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NURS 6531 / NURS6531 Final Exam

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Question 2.   Which of the following is a potential acquired cause of thrombophilia?

 

Homocysteinuria
 

 

Protein C deficiency
 

 

Factor V Leiden
 

 

Antiphospholipid antibodies

Question 3

Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of:

 

Ulnar tunnel syndrome
 

 

Carpal tunnel syndrome
 

 

Tarsal tunnel syndrome
 

 

Myofascial pain syndrome

Question 4

Which patient would benefit most from screening for type 2 diabetes?

 

A 30 year old female with unintended weight loss.
 

 

A 25 year old male with family history of type 1 diabetes 
 

 

An obese female with recurrent vaginitis
 

 

A 50 year old hyperlipidemic male

Question 5

 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?

 

Rheumatoid arthritis (RA)
 

 

Osteoarthritis (OA) 
 

 

Lupus
 

 

Peripheral neuropathy

Question 6

 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:

 

Trimethoprim-sulfamethoxazole for 3 days
 

 

Ciprofloxacin for 7-10 days
 

 

Trimethoprim-sulfamethoxazole for 14 days
 

 

Ciprofloxacin for 3 days

A thymectomy is usually recommended in the early treatment of which disease?

 

  Parkinson’s disease
 

 

Multiple sclerosis
 

 

  Myasthenia gravis
 

 

Huntington’s chorea

Question 8

The diagnosis of human papilloma virus (HPV) infection in males is usually made by:

 

Clinical appearance
 

 

Viral culture
 

 

Tzanck smear
 

 

KOH prep

Question 9

The most effective intervention(s) to prevent stroke is (are):

 

81 mg of aspirin daily
 

 

Carotid endarterectomy for patients with high-grade carotid lesions
 

 

Routine screening for carotid artery stenosis with auscultation for bruits
 

 

Smoking cessation and treatment of hypertension

Question 10

 What is the most common cause of Cushing’s syndrome?

 

Excessive ACTH production
 

 

Administration of a glucocorticoid or ACTH
 

 

Pituitary adenoma or a non-pituitary ACTH-producing tumor
 

 

Autonomous cortisol production from adrenal tissue

Question 11

Diagnostic radiological studies are indicated for low back pain: 

 

Routinely after 3 weeks of low back pain symptoms. 
 

 

To screen for spondylolithiasis in patients less than 20 years of age with 2 weeks of more of low back pain. 
 

 

When there is a suspicion of a space-occupying lesion, fracture, cauda equina, or infection. 
 

 

As a part of a pre-employment physical when heavy lifting is included in the job description.

Question 12

After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been cured?

 

 An enzyme-linked immunosorbent assay titer

 

A urea breath test

 

A rapid urease test
 

 

A repeat endoscopy

Question 13

Which appropriate test for the initial assessment of Alzheimer’s disease provides the performance ratings on 10 complex, higher order activities?

 

MMSE
 

 

CAGE questionnaire
 

 

FAQ – Functional Activities Questionnaire 
 

 

Holmes and Rahe social readjustment scale

Question 14

Major depression occurs most often in which of the following conditions?

 

    A.    Myocardial infarction
 

 

  Parkinson’s disease
 

 

  Stroke
 

 

Alzheimer’s disease

Question 15

Which of the following statements about multiple sclerosis (MS) is correct?

 

MS is a chronic, untreatable illness that is almost always fatal. 
 

 

MS is a disease of steadily progressive and unrelenting neurologic deterioration. 
 

 

MS is a chronic, treatable illness with unknown cause and a variable course. 
 

 

Patients with MS who take active steps to improve their health have the best cure rate.

Question 16

Diagnostic evaluation of hypothyroidism reveals:

 

Elevated TSH and decreased T4
 

 

Decreased TSH and increased T4
 

 

Decreased TSH and decreased T3
 

 

Elevated TSH and increased T4

Question 17

Risk factors for prostate cancer include all of the following except:

 

Family history
 

 

Benign prostatic hypertrophy
 

 

African American race

 

Age

Question 18

What information should patients with diabetes and their families receive about hypoglycemia?

 

Hypoglycemia is a rare complication. 
 

 

Hypoglycemia requires professional medical treatment. 
 

 

Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly. 
 

 

Hypoglycemia occurs only as a result of insulin overdose.

Question 19

Which history is commonly found in a patient with glomerulonephritis?

 

Beta-hemolytic strep infection
 

 

Frequent urinary tract infections
 

 

Kidney  stones
 

 

Hypotension

Question 20

Which of the following is characteristic of a manic episode?

 

weight loss of gain
 

 

insomnia or hypersomnia
 

 

diminished ability to think or concentrate
 

 

grandiose delusions

Question 21

Central obesity, “moon” face, and dorsocervical fat pad are associated with:

 

Metabolic syndrome
 

 

Unilateral pheochromocytoma
 

 

Cushing’s syndrome
 

 

None of the above

Question 22

Which of the following is the most common cause of low back pain?

 

Lumbar disc disease
 

 

Spinal stenosis
 

 

Traumatic fracture
 

 

Osteoporosis

Question 23

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:

 

Infection
 

 

Toxoplasmosis
 

 

Mononucleosis
 

 

All of the above

 

None of the above

Question 24

An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects?

 

Weight gain
 

 

Fracture risk
 

 

Hypoglycemia
 

 

Weight loss

Question 25

A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is:

 

cryptococcosis
 

 

toxoplasmosis
 

 

cryptosporidiosis
 

 

cytomegaloviru

Question 26

Which of the following is the most common causative organism of nongonococcal urethritis?

 

Chlamydia trachomatis
 

 

Ureaplasma urealyticum
 

 

Mycoplasma hominis
 

 

Trichonomas vaginalis

Question 27

The most common symptoms of transient ischemic attack (TIA) include:

 

Nausea, vomiting, syncope, incontinence, dizziness, and seizure. 
 

 

Weakness in an extremity, abruptly slurred speech, or partial loss of vision, and sudden gait changes. 
 

 

Headache and visual symptoms such as bright spots or sparkles crossing the visual field. 
 

 

Gradual onset of ataxia, vertigo, generalized weakness, or lightheadedness

Question 28

What is the first symptom seen in the majority of patients with Parkinson’s disease?

 

Rigidity

 

Bradykinesia

 

Rest tremor
 

 

Flexed posture

Question 29

 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

 

1–4 red blood cells per high-powered field
 

 

Specific gravity 1.012

 

Urobilinogen
 

 

10- white blood cells per high-powered field

Question 30

 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:

 

Radial tunnel syndrome
 

 

Ulnar collateral ligament sprain
 

 

Olecranon bursitis
 

 

Lateral epicondylitis

Question 31

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?

 

Depression
 

 

Panic disorder
 

 

Anxiety
 

 

Post-traumatic stress disorder

Question 32

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:

 

Trauma
 

 

Tight shoes
 

 

Arthritis flare
 

 

Hydrochlorothiazide

Question 33

Which of the following is a contraindication for metformin therapy?

 

Insulin therapy
 

 

Creatinine > 1.5
 

 

Edema
 

 

None of the above

Question 34

A positive drawer sign supports a diagnosis of:

 

Sciatica
 

 

Cruciate ligament injury
 

 

Meniscal injury
 

 

Patellar ligament injury

Question 35

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?

 

Apples
 

 

Peppermint
 

 

Cucumbers
 

 

Popsicles

Question 36

 A patient taking levothyroxine is being over-replaced. What condition is he at risk for?

 

Osteoporosis
 

 

Constipation
 

 

Depression
 

 

Exopthalmia

Question 37

Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following:

 

HbA1C

 

2-hour 75 gram oral glucose tolerance test
 

 

C-peptide level
 

 

A and B
 

 

All of the above

Question 38

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 systemic antibiotics
 

 

Prescribe antibiotic ear drops
 

 

Prescribe nasal steroids and oral decongestants
 

 

Refer him to an ear, nose, and throat specialist

Question 39

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?

 

Maintain moderate bed rest for 3-4 days
 

 

Call the office for narcotics if there is no relief with the NSAID in 24-48 hours
 

 

Begin lower back strengthening exercises depending on pain tolerance
 

 

Wear a Boston brace at night

Question 40

Risk factors for Addison’s disease include which of the following?

 

Tuberculosis
 

 

Autoimmune disease
 

 

AIDS
 

 

All of the above

Question 41

Urine cultures should be obtained for which of the following patients?

 

Suspected urinary tract infection in pregnancy
 

 

Febrile patients
 

 

Young men
 

 

All of the above

Question 42

Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond?

 

“Caffeine has not effect on osteoporosis.”
 

 

“A high caffeine intake has a diuretic effect that may cause calcium to be excreted more rapidly.”
 

 

“Caffeine affects bone metabolism by altering intestinal absorption of calcium and assimilation of calcium into the bone matrix.”
 

 

“Caffeine increase bone resorption.”

Question 43

The diagnosis which must be considered in a patient who presents with a severe headache of sudden onset, with neck stiffness and fever, is:

 

Migraine headache
 

 

Subarachnoid hemorrhage
 

 

Glaucoma
 

 

Meningitis

Question 44

What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?

 

You must initiate the plan of care for the patient

 

The physician must be on-site and engaged in patient care
 

 

 You must be employed as an independent contractor
 

 

You must be the main health care provider who sees the patient

Question 45

The most commonly recommended method for prostate cancer screening in a 55 year old male is:

 

Digital rectal examination (DRE) plus prostate specific antigen (PSA)
 

 

Prostate specific antigen (PSA) alone
 

 

Transrectal ultrasound (TRUS) alone
 

 

Prostate specific antigen (PSA) and transrectal ultrasound (TRUS)

Question 46

The primary goals of treatment for patients with alcohol abuse disorder are:

 

Reduction in withdrawal symptoms and reduction in desire for alcohol
 

 

Psychotherapeutic and pharmacological interventions to decrease desire for and effects of alcohol
 

 

Abstinence or reduction in use, relapse prevention, and rehabilitation
 

 

Marital satisfaction, improvement in family functioning, and reduction in psychiatric impairment

Question 47

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:

 

Lateral meniscus
 

 

Cruciate ligament
 

 

Medical meniscus
 

 

Collateral ligament

Question 48

Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia?

 

Musculoskeletal pain
 

 

Difficulty sleeping
 

 

Depression
 

 

Fatigue

Question 49

Differential diagnosis of proteinuria includes which of the following?

 

Orthostatic proteinuria

 

Nephrotic syndrome
 

 

Infection
 

 

Trauma

 

A and B

Question 50

A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as:

 

Underweight
 

 

Normal weight
 

 

Overweight
 

 

Obese

Question 51

Reed-Sternberg B lymphocytes are associated with which of the following disorders:

 

Aplastic anemia
 

 

Hodgkin’s lymphoma
 

 

Non Hodgkin’s lymphoma
 

 

Myelodysplastic syndromes

Question 53

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:

 

Arthritis
 

 

Ulnar neuritis
 

 

Septic arthritis
 

 

Olecranon bursitis

Question 54

Establishment of a definitive diagnosis of osteomyelitis requires:

 

A known causative injury such as a puncture wound, bite, or decubitus ulcer. 
 

 

Biopsy of culture of the pathogen from blood or bone aspirate. 
 

 

Visualization of purulent material draining into soft tissue. 
 

 

Lucent areas identified on plain x-ray.

Question 55

The most accurate measure of diabetes control is: 

 

Avoidance of micro- and macro-vascular complications. 
 

 

Insulin sensitivity. 
 

 

Early morning glucose levels. 
 

 

HgbA1c

Question 56

A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder?

 

Alprazolam or diazepam
 

 

Venlafaxine or buspirone
 

 

Trazodone or sertraline
 

 

Venlafaxine or hydroxyzine pamoate

Question 57

The most common presentation of thyroid cancer is:

 

Generalized enlargement of the thyroid gland. 
 

 

A solitary thyroid nodule. 
 

 

A multinodular goiter. 
 

 

Abnormal thyroid function tests.

Question 58

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
 

 

Chemicals from plastic and rubber

 

Chronic use of phenacetin-containing analgesic agents
 

 

Working long hours and not voiding often

Question 59

You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of:

 

Sjogren’s syndrome
 

 

Pancreatic cancer
 

 

Disseminated malignancy of the hematologic system
 

 

Cancer of the liver

Question 60

Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to:

 

Refer her to a hand surgeon
 

 

Take a more complete history
 

 

Try neutral position wrist splinting and oral NSAID
 

 

Order a nerve conduction study such as am electromyography

Question 61

Which drug category contains the drugs that are the first line Gold standard therapy for COPD?

 

Corticosteroids
 

 

Inhaled beta-2 agonist bronchodilators
 

 

Inhaled anticholinergic bronchodilators
 

 

Xanthines

 

 

 

Question 62

Potential causes of septic arthritis include which of the following?

 

Lyme disease
 

 

Prosthetic joint infection
 

 

Reiter’s syndrome

 

A and B
 

 

All of the above

 

Question 63

 The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is:

 

Oral ciprofloxacin (Cipro)
 

 

Oral doxycycline (Virbamycin) plus intramuscular ceftriaxone
 

 

Oral trimethoprim-sulfamethoxazole (Bactrim DS)
 

 

Intramuscular penicillin

Question 64

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?

 

Advise the patient to stop the antidepressant medication

 

Question the patient to determine if the self-assessment is correct before advising her to discontinue the medication
 

 

Recommend that the patient continue the antidepressant medication for at least 4 more months
 

 

Discuss with the patient the need to take the antidepressant medication indefinitely

Question 65

Your patient has an elevated mean cell volume (MCV). What should you be considering in terms of diagnosis?

 

Iron-deficiency anemia
 

 

Hemolytic anemia
 

 

Lead poisoning
 

 

Liver disease

Question 66

Which of the following medications increase the risk for metabolic syndrome?

 

Antihistamines
 

 

Proton pump inhibitors
 

 

Protease inhibitors
 

 

A and C
 

 

All of the above

Question 67

The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in almost 100% of patients is:

 

Acoustic neuroma
 

 

Astrocytoma of the retina
 

 

Distinctive osseous lesions
 

 

Café au lait spots

Question 68

The most commonly recommended pharmacological treatment regimen for low back pain (LBP) is:

 

Acetaminophen or an NSAID
 

 

A muscle relaxant as an adjunct to an NSAID
 

 

An oral corticosteroid and diazepam (Valium)
 

 

Colchicine and an opioid analgesic

Question 69

Legal authority for advanced practice nursing rests with:

 

The Health Care Financing Administration
 

 

Federal statutes
 

 

State laws and regulations
 

 

Certifying bodies

Question 70

Which of the following physical modalities recommended for treatment of rheumatoid arthritis provides the most effective long term pain relief?

 

Superficial and deep heat
 

 

Application of cold
 

 

Transcutaneous electrical nerve stimulation (TENS)
 

 

Exercise

Question 71

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. 
 

 

Obtain a diet history and check CBC and FBS. 
 

 

Provide nutritional guidance and have the patient return in 1 month. 
 

 

Consult home health for intravenous administration of fluids and electrolytes.

Question 72

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?

 

Start him on an ACE Inhibitor
 

 

Start him on a diuretic
 

 

Have him monitor his blood pressure at home
 

 

Try nonpharmacological methods and have him monitor his blood pressure at home

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:

 

Parkinson’s disease
 

 

Epilepsy
 

 

Multiple sclerosis
 

 

Diabetes mellitus

Question 74

Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus?

 

Hypertriglyceridemia and low high-density lipoprotein (HDL)
 

 

Gestational diabetes and polycystic ovarian syndrome
 

 

Hispanic, African-American, Native-American, and Pacific Islander ethnicity
 

 

Postprandial hypoglycemia

Question 75

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:

 

The patient should start anticoagulant therapy immediately.
 

 

Hereditary thrombophilia does not always require anticoagulation therapy.
 

 

Women of childbearing age cannot take anticoagulant therapy.
 

 

Genetic and risk management counseling are recommended.
 

 

B and D

Question 76

The 4 classic features of Parkinson’s disease are:

 

Mask-like facies, dysarthria, excessive salivation, and dementia.
 

 

Tremor at rest, rigidity, bradykinesia, and postural disturbances. 
 

 

Depression, cognitive impairment, constipation and shuffling gait. 
 

 

Tremor with movement, cogwheeling, repetitive movement, and multi-system atrophy.

Question 77

Which of the following set of symptoms should raise suspicion of a brain tumor?    

 

Recurrent, severe headaches that awaken the patient and are accompanied by visual disturbances. 
 

 

Vague, dull headaches that are accompanied by a reported sense of impending doom. 
 

 

Periorbital headaches occurring primarily in the evening and accompanied by pupillary dilation and photophobia. 
 

 

Holocranial headaches present in the morning and accompanied by projective vomiting without nausea.

Question 78

The most common cause of elevated liver function tests is:

 

Hepatitis
 

 

Biliary tract obstruction
 

 

Chronic alcohol abuse
 

 

A drug-induced injury

Question 79

The physiological explanation of syncope is:

 

Accelerated venous return and increased stroke volume resulting in deactivation of the parasympathetic nervous system. 
 

 

A cycle of inappropriate vasodilation, bradycardia, and hypotension.
 

 

A sudden rise in blood pressure due to overly efficient vasoconstriction. 
 

 

Emotional stress resulting in hypertension, tachycardia, and increased venous return.

Question 80

 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?

 

Thiazide diuretic
 

 

Insulin
 

 

Famotidine (Pepcid)
 

 

Albuterol

Question 81

The cardinal sign of infectious arthritis is:

 

Affected joint is painful at rest, with movement and weight bearing
 

 

Rapid onset that wakes the patient during the night
 

 

Long history of severe pain with associated joint swelling
 

 

None of the above

Question 82

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 Vitamin D restriction
 

 

Primary hyperparathyroidism is treated with parathyroidectomy
 

 

Primary hyperparathyroidism is treated with daily magnesium
 

 

Primary hyperparathyroidism is treated with parenteral parathyroid hormone (PTH)

Question 83

Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis?

 

Doxycycline 100 mg qd
 

 

Nitrofurantoin 100 mg qd
 

 

Bactrim DS qd
 

 

Erythromycin qd

Question 84

Who is at a higher risk for developing nephrolithiasis?

 

Jack, who exercises every day and drinks copious amounts of water
 

 

Mary, who watches her weight and eats a low-sodium diet
 

 

Harvey, a “couch potato” who drinks a lot of no-sodium soda
 

 

Bill, who runs every day and takes excessive amounts of vitamin C

Question 85

Potential side effects of levofloxacin include which of the following?

 

Confusion
 

 

Hypoglycemia
 

 

Achilles tendon rupture
 

 

All of the above

Question 86

A patient has just been diagnosed with Bell’s palsy. He is understandably upset and has questions about the prognosis. You response should be:

 

Although most of your symptoms will disappear, some will remain but can usually be camouflaged by altering your hairstyle or growing a beard
 

 

Unfortunately there is no cure but you have a mild case
 

 

The condition is self-limiting and most likely complete recovery will occur
 

 

With suppressive drug therapy you can minimize the symptoms

Question 87

A diabetic patient is taking low-dose enalapril for hypertension. A record of the patient’s blood pressure over 4 weeks ranges from 130 to 142 mmHg systolic and 75 to 85 mmHg diastolic. How should the nurse practitioner respond?

 

Change to a different class of antihypertensive medication to get better control. 
 

 

Increase the dosage of the current BP medication. 
 

 

Continue the current medication and dosage for 4 more weeks. 
 

 

Add a beta-blocker to the current medication regimen.

Question 88

What diabetic complications result from hyperglycemia?

1.        

1.        

      1.  Retinopathy
      2.  Hypertension resistant to treatment
      3. Peripheral neuropathy
      4.  Accelerated atherogenesis

 

1, 2, 3

 

2, 3, 4

 

1, 3, 4

 

1, 2, 4

Question 89

Diagnostic confirmation of acute leukemia is based on:

 

Bone marrow aspiration and biopsy
 

 

Pancytopenia
 

 

Hyperuricemia
 

 

All of the above

Question 90

The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy:

 

A dipstick strip done during routine urinalysis in the office
 

 

A 24-hour urine collection
 

 

An early morning spot urine collection
 

 

A serum albumin test

Question 91

Which of the following antibiotics should not be prescribed for a pregnant woman in the 3rd trimester?

 

Trimethoprim-sulfamethoxazole
 

 

Erythromycin
 

 

Cefuroxime
 

 

Levofloxacin

Question 92

Martin, a 58 year old male with diabetes, is at your office for his diabetes follow up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Martin receive today regarding the care if his feet?

 

Wash your feet with cold water daily
 

 

See a podiatrist every 2 years, inspect your own feet monthly, and apply lotion to your feet daily
 

 

Go to a spa and have a pedicure monthly
 

 

See a podiatrist yearly; wash your feet daily with warm soapy water and towel dry between the toes; inspect your feet daily for lesions; apply lotion to dry areas

Question 93

The intervention known to be most effective in the treatment of severe depression, with or without psychosis, is:

 

Psychotherapy
 

 

Electroconvulsive therapy (ECT)
 

 

A selective serotonin reuptake inhibitor (SSRI)
 

 

A tricyclic antidepressant (TCA)

Question 94

The initial clinical sign of Dupuytren’s contracture is:

 

Pain with ulnar deviation
 

 

Painless nodule on palmer fascia
 

 

Pain and numbness in the ring finger
 

 

Inability to passively extend finger

Question 95

Which of the following is the most common complication of the myelodysplastic syndromes?

 

Fatigue
 

 

Cardiomyopathy
 

 

Falls
 

 

Bleeding

Question 96

What information should a 42 year old patient with newly diagnosed diabetes receive about exercise?

 

Buy good walking shoes with support and a flexible sole. 

 

Exercise at least 5 days per week. 
 

 

Snack before exercise. 
 

 

Do not exercise if your blood sugar is greater than 180 mg/dL

Question 97

What is the most commonly abused substance?

 

Heroin
 

 

Cocaine
 

 

Alcohol
 

 

Marijuana

Question 98

Sam, age 67, is a diabetic with worsening renal function. He has frequent hypoglycemic episodes, which he believes means that his diabetes is getting “better.” How do you respond?

 

“You’re right; it seems like your diabetes is improving.”

 

“Because your kidneys are not functioning well, your insulin is not being metabolized and excreted as it should, so you need less of it.”
 

 

 “You have watched your diet for all these years and as a result, your body is using less insulin.”
 

 

“I will have to change your oral hyperglycemic agents as it seems your body is making more insulin.”

Question 99

A child with type 1 diabetes mellitus has experienced excessive hunger, weight gain and increasing hyperglycemia. The Somogyi effect is suspected. What steps should be taken to diagnose and treat this condition?

 

Decrease the evening insulin dose and check capillary blood glucose (CBG) at 2:00 am.
 

 

Instruct the child’s parents on physical activities to help weight loss. 
 

 

Increase the evening insulin dose and check CBG at 2:00 am. 
 

 

Refer the child for instruction on a strict diabetic diet.

Question 100

At what age is screening most likely to detect scoliosis?

 

4 to 6 years
 

 

8 to 10 years
 

 

12 to 14 years
 

 

18 to 20 years

Question 101

The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are):

 

Patient report of bladder dysfunction, saddle anesthesia, and motor weakness of limbs. 
 

 

History of significant trauma relative to the patient’s age. 
 

 

Decreased reflexes, strength, and sensation in the lower extremities. 
 

 

Patient report of pain with the crossed straight leg raise.

 

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[Solved] NURS 6531 / NURS6531 Final Exam

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Question 2.   Which of the following is a potential acquired cause of thrombophilia? Homocysteinuria Protein C deficiency Factor V Leiden Antiphospholipid antibodies Question 3 Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of: Ulnar tunnel syndrome Carpal tunnel syndrome Tarsal tunnel syndrome Myofascial pain syndrome Question 4 Which patient would benefit most from screening for type 2 diabetes? A 30 year old female with unintended weight loss. A 25 year old male with family history of type 1 diabetes  An obese female with recurrent vaginitis A 50 year old hyperlipidemic male Question 5  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? Rheumatoid arthritis (RA) Osteoarthritis (OA)  Lupus Peripheral neuropathy Question 6  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: Trimethoprim-sulfamethoxazole for 3 days Ciprofloxacin for 7-10 days Trimethoprim-sulfamethoxazole for 14 days Ciprofloxacin for 3 days A thymectomy is usually recommended in the early treatment of which disease?   Parkinson’s disease Multiple sclerosis   Myasthenia gravis Huntington’s chorea Question 8 The diagnosis of human papilloma virus (HPV) infection in males is usually made by: Clinical appearance Viral culture Tzanck smear KOH prep Question 9 The most effective intervention(s) to prevent stroke is (are): 81 mg of aspirin daily Carotid endarterectomy for patients with high-grade carotid lesions Routine screening for carotid artery stenosis with auscultation for bruits Smoking cessation and treatment of hypertension Question 10  What is the most common cause of Cushing’s syndrome? Excessive ACTH production Administration of a glucocorticoid or ACTH Pituitary adenoma or a non-pituitary ACTH-producing tumor Autonomous cortisol production from adrenal tissue Question 11 Diagnostic radiological studies are indicated for low back pain:  Routinely after 3 weeks of low back pain symptoms.  To screen for spondylolithiasis in patients less than 20 years of age with 2 weeks of more of low back pain.  When there is a suspicion of a space-occupying lesion, fracture, cauda equina, or infection.  As a part of a pre-employment physical when heavy lifting is included in the job description. Question 12 After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been cured?  An enzyme-linked immunosorbent assay titer A urea breath test A rapid urease test A repeat endoscopy Question 13 Which appropriate test for the initial assessment of Alzheimer’s disease provides the performance ratings on 10 complex, higher order activities? MMSE CAGE questionnaire FAQ – Functional Activities Questionnaire  Holmes and Rahe social readjustment scale Question 14 Major depression occurs most often in which of the following conditions?     A.    Myocardial infarction   Parkinson’s disease   Stroke Alzheimer’s disease Question 15 Which of the following statements about multiple sclerosis (MS) is correct? MS is a chronic, untreatable illness that is almost always fatal.  MS is a disease of steadily progressive and unrelenting neurologic deterioration.  MS is a chronic, treatable illness with unknown cause and a variable course.  Patients with MS who take active steps to improve their health have the best cure rate. Question 16 Diagnostic evaluation of hypothyroidism reveals: Elevated TSH and decreased T4 Decreased TSH and increased T4 Decreased TSH and decreased T3 Elevated TSH and increased T4 Question 17 Risk factors for prostate cancer include all of the following except: Family history Benign prostatic hypertrophy African American race Age Question 18 What information should patients with diabetes and their families receive about hypoglycemia? Hypoglycemia is a rare complication.  Hypoglycemia requires professional medical treatment.  Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly.  Hypoglycemia occurs only as a result of insulin overdose. Question 19 Which history is commonly found in a patient with glomerulonephritis? Beta-hemolytic strep infection Frequent urinary tract infections Kidney  stones Hypotension Question 20 Which of the following is characteristic of a manic episode? weight loss of gain insomnia or hypersomnia diminished ability to think or concentrate grandiose delusions Question 21 Central obesity, “moon” face, and dorsocervical fat pad are associated with: Metabolic syndrome Unilateral pheochromocytoma Cushing’s syndrome None of the above Question 22 Which of the following is the most common cause of low back pain? Lumbar disc disease Spinal stenosis Traumatic fracture Osteoporosis Question 23 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: Infection Toxoplasmosis Mononucleosis All of the above None of the above Question 24 An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects? Weight gain Fracture risk Hypoglycemia Weight loss Question 25 A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is: cryptococcosis toxoplasmosis cryptosporidiosis cytomegaloviru Question 26 Which of the following is the most common causative organism of nongonococcal urethritis? Chlamydia trachomatis Ureaplasma urealyticum Mycoplasma hominis Trichonomas vaginalis Question 27 The most common symptoms of transient ischemic attack (TIA) include: Nausea, vomiting, syncope, incontinence, dizziness, and seizure.  Weakness in an extremity, abruptly slurred speech, or partial loss of vision, and sudden gait changes.  Headache and visual symptoms such as bright spots or sparkles crossing the visual field.  Gradual onset of ataxia, vertigo, generalized weakness, or lightheadedness Question 28 What is the first symptom seen in the majority of patients with Parkinson’s disease? Rigidity Bradykinesia Rest tremor Flexed posture Question 29  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 1–4 red blood cells per high-powered field ...
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