Exam (elaborations) NUR 511 POSSIBLE QUESTIONS ON FINAL EXAM (100% ACCURATE)

Exam (elaborations) NUR 511 POSSIBLE QUESTIONS ON FINAL EXAM (100% ACCURATE) 1. The most cost-effective screening test for determining HIV status is which of the following? Enzyme linked immunosorbent assay 2. Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process? C -REACTIVE PROTIEN ( CRP) 3. Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter? DOPAMINE 4. 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: PAIN AT THE ELBOW WITH RESISTED MOVEMENTS AT THE WRIST AND FOREARM 5. Which of the following statements concerning the musculoskeletal examination is true? THE UNINVOLVED SIDE SHOULD BE EXAMINED INITIALLY AND THEN COMPARE TO THE INVOLVED SIDE. 6. Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? MORNING STIFFNESS 7. Which causes the greatest percentage of mammalian bites? DOGS 8. 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? TRANSVAGINAL ULTRASOUND 9. 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? ALL OF THE ABOVE ( CONTROL OF GLUCOSE, REGULARYLY CHECK BLOOD SUGAR AND MONITORING GLUCOSE) 10. 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 sinus bradycardia; muscular spiffiness; course , dry hair; and delay in relaxation in deep tendon reflexes. Which of the follow test should be ordered next? TSH 11. Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy? GLUCOTROL 12. 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? ENLARGED RUBBERY GLAND 13. 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? IMMOBILIZE THE INSECT WITH 2% LIDOCAINE 14. What is the most common cause of microcytic anemia? IRON DEFICIENCY ANEMIA 15. 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? ALL OF THE ABOVE ( PBH, PARKINSON’S AND PROSTATE CANCER) 16. Early rheumatoid disease is characterized by: JOINT SWELLING AND IMMOBILITY ON RISING 17. A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her lef 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 NUR 511 POSSIBLE QUESTIONS ON FINAL EXAM (100% ACCURATE) 2 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? OBTAIN A WRIST X-RAY AND PLACE HER WRIST IN A SPLINT OR PRESCRIBE A SPINT 18. 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: 6 MONTHS 19. 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? THE SCROTUM WILL APPEAR LIGHT PINK OR YELLOW 20. According to Kübler-Ross, the stages of grief occur in which order? DENIAL, ANGER, BARGAINING, DEPRESSION, ACCEPTANCE 21. 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? A FAVORABLE PROGNOSTIC TREND 22. The exanthem of Lyme disease is ERTHEMA MIGRANS 23. 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: ARTICULAR 24. What is the recommended daily calcium intake for adults over the age of 50 with low bone mass?1,500 MG/DAY 25. When assessing a woman for infertility, which of the following tests should be done first? ANALYSIS OF PARTNER’S SPERM 26. 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? DEEP PARTIAL THICKNESS BURNS 27. 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? HUMAN PAPILLOMAVIRUS (HPV) 28. As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin? THREE 29. 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? UNILATERAL RADICULAR PAIN SYMPTOMS THAT EXTEND BELOW THE KNEE AND ARE EQUAL TO OR GREATER THAN THE BACK PAIN 3 30. 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? TESTOSTERONE LEVEL 31. The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective? “ I’LL TAKE MY PILL AT LEAST 30 MIN BEFORE BREAKFAST.” 32. In the United States, what is the second most common connective tissue disease and the most destructive to the joints? RHEUMATOID ARTHRITIS 33. The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety? GAMMA-AMINOBUTRIC ACID (GABA) 34. 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? REFER TO UROLOGIST IMMEDIATELY 35. Which of the following medications can cause hyperglycemia? PREDNISONE 36. During treatment for anaphylaxis, what site is used for the initial injection of epinephrine? UPPER LATERAL THIGH 37. 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? 1 TO 2 WEEKS AFTER THE INITIATION OF TREATMENT 38. What is the most common cause of secondary amenorrhea? PREGNANCY 39. Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration? FLUOXETINE 40. The goals of the 15-minute hour approach include: PREVENT DIRE CONSEQUENCES, AND REESTABLISH PREMORBID LEVELS OF FUNCTIONING 41. John is a 16-year-old boy who presents to the emergency room afer hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of meniscal tear? MCMURRAY CIRCUMDUCTION TEST. 42. The cardinal subjective symptom of sickle cell crisis is which of the following? PAIN 43. A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which of the following pelvic pathologies is the most common cause of dysmenorrhea? ENDOMETROSIS 44. Which arthropod bite can contain cytotoxic and hemolytic toxins that may destroy tissue? BROWN RECLUSE SPIDER 45. Janet is a 30-year old who has recently been diagnosed with a herniated disc at the level L5- S1. She is currently in the emergency room with suspension of cauda equina compression. Which of the following sign or symptom of cauda equina compression? PARESTHESIS OF THE PERINEUM AND BUTTOCKS 46. A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the 4 following tests is essential before prescribing any oral contraceptive? PREGNANCY TEST 47. A patient with type 2 diabetes comes to the clinic afer reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin? ALL OF THE ABOVE ( KETOACIDOSIS, CIRRHOSIS, HYPOGLYCEMIC EPISODES) 48. The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants? SSRI’S ARE THE MORE EFFECTIVE THAN TCAS 49. Which type of bone marrow transplant is obtained from an identical twin? SYNGENEIC 50. Pink, cherry red tissues and skin may result from which type of poisoning? CARBON MONOXIDE 51. Basic human needs are identified as: AUTONOMY AND FEELINGVALUED BY OTHERS 52. The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient? MILD OBESITY 53. A 22- year old male is seen in the clinic because he found a hard lump in his testicular when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnosis? ALL OF THE ABOVE ( TESTICULAR CANCER, INGUINAL HERNIA, VERICOCELE) 54. What is the treatment of choice for a patient diagnosed with testicular cancer? RADICAL ORCHIDECTOMY 55. Which method is used to remove heavy metals, such as lead, that are ingested as poisons? CHELATION 56. A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate? “ WE WILL ORDER A MAMMOGRAM AND ULTRASOUND TO HELP ESTABLISH A DIAGNOSIS.” 57. A 36-year-old woman is seen with complaints of vaginal Itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate? FLUCONAZOLE 58. The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs? “ YOU SHOULD START WITH THE LOWEST DOSE THAT IS EFFECTIVE IN MANAGING YOUR PAIN, BECAUSE LONGTERM USE OF NSAID, CAN RESULT IN GASTROINSTESTINAL (GI) DISORDERS SUCH AS ULCER AND HEMORRHAGE.” 59. A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting of a joint, is more likely related to which musculoskeletal injury? A STRAIN 60. Which type of heat related illness involves a core body temperature of at least 104.9, acute mental status changes, absent seat, and tachypnea? HEAT STROKE 61. Which of the following may be used to evaluate a person's suicide risk? SAD PERSONAS 5 62. One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or non-articular in origin. Which of the following is an example of an articular structure? SYNOVIOUM 63. Afer returning from visiting his grandchildren in England, George, age 59, complains of a flulike illness, including fever, chills, and myalgia. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering? LYME DISEASE 64. A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expected as a manifestation of the disease? SINUS BRADYCARDIA 65. Which of the following tests is essential for a 46-year-old woman who the clinician suspects are perimenopausal? PREGNANCY 66. Afer 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? NORMAL TSH 67. A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment? DIET AND EXERCISE FOR 6 WEEK TRIAL 68. Which of the following should be considered in a patient presenting with erectile dysfunction? ALL OF THE ABOVE ( DM, HTN, ATHEROSCLEROSIS) 69. Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome? GENETIC FACTOR ARE THOUGHT TO ACCOUNT FOR ABOUT ONE -HALF THE RISK OF DEVELOPING CARPAL TUNNEL. 70. A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea? ALL OF THE ABOVE 71. Which of the following statements is true regarding the treatment of carpal tunnel syndrome? ALL OF THE ABOVE 72. Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his lef great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this patient? ELEVATED URIC ACID LEVEL 73. Which of the following data is indicative of testicular torsion? ABSENT CREMASTERIC REFLEX 74. A patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer her, the clinician must understand that exercise has what effect on the patient with type 2 diabetes? ALL OF THE ABOVE ( REDUCE POST PRANDIAL, REDUCE TRIGLYCERIDES AND INCREASE HDL, REDUCE TOTAL CHOLESTEROL) 75. A 26-year-old women is seen with complaints of irregular vaginal bleeding. Which of the following test should be the first priority? PREGNANCY TEST 6 76. What is the most common cause of generalized musculoskeletal pain in women ages 20 to 55? FRBROMYALGIS SYNDYNDROME (FMS) 77. If the international normalized ratio (INR) result is above the therapeutic range in a patient with atrial fibrillation on warfarin, what might the clinician do? WITHHOLDONE OR MORE DAYS OF ANTICOAGULANT THEARPY 78. A 32-year-old woman is seen in the clinic because she has been unable to get pregnant afer 12 months of unprotected sex. In order to determine the cause of the infertility, the clinician should question her about which of these possible causes? PELVIC INFLAMMATORY DISEASE 79. Which of the following statements concerning the treatment of fibromyalgia syndrome is true? ALL OF THE ABOVE ( NOCURE, CONTROLL DISCOMFORT, DIFFICULT TO MANAGE) 80. The clinician should prescribe an antibiotic that covers which of these organisms for a patient with acute prostatitis? GRAM NEGATIVE BACILLUS 81. Which household solution should be used to clean a bathroom if sharing with a friend who has HIV? NINE PARTS H2O TO ONE PART BLEACH 82. Sandra is 42 years old and has just been diagnosed with leukemia. She is complaining of bone and joint pain. Which type of leukemia is most likely the culprit? ACUTE MYELOGENOUS LEUKEMIA 83. Which of the following is identified as an eating disorder in which a person craves food substitutes, such as clay, ice chips, and cotton and is considered an objective finding associated with severe iron deficiency? PICA 84. The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit? HIGH SENSITIVITY THYROID STIMULATING HORMOMEN (TSH) AND FREE T 4 85. The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been effective? “ I KNOW I NEED TO HAVE MY EYES CHECKED EVERY YEAR” 86. Triggering factors for acute exacerbations of which of the following conditions include exposure to ultraviolet (UV)-B and UV-A rays? SLE 87. Which of the following characteristics separates anaphylaxis from a vasovagal reaction? SEVERE BRONCHOCONSTRICTION 88. Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The clinician has explained to Mr. Jackson that the goals for managing osteoarthritis include controlling pain, maximizing functional independence and mobility, minimizing disability, and preserving quality of life. Mr. Jackson explains to the clinician that his first choice would be to use complementary therapies to control his condition and asks what therapies are most effective in treating osteoarthritis. What would be the most appropriate response from the clinician? “ I WOULD BE HAPPY TO DISCUSS ALL THE TREATMENT OPTIONS AVAILABLE TO YOU. COMPLEMENTARY THERAPIES, SUCH AS ACUPUNCTURE, ACUPRESSURE, AND TAI-CHI, ARE BEING STUDIED FOR USE IN THE TREATMENT OF OSTEOARTHRITIS AND HAVE SHOWN PROMIS WHEN USED WITH STANDARD MEDICAL THERAPY.” 89. One benefit of motivational interviewing (MI) is: ALL ARE BENEFITS OF MI 7 90. What percentage of burns is involved using the rule of nines if both front legs are burned? 18 % 91. Women are at the highest risk for developing postpartum depression for up to how long afer childbirth? 6 MONTHS 92. Which statement about HIV post exposure prophylaxis (PEP) for health-care workers is the most accurate? PEP SHOULD BE STARTED WITH IN HOURS OF EXPOSURE 93. The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an x- ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane's description of her injury. Which of the following clues in Diane's examination or history would alert the clinician to the need for obtaining radiographs? ALL OF THE ABOVE ( INABILITY TO BEAR WEIGH, DEVELOPMENT OF ANKLE SWELLING, CREPITATION WITH PALPATION) 94. A vegetarian patient with gout asks the clinician about food he should avoid. The clinician should advise the patient to avoid which of the following foods? SPINACH 95. A patient with a basilar skull fracture may experience an impaired downward gaze or diplopia from which affected cranial nerve? CN IV 96. A patient presents to the clinician afer experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack? ALL OF THE ABOVE ( PHEOCHROMOCYTOMA, HYPERTHYROIDISM, CARDIAC ARRHYTHMIAS) 97. Which test is used to confirm a diagnosis of epididymitis? ULTRASOUND OF THE SCROTUM 98. BATHEing the patient refers to: A TECHNIQUE THAT IS A QUICK SCREEN FOR PSYCHIATRIC ISSUES AND INTERVENTIONS FOR PSYCHOLOGICAL PROBLEMS 99. BATHEing the patient is an advanced practice nursing intervention that allows the practitioner to: DEVELOP A THERAPEUTIC RELATIONSHIP WITHOUT “ OWNING” THE PATIENTS PROBLEM 100.A 45-year-old woman is seen in the clinic with abnormal uterine bleeding and pain during intercourse. The clinician should consider