NSG 6340 Final Exam
1. A 37-year-old female patient with a history of a single episode of depression and frequent
complaints of PMS is being treated for hypothyroidism. Today she complains of poor concentration
and fatigue. Initially, the NP should:
a. Question her further
3. Which of the following is an example of secondary prevention?
a. Annual influenza vaccination
7. A 35-year old female with a history of mitral valve prolapse is scheduled for routine dental
cleaning. According to the 2007 American ___Association’s guideline for endocarditis
prophylaxis, what would you advise this patient?
a. She does not need prophylaxis for any dental procedure
b.
8. A patient recovering from a recent stroke is starting anticoagulant therapy. The nurse practitioner
should teach the patient to avoid all of the following EXCEPT:
a. b. milk and milk products
9. A patient presents with periorbital erythema and edema, fever, and nasal drainage. The nurse
practitioner should
a. start aggressive antibiotic therapy
10. A positive drawer sign support a diagnosis of
b. cruciate ligament injury
11. A 50-year-old patient with diabetes complains of pain bilaterally in her lower legs while
walking. The pain disappears at rest. What else would you expect to identify on her lower extremities.
b. peripheral artery insufficiency
12. A 16-year-old athlete complains of pain underneath his heel every time he walks. There is a verrucous
surface level with the skin of the heel. What pharmacologic interventions should the nurse practitioner
prescribe for this patient?
a. salicylic acid plasters
13. A __-year-old with Type I diabetes has had itching and burning lesions between her toes for 6 months.
Scrapings of the lesion confirm the diagnosis of tinea pedis. What is the best treatment option for this
patient?
a. prescribe an anti-fungal powder for application between her toes and in her shoes and a
topical prescription strength anti-fungal cream for other affected areas. Monitor for a
secondary bacterial infection.
, c. Prescribe an oral anti-fungal for 4 to 12 weeks. Monitor liver enzymes, BUN and creatinine at
one week, 2 weeks, and every month thereafter.
d. Prescribe a prescription strength antifungal/steroid combination cream. Monitor for a secondary
bacterial infection.
14. What is an appropriate drug for prophylactic treatment of migraine headaches in a 21-year-old
female?
a. Sumatriptan (Imitrex)
b. propranolol (Inderal)
c. ibuprofen (Motrin)
d. dihydroergotamine (DHE)
15. Which of the following are the classic features of ulcerative colitis?
a. RLQ pain, frequently accompanied by a palpable mass, fever, and leukopenia
b. Massive painful hematemesis, occasionally accompanied by melena
c. Rapidly progressive dysphagia to solid foods, anoriexia, and weight loss out of proportion to the
dysphagia
d. Remission and exacerbations of bloody diarrhea, tenesmus, fecal incontinence, abdominal pain,
and ___.
16. Which drugs below would be expected to produce the least amount of hypokalemia?
a. Furosemide (Lasix)
b. hydrochlorothiazide (HCTZ) and spironolactone (Aldactone)
c. Spironolactone (Aldactone)
d. hydrochlorothiazide (HCTZ)
17. What information should patients with diabetes and their families receive about hypoglycemia?
a. Hypoglycemia is very rare
b. Hypoglycemia requires professional medical treatment
c. Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly
d. Hypoglycemia occurs only as a result of overdose of insulin
18. A 60-year-old male patient with a past history of glaucoma and frequent sinusitis presents today with
hypertension. On his last 2 visits to the clinic his blood pressures were 150-160/90-98. The nurse
practitioner decides to treat the hypertension with long-acting propranolol (Inderal). Before prescribing it,
the nurse practitioner should ask:
a. whether he smokes or consumes alcohol on a daily basis
b. what other medications have been prescribed for him
c. if he takes a daily antihistamine
d. if other family members are hypertensive
19. Which of the following is NOT associated with Type 2 diabetes mellitus?
a. Gestational diabetes, birth of a macrosomic infant
b. Hispanic, African-American, or Native American descent
c. Alcohol or other drug abuse
d. Obesity, hypertension, hypertriglyceridemia
, 20. A 35-year-old male presents with a severe unilateral headache over his left eye. He says it started
about one hour ago and has rapidly gotten worse. He gives a history of similar headaches over the past 2
years. Physical examination is negative except for left eye lacrimation. What is the most likely diagnosis?
c. Cluster headache
d. Classic migraine headache
21. A 16-year-old sexually active female present to the clinic. She has never had vaccination for hepatitis
A or B, she has had one MMR immunization, and her last tetanus vaccination was 4 years ago. Which
vaccination would be contraindicated without further testing?
c. MMR
22. A 15-year-old male presents with abdominal pain that began in the peri-umbilical area then localized
to the right lower quadrant. He complains of nausea, vomiting, anorexia, and low-grade fever. A complete
blood count (CBC) reveals moderate leukocytosis. What is the most likely diagnosis?
d. Acute appendicitis
23. A 25-year-old hypertensive patient has a BMI of 16. His blood pressure is 165/100. There is an
audible bruit in his left upper abdominal quadrant. He probably has:
a. Essential hypertension
b. Secondary hypertension
24. Which of the following is the most common presenting sign of substance abuse in adolescents?
d. changes in behavior
25. Therapeutic international normalized ratio (INR) for a patient takein warfarin (Coumadin) for chronic
atrial fibrillation is expected to be
a. increased
26. A 199-year-old female reports that she is having “panic attacks.” The NP knows that panic attacks are
characterized by
d. sudden onset of intense fear or terror
27. A 25-year-old complains of fever and throat pain. The tonsils have exudate bilaterally. The patient
describes having an anaphylactic reaction to penicillin in the past. What antibiotic should the NP prescribe
if she believes the causative agent is bacterial?
a. amoxicillin (Amoxil)
b. erythromycin
28. A diagnostic finding of Hodgkin’s lymphoma is the presence of
b. Reed-Sternberg cells
29. With a history of ankle sprain, the nurse practitioner would most likely elicit a history of
d. ankle inversion
1. A 37-year-old female patient with a history of a single episode of depression and frequent
complaints of PMS is being treated for hypothyroidism. Today she complains of poor concentration
and fatigue. Initially, the NP should:
a. Question her further
3. Which of the following is an example of secondary prevention?
a. Annual influenza vaccination
7. A 35-year old female with a history of mitral valve prolapse is scheduled for routine dental
cleaning. According to the 2007 American ___Association’s guideline for endocarditis
prophylaxis, what would you advise this patient?
a. She does not need prophylaxis for any dental procedure
b.
8. A patient recovering from a recent stroke is starting anticoagulant therapy. The nurse practitioner
should teach the patient to avoid all of the following EXCEPT:
a. b. milk and milk products
9. A patient presents with periorbital erythema and edema, fever, and nasal drainage. The nurse
practitioner should
a. start aggressive antibiotic therapy
10. A positive drawer sign support a diagnosis of
b. cruciate ligament injury
11. A 50-year-old patient with diabetes complains of pain bilaterally in her lower legs while
walking. The pain disappears at rest. What else would you expect to identify on her lower extremities.
b. peripheral artery insufficiency
12. A 16-year-old athlete complains of pain underneath his heel every time he walks. There is a verrucous
surface level with the skin of the heel. What pharmacologic interventions should the nurse practitioner
prescribe for this patient?
a. salicylic acid plasters
13. A __-year-old with Type I diabetes has had itching and burning lesions between her toes for 6 months.
Scrapings of the lesion confirm the diagnosis of tinea pedis. What is the best treatment option for this
patient?
a. prescribe an anti-fungal powder for application between her toes and in her shoes and a
topical prescription strength anti-fungal cream for other affected areas. Monitor for a
secondary bacterial infection.
, c. Prescribe an oral anti-fungal for 4 to 12 weeks. Monitor liver enzymes, BUN and creatinine at
one week, 2 weeks, and every month thereafter.
d. Prescribe a prescription strength antifungal/steroid combination cream. Monitor for a secondary
bacterial infection.
14. What is an appropriate drug for prophylactic treatment of migraine headaches in a 21-year-old
female?
a. Sumatriptan (Imitrex)
b. propranolol (Inderal)
c. ibuprofen (Motrin)
d. dihydroergotamine (DHE)
15. Which of the following are the classic features of ulcerative colitis?
a. RLQ pain, frequently accompanied by a palpable mass, fever, and leukopenia
b. Massive painful hematemesis, occasionally accompanied by melena
c. Rapidly progressive dysphagia to solid foods, anoriexia, and weight loss out of proportion to the
dysphagia
d. Remission and exacerbations of bloody diarrhea, tenesmus, fecal incontinence, abdominal pain,
and ___.
16. Which drugs below would be expected to produce the least amount of hypokalemia?
a. Furosemide (Lasix)
b. hydrochlorothiazide (HCTZ) and spironolactone (Aldactone)
c. Spironolactone (Aldactone)
d. hydrochlorothiazide (HCTZ)
17. What information should patients with diabetes and their families receive about hypoglycemia?
a. Hypoglycemia is very rare
b. Hypoglycemia requires professional medical treatment
c. Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly
d. Hypoglycemia occurs only as a result of overdose of insulin
18. A 60-year-old male patient with a past history of glaucoma and frequent sinusitis presents today with
hypertension. On his last 2 visits to the clinic his blood pressures were 150-160/90-98. The nurse
practitioner decides to treat the hypertension with long-acting propranolol (Inderal). Before prescribing it,
the nurse practitioner should ask:
a. whether he smokes or consumes alcohol on a daily basis
b. what other medications have been prescribed for him
c. if he takes a daily antihistamine
d. if other family members are hypertensive
19. Which of the following is NOT associated with Type 2 diabetes mellitus?
a. Gestational diabetes, birth of a macrosomic infant
b. Hispanic, African-American, or Native American descent
c. Alcohol or other drug abuse
d. Obesity, hypertension, hypertriglyceridemia
, 20. A 35-year-old male presents with a severe unilateral headache over his left eye. He says it started
about one hour ago and has rapidly gotten worse. He gives a history of similar headaches over the past 2
years. Physical examination is negative except for left eye lacrimation. What is the most likely diagnosis?
c. Cluster headache
d. Classic migraine headache
21. A 16-year-old sexually active female present to the clinic. She has never had vaccination for hepatitis
A or B, she has had one MMR immunization, and her last tetanus vaccination was 4 years ago. Which
vaccination would be contraindicated without further testing?
c. MMR
22. A 15-year-old male presents with abdominal pain that began in the peri-umbilical area then localized
to the right lower quadrant. He complains of nausea, vomiting, anorexia, and low-grade fever. A complete
blood count (CBC) reveals moderate leukocytosis. What is the most likely diagnosis?
d. Acute appendicitis
23. A 25-year-old hypertensive patient has a BMI of 16. His blood pressure is 165/100. There is an
audible bruit in his left upper abdominal quadrant. He probably has:
a. Essential hypertension
b. Secondary hypertension
24. Which of the following is the most common presenting sign of substance abuse in adolescents?
d. changes in behavior
25. Therapeutic international normalized ratio (INR) for a patient takein warfarin (Coumadin) for chronic
atrial fibrillation is expected to be
a. increased
26. A 199-year-old female reports that she is having “panic attacks.” The NP knows that panic attacks are
characterized by
d. sudden onset of intense fear or terror
27. A 25-year-old complains of fever and throat pain. The tonsils have exudate bilaterally. The patient
describes having an anaphylactic reaction to penicillin in the past. What antibiotic should the NP prescribe
if she believes the causative agent is bacterial?
a. amoxicillin (Amoxil)
b. erythromycin
28. A diagnostic finding of Hodgkin’s lymphoma is the presence of
b. Reed-Sternberg cells
29. With a history of ankle sprain, the nurse practitioner would most likely elicit a history of
d. ankle inversion
