Question 2
In the outpatient office setting, the most common reason for a malpractice suit is failure to:
Properly refer
Diagnose correctly in a
... [Show More] timely
fashion
Obtain informed consent
Manage fractures and trauma
correctly
Question 3
Reed-Sternberg B lymphocytes are associated with which of the following disorders:
Aplastic anemia
Hodgkin’s lymphoma
Non Hodgkin’s
lymphoma
Myelodysplastic
syndromes
Question 4
The initial clinical sign of Dupuytren’s contracture is:
Pain with ulnar deviation
Painless nodule on palmer
fascia
Pain and numbness in the ring
finger
Inability to passively extend
NURS 6531 Final Exam Questions and Answers
finger
Question 5
Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue
syndrome, which have many similarities. Which of the following is more characteristic of
fibromyalgia?
Musculoskeletal
pain
Difficulty sleeping
Depression
Fatigue
Question 6
A child with type 1 diabetes mellitus has experienced excessive hunger, weight gain and
increasing hyperglycemia. The Somogyi effect is suspected. What steps should be taken to
diagnose and treat this condition?
Decrease the evening insulin dose and check capillary blood glucose
(CBG) at 2:00 am.
Instruct the child’s parents on physical activities to help weight loss.
Increase the evening insulin dose and check CBG at 2:00 am.
Refer the child for instruction on a strict diabetic diet.
Question 7
The 4 classic features of Parkinson’s disease are:
Mask-like facies, dysarthria, excessive salivation, and dementia.
Tremor at rest, rigidity, bradykinesia, and postural disturbances.
Depression, cognitive impairment, constipation and shuffling gait.
Tremor with movement, cogwheeling, repetitive movement, and multi-
system atrophy.
Question 8
What conditions must be met for you to bill “incident to” the physician, receiving 100%
reimbursement from Medicare?
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 9
The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is:
Rest from activities which may further stress
the bone.
Daily passive range of motion exercises.
Continuation of the patient’s routine physical
activities.
Application of ice after activity.
Question 10
Which of the following antibiotics should not be prescribed for a pregnant woman in the 3rd
trimester?
Trimethoprimsulfamethoxazole
Erythromycin
Cefuroxime
Levofloxacin
Question 11
Which is the most common cause of end-stage renal disease in the United States?
Diabetic nephropathy
Chronic renal failure secondary to vascular
disorders
Acute tubular necrosis
Kidney trauma
Question 12
A typical description of a tension headache is:
Periorbital pain, sudden onset, often explosive in quality, and associated with nasal
stuffiness, lacrimation, red eye, and nausea.
Bilateral, occipital, or frontal tightness or fullness, with waves of aching pain.
Hemicranial pain that is accompanied by vomiting and photophobia.
Steadily worsening pain that interrupts sleep, is exacerbated by orthostatic changes,
and may be preceded by nausea and vomiting.
Question 13
A patient taking levothyroxine is being over-replaced. What condition is he at risk for?
Osteoporo
sis
Constipati
on
Depression
Exopthalmi
a
Question 14
Which of the following medications increase the risk for metabolic syndrome?
Antihistamines
Proton pump
inhibitors
Protease inhibitors
A and C
All of the above
Question 15
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:
Lateral
meniscus
Cruciate
ligament
Medical
meniscus
Collateral
ligament
Question 16
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:
Gout
Epicondyliti
s
Osteoarthri
tis
Lyme
disease
Question 17
The organism most often associated with prostatitis is:
Klebsiella
Neiserria
gonorrhoaes
Chlamydia
trachomatis
E.Coli
Question 18
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?
Prescribe systemic antibiotics
Prescribe antibiotic ear drops
Prescribe nasal steroids and oral
decongestants
Refer him to an ear, nose, and throat
specialist
Question 19
Maria, age 17, was raped when she was 13 year old. She is now experiencing sleeping
problems, flashbacks, and depression. What is your initial diagnosis?
Depression
Panic disorder
Anxiety
Post-traumatic stress
disorder
Question 20
What diabetic complications result from hyperglycemia?
1.
1.
1. Retinopathy
2. Hypertension resistant to treatment
3. Peripheral neuropathy
4. Accelerated atherogenesis
1, 2,
3
2, 3,
4
1, 3,
4
1, 2,
4
Question 21
Prolonged PT suggests:
Platelet abnormality
Abnormality in intrinsic coagulation
pathway
Abnormality in extrinsic coagulation
pathway
None of the above
Question 22
The most reliable indicator(s) of neurological deficit when assessing a patient with acute low
back pain is(are):
Patient report of bladder dysfunction, saddle anesthesia, and motor
weakness of limbs.
History of significant trauma relative to the patient’s age.
Decreased reflexes, strength, and sensation in the lower extremities.
Patient report of pain with the crossed straight leg raise.
Question 23
A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would
be classified as:
Underweigh
t
Normal
weight
Overweight
Obese
Question 24
Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How
do you respond?
“Caffeine has not effect on osteoporosis.”
“A high caffeine intake has a diuretic effect that may cause calcium to be excreted
more rapidly.”
“Caffeine affects bone metabolism by altering intestinal absorption of calcium and
assimilation of calcium into the bone matrix.”
“Caffeine increase bone resorption.”
Question 25
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?
Start him on an ACE Inhibitor
Start him on a diuretic
Have him monitor his blood pressure at home
Try nonpharmacological methods and have him monitor his blood
pressure at home
Question 26
Diagnostic radiological studies are indicated for low back pain:
Routinely after 3 weeks of low back pain symptoms.
To screen for spondylolithiasis in patients less than 20 years of age with 2 weeks of
more of low back pain.
When there is a suspicion of a space-occupying lesion, fracture, cauda equina, or
infection.
As a part of a pre-employment physical when heavy lifting is included in the job
description.
Question 27
Risk factors for Addison’s disease include which of the following?
Tuberculosis
Autoimmune
disease
AIDS
All of the above
Question 28
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:
Consult with a physician
A 14 day course of ciprofloxacin
To obtain blood cultures from separate site
Obtain urine cultures, CBC, and initiate
antibiotic therapy
Question 29
A patient has just been diagnosed with Bell’s palsy. He is understandably upset and has
questions about the prognosis. You response should be:
Although most of your symptoms will disappear, some will remain but can usually be
camouflaged by altering your hairstyle or growing a beard
Unfortunately there is no cure but you have a mild case
The condition is self-limiting and most likely complete recovery will occur
With suppressive drug therapy you can minimize the symptoms
Question 30
After treating a patient for Helicobacter pylori infection, what test do you order to see if it
has been cured?
An enzyme-linked immunosorbent
assay titer
A urea breath test
A rapid urease test
A repeat endoscopy
Question 31
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?
Obtain a thorough history and physical, and check serum cortisol and
ACTH levels.
Obtain a diet history and check CBC and FBS.
Provide nutritional guidance and have the patient return in 1 month.
Consult home health for intravenous administration of fluids and
electrolytes.
Question 32
The most common symptoms of transient ischemic attack (TIA) include:
Nausea, vomiting, syncope, incontinence, dizziness, and seizure.
Weakness in an extremity, abruptly slurred speech, or partial loss of vision, and
sudden gait changes.
Headache and visual symptoms such as bright spots or sparkles crossing the visual
field.
Gradual onset of ataxia, vertigo, generalized weakness, or lightheadedness
Question 33
Which patient would benefit most from screening for type 2 diabetes?
A 30 year old female with unintended weight
loss.
A 25 year old male with family history of type 1
diabetes
An obese female with recurrent vaginitis
A 50 year old hyperlipidemic male
Question 34
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 low-calorie diet and exercise
Sliding-scale NPH insulin every 12
hours
An oral hypoglycemic agent
Sliding-scale regular insulin every 6
hours
Question 35
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:
Trimethoprim-sulfamethoxazole for 3
days
Ciprofloxacin for 7-10 days
Trimethoprim-sulfamethoxazole for
14 days
Ciprofloxacin for 3 days
Question 36
The most reliable diagnostic indicator of gout is:
Monosodium urate (MSU) crystals in the
synovial fluid.
Tophi visible over joints or in connective
tissue.
Elevated serum uric acid level.
Abrupt onset of single joint inflammation and
pain.
Question 37
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?
Thiazide diuretic
Insulin
Famotidine
(Pepcid)
Albuterol
Question 38
Diabetes screening recommendations for asymptomatic adults age 45 and over include
which of the following:
HbA1C
2-hour 75 gram oral glucose
tolerance test
C-peptide level
A and B
All of the above
Question 39
Diagnostic evaluation of hypothyroidism reveals:
Elevated TSH and
decreased T4
Decreased TSH and
increased T4
Decreased TSH and
decreased T3
Elevated TSH and increased
T4
Question 40
The most effective intervention(s) to prevent stroke is (are):
81 mg of aspirin daily
Carotid endarterectomy for patients with high-grade carotid
lesions
Routine screening for carotid artery stenosis with
auscultation for bruits
Smoking cessation and treatment of hypertension
Question 41
Josh, age 22, is a stock boy and has an acute episode of low back pain. You order and NSAID
and tell him which of the following?
Maintain moderate bed rest for 3-4 days
Call the office for narcotics if there is no relief with the NSAID in
24-48 hours
Begin lower back strengthening exercises depending on pain
tolerance
Wear a Boston brace at night
Question 42
The cardinal sign of infectious arthritis is:
Affected joint is painful at rest, with movement and
weight bearing
Rapid onset that wakes the patient during the night
Long history of severe pain with associated joint
swelling [Show Less]