NURS 6531 MIDTERM EXAM (VERSION-2, 100 Q & A, 2020) / NURS 6531N MIDTERM EXAM (ALL CORRECT ANSWER, RECEIVED SCORE 100%)

NURS 6531 Midterm Exam / NURS6531 Midterm Exam (Latest): Walden University Walden NURS 6531 Midterm Exam / Walden NURS6531 Midterm Exam (Latest) Question 1 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? Question 2 Which type of lung cancer has the poorest prognosis? Question 3 Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by: Question 4 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: Question 5 A 40 year old presents with a hordeolum. The nurse practitioner teaches the patient to: Question 6 Marvin has sudden eye redness that occurred after a strenuous coughing episode. You diagnose a subconjunctival hemorrhage. Your next step is to: Question 7 Which of the following is not a goal of treatment for the patient with cystic fibrosis? Question 8 The most common cancer found on the auricle is: Question 9 Which of the following color changes in a pigmented lesion suggests malignant transformation? Question 10 Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes? Question 11 The Centorcriteria for diagnosis of Group A B-hemolytic streptococcus includes which of the following? Question 12 When teaching a patient with hypertension about restricting sodium, you would include which of the following instructions? Question 13 Mark has just been given a diagnosis of congestive heart failure. Which of his medications should be discontinued? Question 14 Which of the following patient characteristics are associated with chronic bronchitis? Question 15 Treatment of acute vertigo includes: Question 16 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: Question 17 A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most effective in keeping him symptom-free? Question 18 Diagnosis of Crohn’s disease is made considering signs, symptoms and: Question 19 Which of the following is a predisposing condition for furunculosis? Question 20 Expected spirometry readings when the patient has chronic emphysema include: Question 21 A child complains that his “throat hurts” with swallowing. His voice is very “throaty” and he is hyperextending his neck to talk. Examination reveals asymmetrical swelling of his tonsils. His uvula is deviated to the left. What is the most likely diagnosis? Question 22 Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is: Question 23 Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication? Question 24 An active 65-year-old man under your care has known acquired valvular aortic stenosis and mitral regurgitation. He also has a history of infectious endocarditis. He has recently been told he needs elective replacement of his aortic valve. When he comes into the office you discover that he has 10 remaining teeth in poor repair. Your recommendation would be to: Question 25 A middle-aged male presents to urgent care complaining of fever, dysphagia, and shortness of breath. The nurse practitioner notes the patient leaning forward in a tripod position and drooling. The clinical presentation of this patient suggests: Question 26 Alan, age 54, notices a bulge in his midline every time he rises from bed in the morning. You tell him it is a ventral hernia, also known as: Question 27 The differential diagnosis for a patient complaining of a sore throat includes which of the following? Question 28 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? Question 29 The American Cancer Society recommends a flexible sigmoidoscopy for colorectal cancer screening in persons at average risk every: Question 30 Jennifer, age 49, who has a history of hyperlipidemia, has symptoms that lead you to suspect unstable angina. Your next action would be to: Question 31 A 2 year old presents with a white pupillary reflex. What is the most likely cause of this finding? Question 32 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: Question 33 John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia? Question 34 A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him: Question 35 Your patient Jerry has gout. What do you suggest? Question 36 Your well-nourished 75-year-old patient has come into the office for a physical exam and states that she recently had two nosebleeds. She does not take any anticoagulants, and you have ruled out any coagulopathies. The most likely cause of these nosebleeds is: Question 37 A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is: Question 38 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: Question 39 Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect? Question 40 A 55 year old patient has a work-up for hypertension and is noted to have elevated BUN and creatinine. Which of the following should the nurse practitioner suspect? Question 41 Which of the following is not a symptom of irritable bowel syndrome? Question 42 Impetigo and folliculitis are usually successfully treated with: Question 43 Which of the following is not a risk factor for coronary arterial insufficiency? Question 44 The most appropriate treatment for a child with mild croup is: Question 45 John, age 59, presents with recurrent, sharply circumscribed red papules and plaques with a powdery white scale on the extensor aspect of his elbows and knees. What do you suspect? Question 46 Appropriate therapy for peptic ulcer disease (PUD) is: Question 47 An AST that is more than twice the level of ALT is suggestive of: Question 48 A 45 year old with diabetes has had itching and burning lesions between her toes for 2 months. Scrapings of the lesions confirm the diagnosis tineapedis. What is the best initial treatment option for this patient? Question 49 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? Question 50 Sandra has celiac disease. You place her on which diet? Question 51 Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to: Question 52 Group A β-hemolytic streptococcal (GABHS) pharyngitis is most common in which age group? Question 53 A very active elderly patient has a documented diagnosis of arteriosclerosis obliterans. Common expected lower extremity physical exam findings include: Question 54 Which of the following is a secondary cause of hyperlipidemia? Question 55 Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo? Question 56 An employee picnic menu includes grilled hamburgers, potato salad, and homemade ice cream sundaes. Within an hour after the meal, several children and parents begin to have nausea, vomiting and stomach cramps. None of those affected have fever. What is the most likely etiologic agent? Question 57 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? Question 58 A 58-year-old man is diagnosed with Barrett’s esophagus after an endoscopy. He has no known allergies. Which of the following medications is MOST appropriate to treat this patient’s disorder? Question 59 Shirley, age 58, has been a diabetic for 7 years. Her blood pressure is normal. Other than her diabetes medications, what would you prescribe today during her routine office visit? Question 60 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: Question 61 A patient presents to the office with a blood pressure 142/80. This patient is classified as having: Question 62 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? Question 63 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: Question 64 A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough? Question 65 Which choice below is least effective for alleviating symptoms of the common cold? Question 66 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: Question 67 A patient reports to the nurse practitioner that he was diagnosed with hepatitis B a year ago and has not seen a health care provider since then. What information should this patient be given? Question 68 The most common correlate(s) with chronic bronchitis and emphysema is(are): Question 69 If a patient presents with a deep aching, red eye and there is no discharge, you should suspect: Question 70 Treatment of H.pylori includes which of the following? Question 71 Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis? Question 72 What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery? Question 73 Which of the following best describes hypertrophic cardiomyopathy? Question 74 Amaurosisfugax is described as a: Question 75 The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The least likely diagnosis for this patient is: Question 76 Which of the following heart murmurs warrants the greatest concern? Question 77 A patient with elevated lipids has been started on lovastatin. After 3 weeks of therapy, he calls to report generalized muscle aches. The nurse practitioner should suspect: Question 78 Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril5mg daily, and Calcium 1500 mg daily. At today’s visit. Her blood pressure is 170/89. According to JNC VIII guidelines, what should you do next to control Harriet’s blood pressure? Question 79 Of the following, the patient who should be referred for periodic colonoscopy is the patient with: Question 80 Dana has ischemic arterial ulcers. What is your first priority when counseling her? Question 81 After thorough history, physical examination, and laboratory tests, a patient is diagnosed with irritable bowel syndrome (IBS). Which of the following initial treatment plans is currently considered most effective? Question 82 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? Question 83 What is the Gold standard for the diagnosis of asthma? Question 84 An 8 year old presents to the health clinic with history of acute onset severe sore throat and respiratory distress with stridor in the last 2 hours. The child’s history is positive for fever and pharyngitis for 2 days. What is the most likely diagnosis? Question 85 The National Cholesterol Education Program’s Adult Treatment Panel III recommends that the goal for low density lipoproteins in high risk patients be less than: Question 86 Which intervention listed below is safe for long term use by an adult with constipation? Question 87 The nurse practitioner is reviewing a patient’s lab report who completed the hepatitis B series 3 months ago. Which of the following lab results would you expect to see in this patient? Question 88 Sarah has allergic rhinitis and is currently being bothered by nasal congestion. Which of the following meds ordered for allergic rhinitis would be most appropriate? Question 89 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? Question 90 A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is: Question 91 A 60 year old male diabetic patient presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which “is better.” His temperature is 100°F and pulse is 102 bpm. The most appropriate initial action is to: Question 92 A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory? Question 93 Which of the following can result from chronic inflammation of a meibomian gland? Question 94 A 15 year old male presents with abdominal pain that began in the peri-umbilical area then localized to the right lower quadrant (RLQ). He complains of anorexia, and low grade fever. A complete blood count (CBC) reveals moderate leukocytosis. What is the most likely diagnosis? Question 95 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? Question 96 A false-positive result with the fecal occult blood test can result from: Question 97 A patient presents with classic symptoms of gastroesophageal reflux disease (GERD). He is instructed on life style modifications and drug therapy for 8 weeks. Three months later he returns, reporting that he was “fine” as long as he took the medication. The most appropriate next step is: Question 98 Risk factors for acute arterial insufficiency include which of the following? Question 99 A patient presents to the primary care provider complaining of a rash on his right forehead that started yesterday and is burning and painful. The physical exam reveals an erythematous, maculopapular rash that extends over the patient’s right eye to his upper right forehead. Based on the history and examination, the most likely cause of this patient’s symptoms is: Question 100 Which of the following are classic features of ulcerative colitis?