NRNP 6531 Midterm Exam 2024 Test | NRNP 6531 Week 6
Midterm Exam | NRNP 6531 Final Exam 2024 & NRNP 6531 Final
Exam Compliation
A child with a history of asthma is brought to the clinic with a rapid heart rate. A cardiac monitor
shows a heart rate of 225 beats per minute. The provider notifies transport to take the child to
the child emergency department. What initial intervention may be attempted in the clinic?
Administration of intravenous adenosine
Using a vagal maneuver or carotid massage
Providing a loading dose of digoxin
Giving a beta blocker - Using a vagal maneuver or carotid massage
Current American Heart Association (AHA) recommendations include: (Select all that apply.)
Using a ratio of 2 rescue breaths to 30 compressions
A compression depth of 1.5 inches or more on an adult
A rate of 100 compressions per minute at a minimum
Untrained rescuers giving compressions without breaths
Rescue breaths given during 2 seconds to allow full chest rise - Using a ratio of 2 rescue
breaths to 30 compressions
A rate of 100 compressions per minute at a minimum
Untrained rescuers giving compressions without breaths
A patient reports recurrent chest pain that occurs regardless of activity and is not relieved by
rest. The provider administers a nitroglycerin tablet which does not relieve the discomfort. What
is the next action?
Prescribe a calcium channel blocker medication
Start aspirin therapy and refer the patient to a cardiologist
Give the patient a beta blocker medication
Administer a second nitroglycerin tablet - Give the patient a beta blocker medication
A 70-year-old male patient has an aortic aneurysm measuring 5.0 cm. The patient has poorly-
controlled hypertension, and decompensated heart failure. What is the recommendation for
treatment for this patient?
No intervention is necessary for this patient
Immediate open surgical repair of the aneurysm
Endovascular stent grafting of the aneurysm
Serial ultrasonographic surveillance of the aneurysm - Serial ultrasonographic surveillance of
the aneurysm
Which laboratory values representing parathyroid hormone (PTH) and serum calcium are
consistent with a diagnosis of primary hyperparathyroidism?
Appropriately increased PTH and low or normal serum calcium
Inappropriate secretion of PTH along with hypercalcemia
Appropriately high PTH along with hypocalcemia
Prolonged inappropriate secretion of PTH with subsequent hypercalcemia - Inappropriate
secretion of PTH along with hypercalcemia
,A patient who is obese has recurrent urinary tract infections and reports feeling tired most of
the time. What initial diagnostic test will the provider order in the clinic at this visit?
Hemoglobin A1C
Random serum glucose
C-peptide level
Thyroid studies - Hemoglobin A1C
A 20-year-old female patient with tachycardia and weight loss but no optic symptoms has the
following laboratory values: decreased TSH, increased T3, and increased T4 and free T4. A
pregnancy test is negative. What is the initial treatment for this patient?
Radioiodine therapy
Surgical resection of the thyroid gland
Beta blocker medications
Thionamide therapy - Beta blocker medications
A 40-year-old patient with primary hyperparathyroidism has increased serum calcium 0.5
mg/dL above normal without signs of nephrolithiasis. What is the recommended treatment for
this patient?
Avoidance of weight bearing exercises
Annual monitoring of calcium, creatinine, and bone density
Decreasing calcium and Vitamin D intake until values normal
Parathyroidectomy - Annual monitoring of calcium, creatinine, and bone density
A patient has thyroid nodules and the provider suspects thyroid cancer. To evaluate thyroid
nodules for potential malignancy, which test is performed?
Serum calcitonin
Radionucleotide imaging
Serum TSH level
Thyroid ultrasound - Thyroid ultrasound
Which laboratory values representing parathyroid hormone (PTH) and serum calcium are
consistent with a diagnosis of primary hyperparathyroidism?
Prolonged inappropriate secretion of PTH with subsequent hypercalcemia
Inappropriate secretion of PTH along with hypercalcemia
Appropriately high PTH along with hypocalcemia
Appropriately increased PTH and low or normal serum calcium - Inappropriate secretion of
PTH along with hypercalcemia
What is important about increased PAI-1 levels in patients with metabolic syndrome?
They cause increased insulin resistance.
They predispose patients to dyslipidemia.
They lower the risk of hypertension.
,They increase the risk of arterial thrombosis. - They increase the risk of arterial thrombosis.
A patient who has diabetes has a blood pressure of 140/90 mm Hg and albuminuria. Which
initial action by the primary care provider is indicated for management of this patient?
Consulting with a nephrologist
Prescribing an antihypertensive medication
Referring to an ophthalmologist
Limiting protein intake - Consulting with a nephrologist
A postpartum woman develops fatigue, weight gain, and constipation. Laboratory values reveal
elevated TSH and decreased T3 and T4 levels. What will the provider tell this patient?
She will need lifelong medication.
A thyroidectomy will be necessary.
This condition may be transient.
She should be referred to an endocrinologist. - This condition may be transient.
A health care provider in a clinic finds a patient in a room, unresponsive and pale. Which sign
should be used to identify the need to initiate cardiopulmonary resuscitation (CPR)?
Evaluation of peripheral perfusion and level of consciousness
Obtaining a history of previous myocardial infarction
Determination of pulselessness or bradycardia
Assessment of gasping breaths or not breathing - Assessment of gasping breaths or not
breathing
An African-American patient who is being treated with a thiazide diuretic for chronic
hypertension reports blurred vision and shortness of breath. The provider notes a blood
pressure of 185/115. What is the recommended action for this patient?
Increase the dose of the thiazide medication
Add a beta blocker to the patient's regimen
Admit to the hospital for evaluation and treatment
Prescribe a calcium channel blocker - Admit to the hospital for evaluation and treatment
A patient reports sustained, irregular heart palpitations. What is the most likely cause of these
symptoms?
Atrial fibrillation
Anemia
Extrasystole
Paroxysmal attacks - Atrial fibrillation
A patient has a cardiac murmur that peaks in midsystole and is best heard along the left sternal
border. The provider determines that the murmur decreases in intensity when the patient
changes from standing to squatting and increases in intensity with the Valsalva maneuver.
Which cause will the provider suspect for this murmur?
Aortic stenosis
Tricuspid regurgitation
Hypertrophic cardiomyopathy
Mitral valve prolapse - Hypertrophic cardiomyopathy
, A patient is brought to an emergency department with symptoms of acute ST-segment
elevation MI (STEMI). The nearest hospital that can perform percutaneous coronary
intervention (PCI) is 3 hours away. What is the initial treatment for this patient?
Give the patient an oral beta blocker
Transfer to the PCI-capable institution
Administer heparin
Initiate fibrinolytic treatment - Initiate fibrinolytic treatment
Patients who meet the criteria for statin therapy to help prevent atherosclerotic cardiovascular
disease are those with a history of (Select all that apply.)
previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
diabetes and an LDL between 40 and 70 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
a 10 year risk score of 5% and an LDL of 165 mg/dL. - previous myocardial infarction.
a low-density lipoprotein (LDL) level >190 mg/dL.
a 10 year risk score of 8% with an LDL of 80 mg/dL.
A 75-year-old patient reports pain and a feeling of tiredness in both legs that only relieves after
sitting for 30 minutes or more. What the does provider suspect as the cause for these
symptoms?
Buerger's disease
Cauda equina syndrome
Diabetic neuropathy
Peripheral arterial disease - Cauda equina syndrome
Which are causes of secondary hypertension? (Select all that apply.)
Oral contraceptives
Isometic excercises
NSAIDS
Sleep apnea
Increased salt intake - Oral contraceptives
NSAIDS
Sleep apnea
A young female patient has known mitral valve prolapse. During a routine health maintenance
exam, the provider notes an apical systolic murmur and a midsystolic click on auscultation. The
patient denies chest pain, syncope, or palpitations. What will the provider do?
Reassure the patient that these findings are expected
Continue to monitor the patient every 3 years
Admit the patient to the hospital for evaluation and treatment
Consult with cardiology to determine appropriate diagnostic tests - Consult with cardiology to
determine appropriate diagnostic tests
A patient reports abdominal and back pain with anorexia and nausea. During an exam, the
provider notes a pulsatile abdominal mass. What is the initial action?
Scheduling an MRI to evaluate for aortic disease
Immediate referral to a thoracic surgeon
US of the mass to determine size
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