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NR 601 FINAL EXAM NEW UPDATED AND VERIFIED A+ QUESTIONS
AND ANSWERS (202 5 )
A 52 year old female patient screened for diabetes has a fasting plasma glucose level of 123 mg/dl. The nurse practitioners plan includes: a. repeat fasting glucose in 1 month b. prescribe memformin 500mg BID po c. repeat fasting plasma glucose in one year d. repeat fasting glucose in three years c. repeat fasting plasma glucose in one year A 56-year old male patient screened for diabetes has a fasting plasma glucose level of 96mg/dl. The nurse practitioner management plan includes: a. repeat fasting plasma glucose in three years b. prescribe Metformin 500mg po BID c. repeat fasting plasma glucose in one year d. refer to ophthalmology for eye exam a. repeat fasting plasma glucose in three years RW, a 57 year old native American female, presents to the office. RW states she feels irritable and has difficulty concentrating as well as fallingn asleep and staying aleep. She states she is worried about her finances, her husband has just lost his job. The NP diagnoses anxiety. The NP prescribes a first line treatment which is a. Diazepam b. Clonazepam c. Ariprprazole d. Paroxetine d. Paroxetine The most common sustained rhythmic disorder, which consists of fibrillatory p waves is: a. AV block
b. atrial tachycardia c. atrial fibrillation d. atrial flutter c. atrial fibrillation According to the Sexually presentation, atrophic vaginitis a. the symptomsm are the same for each woman b. creates a more acidic vaginal environment c. is a contributing factor for frequent urinary tract infections d. is not treated with vaginal lubricants c. is a contributing factor for frequent urinary tract infections Which of the following is the most appropriate screening tool for delirium? a. St Louis University Mental Status Exam (SLUMS) b. Montreal Cognitive Assessment c. Lawton Scale of instrumental Activities of Daily Living d. Confusion Assessment Model d. Confusion Assessment Model A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea_ is: a. lorazepam b. Gabapentin c. Methadone d. Morphine d. Morphine Which of the following would you recommend annually for the elderly type 2 diabetic? a. periodic visits to a gastroenterologist b. colonoscopy
c. identifying and managing complications of care d. all of the above d. all of the above A 58 year old Caucasian mane with type 2 diabetes mellitus presents to the clinic as a new patient. He takes metformin 500mg twice a day. His last Hgb A1c was 7%. He is up to date on eye and foot examinations. His BP is 142/96. According to ACC 2017 guidelines for high blood pressure in adults, what is the most appropriate first line medication? a. lisinopril b. furosemide c. amlodipine d. clonidine a. lisinopril An older male patient is experiencing acute onset of right sided weakness, slurred speech and confusion. What should the nurse practitioner do promptly? a. order an EKG and administer O2 by cannula immediately b. Do a through medication review and stat blood sugar c. evaluate for a stroke and arrange transport to the hospital right away d. administer an aspirin by mouth c. evaluate for a stroke and arrange transport to the hospital right away Mr. A, experienced a brief onset of right sided weakness, slurred speech and confusion yesterday. The symptoms have resolved and the CT is normal. What is the next step of the plan for Mr. A? a. assure the patient that he will not experience the symptoms again b. identify modifiable cardiovascular risk factors c. order ASA 81mg stat d. order a stat EEG and administer O2 by mask b. identify modifiable cardiovascular risk factors
The NP knows that medications can trigger or worsen heart failure. With this knowledge in mind, the NP will avoiding prescribing the following classes of medications a. benzodiazepines b. macrolides c. muscle relaxants d. NSAIDS d. NSAIDS MG, a 60 year old female presents with complaints of her "heart flipping in her chest" The NP wants to evaluate for arrhythmia. The nP knows that the cornerstone for arrhythmia evaluation includes: a. electrocardiogram b. physical examination c. all options are appropriate d. history c. all options are appropriate The elderly are at high risk for delerium because of: a. multiple medical problems b. multisensory deficits c. polypharmacy d. all of the above d. all of the above A 68 year old woman presents with a complaint of urine leakage whenever she sneezes, laughs or strains for the past 4 months. She denies dysuria, frequency and nocturia. US dipstick is negative for RBC's leukocyte esterase, nitrates, ketones and urobilinogen. What is the diagnosis? a. stress incontinence b. urinary incontinence c. urge incontinence
d. mirtazapine b. amitryptyline Male patient presents with a BMI of 30 presents to the office for an annual exam. You are reviewing the lab results. You ordered a CMP as part of routine labs. The fasting glucose was 130. Your next action is: a. repeat the fasting glucose b. start metformin 500mg BID c. repeat fasting glucose in 1 year d. call the patient and report lab results as normal a. repeat the fasting glucose The task of grieving include all of the following except a. begin to disengage b. acknowledge the reality of death c. work through the pain of grief d. restructure relationships a. begin to disengage All of the following are true statements regarding elder abuse except: a. a new STI in an elderly patient can be a sign of abuse b. persons over 80 years of age are at highest risk for abuse c. missing scheduled appointments and delays in medical care are common d. common signs of abuse include decreased anxiety and depression d. common signs of abuse include decreased anxiety and depression Hospice care differs from palliative care in that: a. it cannot be provided in the nursing home b. the majority of those admitted to hospice die within 7 days c. it is not covered by insurance
d. it is designed for the last six months of life d. it is designed for the last six months of life When assessing an elderly client who reports a tremor, which assessment findings would be most reliable in identifying Parkinsons disease? a. congwheel rigidity, bradykinesia, and macrorgraphia b. any presence of fever c. symptoms of slowed movement, unstable angina and tremor d. resting tremor, slow unsteady gait and cogwheel rigidity d. resting tremor, slow unsteady gait and cogwheel rigidity How dies womans anatomy make them more susceptible to UTI's a. the female urethra is shorter b. aymptomatic UTI's do not resolve themselves without treatment c. women tend to get UTI's when they are pregnant d. there is a longer distance between the urethra and anus a. the female urethra is shorter Mrs. Smith, a 64 year old woman presents to the clinic for the first time and complains of uruinary incontinece and dyspareunia. She went through menipause 10 years ago without any hormone replacement therapy and had a hysterectomy for a fibroid. Her mother had a hip fracture at 87 years of age. The patiennt's most recent mammogram was 7 years ago and no known family history of breast cancer. She is not taking any medications. Her physical exam is unremarkable except for findings consistant with atrophic vaginitis. You prescribed topical hormone replacement therapy today. Which of the following evaluations should also be ordered today a. bone mineral density measurement b. mammogram b. mammogram All of the following patients should be screened for diabetes except: a. a 44 year old caucasian male with hypertension b. a 42 year old femal on disability from back injury from back injury who is unable to exercise
b. increased arm swing c. macrographia and bradycardia d. micrographia and bradykinesia d. micrographia and bradykinesia The most common neurological cause of seizures in an older adult is: a. multiple sclerosis b. stroke c. alzheimemrs disease d. peripheral neuropathy b. stroke Patients with osteoarthritis of the hip and knee have a distinguishable gait described as: a. antalgic b. festinating c. steppage d. ataxic a. antalgic According to the 2017 Guideline for High Blood Pressure in Adults the recommended blood pressure goal for a 55 year old man with a history of chronic kidney disease is: a. <140/ b. <120/ c. <130/ d. <150/ c. <130/ Periods of increased activity, when the patient did not seem to need to sleep or reports being very productive not needing sleep are: a. symptoms of schizophrenia
b. symptoms of worsening depression c. symtoms of unipolar depression d. symptoms of hypomania or mania d. symptoms of hypomania or mania A 56 year old man presents to the office with concerns about low energy, lack of joy in his life and decreased appetite for 2 weeks. The nurse practitioner assesses him using SIG-E CAPS, the NP knows that the E stands for a. energy (decreased) b. emotional instability c. ego dystonia d. enthusiasm (decreased) a. energy (decreased) Terazosin, an alpha blocker, is prescribed to treat the following conditions: a. benign prostatic hypertrophy and hypertension b. benign prostatic hypertrophy and hypotension c. urinary tract infection and arrhythmia d. chronic prostatitis and atrial fibrillationn a. benign prostatic hypertrophy and hypertension A 65 year old Hispanic woman who presents to the office for routine follow up of her type 2 diabetes mellitus. Her routine UA results are as follows: few epithelial cells, negative leukocytes, negative nitrates, negative protein, no ketones. Which of the following tests should also be ordered annually for diabetic patients: a. result is normal, no further testing is necessary b. urine for culture and sensitivity c. recommend a screening intravenous pyelogram (IVP) d. micoralbumin d. micoralbumin
b. fasting plasma glucose c. two-hour OGTT d. Hemaglobin A1C a. all options are appropriate The first step in treating delriuim is to: a. use side rails and/or wrist restraints to keep the patients safe b. give low dose haldol if the patient has psychosis c. identify the cause d. provide reality orientation c. identify the cause A 65 caucasian female presents for her yearly physical. She is 5"1 tall and weighs 102 lbs. A review of her chart reveals she smokes 1 pack of cigarettes a day, and drinks 2 beers every evening since she retired. She has taken synthroid and simvastatin for 10 years. She does not exercise, she likes to sit and knit. The NP knows the non- modifiable risk factor for osteoporosis for this patient include: a. activity level b. age c. tobacco use d. medications b. age MM, is a 78 year old female presents to the office MM states she feels restless and has a poor appetite. She states she is worried about her health but has no other symptoms. The physical exam is normal. The NP diagnoses depression. The NP prescribes a first line treatment for depression, which is: a. sertaline b. diazepam a. sertaline Which obstructive lung disease is classified as reversible? a. Asthma
b. Chronic bronchitis c. Emphysema d. COPD a. Asthma The 2017 HTN guidelines recommend the following treatment for a healthy 54 year old African American woman with a BI of 23 and consistent BP readings of 116- 120/ a. none, this is a normal BP b. hypertension, stage 1 requiring treatment c. elevated BP requiring treatment with a thiazide d. hypertension, stage 1 requiring treatment with a calcium channel blocker a. none, this is a normal BP According to the genitourinary presentation, the number 1 risk factor for urinary incontinence is: a. smoking and caffeine levles b. uncontrolled diabetes c. aging d. obesity c. aging Which of the following would be an appropriate treatment for a patient with moderated bothersome symptoms of BPH. a. recommend cranberry supplements b. reevaluate symptoms in 1 to 3 months c. prescribe finasteride and saw palmetto d. prescribe tamsulosin d. prescribe tamsulosin Acanthosis nigricans is associated with all of the following conditions except:
b. the patient is asked to recall five images from picture cards following the drawing of the clock hands c. the patient will be asked to repeat five eworkds immediately following the directions by the practitioner d. the patient is asked to draw the hour and minute hands on a picture of an analog clock a. a score of 0-2 is a positive screen for cognitive impairment When assessing a patient who complains of a tremor, the nurse practitioner must differentiate essential tremor from the tremor of Parkinson's disease. Which of the following findings are consistent with essential tremors? a. the tremor occurs with purposeful movement b. the handwriting is not affected by the tremor a. the tremor occurs with purposeful movement A 56 year old man is diagnosed with acute prostatitis, he is afebrile without severe pain and will be managed outpatient. He should initially be treated with antibiotics for how long? a. 6-12 weeks b. 14-21 days c. 3-6 weeks d. 10-14 days d. 10-14 days An 80 year old female widow asks her nurse practitioner about her end of life options. Her diagnosis include congestive heart failure, hypertension and type 2 diabetes mellitus. She has noticed that in the last month she has lower extremity edema and she if finding it difficult to walk to the grocery store and chrch. She does not use oxygen. She is able to maintain her home but requires more frequent rests after vacuuming. She does not wish to be admitted to the hospital again in the future but if admitted wants to maintain full code status. How should the NP address this patients concerns today? a. start her on a medication for depression b provide her with information for senior day care services c. offer the patient a palliative care referral
c. offer the patient a palliative care referral Hospice services and palliative care services are underutilized due to a. denial of impending death b. confusion remains over when it is appropriate to consult palliative care c. services are not understood d. all options are appropriate d. all options are appropriate Jean, a 47 year old presents to the clinic with complaints of dysuria, frequency and strong odor of her urine for 5 days. This is the second occurrence this year. The first occurrence was 3 months ago. Today, UA reveals positive leukocyte esterase, positive nitrates, 18 WBC's, few RBC's, no protein, no casts. What is the appropriate next step for this patient a. order a urine culture and sensitivity and hold treatment until you receive results b. prescribe a 7 day course of antibiotics and order a urine culture and sensitivity c. treat the patient with a stronger antibiotic, ofloxin, for 10 days d. treat the patient with antibiotics today d. treat the patient with antibiotics today Delirium is typically characterized by all of the following except: a. altered level of consciousness b. insidious onset c. inattention b. insidious onset Not sure of the question but a. dominant personality b. obesity c. cardiovascular disease d. diabetes
c. discontinue the medication immediately d. reassure the patient that this is an anticipated side effect d. reassure the patient that this is an anticipated side effect An 82 year old mamn is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnosis. a. parkinson's disease b. prostate cancer c. all options are appropriate d. benign prostatic hyperplasia (BPH) c. all options are appropriate A 67 year old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis? a. psychogenic nocturia b. benign prostatic hypertrophy c. drug induced impotence d. irritative posterior urethral lesion b. benign prostatic hypertrophy Which of the following maneuvers is contraindicated in acute prostatitis a. palpation of the epididymis b. massaging the infected prostate c. serial urine samples d. rectal exams b. massaging the infected prostate You are working up a 52 year old patient for microscopic hematuria. Your differential diagnosis list includes all of the following except a. nephrocalcinosis
b. acute pyelonephritis c. renal stenosis d. bladder cancer c. renal stenosis A 48 year old male patient screened for diabetes has a fasting plasma glucose level of 120mg/dl (6.7mmol/L). The nurse practitioner plan includes: a. prescribe metformin 500mg po BID b. educate the patient on lifestyle changes to lower blood glucose c. initiate self monitoring of blood glucose d. review the effects of oral hypoglycemic medications b. educate the patient on lifestyle changes to lower blood glucose Terazosin, an alpha blocker, is prescribed to treat the following conditions: a. benign prostatic hypertrophy and hypertension b. benign prostatic hypertrophy and hypotension c. urinary tract infection and arrythmia d. chronic prostatitis and atrial fibrillation a. benign prostatic hypertrophy and hypertension A 65 year old hispanci woman presents to the office for routine follow up for her type 2 diabetes mellitus. Her routine UA reveals few epithelial cells, negative leukocytes, negative nitrates, negative protein, no ketones. Which of the following tests should also be ordered annually for diabetic patients. a. reslult is normal, no further testing is necessary b. urine for culture and sensitivity c.recommend a screening intravenous pyelopgram (IVP) d. microalbumin d. microalbumin Age-related changes in the bladder, urethra and ureters include all of the following in older women except:
