MN551 Final Exam (2 Versions) / MN 551 Final Exam: Kaplan University |Latest-2020, 100% Correct Answers|

MN551 Unit 10 Final Exam / MN 551 Unit 10 Final Exam (Latest): Kaplan University MN551 Week 10 Final Exam / MN 551 Week 10 Final Exam (Latest): Kaplan University Question 1. During an examination, the nurse observes a female patient's vestibule and expects to see the: A ) urethral meatus and vaginal orifice. B) vaginal orifice and vestibular (Bartholin) glands. C) urethral meatus and paraurethral (Skene) glands. D) paraurethral (Skene) and vestibular (Bartholin) glands. 2. During a speculum inspection of the vagina, the nurse would expect to see what at the end of the vaginal canal? A) Cervix B) Uterus C) Ovaries D) Fallopian tubes 3. The uterus is usually positioned tilting forward and superior to the bladder. This position is known as: A) anteverted and anteflexed. B) retroverted and anteflexed. C retroverted and retroflexed. D)superiorverted and anteflexed. 4. An 11-year-old girl is in the clinic for a sports physical. The nurse notices that she has begun to develop breasts, and during the conversation the girl reveals that she is worried about her development. The nurse should use which of these techniques to best assist the young girl in understanding the expected sequence for development? The nurse should: A) use the Tanner's table on the five stages of sexual development. B) describe her development and compare it with that of other girls her age. C) use Jacobsen's table on expected development on the basis of height and weight data. D) reassure her that her development is within normal limits and should tell her not to worry about the next step. 5. A woman who is 8 weeks pregnant is in the clinic for a checkup. The nurse reads on her chart that her cervix is softened and looks cyanotic. The nurse knows that the woman is exhibiting _____ sign and _____ sign. A) Tanner's; Hegar's B) Hegar's; Goodell's C) Chadwick's; Hegar's D) Goodell's; Chadwick's 6. A woman who is 22 weeks pregnant has a vaginal infection. She tells the nurse that she is afraid that this infection will hurt the fetus. The nurse knows that which of these statements is true? A) If intercourse is avoided, then the risk for infection is minimal. B) A thick mucus plug forms that protects the fetus from infection. C) The acidic pH of vaginal secretions promotes the growth of pathogenic bacteria. D) The mucus plug that forms in the cervical canal is a good medium for bacterial growth. 7. The changes normally associated with menopause occur generally because the cells in the reproductive tract are: A)aging. B)becoming fibrous. C)estrogen dependent. D)able to respond to estrogen. 8. The nurse is reviewing the changes that occur with menopause. Which of these are changes associated with menopause? A) Uterine and ovarian atrophy along with thinning vaginal epithelium B) Ovarian atrophy, increased vaginal secretions, and increasing clitoral size C) Cervical hypertrophy, ovarian atrophy, and increased acidity of vaginal secretions D) Vaginal mucosa fragility, increased acidity of vaginal secretions, and uterine hypertrophy 9. A 54-year-old woman who has just completed menopause is in the clinic today for a yearly physical examination. Which of these statements should the nurse include in patient education? "A postmenopausal woman: A) is not at any greater risk for heart disease than a younger woman is." B) should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions." C) has only stopped menstruating; there really are no other significant changes with which she should be concerned." D) is likely to have difficulty with sexual pleasure as a result of drastic changes in the female sexual response cycle." 10. A woman is in the clinic for an annual gynecologic examination. The nurse should plan to begin the interview with the: A) menstrual history because it is generally nonthreatening. B) obstetric history because it is the most important information. C) urinary system history because there may be problems in this area as well. D) sexual history because it will build rapport to discuss this first. 11. A patient has had three pregnancies and two live births. The nurse would record this information as gravida _____, para _____, AB _____. A) 2; 2; 1 B) 3; 2; 0 C) 3; 2; 1 D) 3; 3; 1 12. During the interview with a female patient, the nurse gathers data that indicate that the patient is perimenopausal. Which of these statements made by this patient leads to this conclusion? A)"I have noticed that my muscles ache at night when I go to bed." B) "I will be very happy when I can stop worrying about having a period." C) "I have been noticing that I sweat a lot more than I used to, especially at night." D) "I have only been pregnant twice, but both times I had breast tenderness as my first symptom." 13. A 50-year-old woman calls the clinic because she has noticed some changes in her body and breasts and wonders if they could be due to the hormone replacement therapy (HRT) she started 3 months ago. The nurse should tell her: A) "Hormone replacement therapy is at such a low dose that side effects are very unusual." B) "Hormone replacement therapy has several side effects, including fluid retention, breast tenderness, and vaginal bleeding." C) "It would be very unusual to have vaginal bleeding with hormone replacement therapy, and I suggest you come in to the clinic immediately to have this evaluated." D)"It sounds as if your dose of estrogen is too high; I think you may need to decrease the amount you are taking and then call back in a week." 14. A 52-year-old patient states that when she sneezes or coughs she "wets herself a little." She is very concerned that something may be wrong with her. The nurse suspects that the problem is: A) dysuria. B) stress incontinence. C) hematuria. D) urge incontinence. 15. During the interview a patient reveals that she has some vaginal discharge. She is worried that it may be a sexually transmitted infection. The nurse's most appropriate response to this would be: A) "Oh, don't worry. Some cyclic vaginal discharge is normal." B) "Have you been engaging in unprotected sexual intercourse?" C) "I'd like some information about the discharge. What color is it?" D) "Have you had any urinary incontinence associated with the discharge?" 16. A woman states that 2 weeks ago she had a urinary tract infection that was treated with an antibiotic. As a part of the interview, the nurse should ask, "Have you noticed: A) a change in your urination patterns?" B) any excessive vaginal bleeding?" C) any unusual vaginal discharge or itching?" D) any changes in your desire for intercourse?" 17. Which statement would be most appropriate when the nurse is introducing the topic of sexual relationships during an interview? A)"Now it is time to talk about your sexual history. When did you first have intercourse?" B) "Women often feel dissatisfied with their sexual relationships. Would it be okay to discuss this now?" C) "Often women have questions about their sexual relationship and how it affects their health. Do you have any questions?" D) "Most women your age have had more than one sexual partner. How many would you say you have had?" 18. A 22-year-old woman has been considering using oral contraceptives. As a part of her history, the nurse should ask: A) "Do you have a history of heart murmurs?" B) "Will you be in a monogamous relationship?" C) "Have you thought this choice through carefully?" D) "If you smoke, how many cigarettes do you smoke per day?" 19. A married couple has come to the clinic seeking advice on pregnancy. They have been trying to conceive for 4 months and have not been successful. What should the nurse do first? A) Ascertain whether either of them has been using broad-spectrum antibiotics. B) Explain that couples are considered infertile after 1 year of unprotected intercourse. C) Immediately refer the woman to an expert in pelvic inflammatory disease—the most common cause of infertility. D) Explain that couples are considered infertile after 3 months of engaging in unprotected intercourse and that they will need a referral to a fertility expert. 20. A nurse is assessing a patient's risk of contracting a sexually transmitted infection (STI). An appropriate question to ask would be: A) "You know that it's important to use condoms for protection, right?" B) "Do you use a condom with each episode of sexual intercourse?" C) "Do you have a sexually transmitted infection?" D) "You are aware of the dangers of unprotected sex, aren't you?" 21. When the nurse is interviewing a preadolescent girl, which opening statement would be least threatening? A) "Do you have any questions about growing up?" B) "What has your mother told you about growing up?" C) "When did you notice that your body was changing?" D) "I remember being very scared when I got my period. How do you think you'll feel?" 22. When the nurse is discussing sexuality and sexual issues with adolescents, a permission statement helps to convey that it is normal to think or feel a certain way. Which of these is the best example of a permission statement? A) "It is okay that you have become sexually active." B) "Often girls your age have questions about sexual activity. Have you any questions?" C) "If it is okay with you, I'd like to ask you some questions about your sexual history." D) "Often girls your age engage in sexual activity. It is okay to tell me if you have had intercourse." 23. The nurse is preparing to interview a postmenopausal woman. Which of these statements is true with regard to the history of a postmenopausal woman? A) The nurse should ask a postmenopausal woman if she ever has vaginal bleeding. B) Once a woman reaches menopause, the nurse does not need to ask any further history questions. C) The nurse should screen for monthly breast tenderness. D) Postmenopausal women are not at risk for contracting sexually transmitted infections and thus these questions can be omitted. 24. During the examination portion of a patient's visit, she will be in lithotomy position. Which statement below reflects some things that the nurse can do to make this more comfortable for her? A) Ask her to place her hands and arms behind her head. B) Elevate her head and shoulders to maintain eye contact. C) Allow her to choose to have her feet in the stirrups or have them resting side by side on the edge of the table. D) Allow her to keep her buttocks about 6 inches from the edge of the table to prevent her from feeling as if she will fall off. 25. An 18-year-old patient is having her first pelvic examination. Which action by the nurse is appropriate? A) Invite her mother to be present during the examination. B) Avoid the lithotomy position this first time because it can be uncomfortable and embarrassing. C) Raise the head of the examination table and give her a mirror so that she can view the exam. D) Drape her fully, leaving the drape between her legs elevated to avoid embarrassing her with eye contact. 26. The nurse has just completed an inspection of a nulliparous woman's external genitalia. Which of these would be a description of a finding within normal limits? A) Redness of the labia majora B) Multiple nontender sebaceous cysts C) Discharge that is sticky and yellow-green D) Gaping and slightly shriveled labia majora 27. The nurse is preparing for an internal genitalia examination of a woman. Which order of the examination is correct? A) Bimanual, speculum, rectovaginal B) Speculum, rectovaginal, bimanual C) Speculum, bimanual, rectovaginal D) Rectovaginal, bimanual, speculum 28. During an internal examination of a woman's genitalia, the nurse will use which technique for proper insertion of the speculum? A) Instruct the woman to bear down, open the speculum blades, and apply in a swift, upward movement. B) Insert the blades of the speculum on a horizontal plane, turning them to a 30-degree angle while continuing to insert them. Ask the woman to bear down after the speculum is inserted. C) Instruct the woman to bear down, turn the width of the blades horizontally, and insert the speculum at a 45-degree angle downward toward the small of the woman's back. D) Lock the blades open by turning the thumbscrew. Once the blades are open, apply pressure to the introitus and insert the blades at a 45-degree angle downward to bring the cervix into view. 29. The nurse is examining a 35-year-old female patient. During the history, the nurse notices that she has had two term pregnancies, and both babies were delivered vaginally. During the internal examination the nurse observes that the cervical os is a horizontal slit with some healed lacerations and that the cervix has some nabothian cysts that are small, smooth, and yellow. In addition, the nurse notices that the cervical surface is granular and red, especially around the os. Finally, the nurse notices the presence of stringy, opaque, odorless secretions. Which of these findings are abnormal? A) Nabothian cysts are present. B) The cervical os is a horizontal slit. C) The cervical surface is granular and red. D) Stringy and opaque secretions are present. 30. A patient calls the clinic for instructions before having a Papanicolaou (Pap) smear. The most appropriate instructions from the nurse are: A) "If you are menstruating, please use pads to avoid placing anything into the vagina." B) "Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment." C) "If you suspect that you have a vaginal infection, please gather a sample of the discharge to bring with you." D) "We would like you to use a mild saline douche before your examination. You may pick this up in our office." 31. During an examination, which tests will the nurse collect to screen for cervical cancer? A) Endocervical specimen, cervical scrape, and vaginal pool B) Endocervical specimen, vaginal pool, and acetic acid wash C) Endocervical specimen, KOH preparation, and acetic acid wash D) Cervical scrape, acetic acid wash, saline mount ("wet prep") 32. When performing the bimanual examination, the nurse notices that the cervix feels smooth and firm, is round, and is fixed in place (does not move). When cervical palpation is performed, the patient complains of some pain. The nurse's interpretation of these results should be which of these? A) These findings are all within normal limits. B) The cervical consistency should be soft and velvety—not firm. C) The cervix should move when palpated; an immobile cervix may indicate malignancy. D) Pain may occur during palpation of the cervix. 33. The nurse is palpating a female patient's adnexa. The findings include a firm, smooth uterine wall; the ovaries are palpable and feel smooth and firm. The fallopian tube is firm and pulsating. The nurse's most appropriate course of action would be to: A) tell the patient that her examination was normal. B) give her an immediate referral to a gynecologist. C) suggest that she return in a month for a recheck to verify the findings. D) tell the patient that she may have an ovarian cyst that should be evaluated further. 34. A 65-year-old woman is in the office for routine gynecologic care. She had a complete hysterectomy 3 months ago after cervical cancer was detected. The nurse knows that which of these statements is true with regard to this visit? A) Her cervical mucosa will be red and dry looking. B) She will not need to have a Pap smear done. C) The nurse can expect to find that her uterus will be somewhat enlarged and her ovaries small and hard. D) The nurse should plan to lubricate the instruments and the examining hand well to avoid a painful examination. 35. The nurse is preparing to examine the external genitalia of a school-age girl. Which of these positions would be most appropriate in this situation? A) In the parent's lap B) In a frog-leg position on the examining table C) In the lithotomy position with the feet in stirrups D) Lying flat on the examining table with legs extended 36. When assessing a newborn infant's genitalia, the nurse notices that the genitalia are somewhat engorged. The labia majora are swollen, the clitoris looks large, and the hymen is thick. The vaginal opening is difficult to visualize. The infant's mother states that she is worried about the labia being swollen. The nurse should reply: A) "This is a normal finding in newborns and should resolve within a few weeks." B "This could indicate an abnormality and may need to be evaluated by a physician." C) "We will need to have estrogen levels evaluated to make sure that they are within normal limits." D) "We will need to keep close watch over the next few days to see if the genitalia decrease in size." 37. During a vaginal examination of a 38-year-old woman, the nurse notices that the vulva and vagina are erythematous and edematous with thick, white, curdlike discharge adhering to the vaginal walls. The woman reports intense pruritus and thick white discharge from her vagina. The nurse knows that these history and physical examination findings are most consistent with which of these conditions? A) Candidiasis B) Trichomoniasis C) Atrophic vaginitis D) Bacterial vaginosis 38. A 22-year-old woman is being seen at the clinic for problems with vulvar pain, dysuria, and fever. On physical examination, the nurse notices clusters of small, shallow vesicles with surrounding erythema on the labia. There is also inguinal lymphadenopathy present. The most likely cause of these lesions is: A) pediculosis pubis. B) contact dermatitis. C) human papillomavirus. D) herpes simplex virus type 2. 39. When performing an external genitalia examination of a 10-year-old girl, the nurse notices that there is no pubic hair, and the mons and the labia are covered with fine vellus hair. These findings are consistent with stage _____ of sexual maturity, according to the Sexual Maturity Rating scale. A) 1 B) 2 C) 3 D) 4 40. A 46-year-old woman is in the clinic for her annual gynecologic examination. She voices a concern about ovarian cancer because her mother and sister died of it. The nurse knows that which of these statements is correct regarding ovarian cancer? A) Ovarian cancer rarely has any symptoms. B) The Pap smear detects the presence of ovarian cancer. C) Women at high risk for ovarian cancer should have annual transvaginal ultrasonography for screening. D) Women over age 40 years should have a thorough pelvic examination every 3 years. 41. During a bimanual examination, the nurse detects a solid tumor on the ovary that is heavy and fixed, with a poorly defined mass. This finding is suggestive of: A) an ovarian cyst. B) endometriosis. C) ovarian cancer. D) an ectopic pregnancy. 42. A 25-year-old woman comes to the emergency department with a sudden fever of 101° F and abdominal pain. Upon examination, the nurse notices that she has rigid, boardlike lower abdominal musculature. When the nurse tries to perform a vaginal examination, the patient has severe pain when the uterus and cervix are moved. The nurse knows that these signs and symptoms are suggestive of: A) endometriosis. B) uterine fibroids. C) ectopic pregnancy. D) pelvic inflammatory disease. 43. During an external genitalia examination of a woman, the nurse notices several lesions around the vulva. The lesions are pink, moist, soft, and pointed papules. The patient states that she is not aware of any problems in that area. The nurse recognizes that these lesions may be: A) syphilitic chancre. B) herpes simplex virus type 2 (herpes genitalis). C) human papillomavirus (HPV), or genital warts. D) pediculosis pubis (crab lice). 44. During an examination, the nurse would expect the cervical os of a woman who has never had children to appear: A) stellate. B) small and round. C) as a horizontal irregular slit. D) everted. 45. A woman has just been diagnosed with HPV, or genital warts. The nurse should counsel her to receive regular examinations because this virus makes her at a higher risk for _____ cancer. A) uterine B) cervical C) ovarian D) endometrial 46. During an internal examination, the nurse notices that the cervix bulges outside the introitus when the patient is asked to strain. The nurse will document this as: A) uterine prolapse, graded first degree. B) uterine prolapse, graded second degree. C) uterine prolapse, graded third degree. D) a normal finding. 47. A 35-year-old woman is at the clinic for a gynecologic examination. During the examination, she asks the nurse, "How often do I need to have this Pap test done?" Which reply by the nurse is correct? A)"It depends. Do you smoke?" B)"This will need to be done annually until you are 65." C)"If you have 2 consecutive normal Pap tests, then you can wait 5 years between tests." D)"After age 30, if you have 3 consecutive normal Pap tests, then you may be screened every 2 to 3 years." 48. The nurse is palpating an ovarian mass during an internal examination of a 63-year-old woman. Which findings of the mass's characteristics would suggest the presence of an ovarian cyst? Select all that apply. A) Heavy and solid B) Mobile and fluctuant C)Mobile and solid D) Fixed E) Smooth and round F) Poorly defined MN551 Unit 10 Final Exam / MN 551 Unit 10 Final Exam / MN551 Week 10 Final Exam / MN 551 Week 10 Final Exam (Latest): Kaplan University Question 1 2 / 2 points A student is feeling inside her backpack to find her mobile phone, which has fallen to the bottom, and there are a number of items in the bag in addition to the phone. Which of the following components of somatosensory conduction is most likely to provide the detailed sensory information that will help her distinguish her phone from other items? Question options: The primary dorsal root ganglion neuron, the dorsal column neuron, and the thalamic neuron A slow-conducting pathway that projects into the intralaminar nuclei of the thalamus The opposite anterolateral pathway that travels to the reticular activating system A bilateral, multisynaptic, slow-conducting tract Question 2 2 / 2 points A 29-year-old female has been admitted to the emergency department following a suicide attempt by overdose of acetaminophen. What changes in the patient's liver and diagnostic results would the care team most likely anticipate? Question options: Centrilobular necrosis evidenced by increased ALT and AST levels Allergic inflammation accompanied by an increase in serum IgE and basophils Cholestatic reaction with increased bilirubin count Rapid onset of hepatitis and increased GGT, ALT, and bilirubin levels Question 3 2 / 2 points A nurse practitioner and social worker are facilitating a family meeting for the children and wife of a 79-year-old man who has been diagnosed with Alzheimer disease. What goal of treatment will the clinicians most likely prioritize in their interactions with the family? Question options: Modest reversal of brain plaque formation and improved symptomatology through cholinesterase inhibitors Surgical treatment of the ischemic changes that underlie the manifestations of the man's disease The use of medications such as donepezil and rivastigmine to slow the progression of the disease Cognitive and behavioral therapy to counteract the agitation, depression, and suspiciousness associated with Alzheimer disease. Question 4 2 / 2 points A 40-year-old woman has been found to have a deficiency in estrogen. Which of the following physiological phenomena is most likely to remain unaffected? Question options: Parathyroid hormone antagonism and the rate of bone resorption The regulation of uterine endothelial development The maintenance of normal skin and blood vessel structure The synthesis and release of adrenal glucocorticoids Question 5 2 / 2 points Following the identification of low levels of T3 and T4 coupled with the presence of a goiter, a 28-year-old female has been diagnosed with Hashimoto thyroiditis. In light of this diagnosis, which of the following assessment results would constitute an unexpected finding? Question options: The presence of myxedema in the woman's face and extremities Recent weight gain despite a loss of appetite and chronic fatigue Coarse, dry skin and hair with decreased sweat production Increased white cell count and audible crackles on chest auscultation Question 6 2 / 2 points Laparoscopic knee surgery on a 22-year-old basketball player has necessitated entry into the synovial cavity. The surgeon performing the procedure would be aware of which of the following relevant characteristics of synovial tissue? Question options: Synovial tissue has a slow rate of healing compared to muscle tissue. Damage to synovial tissue is known to be excruciatingly painful. The synovial membrane lacks direct blood supply, precluding bleeding into the joint. Few pain receptors are located in the synovial membrane. Question 7 2 / 2 points Having heard positive reports of the benefits of HT from her sister-in-law and friends, a 49-year-old woman has presented to her nurse practitioner asking to start HT. Her uterus is intact and previous bone scans have indicated low bone density. The patient also has a family history of heart disease. She characterizes her symptoms of menopause as “noticeable, but not debilitating by any means.” Based on the most current research, what is her nurse practitioner's best course of action? Question options: Begin estrogen-progesterone HT (EPT) to prevent future menopausal symptoms and coronary heart disease (CHD) Forgo HT in light of her preexisting low bone density and consequent risk of osteoporosis Forgo HT but consider alternative therapies and reevaluate if her symptoms significantly affect her quality of life Begin low-dose HT but perform regular breast cancer screening and heart health checks Question 8 2 / 2 points A 13-year-old female is undergoing rapid development of her breasts after experiencing menarche several months ago. Which of the following hormones are NOT active in the development of her breasts? Question options: Prolactin Oxytocin Estrogen Follicle-stimulating hormone Progesterone Question 9 2 / 2 points An endocrinologist is providing care for a 30-year-old male who has lived with the effects of increased levels of GH. Which of the following teaching points about the patient's future health risks is most accurate? Question options: “It's not unusual for unusually high GH levels to cause damage to your hypothalamus.” “GH excess inhibits your pancreas from producing enough insulin.” “The high levels of GH that circulate in your body can result in damage to your liver.” “When your pituitary gland is enlarged, there's a real risk that you'll develop some sight deficiencies. Question 10 2 / 2 points Which of the following statements best captures the role of the adrenal cortex in maintaining homeostasis? Question options: The adrenal cortex is responsible for the production of epinephrine and norepinephrine, which are part of the sympathetic nervous system. The adrenal cortical hormones are primarily steroids and sex hormones. Redundant, secondary production of adrenal cortical hormones can compensate for the loss of the adrenal glands. Normal sexual function is dependent on adequate adrenal cortical function. Question 11 2 / 2 points A 41-year-old woman has been diagnosed as having a loose body of cartilage in her left knee. What data would be most likely to lead clinicians to this conclusion? Question options: A visible hematoma is present on the anterior portion of the knee. The woman experiences intermittent, painful locking of her joint. Computed tomography indicates a complete tear of her knee ligament. An X-ray shows that her femoral head and tibia are no longer articulated. Question 12 2 / 2 points Following exposure to poison oak while camping, a 20-year-old male is experiencing pruritus as a consequence of his immune response to irritants in the plant. What physiologic process best accounts for his complaint? Question options: His body is communicating a low-level pain response as a protective measure. Free nerve endings are initiating an itch-specific signal to the somatosensory cortex. Local irritation of Langerhans cells is sending signals by way of myelinated type C nerve fibers. Ruffini corpuscles are transmitting the message of pruritis to the cerebral cortex. Question 13 2 / 2 points Which of the following phenomena constitutes a component of axonal transport? Question options: Anterograde and retrograde axonal transport allow for the communication of nerve impulses between a neuron and the central nervous system (CNS). Materials can be transported to the nerve terminal by either fast or slow components. The unidirectional nature of the axonal transport system protects the CNS against potential pathogens. Axonal transport facilitates the movement of electrical impulses but precludes the transport of molecular materials. Question 14 2 / 2 points A patient with a new diagnosis of an endocrine disorder is unclear about how the body can control the levels of different hormones over time. Which of the following statements most accurately underlies the dominant regulation process of hormone levels in the body? Question options: A positive feedback cycle ensures that stable levels of hormones exist in the body over time. With input from various sensors, hormone production and release are adjusted based on existing hormone levels. The hypothalamus ensures that hormone levels correspond accurately to the diurnal cycle. The pituitary gland is genetically programmed to stimulate and inhibit hormone production and/or release based on needs at different points in the life cycle. Question 15 2 / 2 points As part of the intake protocol at an eating disorders clinic, an interview precedes a physical examination. Which of the following questions would a clinician be justified in excluding from an intake interview for a 16-year-old female referred by her pediatrician for the treatment of anorexia nervosa? Question options: “Do you remember when your last menstrual period was? “Have you noticed any new hair growth on your body in the last several months?” “Have you had any episodes of shortness of breath in the recent past?” “Can you tell me about some of the habits that you have related to food in your daily routine?” Question 16 2 / 2 points Which of the following patients on a hospital medical unit is most clearly demonstrating the signs and symptoms of liver failure? Question options: A 44-year-old man with low hemoglobin levels, low platelet levels, and spider angiomas A 50-year-old woman with blood pressure of 189/103, jaundice, and multiple thromboses A 68-year-old female patient with sudden onset of confusion, a history of alcohol abuse, and low levels of serum AST and ALT A 55-year-old man with ascites, fever, and recent onset of atrial fibrillation Question 17 2 / 2 points A 43-year-old male patient has presented to the emergency department with vomiting that he claims is of sudden onset. The patient also states that the emesis has often contained frank blood in the hours prior to admission. Which of the following potential contributing factors would the care team first suspect? Question options: Overuse of aspirin Alcohol consumption Staphylococcal enterotoxins Effects of Helicobacter pylori Question 18 2 / 2 points A female toddler has been diagnosed with toeing-in (metatarsus adductus). What teaching should the nurse practitioner provide to the parents of the child about her diagnosis? Question options: “She will likely walk later than most children, but it will resolve itself with time.” “We'll likely need to start putting the first of a series of casts on her legs quite soon.” “The best time to perform the surgery that's needed will be at age three or four.” “While there's no effective treatment for her toeing-in, most children learn to accommodate the problem and walk independently.” Question 19 2 / 2 points A 40-year-old female has been categorized as being obese, with a BMI of 33.2. Which of the following health problems is the patient at a significantly increased risk for compared with individuals with a BMI below 25? Question options: Cardiac arrhythmias Osteoarthritis Multiple sclerosis Atelectasis Gallbladder disease Insulin resistance Question 20 2 / 2 points A 51-year-old woman has been experiencing signs and symptoms of perimenopause and has sought help from her nurse practitioner. Doctors have confirmed a deficiency in estrogen levels as a contributing factor. Which of the following phenomena could potentially underlie the woman's health problem? Question options: Sufficient synthesis of estrogen but inadequate vesicle-mediated release Inadequate synthesis in the rough endoplasmic reticulum of her ovarian cells Insufficient estrogen production within the smooth endoplasmic reticulum of the relevant cells A lack of prohormone precursors needed for estrogen synthesis and release Question 21 2 / 2 points Long, stretchy cervical mucus that exhibits ferning on a microscope slide is characteristic of which of the following? Question options: High LH levels Low estrogen levels High progesterone levels Low human chorionic gonadotropin levels Question 22 2 / 2 points A 24-year-old woman undergoing a premarital screening test is found to have elevated levels of AST, ALT, and IgG, but no antibody-specific markers for viral hepatitis. A liver biopsy reveals inflammation and cellular damage. Which of the following treatments is most likely to be effective for her? Question options: Lamivudine Peginterferon and ribavirin Interferon-alfa-2b Corticosteroids and immunosuppressant drugs Question 23 2 / 2 points A 74-year-old female has been diagnosed with osteoporosis after her bone density scan indicated osteopenia. Which of the following factors would her care team be most likely to rule out as contributors to her health problem? Question options: The woman is African American and was exposed to asbestos in her work. She has been a heavy drinker for her whole adult life and has diabetes mellitus. The patient takes corticosteroids for treatment of her long-standing osteoarthritis. The woman has an estrogen deficiency and has never undergone hormone therapy. Question 24 2 / 2 points A male newborn infant has been diagnosed with spina bifida occulta. Which of the following pathophysiologic processes has most likely contributed to the infant's health problem? Question options: The vertebral arches around his neural tube have failed to completely close. The infant's spinal cord and meninges protrude through his skin. The child's central and peripheral nervous systems have insufficiently differentiated during embryonic development. The infant's soma and viscera are underdeveloped. Question 25 2 / 2 points Chronic anxiety and stress contribute to ulcers. Which of the following effects of the sympathetic nervous system is most responsible for this effect? Question options: Inhibition of the actions of Brunner glands Overstimulation of the oxyntic glands Suppression of cholecystokinin Inflammation of the parotid glands Question 26 2 / 2 points A 43-year-old male who is 5 feet 10 inches tall and weighs 216 pounds has been informed by his nurse practitioner that his body mass index (BMI) is 31. Which of the following clinical conclusions based on these data would his nurse be most justified in rejecting? Question options: Further investigation of his nutritional status is needed to supplement the BMI value. The patient faces an increased risk of type 2 diabetes and hyperlipidemia. He is classified as being obese, likely as the result of the interplay of genetic and lifestyle factors. The patient is borderline obese but is not yet at the point of significantly increased risks to health. Question 27 2 / 2 points Which of the following pathophysiologic phenomena would be most indicative of ankylosing spondylitis? Question options: Loss of motion in the spinal column and eventual kyphosis A progressive loss of range of motion in knee and hip joints A facial “butterfly rash” and multiorgan involvement Decreased bone density in long bones Question 28 2 / 2 points A 32-year-old man is complaining of burning, itching, photophobia, and severe pain in his right eye after swimming in the ocean. To determine that the eye condition is corneal rather than a conjunctival disease, which of the following would be the distinguishing symptom? Question options: Burning Itching Photophobia Severe pain Question 29 2 / 2 points Following a progressive onset of fatigue, aching, and joint stiffness over the last 2 years, a 69-year-old male has recently been diagnosed with rheumatoid arthritis (RA). Which of the following teaching points should his primary care nurse practitioner include during the office visit in which this diagnosis is communicated to the patient? Question options: “The symptoms you've been experiencing are the result of damage inside your joints, but I'll start you on medications that will reverse this damage.” “It's important that you maximize your level of activity, since decreasing your mobility will worsen the disease.” “The best treatment plan is to try all other available treatments before resorting to using medications.” “Steroids and anti-inflammatory drugs that I'll prescribe will likely bring some relief of your symptoms.” Question 30 2 / 2 points A 17-year-old male experienced third-degree, full-thickness burns to his lower limbs after a fire at his workplace 2 days ago. Which of the following complications should his care team NOT foresee and regularly assess for? Question options: Systemic infection Increased cardiac output Respiratory dysfunction Hypermetabolic response Constipation and Bowel obstruction Question 31 2 / 2 points A three-year-old girl has been diagnosed with amblyopia. Which of the following pathophysiologic processes is most likely to underlie her health problem? Question options: The child may have a congenital deficit of rods and/or cones The girl may have chronic bacterial conjunctivitis She may have been born with infantile cataracts The child may have a neural pathway disorder Question 32 2 / 2 points The unique clinical presentation of a three-month-old infant in the emergency department leads the care team to suspect botulism. Which of the following assessment questions posed to the parents is likely to be most useful in the differential diagnosis? Question options: “Have you ever given your child any honey or honey-containing products?” “Is there any family history of neuromuscular diseases?” “Has your baby ever been directly exposed to any chemical cleaning products?” “Is there any mold in your home that you know of?” Question 33 2 / 2 points Which of the following statements best captures an aspect of the role of hormones in the body? Question options: Some chemical substances can function as either hormones or neurotransmitters. Hormones directly initiate many of the processes that contribute to homeostasis. Control of body processes is ensured by the fact that a single hormone can only exert one effect on one specific system or tissue. Each hormone that exists in the body is produced by only one specific endocrine gland. Question 34 2 / 2 points A 48-year-old male has a new diagnosis of Guillain-Barré syndrome. Which of the following processes underlies the deficits that accompany the degeneration of myelin in his peripheral nervous system (PNS)? Question options: The destruction of myelin causes fewer Schwann cells to be produced in the patient's PNS. The axonal transport system is compromised by the lack of myelin surrounding nerve cells. Nerve cells lack insulation and impulse conduction is compromised by the destruction of myelin. A deficit of myelin predisposes the patient to infection by potential pathogens. Question 35 2 / 2 points A newborn male has been diagnosed with hypospadias following his postpartum assessment by a nurse practitioner. Which of the following diagnostics and treatment options is the nurse practitioner most likely to rule out first? Question options: Chromosomal studies Circumcision Surgical repair Testosterone supplementation Question 36 2 / 2 points Which of the following statements best captures an aspect of normal spermatogenesis? Question options: Testosterone chemically lyses each primary spermatocyte into two secondary spermatocytes with 23 chromosomes each. Sertoli cells differentiate into spermatids, each of which can contribute half of the chromosomes necessary for reproduction. Spermatogonia adjacent to the tubular wall undergo meiotic division and provide a continuous source of new germinal cells. Each primary spermatocyte undergoes two nuclear divisions, yielding four cells with 23 chromosomes each. Question 37 2 / 2 points A 30-year-old woman has sought care because of her recurrent photophobia, tearing, and eye irritation. During assessment, her care provider asks about any history of cold sores or genital herpes. What is the rationale for the care provider's line of questioning? Question options: Herpes simplex virus (HSV) conjunctivitis indicates a need for antiviral rather than antibacterial treatment. HSV infection of the cornea is a common cause of corneal ulceration and blindness. Chronic viral infection of the eyes can result in HSV autoinoculation of the mouth and labia. A history of HSV with eye irritation is suggestive of glaucoma. Question 38 2 / 2 points A patient in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood–brain barrier and been transferred from the vascular space into the patient's interstitial space. Which of the following diagnoses best captures this pathophysiology? Question options: Focal hypoxia Cytotoxic edema Hydrocephalus Vasogenic edema Question 39 2 / 2 points Which of the following hormones are derivatives of cholesterol? Question options: Epinephrine and norepinephrine Insulin and glucagon Aldosterone and testosterone Eicosanoids and retinoids Question 40 2 / 2 points When a 4-year-old boy stands erect with his medial malleoli touching, the distance between his knees is two inches. What is the child's most likely diagnosis and treatment? Question options: Genu varum, which can be treated by bracing Flatfoot, which will require orthopedic shoes Genu valgum, necessitating a series of surgeries Femoral torsion, which will spontaneously resolve before puberty Question 41 2 / 2 points A 71-year-old man has visited his nurse practitioner for a check-up, during which the nurse practitioner has initiated a discussion about the patient's sexual function. Which of the following phenomena would the nurse practitioner most likely consider a pathological rather than an age-related change? Question options: The presence of relative or absolute hypogonadism A decrease in the size and firmness of the patient's testes Cessation of FSH production A decrease in the force of the man's ejaculation Question 42 2 / 2 points A 39-year-old male patient has been recently diagnosed with primary hypogonadism. Which of the following lab results would be most indicative of this diagnosis? Question options: Normal levels of free testosterone; low levels of total testosterone Low free testosterone, LH, and FSH levels Low levels of GnRH Low testosterone levels; normal levels of LH and FSH Question 43 2 / 2 points Following a visit to her campus medical clinic motivated by persistent abdominal pain and dyspareunia, a 20-year-old female college student has been referred for a diagnostic workup to rule out pelvic inflammatory disease. Her elevated white cell and C-reactive protein levels lead her care provider to suspect pelvic inflammatory disease (PID). What follow-up question is most likely to help with the differential diagnosis? Question options: “Are you using tampons during your period, or do you normally use pads?” “What does your daily hygiene routine usually consist of?” “How many sexual partners have you had?” “Have you ever had a therapeutic abortion in the past?” Question 44 2 / 2 points Which of the following situations would be considered pathologic in an otherwise healthy 30-year-old female? Question options: The woman's ovaries are not producing new ova. The woman's ovaries do not synthesize or secrete luteinizing hormone (LH). The epithelium covering the woman's ovaries is broken during the time of ovulation. The woman's ovaries are not producing progesterone. Question 45 2 / 2 points Which of the following individuals, who have recently presented to a hospital emergency department, is displaying an injury that involves his or her fibrocartilage? Question options: A seven-year-old girl whose ear has been lacerated during a dog attack A 24-year-old male who has had his trachea crushed in a workplace accident A 15-year-old boy who has suffered a knee injury during a football game A 78-year-old man who has fallen and is suspected of having a “slipped disc” in his back