D027 Practice Test #2 Questions and Answers 2023

D027 Practice Test #2 Questions and Answers 2023 As an advanced practice nurse, you want to learn more about the CDC's initiatives relative to asthma care and management in order to advocate for asthma sufferers at the state legislative level. Your goal is to reduce medications costs to patients. Which CDC recommendation supports your goal? a. The CDC recommends that payers and employers promote healthy workspaces to decrease environmental trigger exposures. b. The CDC recommends that providers prescribe the most cost-efficient long-acting inhalers to lower patient co-pays. c. The CDC recommends that providers deviate from the stepwise approach to lessen the financial impact to the patient. d. The CDC recommends that co-pays be removed for inhaled corticosteroids and other prescribed medications d. The CDC recommends that co-pays be removed for inhaled corticosteroids and other prescribed medications What syndrome, characterized by an absent homologous X chromosome with only a single X chromosome, exhibits features that include a short stature, total chromosome count of 45, webbed neck, and a shield like chest? a. Cri du chat syndrome b. Down syndrome c. Klinefelter syndrome d. Turner syndrome d. Turner syndrome A female patient has been recently diagnosed with invasive ductal carcinoma. As an advanced practice nurse, you understand that she will be undergoing a multi-faceted treatment approach that will include one or more medications. Which medication is considered the "gold standard" endocrine treatment for breast cancer? a. Fulvestrant (Faslodex), an antiestrogen indicated for metastatic estrogen receptor-positive breast cancer in post-menopausal women b. Tamoxifen (Nolvadex), a prodrug that must be converted to active metabolites in order to block estrogen receptors in breast tissue c. Trastuzumab (Herceptin), a monoclonal antibody approved for HER2-positive metastatic breast cancer d. Lapatinib (Tykerb), an oral inhibitor of HER2 tyrosine kinase and EGFR tyrosine kinase, resulting in apoptosis and suppression of tumor cell growth b. Tamoxifen (Nolvadex), a prodrug that must be converted to active metabolites in order to block estrogen receptors in breast tissue A patient with T2DM comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin? a. Renal disease b. Congestive heart failure c. Rheumatoid arthritis d. Hepatitic C virus a. Renal disease A newborn born with hypoplastic left heart syndrome is receiving intravenous infusion of prostaglandin. This medication is essential in keeping which two vessels patent? a. Foramen ovale b. Pulmonary vein c. Ductus arteriosus d. Hepatic portal vein a. Foramen ovale c. Ductus arteriosus A patient in the clinic reports fever, arthralgia, a rash, and nosebleeds. What other information should the healthcare professional elicit from this patient? a. Family history of Marfan's disease b. History of a recent bacterial infection c. History of any recent chest trauma d. Any illnesses in family members b. History of a recent bacterial infection Urinalysis is ordered for a diabetic patient. The results are 4+ ketones, trace leukocytes, negative nitrates, and red blood cells. Which of the following actions would the health practitioner take next? a. Order an ultrasound of the kidneys to rule out sub-acute renal failure b. Check the patient glucose level c. Order a 24-hour urine test for microalbumin d. Assess for a history of illicit drug or alcohol use b. Check the patient glucose level A 56-year-old diabetic patient has not taken his insulin in 4 days due to him" feeling well without it". He is admitted to the ED with an elevated blood sugar. What electrolyte should be assessed first? a. Calcium b. Sodium c. Potassium d. Chloride c. Potassium A patient has a pulmonary capillary wedge pressure of 30mmHg. What assessment finding by the healthcare professional would be most consistent with this reading? a. Pink, frothy sputum b. Normal lung sounds c. Rhonchi d. Eupnea a. Pink, frothy sputum A child has a disorder that resulted in the failure of bones to ossify, resulting in soft bones and skeletal deformity. What treatment plan does the healthcare professional discuss with the parents? a. Extremely careful handling b. Increasing vitamin D intake c. Revascularization d. Containment and motion therapy b. Increasing vitamin D intake A health professional is caring for a child that was sexually abused. She is trying to decide which medication option she should provide to the child. What should she know before providing the treatment option? a. The age and weight of the child b. The race of the child c. The height of the child d. The developmental stage a. The age and weight of the child The physician prescribes the patient a loop diuretic. As the nurse you know that this type of diuretic causes diuresis by affecting which structure in the nephron? a. Distal convoluted tubule b. Descending limb of the loop of Henle c. Proximal convoluted tubule d. Ascending limb of the loop of Henle d. Ascending limb of the loop of Henle A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer? a. No insulin should be administered b. NPH c. 70/30 mix d. Lispro (Humalog) d. Lispro (Humalog) A patient is in severe shock and is receiving vasopressin. A family member asks the health care professional to explain the rationale for this type of treatment. What response by the professional is most accurate? a. "Antidiuretic hormone causes vasoconstriction to help increase blood pressure." b. "Antidiuretic hormone causes serum osmolality to be increased." c. "Antidiuretic hormone leads to better insulin utilization." d. "Antidiuretic hormone conserves fluid when urine output is less than 20 mL/hr." a. "Antidiuretic hormone causes vasoconstriction to help increase blood pressure." A patient will begin taking fexofenadine [Allegra] for hay fever. The nurse teaching this patient will tell the patient that: a. Fexofenadine should be taken with food to prevent gastrointestinal (GI) symptoms. b. The medication may be taken once or twice daily. c. Tolerance to sedation will occur in a few weeks. d. With renal impairment, this drug should be taken every other day. b. The medication may be taken once or twice daily. A patient has recently started taking an anti-depressant. She complains to you that she has been taking this medication for two weeks and hasn't started to feel any better. What would be your response to the patient? a. "I understand your concern. I'm going to try another medication to see if that medication will work better for you". b. "I understand your frustration, I will up the dosage of your medication". c. "I understand your concern, but it can take up to 12 weeks before you could see a response from the medication" d. "You're right, you should have started to see a response from the medication by now". c. "I understand your concern, but it can take up to 12 weeks before you could see a response from the medication" Four patients are in the intensive care unit with different types of shock. Which patient would the healthcare professional assess as the priority? a. Septic b. Hypovolemic c. Anaphylactic d. Neurogenic c. Anaphylactic A nurse working in a family planning clinic is teaching a class on intrauterine devices (IUDs). Which patient should be advised against using an IUD for contraception? a. A 45-year-old married woman with four children. b. A 30-year-old monogamous married woman. c. An 18-year-old woman with multiple sexual partners. d. A 35-year-old woman with a history of rosacea. c. An 18-year-old woman with multiple sexual partners. Which of the following is a cornerstone for treatment of a patient in heart failure? a. Digoxin b. Calcium channel blockers c. Angiotensin-converting enzyme (ACE) inhibitors d. Nitrates c. Angiotensin-converting enzyme (ACE) inhibitors When the nurse is providing educational material for a new medication regimen to her newly diagnosed heart failure patient, she must remember to: (Select all that apply) a. Focus on main points. b. Place important information last. c. Select images or drawings that have a purpose or that reinforce a point in the handout. d. Materials should be written at a higher education level that can be understood by most patients. e. Use common terms in short, simple sentences that patients can easily understand. a. Focus on main points. c. Select images or drawings that have a purpose or that reinforce a point in the handout. e. Use common terms in short, simple sentences that patients can easily understand. Which choice below describes a patient being impacted by social and community context? a. A patient with heart failure attends the heart failure clinic weekly, but occasionally forgets his afternoon furosemide dose. b. A patient with renal failure is traveling and searching for a dialysis center in her vacation destination. c. A patient with coronary artery disease is unable to afford his medications. d. A patient reports feeling isolated and depressed after the death of her spouse. d. A patient reports feeling isolated and depressed after the death of her spouse. Healthy People 2020 endorses the completion of a high school education primarily to enable a person to: a. Secure a better job b. Increase the quality of life c. Make healthy lifestyle choices d. Maintain the family unit c. Make healthy lifestyle choices The healthcare professional is caring for a 7-year-old patient. She is trying to determine the best way to make sure the patient adheres to his new medication regimen. What is a key factor she must consider in making sure the child adheres to his medication? a. Allow the child to decide if he would like to take the medication that day. b. Educate the parents and/or care giver about the child's medication and reinforce the information with written instructions. c. Suggest keeping the medication in a warm spot on the counter so it can be easily seen and remembered. d. Allow the child to administer his own medication and have him log it into a daily journal. b. Educate the parents and/or care giver about the child's medication and reinforce the information with written instructions. The Center for Medicare and Medicaid Innovations created the Accountable Health Communities' with the aim to do which one of the following? a. Improve screening for common diseases leading to mortality in the United States b. Monitoring adherence to Health Information Technology guidelines. c. Connecting Medicare and Medicaid beneficiaries with community resources. d. Ensuring all Medicare and Medicaid beneficiaries are adhering to medication formulary restrictions. c. Connecting Medicare and Medicaid beneficiaries with community resources. A parent wants to know how to prevent type 1 diabetes in the newborn. The healthcare professional explains that prevention is not possible, because of which characteristic being associated with type 1 diabetes mellitus? a. Partial insulin secretion b. An autoimmune response c. Insulin resistance d. Obesity as a common risk factor b. An autoimmune response How does the normal aging process effect wound healing? Select all that apply a. Decreased cell proliferation b. Decreased blood supply c. Depressed immune responses d. Depressed appetite e. Decreased cognitive function a. Decreased cell proliferation b. Decreased blood supply c. Depressed immune responses A pediatric patient with Down syndrome has had repeated infections over the last few months and now presents with bruising in all extremities. Which lab would be important to check? a. WBC count since leukemia is 10-20 times more likely to develop in patients with Down Syndrome b. HgbA1c since there is a genetic predisposition in patients with Down Syndrome to develop Type 1 Diabetes c. RBC since the bruising suggests increased internal bleeding d. No labs are recommended at this time because repeated infections and frequent bruising is normal in patients with Down syndrome a. WBC count since leukemia is 10-20 times more likely to develop in patients with Down Syndrome Which of the following is not a risk factor for hypertension? a. Race b. Family history c. Sexual orientation d. Alcohol use c. Sexual orientation What is a common side effect of a stimulant medication such as Adderall? a. Elevated liver enzymes b. Blood dyscrasias c. Difficulty falling asleep at night d. A common side effect of a stimulant is difficulty sleeping Mania c. Difficulty falling asleep at night Infant mortality rates are based on infant deaths that occur: a. At birth, per 1000 deliveries b. Before 1 year of age, per 1000 live births c. From infection and congenital disorders, per 1000 live births d. From unexplained causes, per 1000 live births b. Before 1 year of age, per 1000 live births A healthcare professional is caring for four postop patients. Based on an understanding of the physiologic process of nociceptors, the nurse expects to give more pain medication to which patient? a. Right dislocated shoulder replacement b. Ovary cyst removal c. Repair of several crushed fingers d. Repair of a ruptured spleen c. Repair of several crushed fingers The healthcare professional is caring for a patient with a severe traumatic brain injury. Despite other extensive injuries, this patient shows no signs of pain. Which pain relay center of the body may have been impacted by the patient's injuries? a. Thalamus b. Midbrain c. Basal ganglia d. Hypothalamus c. Basal ganglia What is the most influential factor in whether a person will experience a stress reaction? a. General state of physical health b. Spiritual belief system c. Intellectual abilities d. Ability to cope d. Ability to cope A severely stressed patient has hypoglycemia each time the patient's blood glucose is checked. The healthcare professional should order laboratory tests to measure which hormone in the patient's blood? a. Epinephrine b. Norepinephrine c. Cortisol d. Growth hormone c. Cortisol A young adult patient has been taking an antidepressant medication for several weeks and reports having increased thoughts of suicide. The nurse questions further and learns that the patient has attempted suicide more than once in the past. The patient identifies a concrete plan for committing suicide. The nurse will contact the provider to discuss: a. Changing the medication to another drug class b. Discontinuing the medication immediately c. Hospitalizing the patient for closer monitoring d. Requiring more frequent clinic visits for this patient c. Hospitalizing the patient for closer monitoring The recommended length of time, for a patient diagnosed with major depression for the first time, to continue taking an antidepressant once the therapeutic level is reached is: a. Six months b. Two years c. One month d. Lifelong a. Six months A patient is given a prescription for clozapine for treatment-resistant schizophrenia. Which of the following symptoms should the patient seek medical attention? Select all that apply. a. Nausea b. Polydipsia c. Seizures d. Syncope e. Metallic taste in the mouth b. Polydipsia c. Seizures d. Syncope