Exam (elaborations) NUR 6531 final exam 1
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Question 2
1 out of 1 points
Central obesity, “moon” face, and dorsocervical fat pad are
... [Show More] associated with:
A
.
Metabolic syndrome
B
.
Unilateral
pheochromocytoma
C
.
Cushing’s syndrome
D
.
None of the above
Question 3
1 out of 1 points
An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days
later, he returns to the office complaining of left great toe pain. On exam, the nurse
practitioner notes an edematous, erythematous tender left great toe. The likely
precipitant of this patient’s pain is:
A
.
Trauma
B
.
Tight shoes
C
.
Arthritis flare
D
.
Hydrochlorothiazide
Question 4
1 out of 1 points
The most effective treatment of non-infectious bursitis includes: Conservative treatment
NUR 6531 final exam 1
includes rest, cold and heat treatments, elevation, administration of nonsteroidal anti-inflammatory
drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections
Question 5
1 out of 1 points
What conditions must be met for you to bill “incident to” the physician, receiving 100%
reimbursement from Medicare?
Selected
Answer:
The physician must be on-site and engaged in
patient care
Answers: You must initiate the plan of care for the patient
The physician must be on-site and engaged in
patient care
You must be employed as an independent
contractor
You must be the main health care provider who
sees the patient
Question 6
1 out of 1 points
Which of the following is not a risk factor associated with the development of syndrome X
and type 2 diabetes mellitus?
The metabolic syndrome refers to the co-occurrence of several known cardiovascular risk factors,
including insulin resistance, obesity, atherogenic dyslipidemia and hypertension.
Question 7
1 out of 1 points
Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)?
A. Nocturia
B. Urgency incontinence
C. Strong urinary stream flow
D. Straining to void
Question 8
1 out of 1 points
Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to
reduce his lower esophageal sphincter pressure, which substances do you recommend
that he avoid?
Food that is very hot or very cold
Fatty or fried foods
Peppermint or spearmint, including flavoring
Coffee, tea, and soft drinks that contain caffeine
Spicy, highly seasoned foods
Fried food DT caffeine, chocolate and anticholinergics
Question 9
1 out of 1 points
Which drug category contains the drugs that are the first line Gold standard therapy for
COPD?
Beta antagonist
Question 10
1 out of 1 points
The most commonly recommended pharmacological treatment regimen for low back pain
(LBP) is:
Nsaid
Question 11
1 out of 1 points
Which of the following is not appropriate suppression therapy for chronic bacterial
prostatitis?
Erythromycin
Question 12
1 out of 1 points
A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals
hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but
the patient returns 6 weeks later with the same symptoms of hyperpigmentation,
weakness, anorexia, fatigue, and weight loss. What action(s) should the nurse
practitioner take?
.A Obtain a thorough history and physical, and check serum cortisol and ACTH
levels.
B. Perform a diet history and check CBC and FBS.
C. Provide nutritional guidance and have the patient return in one month.
D. Consult home health for intravenous administration
Question 16
1 out of 1 points
You are assessing a patient after a sports injury to his right knee. You elicit a positive
anterior/posterior drawer sign. This test indicates an injury to the: he
A. lateral meniscus
B. cruciate ligament
C. medial meniscus
D. collateral ligament.
Question 17
1 out of 1 points
A 32 year old female patient presents with fever, chills, right flank pain, right
costovertebral angle tenderness, and hematuria. Her urinalysis is positive for leukocytes
and red blood cells. The nurse practitioner diagnoses pyelonephritis. The most
appropriate management is:
Include 500 mg of oral ciprofloxacin (Cipro) twice per day for seven days; 1,000 mg of
extended-release ciprofloxacin once per day for seven days; or 750 mg of levofloxacin
(Levaquin) once per day for five days.
Question 19
1 out of 1 points
A middle-aged man presents to urgent care complaining of pain of the medial condyle of
the lower humerus. The man works as a carpenter and describes a gradual onset of pain.
On exam, the medial epicondyle is tender and pain is increased with flexion and
pronation. Range of motion is full The most likely cause of this patient’s pain is:
epicondylitis
Question 21
1 out of 1 points
The best test to determine microalbuminuria to assist in the diagnosis of diabetic
neuropathy
s to measure albumin in a spot urine sample, collected either as the first urine in the morning
or at random, for example, at the medical visit. This method is accurate,:Early morning
Question 22
1 out of 1 points
What is the first symptom seen in the majority of patients with Parkinson’s disease?
Tremor at rest
Question 23
1 out of 1 points
The most commonly recommended method for prostate cancer screening in a 55 year old
male is:
digital rectal exams,
Question 24
1 out of 1 points
Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of
swimming. What do you suspect?
Otitis externa/ swimmer’s ear
Question 25
1 out of 1 points
Which of the following symptoms suggests a more serious cause of back pain?
Pain associated with lying down at night
Question 28
1 out of 1 points
A patient taking levothyroxine is being over-replaced. What condition is he at risk for?
osteoporosis
Question 29
1 out of 1 points
Which of the following is the most common cause of low back pain?
A
.
Lumbar disc disease
B
.
Spinal stenosis
C
.
Traumatic fracture
D
.
Osteoporosis
Question 30
1 out of 1 points
Which is the most common cause of end-stage renal disease in the United States?
Diabetes
Question 31
1 out of 1 points
A 77-year-old female presents to the office complaining a sudden swelling on her right
elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender
area of swelling over the extensor surface over the right elbow with evidence of trauma
or irritation. The nurse practitioner suspects:
A
.
Arthritis
B
.
Ulnar neuritis
C
.
Septic arthritis
D
.
Olecranon bursitis
Question 32
1 out of 1 points
A 60 year old female patient complains of sudden onset unilateral, stabbing, surface pain
in the lower part of her face lasting a few minutes, subsiding, and then returning. The
pain is triggered by touch or temperature extremes. Physical examination is normal.
Which of the following is the most likely diagnosis?
A. fibromyligia or neuro something
Question 33
1 out of 1 points
Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within
normal limits. Which of the following diagnoses do you explore further?
Arthritis, C
Question 34
D
1 out of 1 points
A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the
following symptoms would lead you to look for another diagnosis?
high fever (102 to 104 degrees F), irregular pulse, accelerated heartbeat (tachycardia),
increased rate of respiration (tachypnea), muscle rigidity, altered mental status, autonomic
nervous system dysfunction resulting in high or low blood pressure, profuse perspiration, and
excessive sweating. called Malignant Hyperthermia” OR Neuroleptic malignant syndrome
hallucinations.
Question 35
1 out of 1 points
Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of:
carpal tunnel syndrome
Question 37
1 out of 1 points
The most common cause of elevated liver function tests is:
alcohol
Question 38
1 out of 1 points
Reed-Sternberg B lymphocytes are associated with which of the following disorders:
A.
Aplastic anemia
B.
Hodgkin’s lymphoma
C.
Non Hodgkin’s
lymphoma
D.
Myelodysplastic
syndromes
Question 39
1 out of 1 points
Which of the following is a potential acquired cause of thrombophilia?
A.
Homocysteinuria
B.
Protein C deficiency
C.
Factor V Leiden
D.
Antiphospholipid
antibodies
Question 41
1 out of 1 points
A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the
nurse practitioner what the treatment for this disorder is. The nurse practitioner
explains:
Primary hyperparathyroidism is treated with Vitamin D restriction
Primary hyperparathyroidism is treated with parathyroidectomy
Primary hyperparathyroidism is treated with daily magnesium
Primary hyperparathyroidism is treated with parenteral parathyroid
hormone (PTH)
Question 43
1 out of 1 points
A 25 year old overweight patient presents with a complaint of dull achiness in his groin
and history of a palpable lump in his scrotum that “comes and goes”. On physical
examination, the nurse practitioner does not detect a scrotal mass. There is no
tenderness, edema, or erythema of the scrotum, the scrotum does not transilluminate.
What is the most likely diagnosis?
A. Testicular torsion
B. Epididymitis
C. Inguinal hernia
D. Varicocele
Question 44
1 out of 1 points
Dave, age 38, states that he thinks he has an ear infection because he just flew back
from a business trip and feels unusual pressure in his ear. You diagnose barotrauma.
What is your next action?
A. Prescribe nasal steroids and oral decongestants
B. Prescribe antibiotic eardrops
C. Prescribe systemic eardrops
D. Refer David to an ear, nose, and throat specialist
A. Prescribe
Question 46
1 out of 1 points
The physiological explanation of syncope is:
Syncope is a transient loss of consciousness (TLOC) due to global cerebral hypoperfusion
characterized by rapid onset, short duration and spontaneous complete recovery.
Question 47
1 out of 1 points
A 20 year old male patient complains of “scrotal swelling.” He states his scrotum feels
heavy, but denies pain. On examination, the nurse practitioner notes transillumination of
the scrotum. What is the most likely diagnosis? hydrocele
Question 48
1 out of 1 points
A 32 year old male patient complains of urinary frequency and burning on urination for 3
days. Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection.
The initial treatment should be: nclude nitrofurantoin monohydrate/macrocrystals,
trimethoprim-sulfamethoxazole (TMP-SMX), or fosfomycin. trimethoprim and
sulfamethoxazole
Question 49
1 out of 1 points
Diagnostic radiological studies are indicated for low back pain:
Diagnostic imaging is indicated for patients with low back pain only if they have severe
progressive neurologic deficits or signs or symptoms that suggest a serious or specific underlying
condition. In other patients, evidence indicates that routine imaging is not associated with
clinically meaningful benefits but can lead to harms.
Question 51
1 out of 1 points
An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy
for this patient, the nurse practitioner is most concerned with which of the following side
effects?
A
.
Weight gain
B
.
Fracture risk
C
.
Hypoglycem
ia
D
.
Weight loss
Question 53
1 out of 1 points
The diagnosis of human papilloma virus (HPV) infection in males is usually made by:
The diagnosis of HPV in men is made when external genital warts are seen. The diagnosis
of genital warts is made by examination of the lesions
Question 54
1 out of 1 points
Which history is commonly found in a patient with glomerulonephritis?
upper respiratory tract infection or a skin infection that was caused by those
bacteria
Question 55
1 out of 1 points
A patient complains of generalized joint pain and stiffness associated with activity and
relieved with rest. This patient history is consistent with which of the following disorders?
Osteoarthritis
Question 56
1 out of 1 points
The most common presentation of thyroid cancer is:
is an asymptomatic thyroid mass or a nodule that can be felt in the neck.
Question 57
1 out of 1 points
The obligatory criteria for diagnosis of muscular dystrophy (MD) are:
Genetic testing to evaluate missing or repeated mutations in the dystrophin gene. A
lack of the dystrophin gene can lead to a diagnosis of Duchenne or Becker MD. The test is
important not only to confirm the MD diagnosis in males but also to determine whether
women with a family history of Duchenne or Becker MD may be carriers.4 The case for
genetic diagnosis.
Accurate diagnosis of the muscular dystrophies is important for patients,
their families, and efficient and cost-effective use of medical resources.
(EEG.)
Question 58
1 out of 1 points
The diagnosis which must be considered in a patient who presents with a severe
headache of sudden onset, with neck stiffness and fever, is:
viral meningitis
Question 59
1 out of 1 points
A 60 year old male patient with multiple health problems presents with a complaint of
erectile dysfunction (ED). Of the following, which medication is most likely to be causing
the problem?
Hypertensive medication such as hydrochlorothiazides, and other DM2 medications
Question 60
1 out of 1 points
A 72 year old patient exhibits sudden onset of fluctuating restlessness, agitation,
confusion, and impaired attention. This is accompanied by visual hallucinations and sleep
disturbance. What is the most likely cause of this behavior?
A. Dementia
B. Delirium
C. Parkinson's disease
D. Depression
Question 61
1 out of 1 points
Which of the following set of symptoms should raise suspicion of a brain tumor?
Holocranial headaches present in the morning and accompanied by projectile vomiting
without nausea
Question 62
1 out of 1 points
The cornerstone of treatment for stress fracture of the femur or metatarsal stress
fracture is: relative rest-that being the cessation of the offending activity for a period of time
until the irritation is eliminated, pain is gone and the bone is given a chance to heal.
Rest the affected part of the body
- Once pain free, the person can gradually begin the sporting activity again
- Air splinting can reduce pain and decrease the time until return to full participation or intensity of
exercise.
- NSAIDs to reduce pain and inflammation
Question 63
1 out of 1 points
Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel
syndrome. Your next step is to:
a. refer her to a hand surgeon
b. take a more complete hx
c. try neutral position wrist splinting and order an oral NSAID
d. order a nerve conduction study such as an electromyography (EMG)
Question 64
1 out of 1 points
Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue
syndrome, which have many similarities. Which of the following is more characteristic of
fibromyalgia?
A. Musculosckeletal pain
B. Difficulty sleeping
C. Depression
D. Fatigue
Question 65
1 out of 1 points
The cardinal sign of infectious arthritis is:
Affected joint is painful at rest, with movement and weight bearing
Question 66
1 out of 1 points
Diagnostic evaluation for urinary calculi includes:
Diagnosis is based on urinalysis and radiologic imaging, usually noncontrast
helical CT.
Question 70
1 out of 1 points
A 15 year-old female patient is 5 feet tall and weighs 85 pounds. You suspect anorexia
and know that the best initial approach is to:
Having the client in view of staff for 90 minutes after each meal
Provide the client with a feeling of responsibility and control over her behavior
Question 71
1 out of 1 points
A 63-year-old man presents to the office with hematuria, hesitancy, and dribbling. Digital
rectal exam (DRE) reveals a moderately enlarged prostate that is smooth. The PSA is 1.2.
What is the most appropriate management strategy for you to follow at this time?
A. Prescribe an alpha adrenergic blocker.
B. Recommend saw palmetto.
C. Prescribe an antibiotic
D. Refer the client to urology.
Question 73
1 out of 1 points
A positive drawer sign supports a diagnosis of:
Posterior cruciate ligament injury
Question 75
1 out of 1 points
A 14 year old female cheerleader reports gradual and progressive dull anterior knee pain,
exacerbated by kneeling. The nurse practitioner notes swelling and point tenderness at
the tibial tuberosity. X-ray is negative. What is the most likely diagnosis?
prepatellar bursitis?
Question 77
1 out of 1 points
Jack, age 55, comes to the office with a blood pressure of 144/98 mm Hg. He states that
he did not know if it was ever elevated before. When you retake his blood pressure at the
end of the exam, it remains at 144/98. What should your next action be? Answer: stage 2
hypertension (lifestyle change, and medication
Question 79
1 out of 1 points
Martin is complaining of erectile dysfunction. He also has a condition that has reduced
arterial blood flow to his penis. The most common cause of this condition is:
diabetes mellitus
Question 80
1 out of 1 points
Successful management of a patient with attention deficit hyperactivity disorder (ADHD)
may be achieved with:
Ritalin and diet
Question 81
1 out of 1 points
What diabetic complications result from hyperglycemia?
1. Retinopathy
2. Hypertension resistant to treatment
3. Peripheral neuropathy
4. Accelerated atherogenesis
Question 82
1 out of 1 points
In which of the following presentations is further diagnostic testing not warranted?
Question 83
1 out of 1 points
The most common symptoms of transient ischemic attack (TIA) include:
Common symptoms are sudden and transient, and include unilateral paresis, speech
disturbance, and monocular blindness.
clinical symptoms typically lasting less than one hour, and without evidence of infarction on
imaging
Question 85
1 out of 1 points
Establishment of a definitive diagnosis of osteomyelitis requires:
Bone biopsy leads to a definitive diagnosis .
Question 86
1 out of 1 points
Which of the following is the most common causative organism of nongonococcal
urethritis?
A
.
Chlamydia
trachomatis
B
.
Ureaplasma
urealyticum
C
.
Mycoplasma
hominis
D
.
Trichonomas
vaginalis
Question 88
1 out of 1 points
A 30 year old female patient presents to the clinic with heat intolerance, tremors,
nervousness, and weight loss inconsistent with increased appetite. Which test would be
most likely to confirm the suspected diagnosis?
TSH. We also assess free thyroid hormone (FT4) and at times T3
Question 90
1 out of 1 points
Potential causes of hypocalcemia include which of the following?
Hypoalbuminemia is the most common cause of hypocalcemia. Causes include cirrhosis,
nephrosis . hypoparathyroidism, vitamin D deficiency, and renal disease.
Question 92
1 out of 1 points
Which of the following is a contraindication for metformin therapy?
hypersensitity metabolic acidiosis, dehydration, sepsis, hypoxemia, hepatic impairment, renal
dysfunction
Question 93
1 out of 1 points
The organism most often associated with prostatitis is:
A
.
Klebsiella
B
.
Neiserria
gonorrhoaes
C
.
Chlamydia
trachomatis
D
.
Escherichia coli
Question 94
1 out of 1 points
The most effective intervention(s) to prevent stroke is (are):
Aspirin is one of the most common, most effective/or life style changes
Question 95
1 out of 1 points
What is the most commonly abused substance?
alcohol is the #1 abused substance in America. An estimated 135.5 million people drink
alcohol, but of those people, 86 million are considered to be abusers,
Question 98
1 out of 1 points
An obese hyperlipidemic patient, newly diagnosed with type 2 diabetes mellitus, has
fasting glucose values 180 to 250 mg/Dl. What is the most appropriate initial treatment
to consider?
A. A low-calorie diet and exercise
B. Sliding-scale NPH insulin every 12 hours
C. A sulfonylurea and/or metformin (Glucophage® -XR)
D. Sliding-scale regular insulin every 6 hours
Question 100
1 out of 1 points
Prolonged PT suggests:
A.
Platelet abnormality
B.
Abnormality in intrinsic coagulation
pathway
C.
Abnormality in extrinsic coagulation
pathway
D.
None of the above
Deficiency of FII, FV, FX, or fibrinogen abnormalities
Question 101
1 out of 1 points
A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient
would be classified as:
Overweight
Question 2
1 out of 1 points
A patient presents with dehydration, hypotension, and fever. Laboratory testing
reveals hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are
corrected, but the patient returns 6 weeks later with the same symptoms of
hyperpigmentation, weakness, anorexia, fatigue, and weight loss. What action(s)
should the nurse practitioner take?
Answer: Obtain a thorough history and physical, and check serum cortisol and ACTH levels.
Question 5
1 out of 1 points
Which of the following is a potential acquired cause of thrombophilia?
Antiphospholipid antibodies
Question 8
1 out of 1 points
Differential diagnosis of proteinuria includes which of the following?
Question 10
1 out of 1 points
Question 35
The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male
patient. The drug of choice for treatment of this patient is: Ceftriaxone 250 mg IM in a
single dose plus. Doxycycline 100 mg [Show Less]