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]