NSG6440 FINAL EXAM PREDICTOR QUESTIONS WITH ANSWERS / NSG 6440 FINAL
EXAM
70) A male patient with chronic atrial fibrillation takes a genetic brand of Coumadin
(Warfarin). He should report all of these to his health care provider EXCEPT
a. Brand name substitution for his genetic warfarin
b. On missed dose of warfarin
c. Chest pain or weakness
d. Blood in his urine
Explanation: If you miss a dose of this medicine, take it as soon as possible. However, if it is
almost time for your next dose, skip the missed dose and go back to your regular dosing
schedule. Do not double doses.
71) which of the following is not an appropriate treatment for chronic bacterial prostatitis
(CBP)?
a) Doxycycline (Vibramycin)
b) Ciprofloxacin (Cipro)
c) Trimethoprim/sulfamethoxazole (Bactrim DS)
d) Nitrofurantoin (Macrobid)
Explanation: Appropriate treatment of chronic bacterial prostatitis include fluoroquinolones,
sulfonamides, tetracyclines, an microlights ..... drop entry into the prostate is limited.
fluoroquinolone's and sulfonamides achieve the highest concentration In the tissue; tetracyclines
and microlights can also reach therapeutic levels in the prostate. nitrofuran towing is avoided in
men with prostatitis because of concern about poor tissue penetration and poor efficacy. there is
also a risk of pulmonary an hepatic adverse effect with prolonged use. recurrences of chronic
bacterial prostatitis are common in warrant a 2nd …. Duration. The antibiotics of choice are the
fluoroquinolones (eg, ciprofloxacin, Trimethoprim/sulfamethoxazole.
Trimethoprim/sulfamethoxazole, Azithromycin. It has good penetration into the prostate and is
active against gram-positive bacteria, Fosfomycin. Fosfomycin achieves reasonable tissues.
72) A new patient presents to the NP clinic stating she wants a second opinion. She started
propiluracil (PTU, Propyl Thyracil) 75 mg 3 times a day a week ago as therapy for newly
diagnosed Grave’s disease. She still feels irritable and jittery. How should the NP response?
a) Obtain a serum TSH and serum T4 today
b) Increase the PTU dose to 100 mg 3 times a day
c) Recommend radioactive therapy
d) Inform the patient that improvement requires 2 – 2 weeks.
Explanation: Propylthiouracil should have some effect on your symptoms around three to four
weeks after treatment starts. Your thyroid hormone levels should be stabilized within four to
eight weeks.
73) A 15 y/o patient has a complaint of vaginal discharge. She is sexually active with
multiple partners. Which of the following symptoms should lead the NP to suspect pelvic
inflammatory disease (PID)?
a. A report of dyspareunia
1
,b. A complaint of low back pain
c. A yellow vaginal discharge
d. Cervical motion tenderness (CMT)
Explanation: Cervical motion tenderness or cervical excitation is a sign found on a
gynecological pelvic examination suggestive of pelvic pathology. Classically, it is present in the
setting of pelvic inflammatory disease (PID) or ectopic pregnancy and is of some use to help
differentiate PID from appendicitis.
74) Which of the following is NOT a component of the fetal biophysical profile?
a) Gestational age estimate
b) Fetal breathing
c) Amniotic fluid volume
d) Fetal movements
Explanation: There are 5 components in the fetal biophysical profile: fetal heart acceleration,
fetal breathing, fetal movements, fetal tone, and amniotic fluid volume measurement.
75) Which murmur is associated with radiation to the neck?
a. Pulmonic stenosis
b. Aortic stenosis
c. Hypertrophic obstructive cardiomyopathy
d. Mitral valve insufficiency
Explanation: The classic murmur of aortic stenosis is a high-pitched, crescendo-decrescendo
(diamond shaped), midsystolic murmur located at the aortic listening post and radiating toward
the neck. The radiation of the AS murmur is often mistaken for a carotid bruit.
76) When examining a pregnant patient, where should the fundal height be at 22 weeks?
a) Slightly above the symphysis pubis
b) At the level of the umbilicus
c) Midway between the symphysis pubis and the umbilicus
d) Above the umbilicus
Explanation: Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus slightly above the
symphysis pubis 16 weeks: fundus midway between the symphysis pubis and umbilicus 20
weeks: fundus at the level of umbilicus 28 weeks: fundus 3 fingerbreadths above the umbilicus
36 weeks: fundus just below the xiphoid process
77) Education of women with fibrocystic breast disease should include which of the
following statement
a. Fibrocystic breast disease is often a precursor of breast cancer
b. Annual mammography is recommended beginning at age 40
c. Caffeine may trigger breast pain
d. Oral contraceptives are not useful in the treatment of this disease
2
,Explanation: avoidance of all methylxanthines (e.g. coffee, tea, chocolate) has been shown to
reduce breast pain in women precursor of malignancy. Mammography is recommended once at
age 35 years, at least every 1-2 years apart contraceptives may help reduce cyclic pain and
swelling.
78) An 18 y/o college student lives in the dormitory. He has been treated for scabies
infestation with permethrin (Nix). He was asymptomatic for 2 weeks but now complains again of
itching and skin burrows. How should the NP proceed?
a. Retreat with a different scadicide
b. Refer him to a physician for treatment
c. Tell him that itching can last 2-4 weeks after infection is clear
d. Retreat him with primethrin and have him launder all of his bedding and clothing.
Explanation: Permethrin cream (Elimite). Permethrin is a topical cream that contains chemicals
that kill scabies mites and their eggs
79) An 83 y/o has heart failure (HF) . He takes Prinivil (lisinopril), metoprolol (Lopressor),
ASA, and low dose furosemide every morning. After assessing the patient today, the NP
determines that he is having a mild exacerbation of HF (heart failure) the LEAST likely cause of
this
a. Three skipped doses of the Prinivil
b. Daily doses of ibuprofen for arthritis in his knees.
c. Atrial fibrillation
d. Consumption of antacid, calcium carbonate 3X yesterday
Explanation: It is unlikely that this patient HF exacerbati0on is due to consumption of antacids
yesterday especially not calcium carbonate because it is relatively lower in sodium. Missed doses
of his ACE inhibitor can lead to an exacerbation, as can consumption of Ibuprofen or any
NSAID. NSAIDs cause the patient to retain sodium, and thus fluid. This increases the workload
of the heart. Atrial fibrillation can lead to an exacerbation of HF. 80% of humans cardiac ....... is
attributable to the ―atrial kick‖. Is ….. because the patient is in a-fib, HF can result. A ……
increase in his ……. reduces the process...............causing his symptoms.
80) Antibiotic administration has been demonstrated to be of little benefit in the treatment of
which of the following disease process?
a) Chronic sinusitis
b) Acute bronchitis
c) Bacterial pneumonia
d) Lobar pneumonia
Explanation: Antibiotics are powerful medicines that treat bacterial infections. But acute
bronchitis is usually caused by a viral infection
81) Which of the following is a medication or medication class that does NOT have dizziness
or vertigo as potential adverse side effect?
a. Aminoglycosides antibiotics
3
, b. high dose salicylates
c. central acting antihypertensive
d. meclizine (Antivert)
Explanation: dizziness is associated with sensation of body movement when there is no body
movement occurring (i.e., the person is spinning, and the person is still, and the room is spinning.
There is no associated muscle weakness or visual disturbance with either of there condition.
…..ingestion, hypotension, inner or middle ear pathology, and positional vertigo. Dizziness is
and adverse reaction associated with certain…. High dose salicylates. Vertigo is associated with
certain inner ear pathology such as labyrinthitis and Meniere’s disease. Meclizine is a long…
chronic vertigo.
82) The NP CORRECTLY teaches an insulin dependent patient the signs and symptoms of
early hypoglycemia, which include
a. Facial flushing and dilated pupils
b. Frequent urination and abdominal pain
c. Diplopia and irregular pulse
d. Blurred vision, pallor and perspirations
Explanation: Early signs Sweating, Racing heartbeat, Flushed face, Anxiety, Hunger pangs
Late Signs: Headaches, Dizziness, Lightheadedness, Confusion, Difficulty speaking, Seizures
Coma.
83) The most effective treatment for a non-infective bursitis included
a. Systemic antibiotic therapy effective against penicillin-resistant staphylococcus aureus
b. Rest, an intra-articular corticosteroid injection, and a concomitant oral NSAID
c. A tapering regimen of oral corticosteroid therapy
d. Frequent active range of joint motion
Explanation: The affected joint should be rested. A sling, cane, or splint may be helpful. A long-
acting corticosteroid injected into the bursa along with an oral NSAID should be effective in
relieving the inflammation and pain on bursitis.
84) Tunner’s syndrome present exclusively in
a. Male infant
b. Female infant
c. African American infants
d. Asian infants
Explanation: Turner syndrome, a condition that affects only females, results when one of the X
chromosomes (sex chromosomes) is missing or partially missing. Turner syndrome can cause a
variety of medical and developmental problems, including short height, failure of the ovaries to
develop and heart defects.
85) Once a competent patient is identified as a victim of domestic violence
a. Recommend join counseling sessions for the pair
b. Suggest resources that will help the victim to develop survival skills
c. Refer the abuser for individual psychological counseling
4
EXAM
70) A male patient with chronic atrial fibrillation takes a genetic brand of Coumadin
(Warfarin). He should report all of these to his health care provider EXCEPT
a. Brand name substitution for his genetic warfarin
b. On missed dose of warfarin
c. Chest pain or weakness
d. Blood in his urine
Explanation: If you miss a dose of this medicine, take it as soon as possible. However, if it is
almost time for your next dose, skip the missed dose and go back to your regular dosing
schedule. Do not double doses.
71) which of the following is not an appropriate treatment for chronic bacterial prostatitis
(CBP)?
a) Doxycycline (Vibramycin)
b) Ciprofloxacin (Cipro)
c) Trimethoprim/sulfamethoxazole (Bactrim DS)
d) Nitrofurantoin (Macrobid)
Explanation: Appropriate treatment of chronic bacterial prostatitis include fluoroquinolones,
sulfonamides, tetracyclines, an microlights ..... drop entry into the prostate is limited.
fluoroquinolone's and sulfonamides achieve the highest concentration In the tissue; tetracyclines
and microlights can also reach therapeutic levels in the prostate. nitrofuran towing is avoided in
men with prostatitis because of concern about poor tissue penetration and poor efficacy. there is
also a risk of pulmonary an hepatic adverse effect with prolonged use. recurrences of chronic
bacterial prostatitis are common in warrant a 2nd …. Duration. The antibiotics of choice are the
fluoroquinolones (eg, ciprofloxacin, Trimethoprim/sulfamethoxazole.
Trimethoprim/sulfamethoxazole, Azithromycin. It has good penetration into the prostate and is
active against gram-positive bacteria, Fosfomycin. Fosfomycin achieves reasonable tissues.
72) A new patient presents to the NP clinic stating she wants a second opinion. She started
propiluracil (PTU, Propyl Thyracil) 75 mg 3 times a day a week ago as therapy for newly
diagnosed Grave’s disease. She still feels irritable and jittery. How should the NP response?
a) Obtain a serum TSH and serum T4 today
b) Increase the PTU dose to 100 mg 3 times a day
c) Recommend radioactive therapy
d) Inform the patient that improvement requires 2 – 2 weeks.
Explanation: Propylthiouracil should have some effect on your symptoms around three to four
weeks after treatment starts. Your thyroid hormone levels should be stabilized within four to
eight weeks.
73) A 15 y/o patient has a complaint of vaginal discharge. She is sexually active with
multiple partners. Which of the following symptoms should lead the NP to suspect pelvic
inflammatory disease (PID)?
a. A report of dyspareunia
1
,b. A complaint of low back pain
c. A yellow vaginal discharge
d. Cervical motion tenderness (CMT)
Explanation: Cervical motion tenderness or cervical excitation is a sign found on a
gynecological pelvic examination suggestive of pelvic pathology. Classically, it is present in the
setting of pelvic inflammatory disease (PID) or ectopic pregnancy and is of some use to help
differentiate PID from appendicitis.
74) Which of the following is NOT a component of the fetal biophysical profile?
a) Gestational age estimate
b) Fetal breathing
c) Amniotic fluid volume
d) Fetal movements
Explanation: There are 5 components in the fetal biophysical profile: fetal heart acceleration,
fetal breathing, fetal movements, fetal tone, and amniotic fluid volume measurement.
75) Which murmur is associated with radiation to the neck?
a. Pulmonic stenosis
b. Aortic stenosis
c. Hypertrophic obstructive cardiomyopathy
d. Mitral valve insufficiency
Explanation: The classic murmur of aortic stenosis is a high-pitched, crescendo-decrescendo
(diamond shaped), midsystolic murmur located at the aortic listening post and radiating toward
the neck. The radiation of the AS murmur is often mistaken for a carotid bruit.
76) When examining a pregnant patient, where should the fundal height be at 22 weeks?
a) Slightly above the symphysis pubis
b) At the level of the umbilicus
c) Midway between the symphysis pubis and the umbilicus
d) Above the umbilicus
Explanation: Between 18 and 32 weeks, there is good correlation between fundal height and
gestational age of the fetus. The expected heights are: 10-12 weeks: fundus slightly above the
symphysis pubis 16 weeks: fundus midway between the symphysis pubis and umbilicus 20
weeks: fundus at the level of umbilicus 28 weeks: fundus 3 fingerbreadths above the umbilicus
36 weeks: fundus just below the xiphoid process
77) Education of women with fibrocystic breast disease should include which of the
following statement
a. Fibrocystic breast disease is often a precursor of breast cancer
b. Annual mammography is recommended beginning at age 40
c. Caffeine may trigger breast pain
d. Oral contraceptives are not useful in the treatment of this disease
2
,Explanation: avoidance of all methylxanthines (e.g. coffee, tea, chocolate) has been shown to
reduce breast pain in women precursor of malignancy. Mammography is recommended once at
age 35 years, at least every 1-2 years apart contraceptives may help reduce cyclic pain and
swelling.
78) An 18 y/o college student lives in the dormitory. He has been treated for scabies
infestation with permethrin (Nix). He was asymptomatic for 2 weeks but now complains again of
itching and skin burrows. How should the NP proceed?
a. Retreat with a different scadicide
b. Refer him to a physician for treatment
c. Tell him that itching can last 2-4 weeks after infection is clear
d. Retreat him with primethrin and have him launder all of his bedding and clothing.
Explanation: Permethrin cream (Elimite). Permethrin is a topical cream that contains chemicals
that kill scabies mites and their eggs
79) An 83 y/o has heart failure (HF) . He takes Prinivil (lisinopril), metoprolol (Lopressor),
ASA, and low dose furosemide every morning. After assessing the patient today, the NP
determines that he is having a mild exacerbation of HF (heart failure) the LEAST likely cause of
this
a. Three skipped doses of the Prinivil
b. Daily doses of ibuprofen for arthritis in his knees.
c. Atrial fibrillation
d. Consumption of antacid, calcium carbonate 3X yesterday
Explanation: It is unlikely that this patient HF exacerbati0on is due to consumption of antacids
yesterday especially not calcium carbonate because it is relatively lower in sodium. Missed doses
of his ACE inhibitor can lead to an exacerbation, as can consumption of Ibuprofen or any
NSAID. NSAIDs cause the patient to retain sodium, and thus fluid. This increases the workload
of the heart. Atrial fibrillation can lead to an exacerbation of HF. 80% of humans cardiac ....... is
attributable to the ―atrial kick‖. Is ….. because the patient is in a-fib, HF can result. A ……
increase in his ……. reduces the process...............causing his symptoms.
80) Antibiotic administration has been demonstrated to be of little benefit in the treatment of
which of the following disease process?
a) Chronic sinusitis
b) Acute bronchitis
c) Bacterial pneumonia
d) Lobar pneumonia
Explanation: Antibiotics are powerful medicines that treat bacterial infections. But acute
bronchitis is usually caused by a viral infection
81) Which of the following is a medication or medication class that does NOT have dizziness
or vertigo as potential adverse side effect?
a. Aminoglycosides antibiotics
3
, b. high dose salicylates
c. central acting antihypertensive
d. meclizine (Antivert)
Explanation: dizziness is associated with sensation of body movement when there is no body
movement occurring (i.e., the person is spinning, and the person is still, and the room is spinning.
There is no associated muscle weakness or visual disturbance with either of there condition.
…..ingestion, hypotension, inner or middle ear pathology, and positional vertigo. Dizziness is
and adverse reaction associated with certain…. High dose salicylates. Vertigo is associated with
certain inner ear pathology such as labyrinthitis and Meniere’s disease. Meclizine is a long…
chronic vertigo.
82) The NP CORRECTLY teaches an insulin dependent patient the signs and symptoms of
early hypoglycemia, which include
a. Facial flushing and dilated pupils
b. Frequent urination and abdominal pain
c. Diplopia and irregular pulse
d. Blurred vision, pallor and perspirations
Explanation: Early signs Sweating, Racing heartbeat, Flushed face, Anxiety, Hunger pangs
Late Signs: Headaches, Dizziness, Lightheadedness, Confusion, Difficulty speaking, Seizures
Coma.
83) The most effective treatment for a non-infective bursitis included
a. Systemic antibiotic therapy effective against penicillin-resistant staphylococcus aureus
b. Rest, an intra-articular corticosteroid injection, and a concomitant oral NSAID
c. A tapering regimen of oral corticosteroid therapy
d. Frequent active range of joint motion
Explanation: The affected joint should be rested. A sling, cane, or splint may be helpful. A long-
acting corticosteroid injected into the bursa along with an oral NSAID should be effective in
relieving the inflammation and pain on bursitis.
84) Tunner’s syndrome present exclusively in
a. Male infant
b. Female infant
c. African American infants
d. Asian infants
Explanation: Turner syndrome, a condition that affects only females, results when one of the X
chromosomes (sex chromosomes) is missing or partially missing. Turner syndrome can cause a
variety of medical and developmental problems, including short height, failure of the ovaries to
develop and heart defects.
85) Once a competent patient is identified as a victim of domestic violence
a. Recommend join counseling sessions for the pair
b. Suggest resources that will help the victim to develop survival skills
c. Refer the abuser for individual psychological counseling
4
