NURS 6531N Midterm Exam – Adv. Practice Care of Adults

NURS 6531N Midterm Exam – Adv. Practice Care of Adults -The most common cancer found on the auricle is: -Basal Cell Carcinoma -Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient? -Antihistamines -A 47-year-old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On examination, external hemorrhoids are noted. How should the nurse practitioner proceed? -Refer the patient for a barium enema and sigmoidoscopy. -Which of the following patient characteristics are associated with chronic bronchitis? -Overweight, cyanosis, and normal or slightly increased respiratory rate -A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent care with new onset left lower quadrant pain. Her current medications include omeprazole 20 milligrams po daily, lisinopril 20 milligrams po daily, simvastatin 20 milligrams po daily, and prednisone 12 milligrams po daily. The nurse practitioner suspects acute diverticulitis and possibly an abscess. The most appropriate diagnostic test for this patient at this time is: -CT scan -A patient reports "something flew in my eye" about an hour ago while he was splitting logs. If there were a foreign body in his eye, the nurse practitioner would expect to find all except: -Purulent drainage -A 21-year-old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect: -Gonococcal conjunctivitis -A 35-year-old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 different thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect: -Herpes zoster and consider that this patient may be immunocompromised -Which type of lung cancer has the poorest prognosis? -Small cell carcinoma -An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3-4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has: -Chronic diarrhea -Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect? -Systemic lupus erythematosus -Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes? -Acute bronchitis -Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in? -Moderate persistent -Which of the following is the most appropriate therapeutic regimen for an adult patient with no known allergies diagnosed with group A B-hemolytic strep? -Penicillin V 500 milligrams PO every 8 hours for 10 days -A cashier complains of dull ache and pressure sensation in her lower legs. It is relieved by leg elevation. She occasionally has edema in her lower legs at the end of the day. What is the most likely cause of these problems? -Varicose veins -Which statement below is correct about pertussis? -It is also called whooping cough -Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis? -Pneumonia -A 70 year old patient presents with left lower quadrant (LLQ) abdominal pain, a markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition? -Diverticulitis -Sylvia, age 83, presents with a 3-day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect? -Herpes zoster -A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is: -Gallstones -When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action? -Order an abdominal ultrasound -A false-positive result with the fecal occult blood test can result from: -a high dietary intake of rare cooked beef -A 76-year-old male complains of weight loss, nausea, vomiting, abdominal cramping and pain. Physical findings include an abdominal mass and stool positive for occult blood. The nurse practitioner pain suspects a tumor in the small intestine. The best diagnostic test for this patient is: -Small bowel follow-through -A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with: -Systolic heart failure -Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized? -Multi-lobar involvement on chest x-ray with the inability to take oral medications -A 55-year-old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him: - “It can be cured with surgical excision or radiation therapy." -Expected spirometry readings when the patient has chronic emphysema include: -Increased total lung capacity (TLC) -An 80-year-old male admits to difficulty swallowing during the review of systems. The nurse practitioner recognizes the differential diagnosis for this patient's dysphagia is: -Esophageal cancer and GERD -A 40 year old female with history of frequent sun exposure presents with a multicolored lesion on her back. It has irregular borders and is about 11mm in diameter. What should the nurse practitioner suspect? -Malignant melanoma -Which of the following is not a goal of treatment for the patient with cystic fibrosis? -Replace water-soluble vitamins -The nurse practitioner is performing a physical exam on a middle-aged African American man. Which of the following areas is a common site for melanomas in African Americans and other dark-skinned individuals? -nails and feet -An adult presents with tinea corporis. Which item below is a risk factor for its development? -Topical steroid use -A patient has experienced nausea and vomiting, headache, malaise, low grade fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is elevated with a shift to the left. He is requesting medication for diarrhea. What is the most appropriate response? -Prescribe a broad-spectrum antibiotic such as ciprofloxacin (Cipro), and symptom management. -Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order? -Antihistamines -Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is: -Weight gain -A 16-year-old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe? -Amoxicillin A 70-year-old man who walks 2 miles every day complains of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 2-mile walk. What question asked during the history, if answered affirmatively, would suggest a diagnosis of arteriosclerosis obliterans? -"Is your leg pain relieved by rest?" -Which of the following statements about malignant melanomas is true? -The prognosis is directly related to the thickness of the lesion -Sheila, age 78, presents with a chief complaint of waking up during the night coughing. You examine her and find an S3 heart sound, pulmonary crackles that do not clear with coughing, and peripheral edema. What do you suspect? -Heart Failure -Which antibiotic would be the most effective in treating community acquired pneumonia (CAP) in a young adult without any comorbid conditions? -Clarithromycin (Biaxin) -Which of the following dermatologic vehicles are the most effective in absorbing moisture and decreasing friction? -Powders -A 70 year old patient presents with a slightly raised, scaly, erythematous patch on her forehead. She admits to having been a "sun worshiper." The nurse practitioner suspects actinic keratosis. This lesion is a precursor to: -Squamous cell carcinoma -An elderly patient is being seen in the clinic for complaint of "weak spells" relieved by sitting or lying down. How should the nurse practitioner proceed with the physical examination? -Compare the patient's blood pressure lying first, then sitting, and then standing. -What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery? -Ursodiol