1. You are treating a patient with acute anxiety and she is having an acute attack in
the office. The ANP has knowledge that the fastest relief of symptoms is:
a TCA a beta-
blocker a
benzodizepine
an SSRI: Correct
answer:
benzodiazepine
The fastest relief of anxiety symptoms will occur with a benzodiazepine. The other
choices list agents that will require multiple doses for results. With daily continued use of
benzodiazepines, the anti-anxiety effect may become diminished.
2. A geriatric patient with cardiovascular disease is in the office being counseled on
lifestyle changes. The ANP knows that which of the following is the most important
to include in this discussion?
"Control your hypertension, stop smoking, maintain a normal weight, and exercise
regularly."
"Have a yearly physical examination, increase fiber in your diet, and exercise
regularly."
"Maintain a normal level of serum blood sugar and decrease cholesterol intake."
"Decrease smoking, increase vitamin supplements, and increase protein intake.":
Correct answer:
"Control your hypertension, stop smoking, maintain a normal weight, and exercise
regularly."
All of these are important for the geriatric patient to decrease cardiovascular risk.
Controlling hyperglycemia, high fiber intake, and vitamins all assist in maintaining a
healthy lifestyle but do not help to prevent cardiovascular disease.
3. You are seeing a female with inflammatory bowel disease, known as IBD. The
Adult Nurse Practitioner knows that if she orders a hemogram on this patient,
which of the following results would be seen if the patient was anemic?
, microcytic, hypochromic type
macrocytic, normochromic type
normocytic, normochromic type
macrocytic, hypochromic type: Correct
Answer: normocytic, normochromic type
Anemia is a common problem in IBD. The etiology is often from multiple causes. The
anemia of chronic disease, a normocytic, normochromic anemia, is a result of
inflammation of the IBD without blood loss. Blood loss would result in a microcytic,
hypochromic anemia. The macrocytic anemias are a result of deficiency in vitamin B12
or other causes.
4. Which of the following is the least likely risk factor for suicide?
physical illness
male increasing age
black race: Correct
answer:
black race
Being of a white race is more likely to be a factor in suicide. Besides the other three
choices risk factors include: substance abuse, living alone, and less education.
5. The healthcare provider's required level of expected conduct as established by
custom, law, or professional organizations is called the:
Standard of care.
Breach of duty.
Duty.
Malpractice.: Correct answer:
Standard of care
Standard of care is another term associated with negligence. Standard of care is a
healthcare provider's required level of expected conduct as established by custom, law, or
professional organizations.
6. A brief account by the patient of any signs or symptoms he or she is experiencing
is one component of:
Review of systems.
Symptom assessment.
,Functional assessment.
Objective assessment.: Correct Answer:
Review of systems
In the review of systems, the patient tells the nurse in his or her own words what signs or
symptoms he or she has experienced in various body systems. It is important that these be
in a patient's own words to perform the most complete and accurate assessment.
7. All of the following are typical changes to the gastrointestinal system that come
with aging EXCEPT:
decreased liver size decreased muscle
tone in bowel increased absorption of
calcium atrophy of salivary glands:
Correct answer:
increased absorption of calcium
Decreased absorption of calcium is a common change that comes with aging, not
increased absorption. Other gastrointestinal changes include: less efficient cholesterol
stabilization and absorption, atrophy of taste buds, and slowing in esophageal emptying,
among others.
8. A 28-year-old female patient is in the office and is to undergo radioactive iodine
treatment for Graves disease. The ANP is counseling her and understands that
the mechanism of action of this treatment therapy is:
alter the thyroid metabolic rate
relieve distress caused by increased thyroid size
destroy the overactive thyroid tissue reduce
production of TSH: Correct answer: destroy the
overactive thyroid tissue
Graves disease is the most common form of thyrotoxicosis. Radioactive iodine is used for
thyroid ablation to destroy the overactive thyroid tissue that causes the thyroid hormone
dysfunction.
9. Which of the following statements about falls in the elderly is least accurate?
Black women are at higher risk for hip fractures than white women.
The majority of deaths from falls are among people aged 65 years or older.
Injuries from falls include head injuries, pelvic injuries, lacerations, and more.
About 90% of hip fractures are due to falls.: Correct Answer:
, Black women are at higher risk for hip fractures than white women.
It is white women, not black women, who are at higher risk for hip fractures. Falls are
one of the most common adverse events that threaten the quality of life of older adults.
Falls among older adults are not a normal consequence of aging.
10. Normal age-related changes of the skin may be confused with which of the
following clinical abnormalities?
Normal age-related changes of the skin may be confused with dehydration. Sebaceous
gland activity tends to decrease with age, and the skin's natural hydrators decline over the
years. The skin's ability to regenerate lipids compromising the protective lipid barrier
layer of the Stratum Corneum also declines with age, as does blood flow to the skin,
which may cause a drop in sebum production.
11. A 29-year old woman who is 6 weeks postpartum reports she is having rectal
bleeding that she believes is related to hemorrhoids. The Adult Nurse
Practitioner knows that this type of rectal bleeding is usually described as:
dark brown to black blood color with normal-appearing stool
significant amounts of bright red blood large blood clots and
mucus mixed with stool streaks of bright red blood on the stool:
The Correct answer is: streaks of bright red blood on the stool
Choice D is the right answer. The color of blood related to hemorrhoids is described as
bright red, eliminating choice A. Amount of blood with hemorrhoids is usually small or
scant, eliminating choices B and C. Internal hemorrhoids can occur during or after
childbirth. With chronically protruding or prolapsing hemorrhoids, the patient often
reports mucous leaking and staining of the undergarments. Other causes are obesity,
constipation, and prolonged sitting.
12. You have a patient with AIDS. You recognize that a low CD4 T-cell count
puts the patient at risk for opportunistic infections. You are reviewing his lab
reports and see that his CD4 T-cell count is indeed low. Which of the following is
the normal range for CD4 T-cell count?
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