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NURS 6531N Final Exam – NURS6531N Adv. Practice Care of Adults

1. A patient complains of generalized joint pain and stiffness associated with activity and relieved with rest. This patient history is consistent with which of the following disorders?
2. What diabetic complications result from hyperglycemia?
3. Which factors are associated with high risk for foot complications in a patient with diabetes mellitus?
4. Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)?What are common early signs of BPH –
5. A 63-year-old man presents to the office with hematuria, hesitancy, and dribbling. Digital rectal exam (DRE) reveals a moderately enlarged prostate that is smooth. The PSA is 1.2. What is the most appropriate management strategy for you to follow at this time?
6. A 30 year old female patient presents to the clinic with heat intolerance, tremors, nervousness, and weight loss inconsistent with increased appetite. Which test would be most likely to confirm the suspected diagnosis?
7. Which history is commonly found in a patient with glomerulonephritis?
8. 60 year old male patient with multiple health problems presents with a complaint of erectile dysfunction (ED). Of the following, which medication is most likely to be causing the problem?
9. Which of the following is not a characteristic of type 2 diabetes mellitus?
10. A patient has been diagnosed with hypothyroidism and thyroid hormone replacement therapy is prescribed. How long should the nurse practitioner wait before checking the patient’s TSH?
11. A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder?Treatment may include counseling and medications, such as antidepressants. Selective Serotonin Reuptake Inhibitor (SSRI), Anxiolytic, and Antidepressant
12. What is the most common cause of Cushing’s syndrome?
13. Which of the following is the most cause of low back pain?
14. Warfarin (Coumadin) is prescribed for a frail, elderly male with new onset atrial fibrillation. The goal INR for this patient should be:2.0 to 3.0 16. A 72 year old patient exhibits sudden onset of fluctuating restlessness, agitation, confusion, and impaired attention. This is accompanied by visual hallucinations and sleep disturbance. What is the most likely cause of this behavior?
15. Which of the following is the most common causative organism of nongonococcal urethritis? which of the following does not cause nongonococcal urethritis
16. What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?
17. Diagnostic evaluation for urinary calculi includes:
18. Which appropriate test for the initial assessment of Alzheimer’s disease provides the performance ratings on 10 complex, higher order activities?
19. Reed-Sternberg B lymphocytes are associated with which of the following disorders:
20. Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia?
21. Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within normal limits. Which of the following diagnoses do you explore further?
22. Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid?
23. The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is:
24. Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus?
25. A thymectomy is usually recommended in the early treatment of which disease?
26. The most common cause of elevated liver function tests is:
27. A 14 year old female cheerleader reports gradual and progressive dull anterior knee pain, exacerbated by kneeling. The nurse practitioner notes swelling and point tenderness at the tibial tuberosity. X-ray is negative. What is the most likely diagnosis?
28. Which of the following is a contraindication for metformin therapy?
29. The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy:
30. Which is the most common cause of end-stage renal disease in the United States?
31. A middle-aged female presents complaining of recent weight loss. The physical exam reveals an enlarged painless cervical lymph node. The differential diagnosis for this patient’s problem includes:
32. A Risk factors for prostate cancer include all of the following except:
33. Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of:
34. The most effective intervention(s) to prevent stroke is (are):
35. A diabetic patient is taking low-dose enalapril for hypertension. A record of the patient’s blood pressure over 4 weeks ranges from 130 to 142 mmHg systolic and 75 to 85 mmHg diastolic. How should the nurse practitioner respond?
36.  Microalbuminuria is a measure of:
37. Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect?
38. A 32 year old male patient complains of urinary frequency and burning on urination for 3 days. Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial treatment should be:
39. A 21-year-old female presents to the office complaining of urinary frequency and urinary burning. The nurse practitioner suspects a urinary tract infection when the urinalysis reveals
    10 WBC/ HP
40. Which of the following medications increase the risk for metabolic syndrome?
41. The most accurate measure of diabetes control is: a1c
42. The 4 classic features of Parkinson’s disease are:
43. A child with type 1 diabetes mellitus has experienced excessive hunger, weight gain and increasing hyperglycemia. The Somogyi effect is suspected. What steps should be taken to diagnose and treat this condition?
44. A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness, anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take?
45. Other than smoking cessation, which of the following slows the progression of COPD in smokers?Engaging in moderate-to-high levels of physical activity
46. A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains:
47. The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in almost 100% of patients is:
48. A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is:. Cryptosporidiosis
49. How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout?
50. The treatment of choice for chronic bacterial prostatitis (CBP) is:
51. Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to:try neutral position wrist splinting and order an oral NSAID
52. Urine cultures should be obtained for which of the following patients?All of the above (pregnant females, males, and febrile patients)
53. Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse?
54. The diagnosis which must be considered in a patient who presents with a severe headache of sudden onset, with neck stiffness and fever, is:
55. An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects?
56. Which patient would benefit most from screening for type 2 diabetes?
57. The intervention known to be most effective in the treatment of severe depression, with or without psychosis, is: nurs 6531n final exam
58. Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond?
59. Which of the following patients most warrants screening for hypothyroidism?62. Successful management of a patient with attention deficit hyperactivity disorder (ADHD) may be achieved with:
60. Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following:
61. Prolonged PT suggests:
62. Diagnostic confirmation of acute leukemia is based on:
63. Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis? 67. The most effective treatment of non-infectious bursitis includes:
64. Differential diagnosis of proteinuria includes which of the following?
65. You are assessing a patient after a sports injury to his right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to the:
66. A positive drawer sign supports a diagnosis of:
67. A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as: nurs 6531n final exam
68. A patient has been taking fluoxetine (Prozac) since being …..with major depression, first episode, 2 months ago. She reports considerable improvement in her symptoms and her intention to discontinue the medication. What should be the nurse practitioner’s recommendation?
69. Diagnostic radiological studies are ….for low back pain:
70. A 32 year old female patient presents with fever, chills, right flank pain, right costovertebral angle tenderness, and hematuria. Her urinalysis is positive for leukocytes and red blood cells. The nurse practitioner diagnoses pyelonephritis. The most appropriate management is:
71. Which of the following symptoms suggests a more serious cause of back pain? Pain with lying
72. What is the first step in the treatment of uric acid kidney stones?
73. A 20 year old male patient complains of “scrotal swelling.” He states his scrotum feels heavy, but denies pain. On examination, the nurse practitioner notes transillumination of the scrotum. What is the most likely diagnosis?
74. What is the first symptom seen in the majority of patients with Parkinson’s disease?
75. A 60 year old female patient complains of sudden onset unilateral, stabbing, surface pain in the lower part of her face lasting a few minutes, subsiding, and then returning. The pain is trigger by touch or temperature extremes. Physical examination is normal. Which of the following is the most likely diagnosis?Trigeminal neuralgia nurs 6531n final exam
76. Which of the following set of symptoms should raise suspicion of a brain tumor?
77. The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are):
78. A 25 year old overweight patient presents with a complaint of dull achiness in his groin and history of a palpable lump in his scrotum that “comes and goes”. On physical examination, the nurse practitioner does not detect a scrotal mass. There is no tenderness, edema, or erythema of the scrotum, the scrotum does not transilluminate. What is the most likely diagnosis?
79. Which of the following characteristics are associated with prepatellar bursitis?
80. Which drug category contains the drugs that are the first line Gold standard therapy for COPD?
81. A 35 year old male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency, and reduced force of stream. The nurse practitioner suspects acute bacterial prostatitis. Which of the following specimens would be least helpful for diagnosis?
82. In which of the following presentations is further diagnostic testing not warranted?
83. Which of the following physical modalities recommended for treatment of rheumatoid arthritis provides the most effective long term pain relief?
84. Which of the following accounts for half of the bladder tumors among men and one-third in women?Cigarette smoke, both active and passive inhalation
85. Martin is complaining of erectile dysfunction. He also has a condition that has reduced arterial blood flow to his penis. The most common cause of this condition is:
86. Which of the following is the most common complication of the myelodysplastic syndromes?
87. You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of nurs 6531n final exam
88. A 15 year-old female patient is 5 feet tall and weighs 85 pounds. You suspect anorexia and know that the best initial approach is to:
89. A patient taking levothyroxine is being over-replac. What condition is he at risk for?
90. A nurse practitioner diagnoses a 60 year old male with balanitis. Which disease is commonly …..with balanitis?
91. The diagnosis of human papilloma virus (HPV) infection in males is usually made by:
92. Martin, a 58 year old male with diabetes, is at your office for his PRO follow up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Martin receive today regarding the care if his feet?
93. Which of the following is a potential ….cause of thrombophilia?
94. Deficiency of which nutritional source usually presents with an insidious onset of paresthesias of the hands and feet that are usually painful?
95. What information should patients with diabetes and their families receive about hypoglycemia?
96. Josh, age 22, is a stock boy and has an acute episode of low back pain. You order and NSAID and tell him which of the following?
97. A 28-year-old female presents to the office requesting testing for diagnosis of hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her risk factors. The nurse practitioner explains that:
98. Which of the following is the most common cause of low back pain?
99. The cardinal sign of infectious arthritis is nurs 6531n final exam
100. Which of the following best reflects the National Osteoporosis Foundation daily calcium recommendations for adults?
101. Risk factors for osteoporosis include: 106. The Institute of Medicine’s recommended daily allowance (RDA) for Vitamin D in adults over age 70 years of age is:
102. A middle-aged man presents to urgent care complaining of pain of the medial condyle of the lower humerus. The man works as a carpenter and describes a gradual onset of pain. On exam, the medial epicondyle is tender and pain is …..with flexion and pronation. Range of motion is full The most likely cause of this patient’s pain is:
103. Which of the following characteristics are …..with prepatellar bursitis?
104. A patient complains of generalized joint pain and stiffness associated with activity and relieved with rest. This patient history is consistent with which of the following disorders?
105. A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects nurs 6531n final exam
106. Potential causes of septic arthritis include which of the following?
107. Your patient has an elevated mean cell volume (MCV). What should you be considering in terms of diagnosis?
108. Risk factors for Addison’s disease include which of the following?
109. Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)?
110. The physiological explanation of syncope is:
111. A 65-year-old patient complains of a recurrent bilateral temporal headaches, malaise, muscle aches, and low grade fever. The headache is ….as superficial tenderness rather than deep pain. Giant cell arteritis is suspect. Appropriate treatment is:
112. You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of:
113. Which history is commonly found in a patient with glomerulonephritis?
114. Sam, age 42, has had persistent proteinuria on the previous two office visits. Which action is warrant next?
115. The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy:
116. A typical description of a tension headache is nurs 6531n final exam
117. The treatment of choice for chronic bacterial prostatitis (CBP) is:
118. The obligatory criteria for diagnosis of muscular dystrophy (MD) are:
119. The primary goals of treatment for patients with alcohol abuse disorder are:
120. The most common presentation of thyroid cancer is: