NRNP 6531 Midterm Exam: Practice Questions and Answers for Nurse Practitioners, Exams of Nursing

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NRNP 6531 Midterm Exam /

NRNP6531 Midterm Exam / NRNP

6531 Week 6 Midterm Exam /

NRNP6531 Week 6 Midterm

Exam(3 Versions each 100 Q &

A):Walden university

B.

No a. It^ assesses^ numeracy^ skills. It enhances patient–provider b. communication.

*c It evaluates medical word

recognition.

d.

It measures technology knowledge.

*a Bonuses based on achievement of

benchmarks Care coordination for chronic diseases Standards for minimum cash reserves Strict requirements for financial reporting NRNP 6531 Midterm Exam Angie is a new NP who just finished her FNP program. She is having a difficult time finding an FNP position in the rural area where she lives. So, since she was an ER nurse prior to her graduate program she decides to go back to the ER as an APRN. Does she meet the competency requirements for such a position?

*A

Ye

s What is the main reason for using the REALM-SF instrument to evaluate health literacy? A small, rural hospital is part of an Accountable Care Organization (ACO) and is designated as a Level 1 ACO. What is part of this designation? Question 4 The Consensus Model identifies 3 core courses that all ANPs must take. All the following are Advanced core courses except:

*A Public Health

B. Physiology C. Pharmacolo gy Physical D. Assessment The care provided by APRNs is not limited by setting but by patient care needs.

*True

*Tru

e

*Tru

e

Apply a thick layer of medication over the affected

a. area.

A solution spray preparation will be more effective on

b. hairy^ areas.

*E All the

Above A, B & C

F. only

When assisting with a skin biopsy of a patient suspected of having bullous pemphigoid (BP) lesions, what will the p Punch biopsy Shave biopsy Wide excision biopsy

*a Excisional

Rules proposed by the various State Boards of Nursing must be approved by the state Legislatures. In reviewing the Total Percentage of Body surface area for adult burn patients each, leg, arm and head are noted evaluated at 9%. What is the initial approach when obtaining a biopsy of a potential malignant melanoma lesion? a. Avoid^ contact^ with^ the^ infected^ lesions. Elicit a positive Nikolsky sign to confirm the b. diagnosis.

*c

Perform direct immunofluorescence

microscopy. Prevent spread of the lesions to other areas of

d. the^ skin.

When recommending an over-the-counter topical medication to treat a dermatologic condition, which instruction to the patient is important to enhance absorption of the drug?

*Tru

e

*Tru

e

*Tru

e

a.

Clean and dress the burn wounds.

*b Order a CBC, glucose, and electrolytes.

c.

Perform a chest radiograph. Refer the patient to the emergency

d. department^ (ED).

*c Put cool compresses over the affected area after

application. Use a lotion or cream instead of an ointment

d. preparation.

A progesterone-only contraceptive is most beneficial for treating acne. Combined oral contraceptives are effective for non-inflammatory acne only. Oral contraceptives are effective because of their androgen enhancing effects.

*d Yaz, Ortho Tri-Cyclen, and Estrostep, are approved for acne

treatment. Carbuncles are typically treated with systemic antibiotics. Mild acne is treated only with topicals. Steroids should be avoided in cases of suspected fungal etiology. A patient comes to the clinic after being splashed with boiling water while cooking. The patient has partial thickness burns on both forearms, the neck, and the chin. What will the provider do? A provider is considering an oral contraceptive medication to treat acne in an adolescent female. Which is an important consideration when prescribing this drug? Ashley a 24 y/o female comes to the clinic with the following chief complaint: “I have these reddish/purple raised patches all over my skin. On physical exam the NP notes that the lesions are erythematous with discrete borders that are irregular, oval or round. The most likely diagnosis based on the physical exam is:

A. Nevi Acanthosis B. Nigricans

* Acrochordon

C.

D.

Cherry Angioma

*A First degree

burn Second degree

B. burn

Third degree

C. burn

Fourth degree

D. burn

keratoses

*B Urticaria

C.

Xanthelasma

D.

Melasma The most common type of melanoma in African Americans and Asians is: A. Basal^ Cell^ carcinoma B. Actinic^ Keratosis

Acral Lentiginous C. Melanoma Toxic Epidermal D. Necrolysis Olga was making French fries for her kids and gets splashed with hot oil. At the clinic the NP notes that she has red colored skin with superficial blisters and pain where the oil splashed. The most likely diagnosis is: Patty comes to the clinic with these soft fatty cystic lesions on her neck, trunk and arms. The most likely diagnosis is: During a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient’s nose. What will the provider do?

Consult with a dermatologist about possible melanoma. Reassure the patient that this is a benign lesion.

*c Refer the patient for possible electrodessication and

curettage. Tell the patient this is likely a squamous cell

d. carcinoma.

During an eye examination, the provider notes a red-light reflex in one eye but not the other. What is the significanc

C. Penicillin

Azithromyci

D. n

Amoxicillin Doxycycline Oral Consider prescribing a topical mast cell

a. stabilizer.

*b Determine the duration of treatment with this

medication.

c. Prescribe a non-sedating oral antihistamine.

d. Refer the patient to an ophthalmologist for

Mikey is a 19 y/o male who is brought to the clinic because he has a fever, sore throat, pain on swallowing and mildly enlarged submandibular nodes First line pharmacological treatment for Mikey would include:

a.

Normal physiologic variant

*b

Ocular disease requiring

referral Potential infection in the

c. “red”^ eye

Potential vision loss in one

d. eye

A patient diagnosed with allergic conjunctivitis and prescribed a topical antihistamine- vasoconstrictor medication reports worsening symptoms. What is the provider’s next step in managing this patient’s symptoms?

A.

Lateralization to the good ear

*B Lateralization to the bad ear

Lateralization would be equal to

C. either^ ear.

*a

Allergic

Bacteri

b. al

Chemic

c. al

*a Aqueous

deficiency

b. Corneal abrasion Evaporative

c. disorder

Poor eyelid

d. closure

Bacteremic spread from remote infections Inoculation from local trauma or bug bites

*c Local spread from the ethmoid

sinus

d. Paranasal sinus inoculation

Audrey is a 16 y/o female who comes to the clinic because her teacher says that she is having a hard time hearing in class. The NP examines her ears and notes that she has otitis media. If the NP performed a Weber test on Audrey she would discover that there would be: A patient experiencing chronically dry eyes reports having a foreign body sensation, burning, and itching. A Schirmer test is abnormal. What is the suspected cause of this patient’s symptoms based on this test finding? Which is the most common cause of orbital cellulitis in all age groups? A patient reports bilateral burning and itching eyes for several days. The provider notes a boggy appearance to the conjunctivae, along with clear, watery discharge. The patient’s eyelids are thickened and discolored. There are no other symptoms. Which type of conjunctivitis is most likely?

*Tru

e

Good hand

A. washing

B. Adequate rest

C. Zinc Lozenges

*D All the above

E.

A & B only Artificial tear drops are contraindicated. Spontaneous bleeding is likely.

*c UVB eye protection is especially

important. Visine may be used for symptomatic

d. relief.

*a Asymmetric red

reflex Corneal

b. opacification

c. Excessive tearing

Injection of

d. conjunctiva

d.

Viral A retinal detachment would be identified by a shower of floaters with the addition of sudden flashes of light. A patient has an elevated, yellowish-white lesion adjacent to the cornea at the 3 o’clock position of the right eye. The provider notes pinkish inflammation with dilated blood vessels surrounding the lesion. What information will the provider provide the patient about this lesion? A primary care provider may suspect cataract formation in a patient with which finding? Aaron an 18 y/o male comes to the clinic with the following symptoms: nasal stuffiness, sneezing, scratchy irritated throat and hoarseness. He also complains of a low-grade fever and a cough that he has had for the past 4 days. Prevention of Aaron’s condition would include which of the following:

According to the JNC 8 guidelines the hypertension treatment goal for patients 60 years and younger should be:

Anagen effluvium Cicatricial alopecia Telogen effluvium Add a beta blocker to the patient’s

A. regimen.

*B Admit to the hospital for evaluation and

treatment. Increase the dose of the thiazide

C. medication.

D. Prescribe a calcium channel blocker.

Admit the patient to the hospital for evaluation and

a. treatment.

*b Consult with the cardiologist to determine appropriate

diagnostic tests.

c. Continue to monitor the patient every 3 years.

An African-American patient who is being treated with a thiazide diuretic for chronic hypertension reports blurred vision and shortness of breath. The provider notes a blood pressure of 185/115. What is the recommended action for this patient? A young adult patient is diagnosed with a mitral valve prolapse. During a routine 3-year health maintenance exam, the provider notes an apical systolic murmur and a mid- systolic click on auscultation. The patient denies chest pain, syncope, or palpitations. What action will the provider take?

Autoimmune

a. disorder

b. Bacterial infection

c. Protozoal

infection

*d Viral infection

a. Daily^ aspirin^ therapy^ to^ prevent clotting b. Statin therapy with clopidogrel Walking slowly for 15 to 20 minutes c. twice^ daily

*d Walking to the point of pain each day

*Tru

e

*Tru

e

True

* False

A. Normal

*B Prehypertensi

d.

Reassure the patient that these findings are expected. A previously healthy patient presents with sudden onset of dyspnea, fatigue, and orthopnea. A family history is negative. The provider suspects myocarditis. What is the most likely etiology for this patient? A patient is diagnosed with peripheral arterial disease (PAD) and elects not to have angioplasty after an angiogram reveals partial obstruction in lower extremity arteries. What will the provider recommend to help manage this patient’s symptoms? A split S2 is best heard at the upper left sternum. In coarctation of the aorta the BP of the arms is higher than the BP of the legs. Pulsus paradoxus is a phenomenon in which the radial pulse can be palpated even though the apical pulse can’t be heard. Juan is a known patient to the NP. He comes in for his quarterly check on his blood pressure. His blood pressure is 125/85. According to JNC 8 his BP falls into the category of:

a. Exercise^ is^ contraindicated^ for^ life. Exercise may resume when symptoms b. subside.

*c He may resume exercise in 6

months.

d.

He must be symptom-free for 1 year.

*a Echocardiogram

b. Electrocardiogram c. Endomyocardial biopsy Magnetic resonance d. imaging Dorsiflexion of the foot that produces lower leg pain is termed Homan’s Sign.

*True False

surgical consult.

Order a CBC, type and crossmatch, electrolytes, and renal function tests. Perform an ultrasound examination to evaluate the cause. Schedule the patient for an aortic angiogram.

*d Transfer the patient to the emergency department for a

*A CHF

Left Ventricular Hypertrophy

B. (LVH)

C. Right sided heart failure

D. None of the above

A patient who is an avid long-distant runner is diagnosed with viral myocarditis. What will the provider tell this patient when asked when resuming exercising is permitted? A patient is in clinic for evaluation of sudden onset of abdominal pain. The provider palpates a pulsatile, painful mass between the xiphoid process and the umbilicus. What is the initial action? Which test is diagnostic for diagnosing myocarditis? Patients with hypertensive retinopathy will have all of the following except:

Vitami n A Vitami n C *Vitamin K Vitami n D

*A Bronchitis

Copper wire arterioles Silver wire arterioles Atriovenous nicking

*D Optic disc with blurred

margins Cotton wool spots Silver wire vessels

* Retinal

C. hemorrhages

D. A & B only

Guy is a 65 y/o male who comes to the clinic with the following chief complaint: “I have been feeling feverish, have chills, and am tired all the time. My heart also makes a funny sound. In the physical exam the NP auscultates a heart murmur, and notices that he patient has subungual hemorrhages, petechiae on the palate, violet colored nodes on the fingers and feet, and nontender red nodes on the palms and soles of his feet. In a patient with Guy’s diagnosis, on funduscopic exam one might see: Ashley is a 47 y/o female who comes to the clinic with a chief complaint of sudden onset of palpitations and a feeling of weakness and dizziness. Additionally she notes that she has dyspnea on exertion. On the physical exam the NP notes that he HR is 120 bpm and her BP drops to 98/60. Her EKG shows no discrete p waves and irregularly irregular rhythm. If Ashley were to start bleeding she would go to the ER and they would initiate which intervention below to reverse the effects of her warfarin: Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some rhinitis and low-grade fever. His likely diagnosis is:

a. Chest^ radiograph b. Complete^ blood count Computerized c. tomography

*d Spirometry

Albuterol Salmeterol Levalbuterol

*D metaprotere

nol Surgical resection will improve survival chances

a. dramatically.

*b That relapse is likely with a 2-year overall survival

of 50%.

c. There is an 80% chance of 5-year survival.

d. Treatment will proceed with curative intent.

disease

c.

Gastroesophageal reflux disease

d.

A youngPsychogenic adult patient cough without a previous history of lung disease has an increased respiratory rate and reports a feeling of “not getting enough air.” The provider auscultates clear breath sounds and notes no signs of increased respiratory effort. Which diagnostic test will the provider perform initially? Martin is a 73 y/o male who has a 50 year/pack history of smoking and comes to the clinic for his annual physical. As you are leading him back to the exam room you note that he has dyspnea with minimal cough, a barrel chest, and appears to have lost weight since his last visit. Your physical exam confirms a 20 lb. weight loss, and a more noticeable pursed lip breathing. Given Martin’s condition the first line treatment would be all the following except: A patient with limited stage small cell lung cancer (SCLC) has undergone chemotherapy with a good initial response to therapy. What will the provider tell this patient about the prognosis for treating this disease? Which test is the most diagnostic for chronic obstructive pulmonary disease (COPD)?

a. COPD^ Assessment^ Test

A. Rest B. Mucolytics

* Antibiotics

C.

Increased fluid

D. intake.

Forced expiratory time

b. maneuver

c. Lung radiograph

*d Spirometry for FVC and

FEV

a. Damage to the alveolar wall

*b Destruction of alveolar

architecture Mild alteration in lung tissue

c. compliance

Mismatch of ventilation and

d. perfusion

*a Ipratropium

bromide

b. Pirbuterol acetate Salmeterol

c. xinafoate

d. Theophylline

Mike is a 22 y/o male who comes to your clinic with a 5-day history of cough without sputum production. He states that his cough is worse in the morning and he has some hoarseness, post-nasal drip and a low- grade fever. Mike has otherwise been healthy Treatment for Mike’s condition would include all the following except: Which is characteristic of obstructive bronchitis and not emphysema? A patient diagnosed with chronic obstructive pulmonary disease reports daily symptoms of dyspnea and cough. Which medication will the primary health care provider prescribe? A young adult patient develops a cough persisting longer than 2 months. The provider prescribes pulmonary function tests and a chest radiograph, which are normal. The patient