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NSG 6340 Final Exam 2 with Answers

1. Which of the following physical findings is consistent with a diagnosis of beta-thalassemia major?
2. Weber test with lateralization to right ear
3. Yesterday, a patient got sand in his eye during a volleyball game at the beach. Today, he presents with an exquisitely painful left eye, photophobia, and constant tearing. The nurse practitioner removes a tiny spec of sand from under the lid and notes vertical corneal abrasion. The treatment of choice is:
4. A critically ill patient states “my family is well provided for. The nurse practitioner must interpret this as meaning the patient
5. The patient who has iron deficiency anemia should be advise that food high in iron content include:
6. Appropriate therapy for peptic ulcer disease (PUD) is:
7. All of the following are medical emergencies which may be attribute to acute cocaine intoxication EXCEPT:
8. The treatment of choice for chronic bacterial prostatitis (CBP) is:
9. Before initiating a HMG-CoA-reductase inhibitor for hyperlipidemia, the nurse practitioner orders liver function studies. The patient’s aminotransferase (ALT) is elevated. What lavoratory test(s) should be ordered?
10. Subsequent to successful completion of the nurse practitioner certification exam, the candidate is considered to be:
11. Which of the following patient characteristics are associate with chronic bronchitis?
12. The nurse practitioner would be correct to include all of the following points in the education of patients with folic acid deficiency anemia EXCEPT:
13. On examination, a 67-year-old patient is note to have high-tone hearing loss. This finding is consistent with what diagnosis.
14. Which of the following is appropriate to teach a patient who is using a daily nitrate agent for treatment of chronic angina?
15. An 83-year-old has heart failure (HF). He takes Prinivil (Lisinopril), metoprolol (Lopressor), ASA, and low dose furosemide every morning. After assessing the patient today, the NP determines that he is having a mild exacerbation of HF. The LEAST likely cause of this is:
16. Upon ophthalmic examination of a 78-year-old patient, the nurse practitioner observes dark spots against a red retina. What diagnosis is this finding most consistent with?
17. Which immunization(s) is (are) contraindicated in an immunodeficient individual? 1. Varicella 2. IPV 3. MMR 4. HBV
18. Which of the following may predispose the patient to hyperglycemia?
19. An 18-year-old college student lives in the dormitory. He has been treated for scabies infestation with permethrin (Nix). He was asymptomatic for two weeks, but now complain again of itching and skin bumps. How should the nurse practitioner proceed?
20. Pre-diabetes is:
21. The nurse practitioner suspects a TMJ disorder. As the patient slowly opens and closes the lower jaw, the nurse practitioner palpates the temporomandibular joint (TMJ) bilaterally:
22. A patient newly diagnosed with Type 2 diabetes referred to a diabetes nurse educator and complete the initial educational program. The need for further education is indicated when the patient says which of the following?
23. A 44-year-old patient complains of stiffness and soreness in his hands, hips, and knees. There is noticeable PIP and DIP joint enlargement in his hands. The nurse practitioner suspects arthritis. All of the following questions are helpful in differentiation between rheumatoid arthritis (RA) and osteoarthritis(OA) EXCEPT:
24. Changes in pulmonary air flow associate with asthma exacerbations and remissions is best assessed by monitoring:
25. The most effective intervention to prevent stroke is (are):
26. A patient recovering from a recent stroke is starting anticoagulant therapy. The nurse practitioner should teach the patient to avoid all of the following EXCEPT:
27. What is the most common chronic condition in the elder population in the United States?
28. It is imperative that the nurse practitioner teach patients taking oral contraceptives to report any of the danger signs of complications. Which of the following, would be of LEAST concern to the nurse practitioner?
29. A patient reports to the nurse practitioner that he was diagnose with hepatitis B one year ago and has not seen a health care provider since then. What information should this patient be given?
30. An active 82-year-old male in good health complains “I don’t see as well as I used to and my eyes are very sensitive to glare.” His near-distant visual acuity is diminish, and he has a bilateral white pupillary reflex. The most likely diagnosis is:
31. A female patient asks “How do I calculate my ideal body weight?” The nurse practitioner appropriately answers:
32. What assessment findings are NOT typical of the patient with psoriasis?
33. A patient presents to the nurse practitioner with complaints of diarrhea and malaise which started at 2:00 am the morning of the visit. After history and examination, the nurse practitioner advises the patient that the problem should be self-limiting. If the diarrhea does not resolve, when should the nurse practitioner advise the patient to return?
34. The nurse practitioner diagnoses epididymitis in a 24-year-old sexually active male patient. The drug of choice for treatment of this patient is:
35. A 75-year-old patient is well controlled on timolol maleate (Timoptic) for chronic open-angle glaucoma. Prescribing propranolol (Inderal) for this patient may precipitate:
36. What intervention does the American College of Rheumatology recommend as first-line therapy for osteoarthritis?
37. Electrocardiogram markers of hypokalemia include all of the following EXCEPT:
38. Which of the following drugs classes would be most effective in decreasing elevated triglyceride levels (650 md/dL)?
39. The most effective treatment for anemia of chronic disease is:
40. A 17-year-old presents with a wound receive while building a fence. He has completed a primary vaccination series and he had a Td booster 3 years ago. Does he need a Td booster today?
41. Phalen’s test, 90 degress wrist flexion for 60 seconds, reproduces symptoms of:
42. Health People 2020 published by the U.S. Department of Health and Human Service:
43. A 16-year-old receive stitches in his arm after an accident. He tells the nurse practitioner that his last tetanus shot was “on time.” Should he receive another one?
44. Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis?
45. A 72-year-old patient reports a 6-month history of progressively more swollen and painful distal interphalangeal (DIP) joints of one hand. There are no systemic symptoms but the erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA) and rheumatoid factor (RF) are all minimally elevated. What is the most likely diagnosis?
46. Persons with thalassemia should avoid:
47. Of the following characteristics, which are most closely associate with risk for becoming an abusive parent? nsg 6340 final exam
48. The nurse practitioner must increase a patient’s dosage of theophylline to achieve a therapeutic level. After the dosage has been increased, a serum theophylline level should be checked:
49. Education of women with fibrocystic breast disease should include which of the following statements?
50. An adult patient has an S4 heart sound and the PMI is located at the 5th left ICS, left of the MCL. What are these findings associated with?
51. Which of the following is an appropriate drug for initial treatment of gastroesophageal reflux disease (GERD) in adults? nsg 6340 final exam
52. The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is:
53. What diabetic complications result from hyperglycemia? 1. Retinopathy 2. Hypertension resistant to treatment 3. Peripheral neuropathy 4. Accelerated atherogenesis
54. A 66-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?
55. The preferred therapeutic regimen for an 18-year-old pregnant patient diagnosed with Chlamydia trachomatis infection is:
56. An 80-year-old Caucasian female has heart failure (HF). Which symptom below is an early indication of failure?
57. What is the most common cause of Cushing’s syndrome?
58. A 45-year-old male is diagnose with hypertension. The blood pressures have been gradually increasing over time, with a reading today of 152/98. Diagnostic studies are normal. The most likely diagnosis for this patient is:
59. A patient with hepatic cirrhosis presents with pedal edema. He reports that his iwfe prepares the same lunch for him every day: a ham and cheese sandwich on white bread with mustard, a bowl of fresh vegetable soup, a fresh orange, banana or grapes, and sweetened iced tea. He denies adding salt to his food. The food that is most likely causing his edema is the:
60. A depressed patient has been treated and has had relief of symptoms while on medication for depression. Which patient statements is a correct understanding of depression? nsg 6340 final exam
61. A 16-year-old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be the LEAST appropriate to prescribe?
62. An 87-year-old patient was place on low dose amlodipine (Norvasc) for treatment of hypertensionadn angina. She takes no other medications. What side effects might be expected from amlodipine?
63. Patients diagnosed with polycystic ovarian disease are at increase risk of developing:
64. A patient present with an inflamed upper eyelid margin. The conjunctiva is red and there is particulate matter along the upper eyelid. The patient complains of a sensation that “there is something in my eye.” What is the diagnosis and how should it be treated?
65. What disease process are Bouchard’s nodes most commonly associate with?
66. An adult female presents with a hordeolum. A topical antibiotic is prescribed. Which of the following instructions is NOT appropriate advice for the nurse practitioner to give the patient?
67. A 43-year-old patient complains of dull ache around both ankles after a day’s work as a cashier. Her symptoms are relieved by sitting and elevating her legs. She reports ankle edema at the end of the day. What is the most likely cause of these problems?
68. A patient reports, “something flew in my eye” about an hour ago while he was splitting logs. If there was a foreign body in his eye, the nurse practitioner would expect to find all EXCEPT:
69. Which of the following is NOT a symptom of irritable bowel syndrome?
70. A 76-year-old female patient with chronic atrial fibrillation is taking warfarin (Coumadin) and being manage on an outpatient basis. What is the preferred laboratory test to evaluate this patient’s coagulation status?
71. Which drug(s) below would be expect to produce the least amount of hypokalemia?
72. Which choice below is NOT a symptom of COPD?
73. A 21-year-old patient presents with abdominal guarding, rigid abdominal musculature, rebound tenderness at McBurney’s point, and leukocytosis. What is the most likely diagnosis?
74. What is the marker for asthma in the WBC differential?
75. The most appropriate first-line drug treatment for African American patients diagnosed with hypertension is: nsg 6340 final exam
76. A 25-year-old female complains that she never had a bladder infection before she became sexually active, but now she has had 3 in the past year. What intervention is especially important for the nurse practitioner to teach this patient to help prevent recurrence of bladder infections?
77. An obese patient presents with intertrigo under her breasts. The nurse practitioner prescribes an anti-fungal cream and encourages her to:
78. The long-term prognosis for a patient with a diagnosis of dementia is:
79. A mother has been breastfeeding her infant since giving birth 6 weeks ago. Her right breast is engorge, erythematous, hot to touch, and very painful. She says the problem began 48 hours earlier. She has been feeding exclusively with the left breast. The nurse practitioner diagnosis acute mastitis and recommends all of the following EXCEPT:
80. Which murmur is associate with radiation to the neck?
81.  A 50-year-old nonsmoker with no comorbidities presents to the clinic and is diagnosed with community-acquired pneumonia. His vitals are normal except for temperature 101.6 F. A sputum specimen is collect and sent for culture and sensitivity. What action does the nurse practitioner take today?
82. correct answer is fenofibrate
83. A 24-year-old female insists on having a screening mammogram. Upon further questioning, the nurse practitioner discovers the patient is concerned about breast cancer because her mother has fibrocystic breast disease. The nurse practitioner would be accurate if she tells patient that a major risk factor for development of breast cancer in women is: nsg 6340 final exam
84. A 44-year-old female patient has diabetes. Her total cholesterol (TC) is 250 mg/dL (6.5 mmol/L), LDL=190 mg/dL (4.94 mmol/L), HDL = 25 mg/dL (6.5 mmol/L), and triglycerides = 344 mg/dL (8.94 mmol/L). What agent would have the greatest effect on improving her lipid profile and reducing morbidity and mortality associated with dyslipidemia?
85. In which of the following presentation is further diagnostic testing NOT warranted?
86. A 65-year-old presents with a past medical history of coronary artery disease, temperature 101 degrees F, tachypnea 24 breaths per minute, and consolidation in the left lower lobe. A chest x-ray confirms left lower lobe pneumonia. What antimicrobial agent(s) should the nurse practitioner prescribe?
87. A 17-year-old female is diagnose with secondary amenorrhea. Findings in her history which may account for the cessation of menses include all of the following EXCEPT she:
88. Atenolol (Tenormin) should be avoid in:
89. The correct treatment for ankle sprain during the first 48 hours after injury include:
90. Medical interventions that have proven most successful in the initial treatment of bulimia nervosa are:
91. Prescriptive authority for APRNs is:
92. What diagnosis is associate with an elevated serum amylase?
93. A very active 35-year-old male has painful hemorrhoids, but he does not want hemorrhoid surgery at this time. His diet has been indiscriminate as his job requires frequent travel. The most appropriate recommendation is for him to select foods that are:
94. An 18-year-old patient is diagnosed with classic migraine headache. Her headaches are frequent and debilitating. She is offer an abortive therapy, but say she would rather take a medication for prophylaxis. The nurse practitioner would recommend:
95. Which of the following set of symptoms should raise suspicion of a brain tumor? nsg 6340 final exam
96. A patient with a history of alcohol abuse presents with acute nausea vomiting, and severe retrosternal pain which radiates to the ____. Based on the most probable diagnosis, the nurse practitioner would appropriately order a CBC, chemistry profle, and:
97. A 65-year-old male patient presents with a history of alcoholism, hemoglobin of 10 g/dL, and mean corpuscular volume (MCV) 110. These laboratory values are most consistent with which of the following:
98. During a routine pre-employment screen, a patient is noted to have a positive hepatitis B surface antigen. This finding indicates he:
99. The nurse practitioner correctly teaches the patient with diabetes mellitus that if blood glucose is less than 100 mg/dL and she want to exercise, the patient should first consume 15 grams of carbohydrates, such as:
100. A 35-year old high school student presents with a mild sore throat, and low-grade fever that has persisted for about 1 week. She has general malaise, fatigue and loss of appetite. The nurse practitioner suspects mononucleosis. Which of the following is the LEAST appropriate intervention?
101. Which class of drugs increases a patient’s risk for developing rhabdomyolysis?
102. The nurse practitioner assess an asymptomatic 43-year-old male and determines that he is at minimal risk for a myocardial infarction (MI). The patient asks whether he would benefit from taking aspirin 325 mg every day to prevent an MI. What should the nurse practitioner recommend?
103. Which oral hypoglycemic agent would be safest for an elderly patient if hypoglycemia is a major concern? nsg 6340 final exam
104. A 42-year-old male executive has been diagnose with depression. He is otherwise healthy. An appropriate initial treatment choice is a:
105. A patient requests information about foods to include in his diet while vacationing in Mexico to avoid “Montezuma’s revenge.” The nurse practitioner should advise him to ingest only:
106. A 36-year-old penicillin allergic patient has folliculitis on a bearded part of his face. The nurse practitioner prescribes erythromycin and tells the patient:
107. A PPD is consider positive at 5 millimeters for which population?
108. According to Erikson, the developmental task of the elderly adult is: