NURS-656- STUDENT QUESTIONS 2024-
2025 WITH LATEST VERIFIED AND 100%
CORRECT ANSWERS ALREADY GRADED
A+
A female patient, currently at 26 weeks gestation, has experienced a slow rise of her blood pressure
over the past 2 weeks. Her urine specimen is negative for protein. She has reduced her sodium intake
and has begun a walking program. The patient's blood pressure today is 155/102, which is consistent
with her readings at home. Associated symptoms include a dull headache. The nurse practitioner's best
response is:
a. "Try yoga and meditation to decrease your blood pressure."
b. Start the patient on methyldopa 250 mg po twice daily.
c. "Monitor your blood pressure at home and call the office if you have swelling or a pounding
headache."
d. Start the patient on metoprolol 100mg po twice daily. - ANS-*b. Start the patient on methyldopa 250
mg po twice daily.
,Rationale: Methyldopa has the longest record of safety at a starting dosage of 250 mg po bid or tid.
Therapy with beta blockers or calcium channel blockers is also acceptable. (Papadakis& McPhee, 2015.
P. 801.) Metoprolol is a Category C medication and 100 mg po bid is not the lowest possible starting
dose. The initiation of anti-hypertensive therapy in pregnant women is indicated if the sustained blood
pressure is > 150/100 or if there is evidence of end-organ damage (Papadakis &McPhee, 2015, p. 801)
Resistant hypertension may be caused by which of the following?
a. NSAIDs
b. Oral Contraceptives
c. Obesity
d. All of the above - ANS-*d. All of the above
Rationale: (pg 716) Fibrocystic condition is the most frequent lesion of the breast. The masses are
painful, often multiple, usually bilateral masses in the breast. Rapid fluctuation in the size of the masses
is common. Pain occurs or worsens and size increases during premenstrual phase of
cycle. Most common age is 30-50. Rare in postmenopausal women not receiving hormonal replacement.
Giuliano, A. E. & Hurvitz, S. A. (2015). Breast disorders. In M. A. Papadakis, & S. J. McPhee, Current
medical diagnosis & treatment, p. 716-744). San Francisco, CA: McGraw-Hill Education.
A 75-year-old male comes into your office complaining of hesitancy, urgency, frequency, nocturia, and
sensation of incomplete bladder emptying. He denies pain or hematuria. What most likely is his
diagnosis?
a. Urinary tract infection
b. Benign prostatic hyperplasia
c. Neurogenic bladder
d. Carcinoma of the bladder - ANS-*b. Benign prostatic hyperplasia
Rationale: JNC 7 defines resistant hypertension as the inability to control blood pressure in those
patients who are compliant with the appropriate three-drug regimen, including a diuretic. Causes of
resistant hypertension listed in table 11-11 include nonadherence, NSAIDs, oral contraceptives, adrenal
steroids, licorice, obesity, and excessive alcohol intake (Sutters, 2015, p.458-459).
,Cholesterol medication that works by obstructing the absorption of cholesterol by blocking the passage
of cholesterol across the intestinal wall through the inhibition of a cholesterol transporter is ?
a. Statins
b. Fibric Acid
c. Ezetimibe
d. Bile Acid - ANS-*c. Ezetimibe (Zetia) [Cholesterol absorption inhibitor]
Rationale: "Ezetimibe is the lipid lower drug that works by inhibiting the intestinal absorption of biliary
and dietary cholesterol by blocking passage across the intestinal wall by inhibiting a cholesterol
transporter. Statins block the rate-limiting enzyme in the formation of cholesterol. Fibrates are
peroxisome proliferative-activated receptor-alpha agonists that results in potent reductions of plasms
triglycerides and increases in HDL. Bile acids work by binding bile acid in the intestine" (Baron, 2015).
A 2 year girl arrives to your clinic with a history of a fever for 7 days, cervical lymphadenopathy, edema
and desquamation of extremities, bilateral, non-exudative conjunctivitis, and polymorphous exanthema.
You correctly diagnose the girl with :
a. Rheumatic fever
b. Kawasaki disease
c. Lyme disease
d. Infective endocarditis - ANS-*b. Kawasaki disease
Rationale: The diagnostic criteria for Kawasaki disease are fever that lasts for greater than 5 days and at
least 4 of the following other manifestations: (1) cervical lymphadenopathy, usually unilateral and great
than or equal to 1.5 cm in diameter, (2) extremity changes (redness and swelling of the hands and feet
with subsequent desquamation), (3) polymorphous exanthema, (4) oral cavity or lip changes, (such as
strawberry tongues, fissuring and cracking, and inflammation of the oral mucosa), and (5) painless,
bilateral, non-exudative conjunctivitis. Rheumatic fever consists of 2 major criteria such as carditis,
erythema marginatum, Sydenham chorea, or polyarthritis, or 1 major criteria and 1 minor criteria, such
as polyarthalgia, fever, and previous rheumatic heart disease or fever, plus evidence to support
, streptococcal infection. Infective endocarditis often presents with weight loss, malaise, and fever.
(Darst, Collins, & Miyamoto, 2014, p. 628). Lyme disease may develop after a tick bite, and is
characterized by erythema chronicum migrans (Ogle & Anderson, 2014, p. 1350).
The Moro Reflex:
a. Disappears by age 3 months.
b. Disappears by age 4 months.
c. Disappears by age 8 months.
d. Disappears by age 12 months - ANS-*a. Disappears by age 3 months.
Rationale: (pg 15) The Moro (startle) reflex - hold the infant supine while supporting the head. Allow
head to drop 1-2 cm suddenly. Arms will abduct at shoulder and extend at elbow with spreading of
fingers. Adduction with flexion will follow. Develops by 28 weeks' gestation (incomplete) and disappears
by age 3 months. The palmar grasp disappears by age 4 months. The tonic neck reflex disappears by age
8 months.
Rosenberg, A. A., & Grover, T. (2014). The newborn infant. In W. W. Hay Jr, M. J. Levin, R. R. Deterding,
& M. J. Abzug, Current diagnosis & treatment (22nd ed., p. 15). San Francisco, CA: McGraw Hill
Education.
*P. 568 Seidel-infant supported in semisitting position, allow head and trunk to dropback*
Signs of hypoglycemia in the newborn infant include all of the following *except:*
a. Lethargy
b. Apnea
c. Poor feeding
d. Kernicterus - ANS-*d. Kernicterus
Rationale: (pg 27) Signs of hypoglycemia in newborn infant may be non-specific and subtle: lethargy,
poor feeding, irritability, tremors, jitteriness, apnea, seizures.
Rosenberg, A. A., & Grover, T. (2014). The newborn infant. In W. W. Hay Jr, M. J. Levin, R. R. Deterding,
& M. J. Abzug, Current diagnosis & treatment (22nd ed., p. 27). San Francisco, CA: McGraw Hill
Education.
*Kernicterus is Chronic Bilirubin Encephalopathy-irreversible brain injury char. by cerebral palsy and
hearing impairment*
2025 WITH LATEST VERIFIED AND 100%
CORRECT ANSWERS ALREADY GRADED
A+
A female patient, currently at 26 weeks gestation, has experienced a slow rise of her blood pressure
over the past 2 weeks. Her urine specimen is negative for protein. She has reduced her sodium intake
and has begun a walking program. The patient's blood pressure today is 155/102, which is consistent
with her readings at home. Associated symptoms include a dull headache. The nurse practitioner's best
response is:
a. "Try yoga and meditation to decrease your blood pressure."
b. Start the patient on methyldopa 250 mg po twice daily.
c. "Monitor your blood pressure at home and call the office if you have swelling or a pounding
headache."
d. Start the patient on metoprolol 100mg po twice daily. - ANS-*b. Start the patient on methyldopa 250
mg po twice daily.
,Rationale: Methyldopa has the longest record of safety at a starting dosage of 250 mg po bid or tid.
Therapy with beta blockers or calcium channel blockers is also acceptable. (Papadakis& McPhee, 2015.
P. 801.) Metoprolol is a Category C medication and 100 mg po bid is not the lowest possible starting
dose. The initiation of anti-hypertensive therapy in pregnant women is indicated if the sustained blood
pressure is > 150/100 or if there is evidence of end-organ damage (Papadakis &McPhee, 2015, p. 801)
Resistant hypertension may be caused by which of the following?
a. NSAIDs
b. Oral Contraceptives
c. Obesity
d. All of the above - ANS-*d. All of the above
Rationale: (pg 716) Fibrocystic condition is the most frequent lesion of the breast. The masses are
painful, often multiple, usually bilateral masses in the breast. Rapid fluctuation in the size of the masses
is common. Pain occurs or worsens and size increases during premenstrual phase of
cycle. Most common age is 30-50. Rare in postmenopausal women not receiving hormonal replacement.
Giuliano, A. E. & Hurvitz, S. A. (2015). Breast disorders. In M. A. Papadakis, & S. J. McPhee, Current
medical diagnosis & treatment, p. 716-744). San Francisco, CA: McGraw-Hill Education.
A 75-year-old male comes into your office complaining of hesitancy, urgency, frequency, nocturia, and
sensation of incomplete bladder emptying. He denies pain or hematuria. What most likely is his
diagnosis?
a. Urinary tract infection
b. Benign prostatic hyperplasia
c. Neurogenic bladder
d. Carcinoma of the bladder - ANS-*b. Benign prostatic hyperplasia
Rationale: JNC 7 defines resistant hypertension as the inability to control blood pressure in those
patients who are compliant with the appropriate three-drug regimen, including a diuretic. Causes of
resistant hypertension listed in table 11-11 include nonadherence, NSAIDs, oral contraceptives, adrenal
steroids, licorice, obesity, and excessive alcohol intake (Sutters, 2015, p.458-459).
,Cholesterol medication that works by obstructing the absorption of cholesterol by blocking the passage
of cholesterol across the intestinal wall through the inhibition of a cholesterol transporter is ?
a. Statins
b. Fibric Acid
c. Ezetimibe
d. Bile Acid - ANS-*c. Ezetimibe (Zetia) [Cholesterol absorption inhibitor]
Rationale: "Ezetimibe is the lipid lower drug that works by inhibiting the intestinal absorption of biliary
and dietary cholesterol by blocking passage across the intestinal wall by inhibiting a cholesterol
transporter. Statins block the rate-limiting enzyme in the formation of cholesterol. Fibrates are
peroxisome proliferative-activated receptor-alpha agonists that results in potent reductions of plasms
triglycerides and increases in HDL. Bile acids work by binding bile acid in the intestine" (Baron, 2015).
A 2 year girl arrives to your clinic with a history of a fever for 7 days, cervical lymphadenopathy, edema
and desquamation of extremities, bilateral, non-exudative conjunctivitis, and polymorphous exanthema.
You correctly diagnose the girl with :
a. Rheumatic fever
b. Kawasaki disease
c. Lyme disease
d. Infective endocarditis - ANS-*b. Kawasaki disease
Rationale: The diagnostic criteria for Kawasaki disease are fever that lasts for greater than 5 days and at
least 4 of the following other manifestations: (1) cervical lymphadenopathy, usually unilateral and great
than or equal to 1.5 cm in diameter, (2) extremity changes (redness and swelling of the hands and feet
with subsequent desquamation), (3) polymorphous exanthema, (4) oral cavity or lip changes, (such as
strawberry tongues, fissuring and cracking, and inflammation of the oral mucosa), and (5) painless,
bilateral, non-exudative conjunctivitis. Rheumatic fever consists of 2 major criteria such as carditis,
erythema marginatum, Sydenham chorea, or polyarthritis, or 1 major criteria and 1 minor criteria, such
as polyarthalgia, fever, and previous rheumatic heart disease or fever, plus evidence to support
, streptococcal infection. Infective endocarditis often presents with weight loss, malaise, and fever.
(Darst, Collins, & Miyamoto, 2014, p. 628). Lyme disease may develop after a tick bite, and is
characterized by erythema chronicum migrans (Ogle & Anderson, 2014, p. 1350).
The Moro Reflex:
a. Disappears by age 3 months.
b. Disappears by age 4 months.
c. Disappears by age 8 months.
d. Disappears by age 12 months - ANS-*a. Disappears by age 3 months.
Rationale: (pg 15) The Moro (startle) reflex - hold the infant supine while supporting the head. Allow
head to drop 1-2 cm suddenly. Arms will abduct at shoulder and extend at elbow with spreading of
fingers. Adduction with flexion will follow. Develops by 28 weeks' gestation (incomplete) and disappears
by age 3 months. The palmar grasp disappears by age 4 months. The tonic neck reflex disappears by age
8 months.
Rosenberg, A. A., & Grover, T. (2014). The newborn infant. In W. W. Hay Jr, M. J. Levin, R. R. Deterding,
& M. J. Abzug, Current diagnosis & treatment (22nd ed., p. 15). San Francisco, CA: McGraw Hill
Education.
*P. 568 Seidel-infant supported in semisitting position, allow head and trunk to dropback*
Signs of hypoglycemia in the newborn infant include all of the following *except:*
a. Lethargy
b. Apnea
c. Poor feeding
d. Kernicterus - ANS-*d. Kernicterus
Rationale: (pg 27) Signs of hypoglycemia in newborn infant may be non-specific and subtle: lethargy,
poor feeding, irritability, tremors, jitteriness, apnea, seizures.
Rosenberg, A. A., & Grover, T. (2014). The newborn infant. In W. W. Hay Jr, M. J. Levin, R. R. Deterding,
& M. J. Abzug, Current diagnosis & treatment (22nd ed., p. 27). San Francisco, CA: McGraw Hill
Education.
*Kernicterus is Chronic Bilirubin Encephalopathy-irreversible brain injury char. by cerebral palsy and
hearing impairment*
