Nur 504 Exam 5 Practice Questions and
Complete Solutions
Kyphosis is a late sign of:
A) Rheumatoid arthritis
B) Osteopenia
C) Osteoporosis
D) Osteoarthritis ✅C) Osteoporosis
Kyphosis is a curvature of the spine that causes a rounding of the back, which leads to
a slouching posture. Severe thinning of the bones (osteoporosis) contributes to this
curvature in the spine. Symptoms that may occur with severe cases of kyphosis include
difficulty breathing, fatigue, and back pain.
Which of the following antihypertensive medications has beneficial effects for an elderly
White woman with osteoporosis?
A) Calcium channel blockers
B) Angiotensin-converting enzyme (ACE) inhibitors
C) Beta-blockers
D) Thiazide diuretics ✅D) Thiazide diuretics
Thiazide diuretics have a favorable effect in patients with osteopenia and osteoporosis
by slowing down the kidney's excretion of calcium and increasing distal tubule calcium
reabsorption. This results in decreased bone demineralization. Thiazide diuretics are a
good choice of therapy for this population because they treat hypertension and slow
bone loss.
Epidemiological studies show that Hashimoto's disease occurs most commonly in:
A) Middle-aged to older women
B) Smokers
C) Obese individuals
D) Older men ✅A) Middle-aged to older women
Hashimoto's disease (Hashimoto's thyroiditis, or chronic lymphocytic thyroiditis) is an
autoimmune disease. An enlarged thyroid is most often the first sign of the disease.
Hashimoto's disease is about seven times more common in women than in men. It can
occur in teens and young women, but is more common in middle age.
A 48-year-old woman is told by a physician that she is starting menopause. All of the
following are possible findings except:
,A) Hot flashes
B) Irregular menstrual periods
C) Severe vaginal atrophic changes
D) Cyclic mood swings ✅C) Severe vaginal atrophic changes
As women reach menopause, changes that may occur include hot flashes, irregular
menstrual periods, and cyclic mood swings. Vaginal changes, such as dryness and
thinning, may also begin to occur. Vaginal atrophy (atrophic vaginitis) is the thinning and
inflammation of the vaginal walls due to a decline in estrogen. Vaginal atrophy occurs
most often after menopause and worsens as women get older.
An 8-year-old boy with type 1 diabetes is being seen for a 3-day history of urinary
frequency and nocturia. He denies flank pain and is afebrile. The urinalysis result is
negative for blood and nitrites but is positive for a large amount of leukocytes and
ketones. He has a trace amount of protein. Which of the following is the best test to
order initially?
A) Urine for culture and sensitivity
B) 24-hour urine for protein and creatinine clearance
C) 24-hour urine for microalbumin
D) Intravenous pyelogram ✅A) Urine for culture and sensitivity
An 8-year-old male patient with the diagnosis of diabetes has a high risk of urinary tract
infections (UTIs). A large amount of leukocytes in the urinalysis is abnormal, and he has
been having symptoms of frequency and nocturia for the past 3 days. The urine culture
would be ordered because he has a high risk of infection. The urine culture and
sensitivity (C&S) is the best evaluation for diagnosing a UTI.
All of the following are false statements about atopic dermatitis except:
A) Contact with cold objects may exacerbate the condition
B) It does not have a linear distribution
C) It is associated with bullae
D) The lesions have vesicles that are full of serous exudate ✅B) It does not have a
linear distribution
Atopic dermatitis, also known as eczema, is a skin condition in which the lesions occur
in a linear fashion. They may have many different stages, including erythematous
papules and vesicles, with weeping, drainage, and/or crusting. Lesions are commonly
pruritic and are found on the scalp, face, forearms, wrists, elbows, and backs of the
knees.
Human chorionic gonadotropin (hCG) is produced by the:
A) Placenta
B) Hypothalamus
,C) Anterior pituitary
D) Ovaries ✅A) Placenta
Human chorionic gonadotropin (hCG) is a hormone produced by the placenta after
implantation. It can also be produced in gestational trophoblastic disease or
hydatidiform mole (molar pregnancy).
The majority of serum alpha fetoprotein is produced by the:
A) Fetal liver
B) Maternal liver
C) Placenta
D) Fetal neural tube ✅A) Fetal liver
Alpha fetoprotein (AFP) is produced mainly by the growing fetal liver. A small amount
comes from the mother's liver, but by the end of the first trimester, most of the AFP is
produced by the fetal liver.
The nurse practitioner who suspects that one of her hypertensive patients has
Cushing's syndrome would expect to find which of the following laboratory results?
A) Hyponatremia
B) Hypoglycemia
C) Elevated serum cortisol levels
D) Decreased urine 17-ketosteroids ✅C) Elevated serum cortisol levels
Elevated serum cortisol levels are seen in patients with Cushing's syndrome.
A 44-year-old woman who is undergoing treatment for infertility complains of not having
had a menstrual period for a few months. The night before, she started spotting and is
now having cramp-like pains in her pelvic area. Her blood pressure (BP) is 160/80
mmHg, pulse is 110 beats/min, and she is afebrile. Her labs reveal mild anemia with
mild leukocytosis. On pelvic exam, the uterine fundus is noted to be above the
symphysis pubis. The cervical os is dilated at 3 cm. Which of the following is most
likely?
A) Inevitable abortion
B) Threatened abortion
C) Incomplete abortion
D) Acute pelvic inflammatory disease ✅A) Inevitable abortion
Inevitable abortion is defined as vaginal bleeding with pain, cervical dilation, and/or
cervical effacement. Threatened abortion is defined as vaginal bleeding with absent or
minimal pain and a closed, long, and thick cervix. Incomplete abortion involves
moderate to diffuse vaginal bleeding, with the passage of tissue and painful uterine
cramping or contractions. Acute pelvic inflammatory disease is a sudden onset of
, inflammation and pain that affects the pelvic area, cervix, uterus, and ovaries, and is
caused by infection.
A 14-year-old girl who is sexually active is brought to the health clinic by her mother for
an immunization update. According to the mother, her daughter has had one dose of
hepatitis B vaccine. Which of the following vaccines would you administer at this visit?
A) Tdap, hepatitis B, and HPV vaccine
B) DTaP (diphtheria, tetanus, acellular pertussis) and hepatitis B
C) Hepatitis B only
D) MMR (measles, mumps, rubella), Td, and HPV vaccine ✅A) Tdap, hepatitis B, and
HPV vaccine
There are two types of HPV vaccine. Gardasil can be used for both girls and boys, but
Cervarix can only be used for females. HPV vaccine is recommended for preteen boys
and girls at age 11 or 12 years. Young women can get HPV vaccine until age 27 years
and men can get the HPV vaccine until age 22 years.
An Rh-negative pregnant woman with negative rubella titers can be vaccinated at what
time in pregnancy?
A) At any time in pregnancy
B) During the second trimester
C) During the third trimester
D) During the postpartum period ✅D) During the postpartum period
The measles, mumps, and rubella (MMR) vaccine is contraindicated in pregnancy. The
Advisory Committee on Immunization Practices recommends that regnancy be avoided
for 4 weeks after vaccination, that women who become pregnant within that period be
advised of the theoretical risk to the fetus (congenital rubella syndrome), and that
vaccination during pregnancy is generally not a reason to terminate the pregnancy.
All of the following measures have been found to help lower the risk of osteoporosis
except:
A) Drinking organic orange juice
B) Eating low-fat dairy foods
C) Performing weight-bearing exercises
D) Vitamin D supplementation ✅A) Drinking organic orange juice
Commercial orange juice is fortified with calcium and vitamin D. But organic products
usually do not have any additives such as calcium. Vitamin D levels must be sufficient
for the body to absorb calcium. Eating foods high in vitamin D and calcium along with
calcium and vitamin D supplements is advised to protect the bones and prevent bone
loss. Performing weight-bearing exercises daily also increases bone strength.
