An advanced practice registered nurse (APRN) is working with patients at an eating disorder clinic. One patient is a 64-year-old woman with a long history
... [Show More] of anorexia nervosa.
Which health promotion intervention is appropriate for this patient due to complications of her disease process?
Encouraging high-impact aerobic exercise
Recommending daily calcium and vitamin D supplements
Prescribing a cholesterol-lowering medication
Ordering a screening colonoscopy and antidiarrheal medication
Recommending daily calcium and vitamin D supplements
This patient is at high risk of osteoporosis and stress fractures due to the extensive history of anorexia nervosa. The body changes its hormone production in response to low body weight, which negatively affects bone growth and strength.
A young adult patient and the patient's spouse are meeting with an advanced practice registered nurse (APRN) for a fertility consultation. The patient informs the nurse practitioner that the couple culturally identifies as African American, and the APRN recommends that the couple consult a genetic counselor for a preconception consultation.
Which health topic is important for this patient to review based on prevalence of disease?
Stomach cancer
Cystic fibrosis
Sickle cell anemia
Huntington disease
Sickle cell anemia
Sickle cell disease has an increased prevalence in African Americans (1 in 600).
A patient with a basal metabolic index (BMI) of 29 is seen by an advanced practice registered nurse (APRN) to discuss routine health maintenance. The patient reports a strong family history of colorectal cancer and has mild hypertension and normal cholesterol.
Which primary recommendation should the APRN make to decrease the risk associated with this patient's family history?
Multiple vitamin with iron daily
Exercise of one hour daily
Low-fat dietary intake daily
Two glasses of red wine daily
Low-fat dietary intake daily
A high-fat diet raises the risk of colorectal cancer. It would be important for this patient who has a familial risk (nonmodifiable) for colorectal cancer to decrease as many modifiable risks possible.
A patient undergoes surgical consultation for the removal of scar tissue related to facial trauma that resulted in keloid formation.
Which phase of wound healing is represented in this patient?
Inflammatory
Remodeling
Dehiscence
Reconstruction
Reconstruction
Keloid formation occurs during reconstruction and is a dysfunctional collagen synthesis, which may involve excessive production of collagen, causing surface overhealing and leading to a hypertrophic scar or keloid. A hypertrophic scar is raised but remains within the original boundaries of the wound and tends to regress over time. A keloid is a raised scar that extends beyond the original boundaries of the wound, invades surrounding tissue, and is likely to recur after surgical removal.
An advanced practice registered nurse (APRN) is consulting with a new mother during a scheduled well-child visit. The mother informs the APRN that her father-in-law has been diagnosed with Huntington disease. The mother asks if her husband and her male child will also have the disease. The APRN is aware that the disease is autosomal dominant and age dependent and suggests genetic testing for the mother, husband, and child.
Which additional information should the APRN provide for this type of genetic transmission?
Both parents must carry the autosomal dominant gene for the child to develop the condition.
Men are more likely to exhibit autosomal dominant diseases than women.
Autosomal dominant diseases usually have a 50% recurrence risk.
Autosomal dominant diseases typically skip generations.
Autosomal dominant diseases usually have a 50% recurrence risk.
Autosomal dominant is a pattern of inheritance in which an affected individual has one copy of a mutant gene (one parent) and one normal gene on a pair of autosomal chromosomes. Autosomal recessive diseases require that the individual have two copies of the mutant gene. Individuals with autosomal dominant diseases have a 50-50 chance of passing the mutant gene and the disorder on to each of their children.
An older adult patient who is prescribed amitriptyline (antidepressant) presents with complaints of impaired taste, fatigue, and confusion. Lab results reveal a sodium level of 128 mEq/L.
Which endocrine disorder is the patient experiencing?
Syndrome of inappropriate antidiuretic hormone
Chronic lymphocytic thyroiditis
Diabetes insipidus
Serotonin syndrome
Syndrome of inappropriate antidiuretic hormone
Amitriptyline can cause hyponatremia with characteristics of SIADH.
A patient is being monitored in an ICU after a head injury of unknown origin. Initially, the patient is awake and alert but cannot remember what happened. The patient begins to show signs of increased intracranial pressure with episodes of confusion, restlessness, and lethargy.
Which stage of intracranial hypertension should be diagnosed by an advanced practice registered nurse (APRN)?
Stage 1
Stage 2
Stage 3
Stage 4
In stage 2, compensatory mechanisms are exhausted, and there is a slow rise in ICP. Clinical signs and symptoms include drowsiness and headache.
A patient presents to a mental health facility with complaints of hallucinations, disorganized thoughts, decreased intimacy, and a flat affect. An advanced practice registered nurse (APRN) orders neuroimaging.
Which pathologic change should the APRN expect to find?
Enlarged third ventricle
Increased size of thalamus
Increased temporal lobe gray matter
Enlarged medulla in the brain stem
There is third ventricle enlargement and neuropsychological deficits in schizophrenia.
A patient presents to an emergency department accompanied by a family member. The family member states the patient's body became stiff and rigid, showing jerking movements and loss of bowel and bladder control prior to arrival. Upon examination, an advanced practice registered nurse (APRN) notes the patient's eyes deviating upward, dilated pupils, a loss of consciousness for about one to two minutes, and abdominal muscle contractions.
What is the pathologic mechanism of this episode?
Alteration of immune responses
Excessive electrical discharges of the cerebral neurons
Interruption of blood flow to the cerebral neurons
Degeneration of nerve cells
Excessive electrical discharges of the cerebral neurons
Nerve cells (neurons) in the brain create, send, and receive electrical impulses which allow the brain's nerve cells to communicate. Anything that disrupts these communication pathways can lead to a seizure. [Show Less]