Walden NRNP 6531 Primary Care of Adults Across the Lifespan
Midterm Exam Spring 2023
1. What is the purpose of clinical research trials in the spectrum of translational research?
Examination of safety and effectiveness of various interventions
2. What is the purpose of Level II research?
To describe relationships among characteristics or variables
3. The care provided by APRNs is not limited by setting but by patient care needs.
A. B. Tru
e
4. APRN Fals Consensus Model/LACE include all except:
A.
e Licensure
B. Accreditation
C. Certification
D. It’s the one that stars with an E (Education)
5. All of the following are core quality competencies expected of APRNs except:
A. Uses best evidence to improve care
B. Assumes advanced leadership role
C. Applies skills in peer review to promote culture of excellence
D. Evaluates organizational structures to improved care – Not
sure??
6. What was an
important finding of the Advisory Board survey of 2014 about primary care preferences of
patients?
A. Associations with area hospitals B. Costs of ambulatory care
C. Ease of access to care.
D. The ratio of providers to patients
7. To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have implemented which policy?
A. Mandates for communication among primary caregivers and hospitalists
B. Penalties for failure to perform medication reconciliations at time of discharge
C. Reduction of payments for patients readmitted within 30 days after discharge
D. Requirements for written discharge instructions for patients and d. caregivers
8. Rules proposed by the various State Boards of Nursing must be approved by the state
Legislatures.
A. True
B. False
, 9. To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have implemented which policy?
10. What was an important finding of the Advisory Board survey of 2014 about primary care
preferences of patients?
11. The Consensus Model for APRN regulation consists of which of the following roles?
A. CNM
B. CRNA
C. APN
D. CNS
E All the Above
A, B & C F. only
12. In reviewing the Total Percentage of Body surface area for adult burn patients each, leg,
arm and head are noted evaluated at 9%.
A. True
B. False
13. What is the initial approach when obtaining a biopsy of a potential malignant melanoma
lesion?
A. Excisional biopsy
B. Punch biopsy
C. Shave biopsy
D. Wide excision
14. Which of the following are independent practice competencies for APRNs?
A. Prescribes medications
B. Functions as an independent practitioner
C. Employs screening and diagnostic strategies to arrive at diagnoses D.
Manages health/illness strategies of patients and families over time.
E. All the Above
F. A, C & D only
15. A female patient is diagnosed with androgenetic alopecia. Which medication will the
primary health care provider prescribe? a. Anthralin
b. Cyclosporine
c. Finasterided Minoxidil
16. Agnes is a 72 y/o grandmother who comes to the clinic with an acute onset of severe eye
pain. She has been having headaches, nausea and vomiting, and seeing halos around
lights. Eye exam reveals cupping of optic nerve the pupil is oval and the cornea is cloudy.
Her most likely diagnosis is:
,17. Mikey is a 19 y/o male who is brought to the clinic because he has a fever, sore throat,
pain on swallowing and mildly enlarged submandibular nodes. The most likely diagnosis
for Mikey is:
18. A 50-year-old, previously healthy patient has developed gastritis. What is the most likely
cause of this condition?
a. H. pylori infection
b. NSAID use
c. Parasite infestation
d. Viral gastroenteritis
19. Which diagnostic test will the provider safely order for a 30-year-old woman reporting
right upper quadrant abdominal pain, nausea, and vomiting?
a. Abdominal computed tomography (CT) with contrast
b. Abdominal ultrasound
c. Magnetic resonance imaging (MRI) of the abdomen
20. A patient, who first developed acute diarrhea 2 weeks ago, presents to clinic reporting
profuse watery, bloody diarrheal stools 6 to 8 times daily. The provider notes a toxic
appearance with moderate dehydration. Which test is indicated to diagnose this problem?
a. Qualitative and quantitative fecal fat
b. Stool collection for 24-hour stool pH
c. Stool sample for C. difficile toxin
d. Wright stain of stool for white blood cells
21. A patient with a positive HbeAg indicates the patient has chronic Hepatitis B. A.
True
B. False
22. Classic pain of acute pancreatitis is severe midgastric pain that refers to the midback.
A. True I think B. False
23. A patient with hemoptysis and no other symptoms has a normal chest radiograph (CXR),
computed tomography (CT), and fiberoptic bronchoscopy studies. What is the next action
in managing this patient?
24. Jeremy is an 18 y/o male who comes to the clinic with a chief complaint of periumbilical
pain. Over the past 24 hours he has had bouts of nausea and diarrhea and pain at
McBurney’s point. Which of the following assessments would aide in confirming
Jeremy’s diagnosis:
A. Psoas Sign
B. Obturator Sign
C. Murphy’s Sign
D. All the Above
E. A & B only
, 25. A patient diagnosed with cirrhosis develops ascites. Which medication will be ordered
initially to improve symptoms?
a. Cephalosporin
b. Furosemide
c. Lactulose
d. Spironolactone
26. Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of
fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some
rhinitis and low-grade fever. His likely diagnosis is:
A. Bronchitis
B. Atypical Pneumonia (Walking pneumonia)
C. Allergic Rhinitis
D. Community acquired bacterial pneumonia
27. Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of
fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some
rhinitis and low-grade fever. Potential organisms that might have caused Sam’s condition
include which of the following:
A. Mycoplasma pneumoniae
B. Chlamydia pneumoniae
C. Legionella pneumonia
D. All the above
E. None of the above
28. Martin is a 73 y/o male who has a 50 year/pack history of smoking and comes to the
clinic for his annual physical. As you are leading him back to the exam room you note
that he has dyspnea with minimal cough, a barrel chest, and appears to have lost weight
since his last visit. Your physical exam confirms a 20 lb. weight loss, and a more
noticeable pursed lip breathing. Your diagnosis is:
A. Chronic Bronchitis
B. Emphysema C. COPD
29. Mike is a 56 y/o male who lives in an abandoned building. With about 40 other street
people. He comes to the clinic with a social worker who describes his symptoms as: a
cough, dyspnea, pleuritic chest pain, fever and tachypnea. Your physical exam notes that
he has some consolidation in the lower lobes with an audible friction rub.
30. A patient with a cough has a suspicious lung lesion, a mediastinal lymph mass, and
several bone lesions. What test is indicated to determine histology and staging of this
cancer?
31. A young adult patient without a previous history of lung disease has an increased
respiratory rate and reports a feeling of “not getting enough air.” The provider auscultates
clear breath sounds and notes no signs of increased respiratory effort. Which diagnostic
test will the provider perform initially?
Midterm Exam Spring 2023
1. What is the purpose of clinical research trials in the spectrum of translational research?
Examination of safety and effectiveness of various interventions
2. What is the purpose of Level II research?
To describe relationships among characteristics or variables
3. The care provided by APRNs is not limited by setting but by patient care needs.
A. B. Tru
e
4. APRN Fals Consensus Model/LACE include all except:
A.
e Licensure
B. Accreditation
C. Certification
D. It’s the one that stars with an E (Education)
5. All of the following are core quality competencies expected of APRNs except:
A. Uses best evidence to improve care
B. Assumes advanced leadership role
C. Applies skills in peer review to promote culture of excellence
D. Evaluates organizational structures to improved care – Not
sure??
6. What was an
important finding of the Advisory Board survey of 2014 about primary care preferences of
patients?
A. Associations with area hospitals B. Costs of ambulatory care
C. Ease of access to care.
D. The ratio of providers to patients
7. To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have implemented which policy?
A. Mandates for communication among primary caregivers and hospitalists
B. Penalties for failure to perform medication reconciliations at time of discharge
C. Reduction of payments for patients readmitted within 30 days after discharge
D. Requirements for written discharge instructions for patients and d. caregivers
8. Rules proposed by the various State Boards of Nursing must be approved by the state
Legislatures.
A. True
B. False
, 9. To reduce adverse events associated with care transitions, the Centers for Medicare and
Medicaid Service have implemented which policy?
10. What was an important finding of the Advisory Board survey of 2014 about primary care
preferences of patients?
11. The Consensus Model for APRN regulation consists of which of the following roles?
A. CNM
B. CRNA
C. APN
D. CNS
E All the Above
A, B & C F. only
12. In reviewing the Total Percentage of Body surface area for adult burn patients each, leg,
arm and head are noted evaluated at 9%.
A. True
B. False
13. What is the initial approach when obtaining a biopsy of a potential malignant melanoma
lesion?
A. Excisional biopsy
B. Punch biopsy
C. Shave biopsy
D. Wide excision
14. Which of the following are independent practice competencies for APRNs?
A. Prescribes medications
B. Functions as an independent practitioner
C. Employs screening and diagnostic strategies to arrive at diagnoses D.
Manages health/illness strategies of patients and families over time.
E. All the Above
F. A, C & D only
15. A female patient is diagnosed with androgenetic alopecia. Which medication will the
primary health care provider prescribe? a. Anthralin
b. Cyclosporine
c. Finasterided Minoxidil
16. Agnes is a 72 y/o grandmother who comes to the clinic with an acute onset of severe eye
pain. She has been having headaches, nausea and vomiting, and seeing halos around
lights. Eye exam reveals cupping of optic nerve the pupil is oval and the cornea is cloudy.
Her most likely diagnosis is:
,17. Mikey is a 19 y/o male who is brought to the clinic because he has a fever, sore throat,
pain on swallowing and mildly enlarged submandibular nodes. The most likely diagnosis
for Mikey is:
18. A 50-year-old, previously healthy patient has developed gastritis. What is the most likely
cause of this condition?
a. H. pylori infection
b. NSAID use
c. Parasite infestation
d. Viral gastroenteritis
19. Which diagnostic test will the provider safely order for a 30-year-old woman reporting
right upper quadrant abdominal pain, nausea, and vomiting?
a. Abdominal computed tomography (CT) with contrast
b. Abdominal ultrasound
c. Magnetic resonance imaging (MRI) of the abdomen
20. A patient, who first developed acute diarrhea 2 weeks ago, presents to clinic reporting
profuse watery, bloody diarrheal stools 6 to 8 times daily. The provider notes a toxic
appearance with moderate dehydration. Which test is indicated to diagnose this problem?
a. Qualitative and quantitative fecal fat
b. Stool collection for 24-hour stool pH
c. Stool sample for C. difficile toxin
d. Wright stain of stool for white blood cells
21. A patient with a positive HbeAg indicates the patient has chronic Hepatitis B. A.
True
B. False
22. Classic pain of acute pancreatitis is severe midgastric pain that refers to the midback.
A. True I think B. False
23. A patient with hemoptysis and no other symptoms has a normal chest radiograph (CXR),
computed tomography (CT), and fiberoptic bronchoscopy studies. What is the next action
in managing this patient?
24. Jeremy is an 18 y/o male who comes to the clinic with a chief complaint of periumbilical
pain. Over the past 24 hours he has had bouts of nausea and diarrhea and pain at
McBurney’s point. Which of the following assessments would aide in confirming
Jeremy’s diagnosis:
A. Psoas Sign
B. Obturator Sign
C. Murphy’s Sign
D. All the Above
E. A & B only
, 25. A patient diagnosed with cirrhosis develops ascites. Which medication will be ordered
initially to improve symptoms?
a. Cephalosporin
b. Furosemide
c. Lactulose
d. Spironolactone
26. Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of
fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some
rhinitis and low-grade fever. His likely diagnosis is:
A. Bronchitis
B. Atypical Pneumonia (Walking pneumonia)
C. Allergic Rhinitis
D. Community acquired bacterial pneumonia
27. Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of
fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some
rhinitis and low-grade fever. Potential organisms that might have caused Sam’s condition
include which of the following:
A. Mycoplasma pneumoniae
B. Chlamydia pneumoniae
C. Legionella pneumonia
D. All the above
E. None of the above
28. Martin is a 73 y/o male who has a 50 year/pack history of smoking and comes to the
clinic for his annual physical. As you are leading him back to the exam room you note
that he has dyspnea with minimal cough, a barrel chest, and appears to have lost weight
since his last visit. Your physical exam confirms a 20 lb. weight loss, and a more
noticeable pursed lip breathing. Your diagnosis is:
A. Chronic Bronchitis
B. Emphysema C. COPD
29. Mike is a 56 y/o male who lives in an abandoned building. With about 40 other street
people. He comes to the clinic with a social worker who describes his symptoms as: a
cough, dyspnea, pleuritic chest pain, fever and tachypnea. Your physical exam notes that
he has some consolidation in the lower lobes with an audible friction rub.
30. A patient with a cough has a suspicious lung lesion, a mediastinal lymph mass, and
several bone lesions. What test is indicated to determine histology and staging of this
cancer?
31. A young adult patient without a previous history of lung disease has an increased
respiratory rate and reports a feeling of “not getting enough air.” The provider auscultates
clear breath sounds and notes no signs of increased respiratory effort. Which diagnostic
test will the provider perform initially?
