NRNP 6531 Final Exam Questions and Answers, Exams of Nursing

Download NRNP 6531 Final Exam Questions and Answers and more Exams Nursing in PDF only on Docsity!

NRNP 6531 Final Exam / NRNP

Final Exam/ NRNP 6531 Week 11

Final Exam / NRNP6531 Week 11

Final Exam(2 Versions)(Each 100 Q

& A):Walden university

NRNP 6531 Final Exam

(132 Exam Questions & Answers alphabetical)

A,B,C

1.) What is the most commonly abused substance? alcohol is the #1 abused substance in America. An estimated 135.5 million people drink alcohol, but of those people, 86 million are considered to be abusers, 2.) Diagnostic confirmation of acute leukemia is based on: Bone marrow aspiration and biopsy 3.) Risk factors for Addison’s disease include which of the following? Tuberculosis, Autoimmune disease, AIDS (all of the above) 4.) Successful management of a patient with attention deficit hyperactivity disorder (ADHD) may be achieved with: Ritalin and diet 5.) The correct treatment for ankle sprain during the first 48 hours after injury includes: a cold compress to help reduce swelling (Rest, ice, compression, elevation) 6.) A 15 year-old female patient is 5 feet tall and weighs 85 pounds. You suspect anorexia and know that the best initial approach is to: Having the client in view of staff for 90 minutes after each meal Provide the client with a feeling of responsibility and control over her behavior 7.) 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: include nitrofurantoin monohydrate/macrocrystals, trimethoprim- sulfamethoxazole (TMP-SMX), or fosfomycin. trimethoprim and sulfamethoxazole 8.) 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 nasal steroids and oral decongestants 9.) A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as: Overweight 10.)Which of the following is not a common early sign of benign prostatic hyperplasia (BPH )? Strong urinary stream flow. 11.)Which of the following accounts for half of the bladder tumors among men and one third in women? Cigarette smoke, both active and passive inhalation 12.)Which of the following set of symptoms should raise suspicion of a brain tumor? Holocranial headaches present in the morning and accompanied by projectile vomiting without nausea 13.)Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to: try neutral position wrist splinting and order an oral NSAID 14.)Which drug category contains the drugs that are the first line Gold standard therapy for COPD? Beta antagonist 15.)Other than smoking cessation, which of the following slows the progression of COPD in smokers? oxygen 16.)Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis? Erythromycin 17.)Central obesity, “moon” face, and dorsocervical fat pad are associated with: Cushings syndrome 18.)What is the most common cause of Cushing’s syndrome? the long-term, high-dose use of the cortisol-like glucocorticoids

D, E, F

29.)The intervention known to be most effective in the treatment of severe depression , with or without psychosis, is: electroconvulsive therapy (ECT). 30.)A 72 year old female patient reports a 6 month history of gradually progressive swollen and painful distal interphalangeal (DIP) joints of one hand. She has no systemic symptoms but the erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), and rheumatoid factor (RF) are all minimally elevated. What is the most likely diagnosis? Osteoarthritis 31.)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: cruciate ligament 32.)A positive drawer sign supports a diagnosis of: Posterior cruciate ligament injury 33.)The initial clinical sign of Dupuytren’s contracture is: Painless nodule on palmer fascia 34.)A 26 year old female presents with elbow pain that is described as aching and burning. There is point tenderness along the lateral aspect of the elbow and painful passive flexion and extension. She reports she has been playing tennis almost daily for the past month. The most likely diagnosis is: lateral epicondylitis (tennis elbow) 35.)Which is the most common cause of end-stage renal disease in the United States? Diabetes 36.)The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is: Ceftriaxone 250 mg IM in a single dose plus. Doxycycline 100 mg orally twice a day for 10 days 37.)A 27 year old female patient with epilepsy is well controlled with phenytoin (Dilantin). She requests information about contraception. The nurse practitioner should instruct her that while taking phenytoin: the effective of an oral contraceptive may be reduced 38.)Martin is complaining of erectile dysfunction. He also has a condition that has reduced arterial blood flow to his penis. The most common cause of this condition is: diabetes mellitus 39.)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? Hypertensive medication such as hydrochlorothiazides, and other DM2 medications 40.)A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the following symptoms would lead you to look for another diagnosis? high fever (102 to 104 degrees F), irregular pulse, accelerated heartbeat (tachycardia), increased rate of respiration (tachypnea), muscle rigidity, altered mental status, autonomic nervous system dysfunction resulting in high or low blood pressure, profuse perspiration, and excessive sweating. called Malignant Hyperthermia” OR Neuroleptic malignant syndrome 41.)Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? Musculosckeletal pain

G, H, I

42.)A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder? benzodiazepines include Xanax, Librium, Valium, and Ativan 43.)Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid? Food that is very hot or very cold. Fatty or fried foods. Peppermint or spearmint, including flavoring Coffee, tea, and soft drinks that contain caffeine. Spicy, highly seasoned foods. Fried food DT caffeine, chocolate and anticholinergics 44.)A 65 year old patient complains of recurrent bilateral temporal headaches, malaise, muscle aches, and low grade fever. The headache is described as superficial tenderness rather than deep pain. Giant cell arteritis is suspected. Appropriate treatment is: refer for temporal artery biopsy and initiation of oral prednisone 45.)Which history is commonly found in a patient with glomerulonephritis? upper respiratory tract infection or a skin infection that was caused by those bacteria 46.)The most reliable diagnostic indicator of gout is: Elevated serum uric acid levels 47.)After treating a patient for Helicobacter pylori infection , what test do you order to see if it has been cured? A urea breath test 48.)A 28-year-old female presents to the office requesting testing for diagnosis of hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her risk factors. The nurse practitioner explains that: B and D (does not always require anticoagulation therapy and genetic and risk management counseling are recommended 49.)A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is: Cryptosporidiosis 50.)A patient with HIV infection has a fever of unknown origin (FUO). Which of the following is a possible cause of FUO in a patient with HIV? drug fever 51.)The diagnosis of human papilloma virus (HPV) infection in males is usually made by: The diagnosis of HPV in men is made when external genital warts are seen. The diagnosis of genital warts is made by examination of the lesions 52.)A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains: Primary hyperparathyroidism is treated with parathyroidectomy 53.)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. 54.)What diabetic complications result from hyperglycemia? Retinopathy 2. Hypertension resistant to treatment 3. Peripheral neuropathy 55.)Potential causes of hypocalcemia include which of the following? Hypoalbuminemia is the most common cause of hypocalcemia. Causes include cirrhosis, nephrosis. hypoparathyroidism, vitamin D deficiency, and renal disease. 56.)Which of the following patients most warrants screening for hypothyroidism? An elderly female with recent onset of mental dysfunction

71.)Diagnostic radiological studies are indicated for low back pain : Pain lasting more than 1 month - Objective radiculopathy - Cauda equina syndrome - Considering "red flag": systemic arthritis, infection, malignancy, trauma, congenital/developmental abnormalities 72.)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? Begin lower back strengthening exercises depending on pain tolerance. M, N, O 73.) Major depression occurs most often in which of the following conditions? Stroke 74.)Which of the following is characteristic of a manic episode? Grandiosity or grandiose delusions 75.)Your patient has an elevated mean cell volume (MCV). What should you be considering in terms of diagnosis? Anemia (pernicious or folic acid anemia) macrocytic Liver disease 76.)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: epicondylitis 77.)Which of the following medications increase the risk for metabolic syndrome? Answer: antihistamines and proton pump inhibitors, diuretics, beta-blockers 78.)Which of the following is a contraindication for metformin therapy? hypersensitity metabolic acidiosis, dehydration, sepsis, hypoxemia, hepatic impairment, renal dysfunction 79.)The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy: to measure albumin in a spot urine sample, collected either as the first urine in the morning or at random, for example, at the medical visit. This method is accurate,:Early morning 80.) Microalbuminuria is a measure of: Urinary excretion of 30-299mg/24 hours of albumin, Expressing albumin and creatinine ratio (ACR) takes the variability into account and normalizes the albumin in a spot specimen 81.)The obligatory criteria for diagnosis of muscular dystrophy (MD) are: Genetic testing to evaluate missing or repeated mutations in the dystrophin gene. A lack of the dystrophin gene can lead to a diagnosis of Duchenne or Becker MD. The test is important not only to confirm the MD diagnosis in males but also to determine whether women with a family history of Duchenne or Becker MD may be carriers 82.)Which of the following is the most common complication of the myelodysplastic syndromes? Bleeding 83.)Who is at a higher risk for developing nephrolithiasis? Bill, who runs every day and takes excessive amounts of vitamin C 84.)The most effective treatment of non-infectious bursitis includes: Conservative treatment includes rest, cold and heat treatments, elevation, administration of nonsteroidal anti- inflammatory drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections. 85.)Which of the following is the most common causative organism of nongonococcal urethritis? Chlamydia trachomatis 86.)A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling

over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects: Olecranon bursitis 87.)What intervention does the American College of Rheumatology recommend as first line therapy for osteoarthritis? Acetaminophen should be used as first-line therapy for mild osteoarthritis. Nonsteroidal anti-inflammatory drugs are superior to acetaminophen for treating moderate to severe osteoarthritis 88.)Establishment of a definitive diagnosis of osteomyelitis requires: Bone biopsy leads to a definitive diagnosis 89.)Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond? "A high caffeine intake has a diuretic effect that may cause calcium to be excreted more rapidly." 90.)Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect? Otitis externa/ swimmer’s ear P, Q, R 91.)What is the first symptom seen in the majority of patients with Parkinson’s disease? Tremor at rest 92.)Which of the following antibiotics should not be prescribed for a pregnant woman in the 3rd trimester? Trimethoprim-sulfamethoxazole 93.) Phalen’s test , 90°wrist flexion for 60 seconds, reproduces symptoms of: carpal tunnel syndrome 94.)Which of the following characteristics are associated with prepatellar bursitis? Repetitive knee trauma 95.)A patient has been taking fluoxetine (Prozac) since being diagnosed with major depression, first episode, 2 months ago. She reports considerable improvement in her symptoms and her intention to discontinue the medication. What should be the nurse practitioner’s recommendation? Answer: Recommend that the patient continue the antidepressant medication for at least 4 more months 96.)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? Post-traumatic stress disorder 97.)The most commonly recommended method for prostate cancer screening in a 55 year old male is: digital rectal exams 98.)Risk factors for prostate cancer include all of the following except: BPH 99.)A 63-year-old man presents to the office with hematuria, hesitancy, and dribbling. Digital rectal exam (DRE) reveals a moderately enlarged prostate that is smooth. The PSA is 1.2. What is the most appropriate management strategy for you to follow at this time? Prescribe an alpha adrenergic blocker. 100.) The organism most often associated with prostatitis is: Escherichia coli 101.) Prolonged PT suggests: Abnormality in extrinsic coagulation pathway, Deficiency of FII, FV, FX, or fibrinogen abnormalities 102.) 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: Include 500 mg of oral ciprofloxacin (Cipro) twice per day for seven days; 1, mg of

117.) Which of the following is a potential acquired cause of thrombophilia? Antiphospholipid antibodies 118.) A 28-year-old female presents to the office requesting testing for diagnosis of hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her risk factors. The nurse practitioner explains that: B and D (does not always require anticoagulation therapy and genetic and risk management counseling are recommended 119.) The most common symptoms of transient ischemic attack (TIA) include: Common symptoms are sudden and transient, and include unilateral paresis, speech disturbance, and monocular blindness. clinical symptoms typically lasting less than one hour, and without evidence of infarction on imaging 120.) 121.) The most common presentation of thyroid cancer is: is an asymptomatic thyroid mass or a nodule that can be felt in the neck. 122.) A 14 year old female cheerleader reports gradual and progressive dull anterior knee pain, exacerbated by kneeling. The nurse practitioner notes swelling and point tenderness at the tibial tuberosity. X-ray is negative. What is the most likely diagnosis? prepatellar bursitis? 123.) Diagnostic evaluation for urinary calculi includes: Diagnosis is based on urinalysis and radiologic imaging, usually noncontrast helical CT. 124.) A 21-year-old female presents to the office complaining of urinary frequency and urinary burning. The nurse practitioner suspects a urinary tract infection when the urinalysis reveals 10WBC/HPF. V, W, X, Y, Z 125.) The diagnosis which must be considered in a patient who presents with a severe headache of sudden onset, with neck stiffness and fever, is: viral meningitis 126.) A middle-aged female presents complaining of recent weight loss. The physical exam reveals an enlarged painless cervical lymph node. The differential diagnosis for this patient’s problem includes: Answer: infection 127.) The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in almost 100% of patients is: cafe au lait spots. Misc 128.) What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare? The physician must be on-site and engaged in patient care. 129.) A 30 year old female patient presents to the clinic with heat intolerance, tremors, nervousness, and weight loss inconsistent with increased appetite. Which test would be most likely to confirm the suspected diagnosis? TSH. We also assess free thyroid hormone (FT4) and at times T

A Trauma . B Tight shoes . C Arthritis flare

- Question^2

1 out of 1 points

A Metabolic syndrome . B Unilateral . pheochromocytoma C Cushing’s syndrome . D None of the above .

- Question^3

1 out of 1 points

130.) A 72 year old patient exhibits sudden onset of fluctuating restlessness, agitation, confusion, and impaired attention. This is accompanied by visual hallucinations and sleep disturbance. What is the most likely cause of this behavior? Delirium 131.) 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? stage 2 hypertension (lifestyle change, and medication 132.) How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout? 20 3x per week

NRNP 6531 Final Exam

Central obesity, “moon” face, and dorsocervical fat pad are associated with: An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days later, he returns to the office complaining of left great toe pain. On exam, the nurse practitioner notes an edematous, erythematous tender left great toe. The likely precipitant of this patient’s pain is: The most effective treatment of non-infectious bursitis includes: Conservative treatment

- Question^9

1 out of 1 points

- Question^10

1 out of 1 points

- Question^11

1 out of 1 points

- Question^12

1 out of 1 points

reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid? Food that is very hot or very cold Fatty or fried foods Peppermint or spearmint, including flavoring Coffee, tea, and soft drinks that contain caffeine Spicy, highly seasoned foods

Fried food DT caffeine, chocolate and anticholinergics

Which drug category contains the drugs that are the first line Gold standard therapy for COPD? Beta antagonist The most commonly recommended pharmacological treatment regimen for low back pain (LBP) is: Nsaid Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis? Erythromycin 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? .A Obtain a thorough history and physical, and check serum cortisol and ACTH levels. B. Perform a diet history and check CBC and FBS.

- Question^16

1 out of 1 points

- Question^17

1 out of 1 points

- Question^19

1 out of 1 points

- Question^21

1 out of 1 points

C. Provide nutritional guidance and have the patient return in one month. D. Consult home health for intravenous administration 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: he A. lateral meniscus B. cruciate ligament C. medial meniscus D. collateral ligament. 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: Include 500 mg of oral ciprofloxacin ( Cipro ) twice per day for seven days; 1,000 mg of extended-release ciprofloxacin once per day for seven days; or 750 mg of levofloxacin ( Levaquin ) once per day for five days. 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: epicondylitis

A Lumbar disc disease . B Spinal stenosis . C Traumatic fracture . A Arthritis . B Ulnar neuritis . C Septic arthritis . D Olecranon bursitis

- Question^30

1 out of 1 points

- Question^31

1 out of 1 points

Which of the following is the most common cause of low back pain? Which is the most common cause of end-stage renal disease in the United States? Diabetes A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects:

1 out of 1 points

**- Question 38

• Question**^32

1 out of 1 points

- Question^33

1 out of 1 points

- Question^35

1 out of 1 points

- Question^37

1 out of 1 points

A 60 year old female patient complains of sudden onset unilateral, stabbing, surface pain in the lower part of her face lasting a few minutes, subsiding, and then returning. The pain is triggered by touch or temperature extremes. Physical examination is normal. Which of the following is the most likely diagnosis? A. fibromyligia or neuro something Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within normal limits. Which of the following diagnoses do you explore further? Arthritis, C

**- Question 34

• D**

1 out of 1 points

A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the following symptoms would lead you to look for another diagnosis?

high fever (102 to 104 degrees F), irregular pulse, accelerated heartbeat (tachycardia),

increased rate of respiration (tachypnea), muscle rigidity, altered mental status, autonomic

nervous system dysfunction resulting in high or low blood pressure, profuse perspiration, and

excessive sweating. called Malignant Hyperthermia” OR Neuroleptic malignant syndrome

hallucinations. Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of: carpal tunnel syndrome The most common cause of elevated liver function tests is: alcohol

- Question^44

1 out of 1 points

- Question^46

1 out of 1 points

and history of a palpable lump in his scrotum that “comes and goes”. On physical examination, the nurse practitioner does not detect a scrotal mass. There is no tenderness, edema, or erythema of the scrotum, the scrotum does not transilluminate. What is the most likely diagnosis? A. Testicular torsion B. Epididymitis C. Inguinal hernia D. Varicocele 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?

A. Prescribe nasal steroids and oral decongestants

B. Prescribe antibiotic eardrops

C. Prescribe systemic eardrops

D. Refer David to an ear, nose, and throat specialist

A. Prescribe

The physiological explanation of syncope is: Syncope is a transient loss of consciousness (TLOC) due to global cerebral hypoperfusion characterized by rapid onset, short duration and spontaneous complete recovery.

- Question^47

1 out of 1 points