,1. A patient with a history of chronic heart failure presents with symptoms
of worsening dyspnea and fatigue. Which intervention should the nurse
practitioner prioritize?
a) Prescribing a short course of oral corticosteroids.
b) Initiating oxygen therapy and titrating to maintain SpO2 above 92%.
c) Increasing the dose of the patient's current diuretic medication.
d) Advising the patient to limit fluid intake to 1 liter per day.
Answer: b) Initiating oxygen therapy and titrating to maintain SpO2
above 92%.
Rationale: Oxygen therapy is essential for patients presenting with
symptoms of acute heart failure exacerbation to improve oxygenation and
reduce the workload on the heart.
2. In evaluating a patient for potential sepsis, which laboratory result
would be most indicative of this diagnosis?
a) Elevated white blood cell count.
b) Decreased serum sodium level.
c) Increased serum lactate level.
d) Decreased hemoglobin level.
Answer: c) Increased serum lactate level.
Rationale: An increased serum lactate level indicates tissue
hypoperfusion, which is a concern in sepsis and can guide the urgency of
intervention.
3. A nurse practitioner is considering pharmacological treatment options
for a patient with newly diagnosed type 2 diabetes mellitus. Which factor
is most important in selecting an initial medication?
a) The patient's preference for oral or injectable medication.
b) The presence of comorbid cardiovascular disease.
c) The patient's body mass index (BMI).
d) The cost and availability of the medication.
Answer: b) The presence of comorbid cardiovascular disease.
Rationale: Comorbid conditions, especially cardiovascular disease,
significantly influence the choice of diabetic medication due to the impact
on patient outcomes.
4. When educating a patient about managing chronic kidney disease,
, which dietary modification should be emphasized?
a) Increased consumption of protein.
b) Reduced intake of potassium.
c) Increased intake of calcium.
d) Unrestricted fluid consumption.
Answer: b) Reduced intake of potassium.
Rationale: Patients with chronic kidney disease often need to limit
potassium to prevent hyperkalemia due to decreased renal excretion.
5. A 58-year-old patient presents with a persistent cough and unintentional
weight loss. A chest X-ray reveals a mass in the right lung. What is the
next best step in management?
a) Prescribe a broad-spectrum antibiotic and schedule a follow-up in two
weeks.
b) Refer the patient for immediate bronchoscopy and biopsy.
c) Advise the patient to quit smoking and reassess in one month.
d) Order a full-body CT scan to rule out metastasis.
Answer: b) Refer the patient for immediate bronchoscopy and biopsy.
Rationale: A lung mass with associated symptoms like a cough and
weight loss warrants prompt investigation to rule out malignancy.
6. A patient with rheumatoid arthritis reports increased joint pain and
stiffness. Which medication adjustment might be appropriate?
a) Discontinue NSAIDs and start a glucocorticoid taper.
b) Increase the dose of the current disease-modifying antirheumatic drug
(DMARD).
c) Add a biologic DMARD if not already prescribed.
d) Initiate muscle relaxants for symptomatic relief.
Answer: c) Add a biologic DMARD if not already prescribed.
Rationale: For patients with rheumatoid arthritis not adequately
controlled on a traditional DMARD, adding a biologic agent can be
beneficial.
7. In assessing a patient with suspected acute pancreatitis, which finding
would support this diagnosis?
a) Hyperactive bowel sounds.
b) Grey Turner's sign.
c) Murphy's sign.
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