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NSG 6420 Final Exam Week 10 –
Question and Answers
In AR disorders, carriers have:
- Two mutated genes; two from one parent that cause disease
- A mutation on a sex chromosome that causes a disease
- A single gene mutation that causes the disease
- One copy of a gene mutation but not the disease
A 76-year-old patient with a 200-pack year smoking history presents with complaints of chronic cough, dyspnea, fatigue, hemoptysis, and weight loss over the past 2 months. The physical exam reveals decreased breath sounds and dullness to percussion over the left lower lung field. The chest X-ray demonstrates shift of the mediastinum and trachea to the left. These are classic signs of: Lung cancer Tuberculos is Pneumonia COPD
The nurse practitioner is discussing lifestyle changes with a patient diagnosed with gastroesophageal reflux. What are the nonpharmacological management interventions that should be included? It will be helpful to keep the head of your bed elevated on blocks
In examining the mouth of an older adult with a history of smoking, the nurse practitioner finds a suspicious oral lesion. The patient has been referred for a biopsy to be sent for pathology. Which is the most common oral precancerous lesion? leukoplakia
You have a patient complaining of vertigo and want to know what could be the cause. Knowing there are many causes for vertigo, you question the length of time the sensation lasts. She tells you several hours to days and is accompanied by tinnitus and hearing loss. You suspect which of
the following conditions? Ménière’s disease Benign paroxysmal positional vertigo Transient ischemic attack (TIA) MigraineDefinition
Age-related changes in the bladder, urethra, and ureters include all of the following in older women except: A. Increased estrogen production’s influence on the bladder and ureter B. Decline in bladder outlet function C. Decline in ureteral resistance pressure D. Laxity of the pelvic muscle
Herpes Zoster
n differentiating a gastric ulcer from a duodenal ulcer, you know that each type of ulcer can present with distinct signs and symptoms. Which of the following pieces of information from the patient’s history is the least useful for you to determine that the patient has a duodenal ulcer? A. Pain occurs on an empty stomach B. Diffuse epigastric pain
C. Rarely associated with non-steroidal use D. Occurs in patients under 40 years of age
A pneumatic otoscopic examination is used to assess: A. Inner ear conditions B. Otitis externa C. Cerumen impaction D. Tympanic membrane mobility
In autosomal recessive (AR) disorders, individuals need:
Which of the following disorders can cause urinary incontinence? Cystocele Overactive bladder Uterine prolapse All of the above
- Only one mutated gene on the sex chromosomes to acquire the disease
- Only one mutated gene to acquire the disease
- Two mutated genes to acquire the disease
- Two mutated genes to become carriers
An older patient reports burning pain after ingestion of many foods and large meals. What assessment would assist the nurse practitioner in making a diagnosis of GERD? A. Identification of a fluid wave B. Positive Murphy’s sign C. Palpable spleen D. Midepigastric pain that is not reproducible with palpation
Which of the following medications are commonly associated with the side effect of cough Beta blocker B. Diuretic C. ACE inhibitor D. Calcium antagonist
A 55-year-old post-menopausal woman with a history of hypertension complains of jaw pain on heavy exertion. There were no complaints of chest pain. Her ECG indicates normal sinus rhythm
Your 24-year-old female patient complains of dysuria as well as frequency and urgency of urination that develops the day after she uses her diaphragm. Urine culture reveals a bacterial count of 100 CFU/mL. These signs and symptoms indicate
. Upper urinary tract infection B. Lower urinary tract infection C. Normal bacteriuria D. Urethritis
Epistaxis can be a symptom of:
A careful history of a female client with a chief complaint of intermittent diarrhea reveals that she also experiences bouts of constipation. She has no known allergies and experienced no unintentional weight loss. What is the most likely condition Inflammatory bowel disease Irritable bowel syndrome Giardiasis Lactose intolerance
When assessing an elderly client who reports a tremor, which assessment findings would be most reliable in identifying Parkinson’s disease? Any presence of tremor Symptoms of slowed movement, unstable angina, and tremor Resting tremor, slow unsteady gait, and cogwheel resistance Cogwheel rigidity, bradykinesia, and amnesia
Which of the following best describes the pain associated with osteoarthritis? A. Constant, burning, and throbbing with an acute onset? B. Dull and primarily affected by exposure to cold and barometric pressure C. Begins upon arising and after prolonged weight bearing and/or use of the joint D. Begins in the morning but decreases with activity
During physical examination of a patient, you note resonance on percussion in the upper lung fields. This is consistent with: A. COPD B. Pneumothorax C. A normal finding D. Pleural effusion
Jeff, 48 years old, presents to the clinic complaining of fleeting chest pain, fatigue, palpitations,
lightheadedness, and shortness of breath. The pain comes and goes and is not associated with activity or exertion. Food does not exacerbate or relieve the pain. The pain is usually located under the left nipple. Jeff is concerned because his father has cardiac disease and underwent a CABG at age 65. The ANP examines Jeff and hears a mid-systolic click at the 4th ICS mid- clavicular area. The ANP knows that this is a hallmark sign of:
demonstrated by a BMI of 35 and blood pressure of 145/ 90. The signs and symptoms are characteristic of: Type 2 diabetes mellitus B. Chronic fatigue syndrome C. Cushing’s disease D. Clinical depression
Your 66-year-old male patient has recently started treatment for metabolic syndrome and is currently taking the following medications: an ACE inhibitor and beta blocker for treatment of hypertension. He is also taking a statin medication, simvastatin for hyperlipidemia, and a biguanide, metformin, for type 2 diabetes. The patient
complains of myalgias of the legs bilaterally and blood work shows elevated serum creatine kinase. Which of the medications can cause such a side effect? A. Beta blocker B. ACE inhibitor C. Statin medication D. Metformin
. Helicobacter pylori is implicated as a causative agent in the development of duodenal or gastric ulcers. What teaching should the nurse practitioner plan for a patient who has a positive Helicobacter pylori test? A. It is highly contagious and a mask should be worn at home. B. Treatment regimen is multiple lifetime medications. C. Treatment regimen is multiple medications taken daily for a few weeks. D. Treatment regimen is complicated and is not indicated unless the patient is symptomatic.
Which of the following is the most important question to ask during cardiovascular health history? Sudden death of a family member
Dan G., a 65-year-old man, presents to your primary care office for the evaluation of chest pain and left-sided shoulder pain. Pain begins after strenuous activity, including walking. Pain is characterized as dull, aching; 8/10 during activity, otherwise 0/10. Began a few months ago, intermittent, aggravated by exercise, and relieved by rest. Has occasional nausea. Pain is retrosternal, radiating to left shoulder, definitely affects quality of life by limiting activity. Pain is worse today; did not go away after he stopped walking. BP 120/80. Pulse 72 and regular. Normal heart sounds, S1 and S2, no murmurs. Which of the following differential diagnoses would be most likely Musculoskeletal chest wall syndrome with radiation Esophageal motor disorder with radiation Acute cholecystitis with cholelithiasis Coronary artery disease with angina pectoris
The most common neurological cause of seizures in an older adult is Alzheimer’s disease Multiple sclerosis Stroke Peripheral neuropathy
A 70-year-old white male comes to the clinic with a slightly raised, scaly, pink, and irregular
Peptic ulcer disease Barrett’s esophagus Esophageal varices Pancreatitis
A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The patient reports a smoking history of 2 packs of cigarettes per day since age 16. This would be recorded in the chart as: A. 50 x 2-pack years B. 100-pack years C. 50-year, 2-pack history D. 100 pack history
Which of the following conditions is the most common cause of nausea, vomiting, and diarrhea A. Viral gastroenteritis B. Staphylococcal food poisoning C. Acute hepatitis A D. E.coli gastroenteritis
The nurse practitioner orders bilateral wrist X-rays on a 69-year-old gentleman complaining of pain in both wrists for the past 6 weeks not related to any known trauma. The nurse practitioner suspects elderly onset rheumatoid arthritis. The initial radiographic finding in a patient with elderly onset rheumatoid arthritis would be: A. Symmetric joint space narrowing B. Soft tissue swelling C. Subluxations of the joints D. Joint erosion
Rheumatic heart disease is a complication that can arise from which type of infection? Epstein-Barr virus Diphtheria Group A beta hemolytic streptococcus Streptococcus pneumoniae
A 23-year-old patient who has had bronchiectasis since childhood is likely to have which ofthe following: Barrel-shaped chest Clubbing Pectus excavatum Prolonged capillary
refill 45. Iron Deficiency Anemia (IDA) is classified as a microcytic, hypochromic anemia. This classification refers to which of the following laboratory data? A. Hemoglobin and hematocrit B. Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH) C. Serum ferritin and serum iron D. Total iron binding capacity and transferrin saturation
An 82-year-old female presents to the emergency department with epigastric pain and weakness. She admits to having dark, tarry stools for the last few days. She reports a long history of pain due to osteoarthritis. She self-
(Cytotec) Cimetidine (Tagamet) Metronidazole (Flagyl) Bismuth subsalicylate (Pepto bismol)
A patient has a tender, firm, nodular cystic lesion on his scalp that produces cheesy discharge with foul odor. This is most likely a: A. Bacterial folliculitis
B. Basal cell carcinoma C. Bullous impetigo D. Epidermoid cyst
The appearance of a 2-10 cm. herald patch with subsequent development of parallel oval lesions on the trunk in a christmas tree distribution involving the upper arms and upper legs are common in Pityriasis Rosea Shingles Psoriasis Lymes Disease
The most common complication of an untreated urinary obstruction due to a ureteral calculus is: Hydronephrosis B. Renal artery stenosis C. Ureteral rupture D. Kidney mass
Which of the following findings would indicate a need for another endoscopy in clients with peptic ulcer disease? Cases of dyspepsia with constipation B. Symptoms persisting after 6-8 weeks of therapy C. All cli ents with dyspepsia who smoke and drink alcohol D. When a therapeutic response to empiric treatment is obtained
Your patient complains of lower abdominal pain, anorexia, extreme fatigue, unintentional weight loss of 10 pounds in last 3 weeks, and you find a positive hemoccult on digital rectal examination. Laboratory tests show iron deficiency anemia. The clinician needs to consider A. Diverticulitis B. Appendicitis C. Colon cancer D. Peptic ulcer diseaseDefinition
A 43-year-old male patient complains of right-sided abdominal and pain in the back in the right costovertebral angle region, fever, chills, dysuria, and nausea. On physical examination, there is 102 degree fever, tachycardia, and right costovertebral angle tenderness to percussion. The most likely condition is: Lower urinary tract infection Pyelonephritis
A 34-year-old female presents with fever, general malaise, fatigue, arthralgias and rash for the last 2 weeks. On physical examination, you note facial erythema across the nose and cheeks. Serum diagnostic tests reveal positive antinuclear antibodies, anti-DNA antibodies, elevated C- reactive protein and erythrocyte sedimentation rate. The clinician should include the following disorder in the list of potential problems: A. Fibromyalgia B. Sarcoidosis C. Systemic lupus erythematosus D. Rheumatoid arthritis
In examination of the nose, the clinician observes gray, pale mucous membranes with clear, serous discharge. This is most likely indicative of Bacterial sinusitis Allergic rhinitis Drug abuse Skull fracture
A 72-year-old female patient has been diagnosed with gout. She also has a long history of chronic congestive heart failure. The most likely contributing factor to the development of gout in this older female is: A. Lead intoxication B. Illegal whiskey C. Binge-eating D. Thiazide diuretics
A woman complains of malaise and arthralgias. You note a butterfly-shaped, macular, erythematous rash across her cheeks and nose. These conditions are common in:
. Psoriasis B. Lichen planus C. Systemic lupus erythematosus D. Erythema nodosum
Patients that have atopic disorders are mediated by the production of Immunoglobulin E (IgE) will have histamine stimulated as an immediate phase response. This release of histamine results in which of the following?
Alteration in micturition is the hallmark symptom for abdominal pain of genitourinary origin. Symptoms in alteration in micturition would include: Fever
Dysuria Nausea/vomiting Right lower quadrant pain
Presbycusis is the hearing impairment that is associated with: Physiologic aging Ménière’s disease Cerumen impaction Herpes zoster
