NSG6340 Predictor Study Guide 2
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1. A 37-year-old female patient with a history of a single episode of depression and frequent
complaints of PMS is
... [Show More] being treated for hypothyroidism. Today she complains of poor concentration
and fatigue. Initially, the NP should:
a. Question her further
3. Which of the following is an example of secondary prevention?
a. Annual influenza vaccination
7. 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. She does not need prophylaxis for any dental procedure
b.
8. 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. b. milk and milk products
9. A patient presents with periorbital erythema and edema, fever, and nasal drainage. The nurse
practitioner should
a. start aggressive antibiotic therapy
10. A positive drawer sign support a diagnosis of
b. cruciate ligament injury
11. 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.
b. peripheral artery insufficiency
12. 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. salicylic acid plasters
13. 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?
a. 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.
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d. Prescribe a prescription strength antifungal/steroid combination cream. Monitor for a secondary
bacterial infection.
14. What is an appropriate drug for prophylactic treatment of migraine headaches in a 21-year-old
female?
a. Sumatriptan (Imitrex)
b. propranolol (Inderal)
c. ibuprofen (Motrin)
d. dihydroergotamine (DHE)
15. Which of the following are the classic features of ulcerative colitis?
a. RLQ pain, frequently accompanied by a palpable mass, fever, and leukopenia
b. Massive painful hematemesis, occasionally accompanied by melena
c. Rapidly progressive dysphagia to solid foods, anoriexia, and weight loss out of proportion to the
dysphagia
d. Remission and exacerbations of bloody diarrhea, tenesmus, fecal incontinence, abdominal pain,
and ___.
16. Which drugs below would be expected to produce the least amount of hypokalemia?
a. Furosemide (Lasix)
b. hydrochlorothiazide (HCTZ) and spironolactone (Aldactone)
c. Spironolactone (Aldactone)
d. hydrochlorothiazide (HCTZ)
17. What information should patients with diabetes and their families receive about hypoglycemia?
a. Hypoglycemia is very rare
b. Hypoglycemia requires professional medical treatment
c. Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly
d. Hypoglycemia occurs only as a result of overdose of insulin
18. 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:
a. whether he smokes or consumes alcohol on a daily basis
b. what other medications have been prescribed for him
c. if he takes a daily antihistamine
d. if other family members are hypertensive
19. Which of the following is NOT associated with Type 2 diabetes mellitus?
a. Gestational diabetes, birth of a macrosomic infant
b. Hispanic, African-American, or Native American descent
c. Alcohol or other drug abuse
d. Obesity, hypertension, hypertriglyceridemia
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20. A 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?
c. Cluster headache
d. Classic migraine headache
21. 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?
c. MMR
22. 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?
d. Acute appendicitis
23. 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:
a. Essential hypertension
b. Secondary hypertension
24. Which of the following is the most common presenting sign of substance abuse in adolescents?
d. changes in behavior
25. Therapeutic international normalized ratio (INR) for a patient takein warfarin (Coumadin) for chronic
atrial fibrillation is expected to be
a. increased
26. A 199-year-old female reports that she is having “panic attacks.” The NP knows that panic attacks are
characterized by
d. sudden onset of intense fear or terror
27. 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. amoxicillin (Amoxil)
b. erythromycin
28. A diagnostic finding of Hodgkin’s lymphoma is the presence of
b. Reed-Sternberg cells
29. With a history of ankle sprain, the nurse practitioner would most likely elicit a history of
d. ankle inversion
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30. Certification for nurse practitioners is offered through:
c. national certifying organizations
31. Simple cases of impetigo and folliculitis are usually successfully treated with:
a. systemic antibiotics
b. topical antibiotics
32. 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:
c. green, leafy vegetables
33. 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
c. avoidance of dietary purine sources
34. 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:
b. prescription of a prophylactic antibiotic
37. A 64-year-old female has sudden onset of right eye pain, blurred vision, and dilated pupil. The most
likely diagnosis is acute:
b. angle-closure glaucoma
38. 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:
d. herpes simplex II
39. 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?
c. Oral acyclovir (Zovirax) for 7-10 days, NSAIDs, and topical capsaicin cream after
resolution of the lesions
40. 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:
a. a minor must have the informed consent of a parent or guardian to receive an
immunization
41. 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:
c. peer review
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42. 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:
c. schedule an ultrasound of the breast
43. Which of the following is NOT a characteristic of the S3 heart sound?
d. An S3 is fairly common in children, young adults, and females in the last trimester of
pregnancy
44. A characteristic of elders which affects the pharmacotherapeutics of drug therapy in that population is
an increase in:
d. percent of body fat
45. The AUDIT questionnaire is useful to assess:
a. alcohol use disorders
46. 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:
b. No medication will help this to clear. It must clear on its own and may take 4-8 weeks
.
47. For the general adult population, total dietary fat intake should be no more than what percent of total
calories?
c. 30%
48. 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?
d. Td and HBV
49.Which of the following patients is most likely to have a diagnosis of Type 2 diabetes mellitus?
b. A 49-year-old male with impotence and HbAIC 10.0%
50. Which of the following findings is consistent with otitis externa?
d. pain
51. The most effective primary prevention of skin cancer is to educate the public about:
d. limiting exposure to natural solar radiation
52. Which of the following is NOT a symptom of irritable bowel syndrome?
d. Weight loss
53. 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:
b. if prescribed topiramate (Topamax) for the treatment of migraines
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54. 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?
a. uterine fibroids
b. normal peri-menopause
c. endometrial cancer
d. cervical cancer
55. Which agent is most effective for the treatment of nodulocystic acne?
d. isotretinoin (Accutane)
56. Which of the following signs and symptoms is typical of hyperthyroidism?
a. heat intolerance
57. An 83-year-old man has a resting hand tremor. What disease process is this type of tremor is most
commonly associated with?
a. Multiple sclerosis (MS)
b. Parkinson’s disease
c. diabetic neuropathy
58. 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:
c. an oral antiviral
d. a topical steroid cream
59. Expected spirometry redings when the patient has chronic emphysema include:
d. increased total lung capacity (TLC)
60. Right-sided heart failure is characterized by all of the following clinical findings EXCEPT:
Answer: a 4th heart sound
61. Moderate weight loss, particularly of visceral adipose tissue, in patients with Type 2 diabetes mellitus
may have all of the following beneficial effects EXCEPT:
c. increased lean muscle mass
d
62. Nurse practitioner services are filed with Medicare for reimbursement
a. and paid by Medicare Part B
63. Which of the following drugs has a beneficial effect on benign prostatic hyperplasia?
a. doxazosin (Cardura)
64. 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?
d. migraine prophylaxis
65. The finding which is most consistent with a diagnosis of benign prostatic hyperplasia is digital
palpation of a prostate gland that is:
a. enlarged, symmetrical, semi-firm, and non-tender
b. enlarged, symmetrical, boggy, and exquisitely tender
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66. 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?
d. psoriasis
67. 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. doxepin (Sinequan)
68. 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?
a. Recommend a fasting lipid profile
69. Swan neck and boutonniere deformities are typical clinical findings in the later presentation of:
a. gouty arthritis
b. rheumatoid arthritis
70. 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. an audible or palpable click is positive for a torn meniscus
71. 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?
d. Metformin (Glucophage)
72. A patient with a diagnosis of giardiasis is being treated with metronidazole (Flagyl). What information
would be important to obtain before prescribing this medication?
c. if the patient drinks alcohol
73. 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:
d. cardiac arrhythmias
74. 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?
d. Topical conjugate estrogen cream
75. 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:
c. certification
76. 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:
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d. confidentiality
77. 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?
a. varicose veins
78. 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
a. 1,2,3
b. 2,3
c. 1,4
79. The sexual partner of a symptomatic male patient with gonorrhea should be empirically treated:
c. with ceftriaxone and doxycycline (Vibramycin)
80. A patient on oral contraceptives complains of breast fullness, tenderness, and some nausea. The
patient is concerned. How should the NP manage this?
b. change the pill to one containing less estrogen
81. 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?
d. renal insufficiency
82. 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:
a. Apply selenium sulfide (Versel) lotion and allow to dry for 10 minutes, then rinse off
83. The goals of treatment for patients with alcohol abuse disorder are:
c. abstinence or reduction in sue, relapse prevention and rehabilitation
d. marital satisfaction, improvement in family functioning, and reduction in psychiatric
impairment
84. Which of the following drug classes may potentiate hyperkalemia in a patient taking a potassiumsparing supplement?
a. thiazide diuretic
b. angiotensin-converting enzyme inhibitor
85. A patient has laboratory studies performed which demonstrate increased TSH, decreased free T4, and
T3. Which symptoms might she complain of?
d. hair loss
86. The anatomical site currently believed to be the best location for subcutaneous insulin administration
is the
c. abdomen
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87. 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:
a. normal PSA is 10 mg/ml or less
88. 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:
a. recommended screening for diabetes mellitus and HIV infection
89. Which statement is true regarding dental health?
a. a diet high in sugar has no effect on dental caries
b. individuals with dentures should visit the dentist every 2 years
90. A 51-year-old post-menopausal female, requests guidance regarding osteoporosis risk. The NP would
be correct to recommend all of the following EXCEPT:
d. weight loss
91. When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse
practitioner action?
a. order abdominal x-rays
b. order abdominal ultrasound
92. Which of the following is NOT an appropriate treatment for chronic bacterial prostatitis (CBP)
d. nitrofurantoin (Macrobid)
93. The first step when taking a patient history is the
c. introductory information
94. Characteristics of prescription and OTC drug use in the elder population include all of the following
EXCEPT:
a. high incidence of drug reactions
b. multiple prescribers and polypharmacy
95. 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. kinesthesia
b. stereognosis
c. Romberg
96. 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:
d. education regarding low fiber diet
97. 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?
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c. herpes simplex
d. chlamydia
98. The differential diagnoses for transient episodes of dizziness would appropriately include all of the
following EXCEPT:
c. allergic rhinitis
99. Which of the following is NOT a common early sign of benign prostatic hyperplasia (BPH)?
d. increased force of urine flow
100. 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. acute otitis media (AOM)
101. 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? [Show Less]