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NR 601 Final Exam – Question with Answers

1. Which of the following statements is NOT true about palliative care teams?
2. A 55-year-old women has type 2 DM she had three UTIs in the last 9 months and she is concerned about her kidneys. She has no report of dysuria, frequency or urgency at this time. Which of the following is the best action to follow?
3. According to the sexuality presentation, atrophic vaginitis (AV)
4. L 55-year-old women with BMI of 28, has 20-yearhx of primary HTN and has been on hydrochlorothiazide 25 mg daily for years with excellent response. During follow up visit Mrs L reports that for the last 6 months she has felt thirsty all of the time even though she drinks at least 10 glasses of water a day. Upon chart review the N notes that the last two fasting blood glucose levels have been 136 mg/dl and 165 mg/dl. The NP checks a random blood glucose, which is 210 mg/dl. What is the next appropriate test?
5. A patient has been prescribed Metformin (Glucophage). One week later he returns with lowered blood sugars but complaints of some loose stools during the week. How should the NP respond?
6. A 60-year-old obese male client has type 2 DM and a lipid panel of TC= 250, HDL = 32, LDL= 165. The NP teaches the patient about his modifiable cardiac risk factors which include:
7. Lifestyle approaches to postmenopausal symptom management include
8. When treating depression associated with dementia, which of the following would be a poor choice and should not be prescribed?
9. How does women’s anatomy make them more susceptible to UTIs?
10. A 48-year-old male patient screened for diabetes has a fasting plasma glucose level of 120 mg/dl. The NP plan includes
11. Which of the following assessments are commonly noted in a client with Parkinson’s disease?
12. A 76-year-old man is seen in the office for c/o urinary incontinence. The clinician should explore which of these causes of incontinence in men?
13. Which of the following maneuvers is contraindicated in acute prostatis?
14. N a 65-year-old women with BMI of 29 on Medicare , has a 20-yearhx of primary HTN and has been on HCTZ 25 mg daily for years , reports that for the past 6 months she has felt thirsty all of the time even though she drinks at least 10 glasses of water a day. Upon charting NP notes that the last two fasting blood glucose levels  have been 136 mg/dl and 165 mg/dl. What actions should the NP perform next?
15. According to the WHO analgesic ladder, which drug combination would be most appropriate in an opiate-naïve patient who presents with moderate pain?
16.  The cornerstone of pharmacotherapy in treating Alzheimer’s disease is :
17.  The highest level of evidence to support interventions at the end of life is with:
18.  The comorbid psychiatric problem with the highest frequency in dementia is:
19. All of the following are true statements regarding elder abuse EXCEPT:
20.  Which of the following is a role of the advanced nurse in ?????
21.  The proposed mechanism by which diphenhydramine causes delirium is:
22.  A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea) is :
23. According to the Palliative Care presentation, hospice care may be provided to:
24.  A 68-year-old women is being worked up for stress incontinence. UA reveals positive leukocyte esterase, positive nitrites, 15 WBCs, no RBS, no protein, no casts. She denies frequency, urgency, suprapubic pressure or urgency. What is the first treatment for her US results?
25.  The elderly are at higher risk for delirium because of:
26. A 63-year-old man is seen in the clinic with a c/o nocturia. Which of the following should be included in the differential diagnosis?
27.  A 75-year-old man is being treated as an outpatient for metastatic prostate cancer. Which of the following statements is true regarding the management of pain with opioids in the elderly?
28.  The highest level of evidence with the use of adjuvant analgesics is with:
29.  The 56-year-old man with chronic prostatis should initially be treated with antibiotics for how long?
30. A 50-year-old female patient screened for diabetes has a fasting plasma glucose level of 124 mg/dl. The NP plan includes:
31.  When assessing a patient who complains of a tremor, the NP must differentiate essential tremor from the tremor of Parkinson’s disease. Which of the following findings are consistent with essential tremor?
32.  Which characteristic of delirium helps to distinguish it from dementia?
33. According to the sexuality presentation, the biggest barrier to appropriate sexual evaluation in the older patient:
34. Smith a 65-year-old women presents to the clinic for the first time and c/o UI and dyspareunia, she went through menopause 10 years ago without any hormone replacement therapy and had a hysterectomy for fibroid. Her mother had a hip fracture at 82, pt had mammogram 5 years ago and no known fam hx of breast cancer……you decide to begin topical hormone replacement therapy. Which of the following evaluations would be necessary prior initiating hormone replacement therapy?
35.  A experienced a brief onset of right-sided weakness, slurred speech and confusion yesterday. The symptom has resolved. What should the NP do?
36.  Any women with a complicated cystitis or symptoms of upper tract disease needs a urine culture and
37. All of the following patients have a risk of adverse reaction from Metformin except:
38. A middle-aged patient has been diagnosed with Parkinson’s disease. What influences the NP’s decision to begin pharmacological treatment for this patient?
39. Which of the following medications can blunt the signs of hypoglycemia in diabetes?
40. The Mini-cog is a short screening tool used to assess cognition. Which of the following statements pertaining to the test is a true statement?
41. What is a sign of insulin resistance that can present in African American patients?
42. Age related changes in bladder, urethra and ureters include all of the following in older womenexcept:
43. The majority of patients enrolled in hospice care die:
44. Diabetes is the leading cause of:
45. A male pt with a BMI of 30 presents to the office for an annual exam. You ordered a CMP as part of routine labs. The fasting glucose was 130. Your next action is:
46. A pelvic mass in a postmenopausal woman:
47. A 65-year-old Hispanic woman presents to the office for routine follow up for her DM2. Her routine UA results are as follows: few epithelial cells, negative leukocytes, negative nitrates, negative protein, no ketones. Which test would you order next?
48. Hospice services and palliative services are underutilized due to:
49. Which of the following would be an appropriate treatment for a patient with mild BPH?
50.  The most common neurological cause of seizures in an older adult is:
51. A 68-year-old women presents with a c/o urine leakage whenever she sneezes, laughs, or strains for the past 4 months. She denies dysuria, frequency and nocturia. US dipsticks is negative for RBCs, leukocytes esterase, nitrites, ketones and urobilinogen. What is the diagnosis?
52. The tasks of grieving include all of the following EXCEPT:
53.  Acanthosis nigrans is associated with all of the following conditions except:
54.  Which of the following statements is trueregarding pain?
55. A 51-year-old male pt screened for diabetes has a fasting plasma glucose level of 98 mg/dl. The NP plan includes:
56. Increased risk factors for erectile dysfunction include all EXCEPT:
57. When assessing an elderly client who reports a tremor, which assessment findings would be most reliable in identifying Parkinson’s disease?
58.  Which of the following is the most appropriate screening tool for delirium?
59. An 82-year-old man is seen in the primary care office with complaints of dribbling urine, difficulty starting his stream. Which of the following should be included in the list of differential diagnosis?
60. The patient with BPH is seen for follow up. He has been taking finasteride(Proscar) for 6 months. The clinician should assess this patient for which of the side effects?
61. Hospice care differs from palliative care in that:
62. According to the genitourinary presentation, the number 1 risk factor for urinary incontinence is:
63. The firs step in treating delirium is to:
64.  Which of the listed conditions is most likely to cause delirium?
65. You are working up a 52-year-old patient for microscopic hematuria. Your differential diagnosis list includes all of the following EXCEPT:
66. A 55-year-old Caucasian man with type 2 DM presents to the clinic a as new pt. he takes metformin 500 mg twice a day. His last Hgb A1C was 7%. He is up to date on eye and foot examinations. His BP is 142/96. According to JNC8, what is the most appropriate medication?
67. Delirium is typically characterize by all of the following except:
68. An 80-year-old female widow asks her NP about hospice enrolment. Her diagnosis includes congestive HF, HTN and DM2. She has noticed that in the last month she has lower extremity edema and she is finding it difficult to walk to the grocery store and church, she does not use oxygen. She-is able to maintain her home but requires more frequent rest after vacuuming. She does not wish to be admitted to the hospital again in the future but if admitted wants to remain full code status. Why is this patient NOT appropriate for hospice?
69. Jean a 42-year-old, presents to the clinic with c/o dysuria, frequency and strong odor of her urine for 5 days. This is the second occurrence this year. What is the appropriate next step to this patient?
70. All of the following patients should be …..for diabetes EXCEPT:
71. A male patient with a BMI of 33 presents to the office with c/o fatique, excessive hunger and excessive thirst. You suspect type 2 DM . initial testing to confirm diagnosis can include nr 601 final exam
72. An 87-year-old tells the NP that his grandson locks him in his bedroom when he goes out. The grandson withholds food if the patient does not give him money every week. The patient appears frail, ungroomed, and his clothes are visibly dirty and smell of urine. Which of the following is the best action for NP?
73.  The leading cause of death in elderly travelers worldwide is:
74. The majority of depressed older adults remain untreated because of :
75.  When examining the spine of an older adult you notice a curvature with a sharp angle. This is refer to as a:
76. Which of the following patients has the highest risk for the development of osteoporosis?
77.  When assessing a patient’s mental health, the NP knows nr 601 final exam
78.  You are working with an older male adult with a long hx of alcohol abuse and a 30-yearhx of smoking. In recommending an intervention for this client, your responsibility is to:
79. The pathophysiology of heart failure is due to:
80. The leading cause of disability worldwide is:
81.  Which of the following patients has the highest risk for the development of osteoporosis?
82.  G is a 65-year-old Caucasian female who presents for her yearly physical. A review of her chart reveals she smokes 1 pack of cigarettes a day, and drinks 2 beers every evening since she retired. She does not exercise, she likes to sit and knit. The NP know the NONMODIFIABLE risk factor for osteoporosis for Mrs. G is  nr 601 final exam
83. The NP orders bilateral wrist X-rays on a 69-year-old gentleman c/o of pain in both wrists for the past 6 weeks not related to any known trauma. The NP suspects elderly onset RA. The initial radiographic finding in a patient with elderly onset RA would be nr 601 final exam
84.  The NP is reviewing a patient chart prior to the start of the encounter. The-NP notes that the patient is using topical CAPSAICIN. The NP knows that topical capsaicin id often used for treatment of:
85. Which of the following statements about OA is true?
86.  MJ presents to the clinic with the following hx and presentation: hx of structural damage with current s/s of HF. Treatment will be based on MJs stage of HF which is:
87. Dietary supplements such as Omega 3 (fish oils) are often ….for cardioprotective benefit. The NP knows regarding Omega 3 consumption nr 601 final exam
88. A 55-year-old Caucasian male pt follows up with you after referral to a cardiologist. The pt reports he thinks the medication is causing cough and sometimes he has difficulty breathing, which of the following medication was most likely …….?
89. The prevalence of depression in nursing home residents is _____greater than adults living in the community:
90. The NP orders bilateral wrist Xrays on a 69-year-old gentleman c/o of pain in both wrists for the past 6 weeks not related to any known trauma. The NP suspects elderly onset RA. The initial radiographic finding in a patient with elderly onset RA would be:
91. The NP knows that the goal of treatment for anxiety should:
92. All of the following statements are true regarding anxiety EXCEPT:
93. Which of the following best describes the pain associated with OA?
94. Which organism that can be prevented by immunization is most often responsible for infectious outbreak in the nursing home setting?
95. JK 60 year old women comes to the office today for evaluation of mgmt. plan of her c/o insomnia…..she wakes up after about 4 hrs and cannot return to sleep. The next step in treatment of insomnia is:
96.  You have ordered a CBC for your patient you suspect has PMR. Which two clinical findings are common in pt with PMR?
97. PG is a 58-year-old Caucasian man with stable mental health diagnosis of schizophrenia who presents for a yearly physical. PG is prescribe aripiprazole for treatment of his schizophrenia. The NP knows the following labs should be …..to assess for cardiometabolic changes related to his medication EXCEPT: