AANP Test 2 for Boards Questions & Answers

AANP Test 2 for Boards Questions & Answers You are treating a patient with acute anxiety and she is having an acute attack in the office. The ANP has knowledge that the fastest relief of symptoms is: a TCA a beta-blocker a benzodizepine an SSRI Correct answer: benzodiazepine The fastest relief of anxiety symptoms will occur with a benzodiazepine. The other choices list agents that will require multiple doses for results. With daily continued use of benzodiazepines, the anti-anxiety effect may become diminished. A geriatric patient with cardiovascular disease is in the office being counseled on lifestyle changes. The ANP knows that which of the following is the most important to include in this discussion? "Control your hypertension, stop smoking, maintain a normal weight, and exercise regularly." "Have a yearly physical examination, increase fiber in your diet, and exercise regularly." "Maintain a normal level of serum blood sugar and decrease cholesterol intake." "Decrease smoking, increase vitamin supplements, and increase protein intake." Correct answer: "Control your hypertension, stop smoking, maintain a normal weight, and exercise regularly." All of these are important for the geriatric patient to decrease cardiovascular risk. Controlling hyperglycemia, high fiber intake, and vitamins all assist in maintaining a healthy lifestyle but do not help to prevent cardiovascular disease. You are seeing a female with inflammatory bowel disease, known as IBD. The Adult Nurse Practitioner knows that if she orders a hemogram on this patient, which of the following results would be seen if the patient was anemic? microcytic, hypochromic type macrocytic, normochromic type normocytic, normochromic type macrocytic, hypochromic type Correct Answer: normocytic, normochromic type Anemia is a common problem in IBD. The etiology is often from multiple causes. The anemia of chronic disease, a normocytic, normochromic anemia, is a result of inflammation of the IBD without blood loss. Blood loss would result in a microcytic, hypochromic anemia. The macrocytic anemias are a result of deficiency in vitamin B12 or other causes. Which of the following is the least likely risk factor for suicide? physical illness male increasing age black race Correct answer: black race Being of a white race is more likely to be a factor in suicide. Besides the other three choices risk factors include: substance abuse, living alone, and less education. The healthcare provider's required level of expected conduct as established by custom, law, or professional organizations is called the: Standard of care. Breach of duty. Duty. Malpractice. Correct answer: Standard of care Standard of care is another term associated with negligence. Standard of care is a healthcare provider's required level of expected conduct as established by custom, law, or professional organizations. A brief account by the patient of any signs or symptoms he or she is experiencing is one component of: Review of systems. Symptom assessment. Functional assessment. Objective assessment. Correct Answer: Review of systems In the review of systems, the patient tells the nurse in his or her own words what signs or symptoms he or she has experienced in various body systems. It is important that these be in a patient's own words to perform the most complete and accurate assessment. All of the following are typical changes to the gastrointestinal system that come with aging EXCEPT: decreased liver size decreased muscle tone in bowel increased absorption of calcium atrophy of salivary glands Correct answer: increased absorption of calcium Decreased absorption of calcium is a common change that comes with aging, not increased absorption. Other gastrointestinal changes include: less efficient cholesterol stabilization and absorption, atrophy of taste buds, and slowing in esophageal emptying, among others. A 28-year-old female patient is in the office and is to undergo radioactive iodine treatment for Graves disease. The ANP is counseling her and understands that the mechanism of action of this treatment therapy is: alter the thyroid metabolic rate relieve distress caused by increased thyroid size destroy the overactive thyroid tissue reduce production of TSH Correct answer: destroy the overactive thyroid tissue Graves disease is the most common form of thyrotoxicosis. Radioactive iodine is used for thyroid ablation to destroy the overactive thyroid tissue that causes the thyroid hormone dysfunction. Which of the following statements about falls in the elderly is least accurate? Black women are at higher risk for hip fractures than white women. The majority of deaths from falls are among people aged 65 years or older. Injuries from falls include head injuries, pelvic injuries, lacerations, and more. About 90% of hip fractures are due to falls. Correct Answer: Black women are at higher risk for hip fractures than white women. It is white women, not black women, who are at higher risk for hip fractures. Falls are one of the most common adverse events that threaten the quality of life of older adults. Falls among older adults are not a normal consequence of aging. Normal age-related changes of the skin may be confused with which of the following clinical abnormalities? dehydration vitiligo scabies shingles Correct Answer: dehydration Normal age-related changes of the skin may be confused with dehydration. Sebaceous gland activity tends to decrease with age, and the skin's natural hydrators decline over the years. The skin's ability to regenerate lipids compromising the protective lipid barrier layer of the Stratum Corneum also declines with age, as does blood flow to the skin, which may cause a drop in sebum production. A 29-year old woman who is 6 weeks postpartum reports she is having rectal bleeding that she believes is related to hemorrhoids. The Adult Nurse Practitioner knows that this type of rectal bleeding is usually described as: dark brown to black blood color with normal-appearing stool significant amounts of bright red blood large blood clots and mucus mixed with stool streaks of bright red blood on the stool The Correct answer is: streaks of bright red blood on the stool Choice D is the right answer. The color of blood related to hemorrhoids is described as bright red, eliminating choice A. Amount of blood with hemorrhoids is usually small or scant, eliminating choices B and C. Internal hemorrhoids can occur during or after childbirth. With chronically protruding or prolapsing hemorrhoids, the patient often reports mucous leaking and staining of the undergarments. Other causes are obesity, constipation, and prolonged sitting. You have a patient with AIDS. You recognize that a low CD4 T-cell count puts the patient at risk for opportunistic infections. You are reviewing his lab reports and see that his CD4 T-cell count is indeed low. Which of the following is the normal range for CD4 T-cell count? 800 -1400 700 -1400 400 - 1000 600 -1200 Correct answer: 600 -1200 The normal CD4 T-cell count is 600 - 1200. A low CD4 T-cell count is below 600. The destruction of the CD4 T-cell causes depletion in the number of CD4 T-cells and consequently increases the risk of infection. This puts the patient at risk for infection. ou have an adult patient with diabetes whose blood pressure is 145/95 mm Hg. Which stage of hypertension does this indicate? normal pre-hypertension Stage I Stage II Correct Answer: Stage I Stage I hypertension is characterized by a systolic pressure of 140 - 159 mm Hg and a diastolic pressure of 90 - 99 mm Hg. The treatment recommendation for this stage is usually a thiazide diuretic and for those with diabetes, either ACE inhibitors or ARBs, because of their renal protective properties. Clinical findings that are characteristic of asthma include all of the following EXCEPT: wheezing with and without associated respiratory infections a congested cough worse during the day recurrent shortness of breath with exercise a recurrent spasmodic cough that is worse at night The Correct answer is: a congested cough worse during the day Choice B is the right answer. The asthmatic patient complains of a cough that is worse at night and has little congestion or sputum production. There is a history of wheezing and chest tightness, shortness of breath with exercise, and symptoms that worsen after airborne allergen exposure. Which of the following is an example of objective data used for diagnosis? Patient reports being more tired than usual. Patient reports having difficulty breathing. Patient reports productive cough. Patient's cough produces yellow sputum. Correct Answer: Patient's cough produces yellow sputum Objective data must be measurable and verifiable. It is key to collect both objective and subjective data to form correct differential diagnoses and then to determine the correct diagnosis and course of further testing or treatment for a patient. The ability to synthesize both objective and subjective data is a key skill for NPs. A 68-year-old woman has been admitted to the hospital suffering from peripheral vascular disease (PVD). You check her medical records for predisposing factors. You recognize that all of the following are predisposing factors EXCEPT: arteriosclerosis advanced age a history of renal problems valvular incompetence Correct answer: a history of renal problems A predisposing factor for PVD is a history of deep vein thrombosis (DVT). All of the other choices are valid predisposing factors. Which of the following is NOT an indication of impaired skin integrity? A mole with irregular borders. Bruises in various stages of healing. Cuts in various stages of healing. A navel piercing more than a year old. Correct Answer: A navel piercing more than a year old. Unless the piercing is marked by scabbing or other evidence of trauma, it is not evidence of impaired skin integrity. Tattoos and other body modifications should be noted in the patient's assessment, but they are not in themselves cause for concern. You are determining the peak expiratory flow (PEF) for a 67-year-old female patient who suffers from asthma. Which of the following is NOT a factor in determining peak expiratory flow (PEF) for this patient? age height weight gender Correct Answer: weight Weight is not a factor in determining PEF. The PEF is based on height (H), age, (A), and gender (G) - HAG. Upon examination of a patient with a heart murmur, you hear a grade 1-3/6 late systolic crescendo murmur with a honking quality. This is most likely indicative of which of the following? pulmonary hypertension mitral regurgitation mitral valve prolapse aortic sclerosis Correct Answer: mitral valve prolapse In a patient with mitral valve prolapse, you would hear a grade 1-3/6 late systolic crescendo murmur with a honking quality. This is best heard at the apex of the heart. The murmur follows a mid-systolic click. All but which of the following conditions in the patient's past medical history is likely to be associated with congestive heart failure (CHF)? diabetes COPD cancer CAD Correct Answer: cancer Cancer is not normally associated with CHF. A past medical history of any of the following may be associated with CHF: CAD, COPD, renal disease, diabetes, hypertension, previous MI, valvular disease, severe anemia, and more. You are seeing a 34-year old woman in the office today. She has a long-standing history of alcohol abuse and presents with a 4-day history of mid-abdominal pain that radiates through to the back and remains relatively constant. This has been accompanied by nausea and three episodes of vomiting. Antacids have not helped her pain and symptoms. Her abdominal examination reveals slightly hyperactive bowel sound with upper abdominal tenderness. There is no localization or rebound. Her skin is moist and cool, blood pressure is 92/54 and pulse rate is elevated at 122 bpm. The most likely diagnosis is: acute gastroenteritis acute viral hepatitis acute pancreatitis acute alcohol toxicity Correct Answer: acute pancreatitis The most common risk factors for pancreatitis include gallstones and excessive alcohol use. Significant pain and volume constriction are common in patients with this condition. Mary Jane, a 50-year-old female tripped on a curb and fell. She suffered a Colles' fracture. You understand that a Colles' fracture is associated with a fall on which of the following? finger outstretched hand elbow thumb Correct answer: outstretched hand Loss in continuity in the substance of a bone is called a fracture. A Colles' fracture is associated with a fall on an outstretched hand such as when a person tries to break a fall. Which of the following is NOT an appropriate serving size of vegetables for a person on the ADA diet? 1 c romaine lettuce. ½ c steamed broccoli. 1 c cooked baby spinach. 1 c raw baby spinach. Correct Answer 1 c cooked baby spinach A serving of vegetables on the ADA diet is 1 c of raw or ½ c of cooked vegetables. Even leafy vegetables, when cooked, should be eaten in ½ c servings. In terms of liver function tests, which of the following test has a normal reference range of 5 - 50 u/L? Alkaline Phosphatase Serum GGT Serum ALT Serum AST Correct answer: Serum AST Serum AST is normal at 5 to 50 u/L. It is present in the liver, heart muscle, skeletal muscle, kidney and lung. It is not specific for liver injury because it is also elevated in other conditions such as acute MI. Which of the following would not be considered a body change related to menopause? palpable ovaries labia and vagina become atrophic and thinner urinary incontinence atrophied ovaries Correct Answer: palpable ovaries Palpable ovaries are considered an abnormal finding in menopausal women. After several years of menopause, the ovaries are atrophied and a smaller size. Ovarian cancer must be ruled out when a palpable ovary is found. Regarding the scientific method for conducting research which uses the null hypothesis, the ANP knows this is statistically based and the correct format for the null hypothesis is: Group "A" is less than group "B". Group "A" is greater than group "B". There is a 95% probability that group "A" is different from group "B". There is no significant difference between the two groups. Correct answer: "There is no significant difference between the two groups." The research hypothesis may take the other forms. What is the two-hour (2-hour) blood glucose value indicating diabetes mellitus? ≥126 mg/dL. ≥150 mg/dL. ≥176 mg/dL. ≥200 mg/dL. Correct answer: ≥200 mg/dL Two-hour blood glucose is a diagnostic measurement for diabetes. A value of ≥200 mg/dL indicates diabetes mellitus. Mrs. Layden is a 56-year-old female patient who is complaining of facial pain that she says begins on the side of her mouth and then shoots up toward her ear. You suspect which of the following? cluster headaches facial migraine herpes zoster trigeminal neuralgia Correct Answer: trigeminal neuralgia Trigeminal neuralgia is a recurrent unilateral facial pain syndrome. It most often affects the maxillary division of the trigeminal nerve. Patients complain of pain on one side of the face and may have a small degree of numbness. What is the recommended level for LDL for healthy adults? 100 mg/dL. 130 mg/dL. 40 mg/dL. 200 mg/dL. Correct answer: 100 mg/dL Expert panels have established several limits for lipid levels. For low density lipoprotein (LDL), the level is 100 mg/dL for adults. More that this amount places the individual at risk for cardiovascular disease. Your patient complains of constipation. Your examination reveals no flatus, abdominal distention, and an absence of bowel sounds. Which of the following is the most likely cause? bowel ischemia volvulus diverticular disease bowel obstruction Correct Answer: bowel obstruction Of the choices given, the most likely cause would be bowel obstruction. The client may also be experiencing vomiting. An abdominal radiograph would show free air. What is the purpose of certification for the Adult Nurse Practitioner? The purpose is to define a specific legal scope of practice determined by state statutes, boards of nursing, educational requirements, and common practice. The purpose is to protect the public by ensuring a minimum level of professional competence. The purpose is to assure the public that an individual has mastery of a body of knowledge and has acquired the necessary skills to function in a particular specialty. none of the above Correct Answer: The purpose is to assure the public that an individual has mastery of a body of knowledge and has acquired the necessary skills to function in a particular specialty. The purpose of scope of practice for ANPs is to define a specific legal scope of practice determined by state statues, boards of nursing, educational requirements, and common practice. The purpose of licensure for ANPs is to protect the public by ensuring a minimum level of professional competence. All of the following are true of informed consent except: It must be documented in the medical records that the patient has been informed of his or her healthcare options. This is the right of all competent adults who are over the age of 18 and the right of emancipated minors. The clinician has the duty to explain relevant information to the patient so that the patient can make an appropriate decision regarding the care to be provided. This consent will absolve the ANP from allegations of malpractice should it occur. Correct answer: This consent will absolve the ANP from allegations of malpractice should it occur. The information of informed consent includes diagnosis, nature and purpose of proposed treatment or procedure, risks and benefits, prognosis, alternative methods of treatment or care with their risks and benefits, and the remote possibility of serious harm or complications. Informed consent does NOT absolve the ANP from allegations of malpractice, should it occur. Upon your examination of a patient you find bony nodules on the proximal interphalangeal joints. These are known as which of the following? Heberden's nodes degenerative joint nodes Bouchard's nodes meniscus tears Correct answer: Bouchard's nodes Bouchard's nodes are bony nodules on the proximal interphalangeal joints. Heberden's nodes are bony nodules on the distal interphalangeal joints. Over twenty different scales have been proposed to define and measure the syndrome of frailty. The majority of these tools include a measure of at least one each of the five domains that make up the frailty phenotype. Each of the following is one of these EXCEPT: slowness intellectual decline weakness low physical activity Correct Answer: intellectual decline Intellectual decline is not one of the five domains that make up the frailty phenotype. Besides the other three choices, the remaining domains are exhaustion and decreased muscle mass. Which of the following is true of milk consumption on the ADA diet? Only nonfat milk should be consumed. Low or nonfat milk should be consumed. Full, low, or nonfat milk can be consumed. Nonfat milk should be avoided. Correct Answer Low or nonfat milk should be consumed Milk is a key part of the ADA diet, though servings should be limited. Low fat and nonfat varieties of milk and yogurt should be consumed by people on the ADA diet. Full fat milk products can raise blood cholesterol levels. Older adults often have visual problems. Which of the following is the term for decreased ability of the eye to accommodate to close work? glaucoma presbyopia myopia arcus senilis Correct answer: presbyopia Presbyopia is the decreased ability of the eye to accommodate to close work. Myopia is just the opposite. In myopia distance vision is poor and items can be seen better the closer they are. Upper airway disorders that mimic asthma include which of the following? vocal fold paralysis conversion disorder bronchiectasis eosinophilic pneumonia Correct Answer: vocal fold paralysis Patients who have atypical symptoms or poor response to asthma therapy may have a condition that mimics asthma. Of the choices given, vocal fold paralysis is an upper airway disorder. Conversion disorder is a psychiatric cause; bronchiectasis and eosinophilic pneumonia are lower airway disorders. Your elderly patient is bedridden and has developed pressure ulcers. There has been damage to the epidermis with blisters forming. The wound bed is pink in color. This would be a pressure ulcer of which of the following stages? stage II stage III stage IV unstageable Correct answer: stage II Pressure ulcer staging ranges from I to IV plus unstageable or unclassified. This patient has a stage II pressure ulcer which is characterized by damage to the epidermis where blisters form and erupt into red shiny skin or shallow superficial ulcers. The wound be is pink to red in color. Hemoptysis may be the presenting symptom for many different diseases. If your 65-year-old male patient also has dyspnea and pleuritic chest pain along with the hemoptysis this is indicative of which of the following? pulmonary embolism bronchitis bronchogenic carcinoma alveolar hemorrhage syndrome Correct Answer: pulmonary embolism Hemoptysis along with dyspnea and pleuritic chest pain are indicative of pulmonary embolism. Bronchitis symptoms may include fever, cough, and bloody sputum. Bronchogenic carcinoma may present with chronic weight loss and a change in cough. Alveolar hemorrhage syndrome may be indicated by chronic dyspnea and minor hemoptysis. Glaucoma is primarily a condition in older adults. All of the following statements about glaucoma are true except: Glaucoma involves gradual, painless vision loss. Glaucoma can be cured with the proper treatment. Glaucoma is generally asymptomatic, especially in early stages. Glaucoma may lead to blindness if untreated. Correct answer: Glaucoma can be cured with the proper treatment. This statement is not true. Glaucoma cannot be cured, but it can be treated with success pharmacologically and surgically. Subclinical hypothyroidism is characterized by all but which of the following? profound symptoms increased serum TSH concentrations normal free T4 normal free T3 levels Correct Answer: profound symptoms Subclinical hypothyroidism is characterized by increased serum TSH concentrations with normal free T4 and free T3 levels. It occurs in 10% to 15% of the general population. The presentation is nonspecific, and symptoms are usually subtle (not profound). In terms of diagnosing pneumonia, acute bacterial pneumonia should be differentiated from acute bacterial bronchitis. On auscultation, a patient with acute bacterial bronchitis will have crackles clear lung sounds except for scattered rhonchi abnormal breath sounds dullness to percussion Correct Answer: clear lung sounds except for scattered rhonchi On auscultation, a patient with acute bacterial bronchitis will have clear lung sounds except for scattered rhonchi. In comparison, the patient with bacterial pneumonia will likely have crackles, dullness to percussion, and abnormal breath sounds. A 48-year-old male patient complains of a sudden onset of severe "ice pick" pains behind one eye. He tells you that the headache is accompanied by tearing, a clear runny nasal discharge, and a drooping eyelid. What type of headache would you diagnose? muscle tension headache cluster headache migraine headache temporal arteritis Correct answer: cluster headache Cluster headaches are severe headaches with lancinating pain behind one eye that occurs several times a day, usually at the same times every day. Their cause is unknown and they are more common in adult males in their 30s and 40s. When communicating with a Native American patient, the GNP knows that: Silence indicates respect for the speaker. Members speak in a loud tone of voice. Eye contact is viewed as a sign of respect. Body language is not important. Correct answer:Silence indicates respect for the speaker. With the Native American patient, silence does indicate respect. Members speak in a low tone of voice and expect others to be attentive. Eye contact is often viewed as disrespectful and body language is important. One of the most sensitive tools for diagnosis of pulmonary emboli that is done through a catheter advanced into the pulmonary artery is which of the following? MRI CT scan pulmonary angiogram x-ray Correct Answer: pulmonary angiogram Pulmonary angiograms are one of the most sensitive tools for diagnosis of pulmonary emboli. Through a catheter advanced into the pulmonary artery, contrast material is injected during rapid filming. Emboli appear as filling defect, or dark circumscribed areas, within the white vascular images of the artery. An older adult complains of sudden onset of dyspnea and coughing. Cough produces pink-tinged frothy sputum. tachycardia, pallor, and feelings of impending doom are also present. Of the following which is the most likely diagnosis? tuberculosis pulmonary embolus bronchitis COPD Correct Answer: pulmonary embolus Pulmonary embolus is characterized by all of the symptoms set forth in the question. Any condition that increases risk of blood clots will increase risk of PE. These patients have a history of atrial fibrillation, estrogens, surgery, pregnancy, long bone fractures, and prolonged inactivity. In terms of blood pressure control, in patients aged 60 years and older, treatment for hypertension should be started when SBP ≥ 150 and DBP ≥ 90 SBP ≥ 120 and DBP ≥ 90 SBP ≥ 110 and DBP ≥ 80 SBP ≥ 150 and DBP ≥ 80 Correct Answer: SBP ≥ 150 and DBP ≥ 90 In patients aged 60 years and older, treatment for hypertension should be started when SBP ≥ 150 and DBP ≥ 90. After initiation of pharmacological treatment, the patient should be reevaluated within a month. A patient has lost weight but swears she has been eating regularly. Which type of assessment would you use before making a definitive diagnosis? Nutrition. NGASR. Sleep. Psychosocial. Correct Answer: Nutrition. Poor body image may be related to a nutrition imbalance. There may also be other factors that affect the imbalance. A nutrition assessment will help determine the patient's attitude towards food. Gastric parietal cells secrete which of the following? mucous hydrochloric acid blood cells lymphatic fluid Correct Answer: hydrochloric acid Gastric parietal cells secrete hydrochloric acid. This is mediated by histamine2-receptor sites. A cancer in which there is extensive local and regional spread is in which stage? Stage I Stage II Stage III Stage IV Correct answer: Stage III Staging classifies the clinical aspects of the cancer and the degree of metastasis at diagnosis. A cancer with extensive local and regional spread is a Stage III cancer. Which of the following do you NOT use to determine priorities? Health concerns and strengths. Self-actualization. Maslow's hierarchy. Moral and ethical issues. Correct Answer: Self-actualization. Maslow's hierarchy of needs includes self actualization. Nurses use the other answer choices to prioritize diagnosis and action. Which potential diagnosis would you give a patient who wrings his or her hands during the interview? Ineffective coping. Anxiety. Disturbed personal identity. Infection risk. Correct answer: Anxiety The patient wringing his or her hands is an objective system. This signals anxiety even if the patient does not mention feeling anxious. The diagnosis should be considered with other symptoms. Insensible fluid loss from fever in older adults is often associated with all but which of the following? dry oral mucosa dry furrowed tongue hyponatremia serum sodium less than 150 mEq/L Correct answer: hyponatremia Insensible fluid loss from fever is associated with hypernatremia which presents with thirst. Disorientation, seizures, and coma occur in severe hypernatremia. Nurse Terri is assessing a female patient with red, itchy spots on various parts of the body. Her chart shows she isn't allergic to anything but the patient admits to changing her laundry detergent recently. Terri believes it is an allergic reaction due to what? An external irritant. A new medicine. A interaction of current medicines. Outdoor allergy. Correct answer: An external irritant When a patient present with an itchy rash or skin disorder, one of the first things to consider is an allergy to a medicine or food. When no allergy is detected, one of the most common forms of dermatitis happens when a patient tries a new cosmetic or laundry detergent. These types of disorders is often resolved once the product is discontinued.. The type of shock associated with impaired tissue perfusion caused by damage to or dysfunction of the sympathetic nervous system is which of the following? obstructive shock septic shock neurogenic shock hypovolemic shock Correct Answer: neurogenic shock Neurogenic shock is rare and may be associated with trauma, anesthesia, or spinal shock. In neurogenic shock, impaired tissue perfusion is caused by damage to or dysfunction of the sympathetic nervous system. Almost all lung cancers fall within one of four histologic categories. Which of the following is NOT one of these categories? malignant mesothelioma small cell carcinoma squamous cell carcinoma adenocarcinoma Correct Answer: malignant mesothelioma Malignant mesothelioma is not one of the four histologic categories for neoplastic lung disease. Besides the other three choices, large cell carcinoma is also one of the four categories. A 65-year-old Caucasian female is in the office with rosacea. She is asking about treatment options. What is the recommended treatment for her? topical 5-fluorouracil low-dose tetracycline oral ketoconazole oral hydrocortisone Correct Answer: low-dose tetracycline Treatment with systemic low-dose tetracycline is a very effective measure for rosacea; topical treatment with metronidazole or a low-dose steroid cream may also be helpful. Topical 5-fluorouracil is used to treat actinic keratosis. Mr. McBurney is an elderly patient who has severe COPD. Which of the following medications are you likely to prescribe for him at this stage of the disease? extended-release theophylline Ventolin Atrovent triamcinolone Correct Answer: extended-release theophylline Extended-release theophylline is used in severe COPD to improve respiratory muscle performance. For moderate COPD regular treatment with one or more of the other three choices is recommended. Which of the following is NOT an appropriate way to incorporate complementary therapies into a patient's plan of care? Asking a Reiki practitioner you work with to come in and do a treatment on the patient while he or she is sleeping. Allowing a Christian patient's prayer group to come and pray with her, at the patient's request. Helping a patient who wishes to incorporate acupuncture into her treatment to locate a practitioner in the area. Discussing the possible side effects of herbal medications with a patient who expresses a wish to use them. Correct Answer: Asking a Reiki practitioner you work with to come in and do a treatment on the patient while he or she is sleeping Complementary therapies can be helpful to patients and should be incorporated where possible if the patient wishes it. It is wise to discuss the side effects of any herbal medications with a patient, but unless there is a medical reason such as a drug interaction, there is no need to forbid them. Never engage in any spiritual therapies such as prayer or energy healing practices unless the patient requests it. You have diagnosed a 74-year-old patient with angle-closure glaucoma. Which of these MOST likely caused the condition? Sudden increase in intraocular pressure. Hardening of the lens. Lens clouding. Gradual onset of increased intraocular pressure. Correct answer: Sudden increase in intraocular pressure Presbyopia is caused by the hardening of the lens. Senile cataracts is caused by lens clouding. Open-angle glaucoma is caused by the gradual onset of increased intraocular pressure. Angle-closure glaucoma is caused by the sudden increase in intraocular pressure.