NSG 6440;PREDICTOR TEST UPDATED QUESTIONS 1
n n n n nn
00% CORRECT ANSWERS WITH EXPALANTION
n n n n
PREDICTOR
1) An15nyearsn old n highn schoolnstudent n withn anmild n sorenthroat n and n low-
graden fevern that n hasnpersisted n fornaboutn3nweeks.nShenreportsngeneraln malaise,n fatigue,n and nlossn
of nappetite.n Then NPn suspectsn mononucleosis.n Whichn of nthenfollowingn isnthen LEASTn appropriat
en intervention?
a. Palpaten then lymphn nodesnand nspleen
b. Examinen thenposteriorn oropharynxn forn petechiae
c. Obtainn anCBC,nthroat n culture,n and n heterophiln antibodyn test.
d. Obtainn annurinalysesn and nserumn fornLFTsn and namylasen
Explanation:n mononucleosisn isnansymptomaticn infectionn caused n bynthenEpstein-
Barn virus.n Commonn isnpeoplen 15-
24nyearsn of nage.n Commonn signsn and n symptomsn followingn incubationn period n (1-
2nmonths)n includen fatigue,n chills,n malaise,n anorexia,n whiten tonsillarn exudatesn andnlymphadenopath
yn ornposteriorn cervicaln region.n Splenomegalyn cannbenpresent.n Anmaculopapularn orn occasionallyn anpe
techialn rashn occursn inn lessn thann 15%n ofnpatients.n Andiagnosisn isn usuallyn maden usingn thenMonospot.nI
nnaddition,n neutropenian and n lymphocytosisn arenusuallyn detected n inn then CBC.
2) An32nyearsnoldnmalenpatientncomplaint nofnurinarynfrequencynand nburningnonnurinationnforn3nd
ays.n Urinalysesn revealsn bacteriurian andn positiven nitrites.n Hendeniesn anynpastn hx.nOf nurinaryn tractn inf
ections.n Then initialn treatment n should n be:
a. trimethoprim-sulfamethoxazolen (Bactrim,n Sulfatrim)n forn 7-10nday
b. ciprofloxacinn (Cipro)n forn 3-5ndays
c. Trimethoprim-Sulfamethoxazolen forn 3ndays
d. 750nmgn ciprofloxacinn asnanone-timen dose
Explanation:n trimethoprim-
sulfamethoxazolen (TMPS)n isn usuallyn nnappropriaten medicationn ton treat nurinaryn tract n infectionsn inn
most n patients.n Inn then casen of ncommunityn resistancen tonTMPS
>20%^,nanothern medicationn should n bensubstituted.n Innmen,n then appropriaten lengthn of ntimen isn 7-
10n days.n Womenn mayn bentreated n forn 3ndaysn forn uncomplicated n UTI
3) Whichn agent n isnmost n effectiven forn then treatment n of nnodulocysticn acne?
a. Benzoyln peroxiden (Benzac)
b. Retinoicn acid n (Retinn A)
c. Topicaln tetracycline
d. Isotretinoin)n
Explanation:n Isotretinoinn (Accutane)n isnansystemicn agent n indicated n forntreatment n withn severen infl
ammatoryn acne.n Guidelinesn fornitsn usenmust n benclearlyn understoodn bynthenpatient.n Anwomann of n child
bearingn agen must n usen anneffectiven methodn ofncontraceptionn becausen isotretinoinn isn teratogenic.n Th
eren aren manyn restrictionsn inn prescribingn thisn medicationn becausenofnthenteratogenicn effectsn isn givenn d
1
,uringn pregnancy.n Therefore,n it n isnanpregnancyn categoryn X.
4) Ann18ny/on womann isn takingn ancombined n hormonaln oralncontraceptive.n Shen should n be
2
,instructed n tonusenanbackupnmethod n forn thenpreventionn of npregnancy
a. Throughout n thenweeknof nplacebon pills
b. If nprescribed n topiramaten (Topamax)n forn then treatment n of nmigraines.n
3
, c. If nprescribed n amoxicillin/clavulanaten (Augmentin)n forn ansinusn infection
d. if n shen forgetsn ton takenansinglen dosenof nthen contraceptive
Explanation:n Anticonvulsant n includingn phenytoinn (Dilantin),n carbamazepinen (Tegretol),n primido
nen (Mysoline),n topiramaten (Topamax)n and noxcarbazepinen (Trileptal)n reducen then effectivenessn of nc
ontraceptives.n Depo-medroxyprogesteronen acetaten injectionsn ornlevonorgestrel-
n releasingn intrauterinen devicesn would n benanbetternmethodn of ncontraceptiven forn patientsn takingn antic
onvulsants.n Most ncommonlyn used n antibioticsn haven not nbeenn provenntonreducenthen effectivenessn of n
contraceptives.n Rifampinn isnannexception,n andnadditionaln ….nBenusedn bynwomenn takingn thisn drugnan
d n usingn oralncontraceptives,n transdermal,n ornvaginaln ringn preparations.
Additionaln backupn contraceptionn shouldn benusednif ntakingn antifungaln agents.n Nonadditionaln protecti
onn isn needednthoughtn thenweeknofnplacebonpills.n Missingn onensinglen dosenofncontraceptivendoesnnotn re
quiren additionaln protection,n missingn moren thann onen dosesn does.
5) An44nyearsn old n femalen patient n hasndiabetes.n Hern totaln cholesteroln (TC)n isn 250nmg/dln (6.5n mm
ol/L),n LDL=n 190nmg/dLn (4.94nmmol/L),n HDL=n 25nmg/dLn (65nmmol/L),n and ntriglycerides=n 344nm
g/dLn (8.94nmmol/L).n What nagentnhaven thengreatest n effectn onnimprovingn hernlipidn profilen andnreducin
gn morbidityn and nmortalityn associatesn withn dyslipidemia?
a. Niacinn (Niaspan)
b. Atorvastatinn
c. Omegan 3nfattyn acids
d. Fenofibrates
Explanation:n First n and n foremost,n it n isn essentialn toneducaten individualsn onnanheart-
healthyn lifestyle.n LDL-
Cn isnonen of nthenmajorn culpritsn inn thendevelopment n of natheroscleroticn heartn disease.n Then target n leveln o
f nLDL-
Cn isn betweenn 50nton70mg/dln ton prevent n plaquen formationn inn thenblood nvessels.n Guidelinesn stronglyn
recommend n statinn therapyn becausen theyn primarilyn lowern LDL-
Cn levels,n but n theynalson haven then secondaryn effectsn of nloweringn triglyceriden and nincreasingn HDL-
Cn levels.
6) An30nyearsnoldnfemalencomesnintonanclinicn withn classicn signsn and nsymptomsn of nappendicitis.n T
henNPnfailsn tonrefern thenpatient ntonansurgeon.n Then appendixn rupturesn and nthen womanndie.nThisn isn ann
examplen of
a. Failuren of ndiligence
b. Professionaln liability
c. Negligence
d. Malpracticen
Explanation:n malpractice,n annegligencen tort,noccursnwhennanhealthn carenprofessional’sn actionsn falln b
ellow n then appropriaten standard nofncarenandnhurtsn then patient.n Innthisn casenthen patient n camen withn sing
sn and nsymptomsn indicatingn appendicitisn and n then NPnfailed n tonrefern thenpatient..
7) AnNPnhasnrecentlyn beennhired n tonworkninn anfastntracknfacility.n Then NPnemployern asked nif n s
henhasn “an problemn prescribingn medicationsn forn emergencyn contraception.”n Then NPnrepliesn aff
irmatively.n Thisn is:
a. Groundsn forn dismissal
4
n n n n nn
00% CORRECT ANSWERS WITH EXPALANTION
n n n n
PREDICTOR
1) An15nyearsn old n highn schoolnstudent n withn anmild n sorenthroat n and n low-
graden fevern that n hasnpersisted n fornaboutn3nweeks.nShenreportsngeneraln malaise,n fatigue,n and nlossn
of nappetite.n Then NPn suspectsn mononucleosis.n Whichn of nthenfollowingn isnthen LEASTn appropriat
en intervention?
a. Palpaten then lymphn nodesnand nspleen
b. Examinen thenposteriorn oropharynxn forn petechiae
c. Obtainn anCBC,nthroat n culture,n and n heterophiln antibodyn test.
d. Obtainn annurinalysesn and nserumn fornLFTsn and namylasen
Explanation:n mononucleosisn isnansymptomaticn infectionn caused n bynthenEpstein-
Barn virus.n Commonn isnpeoplen 15-
24nyearsn of nage.n Commonn signsn and n symptomsn followingn incubationn period n (1-
2nmonths)n includen fatigue,n chills,n malaise,n anorexia,n whiten tonsillarn exudatesn andnlymphadenopath
yn ornposteriorn cervicaln region.n Splenomegalyn cannbenpresent.n Anmaculopapularn orn occasionallyn anpe
techialn rashn occursn inn lessn thann 15%n ofnpatients.n Andiagnosisn isn usuallyn maden usingn thenMonospot.nI
nnaddition,n neutropenian and n lymphocytosisn arenusuallyn detected n inn then CBC.
2) An32nyearsnoldnmalenpatientncomplaint nofnurinarynfrequencynand nburningnonnurinationnforn3nd
ays.n Urinalysesn revealsn bacteriurian andn positiven nitrites.n Hendeniesn anynpastn hx.nOf nurinaryn tractn inf
ections.n Then initialn treatment n should n be:
a. trimethoprim-sulfamethoxazolen (Bactrim,n Sulfatrim)n forn 7-10nday
b. ciprofloxacinn (Cipro)n forn 3-5ndays
c. Trimethoprim-Sulfamethoxazolen forn 3ndays
d. 750nmgn ciprofloxacinn asnanone-timen dose
Explanation:n trimethoprim-
sulfamethoxazolen (TMPS)n isn usuallyn nnappropriaten medicationn ton treat nurinaryn tract n infectionsn inn
most n patients.n Inn then casen of ncommunityn resistancen tonTMPS
>20%^,nanothern medicationn should n bensubstituted.n Innmen,n then appropriaten lengthn of ntimen isn 7-
10n days.n Womenn mayn bentreated n forn 3ndaysn forn uncomplicated n UTI
3) Whichn agent n isnmost n effectiven forn then treatment n of nnodulocysticn acne?
a. Benzoyln peroxiden (Benzac)
b. Retinoicn acid n (Retinn A)
c. Topicaln tetracycline
d. Isotretinoin)n
Explanation:n Isotretinoinn (Accutane)n isnansystemicn agent n indicated n forntreatment n withn severen infl
ammatoryn acne.n Guidelinesn fornitsn usenmust n benclearlyn understoodn bynthenpatient.n Anwomann of n child
bearingn agen must n usen anneffectiven methodn ofncontraceptionn becausen isotretinoinn isn teratogenic.n Th
eren aren manyn restrictionsn inn prescribingn thisn medicationn becausenofnthenteratogenicn effectsn isn givenn d
1
,uringn pregnancy.n Therefore,n it n isnanpregnancyn categoryn X.
4) Ann18ny/on womann isn takingn ancombined n hormonaln oralncontraceptive.n Shen should n be
2
,instructed n tonusenanbackupnmethod n forn thenpreventionn of npregnancy
a. Throughout n thenweeknof nplacebon pills
b. If nprescribed n topiramaten (Topamax)n forn then treatment n of nmigraines.n
3
, c. If nprescribed n amoxicillin/clavulanaten (Augmentin)n forn ansinusn infection
d. if n shen forgetsn ton takenansinglen dosenof nthen contraceptive
Explanation:n Anticonvulsant n includingn phenytoinn (Dilantin),n carbamazepinen (Tegretol),n primido
nen (Mysoline),n topiramaten (Topamax)n and noxcarbazepinen (Trileptal)n reducen then effectivenessn of nc
ontraceptives.n Depo-medroxyprogesteronen acetaten injectionsn ornlevonorgestrel-
n releasingn intrauterinen devicesn would n benanbetternmethodn of ncontraceptiven forn patientsn takingn antic
onvulsants.n Most ncommonlyn used n antibioticsn haven not nbeenn provenntonreducenthen effectivenessn of n
contraceptives.n Rifampinn isnannexception,n andnadditionaln ….nBenusedn bynwomenn takingn thisn drugnan
d n usingn oralncontraceptives,n transdermal,n ornvaginaln ringn preparations.
Additionaln backupn contraceptionn shouldn benusednif ntakingn antifungaln agents.n Nonadditionaln protecti
onn isn needednthoughtn thenweeknofnplacebonpills.n Missingn onensinglen dosenofncontraceptivendoesnnotn re
quiren additionaln protection,n missingn moren thann onen dosesn does.
5) An44nyearsn old n femalen patient n hasndiabetes.n Hern totaln cholesteroln (TC)n isn 250nmg/dln (6.5n mm
ol/L),n LDL=n 190nmg/dLn (4.94nmmol/L),n HDL=n 25nmg/dLn (65nmmol/L),n and ntriglycerides=n 344nm
g/dLn (8.94nmmol/L).n What nagentnhaven thengreatest n effectn onnimprovingn hernlipidn profilen andnreducin
gn morbidityn and nmortalityn associatesn withn dyslipidemia?
a. Niacinn (Niaspan)
b. Atorvastatinn
c. Omegan 3nfattyn acids
d. Fenofibrates
Explanation:n First n and n foremost,n it n isn essentialn toneducaten individualsn onnanheart-
healthyn lifestyle.n LDL-
Cn isnonen of nthenmajorn culpritsn inn thendevelopment n of natheroscleroticn heartn disease.n Then target n leveln o
f nLDL-
Cn isn betweenn 50nton70mg/dln ton prevent n plaquen formationn inn thenblood nvessels.n Guidelinesn stronglyn
recommend n statinn therapyn becausen theyn primarilyn lowern LDL-
Cn levels,n but n theynalson haven then secondaryn effectsn of nloweringn triglyceriden and nincreasingn HDL-
Cn levels.
6) An30nyearsnoldnfemalencomesnintonanclinicn withn classicn signsn and nsymptomsn of nappendicitis.n T
henNPnfailsn tonrefern thenpatient ntonansurgeon.n Then appendixn rupturesn and nthen womanndie.nThisn isn ann
examplen of
a. Failuren of ndiligence
b. Professionaln liability
c. Negligence
d. Malpracticen
Explanation:n malpractice,n annegligencen tort,noccursnwhennanhealthn carenprofessional’sn actionsn falln b
ellow n then appropriaten standard nofncarenandnhurtsn then patient.n Innthisn casenthen patient n camen withn sing
sn and nsymptomsn indicatingn appendicitisn and n then NPnfailed n tonrefern thenpatient..
7) AnNPnhasnrecentlyn beennhired n tonworkninn anfastntracknfacility.n Then NPnemployern asked nif n s
henhasn “an problemn prescribingn medicationsn forn emergencyn contraception.”n Then NPnrepliesn aff
irmatively.n Thisn is:
a. Groundsn forn dismissal
4
