis or the epididymis and should be your first choice. Question 3 0 / 1 pts A 51-year-old male requests a prescription for sildenafil (Viagra). He says that the only medication he takes is isosorbide mononitrate (Monoket) oral tablets and that he has diabetes which is controlled with diet alone. What should the nurse practitioner tell him? Correct Answer “Viagra is contraindicated with isosorbide mononitrate; let’s discuss other options.” “I’d better refer you to a urologist.”u Answered “Let’s try a sample and see how you do.” “Because of your history of diabetes, we can’t use it.” Because sexual stimulation leads to the release of nitric oxide in the corpus cavernosum of the penis and sildenafil (Viagra) potentiates that release, there is a double hypotensive effect between sildenafil and a nitric oxide donor such as isosorbide mononitrate (Monoket, Imdur, and Ismo). Therefore, the use of sildenafil with Monoket is contraindicated. Question 4 1 / 1 pts A 72-year-old unmarried, sexually active man, presents to the clinic with complaints of hesitancy, urgency, and occasional uncontrolled dribbling. Although the nurse practitioner suspects benign prostatic hyperplasia, what else should the differential diagnosis include? Antihistamine use. Renal calculi. Detrusor hyperreflexia.Correct! Urethral stricture. Urethral strictures may develop as a result of sexually transmitted diseases and should be considered in sexually active individuals (primarily males) no matter their age. Antihistamine use generally will result in hesitancy and urinary retention but not incontinence. Question 5 1 / 1 pts A 54-year-old male 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: orrect! Diabetes mellitus. Multiple sclerosis. Parkinson disease. Epilepsy. About 50% of men who have had diabetes for longer than 6 years develop erectile dysfunction to some extent as a result of pathological changes in the vascular wall that lead to a reduction of arterial blood flow to the penis. Many other conditions can cause erectile dysfunction as well. These include cerebrovascular accidents (ie, strokes or brain attacks), spinal cord injury, temporal lobe epilepsy, multiple sclerosis, chronic obstructive pulmonary disease, angina, chronic renal failure, and Parkinson disease. Question 6 1 / 1 pts A 58-year-old male has been diagnosed with erectile dysfunction and says that a friend told him about a method that uses a constricting ring around the base of the penis. What is he referring to? Surgery Intracavernous injection therapy. Urethral suppositories. orrect! An external vacuum device. An external vacuum device is a viable method for alleviating erectile dysfunction regardless of the cause of the disorder. A plastic cylinder is placed around the penis, a vacuum pump causes cavernosal engorgement, and a constrictor ring is applied around the base of the penis, allowing the client to hold an erection for 30 minutes. Question 7 1 / 1 pts A 52-year-old male patient is in a new relationship and is not sure whether his erectile dysfunction is organic or is caused by stress about his performance. What simple test could the clinician suggest to determine if he has the ability to have an erection? Intracavernous injection. Penile duplex ultrasonography. Serum prostate-specific antigen (PSA). Correct! Nocturnal penile tumescence and rigidity (NPTR) test. The NPTR test is a simple test the client may do at home by himself to determine if he has the ability to have a nocturnal erection, which would rule out an organic cause of erectile dysfunction. Have the client place the simple device on his penis before going to bed. This device records the frequency, as well as the rigidity, of erections. Question 8 1 / 1 pts A 72-year-old male presents to the office for follow-up of several episodes of orthostatic hypotension. After obtaining a review of systems and a digital rectal examination, it also appears that he has benign prostatic hyperplasia (BPH) with lower urinary tract symptoms. The nurse practitioner reviews his recent ultrasound evaluation, which reports a prostate volume of over 40 mL, and the results of the American Urological Association (AUA) symptom index for BPH, which shows his score to be 12. Based on the preceding information and the patient’s desire for noninvasive medical therapy, what management should he be offered? Phenoxybenzamine (Dibenzyline). Doxazosin (Cardura).orrect! Finasteride (Proscar). Prazosin (Minipress). Finasteride is a 5-alpha-reductase inhibitor and is recommended for individuals with a prostate volume greater than 40 mL to help decrease its size. Question 9 1 / 1 pts A 32-year-old male presents with complaints of a scrotal mass; however, the scrotum is so edematous that it is difficult to assess. How would the nurse practitioner (NP) best determine whether the condition is a hernia or a hydrocele?rrect! Bowel sounds may be heard over a hernia. The NP can transilluminate a hernia. The NP can always return a hernia’s contents to the abdominal cavity. With a hydrocele, a bulge appears on straining. Hydroceles can be illuminated to show the full size and shape, which assist in the diagnosis, however hernias cannot. Hernias, if not incarcerated, will be able to be returned to the abdominal cavity. Buldging upon straining is not one of the characteristics associated with hydrocele but it is with inguinal hernia. While ultrasound would definitively diagnosis the presence of abdominal contents in the scrotum, understanding the pathophysiology of an inguinal hernia is necessary to understand that bowel sounds would be audible over a hernia. All of the other choices are incorrect. While a scrotal ultrasound would definitively confirm the diagnosis, this is not one of the options available. Question 10 1 / 1 pts Regular testicular self-exams have not been studied enough to show if they lower the risk of dying from testicular cancer. This is why the American Cancer Society and other agencies do not have a recommendation about regular testicular self-exams for all men. Still, some practitioners do recommend that all men examine their testicles monthly after reaching puberty. In teaching a patient how to do a testicular self-examination, which of the following should the clinician advise? “Examine your testicles when you are cold because this makes them more sensitive.” “If you feel firmness above and behind the testicle, make an appointment.”orrect! “Make an appointment if you note any hard lumps directly on the testicle, regardless of whether they are tender.” “Make sure your hands are dry to create friction.” If you advise men to perform a monthly testicular self-examination, instruct them to call if they notice any hard lumps directly on the testicle, regardless of whether the lumps are tender. If parts of the testicle above and behind feel rather firm, this is the epididymis and is normal. The spermatic cord, a small, round, movable tube, extends up from the epididymis and also feels firm and smooth. Testicles should be examined with soapy hands when taking a warm shower or bath to allow easy mnipulation of the tissue. Question 11 1 / 1 pts A 62-year-old male has a low International Prostate Symptom Score for lower urinary tract symptoms associated with his benign prostatic hyperplasia (BPH). The nurse practitioner should recommend: rrect! No treatment at this time. Balloon dilation. Immediate referral to urology. Starting an alpha blocker. Asymptomatic clients with BPH rarely require treatment. Watchful waiting is an appropriate strategy for following the progression of the disease and the development of any complications. Question 12 1 / 1 pts A male patient presents to the clinic for evaluation of infertility. Subjectively, the patient complains of pain and fullness of the testes and states, “My testicles feel like a bag of worms.” On physical examination, the nurse practitioner notes tortuous veins posterior to and above the testes that extend up into the external inguinal ring. Based on the preceding assessment, the nurse practitioner refers the patient to urology with a diagnosis of: Orchitis. Hydrocele. Urethritis.orrect! Varicocele. A varicocele is an abnormal degree of venous dilation of the pampiniform plexus in the spermatic cord above the testes, which results in pain and swelling. A patient often describes the sensation as feeling like a “bag of worms.” Question 13 1 / 1 pts A 63-year-old man presents to your office with hematuria, hesitancy, and dribbling. Digital rectal examination (DRE) reveals a smooth, moderately enlarged prostate. The client’s prostate-specific antigen (PSA) is 1.2. What is the most appropriate management strategy at this time? Referring the client to urology. Recommending saw palmetto extract. Prescribing an antibiotic.orrect! Prescribing an alpha-adrenergic blocker. The patient’s symptoms appear to be related to benign prostatic hyperplasia (BPH) and not a urinary tract infection. An alpha-adrenergic blocker will relax the smooth muscle of the prostate and bladder, which will improve flow and relieve symptoms. Benign prostatic hyperplasia (BPH) can be successfully treated by primary health care providers, and a referral is not appropriate until standard treatment is no longer effective. Question 14 1 / 1 pts A 15-year-old male comes to the clinic in acute distress with “belly pain.” When obtaining his history, the nurse practitioner (NP) finds that he fell off his bike this morning and has vomited. Upon closer examination, the NP determines the belly pain to be left-sided groin pain or pain in his left testicle. He is afebrile and reports no dysuria. Which of the following diagnoses is most likely? Varicocele.orrect! Testicular torsion Epididymitis. Hydrocele. Testicular torsion is a condition in which the testis twists on the spermatic cord, thereby compromising blood flow to the testicle. This is a surgical emergency. Examination usually reveals a tender scrotal mass high in the hemiscrotum, and there is frequently a reactive hydrocele around the testis, obscuring anatomical detail. The scrotum can become erythematous and edematous. The cremasteric reflex is frequently blunted on the side of the torsion. Question 15 1 / 1 pts A patient’s chief complaint is pain and heaviness in the scrotum. The nurse practitioner notes swelling of the testes, along with warm scrotal skin. Which of the following diagnoses is most probable? Epididymitis. Testicular torsion.orrect! Orchitis. Cryptorchidism. Orchitis refers to an acute, painful onset of swelling of the testicle accompanied by warm scrotal skin. The client usually complains of a heavy feeling in the scrotum. It is typically unilateral but after 1 week may progress to the other testicle. [Show Less]
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Chamberlain College of Nursing NR 511 Midterm Exam 1 – Question and Answers
Chamberlain College of Nursing NR 511 Midterm Exam 1 – Question and Answers. Question 1. Question : Which of the following is a crucial element of d... [Show More] eveloping a guideline? Student Answer: Creating a physician expert panel Reviewing the literature with ratings of available evidence Conducting an external review of a guideline Developing evidence-based tables Points Received: 2 of 2 Comments: Question 2. Question : African American patients seem to have a negative reaction to which of the following asthma medications? Student Answer: Inhaled corticosteroids Long-term beta-agonist bronchodilators Leukotriene receptor agonists Oral corticosteroids Points Received: 2 of 2 Comments: Question 3. Question : Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean? Student Answer: The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the distant spread cannot be evaluated. The cancer is in situ; it is spreading into the lymph nodes, but the spread cannot be evaluated otherwise. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body. The cancer is about 5 cm in size; nearby lymph nodes cannot be evaluated; and there is no evidence of distant spreading. Points Received: 2 of 2 Comments: Question 4.Question : Sondra's peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear? Student Answer: Meclizine Diphenhydramine Diamox Promethazine Points Received: 0 of 2 Comments: Question 5.Question : Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a: Student Answer: Filiform/digitate wart Dysplastic cervical lesion Condyloma acuminata Koilocytosis Points Received: 2 of 2 Comments: Question 6.Question : Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of? Student Answer: Dementia Alzheimer's disease Parkinson's disease Delirium Points Received: 2 of 2 Comments: Question 7.Question : You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her? Student Answer: "Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow." "Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow." "Drive to the emergency room now." "Call 911." Points Received: 2 of 2 Comments: Question 8.Question : A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria? Student Answer: NSAIDs Beets Vitamin A Red meat Points Received: 2 of 2 Comments: Question 9.Question : Which of the following is an example of tertiary prevention in a patient with chronic renal failure? Student Answer: Fluid restriction Hemodialysis 4 days a week High-protein diet Maintenance of blood pressure at 120/80 Points Received: 2 of 2 Comments: Question 10.Question : Which of the following conditions is associated with cigarette smoking? Student Answer: Glaucoma Increased sperm quality Bladder cancer Eczema Points Received: 0 of 2 Comments: Question 11.Question : A chronic cough lasts longer than: Student Answer: 3 weeks 1 month 6 months 1 year Points Received: 0 of 2 Comments: Question 12.Question : The 'freezing phenomenon' is a cardinal feature of? Student Answer: Parkinson's disease Alzheimer's disease A CVA Bell's palsy Points Received: 0 of 2 Comments: Question 13.Question : When administered at the beginning of an attack, oxygen therapy may help this kind of headache? Student Answer: Tension Migraine Cluster Stress Points Received: 0 of 2 Comments: Question 14.Question : Which ethnic group has the highest lung cancer incidence and mortality rates? Student Answer: African American men Scandinavian men and women Caucasian women Asian men Points Received: 0 of 2 Comments: Question 15.Question : The most significant precipitating event leading to otitis media with effusion is: Student Answer: Pharyngitis Allergies Viral upper respiratory infection (URI) Perforation of the eardrum Points Received: 2 of 2 Comments: Question 16.Question : Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of: Student Answer: Severe asthma A common valvular lesion Severe hypertension A prosthetic heart valve Points Received: 0 of 2 Comments: Question 17.Question : A 34-year-old patient was treated for a UTI and has not responded to antibiotic therapy. Which of the following actions should be taken next? Student Answer: Send a urine specimen for microscopy and evaluate for fungal colonies. Increase the dose of antibiotic. Order a cytoscopy. Order a different antibiotic. Points Received: 0 of 2 Comments: Question 18.Question : Which statement best describes a carotid bruit? Student Answer: It is felt with the middle three fingers over the carotid artery. A bruit becomes audible when the lumen is narrowed to 1 mm or less. A low-pitched bruit is a medical emergency. The higher the pitch of the bruit, the higher the degree of stenosis. Points Received: 0 of 2 Comments: Question 19.Question : Which statement is true regarding chloasma, the 'mask of pregnancy'? Student Answer: It is caused by a decrease in the melanocyte-stimulating hormone during pregnancy. This condition only occurs on the face. Exposure to sunlight will even out the discoloration. It is caused by increased levels of estrogen and progesterone. Points Received: 2 of 2 Comments: Question 20.Question : Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause? Student Answer: "You must be under a lot of stress lately." "It is hereditary. Did your father experience this also?" "The cause is unknown, but we suspect it is due to an immunologic mechanism." "We'll have to do some tests." Points Received: 0 of 2 Comments: Question 21.Question : A blood pressure (BP) of 150/90 is considered: Student Answer: Stage 2 hypertension Hypertensive Normal in healthy older adults Acceptable if the patient has DM Points Received: 0 of 2 Comments: Question 22.Question : When teaching post MI patients about their NTG tablets, the clinician should stress that the tablets should remain in the light-resistant bottle in which they are packaged and should not be put in another pill box or remain in areas that are or could become warm and humid. Once opened, the bottle must be dated and discarded after how many months? Student Answer: 1 month 3 months 6 months As long as the tablets are kept in this special bottle, they will last forever. Points Received: 0 of 2 Comments: Question 23.Question : Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking? Student Answer: He should stop smoking today. He should stop smoking tomorrow. His quit date should be in 1 week. He will be ready to quit after the first 30 days. Points Received: 0 of 2 Comments: Question 24.Question : When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are? Student Answer: Spores Leukocytes Pseudohyphae Epithelial cells Points Received: 0 of 2 Comments: Question 25.Question : The hallmark of an absence seizure is: Student Answer: No activity at all A blank stare Urine is usually voided involuntarily The attack usually lasts several minutes Points Received: 0 of 2 Comments: Question 26.Question : Which medication used for scabies is safe for children 2 months and older? Student Answer: Permethrin cream Lindane Crotamiton lotion and cream Ivermectin Points Received: 0 of 2 Comments: Question 27.Question : The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis? Student Answer: Viral conjunctivitis Keratoconjunctivitis Bacterial conjunctivitis Allergic conjunctivitis Points Received: 2 of 2 Comments: Question 28.Question : Gabby, aged 22, has Bell's palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her? Student Answer: "Most patients have complete recovery in 3 to 6 months." "Unfortunately, you'll probably have a small amount of residual damage." "Don't worry, I'll take care of everything." "You may have a few more episodes over the course of your lifetime but no permanent damage." Points Received: 2 of 2 Comments: Question 29.Question : How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate? Student Answer: Every 3 months Every 6 months Annually Whenever there is a problem Points Received: 0 of 2 Comments: Question 30.Question : Immunizations are an example of which type of prevention? Student Answer: Primary Secondary Tertiary Points Received: 0 of 2 Comments: Question 31.Question : The result of the patient's 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions? Student Answer: Repeat the test. Refer to a nephrologist. Measure the serum protein. Obtain a blood urea nitrogen (BUN) and creatinine. Points Received: 2 of 2 Comments: Question 32.Question : Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing? Student Answer: CN V CN VII CN IX CN X Points Received: 0 of 2 Comments: Question 33.Question : Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer? Student Answer: Kidneys, ureter, bladder x-ray Cystoscopy with biopsy Magnetic resonance imaging Urine tumor marker (NMP22) Points Received: 2 of 2 Comments: Question 34.Question : The "B" in the ABCDEs of assessing skin cancer represents: Student Answer: Biopsy Best practice Boundary Border irregularity Points Received: 2 of 2 Comments: Question 35.Question : Which statement is true regarding driving and patients with a seizure disorder? Student Answer: Once diagnosed with a seizure disorder, patients must never drive again. After being seizure free for 6 months, patients may drive. Each state has different laws governing driving for individuals with a seizure disorder. These persons may drive but never alone. Points Received: 0 of 2 Comments: Question 36.Question : Which high-density lipoprotein (HDL) level is considered cardioprotective? Student Answer: Greater than 30 Greater than 40 Greater than 50 Greater than 60 Points Received: 0 of 2 Comments: Question 37.Question : The most common cause of CAP is? Student Answer: Streptococcus pneumoniae Klebsiella pneumoniae Legionella pneumoniae Pseudomonas aeruginosa Points Received: 0 of 2 Comments: Question 38.Question : Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause? Student Answer: Serum calcium Electrocardiogram (ECG) Thyroid-stimulating hormone test Complete blood cell count Points Received: 2 of 2 Comments: Question 39.Question : A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be? Student Answer: The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen. A throat culture should be performed to confirm the results of the rapid strep test. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive. Points Received: 0 of 2 Comments: Question 40.Question : Patients with acute otitis media should be referred to a specialist in which of the following situations? Student Answer: Concurrent vertigo or ataxia Failed closure of a ruptured tympanic membrane If symptoms worsen after 3 or 4 days of treatment All of the above Points Received: 0 of 2 Comments: Question 41.Question : Which of the following tests is most useful in determining renal function in a patient suspected of CRF? Student Answer: BUN and creatinine Electrolytes Creatinine clearance Urinalysis Points Received: 0 of 2 Comments: Question 42.Question : Marci has a wart on her hand. She says she heard something about "silver duct tape therapy." What do you tell her about his? Student Answer: It is an old wives' tale. It is used as a last resort. Salicylic acid is more effective. It is a simple treatment that should be tried first. Points Received: 0 of 2 Comments: Question 43.Question : What is the first-line recommended treatment against Group A ?-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis? Student Answer: Penicillin Quinolone Cephalosporin Macrolide Points Received: 0 of 2 Comments: Question 44.Question : Which of the following is an example of sensorineural hearing loss? Student Answer: Perforation of the tympanic membrane Otosclerosis Cholesteatoma Presbycusis Points Received: 0 of 2 Comments: Question 45.Question : Which of the following is "a linear crack extending from the epidermis to the dermis?" Student Answer: An ulcer A fissure Lichenification An excoriation Points Received: 2 of 2 Comments: Question 46.Question : A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma? Student Answer: The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient. Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve. Points Received: 0 of 2 Comments: Question 47.Question : The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection? Student Answer: IgA IgE IgG IgM Points Received: 0 of 2 Comments: Question 48.Question : A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses? Student Answer: Pancreatitis Peptic ulcer disease Diverticulitis All of the above Points Received: 0 of 2 Comments: Question 49.Question : Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test? Student Answer: B-type natriuretic peptide C-reactive protein Serum albumin Erythrocyte sedimentation rate Points Received: 0 of 2 Comments: Question 50.Question : You are doing a cerumen extraction and touch the external meatus of your patient's ear. He winces and starts coughing. What is the name of this reflex? Student Answer: Baker phenomenon Arnold reflex Cough reflex Tragus reflex Points Received: 0 of 2 Comments: * Times are displayed in (GMT-07:00) Mountain Time (US & Canada) Question : The most cost-effective screening test for determining HIV status is which of the following? Student Answer: Western blot Enzyme-linked immunosorbent assay Venereal Disease Research Laboratory test Viral load Points Received: 0 of 2 Comments: Question 2.Question : Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process? Student Answer: Erythrocyte sedimentation rate White blood cell count Polymorphonuclear cells C-reactive protein (CRP) Points Received: 0 of 2 Comments: Question 3.Question : Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter? Student Answer: GABA Acetylcholine Dopamine Serotonin Points Received: 0 of 2 Comments: Question 4.Question : Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is: Student Answer: Ecchymosis, edema, and erythema over the lateral epicondyle Pain at the elbow with resisted movements at the wrist and forearm Inability to supinate and pronate the arm Inability to flex or extend the elbow against resistance Points Received: 2 of 2 Comments: Question 5.Question : Which of the following statements concerning the musculoskeletal examination is true? Student Answer: The uninvolved side should be examined initially and then compared to the involved side. The part of the body that is causing the patient pain should be examined first. When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient. Points Received: (not graded) Comments: Question 6.Question : Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? Student Answer: Decreased C-reactive protein Hyperalbuminemia Morning stiffness Weight gain Points Received: (not graded) Comments: Question 7.Question : Which causes the greatest percentage of mammalian bites? Student Answer: Dogs Cats Humans Rodents Points Received: (not graded) Comments: Question 8.Question : A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first? Student Answer: Transvaginal ultrasound Endometrial biopsy MRI Abdominal computed tomography scan Points Received: (not graded) Comments: Question 9.Question : A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate? Student Answer: "Control of glucose will help postpone or delay complications." "Regularly checking blood sugar will help establish a routine." "Monitoring glucose will promote a sense of control." All of the above Points Received: (not graded) Comments: Question 10.Question : A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next? Student Answer: Serum calcium TSH Electrolytes Urine specific gravity Points Received: (not graded) Comments: Question 11.Question : Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy? Student Answer: Insulin Metformin Glucotrol Precose Points Received: (not graded) Comments: Question 12.Question : During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? Student Answer: An enlarged rubbery gland A hard irregular gland A tender gland A boggy gland Points Received: (not graded) Comments: Question 13.Question : Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step? Student Answer: Remove the insect with tweezers. Immobilize the insect with 2% lidocaine. Sedate Eddie with diazepam. Shine a light in the ear for the insect to "find its way out." Points Received: (not graded) Comments: Question 14.Question : What is the most common cause of microcytic anemia? Student Answer: Anemia of chronic disease Sideroblastic anemia Iron-deficiency anemia Thalassemia Points Received: (not graded) Comments: Question 15.Question : An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses? Student Answer: Benign prostatic hyperplasia (BPH) Parkinson's disease Prostate cancer All of the above Points Received: (not graded) Comments: Question 16.Question : Early rheumatoid disease is characterized by: Student Answer: Pain and swelling in both small and large peripheral joints Rigid joints with diminished range of motion Joint swelling and immobility on rising A cardiac rub or pulmonary friction rub Points Received: (not graded) Comments: Question 17.Question : A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do? Student Answer: Make an immediate referral for an orthopedic evaluation without further assessment. Tell her that it takes time for these bruises to improve, so she should be patient. Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint. Send her to the emergency room for reduction of this obvious wrist fracture. Points Received: (not graded) Comments: Question 18.Question : The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least: Student Answer: 1 month 3 months 6 months 12 months Points Received: (not graded) Comments: Question 19.Question : A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find? Student Answer: The scrotum will be dark. The scrotum will appear light pink or yellow. The scrotum will appear milky white. The internal structures will be clearly visible. Points Received: (not graded) Comments: Question 20.Question : According to Kübler-Ross, the stages of grief occur in which order? Student Answer: Anger, denial, depression, bargaining, acceptance Anger, denial, bargaining, acceptance, depression Denial, anger, depression, bargaining, acceptance Denial, anger, bargaining, depression, acceptance Points Received: (not graded) Comments: Question 21.Question : Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate? Student Answer: A favorable prognostic trend Disease progression The need to be more aggressive with Reuben's medications The eradication of the HIV Points Received: (not graded) Comments: Question 22.Question : The exanthem of Lyme disease is: Student Answer: Erythema infectiosum Laterothoracic exanthem Erythema migrans Morbilli exanthem Points Received: (not graded) Comments: Question 23.Question : You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is: Student Answer: Articular Inflammatory Nonarticular A and B Points Received: (not graded) Comments: Question 24.Question : What is the recommended daily calcium intake for adults over the age of 50 with low bone mass? Student Answer: 1,200 mg/day 1,000 mg/day 1,300 mg/day 1,500 mg/day Points Received: (not graded) Comments: Question 25.Question : When assessing a woman for infertility, which of the following tests should be done first? Student Answer: Analysis of partner's sperm Magnetic resonance imaging (MRI) Hysterosalpingogram Estrogen level Points Received: (not graded) Comments: Question 26.Question : Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact? Student Answer: Superficial burns Superficial partial-thickness burns Deep partial-thickness burns Full-thickness burns Points Received: (not graded) Comments: Question 27.Question : A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination? Student Answer: Human papillomavirus (HPV) Endometrial hyperplasia Vagismus Polycystic ovarian syndrome Points Received: (not graded) Comments: Question 28.Question : As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin? Student Answer: Two Three Four Five Points Received: (not graded) Comments: Question 29.Question : Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? Student Answer: Morning stiffness and limited mobility of the lumbar spine Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain Fever, chills, and elevated erythrocyte sedimentation rate Pathologic fractures, severe night pain, weight loss, and fatigue Points Received: (not graded) Comments: Question 30.Question : A 30-year-old man is seen with a chief complaint of loss of [Show Less]
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Chamberlain College of Nursing NR 511 Final Exam – Question and Answers (Graded A).
Chamberlain College of Nursing NR 511 Final Exam – Question and Answers (Graded A). 1: Which test is used to confirm a diagnosis of epididymitis? Ans:... [Show More] Ultrasound of the scrotum. 2: Which of the following is part of the treatment plan for the patient with irritable bowel syndrome? Ans; High fiber diet 3: Reuben, age 24 years old has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicates? Ans: A favorable diagnostic trend 4: The patient with gastro esophageal reflux disease (GERD) should be instructed to eliminate which of these activities? Ans: Weight lifting 5: you have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is Ans: Articular 6: A 25 years old patient presents to the clinic with fatigue, cold intolerance, weight gain and constipation for the past 3 months. On physical exam, the clinician notice a sinus bradycardia, muscular stiffness, coarse, dry hair, and a delay in relaxation in deep tendon reflexes (DTRs). Which of the following test should be ordered next? Ans: Thyroid Stimulating Hormone (TSH) 7: Sam is a 25years old man who has been diagnosis with low back stain based on his history of localized low back pain and muscle spasm along with a normal numerological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? Ans: Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain. 8: Which of the following data is indication of testicular torsion? Ans: Asecnt cremasteric reflex 9: What is the recommended daily calcium intake for adults over the age of 50 with low bone mass? Ans: 1500mg /day 10: A 14 years old is seen with complaint of severe testicular pain. The clinician suspect testicular torsion. Which of the following is the appropriate action? Ans: Send the patient to the emergency room 11: Which of the following data are indicative of testicular torsion? Ans: Absent cremasteric reflex 12: A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis, in addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses? Ans: Pancreatitis, peptic ulcer disease, diverticulitis, All of the above 13: The patient is seen in the office complaining flank pain. The clinician should assess this patient for which risk factor for kidney stones? Ans: Hypertension 14: A 76 years old man is seen in the office for complaint of urinary incontinence. The clinician should suspect which causes of incontinence in men? Ans; Urinary Tract Infection (UTI) 14: Harvey has a rubbery smooth, round mass on his chest which is compressible and has a soft to to very firm texture. What do you diagnose this as? Ans: Lipoma 15: The patient is prescribed radioactive iodine (RA) and asks the clinician how this drug works. The clinician’s response should include which of the following data? Ans: RAI destroys thyroid tissue. 16: Most nosocomial pneumonias are caused by Ans: Gram-negative bacteria 17: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? Ans: Morning stiffness. 18: A patient presents to the clinician with a sore throat, fever, of 100.7f and tender anterior cervical lymphadenopathy. The clinician suspect strep throat and performed a rapid strep test that is negative. What would the nest step be? Ans: A throat culture should be performed to confirm the result of the rapid strep test. 19:Most Nosocomial pneumonias are caused by……. Ans: ? 20: A patient is diagnosed with Giardia after a backpacking trip in the mountains. Which of the following would be the appropriate treatment? Ans: Metrinidazole. 21: Which causes the greatest percentage of mammalian bites? Ans: Dog 22: One of the initial steps in assessing patient with musculoskeletal complaints is to determine whether the complaint is articular or non-articular in origin. Which of the following is an example of an articular structure? Ans: Synovium 23: Cat bites are commonly associated with which of the following pathogens? Ans: Pasteurella Multocida 24:Which of the following should be considered in a patient presenting with erectile dysfunction? Ans: DM, HTN, Atherosclerosis All of the above 25: Tori is on systemic antifungals for a tines infect. You understand that serum labs monitored for Ans: Hepatotoxicity 26:Fluctuation and reductions in estrogen may be a contributing factor in which type of rhinitis? Ans: Vasomotor rhinitis 27: Severe pain associated with acute otitis media signifies perforation of the tympanic membrane Ans: False 28: The Patient is diagnosed with overactive bladder (OAB).Which of the following instructions should be given to the woman? Ans: Eliminate caffeine from your diet 29: Sally aged 25, present with impetigo that has been diagnosed as infected with staphylococcus. The clinical presentation in pruritic, tender, red vesicles surrounded y erythema with a rash that is ulcerating. Which types of impetigo is this? Ans: Ecthyma 30: Which of the following instructions should be given to the patient with nephrolithiasis? Ans: Take Ibuprofen 600mg every 8 hours 31: A 63 years old man is seen in the clinic with a chief complaint of nocturia . Which of the following should be included in the differential diagnosis? Ans: Benign prostatic hypertrophy 32: Which of the following are predisposing factors for pyelonephritis? Ans: Pregnancy 33: Which of the following statements is true regarding the treatment of carpal tunnel syndrome? Ans: All of the above ===34: A patient is diagnosed with Giardia after a backpacking trip in the mountains. Which of the following would be the appropriate treatment? Ans: ? 35; Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than Ans: 12 weeks 36: A patient is seen in the clinic with right upper quadrant (RUQ) pain that is radiating to the middle of the back. The clinician suspects acute cholelithiasis. The clinician should expect which of the following laboratory findings? Ans; Elevated alkaline phosphatase 37: SNAPPS is pneumonic used to described a technique in orally presenting a patient Ans; True 38; The clinician is caring for Diane a 22 years old woman who presents with an injured ankle. Diane asks the clinician if she will need an X-ray. The clinician explains to Diane that X-ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the exam and Diane’s description of her injury. Which of the following clues in Diane’s exam or history would alert the clinician to the need for obtaining radiography? Ans; All of above 39; The 56 years old man with chronic prostatitis should be treated with trimethoprim 80mg sulfamethoxazole 400mg (TMP-SMX. Actrim) for how long? Ans: 6-12 weeks 40; A 23 years old sexually active man is seen in the clinic with unilateral painful testicular swelling and diagnosed with epididymitis in order to prescribe the correct drug the clinician understands that which of these is the most common causative organism? Ans: Chlamydia trachomatis 41; A 30 years old patient presents with pain on urination. The urine microscopy of unspun urine showed greater than leukocytes/ml and a dipstick was positive for nitrites> What is probable diagnosis? Ans; Lower urinary tract infection 42: Acute angl-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure? Ans: 8 to 21mmHg 43: Joyce is taking a long-acting beta agonist for moderate persistent asthma. Which additional medication should she be taking? Ans; Inhaled corticosteroid (ie Flovent). 44: A patient is seen in the clinic with a chief complaint of hematuria. Which of the following data should be collected in order to make a differential diagnosis? Ans; What medications are you currently taking? 45; Which information should be included when you are teaching your patient about the use of nicotine gum? Ans; the gum must be correctly chewed to a softened state and then place in the buccal mucosa 46; Parkinson’s disease is a progressive neurological disorder that is associated with which type of tremor Ans; Resting tremor 47; If your preceptor is out ill on a day that you are scheduled to be in the clinical setting, another preceptor can supervise you as long as they are willing to take you on as a student and they meet the minimum preceptor qualifications Ans; False 48; A 42 years old woman is seen in the clinic with fever, chills vomiting, and severe dysuria. She is diagnosed with acute pyelonephritis. How should this patient be manged? Ans; Hospitalization 49; The “B” in the ABCDE’s of assessing skin cancer represents Ans; Border irregularity 50; Janet is a 30-year-old woman who has been recently with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equine compression. Which of the following is a sign or symptom of cauda equine compression? Ans; Paresthesia of the perineum and buttocks 51; A 34 year old patient was treated for a urinary tract infection (UTI) and has not responded to antibiotic therapy. Which of the following actions should be taken next? Ans; Send a urine specimen for microscopy looking for fungal colonies 52; Ans; Blood in urine and frequency 53: A patient is diagnosed with gastroesophageal reflux disease (GERD), and his endoscopic report reveals the presence of Barretts epithelium. Which of the following information should the clinician include in the explanation of the pathology Ans; This is a premalignant tissue, This tissue is resistant to gastric acid, This tissue supports healing of the esophagus: All of the above 54; Ian age 62 presents with a wide diffuse area of erythematous skin on his left lower leg that is warm and tender to palpation. There is some edema involved. You suspect Ans; Cellulitis 55; A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease? Ans; Sinus bradycardia 56; As diabetic retinopathy progress, the presence of “cotton wool” spots can be detected Cotton Wool spots refers to Ans; Nerve fiber layer infarction 57; which of the following dietary information should be given to a patient with gastroesophageal reflux disease (GERD) Ans; Eliminate coffee 58; which of the following types of cellulitis is a streptococcal infection of the superficial layers of the skin which does not involve the subcutaneous layers? Ans; Erysipelas 59; The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptom of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs to manage his pain? Ans; You should start with the lowest dose that is effective in managing your pain because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage 60; Mark has necrotizing fasciitis of his left lower extremity. Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria? Ans; Clostridium perfringens 61; The most common precancerous skin lesion found in Caucasians is Ans; Actinic Keratosis 62; The patient is seen complaining of “leaking urine when I sneeze” Which of the following action actions should the clinician take first? Ans; Instruct the patient on Kegel exercises 63; John is a 16 year old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear? Ans; McMurray circumduction test 64; A 27 years old female presents with a chief complaint of burning and pain on urination. She has no previous history of urinary tracy infection(UTI) What are some additional symptoms consistent with a diagnosis of lower UTI? Ans: blood in urine and frequency 65; The patient is seen complaining of leaking urine when I sneeze ‘Which of the following actions should the clinician take first? Ans: Instruct the patient on kegel exercises. 66;Which obstructive lung diseases is classified as reversible? Ans: Asthma 67; Which of the following are risk factors associated with obesity? Ans: Diabetes, Skin infection, Arthritis: All of the above 68; The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following should the clinician order on the initial visit? Ans: Thyroid stimulating hormone (TSH) and free T4 69; The most common offending agents for medication- induced resting tremor are Ans: Anti-psychotics 70;the patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication? Ans: Closed angle Glaucoma 71;The pt presents with costovertebral angle (CVA) tenderness and a sveral day history of high fever and chills and dysuria. Which of the following diagnosis is most likely given the above information? Ans:Pyelonephritis 72; After 6 months of synthroid therapy, the clinician should expect which of the following in the repeated thyroid studies? Ans: Normal TSH 73; Which of the following pt are at risk for developing urinary tract cancer? All of the above. 74;The pt has acute pancreatitis with 7 of the diagnostic criteria from Ranson’s Criteria in order to plan care, the clinician understands that this criteria score has which of the following meanings? Ans: A high mortality rate 75; Mrs Gray is a 55-year-old woman who presents with lightness, pain and limited movement in her right shoulder. She denies any history of trauma. Her exam reveals a 75% reduction in both active and passive range of motion of the right shoulder. Mrs Gray is also experiencing tenderness with motion and pain at the deltoid insertion. Her medical history is significant for type 1 diabetes mellitus and hypertension. Her social history reveals that she is a secretary and that she is right-handed. Based on her exam and medical history you suspect adhesive capsulitis or: frozen shoulder” Which clue in Mrs. Gray’s history supports this diagnosis Ans: His history of diabetes mellitus 76; which of the following type of tremor is characterized by an increase in amplitude when the patient attempts voluntary movement Ans: Intention Tremor 77; Jennifer is an 18 years old girl who comes to the emergency room after a fall during a soccer games. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation? Ans: There is a risk of neurovascular and neurosensory trauma so the clinician should check for distal pulses. 78;The patient is diagnosed with urge incontinence. Before prescribing Detrol XL the provider should question the patient about which of these contraindications to this medication? Ans: ? 79; the A” in SNAPPS stands for assessment Ans: False 80; the most cost effective screening test to determine HIV status is which of the following? Ans: Enzyme-linked immunosorbent assay (ELISA). 81; The clinician see a patient who is 5 feet tall and weighs 150 pounds (BMI 29.3). How would the clinician classify this patient? Ans: Overweight 82; The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection? Ans HIV 83;Nathan a 32 years old policeman has a 15-pack year history of smoking and continue to smoke heavily. He gets irate during every visit when you try to talk to him about quitting. What should you do? Ans: Continue to ask him at every visit if he is ready yet. 84; which of the following test is considered the “gold standard” for definitively diagnosis osteoporosis? Ans: Bone mass density measurement by densitometry 85; You are performing muscle strength testing on a patient presenting with musculoskeletal pain and find that the patient has complete ange of motion with gravity eliminated. Which numeric grade of muscle strength would you give this patient? Ans: 2 86; Preceptors must always see the patients that the student sees in the clinical setting Ans: True 87;Jason; age 62 has obstructive sleep apnea. What do you think is one of his contributing factors? Ans: His collar size is 19inches 88; Treatment for epididymis includes which of the following? Ans: Scrotal elevation 89; Joyce is seen in the clinic complaining of vague symptoms of feeling nervous and irritable and that her hair will not hold a permanent wave anymore. On physical examination, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis should include which of the following conditions? Ans: Thyrotoxicosis 90; A 22 years old male is seen in the clinic because he found a hard lump in his testicle during a testicular self-exam (TSE). Which of the following should be included in the differential diagnosis? Ans: All of the above 91; All student are subject to review of clinical logs to ensure that they have received a well-rounded experience Ans True 92; Josh, aged 22 has tinea vesicolor. Which description is the most likely for this condition? Ans: There are round hypo pigmented macules on his back 93; A pt present with the following signs and symptoms gradual onset of low-grade fever, marked fatgue, severe score throat, and posterior cervical lymphadenopathy. Based on the signs and symptoms alone which patient the following conditions are most likely the cause? Ans: Mononucleosis 94; Cydney was just diagnosed with mild, intermittent asthma. Which is the most appropriate medication foe her? Ans: Short acting beta-agonist as needed 95; which is the differentiating symptom between labyrinthitis and vestibular neuritis? Ans: Hearing loss may be associated with labyrinthitis. But not with vestibular neuritis 96; An 86 years old woman is seen in the clinic for recurrent hematuria. The provider suspect bladder cancer. Which of the following information from the history would be considered a risk factor for this type of cancer? Ans: 65 years old smoking history 97; which of the following statement is true concerning the musculoskeletal exam? Ans: The uninvolved side should be examined initially and compared to the involved 98; The differential diagnosis for vertigo can be classified into which of the following categories Ans: Peripheral vestibular disease, CNC disorders, Systemic Disorders. All of the Above 99; Which statement about HIV post-exposure prophylaxis (PEP) for health-care workers is most accurate? Ans: PEP should be stated within hours after the exposure 100;Your patient has decided to give Chantix a try to quit smoking. You are discussing his quit date and he will begin taking the medication starting tomorrow. When should he plan to quit smoking? Ans: His quit date should be in 1 week. 101; An 82 years old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differentials? Ans: All of the above 102;A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? Ans: Very early 103;In which of the following situations would referral to a specialist be needed for sinusitis? Ans All of the above [Show Less]
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NR 511 Week 6 Quiz: Advanced Pharmacology
NR 511 Week 6 Quiz: Advanced Pharmacology Question 1 1 / 1 pts A client with hyperthyroidism presents with a complaint of a “gritty” feeling in her ... [Show More] eyes. Over the past week, her visual acuity has diminished, and her ability to see colors has changed. She also has a feeling of pressure behind her eyes. The next step for the nurse practitioner is to: Order a total thyroxine (T4). Correct! Refer the client for immediate evaluation by an ophthalmologist. Order a thyroid ultrasound. Prescribe a beta-adrenergic blocker. The practitioner should refer the client for an immediate evaluation by an ophthalmologist. Clinically recognized Graves ophthalmopathy occurs in about 50% of cases of Graves disease. A client with Graves orbitopathy with these complaints is at risk of blindness if there is compression of the optic nerve. Additional symptoms include photophobia and diplopia. Autoantibodies present in Graves disease can cause increased muscle thickness in the eye, leading to edema and compression of the optic nerve. Fundal exam may reveal disk swelling. This is an emergency situation that may require hospitalization and treatment with prednisone to diminish the inflammation. Artificial tears are also helpful. In 75% of clients, the onset of Graves orbitopathy occurs within a year before or after the diagnosis of thyrotoxicosis but can sometimes precede or follow thyrotoxicosis by several years. Question 2 1 / 1 pts A 23-year-old female complains of palpitations that started a few weeks ago; they occur 2 to 4 times a day and last 5 to 10 minutes. She feels nervous and is having trouble sleeping. Her stools have been frequent (1-3 per day) and loose. She is taking levothyroxine 150 µg daily. Her labs indicate free thyroxine (FT4) 2.28 and thyroid-stimulating hormone (TSH) 0.022. She has a history of Graves disease and had radioactive iodine (RAI) treatment a few months ago. She has been on thyroid replacement for 2 months. Based on these findings, what should the clinician do next? Correct! Decrease the levothyroxine dosage. Increase the levothyroxine dosage. Start propranolol every 8 hours. Keep the dosage the same. It appears that she may be overcorrected. The usual dosage of thyroid replacement is 1.6 µg/kg/d. She could skip a dose and then resume at a lower dosage of 125 to 137 µg per day. In an older individual, the lower dose would be preferred because overcorrection can lead to atrial fibrillation. She should take the levothyroxine on an empty stomach with a full glass of water and wait 30 minutes before eating for maximum absorption. Question 3 1 / 1 pts A 72-year-old obese male has gout. When teaching him about diet, which of the following should the clinician advise? "A diet high in red meat will prevent formation of kidney stones." Correct! “Fluid intake should exceed three thousand milliliters daily to prevent formation of uric acid kidney stones.” “Keeping your weight stable, even if you are a little overweight, is better than fluctuating.” “You must go on a restricted, very low calorie diet to effect immediate change.” Fluid intake should exceed 3000 mL daily to prevent formation of uric acid kidney stones. Clients should avoid dehydration because it may precipitate an acute attack. Question 4 1 / 1 pts A 24-year-old female is preparing for radioactive iodine therapy to treat Graves disease. Which test must she undergo first? Basal metabolism rate. Lithium level. Correct! Beta-human chorionic gonadotropin. Serum calcium. Radioactive iodine therapy is the most commonly used treatment in the United States for Graves disease (hyperthyroidism); however, it is contraindicated during pregnancy. Therefore, for women, a pregnancy test (beta-human chorionic gonadotropin) needs to be performed before initiating therapy. Women of childbearing age should also be told to delay conception for a few months after radioactive iodine therapy. It is also contraindicated in women who are breastfeeding. Older adults or clients at risk of developing cardiac complications may be pretreated with antithyroid drugs (ATDs) before therapy to deplete the thyroid gland of stored hormone, thereby minimizing the risk of exacerbation of hyperthyroidism because of radioactive iodine (131I)–induced thyroiditis. Question 5 1 / 1 pts A low thyroid-stimulating hormone (TSH) can lead to: Brittle hair. Bradycardia. Correct! Osteoporosis. Weight gain. Hyperthyroidism presents with a suppressed TSH and elevated free thyroxine (FT4). Manifestations include weight loss, tachycardia, diarrhea, anxiety, and warm, silky skin. The increased metabolic state of hyperthyroidism can cause cardiac dysrhythmias and osteoporosis. The clinical manifestations can also occur when there is excessive thyroid replacement. Question 6 1 / 1 pts What is the medication of choice for an initial acute attack of gout? A corticosteroid. Allopurinol (Zyloprim). Colchicine. Correct! A nonsteroidal anti-inflammatory drug (NSAID). The medication of choice for an initial acute attack of gout is an NSAID. Indomethacin (Indocin) is the most commonly prescribed NSAID for this use. An initial dose of 50 to 75 mg is given, followed by 25 to 50 mg every 8 hours for 5 to 10 days. An alternative to indomethacin is naproxen (Naprosyn). The first dose of naproxen is 750 mg, followed by 250 mg every 8 hours for 5 to 10 days. Question 7 1 / 1 pts A client presents with clinical manifestations of hyperthyroidism. The differential diagnosis includes Graves disease and subacute thyroiditis. Which of the following findings is consistent with subacute thyroiditis? A 24-hour radioactive iodine uptake (RAIU) demonstrating a “cold” nodule. Correct! A 24-hour radioactive iodine uptake (RAIU) demonstrating decreased uptake. A fine-needle aspiration is required for diagnosis of subacute thyroiditis. A 24-hour radioactive iodine uptake (RAIU) demonstrating increased uptake. A 24-hour radioactive iodine uptake helps establish the functional status of the thyroid gland. In subacute thyroiditis, the radioactive iodine uptake is low. Subacute thyroiditis produces symptoms of thyrotoxicosis via the release of preformed thyroid hormones in response to an inflammatory response after an acute infection. Subacute thyroiditis is usually self-limiting and is treated with nonsteroidal anti-inflammatory drugs (NSAIDs), beta-adrenergic antagonists, and, in severe cases, corticosteroids. Thyroid function should be monitored because a state of hypothyroidism can occur. Question 8 1 / 1 pts A 6-year-old girl was bitten by a friend’s dog. Her mother asks the clinician if the child needs anti-rabies treatment. Which of the following should the clinician advise? “Wait until you have observed the animal for 2 weeks to determine if it is rabid.” “Rabies can be contracted only through the bites of wild animals.” Correct! “If the dog is a domestic pet that has been vaccinated, wound cleansing and irrigation is the only treatment needed.” “Anti-rabies treatment must be started immediately.” If the dog is a domestic pet that has been vaccinated, the wound should be washed thoroughly with soap and water and then treated like any other wound. Question 9 1 / 1 pts Which of the following objective findings in a 49-year-old female is a sign of hyperthyroidism? Correct! Exophthalmos. Decreased systolic blood pressure (BP). Dry, coarse, cool skin. Slow pulse. Hyperthyroidism is characterized by exophthalmos, which is a term referring to the forward protrusion of the eyeball. When it is bilateral, it may signify infiltrative ophthalmopathy of Graves disease. There may be associated edema and conjunctival injection as well. Question 10 1 / 1 pts Alice, age 48, has a benign thyroid nodule. The most common treatment involves: Surgery. Radioactive iodine therapy. Administration of levothyroxine therapy. Correct! Watchful waiting with annual follow-up. Thyroid specialists agree that most benign thyroid nodules require no management beyond watchful waiting and annual follow-up to evaluate their size. Question 11 1 / 1 pts The most common cause of hyperthyroidism is: Subacute thyroiditis. A toxic uninodular goiter. A pituitary tumor. Correct! Graves disease. The most common cause of hyperthyroidism is an autoimmune condition known as Graves disease, which accounts for 90% of hyperthyroid conditions in young adults. Question 12 1 / 1 pts An elderly client presents with atrial fibrillation. Which of the following lab tests is important in forming the diagnosis? Comprehensive metabolic panel (CMP). Correct! Thyroid-stimulating hormone (TSH). C-reactive protein (CRP). Complete blood count (CBC). Atrial fibrillation is a common presentation in elderly clients with hyperthyroidism. If the TSH is suppressed, a free thyroxine (FT4) and triiodothyronine (T3) should be drawn. Question 13 1 / 1 pts Which of the following body mass index (BMI) values defines class 1 obesity? 40 25 35 Correct! 30 Class 1 obesity is defined as a BMI of 30 to less than 35. Question 14 1 / 1 pts Which of the following statements about hypothyroidism is not true? The most common worldwide cause of hypothyroidism is iodine deficiency. Lithium use is a risk factor for hypothyroidism. The most common cause of autoimmune hypothyroidism is Hashimoto thyroiditis. Correct! The rate of hypothyroidism decreases with age. This is not true; hypothyroidism becomes more common as we age. Question 15 1 / 1 pts A 46-year-old male presents with a tender, red and swollen knee. The clinician orders a complete blood count (CBC) with differential, uric acid level and erythrocyte sedimentation rate (ESR). Which of the following results would make the clinician suspect a septic joint rather than gout? Normal Erythrocyte Sedimentation Rate (ESR) and a decreased uric acid level. Correct! Elevated white blood cell (WBC) count and an elevated Erythrocyte Sedimentation Rate (ESR). Decreased white blood cell (WBC) count and an elevated uric acid level. High uric acid level and a decreased Erythrocyte Sedimentation Rate (ESR). To diagnose gout, there should be hyperuricemia and a negative joint culture. Quiz Score: 15 out of 15 PreviousNext [Show Less]
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NR 511 Test Bank Solutions (Latest Update)
NR 511 Test Bank Solutions (Latest Update) AANP-FNP lightning round review-#2 1. How many sets of Kegels should be done each day to help with urinary i... [Show More] ncontinence? -Three sets of 10 a day 2. What is the first line treatment for allergic rhinitis? - intranasal corticosteroid—ie: Flonase. 3. What is the term used for the loss of high-pitched tones in geriatrics? -Presbycusis 4. What type of hearing loss does cerumen impaction cause? - Conductive hearing loss 5. You see an older woman bending over leaving on her shopping cart at the grocery store. What is the likely diagnosis? -Spinal stenosis 6. Multiple myeloma is disease of what? -Plasma cells 7. What test in the office can you use to help diagnose sciatica? - Straight leg test (Always pick the cheapest, most noninvasive tests first!!) 8. I have heel pain that is worse in the morning. What is my likely diagnosis? - Plantar fasciitis 9. The Lachman test is used to help diagnose what? - ACL 10. Other tests for acl include -anterior and posterior drawer tests 11. What is the treatment for gout and what would be the medication instructions for a flare? - Colchicine and take 1.2 mg at the first sign of flare, followed in 1 hour with a single dose of 0.6 mg. 12. What is a sign of colchicine toxicity? - Diarrhea 13. What is a common cause of posterior knee pain? -Baker’s cyst 14. Cotton wool spots, neovascularization and microaneurysms are all Eye exam findings in what condition? –Diabetes 15. And what about AV nicking and what it is? - HTN, when an artery crosses over a vein 16. What is the treatment for bacterial sinusitis? -Augmentin 17. I’m tired, have a sore throat and swollen posterior cervical nodes on exam. What is the likely diagnosis? -Mono--The best thing I can say to help differentiate those two for memory is that P in posterior is closer to M in mono in the alphabet so that’s how I remember! 18. Recall that swollen ANTERIOR cervical nodes are seen in - strep. 19. What is a common side effect of Pyridium, an anti-spasmodic for dysuria? -Orange colored urine 20. What would be included in your list of differentials for hematuria? -Bladder cancer, kidney stones, exercise induced, trauma, medications, infection, and BPH are the most common reasons 21. What is the medication treatment for MRSA? Bactrim 22. What are some symptoms a patient with lupus would complain of? - Fatigue, malar rash aka butterfly rash, and joint aches. 23.And what is the lab that you would order it to confirm it? -ANA 24. What is the term used to describe dry, itching skin? -Xerosis 25. What is the most common kind of skin cancer? - Basal cell carcinoma reminder that this cancer presents as a pearly domed nodule, pink or flesh colored and usually has telangiectasia present 26. What medication is used to treat a cat or dog bite? -Augmentin (dogmantin) 27. What do you think of when you hear a bright beefy red rash and what is the treatment? - Candidiasis and treatment is topical anti-fungal (e.g diaper rash) 28. How would you describe the prostate in BPH? - Firm, rubbery, smooth and symmetrically enlarged. NB that prostate cancer on the other hand is asymmetrical 29. A1C> what is considered T2DM? >6.5% 30. My A1C is >10, what would be the medication of choice? Insulin (also first choice medication if fasting glucose is >300!) 31. Hypothyroidism is most common in what population? - Women >50yrs 32. Your pediatric pt has bloody discharge in his ear, what’s the likely dx? - Ruptured TM 33. Your patient presents with a burn and blisters are present. What degree burn is this? -2nd degree 34 What is the treatment for pertussis? - Macrolide (Azithromycin) 35. What bug causes the greatest mortality in community acquired pneumonia? Strep pneumo 36. What would be seen on xray of a pt with TB? A black circle usually in the upper lobes 37. Most common side effect of long-term inhaled corticosteroid use? -Osteopenia and cataracts 38. S3 heart sound is a sign of what? -Congestive heart failure (keep in mind they’re normal during pregnancy) 39. What medication do use to treat a fib? - Beta blockers 40. What is pulsus paradoxus? - A decrease in systolic pressure with inspiration usually seen in asthmatics...to measure use a blood pressure cuff and stethoscope 41. The upcoming July 4th holiday reminds you of what diagnosis? -Raynauds ..red white and blue color changing of the hands. Tx? CCBs 42. Someone with high triglyceride levels is at increased risk of what? -Pancreatitis 43. Subclinical hypothyroidism is described as what lab readings? -High TSH with a normal T4 44. A positive Markle test is significant of what? -Appendicitis ...recall that the Markle test is also known as the heel jar in which the patient raises their heels then drop them suddenly and if they experience pain it’s positive for appendicitis 45. What differentials do you think of in someone with left upper quadrant pain? -Gastritis, pancreatitis, myocardial infarction, and left lower lobe pneumonia. 46. What about left lower quadrant? -Diverticulitis 47. A positive Murphy’s sign is indicative of what? -Cholecystitis. 48. What diagnostic test would you order if this were positive? - An ultrasound 49. What is the first line treatment for GERD? - H2 blockers 50. I was going to go over hepatitis B markers but I think it’s harder to say that out loud versus seeing it on paper so going to skip that but of course remember to review those for the exam too! 51. What diagnostic test should be done for suspicion of appendicitis? -CT scan ...you should also do a CT scan for diverticulitis and speaking of diverticulitis what is the treatment? Cipro and Flagyl 52. What is the confirmatory test for HIV? Per Leik 3rd edition, • Step 1: Order HIV-1/HIV-2 antibodies and P24 antigen (combination assay) with reflexes. "Reflex" means that if positive, the lab will automatically perform the follow-up test to confirm the results. 53. What is the treatment for syphilis? -Pcn G (for all stages of it) 54. And what are some presenting features of syphilis? Rashes on soles of feet and palms of hands, painless lesions (chancre) 55. Gonorrhea treatment? Rocephin (“gone-a-cephin” helps me remember this one!) 56. Cervicitis is seen in which diagnoses? -Chlamydia and gonorrhea 57. I am a healthy 63-year-old patient, what is my goal BP according to JNC 8? - <150/90 for 60yrs+. Recall that less than 60yrs is <140/90 in addition to those with DM and CKD 58. What should we keep in mind when prescribing for the elderly population? -May have to start with half dose and increase slowly, side effects!! Especially anticholinergics 59. A low HDL and high trig level always means what? -Insulin insufficiency 60. The S1 is the closure of which valves? -AV valves, and S2 is closure of semilunar valves 61. On exam you feel a weakened peripheral pulse, what diagnosis do you think of? - PAD 62. An absent red reflex is indicative of what? Cataract 63. During an eye exam you note absent venous pulsations, what is this related to? -Papilledema 64. The Dix Hallpike maneuver is used to test for what condition? -Vertigo 65. What is the most well-known medication treatment for Vertigo? - Meclizine 66. What medication is prescribed for essential tremors? -BB (propranolol) 67. A young adult patient states that she is experiencing episodes of vision loss and abnormal limb sensations. What would be at the top of your list of differentials? - MS---and what would you do? REFER TO NEURO 68. When assessing a patient for dementia, what is the FIRST and best thing you should do? -GET A GOOD HX FROM PT BUT ALSO FAMILY 69. Name a difference between dementia and delirium? - Dementia is slow progress, delirium happens RAPIDLY 70. What is the MAIN cause of delirium? -Infection 71. Cranial Nerves review (just going over the MAIN ones I’ve seen in reviews/questions for the exam) --nose: 1 --vision: 2 --EOM: 3, 4, and 6 --trigeminal: 5 (trigeminal neuralgia) --facial: 7 (bell’s palsy)—HSV can cause Bell’s Palsy (keep in mind!) --ears: 8 --shoulders: 11 72. UTI treatment? - Macrobid 73. What about UTI in a pregnant pt? -Keflex or Amoxicillin 74. Anxiety…which meds to use for situational? -Benzos and GAD? SSRIs, SNRIs 75. What about OCD? SSRI, SNRI, TCA 76. Which population has the highest suicide rate? -Older, white males 77. What symptom is specific to the geriatric population when you think of UTIs? Confusion 78. PNA in Geri’s, how do they present? -We went over this last round, but felt it was important enough to repeat it. Tachypnea, extreme fatigue, and I didn’t mention last time but another thing to keep in mind with geris and PNA is that they MAY not have a fever with it because of decreased thermoregulation. Also can see delirium and falls. 79. What is the difference between sensitivity and specificity? - Sen= TRUE positive, they tested POSITIVE and HAVE the DA, whereas Spec= DON’T have the DA, tested NEG 80. What vitamin deficiency can alcohol lead to? -Thiamine deficiency (vit B1)---and INCREASED GGT levels 81. MMSE, what score indicates dementia? <24 (0-9 is severe) 82. 10mm+ for PPD is needed for continued investigation of TB for what two populations? -Healthcare workers and recent migrants. Note 5mm+ “ “-- HIV patients and immunosuppressant 83. What food is advised to try first in infants 4-6 months of age? -Rice cereal 84. What degree of curvature in scoliosis should warrant bracing? >20 degrees 85. Tanner staging, anyone need a refresher on this? 86. What is the leading cause of death in children? -ACCIDENTS 87. What sound during the Ortolani maneuver is a positive finding and signifies a possible hip abnormality (hip dysplasia) in infants. – -The "clunk" sound 88. A newborn's mother is discovered to be HBsAg (hepatitis B surface antigen) positive. Which of the following would you recommend for this infant? —Give BOTH the Hep B vaccine and immunoglobulin 89. Which method is used to diagnose gonorrheal pharyngitis or proctitis? —Thayer-Martin culture is recommended for screening to diagnose gonorrheal pharyngitis or proctitis. 90. What is the treatment for a medial tibial stress fracture (aka “shin splints”) -RICE Chapter 3. Health Promotion Multiple Choice Identify the choice that best completes the statement or answers the question. _¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬A 1. Which of the following is a primary prevention measure for a 76-year-old man newly diagnosed with a testosterone deficiency? a. Calcium supplementation b. Testicular self-examination c. Bone density test d. Digital rectal examination __A__ 2. Which of the following is an example of secondary prevention in a 50-year-old woman? a. Yearly mammogram b. Low animal fat diet c. Use of seat belt d. Daily application of sunscreen ___B_ 3. Which of the following is an example of tertiary prevention in a patient with chronic renal failure? a. Fluid restriction b. Hemodialysis 4 days a week c. High-protein diet d. Maintenance of blood pressure at 120/80 __A__ 4. Immunizations are an example of which type of prevention? a. Primary b. Secondary c. Tertiary True/False Indicate whether the statement is true or false. __F__ 1. Prevalence is the number of new cases of a particular disease. __F__ 2. The number of cases of a particular disease for the past 5 years is an example of the incidence rate. __T__ 3. “There are 1,185,000 cases of HIV/AIDS in the United States” is an example of the morbidity rate. __T__ 4. Endemic is the term used when the presence of an event is constant. __F__ 5. The “bird” flu of 2005 to 2006 is considered a sporadic outbreak. ___T_ 6. A pandemic affects many communities in a short period of time. Chapter 3. Health Promotion Answer Section MULTIPLE CHOICE 1. ANS: A PTS: 1 2. ANS: A PTS: 1 3. ANS: B PTS: 1 4. ANS: A PTS: 1 TRUE/FALSE 1. ANS: F PTS: 1 2. ANS: F PTS: 1 3. ANS: T PTS: 1 4. ANS: T PTS: 1 5. ANS: F PTS: 1 6. ANS: T PTS: 1 Chapter 5. Evidence-Based Care Multiple Choice Identify the choice that best completes the statement or answers the question. ___D_ 1. Which of the following are parts of evidence-based practice? a. Clinician b. Patient c. Evidence d. All of the above __B__ 2. Which is the most important question to ask in nursing research? a. What findings constitute evidence? b. How will the findings be used? c. Is this a randomized controlled trial? d. What theory is being utilized? __D__ 3. Nursing research should be utilized by: a. Nurses at the bedside b. Advanced practice nurses c. Nurse researchers [Show Less]
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NR 511 Final Exam – Question and Answers
NR 511 Final Exam – Question and Answers Chamberlain College of Nursing NR 511 Final Exam – Question and Answers (Graded A). 1: Which test is used to... [Show More] confirm a diagnosis of epididymitis? Ans: Ultrasound of the scrotum. 2: Which of the following is part of the treatment plan for the patient with irritable bowel syndrome? Ans; High fiber diet 3: Reuben, age 24 years old has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicates? Ans: A favorable diagnostic trend 4: The patient with gastro esophageal reflux disease (GERD) should be instructed to eliminate which of these activities? Ans: Weight lifting 5: you have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is Ans: Articular 6: A 25 years old patient presents to the clinic with fatigue, cold intolerance, weight gain and constipation for the past 3 months. On physical exam, the clinician notice a sinus bradycardia, muscular stiffness, coarse, dry hair, and a delay in relaxation in deep tendon reflexes (DTRs). Which of the following test should be ordered next? Ans: Thyroid Stimulating Hormone (TSH) 7: Sam is a 25years old man who has been diagnosis with low back stain based on his history of localized low back pain and muscle spasm along with a normal numerological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? Ans: Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain. 8: Which of the following data is indication of testicular torsion? Ans: Asecnt cremasteric reflex 9: What is the recommended daily calcium intake for adults over the age of 50 with low bone mass? Ans: 1500mg /day 10: A 14 years old is seen with complaint of severe testicular pain. The clinician suspect testicular torsion. Which of the following is the appropriate action? Ans: Send the patient to the emergency room 11: Which of the following data are indicative of testicular torsion? Ans: Absent cremasteric reflex 12: A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis, in addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses? Ans: Pancreatitis, peptic ulcer disease, diverticulitis, All of the above 13: The patient is seen in the office complaining flank pain. The clinician should assess this patient for which risk factor for kidney stones? Ans: Hypertension 14: A 76 years old man is seen in the office for complaint of urinary incontinence. The clinician should suspect which causes of incontinence in men? Ans; Urinary Tract Infection (UTI) 14: Harvey has a rubbery smooth, round mass on his chest which is compressible and has a soft to to very firm texture. What do you diagnose this as? Ans: Lipoma 15: The patient is prescribed radioactive iodine (RA) and asks the clinician how this drug works. The clinician’s response should include which of the following data? Ans: RAI destroys thyroid tissue. 16: Most nosocomial pneumonias are caused by Ans: Gram-negative bacteria 17: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? Ans: Morning stiffness. 18: A patient presents to the clinician with a sore throat, fever, of 100.7f and tender anterior cervical lymphadenopathy. The clinician suspect strep throat and performed a rapid strep test that is negative. What would the nest step be? Ans: A throat culture should be performed to confirm the result of the rapid strep test. 19:Most Nosocomial pneumonias are caused by……. Ans: ? 20: A patient is diagnosed with Giardia after a backpacking trip in the mountains. Which of the following would be the appropriate treatment? Ans: Metrinidazole. 21: Which causes the greatest percentage of mammalian bites? Ans: Dog 22: One of the initial steps in assessing patient with musculoskeletal complaints is to determine whether the complaint is articular or non-articular in origin. Which of the following is an example of an articular structure? Ans: Synovium 23: Cat bites are commonly associated with which of the following pathogens? Ans: Pasteurella Multocida 24:Which of the following should be considered in a patient presenting with erectile dysfunction? Ans: DM, HTN, Atherosclerosis All of the above 25: Tori is on systemic antifungals for a tines infect. You understand that serum labs monitored for Ans: Hepatotoxicity 26:Fluctuation and reductions in estrogen may be a contributing factor in which type of rhinitis? Ans: Vasomotor rhinitis 27: Severe pain associated with acute otitis media signifies perforation of the tympanic membrane Ans: False 28: The Patient is diagnosed with overactive bladder (OAB).Which of the following instructions should be given to the woman? Ans: Eliminate caffeine from your diet 29: Sally aged 25, present with impetigo that has been diagnosed as infected with staphylococcus. The clinical presentation in pruritic, tender, red vesicles surrounded y erythema with a rash that is ulcerating. Which types of impetigo is this? Ans: Ecthyma 30: Which of the following instructions should be given to the patient with nephrolithiasis? Ans: Take Ibuprofen 600mg every 8 hours 31: A 63 years old man is seen in the clinic with a chief complaint of nocturia . Which of the following should be included in the differential diagnosis? Ans: Benign prostatic hypertrophy 32: Which of the following are predisposing factors for pyelonephritis? Ans: Pregnancy 33: Which of the following statements is true regarding the treatment of carpal tunnel syndrome? Ans: All of the above ===34: A patient is diagnosed with Giardia after a backpacking trip in the mountains. Which of the following would be the appropriate treatment? Ans: ? 35; Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than Ans: 12 weeks 36: A patient is seen in the clinic with right upper quadrant (RUQ) pain that is radiating to the middle of the back. The clinician suspects acute cholelithiasis. The clinician should expect which of the following laboratory findings? Ans; Elevated alkaline phosphatase 37: SNAPPS is pneumonic used to described a technique in orally presenting a patient Ans; True 38; The clinician is caring for Diane a 22 years old woman who presents with an injured ankle. Diane asks the clinician if she will need an X-ray. The clinician explains to Diane that X-ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the exam and Diane’s description of her injury. Which of the following clues in Diane’s exam or history would alert the clinician to the need for obtaining radiography? Ans; All of above 39; The 56 years old man with chronic prostatitis should be treated with trimethoprim 80mg sulfamethoxazole 400mg (TMP-SMX. Actrim) for how long? Ans: 6-12 weeks 40; A 23 years old sexually active man is seen in the clinic with unilateral painful testicular swelling and diagnosed with epididymitis in order to prescribe the correct drug the clinician understands that which of these is the most common causative organism? Ans: Chlamydia trachomatis 41; A 30 years old patient presents with pain on urination. The urine microscopy of unspun urine showed greater than leukocytes/ml and a dipstick was positive for nitrites> What is probable diagnosis? Ans; Lower urinary tract infection 42: Acute angl-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure? Ans: 8 to 21mmHg 43: Joyce is taking a long-acting beta agonist for moderate persistent asthma. Which additional medication should she be taking? Ans; Inhaled corticosteroid (ie Flovent). 44: A patient is seen in the clinic with a chief complaint of hematuria. Which of the following data should be collected in order to make a differential diagnosis? Ans; What medications are you currently taking? 45; Which information should be included when you are teaching your patient about the use of nicotine gum? Ans; the gum must be correctly chewed to a softened state and then place in the buccal mucosa 46; Parkinson’s disease is a progressive neurological disorder that is associated with which type of tremor Ans; Resting tremor 47; If your preceptor is out ill on a day that you are scheduled to be in the clinical setting, another preceptor can supervise you as long as they are willing to take you on as a student and they meet the minimum preceptor qualifications Ans; False 48; A 42 years old woman is seen in the clinic with fever, chills vomiting, and severe dysuria. She is diagnosed with acute pyelonephritis. How should this patient be manged? Ans; Hospitalization 49; The “B” in the ABCDE’s of assessing skin cancer represents Ans; Border irregularity 50; Janet is a 30-year-old woman who has been recently with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equine compression. Which of the following is a sign or symptom of cauda equine compression? Ans; Paresthesia of the perineum and buttocks 51; A 34 year old patient was treated for a urinary tract infection (UTI) and has not responded to antibiotic therapy. Which of the following actions should be taken next? Ans; Send a urine specimen for microscopy looking for fungal colonies 52; Ans; Blood in urine and frequency 53: A patient is diagnosed with gastroesophageal reflux disease (GERD), and his endoscopic report reveals the presence of Barretts epithelium. Which of the following information should the clinician include in the explanation of the pathology Ans; This is a premalignant tissue, This tissue is resistant to gastric acid, This tissue supports healing of the esophagus: All of the above 54; Ian age 62 presents with a wide diffuse area of erythematous skin on his left lower leg that is warm and tender to palpation. There is some edema involved. You suspect Ans; Cellulitis 55; A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease? Ans; Sinus bradycardia 56; As diabetic retinopathy progress, the presence of “cotton wool” spots can be detected Cotton Wool spots refers to Ans; Nerve fiber layer infarction 57; which of the following dietary information should be given to a patient with gastroesophageal reflux disease (GERD) Ans; Eliminate coffee 58; which of the following types of cellulitis is a streptococcal infection of the superficial layers of the skin which does not involve the subcutaneous layers? Ans; Erysipelas 59; The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptom of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs to manage his pain? Ans; You should start with the lowest dose that is effective in managing your pain because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage 60; Mark has necrotizing fasciitis of his left lower extremity. Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria? Ans; Clostridium perfringens 61; The most common precancerous skin lesion found in Caucasians is Ans; Actinic Keratosis 62; The patient is seen complaining of “leaking urine when I sneeze” Which of the following action actions should the clinician take first? Ans; Instruct the patient on Kegel exercises 63; John is a 16 year old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear? Ans; McMurray circumduction test 64; A 27 years old female presents with a chief complaint of burning and pain on urination. She has no previous history of urinary tracy infection(UTI) What are some additional symptoms consistent with a diagnosis of lower UTI? Ans: blood in urine and frequency 65; The patient is seen complaining of leaking urine when I sneeze ‘Which of the following actions should the clinician take first? Ans: Instruct the patient on kegel exercises. 66;Which obstructive lung diseases is classified as reversible? Ans: Asthma 67; Which of the following are risk factors associated with obesity? Ans: Diabetes, Skin infection, Arthritis: All of the above 68; The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following should the clinician order on the initial visit? Ans: Thyroid stimulating hormone (TSH) and free T4 69; The most common offending agents for medication- induced resting tremor are Ans: Anti-psychotics 70;the patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication? Ans: Closed angle Glaucoma 71;The pt presents with costovertebral angle (CVA) tenderness and a sveral day history of high fever and chills and dysuria. Which of the following diagnosis is most likely given the above information? Ans:Pyelonephritis 72; After 6 months of synthroid therapy, the clinician should expect which of the following in the repeated thyroid studies? Ans: Normal TSH 73; Which of the following pt are at risk for developing urinary tract cancer? All of the above. 74;The pt has acute pancreatitis with 7 of the diagnostic criteria from Ranson’s Criteria in order to plan care, the clinician understands that this criteria score has which of the following meanings? Ans: A high mortality rate 75; Mrs Gray is a 55-year-old woman who presents with lightness, pain and limited movement in her right shoulder. She denies any history of trauma. Her exam reveals a 75% reduction in both active and passive range of motion of the right shoulder. Mrs Gray is also experiencing tenderness with motion and pain at the deltoid insertion. Her medical history is significant for type 1 diabetes mellitus and hypertension. Her social history reveals that she is a secretary and that she is right-handed. Based on her exam and medical history you suspect adhesive capsulitis or: frozen shoulder” Which clue in Mrs. Gray’s history supports this diagnosis Ans: His history of diabetes mellitus 76; which of the following type of tremor is characterized by an increase in amplitude when the patient attempts voluntary movement Ans: Intention Tremor 77; Jennifer is an 18 years old girl who comes to the emergency room after a fall during a soccer games. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation? Ans: There is a risk of neurovascular and neurosensory trauma so the clinician should check for distal pulses. 78;The patient is diagnosed with urge incontinence. Before prescribing Detrol XL the provider should question the patient about which of these contraindications to this medication? Ans: ? 79; the A” in SNAPPS stands for assessment Ans: False 80; the most cost effective screening test to determine HIV status is which of the following? Ans: Enzyme-linked immunosorbent assay (ELISA). 81; The clinician see a patient who is 5 feet tall and weighs 150 pounds (BMI 29.3). How would the clinician classify this patient? Ans: Overweight 82; The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection? Ans HIV 83;Nathan a 32 years old policeman has a 15-pack year history of smoking and continue to smoke heavily. He gets irate during every visit when you try to talk to him about quitting. What should you do? Ans: Continue to ask him at every visit if he is ready yet. 84; which of the following test is considered the “gold standard” for definitively diagnosis osteoporosis? Ans: Bone mass density measurement by densitometry 85; You are performing muscle strength testing on a patient presenting with musculoskeletal pain and find that the patient has complete ange of motion with gravity eliminated. Which numeric grade of muscle strength would you give this patient? Ans: 2 86; Preceptors must always see the patients that the student sees in the clinical setting Ans: True 87;Jason; age 62 has obstructive sleep apnea. What do you think is one of his contributing factors? Ans: His collar size is 19inches 88; Treatment for epididymis includes which of the following? Ans: Scrotal elevation 89; Joyce is seen in the clinic complaining of vague symptoms of feeling nervous and irritable and that her hair will not hold a permanent wave anymore. On physical examination, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis should include which of the following conditions? Ans: Thyrotoxicosis 90; A 22 years old male is seen in the clinic because he found a hard lump in his testicle during a testicular self-exam (TSE). Which of the following should be included in the differential diagnosis? Ans: All of the above 91; All student are subject to review of clinical logs to ensure that they have received a well-rounded experience Ans True 92; Josh, aged 22 has tinea vesicolor. Which description is the most likely for this condition? Ans: There are round hypo pigmented macules on his back 93; A pt present with the following signs and symptoms gradual onset of low-grade fever, marked fatgue, severe score throat, and posterior cervical lymphadenopathy. Based on the signs and symptoms alone which patient the following conditions are most likely the cause? Ans: Mononucleosis 94; Cydney was just diagnosed with mild, intermittent asthma. Which is the most appropriate medication foe her? Ans: Short acting beta-agonist as needed 95; which is the differentiating symptom between labyrinthitis and vestibular neuritis? Ans: Hearing loss may be associated with labyrinthitis. But not with vestibular neuritis 96; An 86 years old woman is seen in the clinic for recurrent hematuria. The provider suspect bladder cancer. Which of the following information from the history would be considered a risk factor for this type of cancer? Ans: 65 years old smoking history 97; which of the following statement is true concerning the musculoskeletal exam? Ans: The uninvolved side should be examined initially and compared to the involved 98; The differential diagnosis for vertigo can be classified into which of the following categories Ans: Peripheral vestibular disease, CNC disorders, Systemic Disorders. All of the Above 99; Which statement about HIV post-exposure prophylaxis (PEP) for health-care workers is most accurate? Ans: PEP should be stated within hours after the exposure 100;Your patient has decided to give Chantix a try to quit smoking. You are discussing his quit date and he will begin taking the medication starting tomorrow. When should he plan to quit smoking? Ans: His quit date should be in 1 week. 101; An 82 years old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differentials? Ans: All of the above 102;A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? Ans: Very early 103;In which of the following situations would referral to a specialist be needed for sinusitis? Ans All of the above [Show Less]
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