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NSG 6430 / NSG6430 FINAL EXAM SOUTH UNIVERSITY STUDY GUIDE
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NSG 6430 / NSG6430 WEEK 4 QUIZ
NSG 6430 / NSG6430 WEEK 4 QUIZ 1. PCOs increasing risk for 2. Begins with ovulation and ends with menstrual period starting 3. Which of the followi... [Show More] ng indicates cancer of the breast SELECT ALL 4. SE of dep 5. Alternatives treatment to PMS 6. Assessment of adolescent should include (I shortened the answers but essentially this is what they said) SELECT ALL Counseling an 11 year old regarding HPV vaccine includes (this threw me because I didn’t see a 7. correct answer) I picked seizures but it was prob wrong… it may be that 2 doses are only indicated for this age group 8. Woman is experiencing Severe insominia, irritability and anger 2 weeks prior to menstrual cycle what do they have 9. Tx of AUB in 40 year old 10. Education on diaphragm 11. PCOS symptoms include SELECT ALL in addition to obesity 12. Patient with non tender mobile mass.. what is the likely dx 13. What should you give an adolescent for amenorrhea if testing is normal 14. Patient has htn and smokes which should NOT be prescribed for her for birth control 15. NuvaRing [Show Less]
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NSG 6430 / NSG6430 FINAL EXAM SOUTH UNIVERSITY STUDY GUIDE:
NSG 6430 / NSG6430 FINAL EXAM SOUTH UNIVERSITY STUDY GUIDE: Question 1 The nurse practitioner is performing a bimanual exam on a new OB patient and not... [Show More] ices that the lower portion of the patient’s uterus is soft. This is known as: : A) Hegar's Sign B) Chadwick's Sign C) Nightingale's Sign D) Goodell's Sign Question 2 Your female patient presents for vaginal discharge with an odor, and has noticed painless “bumps” on her vaginal area. Sexual history includes past male partners and her current female partner. On exam you note beefy red papules and an ulcerative lesion on her vulva, granular tissue and scarring, and inguinal adenopathy. You suspect she has: A) HSV-2 B) Granuloma Inguinale C) Chancroid D) Molluscum Contagiosum Question 3 The nurse practitioner knows that a highly valuable assessment tool for evaluating urinary incontinence and contributing factors in daily life is: A) the interview B) a voiding diary C) the physical exam D) the patient's response to non-pharmacologic treatments Question 4 The nurse practitioner is counseling a 57 year-old patient with urinary incontinence. The patient desires to try non- pharmacological, non-invasive methods of treatment at this time. Which of the following should be included in the patient's plan of care? Select all that apply. A. Bladder training B. Kegel exercises C. Eliminate caffeine and alcohol consumption D. Use of bulking agents Question 5 The physical examination of any woman suspected of being abused or battered includes all of the following except: A) a thorough inspection for signs of injury, past and present B) a physical assessment just like that of any other adult female C) a focus on the patient's physical appearance, not her behavior D) the use of body maps and diagrams to accurately portray the patient's physical condition Question 6 The most effective means of obtaining the history of abuse is to use a communication model that: A) avoids having the patient's children present during the discussion B) signals someone is interested and that the woman is not alone C) emphasizes the belief that violence is not acceptable, no matter what the batterer might have said to the patient D) allows the patient to talk without interruption and with time to relate, emphasize, and repeat her full story Question 7 Clinicians should routinely consider intimate partner violence (IPV) as a possible diagnosis for women who present with all of the following except: A) chronic stress-related symptoms B) denial of any physical health problems C) central nervous system (CNS) symptoms D) gynecologic problems, especially multiple ones Question 8 The factors that enable women to enjoy and control their sexual and reproductive lives, including a physical and emotional state of well-being and the quality of sexual and other close relationships, make up a woman's: A) sexual health B) gender identit C) gender role behaviors D) psychosocial orientation Question 9 Which one of the following is not among the ways clinicians can provide a welcoming, safe environment for Lesbian, Gay, Bixsexual, or Transgender (LGBT) patients? A) Avoid the heterosexual assumption by using gender-neutral language. B) Explain whether and how information will be documented in the patient's medical record. C) Ignore the sexual status or gender identity of all patients. D) Offer mainstream referrals that are culturally sensitive to SGMs. Question 10 Which one of the following is the definition of the term "gender identity"? A) People who respond erotically to both sexes B) A self-label, regardless of biologic or natal sex C) People who are similar in age, class, and sexual status D) A label for behavior not usually associated with one's natal sex Question 11 Which one of the following statements about sexually transmitted infections (STIs) is false? A) Lesbians are at very low risk for development of STIs and vaginal infections. B) HIV has been identified in case studies of women who report sex only with women. C) Transgender women (Male to Female) have extremely high rates of HIV infection. D) Risky behaviors for STIs include sex during menses. Question 12 Among the midlife health issues of women, the number one cause of mortality in the United States is: A) primary osteoporosis B) cardiovascular disease C) overweight and obesity D) cancer Question 13 Lifestyle approaches to manage menopause related vasomotor symptoms include: A) sleeping more than 8 hours per night B) avoiding spicy foods, hot drinks, caffeine, and alcohol C) decreasing levels of physical activity D) more than 1,000 international units/day of vitamin E Question 14 The standard for managing moderate to severe menopausal symptoms is: A) lifestyle changes, such as dieting and exercising B) nonhormone products, such as antidepressant medications C) alternative care, such as acupuncture, combined with organic herbs D) prescription systemic hormone products, such as estrogen and progestogen Question 15 The nurse practitioner is managing an adolescent with a 4 cm functional ovarian cyst that was confirmed on a recent ultrasound. What plan of care should be anticipated for this patient? A) Repeat bimanual exam in 1 week B) Refer for surgical consult C) Repeat ultrasound in 2 months D) Stop all ovulatory inhibitor meds Question 16 Non-pharmacologic therapy for chronic pelvic pain includes the following: Select all that apply. A) Vitamin B6 B) Physical therapy C) Aerobic and nonaerobic exercise D) Antidepressants Question 17 The nurse practitioner understands that all of the following organisms are responsible for infection of the Bartholin's gland except: A) Streptococcus faecalis B) Klebsiella C) Staphylococcus aureus D) E. Coli Question 18 Treatment of a large, symptomatic Bartholin's cyst includes all of the following except: A) Sitz baths B) Incision and drainage C) Topical corticosteroids D) Antibiotics Question 19 A 44 year-old African American female presents with complaints of menorrhagia x 15 months. Pelvic ultrasound confirms the presence of a large intramural leiomyomata. The nurse practitioner should discuss all of the following options with the patient except: A) GnRH agonist therapy B) Referral for surgical consult C) Progestin therapy D) Estrogen therapy Question 20 The nurse practitioner is treating a patient with Elimite for scabies. The proper instructions to the patient should include: A) All household contacts should be treated with Elimite regardless of symptoms. B) The medication should be taken orally in one single dose and repeated in 2 weeks. C) Apply only to the body area infested with scabies and repeat treatment in 5 days. D) Apply to all areas of the body from the neck down, wash off after 8 to 14 hours, then repeat treatment in one week Question 21 The nurse practitioner understands that the proper management of an asymptomatic woman with a small fibroid should include: A) Start combination COC therapy. B) Repeat ultrasound in 3-4 months. C) Reassess in 6 to 12 months. D) Refer for myomectomy. Question 22 The nurse practitioner is teaching a patient about pediculosis. Which of the following statements by the nurse practitioner is correct? A) Nits can survive in hot and humid climates up to 21 days.” B) “Adult pubic lice can survive 72 hours off their host.” C) “Pruritus is not a common manifestation.” D) “The condition is treated with Permethrin cream.” Question 23 All of the following medications may be used for neuropathic pain management of vulvodynia, except: A) Neurontin B) SSRIs C) Methotrexate D) Tricyclics Question 24 The nurse practitioner understands that which of the following lab tests is appropriate for the patient who presents with symptoms of dysesthetic vulvodynia? A) RPR B) Pap smear C) Wet mount D) Endometrial biopsy Question 25 Which of the following is a common antibiotic for treatment of an infected Bartholin's cyst? A) Minocycline B) Levaquin C) Bactrim D) Ampicillin Question 26 (2.5 points) The patient presents with complaints of a painful, swollen lump in her vaginal area. She reports difficulty sitting and walking due to the pain. Which of the following is a likely diagnosis for this patient? Question 26 options: Syphilis chancre Lichen Planus Genital Wart Bartholin's cyst Question 27 (2.5 points) The nurse practitioner understands that which of the following are differential diagnoses in an adult female patient with acute pelvic pain. Select all that apply: Question 27 options: A) Ectopic pregnancy B) Appendicitis C) Ovarian cyst with rupture D) Pelvic Congestion Syndrome Question 28 (2.5 points) When women experience mild premenstrual symptoms, such as mild breast tenderness, abdominal bloating, and mild weight gain from water retention, this is known as: Question 28 options: Luteal phase deficiency Premenstrual dysmorphic disorder Premenstrual syndrome Follicular phase deficiency Question 29 (2.5 points) A patient with intraductal papilloma will commonly present with a chief complaint of: Question 29 options: A palpable mass Bloody nipple discharge Bilateral milky discharge Mild localized pain Question 30 (2.5 points) The nurse practitioner understands that the necessary screening techniques in a patient suspicious of ovarian cancer should include the following: Select all that apply. Question 30 options: CA-125 Transvaginal ultrasound Bimanual pelvic exam Pap smear Question 31 (2.5 points) Early symptoms experienced by a woman with ovarian cancer include all of the following except: Question 31 options: Vague abdominal pain Abdominal bloating Fatigue Unexplained weight gain Question 32 (2.5 points) The nurse practitioner is evaluating a patient's risk of ovarian cancer. All of the following factors are associated with an increased risk for ovarian cancer except: Question 32 options: First degree relative with ovarian cancer BRCA -1 and 2 mutations Obesity Oral Contraceptive Use Question 33 (2.5 points) Patient education for condylomataacuminata should include all the following except: Question 33 options: The cause of the condition is a virus of the HPV type Sexual partners should be checked and condoms used to decrease incidence of transmission Treatment and elimination of visible warts is a sign of cure, and transmission will not occur The virus does not always cause a lesion, subclinical infection may occur Question 34 (2.5 points) Tina is evaluated and diagnosed with Molluscum Contagiosum. The nurse practitioner understands that clinical presentation of this disease is characterized by: Question 34 options: Fleshy, papular skin colored lesions with indented centers that contain white curdlike material. Ulcerated ragged edge lesions that are painful Clusters of vesicles that itch and are painful to palpation Painless fleshy clusters of growths that resemble grapes or cauliflower Question 35 (2.5 points) Sara is 72 years old and has been a widow for 12 years. She presents for her yearly well woman exam. Sara has not been sexually active since age 60. She has had regular pap screenings in her life and has had no abnormal pap tests. Sara asks if she needs a Pap test. Your response would be: Question 35 options: Yes, you need a Pap test with HPV testing every 5 years. Yes, you should have a Pap test every 3 years. No, you do not need a Pap test or a pelvic exam again, unless you notice a vaginal discharge, have discomforts, or anything out of the ordinary. No, you do not need a Pap test, but I do recommend we do a pelvic exam to assess for abnormalities. Question 36 (2.5 points) Misty presents with a painful “sores” in her perineal area, dysuria and dyspareunia. On exam she has 2 shallow ulcerated lesions on the right labia majora and one on the left. She also presents with enlarged inguinal lymph nodes. Based on these findings you suspect she has: Question 36 options: HSV-2 Genital warts Chancroid Syphilis lesions Question 37 (2.5 points) Which of the following is not true for HIV infection evaluation? Question 37 options: The CDC recommends HIV testing for all persons seeking evaluation for STIs. HIV evaluation is recommended if a patient has a history of unprotected sex with a previously incarcerated male, an uncircumcised male, or participates in anal penetration. If a patient is fearful they have been exposed to HIV, but denies all risk factors, it is not recommended to test for HIV. Aids is caused by HIV, mainly by sexual contact (anal, vaginal, or oral), contaminated blood and blood products, contaminated semen used for artificial insemination, intrauterine acquisition, and breastmilk. Question 38 (2.5 points) The nurse practitioner understands that the risk factors for developing vaginal candidiasis include which of the following? Question 38 options: Hypoglycemia A diet high in refined sugar Use of Vit C supplement A habit of consuming live culture yogurt several times a week Question 39 (2.5 points) Cindy presents to your clinic for STI testing after realizing her current boyfriend has been seeing other women. She states she was told that one of the women has hepatitis B. Your patient education regarding hepatitis B includes all the following except: Question 39 options: Hepatitis B is transmitted enterically Hepatitis B has an incubation period of 6 weeks to 6 months Hepatitis B surface antigen (HBsAG) indicates if the patient has hepatitis B infection Hepatitis B infection primarily affects the liver Question 40 (2.5 points) Stacy has made an appointment at your clinic for c/o dysuria. During the HPI she explains, “My bottom hurts when I pee, and I have bumps there”. She has never had this before and is worried. She denies fever, although she feels “a little like I have the flu” explaining she has a headache and feels achy and tired. She denies exposure to a STI noting she and her partner have been monogamous for 6 years. On exam you notice a cluster of painful vesicles adjacent to the vaginal introitus. The most likely diagnosis is: Question 40 options: Syphilis Genital Herpes Chancroid Chlamydia Question 41 (2.5 points) You see an 18-year-old woman with a history of Chlamydia infection and a total of five lifetime partners. Based on the latest evidence-based guidelines, you recommend: Question 41 options: Pap smear only Pap smear with HPV testing Pap smear and STI testing STI testing only Question 42 (2.5 points) Karen was recently diagnosed with primary syphilis. The nurse practitioner understands that the first-line treatment option for primary syphilis include: Question 42 options: Penicillin Ciprofloxacin Erythromycin Ceftriaxone Question 43 (2.5 points) While educating Karen about the different stages of syphilis, which of the following is not representative of the presentation of secondary syphilis? Question 43 options: generalized rash chancre arthralgia lymphadenopathy Question 44 (2.5 points) Karen was recently diagnosed with primary syphilis by her primary care provider, she is very upset and inquires how long after sexual contact do syphilis symptoms typically occur. What is the correct response by the primary care provider? Question 44 options: 3-4 days 1 week 3 weeks 6 weeks Question 45 (2.5 points) Which of the following terms describe the mechanism of action of Imiquimod (Aldara) in the management of genital warts? Question 45 options: keratolytic immune modifier cryogenic cytolytic Question 46 (2.5 points) The nurse practitioner understands that HPV types and are most often associated with cervical and anogenital cancer. Question 46 options: 1, 2, and 3 6 and 11 16 and 18 22 and 24 Question 47 (2.5 points) Jenna was evaluated and diagnosed with condylomaacuminatum. Treatment options for Jenna will include all of the following except: Question 47 options: A) Topical acyclovir B) Cryotherapy C) Podofilox D) Tricholoroaceticacid . Question 48 (2.5 points) Which of the following is a treatment option for a 30-year-old woman with PID and a history of severe hive-form reaction when taking a penicillin or cephalosporin? Question 48 options: A) Ofloxacin with metronidazole B) Amoxicillin with gentamicin C) Cefixime with vancomycin D) Clindamycin with azithromycin Question 49 (2.5 points) The nurse practitioner understands that a complication of gonoccocal and chlamydial genitourinary infection in women include which of the following: Question 49 options: A) Pelvic inflammatory disease (PID) B) Conjunctivitis C) Acute pyelonephritis D) Prostatitis Question 50 (2.5 points) The nurse practitioner understands that women with PID typically present with all of the following except: Question 50 options: A) Fever B) Leukopenia C) Cervical motion tenderness D) abdominal pain Question 51 (2.5 points) Elizabeth was evaluated and diagnosed with a primary outbreak of genital herpes in the clinic today. The treatment plan for Elizabeth will include a prescription for: Question 51 options: A) Ribavirin B) Indinavir C) Valacyclovir D) Cyclosporine Question 52 (2.5 points) Elizabeth was recently diagnosed with genital herpes after having unprotected intercourse with a new partner. The nurse practitioner explains to Christine that the incubation period for HSV Type 2 is approximately: Question 52 options: A) 4 to 7 days up to 4 weeks B) 24 hours C) 24 days D) 1 to 3 days up to 14 days Question 53 (2.5 points) Kristin returns to the clinic for follow-up on STI results. The nurse practitioner informs her the Chlamydia test was positive. Which of the following agents will the nurse practitioner prescribe for treatment? Question 53 options: A) Amoxicillin B) Metronidazole C) Azithromycin D) Tinidazole Question 54 (2.5 points) The nurse practitioner student is studying the CDC guidelines for treating sexually transmitted infections. Which of the following agents is recommended for Gonorrhea treatment? Question 54 options: A) Ceftriaxone B) Doxycycline C) Ketoconazole D) Amoxicillin Question 55 (2.5 points) A 30-year-old woman presents without symptoms but states that her male partner has dysuria without penile discharge. Examination of the woman reveals a friable cervix with yellow discharge from the cervical os. This description is most consistent with an infection caused by: Select all that apply. Question 55 options: A) Chlamydia trachomatis B) Neisseria gonorrhoeae C) Human papilloma virus (HPV) D) Trichomonas vaginalis Question 56 (2.5 points) Karen was diagnosed with trichomoniasis by her primary care provider and treated with: Question 56 options: A) Metronidazole 500 mg po BID x 7 days (If single-dose metronidazole treatment fails and reinfection is excluded, metronidazole 500 mg orally twice a day for 7 days should be prescribed.) this is the correct answer if first treatment doesn’t work B) Terconazole vaginally Q HS x 5 days C) Azithromycin 1 gm po x 1 dose D) Bactrim DS ipo Q 12 hours x 3 days Question 57 (2.5 points) A 24-year-old woman presents with a 1-week history of thin, greenish yellow vaginal discharge with perivaginal irritation. Physical examination findings include vaginal erythema with petechial hemorrhages on the cervix, numerous white blood cells, and motile organisms on microscopic examination. These findings most likely represent: Question 57 options: A) motile sperm with irritative vaginitis B) trichomoniasis C) bacterial vaginosis D) condylomaacuminatum Question 58 (2.5 points) For patients needing topical treatment for vulvovaginitis caused by Candida albicans, the nurse practitioner will prescribe: Question 58 options: A) metronidazole gel B) clotrimazole cream C) hydrocortisone ointment D) clindamycin cream Question 59 (2.5 points) The nurse practitioner understands that women with bacterial vaginosis typically present with: Question 59 options: A) vulvitis B) pruritus C) dysuria D) malodorous discharge Question 60 (2.5 points) The U.S. Preventative Services Task Force (USPSTF) recommends of folic acid supplement daily at least one month before conception for all women with average risk for neural tube defects. Question 60 options: A) 8000 mg B) .4 to .8 mg C) 4 to 8 mg D) 4000 mg Question 61 (2.5 points) The American College of Obstetrician &Gynecologists recommend that all pregnant women be offered aneuploidy screening before 20 weeks gestation. This test identifies women whose fetuses are at increased risk for which of the following? Select all that apply. Question 61 options: A) Trisomy 11 B) Trisomy 13 C) Trisomy 18 D) Trisomy 21 Question 62 (2.5 points) An important part of patient education for the patient with bacterial vaginosis who is receiving a prescription for oral Metronidazole is: Question 62 options: The patient should be treated prophylactically for a yeast infection. The medication may cause constipation. Avoid alcohol for 48 hours after completing medication. The patient's partner will need treatment also. Question 63 (2.5 points) For the patient with chronic bacterial vaginosis, the nurse practitioner will prescribe: Question 63 options: A) Metronidazole 500 mg po weekly for 2 months B) Metronidazole 500 mg po BID x 7 days C) Metronidazole gel .75% vaginally BID x 5 days D) Metronidazole gel .75% vaginally 1-2 times a week for 4 to 6 months Question 64 (2.5 points) The nurse practitioner's exam findings on a patient with vaginal Candidiasis is positive for all of the following except: Question 64 options: A) erythematous vaginal mucosa B) thick, white, curd-like vaginal discharge C) vaginal ph of 7 D) hyphae visualized on wet prep Question 65 (2.5 points) A woman arrives at the clinic for a pregnancy test. Her last menstrual period (LMP) was February 14, 2017. Using Nageles Rule, what is the client's expected date of birth (EDB)? Question 65 options: A) September 17, 2017 B) November 7, 2017 C) November 21, 2017 D) December 17, 2017 Question 66 (2.5 points) Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process? Question 66 options: A) Moderate lochia rubra B) Breasts soft and symmetrical C) Fundus below the symphysis pubis and nonpalpable D) Episiotomy pink and healing Question 67 (2.5 points) The nurse practitioner understands that the hormone, , remains elevated in breastfeeding women in the postpartum period. Question 67 options: A) Estrogen B) Progesterone C) Prolactin D) Human placental lactogen Question 68 (2.5 points) The nurse practitioner is recommending daily Calcium supplementation of to her female patients that are older than 50 years of age. Question 68 options: A) 800 mg B) 1000 mg C) 1200 mg D) 1500 mg Question 69 (2.5 points) Osteoporosis is diagnosed when the patient's bone density is more than standard deviation(s) below the average bone mass for women younger than 35 years old. Question 69 options: A) 1 B) 1.5 C) 2.5 D) 4 Question 70 (2.5 points) Based on the latest ACOG guidelines, the nurse practitioner understands that the recommended time to initiate screening for cervical cancer in women is: Question 70 options: A) prior to becoming sexually active B) at age 18 years C) at age 21 years D) three years after first sexual intercourse Question 71 (2.5 points) The nurse practitioner understands the following lifestyle approaches may be used to prevent osteoporosis after menopause: Select all that apply. Question 71 options: Limit alcohol intake Performance of regular weight-bearing activities Increase caffeine consumption Adequate calcium &vitamin D intake Question 72 (2.5 points) What is the primary role of a nurse practitioner in the research process? Question 72 options: A) Designing research studies B) Collecting data for other researchers C) Identifying researchable problems D) Seeking funding to support research studies Question 73 (2.5 points) Whether you order diagnostic testing or refer the patient to an HIV-specific facility, laboratory confirmation is rendered. The test confirming HIV infection is . Question 73 options: A) Western blot assay B) enzyme-linked immunosorbent HIV RNA C) CD4 lymphocyte count D) quantitative plasma HIV RNA Question 74 (2.5 points) The nurse practitioner is examining a twenty-nine-year-old female with a three day history of dysuria and urinary frequency. On examination, the patient is positive for suprapubic tenderness and negative for costovertebral angle (CVA) tenderness. This most likely represents which of the following? Question 74 options: A) Pyelonephritis B) Cystitis C) Ectopic pregnancy D) Asymptomatic Bacteriuria Question 75 (2.5 points) A patient has been diagnosed with trichomoniasis. Which of the following single dose medications would be the best option? Question 75 options: A) Azithromycin 1 g B) Clindamycin 300 mg C) Ofloxacin 500 mg D) Metronidazole 2 g Question 76 (2.5 points) When educating patients about the use of combination oral contraceptive medications, they should be advised that pregnancy is prevented primarily by . Question 76 options: A) cervical mucus thinning B) inflammation of the endometrium C) ovulation suppression D) decreased fallopian tube motility Question 77 (2.5 points) A twenty-four-year-old female presents to the office with a complaint of a “yucky” vaginal discharge. On exam, a milky vaginal discharge is noted. A wet mount preparation reveals a positive whiff test and 75% clue cells. There were no trichomonads or WBCs visualized. Which of the following would be the most likely diagnosis in this patient? Question 77 options: A) Bacterial vaginosis B) Herpes simplex C) Chlamydia D) Cystitis with cervicitis Question 78 (2.5 points) A fifty-five-year-old postmenopausal female patient presents with pain in the upper outer quadrant of her left breast for over one month now. The best course of action would be to . Question 78 options: A) reassure the patient that pain is often not a presenting symptom of breast cancer B) teach the patient breast self- examination C) order laboratory studies as most likely this is secondary to a hormonal fluctuation D) perform a breast examination and order a mammogram Question 79 (2.5 points) A thirty-nine-year-old female has just completed a course of Amoxicillin for the treatment of streptococcal pharyngitis. Her LMP was two weeks ago and reports that it was normal for her. On physical examination, there is some erythema of the external genitalia with a small amount of white discharge. The microscopic wet prep examination reveals few clue cells but an abundance of budding hyphae. There are no WBCs present. Considering the differential diagnoses and results of the microscopic examination, which of the following would be the most appropriate treatment? Question 79 options: A) Metronidazole 500 mg BID for seven days B) OTC hydrocortisone 1% cream TID C) Fluconazole 150 mg tablet as a onetime dose D) Erythromycin 500 mg TID for ten days Question 80 (2.5 points) A forty-nine-year-old female patient presents with a chief complaint of dark, watery brown vaginal discharge. Part of the differential diagnosis includes that of cervical cancer. Which of the following best describes what might be visualized on physical examination in patients with cervical cancer? Question 80 options: A) Ulcerated firm cervix B) Lower abdominal pain that is vague C) Enlarged tender femoral lymph nodes D) Soft, still shaped cervix Question 81 (2.5 points) A twenty-five-year-old female presents with vaginal irritation and discharge. On examination, the cervix is easily friable and erythematous. There is no adnexal tenderness. The wet prep (wet mount) microscopic examination reveals mobile protozoa on the normal saline slide. This most likely represents . Question 81 options: A) trichomoniasis B) mucopurulent cervicitis C) bacterial vaginosis D) gonorrhea Question 82 (2.5 points) A twenty-two-year-old female presents with an initial onset of herpes simplex on the external genitalia. During the patient education, which of the following statements is most important to include? Question 82 options: A) Cesarean section will be necessary for any pregnancy and delivery. B) Antiviral medications will be useful in treating and curing an outbreak. C) The sexual partner will not contract herpes if lesions are not present. D) Symptoms of the initial outbreak of the lesions are typically worse than subsequent outbreaks. Question 83 (2.5 points) Follicle-stimulating hormone (FSH) is released from the anterior pituitary gland and is responsible for which of the following normal physiologic response of the female menstrual cycle? Question 83 options: A) Breast milk production B) Stimulation of ovarian follicles C) Maturation of ovarian follicles D) Luteinizing hormone (LH) inhibition Question 84 (2.5 points) A thirty-two-year-old patient comes in for a workup of infertility. During the history, the nurse practitioner suspects that the patient may be experiencing anovulatory cycles. In order to confirm ovulation, which of the following tests would be most appropriate to order? Question 84 options: A) Endometrial biopsy B) Basal body temperature C) Hysterosalpingogram D) Postcoital testing Question 85 (2.5 points) A nurse practitioner is performing a wet mount with potassium hydroxide (KOH) to assist with a diagnosis in a woman experiencing vaginal discharge. Which of the following would this confirm? Question 85 options: A) Herpes simplex B) Trichomonas C) Candidiasis D) Chlamydia Question 86 (2.5 points) A nurse practitioner is completing a speculum exam on a female patient. Which of the following findings would be considered a normal surface characteristic of the cervix? Question 86 options: A) Small, yellow, raised area on the cervix B) Friable, bleeding tissue opening of the cervical os C) Red patch areas with occasional white spots D) Irregular, granular surface with red patches Question 87 (2.5 points) There are several phases to the menstrual cycle. What phase begins with menses cessation and ends with ovulation? Question 87 options: A) Ovulatory phase B) Follicular phase C) Proliferative phase D) Luteal phase Question 88 (2.5 points) A nurse practitioner is participating in a women’s health fair. When educating the women about risk factors for breast cancer, which of the following statements is incorrect? Question 88 options: A) Pregnancy after age of thirty-five years B) Late menopause after age of fifty-seven years C) History of maternal breast cancer D) Fibrocystic breast disease Question 89 (2.5 points) The first line treatment of severe menstrual cramps that have been occurring for four months in a patient with primary dysmenorrhea includes which of the following? Question 89 options: A) Acetaminophen B) Ibuprofen C) Combination hormone replacement therapy (HRT) D) Amitriptyline Question 90 (2.5 points) Which of the following choices represents a disorder of the reproductive tract that causes pain, erythema, dyspareunia, and a perineal mass? Question 90 options: A) Syphilis B) Bartholin’s cyst C) Labial adhesion D) Herpes simplex type 2 Question 91 (2.5 points) A woman is concerned that she may develop breast cancer and is discussing her concerns with the nurse practitioner. Which of the following is not an associated risk factor for this? Question 91 options: A) Late menarche B) Family history C) Nulliparity D) Late menopause Question 92 (2.5 points) A sixty-one-year-old thin, Caucasian female presents to your practice for a well-woman examination. She remarks that she feels like she is shrinking over the past year, despite keeping active and incorporating sources of calcium in her diet. Which of the following is not a risk factor for osteoporosis? Question 92 options: A) Excessive exercise B) History of maternal osteoporosis C) Smoking D) Using hormone therapy Question 93 (2.5 points) A thirty-five-year-old woman, presents with a six-month history of hypermenorrhea, backache, and pelvic pressure. On examination, you discover a twelve-week size uterus with irregular contour. Which of the following does this most likely represent? Question 93 options: A) Uterine cancer B) Dysfunctional uterine bleeding (DUB) C) Uterine fibroid D) Fecal impaction Question 94 (2.5 points) It is known that a woman who is menopausal has an increased risk of heart disease. Which of the following lipid changes occur with estrogen withdrawal in menopause? Question 94 options: A) Decrease in HDL, LDL, and triglycerides B) Decrease in HDL, LDL, and increase in triglycerides C) Increase in HDL with a decrease in LDL and triglycerides D) Decrease in HDL with an increase in LDL and triglycerides Question 95 (2.5 points) Which of the following is true regarding education of a forty-two-year-old woman diagnosed with a uterine myoma? Question 95 options: A) Myomas usually does not resolve with menopause. B) Myomas will decrease with the withdrawal of estrogen. C) Hysterectomy is the treatment of choice. D) Myomas are never responsible for uterine bleeding. Question 96 (2.5 points) Sheryl, a seventeen-year-old, complains of a vaginal discharge for the past month. When she wipes after urinating, there is "white stuff" on the tissue. Sheryl denies urinary problems but has had some genital itching, but no odor. She also denies sexual activity. Her vaginal discharge is most likely a result of . Question 96 options: A) a yeast infection B) a chlamydia infection C) retained foreign body D) physiologic leukorrhea Question 97 (2.5 points) Urinary tract infections are commonly seen in primary care. A twenty-five-year-old female presents with a new onset of dysuria and suprapubic pain for the last twenty-four hours. The examination reveals only mild tenderness without any peritoneal signs on the lower abdomen. A urinalysis reveals the presence of WBCs. The urine is sent for a culture and sensitivity. In addition to Escherichia coli one might typically expect to see the presence of which bacterium? Question 97 options: A) Klebsiella B) Staphylococcus aureus C) Staphylococcus saprophyticus D) Pseudomonas Question 98 (2.5 points) The pituitary gland is responsible for a variety of functions with respect to hormonal regulation and is composed of two lobes, the anterior and posterior sections. Which of the following list of hormones are secreted by the anterior pituitary gland? Question 98 options: A) Growth hormone (GH) and thyroid- stimulating hormone B) Prolactin and T4 C) Follicle-stimulating hormone (FSH) and T3 D) Luteinizing hormone (LH) and oxytocin Question 99 (2.5 points) The nurse practitioner is counseling a patient on the side effects associated with some birth control methods. The woman complains that she has developed acne and hirsutism while taking oral contraceptives. The nurse practitioner understands that these changes result from _ . Question 99 options: A) increased estrogen levels B) decreased estrogen levels C) increased free androgens D) decreased free androgens Question 100 (2.5 points) You are meeting with twenty-two-year-old Emily to discuss birth control options. She has tried “the pill” in the past but failed to take it regularly. She is interested in depo because she only has to come in every three months for a shot. She also heard that one does not get a period on depo, and she likes the thought of that. Which of the following would be a specific consideration with depo that you would need to discuss with Emily based on her desires for a birth control method? Question 100 options: A) Depo offers no protection from STIs. B) Depo can cause break through bleeding up to the second or third injection C) As with any hormonal birth control, changes in weight can occur. D) Depo does not offer pregnancy protection for those who are obese. [Show Less]
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NSG 6340 / NSG6340 PREDICTOR STUDY GUIDE
NSG 6340 / NSG6340 PREDICTOR STUDY GUIDE A 37-year-old female patient with a history of a single episode of depression and frequent complaints of PMS is b... [Show More] eing treated for hypothyroidism. Today she complains of poor concentration and fatigue. Initially, the NP should: Which of the following is an example of secondary prevention? A 35-year old female with a history of mitral valve prolapse is scheduled for routine dental cleaning. According to the 2007 American Association’s guideline for endocarditis prophylaxis, what would you advise this patient? A patient recovering from a recent stroke is starting anticoagulant therapy. The nurse practitioner should teach the patient to avoid all of the following EXCEPT: A patient presents with periorbital erythema and edema, fever, and nasal drainage. The nurse practitioner should A positive drawer sign support a diagnosis of A 50-year-old patient with diabetes complains of pain bilaterally in her lower legs while walking. The pain disappears at rest. What else would you expect to identify on her lower extremities. A 16-year-old athlete complains of pain underneath his heel every time he walks. There is a verrucous surface level with the skin of the heel. What pharmacologic interventions should the nurse practitioner prescribe for this patient? A -year-old with Type I diabetes has had itching and burning lesions between her toes for 6 months. Scrapings of the lesion confirm the diagnosis of tinea pedis. What is the best treatment option for this patient? prescribe an anti-fungal powder for application between her toes and in her shoes and a topical prescription strength anti-fungal cream for other affected areas. Monitor for a secondary bacterial infection. c. Prescribe an oral anti-fungal for 4 to 12 weeks. Monitor liver enzymes, BUN and creatinine at one week, 2 weeks, and every month thereafter. d. Prescribe a prescription strength antifungal/steroid combination cream. Monitor for a secondary bacterial infection. What is an appropriate drug for prophylactic treatment of migraine headaches in a 21-year-old female? Sumatriptan (Imitrex) b. propranolol (Inderal) c. ibuprofen (Motrin) d. dihydroergotamine (DHE) Which of the following are the classic features of ulcerative colitis? RLQ pain, frequently accompanied by a palpable mass, fever, and leukopenia Massive painful hematemesis, occasionally accompanied by melena Rapidly progressive dysphagia to solid foods, anoriexia, and weight loss out of proportion to the dysphagia Remission and exacerbations of bloody diarrhea, tenesmus, fecal incontinence, abdominal pain, and . Which drugs below would be expected to produce the least amount of hypokalemia? Furosemide (Lasix) hydrochlorothiazide (HCTZ) and spironolactone (Aldactone) Spironolactone (Aldactone) hydrochlorothiazide (HCTZ) What information should patients with diabetes and their families receive about hypoglycemia? Hypoglycemia is very rare Hypoglycemia requires professional medical treatment Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly Hypoglycemia occurs only as a result of overdose of insulin A 60-year-old male patient with a past history of glaucoma and frequent sinusitis presents today with hypertension. On his last 2 visits to the clinic his blood pressures were 150-160/90-98. The nurse practitioner decides to treat the hypertension with long-acting propranolol (Inderal). Before prescribing it, the nurse practitioner should ask: whether he smokes or consumes alcohol on a daily basis what other medications have been prescribed for him if he takes a daily antihistamine if other family members are hypertensive Which of the following is NOT associated with Type 2 diabetes mellitus? Gestational diabetes, birth of a macrosomic infant Hispanic, African-American, or Native American descent Alcohol or other drug abuse Obesity, hypertension, hypertriglyceridemiaA 35-year-old male presents with a severe unilateral headache over his left eye. He says it started about one hour ago and has rapidly gotten worse. He gives a history of similar headaches over the past 2 years. Physical examination is negative except for left eye lacrimation. What is the most likely diagnosis? A 16-year-old sexually active female present to the clinic. She has never had vaccination for hepatitis A or B, she has had one MMR immunization, and her last tetanus vaccination was 4 years ago. Which vaccination would be contraindicated without further testing? A 15-year-old male presents with abdominal pain that began in the peri-umbilical area then localized to the right lower quadrant. He complains of nausea, vomiting, anorexia, and low-grade fever. A complete blood count (CBC) reveals moderate leukocytosis. What is the most likely diagnosis? A 25-year-old hypertensive patient has a BMI of 16. His blood pressure is 165/100. There is an audible bruit in his left upper abdominal quadrant. He probably has: Which of the following is the most common presenting sign of substance abuse in adolescents? Therapeutic international normalized ratio (INR) for a patient takein warfarin (Coumadin) for chronic atrial fibrillation is expected to be A 199-year-old female reports that she is having “panic attacks.” The NP knows that panic attacks are characterized by A 25-year-old complains of fever and throat pain. The tonsils have exudate bilaterally. The patient describes having an anaphylactic reaction to penicillin in the past. What antibiotic should the NP prescribe if she believes the causative agent is bacterial? A diagnostic finding of Hodgkin’s lymphoma is the presence of With a history of ankle sprain, the nurse practitioner would most likely elicit a history of Certification for nurse practitioners is offered through: Simple cases of impetigo and folliculitis are usually successfully treated with: A 43-year-old has chronic gout. He comes to the clinic for the 3rd time in as many months for treatment of an exacerbation. Dietary counseling should include avoidance of all of the following EXCEPT: A 57-year-old patient presents for an annual physical exam. He reports having 3 attacks of acute gout during the past year. He does not take any medication except NSAIDs during the attacks which help “a little bit.” The NP would appropriately recommend A 43-year-old male presents with a large and painful furuncle, the 3rd one in the past 6 months. The NP should _?_ all of the following EXCEPT: A 64-year-old female has sudden onset of right eye pain, blurred vision, and dilated pupil. The most likely diagnosis is acute: A 25-year-old patient presents with complaints of pain and burning in the vulvar area. Upon examination, the NP notices vesicles with an erythematous base arranged ina group on the patient’s labia major. The most likely diagnosis is: An 85 – year-old is diagnosed with shingles. The patient states that she became “miserable” yesterday when the symptoms started. What pharmacologic interventions should the nurse practitioner offer this patient? A 16-year-old presents to the clinic for a scheduled immunization. The patient is unaccompanied by an adult. The NPs action is based on the knowledge that: The mechanism by which nurses are held accountable for practice, based on the quality of nursing car ein a given situation inaccordance with established standards of practice, is: A 52- year-old female has a firm, non-tneder, one centimeter mass in the RLQ of her breast. There are no palpable axillary lymph nodes. A mammogram the month before her examination was netative. The most appropriate nurse practitioner action today is to: Which of the following is NOT a characteristic of the S3 heart sound? A characteristic of elders which affects the pharmacotherapeutics of drug therapy in that population is an increase in: The AUDIT questionnaire is useful to assess: A 32- year-old mother and her 10-year-old child each have a 10 cm round, reddened patch on the trunk. There is central clearing in the lesion. Different lesions run parallel to each other in a Christmas tree pattern. The mother has been treating the “ringworm” with an anti-fungal cream for 7 days without success. The NP best response is: . For the general adult population, total dietary fat intake should be no more than what percent of total calories? A 23-year-old female college student is being evaluated by the nurse practitioner for immunization status. She has documentation of completion of IPV, DTaP, and MMR series. She states “I got a shot when I was 12 years old, but none since.” Which vaccine(s) should she receive today? Which of the following patients is most likely to have a diagnosis of Type 2 diabetes mellitus? Which of the following findings is consistent with otitis externa? The most effective primary prevention of skin cancer is to educate the public about: Which of the following is NOT a symptom of irritable bowel syndrome? An 18-year-old woman is taking a combined hormonal oral contraceptive. She should be instructed to use a backup method for the prevention of pregnancy: A 50-year old patient has abnormal vaginal bleeding with heavy periods and intermenstrual watery discharge with a small amount of blood. What is the most likely diagnosis? uterine fibroids normal peri-menopause c. endometrial cancer d. cervical cancer Which of the following signs and symptoms is typical of hyperthyroidism? An 83-year-old man has a resting hand tremor. What disease process is this type of tremor is most commonly associated with? A young female reports onset of right flank pain 2 days ago that is now severe. Last night she discovered a “burning rash” in the same area. The NP identifies popular fluid-filled lesions that are confluent and follow a linear distribution along the T-8 dermatome. The NP would appropriately order: Expected spirometry redings when the patient has chronic emphysema include: Right-sided heart failure is characterized by all of the following clinical findings EXCEPT: Moderate weight loss, particularly of visceral adipose tissue, in patients with Type 2 diabetes mellitus may have all of the following beneficial effects EXCEPT: Nurse practitioner services are filed with Medicare for reimbursement Which of the following drugs has a beneficial effect on benign prostatic hyperplasia? A 46-year-old female has hypertension and is well managed with propranolol (Inderal). Which of the following is a beneficial secondary effect of this drug? The finding which is most consistent with a diagnosis of benign prostatic hyperplasia is digital palpation of a prostate gland that is: A 20-year-old male complains of a “skin rash” on his knees and elbows. The lesions have silvery scales and are pruritic. A positive Auspitz sign is present. What is the most likely diagnosis? The daughter of a 75-year-old patient reports that her mother roams the house at night saying she cannot fall asleep. She has fallen twice. Of the following choices, which would be the most appropriate to treat her insomnia? A 65-year-old African American patient was screened at his local church for “high cholesterol.” His total cholesterol (no-fasting) was 215 mg/dL (5.6 mmol/L). What action below is most appropriate for the NP? Swan neck and boutonniere deformities are typical clinical findings in the later presentation of: A 13- year-old patient complains the he fell while running during football practice. Now his knee hurts and sometimes “locks.” The NP conducts McMurray’s test. Which of the following is TRUE about this test? A hemoglobin AIC level is 7.2 in a patient with Type 2 diabetes mellitus. The patient is currently taking a sulfonylurea medication. Which of the following drug should be added next to the medication regime? A patient with a diagnosis of giardiasis is being treated with metronidazole (Flagyl). What information would be important to obtain before prescribing this medication? The nurse practitioner is performing a routine assessment of a 47-year-old female who wants to lose weight She has truncal obesity with relatively slender forearm and lower legs. Her BMI is 38. Upon review of her history, physical examination, and laboratory reports, the nurse practitioner diagnoses “Syndrome X.” This diagnosis is based on the previous findings plus all of the following EXCEPT: A 59-year-old postmenopausal woman has atrophic vaginitis. She has a history of breast cancer at age 40 years. What is the appropriate initial treatment for this patient? The process by which a profession association cofers recognition that a licensed profession has demonstrated mastery of a specialist body of knowledge and skills is termed: A nurse practitioner has just diagnosed a patient as having acute hepatitis B. The principle which prohibits the nurse practitioner from notifying the patient’s spouse without permission is: A 43-year-old female patient complains of dull ache around both ankles after a day’s work as a cashier. Her symptoms are relieved by sitting and elevating her legs. She reports ankle edema at the end of the day. What is the most likely cause of these problems? Which of the following are characteristic of patients with Type 2 diabetes mellitus? 1. Beta cell destruction 2. High body mass 3. Central obesity 4. Unexplained weight loss The sexual partner of a symptomatic male patient with gonorrhea should be empirically treated: A patient on oral contraceptives complains of breast fullness, tenderness, and some nausea. The patient is concerned. How should the NP manage this? A 62-year-old with Type 2 diabetes mellitus complains of increased nocturia, fatigue, and weakness. His fasting blood glucose is 110 mg/dL (6.2 mmol/L), he is slightly anemic and his serum creatinine level is slightly elevated. All other laboratory tests and physical examination are within normal limits. What is the most likely diagnosis? A 23-year-old female presents with scaly hypo-pigmented macular lesions on her trunk, shoulders, and upper arms. The lesions fluoresce under Wood’s lamp. Appropriate treatment for this condition is: The goals of treatment for patients with alcohol abuse disorder are: Which of the following drug classes may potentiate hyperkalemia in a patient taking a potassium- sparing supplement? A patient has laboratory studies performed which demonstrate increased TSH, decreased free T4, and T3. Which symptoms might she complain of? The anatomical site currently believed to be the best location for subcutaneous insulin administration is the Following the finding of prostate gland abnormalities on DRE, the nurse practitioner orders appropriate labs. When preparing to review lab reports with the patient, the NP know all of the following are true EXCEPT: An obese 43-year-old has recurrent superficial fungal skin infections over the past 2 years. Today, she presents with intertriginous candida. Her skin is macerated from frequent rubbing and scratching. The plan of care for this patient should include: Which statement is true regarding dental health? A 51-year-old post-menopausal female, requests guidance regarding osteoporosis risk. The NP would be correct to recommend all of the following EXCEPT: When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action? Which of the following is NOT an appropriate treatment for chronic bacterial prostatitis (CBP) The first step when taking a patient history is the Characteristics of prescription and OTC drug use in the elder population include all of the following EXCEPT: The nurse practitioner wants to assess intactness of a patient’s cerebellar function. Which of the following clinical tests will provide information relative to cerebellar function? A 57-year-old patient with known diverticulosis presents with fever, leukocytosis, and bright red rectal bleeding. The nurse practitioner’s least appropriate action at this time is: A 41-year-old woman presents with multiple painful vesicular lesions in the vulvar area She has been with the sexual partner for 21 years. Which of the following is the MOST likely diagnosis? The differential diagnoses for transient episodes of dizziness would appropriately include all of the following EXCEPT: Which of the following is NOT a common early sign of benign prostatic hyperplasia (BPH)? The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The LEAST likely diagnosis is: A 16-year-old presents for a sports physical for football. The nurse practitioner auscultates a diastolic murmur. It is a grade II/IV. He has no history of a murmur. The patient denies symptoms. What is the most appropriate action for the NP? What is the most common causative pathogen found in cystitis, pyelonephritis, and prostatitis? The most common symptoms of a transient ischemic attack (TIA) include: A characteristic of delirium that is typically absent in dementia is: A 48-year-old female presents with a chief complaint of insomnia. On further investigation, she reports fatigue, nervousness and agitation during the daytime, and feeling hot most of the time. Which of the following would NOT be included in the differential diagnosis? The nurse practitioner correctly diagnoses iron deficiency anemia in a female patient whose lab report reveals A 16-year-old sexually active student presents with complaints of a greenish-gray frothy vaginal discharge and vaginal itching. The nurse practitioner should suspect: A 37-year-old female is found to have a negative rubella titer. How long after immunization should she avoid pregnancy? A 60-year-old male diabetic presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which has resolved. His temperature is 102 degrees F and pulse is 100 bpm. The nurse practitioner’s most appropriate initial action is to: A 44-year-old male Caucasian patient’s blood pressures are consistently 170 mm Hg systolic and 100-119 mm Hg diastolic. He has no significant medical history and is of normal weight. His lab tests and EKG are normal. What is the most appropriate action at this time? A 65-year old diabetic patient has periorbital cellulitis secondary to a sinus infections, What course of action should the nurse practitioner take? A 15- year-old swim team member presents with mild “swimmer’s ear.” Vital signs are normal. What is the most appropriate therapy for this patient? Which of the following is true concerning sensitivity and specificity? A nurse practitioner has recently been hired to work in a fast track facility. The NP’s employer asks if she has “a problem prescribing medications for emergency contraception.” The NP replies affirmatively. This is: grounds for dismissal an ethical dilemma for the NP illegal according to the standards of nursing patient abandonment According to the American Diabetes Association, what is the lowest fasting plasma glucose level which warrants a diagnosis of diabetes mellitus if confirmed on a subsequent day? 121 mg/dL b. 126 mg/dL c. 130 mg/dL d. 140 mg/dL A 23-year-old female patient of Italian descent has been diagnosed with anemia secondary to glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. It is important to teach this patient to avoid: beef or pork liver b. fava beans c. phenylalanine d. milk and mild products A 14- year-old develops otitis externa with swelling erythema, and pain,. To facilitate antibiotic deliver to the canal, the NP should: use a cotton tipped swab to apply medication b. insert a wick by gently twisting it into the canal c. prescribe an oral antibiotic prescribe an oil-based otic antibiotic to seep into the canal A patient taking levothyroxine is being over-replaced. What condition is he at risk for? Osteoporosis b. diarrhea c. bipolar disorder d. periorbital puffiness A nurse practitioner plan to open a private clinic. Each patient will be expected pay $45 immediately following the visit. This is a example of: utilitarianism b. fee-for-service c. case management d. preferred providership Along with helping to prevent osteoporosis, hormone replacement therapy (HRT) in the post- menopausal woman has been shown to: An elderly patient presents with a gray-white ring around the periphery of the iris. This is probably A patient complains of “stomach pains” on and off for the past month. In distinguishing between a gastric and duodenal ulcer, what question is least important to ask? Which of the following is a microcytic hypochromic anemia? What information should a 42- year old patient with newly diagnosed diabetes receive about exercise? A 14-year-old female cheerleader reports gradual and progressive dull anterior knee pain, exacerbated by kneeling. She also complains of a “sore lump on my knee.” The nurse practitioner notes swelling and point tenderness at the tibial tuberositiy X-ray is negative. What is the most likely diagnosis? The obesity associated with Type 2 diabetes mellitus is: [Show Less]
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NSG 6430 / NSG6430 FINAL EXAM REVIEW
NSG 6430 / NSG6430 FINAL EXAM REVIEW 1. A patient presents with acute otitis externa with obstruction of the ear canal severe enough to prevent patient ... [Show More] self administration of pharmacologic treatment. What is the most effective means to administer topical agent solutions. A. Oral/systemic antibiotics B. Aural toileting or wicking or a combination of both C. A nebulizer machine D. Surgical debridement 2. Otitis media, hypothyroid disease, deviated nasal septum, and chronic sinusitis are differential diagnoses for what condition? A. Mumps B. Rhinitis C. Dental Abscess D. Viral influenza 3. Which of the following would NOT be included as part of the focused SOAP note for a patient who suffers from allergic rhinitis? A. Review of the HEENT physical examination B. Discussion of health promotion issues C. Patient Vital signs D. Referral for additional allergy testing 4.A patient diagnosed with bacterial conjunctivitis. Which of the following education and counseling notes would NOT be appropriate for this patient? A. Contact lenses should be discarded and new lenses should not be worn until symptoms subside B. Clean all linens thoroughly C. Patient may return to work upon completing the initial dose of antibiotics D. Any eye make up should be replaced 5. Incubation period for Group A beta-hemolytic streptococcus? A. 24-72 hours B. 12-24 hours C. 72-96 D. +96 6. Which of the following demographic groups would NOT be considered at risk for complications of influenza? A. young children B. pregnant women C. Suffering from heart, kidney, or neurologic disease D. those who did not get the influenza vaccine 7. A patient is diagnosed acute bronchitis. What is the most appropriate antibiotic treatment for this patient? A. Penicillin B. Oflaxacin C. Metronidazol D. Antibiotics are not recommended 8. According to the National Asthma education and prevention program (NAAEPP), which treatment would be an example of a Step 1 preferred treatment for an adult with persistent asthma? A. Short acting beta 2 antagonist prn (SABA) B. Medium dose ICS and LABA C. low dose ICS and LABA D. high dose ICS and LABA and oral corticosteroid 9. Which of the following would be appropriate in the plan for a patient diagnosed with COPD? A. Start HCTZ 12.5 mg daily. Discussed diet and exercise including review of DASH diet. B. Demonstrate proper use of inhalers. Discuss importance of influenza vaccine. Prescribed albuterol. 2 puffs every 4 hrs prn for SOB C. Reviewed consequences of untreated condition. Encourage limited caloric intake to 1.800 daily. Prescribe lisinopril 1mg daily. D. Pt prescribed amoxicillin 500 mg po. Refrain from work or school until symptoms improve. 10. Assessment findings include increased AP diameter, hypoxemia, expiratory wheezing, cyanosis, chest tightness, and pursed lip breathing. Based on the symptoms presented what is the most likely diagnosis? A. COPD B. Pharyngitis C. Hypertension D. Alpha thalassemia 11. A 60 y/o white male has presented with HTN and no evidence of CKD or diabetes. According to JNC 8 which of the following pharmacological interventions would be more appropriate? A. Betablocker such as acebutolol B. Nitroglycerine Spray PRN C. Hydrochlorothiazide D. High intensity statin 12. At a 6 week follow up appt, a patient has not reached a goal to treat HTN with hydrochlorothiazide, diet, and exercise. What would be an appropriate addition to the patient’s regimen? A. ACE or ARB B. aspirin C. surgical intervention D. increase in physical activity 13. A 73 y/o female patient with both a personal and family history of HTN and CAD is suffering from mild and intermittent chest pain. Using a direct risk factor assessment, what is the likely level of risk in this patient? A. High risk patient B. Intermediate risk patient C. Low risk patient D. Risk is unknown 14. A patient presents with increased fatigue, persistent shortness of breath, lightheadedness and feelings of being faint. A 2D echocardiogram is consistent aortic stenosis. Which of the following plans should NOT be included in the intermediate treatment? A. A referral to a cardiologist within 7 days B. A cardiac stress test C. Advise to limit exercise until having a consultation with a cardiologist D. Review of diet including a low sodium diet 15. A 69 y/o male presents with symptoms of A. Fib. An ECG and transesophageal echocardiogram are ordered. A transesophageal echocardiogram will be able to identify which of the following? A. Heart rhythm B. Bundle branch block C. Prior myocardial infarction D. Images of heart without interference of lungs 16. A 52 y/o male patient presents with a diagnosis of non-complicated diverticulitis disease. What non-pharmacological recommendations should be made for the A. Avoid seeds or nuts in diet B. Elevate head while sleeping C. Follow a DASH diet D. Increase dietary fiber 17. Which statement best describes the reason for psychological observation and n.. in a patient with differential diagnosis of IBS? A. A diagnosis of IBS is likely to cause depression B. IBS can alter life span C. While not a direct cause, stress and anxiety can exacerbate the symptoms of IBS D. Most uncomplicated IBS stems from psychological causes as opposed to physical 18. Which of the following would NOT be considered a risk factor for C-diff diarrhea? A. Penicillin or other antibiotic use B. Gender C. Antineoplastic agents D. Advanced age 19. Which of the following has the highest risk factor for anemia? A. Recent hospitalization B. Antibiotic use C. Age less than 40 D. Chronic disease such as kidney or liver 20. A pt present with a diagnosis of anemia. Which medications may interfere with absorption, resulting in a vitamin deficiency? A. Antibiotics B. Analgesics C. Antivirals D. Anticonvulsants 21. Which demographic group has a genetic risk for pernicious anemia? A. Women or men from the Thalassemia belt B. Women of northern European descent C. African American men D. Children 22. Which pharmacologic intervention would be the most appropriate for a patient with a diagnosis of pernicious anemia? A. Iron supplements B. Daily multi-vitamin C. Vitamin b12 D. Antibiotics 23. Which of the following tests would be used to diagnose pernicious anemia? A. Schilling test B. CAGE questionnaire C. Gold stage D. Centor criteria 24. Which of the following are most likely to cause GI bleeding? A. Acetylsalicyclic acid B. Antibiotics C. Antivirals D. Hormones 25. A patient being treated for ED would be considered high risk for treatment if also suffering from which of the following conditions? A. Refractory angina B. Asymptomatic coronary artery disease C. Successful coronary revascularization D. Mild vascular disease 26. A patient with a working diagnosis of prostatitis presents with evidence of inflammation of the prostate in absence of any symptoms. According to the NIH, which category would this patient be placed? A. Category III B. Category IV C. Category II D. Category I 27. A pt presenting with testicular torsion which is not a result of trauma will most likely require which intervention? A. TMP-S or other antibiotics B. Detorsion C. Orchiectomy D. Surgery 28. Which of the following would be most appropriate for an adult male patient with a diagnos is of genital herpes? A. NAAT for chlamydia and gonorrhea. Blod test for HIV and syphilis. Start azithromycin 1 g PO 1x. Partner must be treated to avoid re-infection. Avoid sexual intercourse for 7 days. B. Start acyclovir 400 mg PO daily. Patient education for etiology of symptoms. Culture of lesions and blood testing for syphilis and HIV. Follow up in 2 weeks. C. After patient education, start sildenafil 50 mg PO ½ to 4 hours prior to intercourse. Continue all prescribed medications. D. After confirmed diagnosis, begin TMP-S 160 mg PO 2x daily. Instruct patient in medications and proper hygiene with regard to bathing wiping and post intercourse. Follow up if symptoms persist or return. 29. A patient presents with a skin infection, raised red rash and mild itching. What would be the most appropriate pharmacologic treatment for a patient with a diagnosis of scabies? A. NSAIDS B. Permethrin C. Cyclobenzaprine D. Methimazole 30. A pt presents with a red popular rash on her hands arms and feet. A Diagnosis of scabies is made based on observation. Whats the most effective way to confirm this diagnosis? A. Blood test B. Urine analysis C. CT scan D. A skin scraping and microscope 31. Which of the following would be most appropriate for a patient with a diagnosis of contact dermatitis? A. Patient prescribed Glucophage 850 mg PO 2x daily. Pt referred to dietary for structured weight loss program. Instructions detailed for at home glucose monitoring B. Prescribe oral diphenhydramine 1x daily, prescribe topical hydrocortisone cream 2x daily. Clothing and bedding should be cleaned completely in hot water. Instruct patient on avoidance of Toxicodendron C. Discuss the potential causes for episode and the need for CT and additional imaging immediately. Start aspirin 81 mg daily. Continue all meds as prescribed. Discuss importance of maintaining healthy weight, daily exercise and low sodium diet. Patient should go to ER in the case of recurrent symptoms. D. Start acyclovir 400 mg PO daily. Patient education for etiology of symptoms. Culture of lesions and blood testing for syhphilis and HIV. Follow up in 2 weeks. 32. Which pharmacological intervention is recommended for prophylactic treatment of seasonal allergies? A. Furosemide B. Hydrochlorothiazide C. Phenazopyridine D. Fluticasone 33. Gram stain along with a culture and sensitivity would be used to determine treatment in which of the following? A. Wound culture of a CA-MRSA patient B. Melanoma C. Pregnancy D. GERD 34. Which of the following would statistically NOT be considered a greater risk for developing melanoma? A. An individual with a family history of melanoma B. An African American male in this 30’s C. A patient with fair skin and light blue eyes D. A Caucasian male in his 50s with multiple nevi 35. A 56 y/o male Caucasian patient has presented with a diagnosis of melanoma and has a completed biopsy using Moh’s surgery. The American Joint Commission on Cancer’s melanoma staging system, this patients stage is determined by using all of the following categories EXCEPT? A. Color B. Tumor size C. Lymph nodes affected D. Metastases of tumor 36. Lumbosacral sprain, kidney infections or kidney stones, lumbar facet arthropathy, and lumbar A. UTI 37. A patient presents with lower back pain, stiffness and tightness with no trauma injury. Which of the following pharmacologic interventions would be the most appropriate for a patient with these symptoms and NKDA? A. Azithromycin B. Levothyroxine C. Ciprofloxacin D. Cyclobezapine 38. Mcmurry’s test can be used to diagnose which of the following conditions? A. The presence of a meniscal tear B. A patient’s alcohol and drug use C. A patient’s vitamin B12 anemia D. A patient’s rate and severity of depression 39. A pt presents with injury to the ACL based on a traumatic physical injury and no additional underlying conditions. Patient is determined not to require surgery. What would be the most appropriate pharmacologic intervention for this patient? A. NSAIDs and pain relievers B. Cyclobenzapine C. TMP-S D. Phenazopyridine 40. A 53 y/o female presents with carpal tunnel syndrome. Determine which of the following would be the preferred pharmacologic treatment for this patient? A. Muscle relaxants B. NSAIDs C. D. 41. 42. Which of the following would be considered a risk factor for positional vertigo? A. A pt suffering from motion sickness B. A pt with non-specific dizziness C. A pt who suffers from migraine headaches D. A pt aged 60 or older 43. A pt indicates that he is likely to have experienced a seizure while at home with family. Based on the observations of family members who were present during the episode it is likely that the patient experienced a tonic-clonic seizure. Which of the following risk factors would warrant immediate neuroimaging for this patient. A. A pt experiencing his first seizure B. Pt has experienced his first seizure over the age of 40 C. Pt has recovered from an initial seizure D. A seizure is likely cause by a stimulant drug 44. In a patient with a diagnosis of Parkinson’s disease, which of the following pharmacologic treatments would be most appropriate? A. Cyclobenzapine B. Levothyroxine C. Levodopa or carbidopa D. Atorvastatin 45. DEXA imaging would be best used to diagnose which? A. Doppler ultrasound B. PET scan C. Osteoporosis D. DaTscan 46. A mini mental status exam Is used to assess which? A. Range of motion impairment B. Vision impairment C. Cognitive impairment D. Auditory 47. A 60 y/o patient presents with anemia. Signs and symptom include fatigue and pallor. Labwork RBC 4.2, Hgb 9.1, Hct 31, WBC 6.8, and folate levels and serum iron 26 and serum ferritin levels 38 were low. Which of the anemic diagnoses is most likely? A. Anemia of chronic disease B. Aplastic anemia C. Iron def anemia D. Pernicious anemia 48. Which of the following statements are true when differentiating thalassemia from other types of deficiency anemias? A. Thalassemia anemias are associated with low iron levels B. Thalassemia anemias are hereditary anemias C. Thalassemia anemias are associated with chronic disease D. Thalassemia anemias are associated with low vitamin levels 49. The destruction of insulin producing beta cells take place in which organ of the body of patients suffering from diabetes mellitus? A. Kidneys B. Pancreas C. Liver D. Stomach 50. A pt presents with a diagnosis of DM 2. The NP would order which test to assist in the diagnosis? A. LFT B. ECG C. Thyroid panel D. CMP 51. Determine which pharmacologic intervention would be appropriate for a diagnosis of DM 2? A. Atorvastatin B. Omeprazole C. Glucophage D. TMP-s 52. Which of the following would be most appropriate in the treatment plan for a patient with a diagnosis of DM2? A. Patient presents with elevated blood sugar and ketones. Hospitalization through ER referred for admission B. Pt prescribed Glucophage 850 mg PO 2x daily. Pt referred to dietary for structured weight loss program. Instructions detailed for at home glucose monitoring. C. Discuss modification of diet and exercise. Provide details of a DASH diet with patient. D. Reviewed consequences of untreated condition. Encourage limited caloric intake to 1800 daily. Prescribe lisinopril 1 mg daily 53. The deficiency of which element is a cause of hypothyroidism? A. Vitamin b12 B. iodine C. calcium D. folate 54. A pt presents with a diagnosis of hypothyroidism. Which pharmacologic intervention would be most appropriate if there are NKDA? A. Thiazide diuretics B. Levothyroxine C. Amoxicillin D. Atorvastatin 55. A radio uptake scan in addition to laboratory testing can be used to diagnose which of the following conditions? A. Hyperthyroidism B. DM 2 C. COPD D. Anemia of b12 deficiency 56. Anxiety, rapid heart rate, insomnia, and tachy cardia are all symptoms of which of the following disorders? A. Hyperthyroidism B. Hypothyroidism C. DM 1 D. GERD 57. Which of the following factors would NOT be considered a risk factor for Graves disease? A. Gender B. Family history of autoimmune disorder C. A patient over 40 years of age D. pregnancy 58. Which of the following patients is most likely to suffer from metabolic syndrome? A. A patient with a family history of metabolic syndrome B. A 40 y/o pt C. Caucasian men D. A pt who is obese and sedentary 59. Which of the following would be most appropriate in the treatment plan for a pt with a diagnosis of metabolic syndrome? A. ECG demonstrates sinus tachy. Discussed need for radioactive iodine ablations. Prescribed hydrocortisone cream for lower extremity dermopathy. B. Discussed critical importance of weight and lifestyle management. Glucophage 850 mg PO 2x daily and atorvastatin 20 mg po 2x daily C. Reviewed consequences of untreated condition. Encourage limited caloric intake to 1800 daily. Prescribe lisinopril 1- mg daily D. Pt prescribed amoxicillin 500 mg po. Refrain from work or school until symptoms improve. 60. Patients meeting three of the following criteria are considered to be suffering from what condition? Elevated blood sugar (greater than 100 fasting), elevated bp (greater than 135/85 untreated), abdominal obesity (greater than 35 in for women and 40 for men) [Show Less]
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