SU NSG6420 Week 5 Midterm 2019 Question # 00596447 Course Code : NSG6420 Subject: Health Care Due on: 01/05/2019 Posted On: 01/05/2019 05:07 AM Tutorials: 1 Rating: 4.5/5

Week 5 Mid-term

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1.

A 22-year-old female comes to your office with complaints of
right lower quadrant abdominal pain, which has been worsening over the last 24
hours. On examination of the abdomen, there is a palpable mass and rebound
tenderness over the right lower quadrant. The clinician should recognize the
importance of

Digital rectal examination

Endoscopy

Pelvic
examination

UrinalysisDefinition

2.

Which of the following clinical reasoning tools is defined
as evidence-based resource based on mathematical modeling to express the
likelihood of a condition in select situations, settings, and/or patients?

Clinical practice guideline

Clinical decision
rule

Clinical
algorithm

Clinical
recommendation

3.

A common auscultatory finding in advanced CHF is

S3 gallop rhythm

4.

Mr. Keenan is a 42-year-old man with a mild history of GERD
and a remote history of an appendectomy, presenting with an acute onset of
significant right upper-quadrant abdominal pain and vomiting. His pain began
after a large meal, was unrelieved by a proton-pump inhibitor, was unlike his
previous episodes of heartburn, but upon questioning, reports milder, prodromal
episodes of similar post-prandial pain. His pain seems to radiate to his back.
Despite a family history of cardiac disease, he reports no classic anginal
signs or chest pain. He furthermore denies respiratory or pleuritic signs and
denies fever, night sweats, and unintended weight loss. Finally, there are no
dermatologic signs, nor genitourinary symptoms.

The chosen imaging study reveals: “GB normal in size without
wall-thickening, but with 5-6 stones with shadowing. Common bile duct not
dilated. Liver is homogenous and normal in size. Pancreas and kidneys are
normal.” What is the most effective therapeutic/management option at this
point?

chole

5.

A patient complains of fever, fatigue, and pharyngitis. On
physical examination there is pronounced cervical lymphadenopathy. Which of the
following diagnostic tests should be considered?

Mono spot

Strep test

Throat culture

All of the above

6.

Which of the following is not a contributing factor to the
development of esophagitis in older adults?

7.

Essential parts of a health history include all of the
following except:

8.

What test is used to confirm the diagnosis of appendicitis?

9.

The first assessment to complete related to the eyes is

Eye lids

Visual acuity

Extraocular
movements

Peripheral
vision

10.

The best way to diagnose structural heart
disease/dysfunction non-invasively is

Chest X-ray

EKG

CORRECT Echocardiogram

Heart
catheterization

11.

Which of the following is considered a “red flag” when
diagnosing a patient with pneumonia

Fever of 102

Infiltrates on
chest X-ray

Pleural effusion
on chest X-ray

Elevated white
blood cell count

12.

In a patient presenting with suspected recurrence of
diverticulitis, abdominal pain usually presents where in the abdomen?

Left upper quadrant

Right upper
quadrant

Left lower
quadrant

Right lower
quadrant

13.

Mr. A presents to your office complaining of chest pain,
mid-sternal and radiating to his back. He was mowing his lawn. He reports the
pain lasting for about 8 minutes and went away after sitting down. What is his
most likely diagnosis based on his presenting symptoms

Acute MI

GERD

Pneumonia

Angina

14.

In autosomal recessive (AR) disorders, individuals need

Only one mutated gene on the sex chromosomes to acquire the
disease

Only one mutated
gene to acquire the disease

Two mutated
genes to acquire the disease

Two mutated
genes to become carriers

15.

Susan P., a 60-year-old woman with a 30 pack year history,
presents to your primary care practice for evaluation of a persistent, daily
cough with increased sputum production, worse in the morning, occurring over
the past three months. She tells you, “I have the same thing, year after year.”
Which of the following choices would you consider strongly in your critical
thinking process?

chronic bronichitis

16.

The best evidence rating drugs to consider in a post
myocardial infarction patient include:

ASA, ACE/ARB, beta-blocker, aldosterone blockade

ACE, ARB,
Calcium channel blocker, ASA

Long-acting
nitrates, warfarin, ACE, and ARB

ASA,
clopidogrel, nitrates

17.

A 76-year-old patient with a 200-pack year smoking history
presents with complaints of chronic cough, dyspnea, fatigue, hemoptysis, and
weight loss over the past 2 months. The physical exam reveals decreased breath
sounds and dullness to percussion over the left lower lung field. The chest
X-ray demonstrates shift of the mediastinum and trachea to the left. These are
classic signs of:

Lung cancer

Tuberculosis

Pneumonia

COPD

18.

Upon assessment of respiratory excursion, the clinician
notes asymmetric expansion of the chest. One side expands greater than the
other. This could be due to

Pneumothorax

Pleural effusion

Pneumonia

Pulmonary
embolism

19.

A patient presents with eye redness, scant discharge, and a
gritty sensation. Your examination reveals the palpable preauricular nodes,
which are most likely with:

Bacterial conjunctivitis

B. Allergic
conjunctivitis

C. Chemical
conjunctivitis

D. Viral
conjunctivitis

20.

Emphysematous changes in the lungs produce the following
characteristic in COPD patients?

Asymmetric chest expansion

Increased
lateral diameter

Increased
anterior-posterior diameter

Pectus excavatum

21.

An older patient reports burning pain after ingestion of
many foods and large meals. What assessment would assist the nurse practitioner
in making a diagnosis of GERD?

A. Identification of
a fluid wave

B. Positive Murphy’s
sign

C. Palpable spleen

D. Midepigastric pain
that is not reproducible with palpation

22.

Which of the following details are NOT considered while
staging asthma?

A. Nighttime awakenings

B. Long-acting beta
agonist usage

C. Frequency of
symptoms

D. Spirometry
findings

23.

The cytochrome p system involves enzymes that are generally
Inhibited by drugs :

• Inhibited
by drugs

• Induced
by drugs

• Inhibited
or induced by drugs

• Associated
with decreased liver perfusion

24.

Mr. Keenan is a 42-year-old man with a mild history of GERD
and a remote history of an appendectomy, presenting with an acute onset of
significant right upper-quadrant abdominal pain and vomiting. His pain began after
a large meal, was unrelieved by a proton-pump inhibitor, was unlike his
previous episodes of heartburn, but upon questioning, reports milder, prodromal
episodes of similar post-prandial pain. His pain seems to radiate to his back.
Despite a family history of cardiac disease, he reports no classic anginal
signs or chest pain. He furthermore denies respiratory or pleuritic signs and
denies fever, night sweats, and unintended weight loss. Finally, there are no
dermatologic signs, nor genitourinary symptoms.

Of the following lab studies, which would provide little
help in determining your differential diagnosis?

Abdominal plain
films

Liver function
tests

Amylase/lipase

Urinalysis

25.

Jeff, 48 years old, presents to the clinic complaining of
fleeting chest pain, fatigue, palpitations, lightheadedness, and shortness of
breath. The pain comes and goes and is not associated with activity or
exertion. Food does not exacerbate or relieve the pain. The pain is usually
located under the left nipple. Jeff is concerned because his father has cardiac
disease and underwent a CABG at age 65. The ANP examines Jeff and hears a
mid-systolic click at the 4th ICS mid-clavicular area. The ANP knows that this
is a hallmark sign of:

Angina

Pericarditis

Mitral valve
prolapse

Congestive heart
failur

26.

Men have faster and more efficient biotransformation of
drugs and this is thought to be due to:

• Less
obesity rates than women

• Prostate
enlargement

• Testosterone

• Less
estrogen than women

27.

An 82-year-old female presents to the emergency department
with epigastric pain and weakness. She admits to having dark, tarry stools for
the last few days. She reports a long history of pain due to osteoarthritis.
She self-medicates daily with ibuprofen, naprosyn, and aspirin for joint pain.
On physical examination, she has orthostatic hypotension and pallor. Fecal
occult blood test is positive. A likely etiology of the patient’s problem is:

Mallory-Weiss tear

B. Esophageal varices

C. Gastric ulcer

D. Colon cancer

28.

You have a patient complaining of vertigo and want to know
what could be the cause. Knowing there are many causes for vertigo, you
question the length of time the sensation lasts. She tells you several hours to
days and is accompanied by tinnitus and hearing loss. You suspect which of the
following conditions?

Ménière’s disease

Benign
paroxysmal positional vertigo

Transient
ischemic attack (TIA)

MigraineDefinition

29.

. Your patient has been treated for glaucoma for 5 years.
Which of the following will provide indication of the level of progression
during the funduscopic examination for this patient?

Checking the macula

Estimating
cup-to-disk ratio

Verifying a red
reflex

Extraocular
movements

30.

If it has been determined a patient has esophageal reflux,
you should tell them:

They probably have a hiatal hernia causing reflux

They probably
need surgery

They should
avoid all fruit juices

Smoking,
alcohol, and caffeine can aggravate their problem

31.

The following criterion is considered a positive finding
when determining whether a patient with asthma can be safely monitored and
treated at home:

Age over 40

Fever greater than
101

Tachypnea greater than 30 breaths/minute

Productive cough

32.

Jenny is a 24 year old graduate student that presents to the
clinic today with complaints of fever, midsternal chest pain and generalized
fatigue for the past two days. She denies any cough or sputum production. She
states that when she takes Ibuprofen and rest that the chest pain does seem to
ease off. Upon examination the patient presents looking very ill. She is
leaning forward and states that this is the most comfortable position for her.
Temp is 102. BP= 100/70. Heart rate is 120/min and regular. Upon auscultation a
friction rub is audible. Her lung sounds are clear. With these presenting
symptoms your initial diagnosis would be

Mitral Valve Prolapse

Referred Pain from Cholecystitis

Pericarditis

Pulmonary Embolus

33.

During auscultation of the chest, your exam reveals a loud
grating sound at the lower anterolateral lung fields, at full inspiration and
early expiration. This finding is consistent with:

Pneumonia

Pleuritis

Pneumothorax

A and B

34.

Your 35-year-old female patient complains of feeling
palpitations on occasion. The clinician should recognize that palpitations are
often a sign of

Anemia

Anxiety

Hyperthyroidism

All of the
above

35.

Presbycusis is the hearing impairment that is associated
with:

Physiologic aging

Ménière’s
disease

Cerumen
impaction

Herpes zoster

36.

Functional abilities are best assessed by :

• Self-report
of function

• Observed
assessment of function

• A
comprehensive head-to-toe examination

• Family
report of function

37.

In examining the mouth of an older adult with a history of
smoking, the nurse practitioner finds a suspicious oral lesion. The patient has
been referred for a biopsy to be sent for pathology. Which is the most common
oral precancerous lesion?

Fictional keratosis

Keratoacanthoma

Lichen
planus

Leukoplakia

38.

The aging process causes what normal physiological changes
in the heart?

The heart valve thickens and becomes rigid, secondary to
fibrosis and sclerosis

Cardiology
occurs along with prolapse of the mitral valve and regurgitation

Dilation of the
right ventricle occurs with sclerosis of pulmonic and tricuspid valves

Hypertrophy of
the right ventricle

39.

In assessing the eyes, which of the following is considered
a “red flag” finding when associated with eye redness?

History of prior red-eye episodes

Grossly
visible corneal defect

Exophthalmos

Photophobia

40.

Helicobacter pylori is implicated as a causative agent in
the development of duodenal or gastric ulcers. What teaching should the nurse
practitioner plan for a patient who has a positive Helicobacter pylori test?

A. It is highly
contagious and a mask should be worn at home.

B. Treatment regimen
is multiple lifetime medications.

C. Treatment regimen
is multiple medications taken daily for a few weeks.

D. Treatment regimen
is complicated and is not indicated unless the patient is symptomatic.