NU623 Final Exam 100 percent accurate

1.Which of the following is part of the treatment plan for the patient with IBS?
A. High-fiber diet
B. A discussion that the goal of treatment is to cure their disease
C. Daily laxatives
D. A conversation about their expected shorter life span

2.A 62 year old man with a body mass index (BMI) of 30 and a history of asthma has hypertension that has been well controlled with hydrochlorothiazide 12.5 mg PO daily. His total cholesterol is 230 g/dL. How many risk factors for coronary artery disease (CAD) does he have?

One risk factor

Two risk factors

Three risk factors

Four risk factors

3. A patient presents to the emergency department with delirium, dilated pupils bilaterally, and hypoactive bowel sounds. Skin is flushed and dry; mucous membranes are dry. Upon admission, a urinary catheter was inserted with no output. These clinical manifestations describe which common toxidrome?

Cholinergic

Sedative-hypnotic

Anticholinergic

Sympathomimetic

4. If no clinical decompensation is noted when evaluating a poisoned patient, what should you do next?

Evaluate for signs of trauma and central nervous system involvement.

Evaluate the airway, breathing, and circulation.

Order a basic metabolic panel and liver function test panel.

Obtain a urine sample for a toxicology screen

 

5. Which of the following is an accurate description of eliciting Murphy’s sign?

One deep inspiration by the patient, palpate firmly in the right upper quadrant of the abdomen below the costovertebral angle.

Bend the patient’s hips and knees at 90 degrees, then passively rotate the hip externally, and internally

Ask the patient to squat, then place the stethoscope on the apical area

Press into the abdomen deeply, then release it suddenly

 

6. What percentage of burns is involved using the rule of nines if both front legs are burned?

9%

18%

24%

36%

 

7. A patient presents to the clinician with a sore throat, fever of 100.7, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?

The patient should be instructed to rest and increase fluid intake, as the infection is most likely viral and will resolve without antibiotic treatment.

Because the patient does not have strep throat, the clinician should start broad-spectrum antibiotics in order to cover the offending pathogen.

A throat culture should be performed to confirm the results of the rapid strep test.

The patient should be treated with antibiotics for strep throat, as the rapid strep test is not very sensitive.

 

8. Which of the following characteristics applies to type 1 diabetes mellitus?

Which of the following characteristics applies to type 1 diabetes mellitus?

Significant hyperglycemia and ketoacidosis resulting from lack of insulin

This condition is commonly diagnosed on routine examination or workup for other health problems

Initial response to oral sulfonylureas is usually favorable

Insulin resistance is a significant part of the disease

 

9. Rovsing’s sign is associated with which of the following?

An acute abdomen, such as during a ruptured appendix

Knee instability

Damage to the meniscus of the knee

Acute cholelithiasis

 

10. A fixed, painless thyroid mass accompanied by hoarseness and dysphagia should raise the suspicion of:

Adenomatous lesion

Graves’ disease

Hasimoto’s disease

Thyroid malignancy

11. Which of the following is the least helpful test for the assessment of thyroid disease?

Total T4

Thyroid-stimulating hormone (TSH)

Free T4

Thyroid peroxidase (TP) antibodies

 

12. Which of the following is a sign or symptom of a migraine?

Light sensitivity

Nonpulsatile pain

Nasal stuffiness

Bandlike pain

 

13. Which of the following patients is a best candidate for statins?

Jerry is a 55-year-old male with a history of syncope.

Christa is a 61-year-old female with a history of myocardial infarction (MI).

Manny is a 49-year-old male with a 10-year cardiovascular risk of 6.5%.

April is a 38-year-old female with a low-density lipoprotein (LDL) level of 150.

 

14. The most commonly recommended treatment of Cushing’s disease is:

Tapering or ceasing corticosteroid use.

Eliminating trigger medications

Antineoplastic therapy

Surgical intervention

 

15. Cilostazol (Pletal) should be used with great caution in the presence of which of the following diagnosis?

Diabetes mellitus

Heart failure

Hypertension

dyslipidemia

 

16. Which solution should be used when irrigating lacerated tissue over a wound on the arm?

Dilute povidone-iodine solution

Hydrogen peroxide (H₂O₂)

Saline solution infused with an antibiotic

Saline irrigation or soapy water

 

 

17. If a suspected pneumothorax is discovered in the primary-care setting, what should happen first?

Emergency medical services should be activated.

Support cardiovascular and respiratory status as needed.

Administer supplemental oxygen to reabsorb the pneumothorax.

Initiate stabilizing treatments, including emergency chest-tube placement.

 

18. Which condition is characterized by the impaired ability to learn new information along with a cognitive disturbance in either language, function, or perception?

Guillain-Barré syndrome

Parkinson’s disease

Alzheimer’s disease

Delirium

 

19. Willow is a 67-year-old female and her bone mineral density is more than 1 SD below the young adult reference mean. What is her diagnosis?

Normal bone mineral density

Osteopenia

Osteoporosis

Severe osteoporosis

 

20. A patient presents to the office with a few blisters on one arm and on the face.  The patient complains of itching the affected areas.  Some of the lesions have ruptured with yellow serous fluid that crusts easily.  This best describes:

Acute cellulitis

Herpes zoster

Bullous impetigo

Erysipelas

 

21. Connie is a 63-year-old seamstress who presents with pain at the base of her right thumb on abduction and extension of her right thumb. She also complains of pain on the radial side of her right wrist with lifting. Which of these diagnostic tests will help to determine if she has de Quervain’s tenosynovitis?

Allen’s test

Phalen’s maneuver

Tinel’s sign

Finkelstein’s test

 

 

22. You examine a 60 year old man with dilated cardiomyopathy and heart failure.  On examination, you expect to find all of the following except:

Juglar venous distention.

Tenderness on right upper-abdominal quadrant palpation.

Point of maximal impulse at the fifth intercostal space, mid-clavicular line.

Peripheral edema.

 

23. A patient is 66 inches in height, weighing 200 lbs, and newly diagnosed with type 2 diabetes mellitus (DM). The A1c is 7.1%. What is the best initial treatment?

No treatment at this time

Diet and exercise

Diet, exercise, and metformin

Diet, exercise, and exogenous insulin

 

24. A young man reports feeling something on his left scrotum.  On palpation, soft and moveable blood vessels that feel like a “bag of worms” are noted underneath the scrotal skin.  The testicle is not swollen or reddened.  The most likely diagnosis is:

Chronic orchitis

Chronic epididymitis

Testicular torsion

Varicocele

 

25. You have diagnosed a 30 year old male with contact dermatitis on the left side of the face secondary to poison ivy.  You would recommend:

Washing with antibacterial soap BID to reduce risk of secondary bacterial infection until it is healed.

Hydrocortisone cream 1% BID until it is healed

Clotrimazole (Lotrimin) cream BID for 2 weeks

Halcinonide (Halog) 1% ointment BID for 2 weeks

 

26. Which urinalysis (UA) findings suggest a urinary tract infection (UTI)?

Protein only

Alkaline pH and positive nitrite and leukocyte esterase

Hematuria and pyuria only

Red color without presence of red blood cells (RBCs)

 

27. Treatment options for bursitis usually include all of the following except:

Treatment options for bursitis usually include all of the following except:

Corticosteroid bursal injection

Heat to area

Weight bearing exercises

Nonsteroidal anti-inflammatory drugs (NSAIDs)

 

28. Intervention in anemia of chronic disease most often includes:

Intervention in anemia of chronic disease most often includes:

Oral vitamin B12

Treatment of the underlying cause

Transfusion

Parenteral iron

 

29. What number represents normal neurological function on the Glasgow Coma Scale?

7

9

10

15

 

30. A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting of a joint, is more likely related to which musculoskeletal injury?

A sprain

A strain

A partial fracture

A fracture

 

 

31. A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?

NSAIDs

Rhubarb

Vitamin A

Red meat

 

32. A 60 year old man with open angle glaucoma is prescribed Timolol (Timoptic) ophthalmic drops.  All of the following are contraindications to Timolol ophthalmic drops except:

Overt heart failure or sinus bradycardia

History of asthma

Second-or third degree atrioventricular (AV) block

Migraine headaches

 

33. You examine a 29 year old woman who has a sudden onset of right-sided facial asymmetry.  She is unable to close her right eyelid tightly, frown, or smile on the affected side.  Her examination is otherwise unremarkable.  This presentation likely represents paralysis of cranial nerve:

III

IV

VII

VIII

 

34. A 52 year old woman is diagnosed with mild diverticulitis.  In addition to counseling her about increased fluid intake and adequate rest, you recommend antimicrobial treatment with:

Amoxicillin with clarithromycin

Linezolid with daptomycin

Trimethoprim/sulfamethoxazole with metronidazole

Nitrofurantoin with doxycycline

 

35. A patient presents complaining of chest discomfort, with a heaviness in the center of the chest that is precipitated by exercise and relieved by rest.  The patient’s symptoms are highly suggestive of what condition?

Angina pectoris

Acute myocardial infarction

Gastroesophageal reflux disease

Acute costochondritis

 

36. An 18 year old college freshman is brought to the student health center with a chief complaint of a 3 day history of progressive headache and intermittent fever.  On physical examination, he has positive Kernigh and Brudzinski sign.  The most likely diagnosis is:

Vial excephalitis

Bacterial meningitis

Acute subarachnoid hemorrhage

Epidural hematoma

 

37. You see a woman who has been sexually involved without condom use with a man newly diagnosed with acute hepatitis B.  She has not received hepatitis B immunization.  You advise her to:

Start hepatitis immunization series

Limit the number of sexual partners

Be tested for HBsAB

Receive hepatitis B immune globulin and start hepatitis B immunization series

 

38. What is the essential feature of bipolar-I?

Hyperactivity

Mania

Depression

Anxiety

 

39. An immigrant who is from Southeast Asia has an 11.5-mm area of redness and induration on his left forearm after getting a Mantoux test 72 hours ago.  The last test, which was done 12 months ago, was negative.  He has had a cough but denies night sweats and weight loss.  What is the next best intervention?

Obtain a combination of a chest x-ray and a sputum culture

Obtain a chest x-ray

Obtain a sputum sample for culture and sensitivity (C&S) and an acid-fast stain

Obtain a complete blood count (CBC)

 

40. The clinician has instructed Sirius, a 23-year-old patient with cervical muscle strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching about the use of NSAIDs?

“You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.”

“You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication.”

“You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.”

“It is important to take NSAIDs on an empty stomach in order to increase absorption.”

 

41. The cornerstone of moderate persistent asthma drug therapy is the use of:

Oral theophylline

Mast cell stabilizers

Short-acting beta²-agonists (SABA)

Inhaled corticosteroids

 

42. In which type of atrioventricular (AV) block does the pulse rate (PR) interval lengthen until a beat is dropped?

First-degree AV block

Second-degree Mobitz I AV block

Second-degree Mobitz II AV block

Third-degree AV block

 

43. A 40 year old woman comes to the medical office complaining of palpitations and some light-headedness for the past 6 months.  These are random episodes.  The nurse practitioner notices a mid-systolic click with a late systolic murmur that is best heard in the apical area during auscultation of the chest.  You would suspect:

Atrial fibrillation

Sinus arrhythmia

Mitral stenosis

Mitral valve prolapse

 

44. Delayed serum sickness–type reactions in response to multiple bee, wasp, or fire-ant stings can be managed with which of the following?

A corticosteroid such as prednisone (Deltasone), 60 to 100 mg, tapered over 2 weeks

An oral antihistamine, such as hydroxyzine, for 2 weeks

An H2 blocker such as cimetidine for 1 week

0.1 mg (1 mL of 1:10,000 solution epinephrine) in 10 mL of normal saline and administer as a slow IV push over 10 minutes

 

45. A 49 year old man presents with a skin lesion suspicious for malignant melanoma.  You describe the lesion as having:

Deep black-brown coloring throughout

Sharp borders

A diameter of 3 mm or less

Variable pigmentation

 

46. The nurse practitioner understands that finding Heberden’s nodes on physical examination of a client is a cardinal sign of:

Septic arthritis

Rheumatoid arthritis

Gouty arthritis

Osteoarthritis

 

47. Which type of heat-related illness involves a core body temperature of at least 104°F and may present with hot dry skin, acute mental status changes, absent sweat, and tachypnea?

Heat cramps

Heat syncope

Heat exhaustion

Heat stroke

 

48. Which of the following antihypertensive medications should the nurse practitioner avoid when treating patients with emphysema?

Calcium channel blockers

Angiotensin-converting enzyme (ACE) inhibitors

Beta-blockers

Diuretics

 

49. Billy presents with edematous and erythematous lid margins and closer visual inspection with a Wood’s lamp reveals scaling. Which of the following conditions could be the diagnosis?  He should stop smoking today.

Hordeolum

Chalazion

Blepharitis

Iritis

 

50. What condition is characterized by a brief loss of consciousness, then a brief “lucid” moment, followed by momentary unconsciousness minutes after the injury?

Concussive hematoma

Bleeding dyscrasias

Subdural hematoma

Epidural hematoma

Solution: NU623 Final Exam

 

1.Which of the following is part of the treatment plan for the patient with IBS?
A. High-fiber diet
B. A discussion that the goal of treatment is to cure their disease
C. Daily laxatives
D. A conversation about their expected shorter life span

2.A 62 year old man with a body mass index (BMI) of 30 and a history of asthma has hypertension that has been well controlled with hydrochlorothiazide 12.5 mg PO daily. His total cholesterol is 230 g/dL. How many risk factors for coronary artery disease (CAD) does he have?

One risk factor

Two risk factors

Three risk factors

Four risk factors

3. A patient presents to the emergency department with delirium, dilated pupils bilaterally, and hypoactive bowel sounds. Skin is flushed and dry; mucous membranes are dry. Upon admission, a urinary catheter was inserted with no output. These clinical manifestations describe which common toxidrome?

Cholinergic

Sedative-hypnotic

Anticholinergic

Sympathomimetic

4. If no clinical decompensation is noted when evaluating a poisoned patient, what should you do next?

Evaluate for signs of trauma and central nervous system involvement.

Evaluate the airway, breathing, and circulation.

Order a basic metabolic panel and liver function test panel.

Obtain a urine sample for a toxicology screen

 

5. Which of the following is an accurate description of eliciting Murphy’s sign?

One deep inspiration by the patient, palpate firmly in the right upper quadrant of the abdomen below the costovertebral angle.

Bend the patient’s hips and knees at 90 degrees, then passively rotate the hip externally, and internally

Ask the patient to squat, then place the stethoscope on the apical area

Press into the abdomen deeply, then release it suddenly

 

6. What percentage of burns is involved using the rule of nines if both front legs are burned?

9%

18%

24%

36%

 

7. A patient presents to the clinician with a sore throat, fever of 100.7, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?

The patient should be instructed to rest and increase fluid intake, as the infection is most likely viral and will resolve without antibiotic treatment.

Because the patient does not have strep throat, the clinician should start broad-spectrum antibiotics in order to cover the offending pathogen.

A throat culture should be performed to confirm the results of the rapid strep test.

The patient should be treated with antibiotics for strep throat, as the rapid strep test is not very sensitive.

 

8. Which of the following characteristics applies to type 1 diabetes mellitus?

Significant hyperglycemia and ketoacidosis resulting from lack of insulin

This condition is commonly diagnosed on routine examination or workup for other health problems

Initial response to oral sulfonylureas is usually favorable

Insulin resistance is a significant part of the disease

 

9. Rovsing’s sign is associated with which of the following?

An acute abdomen, such as during a ruptured appendix

Knee instability

Damage to the meniscus of the knee

Acute cholelithiasis

 

10. A fixed, painless thyroid mass accompanied by hoarseness and dysphagia should raise the suspicion of:

Adenomatous lesion

Graves’ disease

Hasimoto’s disease

Thyroid malignancy

 

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Related:(Solution) NU623 Week 16 Discussion 

 

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