NRNP 6531 / NRNP6531 Advanced Primary Care of Adults Midterm / Final Exam Quiz Bank Highly Rated |Questions and Answers | Latest 2022/2023

NRNP 6531 / NRNP6531 Advanced Primary Care of Adults Midterm / Final Exam Quiz Bank Highly Rated |Questions and Answers | Latest 2022/2023 1. Dan, age 82, recently lost his wife to breast cancer. He presents with weight loss, fatigue, and difficulty sleeping. What should your first response be? A. " Do you have a history of thyroid problems in your family? " B. " Do you think a sleeping pill might help you sleep at night? " C. " Things might look up if you added nutritional supplements to your diet. " D. " Have you thought of suicide? " Rationale: Direct confrontation should be used when suspecting depression and the possibility of suicide. Fatigue, loss of weight, and insomnia, in combination with the client ' s history of the death of his spouse, should point in the direction of depression with a suicidal potential. 2. If you suspect that your client abuses alcohol, the most appropriate action would be to A. confront the client. B. obtain further confirmatory information. C. consult with family members. D. suggest Alcoholics Anonymous (AA). Rationale: If you suspect that your client abuses alcohol, the most appropriate action would be to confront the client. 3. The use of tricyclic antidepressants in the elderly increases the risk of A. suicide. B. cardiac arrhythmias. C. reactive depression. D. shortness of breath. Rationale: A study by the Heart and Lung Institute of the National Institute of Health in the mid-1980s showed that class 1 antiarrhythmic drugs given to patients with ventricular arrhythmias following myocardial infarction, instead of preventing deaths, actually increased the number of patients dying 4. In the depressed client, antidepressants are most effective in alleviating A. suicidal feelings. B. interpersonal problems. C. sleep disturbances. D. anxiety disorders. Rationale: In the depressed client, antidepressants are most effective in alleviating sleep and appetite disturbances. Psychotherapy is most effective in dealing with suicidal feelings and interpersonal problems. 5. Jim, age 45, has two small children. He states that his wife made him come to this appointment because she thinks he has been impossible to live with lately. He admits to being stressed and depressed because he is working two jobs, and he says he sometimes takes his stress out on his family. About twice a week he complains of palpitations along with nervous energy. What is the most important question to ask him at this time? A. " How is your wife handling stress? " B. " Have you thought about committing suicide? " C. " Do you and your wife spend time alone together? " D. " Tell me more about what you think is causing this. " Rationale: Although all the questions are important, suicidal ideation is an emergency situation, and if it is present, the client needs immediate admission, preferably to a psychiatric hospital 6. What is the medication of choice for obsessive-compulsive disorders? A. Alprazolam (Xanax) B. Carbamazepine (Tegretol) C. Clomipramine (Anafranil) D. Buspirone (Buspar) Rationale: The medication of choice for obsessive-compulsive disorders is clomipramine (Anafranil), a tricyclic antidepressant. It seems to have a much better effect than alprazolam (Xanax), an antianxiety agent; carbamazepine (Tegretol), an anticonvulsant; or buspirone (Buspar), a nonbenzodiazepine anxiolytic. 7. Which of the following objective data are associated with significantly better long-term outcomes in children born with open spina bifida? A. A higher APGAR score B. Presence of Babinski ' s reflex C. Perineal sensation D. A higher score on the Glasgow Coma Scale Rationale: In infants with open spina bifida, the presence of perineal sensation is associated with significantly better long-term outcomes 8. Karen Ann, age 52, has four children and a very stressful job. After you perform her physical, which was normal, she tells you she has insomnia. You make several suggestions for lifestyle changes that might assist in promoting helpful sleep. You know she misunderstands when she states which of the following? A. " I ' ll wind down before bedtime by taking a warm bath or by reading for 10 minutes. " B. " I ' ll try some valerian extract from the health food store. " C. " I ' ll exercise in the evening to tire myself out before bed. " D. " I won ' t read or watch television while in bed. " Rationale: Suggestions for making lifestyle changes that might assist a client in promoting helpful sleep include advising the client to wind down before bedtime by taking a warm bath or by reading for 10 minutes, to try some valerian extract (obtainable from a health food store), and not to read or watch television while in bed. 9. Mary, age 82, appears without an appointment. She is complaining of a new, unilateral headache; fever; and muscle aches. She denies any precipitating event. On further examination, you note that her erythrocyte sedimentation rate is over 100 mm/min. What do you suspect? A. Temporal arteritis B. Meningitis C. Subarachnoid hemorrhage D. Intracerebral hemorrhage Rationale: Temporal arteritis, also called giant cell arteritis, presents as a systemic illness with generalized symptoms such as fever, myalgia, arthralgia, anemia, and elevated liver function tests. 10. Julie, age 15, is 5 ft tall and weighs 85 lb. You suspect anorexia and know that the best initial approach is to A. discuss proper nutrition. B. tell Julie what she should weigh for her height and suggest a balanced diet. C. speak to her parents before going any further. D. confront Julie with the fact that you suspect an eating disorder. Rationale: If you suspect anorexia, the best initial approach is to confront Julie with the fact that you suspect an eating disorder 11. Obsessive-compulsive disorder symptoms usually occur A. before age 15. B. during midlife crises. C. during late adolescence and early adulthood. D. in later life. Rationale: Obsessive-compulsive disorder symptoms usually occur before age 15. Young people in their early teens with obsessive-compulsive disorder are inflexible, lack spontaneity, are ambivalent, and are in a constant state of conflict while harboring hostile feelings 12. Jim, a 45-year-old postal worker, presents for the first time with a sudden onset of intense apprehension, fear, dyspnea, palpitations, and a choking sensation. What is your initial diagnosis? A. Anxiety B. Panic attack C. Depression D. Agoraphobia Rationale: A panic attack is characterized by its episodic nature. It is manifested by the sudden onset of intense apprehension, fear, or terror and the abrupt development of some of the following symptoms: dyspnea, palpitations, chest pain or discomfort, choking or smothering sensations, dizziness, a feeling of being detached, diaphoresis, trembling, and nausea. 13. June, age 79, comes to your office with a recent onset of depression. She is taking several medications. Which medication is safe for her to take because depression is not one of the side effects?