1. As an advanced practice nurse, you want to learn more about the CDC’s initiatives relative to asthma care and management in order to advocate for
... [Show More] asthma sufferers at the state legislative level. Your goal is to reduce medications costs to patients. Which CDC recommendation supports your goal?
(0/1 Point)
The CDC recommends that payers and employers promote healthy workspaces to decrease environmental trigger exposures.
The CDC recommends that providers prescribe the most cost-efficient long-acting inhalers to lower patient co-pays.
The CDC recommends that providers deviate from the stepwise approach to lessen the financial impact to the patient.
The CDC recommends that co-pays be removed for inhaled corticosteroids and other prescribed medications
2. What syndrome, characterized by an absent homologous X chromosome with only a single X chromosome, exhibits features that include a short stature, total chromosome count of 45, webbed neck, and a shield like chest?
(0/1 Point)
Cri du chat syndrome Down syndrome Klinefelter syndrome Turner syndrome
3. A female patient has been recently diagnosed with invasive ductal carcinoma. As an advanced practice
nurse, you understand that she will be undergoing a multi-faceted treatment approach that will include one or more medications. Which medication is considered the “gold standard” endocrine treatment for breast cancer?
(0/1 Point)
Fulvestrant (Faslodex), an antiestrogen indicated for metastatic estrogen receptor-positive breast cancer in post-menopausal women
Tamoxifen (Nolvadex), a prodrug that must be converted to active metabolites in order to block estrogen receptors in breast tissue
Trastuzumab (Herceptin), a monoclonal antibody approved for HER2-positive metastatic breast cancer
Lapatinib (Tykerb), an oral inhibitor of HER2 tyrosine kinase and EGFR tyrosine kinase, resulting in apoptosis and suppression of tumor cell growth
4. A patient with T2DM comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin?
(0/1 Point)
Renal disease Congestive heart failure Rheumatoid arthritis Hepatitic C virus
5. A newborn born with hypoplastic left heart syndrome is receiving intravenous infusion of
prostaglandin. This medication is essential in keeping which two vessels patent? (0/1 Point)
Foramen ovale Pulmonary vein Ductus arteriosus Hepatic portal vein
6. A patient in the clinic reports fever, arthralgia, a rash, and nosebleeds. What other information should
the healthcare professional elicit from this patient? (0/1 Point)
Family history of Marfan’s disease History of a recent bacterial infection History of any recent chest trauma Any illnesses in family members
7. Urinalysis is ordered for a diabetic patient. The results are 4+ ketones, trace leukocytes, negative
nitrates, and red blood cells. Which of the following actions would the health practitioner take next? (1/1 Point)
Order an ultrasound of the kidneys to rule out sub-acute renal failure Check the patient glucose level
ANS: B Check the patient’s blood glucose . Presence of 4+ ketones in the urine indicates sever hyperglycemia so the health professional should further assess the patient’s status.
Order a 24-hour urine test for microalbumin Assess for a history of illicit drug or alcohol use
8. A 56-year-old diabetic patient has not taken his insulin in 4 days due to him” feeling well without it”.
He is admitted to the ED with an elevated blood sugar. What electrolyte should be assessed first? (1/1 Point)
Calcium Sodium Potassium
Insulin facilitates the intracellular transport of potassium, phosphate, and magnesium. Without insulin,
potassium does not get transported to the intracellular environment and the serum potassium will rise.
Chloride
9. A patient has a pulmonary capillary wedge pressure of 30mmHg. What assessment finding by the healthcare professional would be most consistent with this reading?
(1/1 Point)
Pink, frothy sputum
Pulmonary edema usually begins to develop at a pulmonary capillary wedge pressure or left atrial pressure of 20 mmHg. Signs of pulmonary edema include dyspnea, hypoxemia, and increased work of breathing. Physical examination may reveal inspiratory crackles (rales), dullness to percussion over the lung bases, and evidence of ventricular dilation (S3 gallop and cardiomegaly). In severe edema, pink, frothy sputum is expectorated, hypoxemia worsens, and hypoventilation with hypercapnia may develop.
Normal lung sounds Rhonchi
Eupnea
10. A child has a disorder that resulted in the failure of bones to ossify, resulting in soft bones and skeletal deformity. What treatment plan does the healthcare professional discuss with the parents?
(1/1 Point)
Extremely careful handling Increasing vitamin D intake
This description characterizes rickets. Growing bone fails to mineralize because of a problem with vitamin D intake, absorption, or excretion. Treatment includes supplemental vitamin D. Extremely careful handling would be appropriate for osteogenesis imperfecta. Revascularization procedures would benefit a child with osteochondrosis. Containment and motion are the principles of treating Legg-Calvé-Perthes disease.
Revascularization
Containment and motion therapy
11. A health professional is caring for a child that was sexually abused. She is trying to decide which medication option she should provide to the child. What should she know before providing the treatment option?
(1/1 Point)
The age and weight of the child
A Treatment depends on the age and weight of the child The race of the child
The height of the child The developmental stage
12. The physician prescribes the patient a loop diuretic. As the nurse you know that this type of diuretic
causes diuresis by affecting which structure in the nephron? (0/1 Point)
Distal convoluted tubule
Descending limb of the loop of Henle Proximal convoluted tubule Ascending limb of the loop of Henle
13. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and
are ordered before a meal and at bedtime. The patient’s blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer?
(1/1 Point)
No insulin should be administered NPH
70/30 mix
Lispro (Humalog)
Regular insulin is indicated for sliding scale coverage. Insulin is definitely indicated for this high blood sugar level. NPH is used for scheduled insulin doses and is a longer-acting insulin. A 70/30 mix is also used for scheduled insulin coverage.
14. A patient is in severe shock and is receiving vasopressin. A family member asks the health care professional to explain the rationale for this type of treatment. What response by the professional is most accurate?
(1/1 Point)
“Antidiuretic hormone causes vasoconstriction to help increase blood pressure.”
ADH in high doses causes vasoconstriction and a resulting increase in arterial blood pressure which would be important to the patient in shock.
“Antidiuretic hormone causes serum osmolality to be increased.” “Antidiuretic hormone leads to better insulin utilization.”
“Antidiuretic hormone conserves fluid when urine output is less than 20 mL/hr.”
15. A patient will begin taking fexofenadine [Allegra] for hay fever. The nurse teaching this patient will tell the patient that:
(1/1 Point)
Fexofenadine should be taken with food to prevent gastrointestinal (GI) symptoms. The medication may be taken once or twice daily.
Fexofenadine may be given 60 mg twice daily or 180 mg once daily. Fexofenadine does not need to be
given with food. Sedation is not a common side effect of fexofenadine. There is no caution to reduce the dosage or increase the dosing interval in patients with renal impairment who take fexofenadine.
Tolerance to sedation will occur in a few weeks.
With renal impairment, this drug should be taken every other day.
16. A patient has recently started taking an anti-depressant. She complains to you that she has been taking this medication for two weeks and hasn’t started to feel any better. What would be your response to the patient?
(1/1 Point)
“I understand your concern. I’m going to try another medication to see if that medication will work better for you”.
“I understand your frustration, I will up the dosage of your medication”.
“I understand your concern, but it can take up to 12 weeks before you could see a response from the medication”
It can take up to three weeks before a patient can feel the effects of the medication. “You’re right, you should have started to see a response from the medication by now”.
17. Four patients are in the intensive care unit with different types of shock. Which patient would the
healthcare professional assess as the priority? (1/1 Point)
Septic Hypovolemic Anaphylactic
Anaphylactic shock is characterized by massive vasodilation and widespread inflammation that can lead
to death in minutes if treatment is not instituted immediately. If all else is equal, the healthcare professional should assess the patient with anaphylactic shock first.
Neurogenic
18. A nurse working in a family planning clinic is teaching a class on intrauterine devices (IUDs). Which patient should be advised against using an IUD for contraception?
(1/1 Point)
A 45-year-old married woman with four children. A 30-year-old monogamous married woman.
An 18-year-old woman with multiple sexual partners.
Women at risk for sexually transmitted diseases (STDs) should not use an IUD, because the risk of infection is higher. Women who have multiple sexual partners are especially at risk for STDs.
Monogamous married women are less apt to contract STDs. Women with rosacea can use an IUD. A 35-year-old woman with a history of rosacea.
19. Which of the following is a cornerstone for treatment of a patient in heart failure?
(1/1 Point)
Digoxin
Calcium channel blockers
Angiotensin-converting enzyme (ACE) inhibitors
Beta Blockers and ACE inhibitors are the cornerstone treatment for heart failure.
Nitrates
20. When the nurse is providing educational material for a new medication regimen to her newly diagnosed heart failure patient, she must remember to: (Select all that apply)
(1/1 Point)
Focus on main points.
Place important information last.
Select images or drawings that have a purpose or that reinforce a point in the handout. Materials should be written at a higher education level that can be understood by most patients. Use common terms in short, simple sentences that patients can easily understand.
21. Which choice below describes a patient being impacted by social and community context?
(1/1 Point)
A patient with heart failure attends the heart failure clinic weekly, but occasionally forgets his afternoon furosemide dose.
A patient with renal failure is traveling and searching for a dialysis center in her vacation destination. A patient with coronary artery disease is unable to afford his medications.
A patient reports feeling isolated and depressed after the death of her spouse.
Choice A would correlate more closely with health/healthcare, Choice B would correlate more closely with neighborhood and built environment and health/healthcare, choice C would correlate more closely with economic stability, but choice D speaks to the loss of a social outlet via the spouse and is the most appropriate.
22. Healthy People 2020 endorses the completion of a high school education primarily to enable a person to:
(1/1 Point)
Secure a better job Increase the quality of life
Make healthy lifestyle choices
One of the goals of Healthy People 2020 is to increase the number of persons graduating from high school so that they have a better education basis on which to make healthy lifestyle choices.
Maintain the family unit
23. The healthcare professional is caring for a 7-year-old patient. She is trying to determine the best way to make sure the patient adheres to his new medication regimen. What is a key factor she must consider in making sure the child adheres to his medication?
(1/1 Point)
Allow the child to decide if he would like to take the medication that day.
Educate the parents and/or care giver about the child’s medication and reinforce the information with written instructions.
ANS B It is important that child’s caregivers are educated about the medication and its importance to the child’s wellbeing. Providing written information such as brochures help to reinforce the information that was discussed.
Suggest keeping the medication in a warm spot on the counter so it can be easily seen and remembered.
Allow the child to administer his own medication and have him log it into a daily journal.
24. The Center for Medicare and Medicaid Innovations created the 'Accountable Health Communities' with the aim to do which one of the following?
(1/1 Point)
Improve screening for common diseases leading to mortality in the United States Monitoring adherence to Health Information Technology guidelines.
Connecting Medicare and Medicaid beneficiaries with community resources.
ANS: C - The Accountable Health Communities Program aims to provide resources to address health- related social needs.
Ensuring all Medicare and Medicaid beneficiaries are adhering to medication formulary restrictions.
25. A parent wants to know how to prevent type 1 diabetes in the newborn. The healthcare professional explains that prevention is not possible, because of which characteristic being associated with type 1 diabetes mellitus?
(1/1 Point)
Partial insulin secretion An autoimmune process [Show Less]