NURS 6531 Final Exam 3 Questions and Answers Latest Updated 2022/2023,100% CORRECT

NURS 6531 Final Exam 3 Questions and Answers Latest Updated 2022/2023 What diabetic complications result from hyperglycemia? Retinopathy Which factors are associated with high risk for foot complications in a patient with diabetes mellitus? 1. Obesity Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)? What are common early signs of BPH – Frequency, urgency, nocturia TX with alpha adrenergic Terazosin and doxazosin 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? Graves hyperthyroid Which history is commonly found in a patient with glomerulonephritis? Ask about recent infections (skin or upper respiratory); recent travel (possible exposure to viruses, bacteria, fungi, or parasites); recent illnesses, surgery, or invasive procedures (possible infection); any systemic diseases (Systemic Lupus Erythematosus -SLE) Which of the following is not a characteristic of type 2 diabetes mellitus? characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, and unexplained weight loss. A patient has been diagnosed with hypothyroidism and thyroid hormone replacement therapy is prescribed. How long should the nurse practitioner wait before checking the patient’s TSH? 6 to 8 weeks Which of the following is the most cause of low back pain? Lumbar disc disease What is the most common cause of Cushing’s syndrome? Pituitary-dependent/ACTH-dependent (Cushing's disease), one is a pituitary form, which results from excessive production of ACTH by a tumor of the pituitary gland Warfarin (Coumadin) is prescribed for a frail, elderly male with new onset atrial fibrillation. The goal INR for this patient should be: 2.0 to 3.0 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 behaviour? Delirium Which of the following is the most common causative organism of nongonococcal urethritis? Chlamydia trachomatis Which of the following does not cause nongonococcal urethritis Neisseria Which appropriate test for the initial assessment of Alzheimer’s disease provides the performance ratings on 10 complex, higher order activities? FAQ What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare? The physician must be on-site and engaged in client care Diagnostic evaluation for urinary calculi includes: Urinalysis and culture, Non contrast CT, Serum (ALL OF THE ABOVE) Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? Musculoskeletal pain is not characteristic of chronic fatigue syndrome; rather, it is characteristic of fibromyalgia Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within normal limits. Which of the following diagnoses do you explore further? Herniated nucleus pulposus 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? Avoid chocolate, alcohol, carbonated drinks, peppermint, coffee, citrus, onion, and garlic. And weight loss The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is: Rest the affected part of the body - Once pain free, the person can gradually begin the sporting activity again - Air splinting can reduce pain and decrease the time until return to full participation or intensity of exercise. - NSAIDs to reduce pain and inflammation A thymectomy is usually recommended in the early treatment of which disease? Thymectomy is an important treatment option for Myasthenia Gravis The most common cause of elevated liver function tests is: Chronic alcohol abuse Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of: Carpal tunnels 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? Osgood The most likely diagnosis based on the reports of gradual progressive dull anterior knee pain cause of kneeling and the complains of sore lump on the patient’s knee which the result of the assessment notes were swelling and point tenderness is likely Arthritis or gout. It is the symptoms of Arthritis or gouts usually complaining having knee pain and swelling Which of the following is a contraindication for metformin therapy? Creatinine 1.5 • Renal dysfunction. • Congestive cardiac failure needing drug treatment. • Hypersensitivity to metformin. • Acute or chronic metabolic acidosis. • Impaired hepatic function. The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy: albumin-to-creatinine ratio with a spot urine Which is the most common cause of end-stage renal disease in the United States? Diabetic Neuropahty, hypertenson, glomerulonephritis, systemic lupus, cystic kidney disease 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? Increase the dosage of the current BP medication Microalbuminuria is a measure of: Endothelial dysfunction, dm neuropathy, diabetic kidney disease and end organ damage r/t htn Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect? External otitis 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: cipro or Levaquin fluoroquinolones 10 to 14 days trimethoprim sulfamethoxazole for 14 days Which of the following medications increase the risk for metabolic syndrome? Antihistamine and protease inhibitor 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 10 WBC/ HP Pyuria (neutrophils in the urine) Bacteriuria Hematuria Positive leukocyte esterase and/or nitrite dipstick (Leukocyte esterase = indicates presence of WBCs; suggests bacterial cause) (Positive nitrite = indicates gram - organism) Urine culture indicated in symptoms and negative urinalysis The 4 classic features of Parkinson’s disease are: shaking (tremor) of the hands, arms, legs and face; stiffness; slow movement (bradykinesia); and difficulty with balance and coordination 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? Testing blood sugar levels at 3.00 a.m. and again in the morning can help distinguish between the Somogyi effect and the dawn phenomenon.’s relatively easy to test for the Somogyi effect. For several consecutive nights: • Check your blood sugar just before bed. • Set an alarm to check it again around 3:00 a.m. • Test it again upon waking. If your blood glucose is low when you check it at 3:00 a.m., it’s likely the Somogyi effect. Other than smoking cessation, which of the following slows the progression of COPD in smokers? Engaging in moderate-to-high levels of physical activity A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness, anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take? the correct next step is to measure baseline serum cortisol, to test ACTH levels, and to order an ACTH stimulation test with cosyntropin. Primary adrenocortical insufficiency work up for A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains: Primary hyperparathyroidism is treated with parathyroidectomy The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in almost 100% of patients is: Café au lait spots A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is: Cryptosporidiosis When patients with HIV infection have massive diarrhea, a protozoa of the cryptosporidium genus is the most likely cause. How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout? Exercising for at least 20 minutes 3 or more days per week The treatment of choice for chronic bacterial prostatitis (CBP) is: Fluoroquinolones (Ciprofloxacin, levofloxacin, others)- antibiotics of choice Trimethoprim-sulfamethoxazole - less effective but still an option Other antibiotics - doxycycline, cephalexin, erythromycin Treat for 4 weeks minimum Diagnostic confirmation of acute leukemia is based on: Bone marrow aspiration and biopsy Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to: try neutral position wrist splinting and order an oral NSAID Urine cultures should be obtained for which of the following patients? All of the above (pregnant females, males, and febrile patients) The diagnosis which must be considered in a patient who presents with a severe headache of sudden onset, with neck stiffness and fever, is: migraine or meningitis Which patient would benefit most from screening for type 2 diabetes? Gdma, black, htn, pcos, black, family hx The intervention known to be most effective in the treatment of severe depression, with or without psychosis, is: electroconvulsive therapy (ECT) Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond? The effect of caffeine in causing osteoporosis is controversial, but it is postulated to result from caffeine ' s diuretic effect that causes calcium to be excreted more rapidly Which of the following patients most warrants screening for hypothyroidism? Screening whole populations for hypothyroidism is not warranted. There is a high prevalence of hypothyroidism among the elderly with cognitive impairment. Which of the following symptoms suggests a more serious cause of back pain? Pain with lying What is the first step in the treatment of uric acid kidney stones? Encouraging hydration Successful management of a patient with attention deficit hyperactivity disorder (ADHD) may be achieved with: psychostimulant Ritalin ii. Dexedrine iii. Focalin iv. Adderall v. Concerta vi. Strattera Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following: A. HbA1C B. 2-hour 75-gram oral glucose tolerance test D. A and B The most effective treatment of non-infectious bursitis includes: Need options rest, cold and heat treatments, elevation, administration of nonsteroidal anti-inflammatory drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections (with or without local anesthetic agents). Differential diagnosis of proteinuria includes which of the following? A Orthostatic . proteinuria B Nephrotic syndrome . E A and B . You are assessing a patient after a sports injury to his right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to the: cruciatanklee ligament A positive drawer sign supports a diagnosis of: cruciate ligament 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: Cipro if symptoms does not go away within 2 days hospitalization 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? Nonseminoma What is the first symptom seen in the majority of patients with Parkinson’s disease? Resting tremor 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? Trigeminal neuralgia Which of the following set of symptoms should raise suspicion of a brain tumor? Holocranial headaches present in the morning and accompanied by projectile vomiting without nausea The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are): Straight leg raise test is performed to assess for damage to L5-S1 Which drug category contains the drugs that are the first line Gold standard therapy for COPD? Anticholenergic Which of the following accounts for half of the bladder tumors among men and one-third in women? Cigarette smoke, both active and passive inhalation A 35-year-old male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency, and reduced force of stream. The nurse practitioner suspects acute bacterial prostatitis. Which of the following specimens would be least helpful for diagnosis? Post void Ordered test – that are helpful Midstream urine specimens for culture and sensitivity CBC and differential Blood urea nitrogen Creatinine Imaging In which of the following presentations is further diagnostic testing not warranted? Bilateral gynecomastia in a pre-pubertal Which of the following is the most common complication of the myelodysplastic syndromes? Fatigue You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of: A. Infection B. Malignancy C. Inflammation D. Drug E. Endocrine 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: Confront Julie with the fact that you suspect an eating disorder A patient taking levothyroxine is being over-replaced. What condition is he at risk for? Osteoporosis, arrhythmias, afib A nurse practitioner diagnoses a 60-year-old male with balanitis. Which disease is commonly associated with balanitis? Diabetes The diagnosis of human papilloma virus (HPV) infection in males is usually made by: Warts Martin, a 58-year-old male with diabetes, is at your office for his PRO 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? See a podiatrist yearly; wash your feet daily with warm, soapy water and towel dry between the toes; inspect your feet daily for any lesions; and apply lotion to any dry areas Which of the following is the most common cause of low back pain? Lumbar disc disease Which of the following is a potential acquired cause of thrombophilia? 1. Lupus anticoagulant 2. antiphospholipid antibody syndrome --antibody to phospholipids Deficiency of which nutritional source usually presents with an insidious onset of paresthesias of the hands and feet that are usually painful? B 12 What information should patients with diabetes and their families receive about hypoglycemia? Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly 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? 3200mg max dose alternate with Tylenol if needed 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: B Hereditary thrombophilia does not always require anticoagulation . therapy. D Genetic and risk management counseling are recommended. . E B and D . Which of the following best reflects the National Osteoporosis Foundation daily calcium recommendations for adults? mg of calcium daily Risk factors for Addison’s disease include which of the following? Tuberculosis, Autoimmune disease, AIDS (ALL OF THE ABOVE) Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)? Increased force of urine flow The treatment of choice for chronic bacterial prostatitis (CBP) is: Bactrim DS daily for 4 to 16 weeks The physiological explanation of syncope is: A cycle of inappropriate vasodilation, bradycardia, and hypotension A 65-year-old patient complains of a recurrent bilateral temporal headaches, malaise, muscle aches, and low grade fever. The headache is described as superficial tenderness rather than deep pain. Giant cell arteritis is suspected. Appropriate treatment is: Refer for temporal artery biopsy and initiation of oral prednisone You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of: Cancer of the liver Which history is commonly found in a patient with glomerulonephritis? Beta-hemolytic strep infection Sam, age 42, has had persistent proteinuria on the previous two office visits. Which action is warranted next? Have Sam collect one urine specimen on first arising and then another 2 hours later The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy: An early morning spot urine collection A typical description of a tension headache is: Bilateral, occipital, or frontal tightness or fullness, with waves of aching pain The obligatory criteria for diagnosis of muscular dystrophy (MD) are: Progressive, genetic myopathy with degeneration and death of muscle fibers The most common presentation of thyroid cancer is: A solitary thyroid nodule The primary goals of treatment for patients with alcohol abuse disorder are: Abstinence or reduction in use, relapse prevention, and rehabilitation Your patient has an elevated mean cell volume (MCV). What should you be considering in terms of diagnosis? Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis? Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse? UTI in males should be treated with fluoroquinolones for 10 to 14 days. Acute bacterial prostatitis requires 2 weeks of oral antibiotic treatment with trimethoprim- sulfamethoxazole (TMP-SMX) or fluoroquinolones. Chronic bacterial prostatitis may require 4 to 6 weeks of treatment. What information should patients with diabetes and their families receive about hypoglycemia? 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? --------------------------------------------