NR 509 Midterm and Final Exam 1 Practice Test
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, NR 509 Chamberlain Exam
A 31-year-old marathon runner presents for prenatal care with her first pregnancy. She is in her second
trimester and is experiencing some fatigue and muscle aches. Her prepregnancy body mass index
(BMI) was noted at 19.2. How should she be counseled on exercise and nutrition during pregnancy?
a. She should gain at least 40 pounds during the pregnancy to account for being underweight at the
time of conception.
b. Immersion in hot water is a safe and effective nonmedicinal way of coping with musculoskeletal
complaints during pregnancy.
c. She should increase her calorie intake to 300 calories per day or more from her prepregnancy
baseline.
d. She should avoid unpasteurized dairy products and delicatessen meats due to the risk of
mycobacteria, shigellosis, and brucellosis.
e. She should switch from running to weight-lifting (e.g., bench press) to maintain muscle mass while
avoiding the stressors of running on the fetus –
Correct Answer :c. She should increase her calorie intake to 300 calories per day or more from her
prepregnancy baseline.
Rationale: As the patient's BMI was low-normal to begin with, she may need more than the usual 300
calorie increase to account for the growing fetus.
A 29-year-old G2P1 presents to the clinic after a positive home pregnancy test. She confides at the
appointment that her male partner has become increasingly abusive lately and once struck her while
she was holding her older child. How should she be counseled?
a. Ask that she bring the partner to all appointments so that he can be included in decisions and thus
feel less threatened and less likely to harm the patient again.
b. Reassure her that no matter what she reveals, all information she discloses will be kept strictly
confidential.
c. Ask open-ended questions, allow her to make decisions that she feels are best for herself given the
circumstance, and provide immediate or long-term referrals to domestic violence resources.
d. Reassure her that she is safe as very few pregnant women are hurt or murdered by their partners,
who generally become less violent during the vulnerable period of pregnancy.
e. Demand that s –
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, NR 509 Chamberlain Exam
Correct Answer :c. Ask open-ended questions, allow her to make decisions that she feels are best for
herself given the circumstance, and provide immediate or long-term referrals to domestic violence
resources.
Rationale: The approach of asking open-ended questions, allowing her to make decisions that she
feels are best for herself given the circumstance, and providing immediate or long-term referrals to
domestic violence resources is most likely to build trust and provide the resource needed for the
patient to care for herself and her children.
A 34-year-old G3P2 at 27 weeks' gestation is referred to the clinic upon discharge from a correctional
institution where she has been incarcerated for 25 days for a drug offense. She denies any further
substance abuse, but her behavior is concerning for intoxication, and she smells of alcohol and
cigarettes. The clinician inquires about her drug use with open-ended questions and counsels her that
which of the following is true?
a. Pregnant women are not routinely screened for hepatitis C, but this test should be added to the
panel of prenatal blood tests for patients with a history of intravenous drug use.
b. Cigarettes are a rare cause of low birth weight in the growing fetus.
c. Women can safely drink one alcoholic drink per day without risk of fetal alcohol syndrome.
d. If a pregnant patient does not intend to quit tobacco, she should not bother to cut down as there is
no benefit to the pregnancy from decreased us –
Correct Answer :a. Pregnant women are not routinely screened for hepatitis C, but this test should be
added to the panel of prenatal blood tests for patients with a history of intravenous drug use.
Rationale: The U.S. Preventive Services Task Force currently does not recommend routine screening of
pregnant women for hepatitis C but does recommend screening of individuals at elevated risk of the
disease.
A 78-year-old woman presents to clinic with her two daughters, who are concerned about her
continued ability to live independently. She has thus far been highly self-reliant and is opposed to the
idea of leaving of her home of 30 years. The clinician performs a complete history and physical exam
(including mental status and memory testing) as well as orders laboratory tests before providing the
patient and her family the finding that she has age-appropriate changes that do not reflect any
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particular disease process. Which of the following findings is most consistent with the normal aging
process and does not impair the ability to live alone?
a. Age-related cognitive decline
b. Mild cognitive impairment
c. Decreased level of thyroid hormone
d. Persistent urinary incontinence
e. Decreased adipose-to-muscle ratio –
Correct Answer :a. Age-related cognitive decline
Rationale: Age-related cognitive decline is a normal finding and includes mild forgetfulness, difficulty
remembering names, and mildly reduced concentration that are sporadic and do not affect fu
Which of the following best describes the role of the health practitioner in caring for the aging
American population?
a. Prepare all persons age ≥65 years for the eventuality that they will become frail.
b. Understand that the older population is generally homogenous with little variation in needs.
c. Evaluate geriatric conditions in terms of functionality and quality of life rather than via traditional
disease models.
d. Employ the same disease models used to treat younger patients with chronic disease.
e. Assure that all elders complete an annual physical examination. –
Correct Answer :c. Evaluate geriatric conditions in terms of functionality and quality of life rather than
via traditional disease models.
Rationale: Many diseases of older patients are not curable (such as diabetes or dementia) but can be
managed for maximal quality of life. This requires a shift from traditional modes of thinking of disease
as an entity that is addressed and cured.
Which of the following is true about hair in the aging adult?
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