NR 511 Week 8 Final Exam

Question 1. The most cost-effective screening test for determining HIV status is which of the following? Student Answer: Western blot Enzyme-linked immunosorbent assay Venereal Disease Research Laboratory test Viral load Points Received: 0 of 2 Comments: Question 2.Question : Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process? Student Answer: Erythrocyte sedimentation rate White blood cell count Polymorphonuclear cells C-reactive protein (CRP) Points Received: 0 of 2 Comments: Question 3.Question : Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter? Student Answer: GABA Acetylcholine Dopamine Serotonin Points Received: 0 of 2 Comments: Question 4.Question : Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is: Student Answer: Ecchymosis, edema, and erythema over the lateral epicondyle Pain at the elbow with resisted movements at the wrist and forearm Inability to supinate and pronate the arm Inability to flex or extend the elbow against resistance Points Received: 2 of 2 Comments: Question 5.Question : Which of the following statements concerning the musculoskeletal examination is true? Student Answer: The uninvolved side should be examined initially and then compared to the involved side. The part of the body that is causing the patient pain should be examined first. When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient. Points Received: (not graded) Comments: Question 6.Question : Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? Student Answer: Decreased C-reactive protein Hyperalbuminemia Morning stiffness Weight gain Points Received: (not graded) Comments: Question 7.Question : Which causes the greatest percentage of mammalian bites? Student Answer: Dogs Cats Humans Rodents Points Received: (not graded) Comments: Question 8.Question : A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first? Student Answer: Transvaginal ultrasound Endometrial biopsy MRI Abdominal computed tomography scan Points Received: (not graded) Comments: Question 9.Question : A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate? Student Answer: "Control of glucose will help postpone or delay complications." "Regularly checking blood sugar will help establish a routine." "Monitoring glucose will promote a sense of control." All of the above Points Received: (not graded) Comments: Question 10.Question : A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next? Student Answer: Serum calcium TSH Electrolytes Urine specific gravity Points Received: (not graded) Comments: Question 11.Question : Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy? Student Answer: Insulin Metformin Glucotrol Precose Points Received: (not graded) Comments: Question 12.Question : During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? Student Answer: An enlarged rubbery gland A hard irregular gland A tender gland A boggy gland Points Received: (not graded) Comments: Question 13.Question : Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step? Student Answer: Remove the insect with tweezers. Immobilize the insect with 2% lidocaine. Sedate Eddie with diazepam. Shine a light in the ear for the insect to "find its way out." Points Received: (not graded) Comments: Question 14.Question : What is the most common cause of microcytic anemia? Student Answer: Anemia of chronic disease Sideroblastic anemia Iron-deficiency anemia Thalassemia Points Received: (not graded) Comments: Question 15.Question : An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses? Student Answer: Benign prostatic hyperplasia (BPH) Parkinson's disease Prostate cancer All of the above Points Received: (not graded) Comments: Question 16.Question : Early rheumatoid disease is characterized by: Student Answer: Pain and swelling in both small and large peripheral joints Rigid joints with diminished range of motion Joint swelling and immobility on rising A cardiac rub or pulmonary friction rub Points Received: (not graded) Comments: Question 17.Question : A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do? Student Answer: Make an immediate referral for an orthopedic evaluation without further assessment. Tell her that it takes time for these bruises to improve, so she should be patient. Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint. Send her to the emergency room for reduction of this obvious wrist fracture. Points Received: (not graded) Comments: Question 18.Question : The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least: Student Answer: 1 month 3 months 6 months 12 months Points Received: (not graded) Comments: Question 19.Question : A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find? Student Answer: The scrotum will be dark. The scrotum will appear light pink or yellow. The scrotum will appear milky white. The internal structures will be clearly visible. Points Received: (not graded) Comments: Question 20.Question : According to Kübler-Ross, the stages of grief occur in which order? Student Answer: Anger, denial, depression, bargaining, acceptance Anger, denial, bargaining, acceptance, depression Denial, anger, depression, bargaining, acceptance Denial, anger, bargaining, depression, acceptance Points Received: (not graded) Comments: Question 21.Question : Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate? Student Answer: A favorable prognostic trend Disease progression The need to be more aggressive with Reuben's medications The eradication of the HIV Points Received: (not graded) Comments: Question 22.Question : The exanthem of Lyme disease is: Student Answer: Erythema infectiosum Laterothoracic exanthem Erythema migrans Morbilli exanthem Points Received: (not graded) Comments: Question 23.Question : You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is: Student Answer: Articular Inflammatory Nonarticular A and B Points Received: (not graded) Comments: Question 24.Question : What is the recommended daily calcium intake for adults over the age of 50 with low bone mass? Student Answer: 1,200 mg/day 1,000 mg/day 1,300 mg/day 1,500 mg/day Points Received: (not graded) Comments: Question 25.Question : When assessing a woman for infertility, which of the following tests should be done first? Student Answer: Analysis of partner's sperm Magnetic resonance imaging (MRI) Hysterosalpingogram Estrogen level Points Received: (not graded) Comments: Question 26.Question : Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact? Student Answer: Superficial burns Superficial partial-thickness burns Deep partial-thickness burns Full-thickness burns Points Received: (not graded) Comments: Question 27.Question : A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination? Student Answer: Human papillomavirus (HPV) Endometrial hyperplasia Vagismus Polycystic ovarian syndrome Points Received: (not graded) Comments: Question 28.Question : As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin? Student Answer: Two Three Four Five Points Received: (not graded) Comments: Question 29.Question : Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? Student Answer: Morning stiffness and limited mobility of the lumbar spine Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain Fever, chills, and elevated erythrocyte sedimentation rate Pathologic fractures, severe night pain, weight loss, and fatigue Points Received: (not graded) Comments: Question 30.Question : A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis? Student Answer: Testosterone level Prostate-specific antigen Nocturnal penile tumescence and rigidity Prolactin level Points Received: (not graded) Comments: Question 31.Question : The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective? Student Answer: "I'll take my pill at least 30 minutes before breakfast." "I'll take my Glucotrol before bedtime." "It is important to take my medication right after I eat." "Since I only like to eat two meals a day, I can take the pill between my meals." Points Received: (not graded) Comments: Question 32.Question : In the United States, what is the second most common connective tissue disease and the most destructive to the joints? Student Answer: Osteoarthritis Systemic lupus erythematosus (SLE) Rheumatoid arthritis Sjögren's syndrome Points Received: (not graded) Comments: Question 33.Question : The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety? Student Answer: Acetylcholine Gamma-aminobutyric acid (GABA) Dopamine Serotonin Points Received: (not graded) Comments: Question 34.Question : A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action? Student Answer: Refer to a urologist immediately. Obtain a computed tomography (CT) scan. Instruct the patient to elevate the scrotum. Prescribe ibuprofen. Points Received: (not graded) Comments: Question 35.Question : Which of the following medications can cause hyperglycemia? Student Answer: Prednisone Metformin Synthroid Cephalexin Points Received: (not graded) Comments: Question 36.Question : During treatment for anaphylaxis, what site is used for the initial injection of epinephrine? Student Answer: IV Abdomen Upper lateral thigh Deltoid Points Received: (not graded) Comments: Question 37.Question : It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period? Student Answer: Before the initiation of treatment 1 to 2 weeks after the initiation of treatment When switching to a different medication 1 to 2 weeks after tapering off medications Points Received: (not graded) Comments: Question 38.Question : What is the most common cause of secondary amenorrhea? Student Answer: Pregnancy Pituitary dysfunction Inadequate estrogen levels Genetic disorders Points Received: (not graded) Comments: Question 39.Question : Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration? Student Answer: Sertraline Fluoxetine Citoprolam Imipramine Points Received: (not graded) Comments: Question 40.Question : The goals of the 15-minute hour approach include: Student Answer: Enhance self-esteem, expand behavioral repertoire, prevent dire consequences, and reestablish premorbid levels of functioning Emerge with a higher level of functioning and commitment to long-term psychotherapy Accept need for antidepressant therapy and psychiatric referral; share concerns with primary care clinician Improve family functioning and sexual performance as well as accept need for antidepressant medication Points Received: (not graded) Comments: Question 41.Question : John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it