NUR 6531 CARE OF ADULTS ACROSS LIFESPAN,
MIDTERM REVIEW BULK TESTS QUESTIONS WITH
COMPLETE SOLUTIONS
A patient develops a pulmonary embolism (PE) after surgery
and shows signs of right-sided
heart failure. Which drug will be administered to this patient?
a. Low molecular heparin
b. Tissue plasminogen activator
c. Unfractionated heparin
d. Warfarin
ANS: B
Fibrinolytic therapy with recombinant tissue plasminogen
activator is given to patients with
hypotension and right-sided heart failure. Heparin is used for its
anticoagulant properties in all
patients with PE. Warfarin is not indicated.
A patient with increased left-sided heart pressure will have
which type of pulmonary
hypertension?
a. Group 2
b. Group 3
c. Group 4
d. Group 5
ANS: A
Group 2 pulmonary hypertension is associated with increased
left-sided heart pressure.
,A patient who experienced mild pulmonary hypertension with a
previously loud second heart
sound on exam now demonstrates edema and jugular vein
distension. This indicates which
complication?
a. Left ventricular dysfunction
b. Right ventricular dysfunction
c. Tricuspid valve involvement
d. Mitral valve involvement
ANS: B
Right ventricular dysfunction occurs as the disease worsens with
manifestations that include
jugular vein distension, edema, and increased liver size. These
symptoms do not indicate left
ventricular dysfunction or valvular involvement.
A patient diagnosed with pulmonary arterial hypertension
(PAH) has increased dyspnea with
activity. Which medication may be prescribed to manage
symptom on an outpatient basis?
a. An inhaled prostanoid
b. Bosentan
c. Epoprostenol
d. Trepostinil
ANS: B
Bosentan helps promote pulmonary artery smooth muscle cell
proliferation and improves
exercise capacity. It is also given PO, so is easy to give on an
,outpatient basis. Inhaled
prostanoids have a short half-life and must be given 6 to 9 times
daily. Epoprostenol has a
short half-life and must be given IV. Trepostinil is given IV.
A primary care provider is performing a Tzanck test to evaluate
possible herpes simplex
lesions. To attain accurate results, the provider will perform
what intervention?
a. Blanch the lesions while examining them with a magnifying
glass.
b. Gently scrape the lesions with a scalpel onto a slide.
c. Perform a gram stain of exudate from the lesions.
d. Remove the top of the vesicles and obtain fluid from the
lesions.
ANS: D
The Tzanck test requires removing the tops from vesicular
lesions in order to obtain fresh
fluid from the base of the lesions. Blanching of blue to red
lesions under a microscope helps
to evaluate whether blood is in the capillaries of the lesions.
Scraping lesions onto a slide is
done to evaluate the presence of hyphae and spores common
with candidiasis or fungal
infections. Gram staining is performed to distinguish gram-
positive from gram-negative
organisms in suspected bacterial infections.
, When examining a patient's skin, a practitioner uses dermoscopy
for what purpose? (Select all
that apply.)
a. Accentuating changes in color of pathologic lesions by
fluorescence
b. Assessing changes in pigmentation throughout various lesions
c. Determining whether lesion borders are regular or irregular
d. Differentiating fluid masses from cystic masses in the
epidermis
e. Visualizing skin fissures, hair follicles, and pores in lesions
ANS: B, C, E
Dermoscopy is used to visualize the epidermis and superficial
dermis and can reveal changes
in pigmentation throughout lesions, whether borders are regular
or irregular, and the various
fissures, follicles, and pores present in lesions. The Wood's light,
or black light, is used to
fluoresce lesions to accentuate changes in color. A direct light
source is useful for
differentiating fluid masses from cystic masses.
A patient has actinic keratosis and the provider elects to use
cryosurgery to remove the
lesions. How will the provider administer this procedure?
a. Applying one or two freeze-thaw cycles to each lesion
b. Applying two or more freeze-thaw cycles to each lesion
c. Applying until the freeze spreads laterally 1 mm from the
lesion edges
d. Applying until the freeze spreads laterally 4 mm from the
MIDTERM REVIEW BULK TESTS QUESTIONS WITH
COMPLETE SOLUTIONS
A patient develops a pulmonary embolism (PE) after surgery
and shows signs of right-sided
heart failure. Which drug will be administered to this patient?
a. Low molecular heparin
b. Tissue plasminogen activator
c. Unfractionated heparin
d. Warfarin
ANS: B
Fibrinolytic therapy with recombinant tissue plasminogen
activator is given to patients with
hypotension and right-sided heart failure. Heparin is used for its
anticoagulant properties in all
patients with PE. Warfarin is not indicated.
A patient with increased left-sided heart pressure will have
which type of pulmonary
hypertension?
a. Group 2
b. Group 3
c. Group 4
d. Group 5
ANS: A
Group 2 pulmonary hypertension is associated with increased
left-sided heart pressure.
,A patient who experienced mild pulmonary hypertension with a
previously loud second heart
sound on exam now demonstrates edema and jugular vein
distension. This indicates which
complication?
a. Left ventricular dysfunction
b. Right ventricular dysfunction
c. Tricuspid valve involvement
d. Mitral valve involvement
ANS: B
Right ventricular dysfunction occurs as the disease worsens with
manifestations that include
jugular vein distension, edema, and increased liver size. These
symptoms do not indicate left
ventricular dysfunction or valvular involvement.
A patient diagnosed with pulmonary arterial hypertension
(PAH) has increased dyspnea with
activity. Which medication may be prescribed to manage
symptom on an outpatient basis?
a. An inhaled prostanoid
b. Bosentan
c. Epoprostenol
d. Trepostinil
ANS: B
Bosentan helps promote pulmonary artery smooth muscle cell
proliferation and improves
exercise capacity. It is also given PO, so is easy to give on an
,outpatient basis. Inhaled
prostanoids have a short half-life and must be given 6 to 9 times
daily. Epoprostenol has a
short half-life and must be given IV. Trepostinil is given IV.
A primary care provider is performing a Tzanck test to evaluate
possible herpes simplex
lesions. To attain accurate results, the provider will perform
what intervention?
a. Blanch the lesions while examining them with a magnifying
glass.
b. Gently scrape the lesions with a scalpel onto a slide.
c. Perform a gram stain of exudate from the lesions.
d. Remove the top of the vesicles and obtain fluid from the
lesions.
ANS: D
The Tzanck test requires removing the tops from vesicular
lesions in order to obtain fresh
fluid from the base of the lesions. Blanching of blue to red
lesions under a microscope helps
to evaluate whether blood is in the capillaries of the lesions.
Scraping lesions onto a slide is
done to evaluate the presence of hyphae and spores common
with candidiasis or fungal
infections. Gram staining is performed to distinguish gram-
positive from gram-negative
organisms in suspected bacterial infections.
, When examining a patient's skin, a practitioner uses dermoscopy
for what purpose? (Select all
that apply.)
a. Accentuating changes in color of pathologic lesions by
fluorescence
b. Assessing changes in pigmentation throughout various lesions
c. Determining whether lesion borders are regular or irregular
d. Differentiating fluid masses from cystic masses in the
epidermis
e. Visualizing skin fissures, hair follicles, and pores in lesions
ANS: B, C, E
Dermoscopy is used to visualize the epidermis and superficial
dermis and can reveal changes
in pigmentation throughout lesions, whether borders are regular
or irregular, and the various
fissures, follicles, and pores present in lesions. The Wood's light,
or black light, is used to
fluoresce lesions to accentuate changes in color. A direct light
source is useful for
differentiating fluid masses from cystic masses.
A patient has actinic keratosis and the provider elects to use
cryosurgery to remove the
lesions. How will the provider administer this procedure?
a. Applying one or two freeze-thaw cycles to each lesion
b. Applying two or more freeze-thaw cycles to each lesion
c. Applying until the freeze spreads laterally 1 mm from the
lesion edges
d. Applying until the freeze spreads laterally 4 mm from the
