NR511 MIDTERM AND FINAL TEST PREP (SOLVED) (NR511)

Exam (elaborations) NR511 MIDTERM AND FINAL TEST PREP (SOLVED) (NR511) Question 1.Question : Which of the following is a crucial element of developing a guideline? Student Answer: Creating a physician expert panel Reviewing the literature with ratings of available evidence Conducting an external review of a guideline Developing evidence-based tables Points Received: 2 of 2 Comments: Question 2.Question : African American patients seem to have a negative reaction to which of the following asthma medications? Student Answer: Inhaled corticosteroids Long-term beta-agonist bronchodilators Leukotriene receptor agonists Oral corticosteroids Points Received: 2 of 2 Comments: Question 3.Question : Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean? Student Answer: The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the distant spread cannot be evaluated. The cancer is in situ; it is spreading into the lymph nodes, but the spread cannot be evaluated otherwise. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body. The cancer is about 5 cm in size; nearby lymph nodes cannot be evaluated; and there is no evidence of distant spreading. Points Received: 2 of 2 Comments: Question 4.Question : Sondra's peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear? Student Answer: Meclizine Diphenhydramine Diamox NR511 MIDTERM AND FINAL TEST PREP (SOLVED) Diamox Promethazine Points Received: 0 of 2 Comments: Question 5.Question : Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a: Student Answer: Filiform/digitate wart Dysplastic cervical lesion Condyloma acuminata Koilocytosis Points Received: 2 of 2 Comments: Question 6.Question : Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of? Student Answer: Dementia Alzheimer's disease Parkinson's disease Delirium Points Received: 2 of 2 Comments: Question 7.Question : You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her? Student Answer: "Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow." "Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow." "Drive to the emergency room now." "Call 911." Points Received: 2 of 2 Comments: Question 8.Question : 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? Student Answer: NSAIDs NSAIDs Beets Vitamin A Red meat Points Received: 2 of 2 Comments: Question 9.Question : Which of the following is an example of tertiary prevention in a patient with chronic renal failure? Student Answer: Fluid restriction Hemodialysis 4 days a week High-protein diet Maintenance of blood pressure at 120/80 Points Received: 2 of 2 Comments: Question 10.Question : Which of the following conditions is associated with cigarette smoking? Student Answer: Glaucoma Increased sperm quality Bladder cancer Eczema Points Received: 0 of 2 Comments: Question 11.Question : A chronic cough lasts longer than: Student Answer: 3 weeks 1 month 6 months 1 year Points Received: 0 of 2 Comments: Question 12.Question : The 'freezing phenomenon' is a cardinal feature of? Student Answer: Parkinson's disease Alzheimer's disease A CVA Bell's palsy Points Received: 0 of 2 Comments: Question 13.Question : When administered at the beginning of an attack, oxygen therapy may help this kind of headache? Student Answer: Tension Migraine Cluster Stress Points Received: 0 of 2 Comments: Question 14.Question : Which ethnic group has the highest lung cancer incidence and mortality rates? Student Answer: African American men Scandinavian men and women Caucasian women Asian men Points Received: 0 of 2 Comments: Question 15.Question : The most significant precipitating event leading to otitis media with effusion is: Student Answer: Pharyngitis Allergies Viral upper respiratory infection (URI) Perforation of the eardrum Points Received: 2 of 2 Comments: Question 16.Question : Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of: Student Answer: Severe asthma A common valvular lesion Severe hypertension A prosthetic heart valve Points Received: 0 of 2 Comments: Question 17.Question : A 34-year-old patient was treated for a UTI and has not responded to antibiotic therapy. Which of the following actions should be taken next? Student Answer: Send a urine specimen for microscopy and evaluate for fungal colonies. fungal colonies. Increase the dose of antibiotic. Order a cytoscopy. Order a different antibiotic. Points Received: 0 of 2 Comments: Question 18.Question : Which statement best describes a carotid bruit? Student Answer: It is felt with the middle three fingers over the carotid artery. A bruit becomes audible when the lumen is narrowed to 1 mm or less. A low-pitched bruit is a medical emergency. The higher the pitch of the bruit, the higher the degree of stenosis. Points Received: 0 of 2 Comments: Question 19.Question : Which statement is true regarding chloasma, the 'mask of pregnancy'? Student Answer: It is caused by a decrease in the melanocyte-stimulating hormone during pregnancy. This condition only occurs on the face. Exposure to sunlight will even out the discoloration. It is caused by increased levels of estrogen and progesterone. Points Received: 2 of 2 Comments: Question 20.Question : Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause? Student Answer: "You must be under a lot of stress lately." "It is hereditary. Did your father experience this also?" "The cause is unknown, but we suspect it is due to an immunologic mechanism." "We'll have to do some tests." Points Received: 0 of 2 Comments: Question 21.Question : A blood pressure (BP) of 150/90 is considered: Student Answer: Stage 2 hypertension Student Answer: Stage 2 hypertension Hypertensive Normal in healthy older adults Acceptable if the patient has DM Points Received: 0 of 2 Comments: Question 22.Question : When teaching post MI patients about their NTG tablets, the clinician should stress that the tablets should remain in the light-resistant bottle in which they are packaged and should not be put in another pill box or remain in areas that are or could become warm and humid. Once opened, the bottle must be dated and discarded after how many months? Student Answer: 1 month 3 months 6 months As long as the tablets are kept in this special bottle, they will last forever. Points Received: 0 of 2 Comments: Question 23.Question : Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking? Student Answer: He should stop smoking today. He should stop smoking tomorrow. His quit date should be in 1 week. He will be ready to quit after the first 30 days. Points Received: 0 of 2 Comments: Question 24.Question : When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are? Student Answer: Spores Leukocytes Pseudohyphae Epithelial cells Points Received: 0 of 2 Comments: Question 25.Question : The hallmark of an absence seizure is: Question 25.Question : The hallmark of an absence seizure is: Student Answer: No activity at all A blank stare Urine is usually voided involuntarily The attack usually lasts several minutes Points Received: 0 of 2 Comments: Question 26.Question : Which medication used for scabies is safe for children 2 months and older? Student Answer: Permethrin cream Lindane Crotamiton lotion and cream Ivermectin Points Received: 0 of 2 Comments: Question 27.Question : The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis? Student Answer: Viral conjunctivitis Keratoconjunctivitis Bacterial conjunctivitis Allergic conjunctivitis Points Received: 2 of 2 Comments: Question 28.Question : Gabby, aged 22, has Bell's palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her? Student Answer: "Most patients have complete recovery in 3 to 6 months." "Unfortunately, you'll probably have a small amount of residual damage." "Don't worry, I'll take care of everything." "You may have a few more episodes over the course of your lifetime but no permanent damage." Points Received: 2 of 2 Comments: Question 29.Question : How often should drug levels be monitored when a seizure Question 29.Question : How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate? Student Answer: Every 3 months Every 6 months Annually Whenever there is a problem Points Received: 0 of 2 Comments: Question 30.Question : Immunizations are an example of which type of prevention? Student Answer: Primary Secondary Tertiary Points Received: 0 of 2 Comments: Question 31.Question : The result of the patient's 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions? Student Answer: Repeat the test. Refer to a nephrologist. Measure the serum protein. Obtain a blood urea nitrogen (BUN) and creatinine. Points Received: 2 of 2 Comments: Question 32.Question : Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing? Student Answer: CN V CN VII CN IX CN X Points Received: 0 of 2 Comments: Question 33.Question : Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer? Student Answer: Kidneys, ureter, bladder x-ray Cystoscopy with biopsy Magnetic resonance imaging Urine tumor marker (NMP22) Urine tumor marker (NMP22) Points Received: 2 of 2 Comments: Question 34.Question : The "B" in the ABCDEs of assessing skin cancer represents: Student Answer: Biopsy Best practice Boundary Border irregularity Points Received: 2 of 2 Comments: Question 35.Question : Which statement is true regarding driving and patients with a seizure disorder? Student Answer: Once diagnosed with a seizure disorder, patients must never drive again. After being seizure free for 6 months, patients may drive. Each state has different laws governing driving for individuals with a seizure disorder. These persons may drive but never alone. Points Received: 0 of 2 Comments: Question 36.Question : Which high-density lipoprotein (HDL) level is considered cardioprotective? Student Answer: Greater than 30 Greater than 40 Greater than 50 Greater than 60 Points Received: 0 of 2 Comments: Question 37.Question : The most common cause of CAP is? Student Answer: Streptococcus pneumoniae Klebsiella pneumoniae Legionella pneumoniae Pseudomonas aeruginosa Points Received: 0 of 2 Comments: Question 38.Question : Sandra has palpitations that occur with muscle twitching, Question 38.Question : Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause? Student Answer: Serum calcium Electrocardiogram (ECG) Thyroid-stimulating hormone test Complete blood cell count Points Received: 2 of 2 Comments: Question 39.Question : A patient presents to the clinician with a sore throat, fever of 100.7?F, 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? Student Answer: 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. Points Received: 0 of 2 Comments: Question 40.Question : Patients with acute otitis media should be referred to a specialist in which of the following situations? Student Answer: Concurrent vertigo or ataxia Failed closure of a ruptured tympanic membrane If symptoms worsen after 3 or 4 days of treatment All of the above Points Received: 0 of 2 Comments: Question 41.Question : Which of the following tests is most useful in determining renal function in a patient suspected of CRF? Student Answer: BUN and creatinine Electrolytes Creatinine clearance Urinalysis Points Received: 0 of 2 Points Received: 0 of 2 Comments: Question 42.Question : Marci has a wart on her hand. She says she heard something about "silver duct tape therapy." What do you tell her about his? Student Answer: It is an old wives' tale. It is used as a last resort. Salicylic acid is more effective. It is a simple treatment that should be tried first. Points Received: 0 of 2 Comments: Question 43.Question : What is the first-line recommended treatment against Group A ?-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis? Student Answer: Penicillin Quinolone Cephalosporin Macrolide Points Received: 0 of 2 Comments: Question 44.Question : Which of the following is an example of sensorineural hearing loss? Student Answer: Perforation of the tympanic membrane Otosclerosis Cholesteatoma Presbycusis Points Received: 0 of 2 Comments: Question 45.Question : Which of the following is "a linear crack extending from the epidermis to the dermis?" Student Answer: An ulcer A fissure Lichenification An excoriation Points Received: 2 of 2 Comments: Question 46.Question : A 65-year-old man presents to the clinician with complaints Question 46.Question : A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma? Student Answer: The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient. Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve. Points Received: 0 of 2 Comments: Question 47.Question : The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection? Student Answer: IgA IgE IgG IgM Points Received: 0 of 2 Comments: Question 48.Question : A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses? Student Answer: Pancreatitis Peptic ulcer disease Diverticulitis All of the above Points Received: 0 of 2 Comments: Question 49.Question : Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test? making it a good diagnostic test? Student Answer: B-type natriuretic peptide C-reactive protein Serum albumin Erythrocyte sedimentation rate Points Received: 0 of 2 Comments: Question 50.Question : You are doing a cerumen extraction and touch the external meatus of your patient's ear. He winces and starts coughing. What is the name of this reflex? Student Answer: Baker phenomenon Arnold reflex Cough reflex Tragus reflex Points Received: 0 of 2 Comments: * Times are displayed in (GMT-07:00) Mountain Time (US & Canada) Question : The most cost-effective screening test for determining HIV status is which of the following? Student Answer: Western blot Enzyme-linked immunosorbent assay Venereal Disease Research Laboratory test Viral load Points Received: 0 of 2 Comments: Question 2.Question : Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process? Student Answer: Erythrocyte sedimentation rate White blood cell count Polymorphonuclear cells C-reactive protein (CRP) C-reactive protein (CRP) Points Received: 0 of 2 Comments: Question 3.Question : Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter? Student Answer: GABA Acetylcholine Dopamine Serotonin Points Received: 0 of 2 Comments: Question 4.Question : Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is: Student Answer: Ecchymosis, edema, and erythema over the lateral epicondyle Pain at the elbow with resisted movements at the wrist and forearm Inability to supinate and pronate the arm Inability to flex or extend the elbow against resistance Points Received: 2 of 2 Comments: Question 5.Question : Which of the following statements concerning the musculoskeletal examination is true? Student Answer: The uninvolved side should be examined initially and then compared to the involved side. The part of the body that is causing the patient pain should be examined first. When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient. Points Received: (not graded) Comments: Question 6.Question : Which of the following signs or symptoms indicate an Question 6.Question : Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? Student Answer: Decreased C-reactive protein Hyperalbuminemia Morning stiffness Weight gain Points Received: (not graded) Comments: Question 7.Question : Which causes the greatest percentage of mammalian bites? Student Answer: Dogs Cats Humans Rodents Points Received: (not graded) Comments: Question 8.Question : A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first? Student Answer: Transvaginal ultrasound Endometrial biopsy MRI Abdominal computed tomography scan Points Received: (not graded) Comments: Question 9.Question : A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate? Student Answer: "Control of glucose will help postpone or delay complications." "Regularly checking blood sugar will help establish a routine." "Monitoring glucose will promote a sense of control." All of the above Points Received: (not graded) Comments: Question 10.Question : A 25-year-old patient presents to the clinic with fatigue, cold Question 10.Question : A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next? Student Answer: Serum calcium TSH Electrolytes Urine specific gravity Points Received: (not graded) Comments: Question 11.Question : Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy? Student Answer: Insulin Metformin Glucotrol Precose Points Received: (not graded) Comments: Question 12.Question : During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? Student Answer: An enlarged rubbery gland A hard irregular gland A tender gland A boggy gland Points Received: (not graded) Comments: Question 13.Question : Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step? Student Answer: Remove the insect with tweezers. Immobilize the insect with 2% lidocaine. Sedate Eddie with diazepam. Shine a light in the ear for the insect to "find its way out." Points Received: (not graded) Comments: Question 14.Question : What is the most common cause of microcytic anemia? Student Answer: Anemia of chronic disease Sideroblastic anemia Iron-deficiency anemia Thalassemia Points Received: (not graded) Comments: Question 15.Question : An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses? Student Answer: Benign prostatic hyperplasia (BPH) Parkinson's disease Prostate cancer All of the above Points Received: (not graded) Comments: Question 16.Question : Early rheumatoid disease is characterized by: Student Answer: Pain and swelling in both small and large peripheral joints Rigid joints with diminished range of motion Joint swelling and immobility on rising A cardiac rub or pulmonary friction rub Points Received: (not graded) Comments: Question 17.Question : A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do? Student Answer: Make an immediate referral for an orthopedic evaluation without further assessment. Tell her that it takes time for these bruises to improve, so she should be patient. Obtain a wrist x-ray and place her wrist in a splint or Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint. Send her to the emergency room for reduction of this obvious wrist fracture. Points Received: (not graded) Comments: Question 18.Question : The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least: Student Answer: 1 month 3 months 6 months 12 months Points Received: (not graded) Comments: Question 19.Question : A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find? Student Answer: The scrotum will be dark. The scrotum will appear light pink or yellow. The scrotum will appear milky white. The internal structures will be clearly visible. Points Received: (not graded) Comments: Question 20.Question : According to Kübler-Ross, the stages of grief occur in which order? Student Answer: Anger, denial, depression, bargaining, acceptance Anger, denial, bargaining, acceptance, depression Denial, anger, depression, bargaining, acceptance Denial, anger, bargaining, depression, acceptance Points Received: (not graded) Comments: Question 21.Question : Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate? Student Answer: A favorable prognostic trend A favorable prognostic trend Disease progression The need to be more aggressive with Reuben's medications The eradication of the HIV Points Received: (not graded) Comments: Question 22.Question : The exanthem of Lyme disease is: Student Answer: Erythema infectiosum Laterothoracic exanthem Erythema migrans Morbilli exanthem Points Received: (not graded) Comments: Question 23.Question : You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is: Student Answer: Articular Inflammatory Nonarticular A and B Points Received: (not graded) Comments: Question 24.Question : What is the recommended daily calcium intake for adults over the age of 50 with low bone mass? Student Answer: 1,200 mg/day 1,000 mg/day 1,300 mg/day 1,500 mg/day Points Received: (not graded) Comments: Question 25.Question : When assessing a woman for infertility, which of the following tests should be done first? Student Answer: Analysis of partner's sperm Magnetic resonance imaging (MRI) Hysterosalpingogram Estrogen level Points Received: (not graded) Comments: Question 26.Question : Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact? Student Answer: Superficial burns Superficial partial-thickness burns