NR 511 NR511 FINAL EXAM 1.
NR 511 / NR511 FINAL EXAM 1
The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following
neurotransmitters plays a role in anxiety?
Gamma-aminobutyric acid (GABA)
The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Associations
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?
6 months
A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of
the following is the treatment of choice for gonorrhea?
a. Ceftriaxone
b. Doxycycline
c. Acyclovir
d. Metronidazole
Ceftriaxone
A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis,
which of the following questions should be asked?
a. "Do you have a history of liver disease?"
b. "What medications are you currently taking?"
c. "Have you noticed swelling in your ankles?"
d. All of the above
"What medications are you currently taking"
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?
a. NSAIDs
b. Beets
c. Vitamin A
d. Red meat
NSAIDS
A 27-year-old female presents with a chief complaint of burning and pain on urination. She has no
previous history of urinary tract infection (UTI). What are some additional symptoms consistent with a
diagnosis of lower UTI?
a. Back and abdominal pain
b. Fever, chills, costovertebral angle (CVA) tenderness
,NR 511 NR511 FINAL EXAM 1.
c. Blood in urine and frequency
d. Foul-smelling discharge, perineal
itch Blood in urine ad frequency
A 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows
greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis?
a. Lower urinary tract infection
b. Chlamydia infection
c. Candidiasis
d. Pyelonephritis
Lower urinary tract infection
A patient presents with CVA tenderness and a several-day history of high fever, chills, and dysuria.
Which of the following diagnoses is most likely given the above information?
a. Pyelonephritis
b. Cystitis
c. Renal calculi
d. Bladder tumor
Pyelonephritis
A patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question
the patient about which of these contraindications to this medication?
a. Diarrhea
b. Parkinson's disease
c. Closed-angle glaucoma
d. Breast cancer
Closed-angle
glaucoma
A patient is seen in the office complaining of severe flank pain. The clinician should assess this patient for
which risk factor for kidney stones?
a. Hypertension
b. Constipation
c. Tubal ligation
d. Diabetes
Hypertension
A patient is diagnosed with overactive bladder. Which of the following instructions should be given
to this woman?
a. "Limit the amount of water that you
drink." b. "Eliminate caffeine from your diet."
c. "Wear panty liners."
d. All of the above
Eliminate caffeine from your diet
,NR 511 NR511 FINAL EXAM 1.
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?
a. Send a urine specimen for microscopy and evaluate for fungal colonies.
b. Increase the dose of antibiotic.
c. Order a cytoscopy.
d. Order a different antibiotic.
Send a urine specimen for microscopy and evaluate for fungal colonies
Which of the following are predisposing factors for pyelonephritis?
a. Pregnancy
b. Dehydration
c. Smoking
d. Alkaline urine
Pregnancy
A 42-year-old woman is seen in the clinic with fever, chills, vomiting, and severe dysuria. She is
diagnosed with acute pyelonephritis. How should this patient be managed?
a. 3-day course of oral
antibiotics b. Hospitalization
c. Encourage cranberry juice intake.
d. 6-week course of
antibiotics Hospitalization
Oral antibiotics may be prescribed in mild cases of acute pyelonephritis, characterized by the absence of
nausea and vomiting or signs of sepsis. First-line therapy includes ciprofloxacin (Cipro) 500 mg two times
daily for 7 days, or ciprofloxacin extended-release (Cipro XR) 1,000 mg daily for 7 days, or levofloxacin
(Levaquin) 750 mg daily for 5 days.
Hospitalization may be indicated, depending on the patient's ability to maintain adequate fluid
intake
and to tolerate oral antibiotics, along with the severity of the symptoms and evidence of bacteremia.
Hospitalization of patients who are pregnant, vomiting, or dehydrated should be strongly considered.
Likewise, the patient's degree of systemic illness (bacteremia or urosepsis), age, history of
chronic
disease, or nonadherence to therapy may lead to the assessment that hospitalization is
necessary.
Ninety- five percent of patients demonstrate a good response within 48 hours to IV antibiotic
treatment
and may be discharged on appropriate oral medication, once urine culture and antibiotic sensitivity
results are available and subsequent antimicrobial therapy may be narrowed in
spectrum.
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?
a. Pancreatitis
b. Peptic ulcer disease
, NR 511 NR511 FINAL EXAM 1.
c. Diverticulitis
d. All of the
above All of the
above
Which of the following instructions should be given to the patient with
nephrolithiasis? a. Take ibuprofen, 600 mg every 8 hours.
b. Take Tums® for stomach upset.
c. Drink more black tea.
d. Increase intake of vegetables, like
spinach. Take ibuprofen, 600 mg every 8
hours
Which of the following patients is at risk for developing urinary tract cancer?
a. The 45-year-old woman who is 100 lbs overweight
b. The 78-year-old man who smokes three packs of cigarettes a day
c. The 84-year-old man who worked in the asbestos
mines d. All of the above
All of the above
Obesity; exposure to asbestos, cadmium, and/or gasoline; the use of phenacetin- and aspirin-containing
analgesics; and chronic hemodialysis for acquired polycystic kidney disease are all risk factors for renal
cell carcinoma. Cigarette smoking has a 25% to 30% correlation with the development of renal cell
carcinoma.
An 86-year-old woman is seen in the clinic for recurrent hematuria. The provider suspects bladder
cancer. Which of the following data from the history is considered a risk factor for this type of cancer?
a. History of alcoholism
b. Sedentary lifestyle
c. Obesity
d. 65-year smoking
history 65-year smoking
history
Which of the following diagnostic tests should be ordered for a patient suspected of having bladder
cancer?
a. Kidneys, ureter, bladder x-
ray b. Cystoscopy with biopsy
c. Magnetic resonance imaging
d. Urine tumor marker
(NMP22) Cystoscopy with
biopsy
A 78-year-old man is diagnosed with Stage D bladder cancer and asks the provider what that means.
NR 511 / NR511 FINAL EXAM 1
The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following
neurotransmitters plays a role in anxiety?
Gamma-aminobutyric acid (GABA)
The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Associations
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?
6 months
A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of
the following is the treatment of choice for gonorrhea?
a. Ceftriaxone
b. Doxycycline
c. Acyclovir
d. Metronidazole
Ceftriaxone
A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis,
which of the following questions should be asked?
a. "Do you have a history of liver disease?"
b. "What medications are you currently taking?"
c. "Have you noticed swelling in your ankles?"
d. All of the above
"What medications are you currently taking"
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?
a. NSAIDs
b. Beets
c. Vitamin A
d. Red meat
NSAIDS
A 27-year-old female presents with a chief complaint of burning and pain on urination. She has no
previous history of urinary tract infection (UTI). What are some additional symptoms consistent with a
diagnosis of lower UTI?
a. Back and abdominal pain
b. Fever, chills, costovertebral angle (CVA) tenderness
,NR 511 NR511 FINAL EXAM 1.
c. Blood in urine and frequency
d. Foul-smelling discharge, perineal
itch Blood in urine ad frequency
A 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows
greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis?
a. Lower urinary tract infection
b. Chlamydia infection
c. Candidiasis
d. Pyelonephritis
Lower urinary tract infection
A patient presents with CVA tenderness and a several-day history of high fever, chills, and dysuria.
Which of the following diagnoses is most likely given the above information?
a. Pyelonephritis
b. Cystitis
c. Renal calculi
d. Bladder tumor
Pyelonephritis
A patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question
the patient about which of these contraindications to this medication?
a. Diarrhea
b. Parkinson's disease
c. Closed-angle glaucoma
d. Breast cancer
Closed-angle
glaucoma
A patient is seen in the office complaining of severe flank pain. The clinician should assess this patient for
which risk factor for kidney stones?
a. Hypertension
b. Constipation
c. Tubal ligation
d. Diabetes
Hypertension
A patient is diagnosed with overactive bladder. Which of the following instructions should be given
to this woman?
a. "Limit the amount of water that you
drink." b. "Eliminate caffeine from your diet."
c. "Wear panty liners."
d. All of the above
Eliminate caffeine from your diet
,NR 511 NR511 FINAL EXAM 1.
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?
a. Send a urine specimen for microscopy and evaluate for fungal colonies.
b. Increase the dose of antibiotic.
c. Order a cytoscopy.
d. Order a different antibiotic.
Send a urine specimen for microscopy and evaluate for fungal colonies
Which of the following are predisposing factors for pyelonephritis?
a. Pregnancy
b. Dehydration
c. Smoking
d. Alkaline urine
Pregnancy
A 42-year-old woman is seen in the clinic with fever, chills, vomiting, and severe dysuria. She is
diagnosed with acute pyelonephritis. How should this patient be managed?
a. 3-day course of oral
antibiotics b. Hospitalization
c. Encourage cranberry juice intake.
d. 6-week course of
antibiotics Hospitalization
Oral antibiotics may be prescribed in mild cases of acute pyelonephritis, characterized by the absence of
nausea and vomiting or signs of sepsis. First-line therapy includes ciprofloxacin (Cipro) 500 mg two times
daily for 7 days, or ciprofloxacin extended-release (Cipro XR) 1,000 mg daily for 7 days, or levofloxacin
(Levaquin) 750 mg daily for 5 days.
Hospitalization may be indicated, depending on the patient's ability to maintain adequate fluid
intake
and to tolerate oral antibiotics, along with the severity of the symptoms and evidence of bacteremia.
Hospitalization of patients who are pregnant, vomiting, or dehydrated should be strongly considered.
Likewise, the patient's degree of systemic illness (bacteremia or urosepsis), age, history of
chronic
disease, or nonadherence to therapy may lead to the assessment that hospitalization is
necessary.
Ninety- five percent of patients demonstrate a good response within 48 hours to IV antibiotic
treatment
and may be discharged on appropriate oral medication, once urine culture and antibiotic sensitivity
results are available and subsequent antimicrobial therapy may be narrowed in
spectrum.
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?
a. Pancreatitis
b. Peptic ulcer disease
, NR 511 NR511 FINAL EXAM 1.
c. Diverticulitis
d. All of the
above All of the
above
Which of the following instructions should be given to the patient with
nephrolithiasis? a. Take ibuprofen, 600 mg every 8 hours.
b. Take Tums® for stomach upset.
c. Drink more black tea.
d. Increase intake of vegetables, like
spinach. Take ibuprofen, 600 mg every 8
hours
Which of the following patients is at risk for developing urinary tract cancer?
a. The 45-year-old woman who is 100 lbs overweight
b. The 78-year-old man who smokes three packs of cigarettes a day
c. The 84-year-old man who worked in the asbestos
mines d. All of the above
All of the above
Obesity; exposure to asbestos, cadmium, and/or gasoline; the use of phenacetin- and aspirin-containing
analgesics; and chronic hemodialysis for acquired polycystic kidney disease are all risk factors for renal
cell carcinoma. Cigarette smoking has a 25% to 30% correlation with the development of renal cell
carcinoma.
An 86-year-old woman is seen in the clinic for recurrent hematuria. The provider suspects bladder
cancer. Which of the following data from the history is considered a risk factor for this type of cancer?
a. History of alcoholism
b. Sedentary lifestyle
c. Obesity
d. 65-year smoking
history 65-year smoking
history
Which of the following diagnostic tests should be ordered for a patient suspected of having bladder
cancer?
a. Kidneys, ureter, bladder x-
ray b. Cystoscopy with biopsy
c. Magnetic resonance imaging
d. Urine tumor marker
(NMP22) Cystoscopy with
biopsy
A 78-year-old man is diagnosed with Stage D bladder cancer and asks the provider what that means.
