Test Bank for Primary Care: The Art and Scienceof
h h h h h h h h h h
Advanced Practice Nursing and Interprofessional Ap h h h h h
proach 6th Edition M Dunphy h h h h
/ 9781719644655 / Chapter 1-
h h h h
88 ,All Chapterswith Answers and Rationals .
h h h h h h h
A 20 y/o female with asthma presents with symptoms requiring use of al
h h h h h h h h h h h h
buterol three times a week, but less than once a day. The next appropria
h h h h h h h h h h h h h
te medication to add to this patient's regimen is..... - ANS-
h h h h h h h h h h
Inhaled flunisolide (Aerobid)
h h h
A 55-year-
h
old man with a *50 pack year history of smoking* cigarettes has recentl
h h h h h h h h h h h h
y experienced an episode of hemoptysis alongwith his usual cough. On
h h h h h h h h h h h h
physical examination he has no abnormal findings. A sputum for cytolo
h h h h h h h h h h
gy on microscopic examination shows atypical cells with hyperchrom
h h h h h h h h
atic nuclei and orange-
h h h
pink cytoplasm. Labortory studies show an *elevated serum calcium*
h h h h h h h h h
of11.3 mg/dL, with phosphorus 2.1 mg/dL. *Which chest radiographic f
h h h h h h h h h h
inding is this man most likely to have?* - ANS-Large hilar mass
h h h h h h h h h h h
During a cardiac arrest, a 58-year-old man, a non-
h h h h h h h h
smoker, receives cardiopulmonary resuscitative measures and is brou
h h h h h h h
ght to the hospital, where he is intubated. *During the intubation proce
h h h h h h h h h h h
dure hesuffers aspiration of gastric contents.* Over the next 10 days he
h h h h h h h h h h h h h
develops a non- h h
productive cough along with a fever to 37.9°C. *A chest radiograph rev
h h h h h h h h h h h
eals a 4 cm diameter mass with an air-
h h h h h h h h
fluid level* in the right lung. A sputum gram stain reveals mixed flora.
h h h h h h h h h h h h
*Which condition is he most likely to have?* - ANS-Lung Abscess
h h h h h h h h h h
,A 66-year-
h
old man has had increasing dyspnea for the past year. Heis *retired fro
h h h h h h h h h h h h h
m the construction business.* There are some ralesauscultated in bo
h h h h h h h h h h
th lungs on physical examination. A chest radiograph reveals bilateral
h h h h h h h h h h
diaphragmatic *pleural plaques* with focal calcification as well as diff h h h h h h h h h
use interstitial lung disease. A sputum cytology shows no atypical cell
h h h h h h h h h h
s, only ferruginous bodies.
h h h
Pulmonary function studies reveal a low FVC and a normal FEV1/FVC
h h h h h h h h h h h
ratio. *These findings are most likely to suggest prior exposure to what
h h h h h h h h h h h h
environmental agent?* - ANS-Asbestos crystals h h h h
A 44 y/o male with lung cancer presented with swelling of the neck and
h h h h h h h h h h h h h h
right upper extremity. What is this called? - ANS-
h h h h h h h h
Superior Vena Cava Syndrome h h h
What type of pharmacological agent would be used as a first-
h h h h h h h h h h
linemedication to treat obsessive compulsive disorder?
h h h h h h
A. risperidone
h h
B. lonazepam
h h
C. fluoxetine
h h
D. trazadone
h
E. venlafaxine - ANS-fluoxetine
h h h
The risk of extrapyramidal side effects (pseudoparkinsonism) and tard
h h h h h h h h
ive dyskinesia is associated with which class of medications? -ANS-
h h h h h h h h h h
typical (first-generation) antipsychotics
h h
A 24-year-old male has an eight-
h h h h h
month history of loose thought associations, social withdrawal, audito
h h h h h h h h
ry hallucinations, and deterioration in his personal appearance and h
h h h h h h h h h
ygiene. Upon examination, he is noted to have a flat affect, perceptu
h h h h h h h h h h h
al distortions, and behaves like he is detached from his own actions.
h h h h h h h h h h h
,*Which of the following medications used in treatment of thisdisease ha
h h h h h h h h h h h
s the risk of prolonging the ǪTc interval?*
h h h h h h h
Aripiprazole (Abilify) Chlorpro h h
mazine (Thorazine) h
Loxapine (Loxitane) Ǫuetiapi
h h h
ne (Seroquel)
h
Ziprasidone (Geodon) - ANS-Chlorpromazine (Thorazine) h h h h
Which of the following psychiatric conditions has the highestmortality r
h h h h h h h h h h
ate? - ANS-anorexia nervosa
h h h
(higher than any psych illness, including depression)
h h h h h h
A 24-year-
h
old woman comes to your office complaining of anxiety. The patient had
h h h h h h h h h h h h
*witnessed a traumatic event 3 days earlier* that made her feel fearful.
h h h h h h h h h h h h
She has not been able to tell her family aboutthis experience. She now f
h h h h h h h h h h h h h h
eels like she is numb and in a dazed, dreamlike state with poor concen
h h h h h h h h h h h h h
tration, and difficulty sleeping. h h h
She experienced a flashback of the event yesterday. *What is themost li
h h h h h h h h h h h h
kely diagnosis?* - ANS-acute stress disorder
h h h h h
*Mr. Smith leaves home and does not return* nor does he go to work. *A
h h h h h h h h h h h h h h
hfriend of Mr. Smith sees him in another state* while on vacation. When
h h h h h h h h h h h h h
he approaches Mr. Smith, he does not recognize him and has a total di
h h h h h h h h h h h h h
fferent demeanor. *What type of disorder doesMr. Smith have?* - ANS-
h h h h h h h h h h h
dissociative fugue h
Which of the following indicates a poor prognosis for someonediagnos
h h h h h h h h h h
ed with schizophrenia?
h h
A. acute onset h
B. co-
morbid mood disorder C. obvi h h h h
ous precipitating event
h h
, D. younger age at diagnosis - ANS-younger age at diagnosis
h h h h h h h h h
A 16-year-
h
old Caucasian female is brought to your family practiceoffice by her m
h h h h h h h h h h h h
other because she has been missing school and her mother is concern
h h h h h h h h h h h
ed. The patient has symptoms consistent with mild to moderate depr
h h h h h h h h h h
ession. *She has a history of menstrual migraines* and now has vagu
h h h h h h h h h h h
e constitutional symptoms all the timeand doesn't want to get out of be
h h h h h h h h h h h h h
d in the morning. The patient confesses that over the past month she
h h h h h h h h h h h h h
has felt that she is not important to anyone and wonders if the world wil
h h h h h h h h h h h h h h
l be better off without her. *Of the following, which is your greatest conc
h h h h h h h h h h h h h
ern when considering prescribing her a selective serotonin reuptake in
h h h h h h h h h
hibitor (SSRI)?* h
- compliance to the medication regime h h h h
- increased risk of suicide as detailed in black box warnings h h h h h h h h h
- nausea-related side effects as you titrate upwards h h h h h h
- risk of pregnancy when taking psychiatric medications
h h h h h h
- risk of serotonin syndrome, should you need to prescribe a tr -
h h h h h h h h h h h
hANS-
risk of serotonin syndrome, should you need to prescribe atriptan f
h h h h h h h h h h h
or her migraines
h h
A 37-year-
h
old woman under your care is diagnosed with bipolar I disorder. As part
h h h h h h h h h h h h h
of her drug regimen, you prescribe lithium carbonate as long-
h h h h h h h h h
term maintenance therapy. *What lab would bemost appropriate to o
h h h h h h h h h h
rder prior to the initiation of lithium carbonate?* - ANS-
h h h h h h h h h
serum creatinine h
A *68-year-
h
old* man is recently *diagnosed with depression* associated with the l
h h h h h h h h h h
oss of his close sister to an automobile accident. He is currently taking
h h h h h h h h h h h h h
oxybutynin for *overactive bladderdisease* and lisinopril for hypertens
h h h h h h h h
ion. He has no known drug
h h h h h
h h h h h h h h h h
Advanced Practice Nursing and Interprofessional Ap h h h h h
proach 6th Edition M Dunphy h h h h
/ 9781719644655 / Chapter 1-
h h h h
88 ,All Chapterswith Answers and Rationals .
h h h h h h h
A 20 y/o female with asthma presents with symptoms requiring use of al
h h h h h h h h h h h h
buterol three times a week, but less than once a day. The next appropria
h h h h h h h h h h h h h
te medication to add to this patient's regimen is..... - ANS-
h h h h h h h h h h
Inhaled flunisolide (Aerobid)
h h h
A 55-year-
h
old man with a *50 pack year history of smoking* cigarettes has recentl
h h h h h h h h h h h h
y experienced an episode of hemoptysis alongwith his usual cough. On
h h h h h h h h h h h h
physical examination he has no abnormal findings. A sputum for cytolo
h h h h h h h h h h
gy on microscopic examination shows atypical cells with hyperchrom
h h h h h h h h
atic nuclei and orange-
h h h
pink cytoplasm. Labortory studies show an *elevated serum calcium*
h h h h h h h h h
of11.3 mg/dL, with phosphorus 2.1 mg/dL. *Which chest radiographic f
h h h h h h h h h h
inding is this man most likely to have?* - ANS-Large hilar mass
h h h h h h h h h h h
During a cardiac arrest, a 58-year-old man, a non-
h h h h h h h h
smoker, receives cardiopulmonary resuscitative measures and is brou
h h h h h h h
ght to the hospital, where he is intubated. *During the intubation proce
h h h h h h h h h h h
dure hesuffers aspiration of gastric contents.* Over the next 10 days he
h h h h h h h h h h h h h
develops a non- h h
productive cough along with a fever to 37.9°C. *A chest radiograph rev
h h h h h h h h h h h
eals a 4 cm diameter mass with an air-
h h h h h h h h
fluid level* in the right lung. A sputum gram stain reveals mixed flora.
h h h h h h h h h h h h
*Which condition is he most likely to have?* - ANS-Lung Abscess
h h h h h h h h h h
,A 66-year-
h
old man has had increasing dyspnea for the past year. Heis *retired fro
h h h h h h h h h h h h h
m the construction business.* There are some ralesauscultated in bo
h h h h h h h h h h
th lungs on physical examination. A chest radiograph reveals bilateral
h h h h h h h h h h
diaphragmatic *pleural plaques* with focal calcification as well as diff h h h h h h h h h
use interstitial lung disease. A sputum cytology shows no atypical cell
h h h h h h h h h h
s, only ferruginous bodies.
h h h
Pulmonary function studies reveal a low FVC and a normal FEV1/FVC
h h h h h h h h h h h
ratio. *These findings are most likely to suggest prior exposure to what
h h h h h h h h h h h h
environmental agent?* - ANS-Asbestos crystals h h h h
A 44 y/o male with lung cancer presented with swelling of the neck and
h h h h h h h h h h h h h h
right upper extremity. What is this called? - ANS-
h h h h h h h h
Superior Vena Cava Syndrome h h h
What type of pharmacological agent would be used as a first-
h h h h h h h h h h
linemedication to treat obsessive compulsive disorder?
h h h h h h
A. risperidone
h h
B. lonazepam
h h
C. fluoxetine
h h
D. trazadone
h
E. venlafaxine - ANS-fluoxetine
h h h
The risk of extrapyramidal side effects (pseudoparkinsonism) and tard
h h h h h h h h
ive dyskinesia is associated with which class of medications? -ANS-
h h h h h h h h h h
typical (first-generation) antipsychotics
h h
A 24-year-old male has an eight-
h h h h h
month history of loose thought associations, social withdrawal, audito
h h h h h h h h
ry hallucinations, and deterioration in his personal appearance and h
h h h h h h h h h
ygiene. Upon examination, he is noted to have a flat affect, perceptu
h h h h h h h h h h h
al distortions, and behaves like he is detached from his own actions.
h h h h h h h h h h h
,*Which of the following medications used in treatment of thisdisease ha
h h h h h h h h h h h
s the risk of prolonging the ǪTc interval?*
h h h h h h h
Aripiprazole (Abilify) Chlorpro h h
mazine (Thorazine) h
Loxapine (Loxitane) Ǫuetiapi
h h h
ne (Seroquel)
h
Ziprasidone (Geodon) - ANS-Chlorpromazine (Thorazine) h h h h
Which of the following psychiatric conditions has the highestmortality r
h h h h h h h h h h
ate? - ANS-anorexia nervosa
h h h
(higher than any psych illness, including depression)
h h h h h h
A 24-year-
h
old woman comes to your office complaining of anxiety. The patient had
h h h h h h h h h h h h
*witnessed a traumatic event 3 days earlier* that made her feel fearful.
h h h h h h h h h h h h
She has not been able to tell her family aboutthis experience. She now f
h h h h h h h h h h h h h h
eels like she is numb and in a dazed, dreamlike state with poor concen
h h h h h h h h h h h h h
tration, and difficulty sleeping. h h h
She experienced a flashback of the event yesterday. *What is themost li
h h h h h h h h h h h h
kely diagnosis?* - ANS-acute stress disorder
h h h h h
*Mr. Smith leaves home and does not return* nor does he go to work. *A
h h h h h h h h h h h h h h
hfriend of Mr. Smith sees him in another state* while on vacation. When
h h h h h h h h h h h h h
he approaches Mr. Smith, he does not recognize him and has a total di
h h h h h h h h h h h h h
fferent demeanor. *What type of disorder doesMr. Smith have?* - ANS-
h h h h h h h h h h h
dissociative fugue h
Which of the following indicates a poor prognosis for someonediagnos
h h h h h h h h h h
ed with schizophrenia?
h h
A. acute onset h
B. co-
morbid mood disorder C. obvi h h h h
ous precipitating event
h h
, D. younger age at diagnosis - ANS-younger age at diagnosis
h h h h h h h h h
A 16-year-
h
old Caucasian female is brought to your family practiceoffice by her m
h h h h h h h h h h h h
other because she has been missing school and her mother is concern
h h h h h h h h h h h
ed. The patient has symptoms consistent with mild to moderate depr
h h h h h h h h h h
ession. *She has a history of menstrual migraines* and now has vagu
h h h h h h h h h h h
e constitutional symptoms all the timeand doesn't want to get out of be
h h h h h h h h h h h h h
d in the morning. The patient confesses that over the past month she
h h h h h h h h h h h h h
has felt that she is not important to anyone and wonders if the world wil
h h h h h h h h h h h h h h
l be better off without her. *Of the following, which is your greatest conc
h h h h h h h h h h h h h
ern when considering prescribing her a selective serotonin reuptake in
h h h h h h h h h
hibitor (SSRI)?* h
- compliance to the medication regime h h h h
- increased risk of suicide as detailed in black box warnings h h h h h h h h h
- nausea-related side effects as you titrate upwards h h h h h h
- risk of pregnancy when taking psychiatric medications
h h h h h h
- risk of serotonin syndrome, should you need to prescribe a tr -
h h h h h h h h h h h
hANS-
risk of serotonin syndrome, should you need to prescribe atriptan f
h h h h h h h h h h h
or her migraines
h h
A 37-year-
h
old woman under your care is diagnosed with bipolar I disorder. As part
h h h h h h h h h h h h h
of her drug regimen, you prescribe lithium carbonate as long-
h h h h h h h h h
term maintenance therapy. *What lab would bemost appropriate to o
h h h h h h h h h h
rder prior to the initiation of lithium carbonate?* - ANS-
h h h h h h h h h
serum creatinine h
A *68-year-
h
old* man is recently *diagnosed with depression* associated with the l
h h h h h h h h h h
oss of his close sister to an automobile accident. He is currently taking
h h h h h h h h h h h h h
oxybutynin for *overactive bladderdisease* and lisinopril for hypertens
h h h h h h h h
ion. He has no known drug
h h h h h
