Chamberlain College of Nursing NR 511 Midterm Exam 1 – Question and Answers.
Question 1. Question : Which of the following is a crucial element of
... [Show More] developing 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:
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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]