Brenda James I Human Mangement Plan NURS6531 NURS6531 Adele Spencer I Human Management Plan Primary Diagnosis and ICD-10 code: G35 Additional laboratory and diagnostic tests: Initial: Brain MRI, Cervical Spine MRI, Cerebrospinal Fluid (CSF) analysis

NURSING 6531 FINAL EXAM. • Question 1 When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? • Question 2 Which of the following patients most warrants screening for hypothyroidism? • Question 3 Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)? • Question 4 A 32 year old male patient complains of urinary frequency and burning on urination for 3 days. Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial treatment should be: • Question 5 The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is: • Question 6 A patient has been taking fluoxetine (Prozac) since being diagnosed with major depression, first episode, 2 months ago. She reports considerable improvement in her symptoms and her intention to discontinue the medication. What should be the nurse practitioner’s recommendation? • Question 7 The nurse practitioner is following a child with juvenile rheumatoid arthritis (JRA) who has been previously diagnosed and is being managed for the disease by a pediatric rheumatologist. The mother asks for information about the child’s long term prognosis. What is the most appropriate reply? • Question 8 Which is the most common cause of end-stage renal disease in the United States? • Question 9 Which of the following physical modalities recommended for treatment of rheumatoid arthritis provides the most effective long term pain relief? • Question 10 Dave, age 38, states that he thinks he has an ear infection because he just flew back from a business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next action? • Question 11 A child with type 1 diabetes mellitus has experienced excessive hunger, weight gain and increasing hyperglycemia. The Somogyi effect is suspected. What steps should be taken to diagnose and treat this condition? • Question 12 The most commonly recommended method for prostate cancer screening in a 55 year old male is: • Question 13 The most common cause of elevated liver function tests is: • Question 14 The cardinal sign of infectious arthritis is: • Question 15 Central obesity, “moon” face, and dorsocervical fat pad are associated with: • Question 16 Which of the following characteristics are associated with prepatellar bursitis? • Question 17 A diabetic patient is taking low-dose enalapril for hypertension. A record of the patient’s blood pressure over 4 weeks ranges from 130 to 142 mmHg systolic and 75 to 85 mmHg diastolic. How should the nurse practitioner respond? • Question 18 Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following: • Question 19 Diagnostic confirmation of acute leukemia is based on: • Question 20 Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to: • Question 21 You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of: • Question 22 A 14 year old female cheerleader reports gradual and progressive dull anterior knee pain, exacerbated by kneeling. The nurse practitioner notes swelling and point tenderness at the tibial tuberosity. X-ray is negative. What is the most likely diagnosis? • Question 23 The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in almost 100% of patients is: • Question 24 Jack, age 55, comes to the office with a blood pressure of 144/98 mm Hg. He states that he did not know if it was ever elevated before. When you retake his blood pressure at the end of the exam, it remains at 144/98. What should your next action be? • Question 25 A 60 year old male patient with multiple health problems presents with a complaint of erectile dysfunction (ED). Of the following, which medication is most likely to be causing the problem? • Question 26 Which drug category contains the drugs that are the first line Gold standard therapy for COPD? • Question 27 Phalen’s test, 90° wrist flexion for 60 seconds, reproduces symptoms of: • Question 28 A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects: • Question 29 Risk factors for prostate cancer include all of the following except: • Question 30 A 60 year old female patient complains of sudden onset unilateral, stabbing, surface pain in the lower part of her face lasting a few minutes, subsiding, and then returning. The pain is triggered by touch or temperature extremes. Physical examination is normal. Which of the following is the most likely diagnosis? • Question 31 Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect? • Question 32 The most reliable diagnostic indicator of gout is: • Question 33 Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus? • Question 34 Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? • Question 35 What is the most common cause of Cushing’s syndrome? • Question 36 The most accurate measure of diabetes control is: • Question 37 Which of the following is a contraindication for metformin therapy? • Question 38 Sam, age 42, has had persistent proteinuria on the previous two office visits. Which action is warranted next? • Question 39 The most common presentation of thyroid cancer is: • Question 40 A 21-year-old female presents to the office complaining of urinary frequency and urinary burning. The nurse practitioner suspects a urinary tract infection when the urinalysis reveals • Question 41 Microalbuminuria is a measure of: • Question 42 Which of the following medications increase the risk for metabolic syndrome? • Question 43 What information should a 42 year old patient with newly diagnosed diabetes receive about exercise? • Question 44 A 32 year old female patient presents with fever, chills, right flank pain, right costovertebral angle tenderness, and hematuria. Her urinalysis is positive for leukocytes and red blood cells. The nurse practitioner diagnoses pyelonephritis. The most appropriate management is: • Question 45 Which of the following is not a characteristic of type 2 diabetes mellitus? • Question 46 A middle-aged man presents to urgent care complaining of pain of the medial condyle of the lower humerus. The man works as a carpenter and describes a gradual onset of pain. On exam, the medial epicondyle is tender and pain is increased with flexion and pronation. Range of motion is full The most likely cause of this patient’s pain is: • Question 47 Which appropriate test for the initial assessment of Alzheimer’s disease provides the performance ratings on 10 complex, higher order activities? • Question 48 After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been cured? • Question 49 An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects? • Question 50 Josh, age 22, is a stock boy and has an acute episode of low back pain. You order and NSAID and tell him which of the following? • Question 51 An obese hyperlipidemic patient, newly diagnosed with type 2 diabetes mellitus, has fasting glucose values 180 to 250 mg/Dl. What is the most appropriate initial treatment to consider? • Question 52 Which of the following set of symptoms should raise suspicion of a brain tumor? • Question 53 The organism most often associated with prostatitis is: • Question 54 A patient has just been diagnosed with Bell’s palsy. He is understandably upset and has questions about the prognosis. You response should be: • Question 55 A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder? • Question 56 Prolonged PT suggests: • Question 57 Which of the following accounts for half of the bladder tumors among men and one-third in women? • Question 58 A 15 year-old female patient is 5 feet tall and weighs 85 pounds. You suspect anorexia and know that the best initial approach is to: • Question 59 The primary goals of treatment for patients with alcohol abuse disorder are: • Question 60 Which of the following is the most common causative organism of nongonococcal urethritis? • Question 61 Which of the following is the most common complication of the myelodysplastic syndromes? • Question 62 Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid? • Question 63 A thymectomy is usually recommended in the early treatment of which disease? • Question 64 Which of the following is a potential acquired cause of thrombophilia? • Question 65 A patient with HIV infection has a fever of unknown origin (FUO). Which of the following is a possible cause of FUO in a patient with HIV? • Question 66 The most effective intervention(s) to prevent stroke is (are): • Question 67 A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is: • Question 68 Martin, a 58 year old male with diabetes, is at your office for his diabetes follow up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Martin receive today regarding the care if his feet? • Question 69 Diagnostic evaluation of hypothyroidism reveals: • Question 70 A 72 year old patient exhibits sudden onset of fluctuating restlessness, agitation, confusion, and impaired attention. This is accompanied by visual hallucinations and sleep disturbance. What is the most likely cause of this behavior? • Question 71 Which of the following is characteristic of a manic episode? • Question 72 The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy: • Question 73 Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse? • Question 74 Deficiency of which nutritional source usually presents with an insidious onset of paresthesias of the hands and feet that are usually painful? • Question 75 A 20 year old male patient complains of “scrotal swelling.” He states his scrotum feels heavy, but denies pain. On examination, the nurse practitioner notes transillumination of the scrotum. What is the most likely diagnosis? • Question 76 Legal authority for advanced practice nursing rests with: • Question 77 The most commonly recommended pharmacological treatment regimen for low back pain (LBP) is: • Question 78 In the outpatient office setting, the most common reason for a malpractice suit is failure to: • Question 79 Your patient has an elevated mean cell volume (MCV). What should you be considering in terms of diagnosis? • Question 80 Major depression occurs most often in which of the following conditions? • Question 81 The physiological explanation of syncope is: • Question 82 Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond? • Question 83 The 4 classic features of Parkinson’s disease are: • Question 84 Differential diagnosis of proteinuria includes which of the following? • Question 85 The treatment of choice for chronic bacterial prostatitis (CBP) is: • Question 86 Sam, age 67, is a diabetic with worsening renal function. He has frequent hypoglycemic episodes, which he believes means that his diabetes is getting “better.” How do you respond? • Question 87 In which of the following presentations is further diagnostic testing not warranted? • Question 88 The initial clinical sign of Dupuytren’s contracture is: • Question 89 Other than smoking cessation, which of the following slows the progression of COPD in smokers? • Question 90 At what age is screening most likely to detect scoliosis? • Question 91 Which patient would benefit most from screening for type 2 diabetes? • Question 92 Successful management of a patient with attention deficit hyperactivity disorder (ADHD) may be achieved with: • Question 93 A nurse practitioner diagnoses a 60 year old male with balanitis. Which disease is commonly associated with balanitis? • Question 94 A 30 year old female patient presents to the clinic with heat intolerance, tremors, nervousness, and weight loss inconsistent with increased appetite. Which test would be most likely to confirm the suspected diagnosis? • Question 95 A 28-year-old female presents to the office requesting testing for diagnosis of hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her risk factors. The nurse practitioner explains that: • Question 96 A patient taking levothyroxine is being over-replaced. What condition is he at risk for? • Question 97 Warfarin (Coumadin) is prescribed for a frail, elderly male with new onset atrial fibrillation. The goal INR for this patient should be: • Question 98 Potential side effects of levofloxacin include which of the following? • Question 99 The most effective treatment of non-infectious bursitis includes: • Question 100 A 27 year old female patient with epilepsy is well controlled with phenytoin (Dilantin). She requests information about contraception. The nurse practitioner should instruct her that while taking phenytoin: • Question 101 Which of the following is the most common cause of low back pain?