NURS6531 Final Exam Latest 2021 July

Question 1When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

                Yes

                No

Question 2A typical description of a tension headache is:

                Periorbital pain, sudden onset, often explosive in quality, and associated with nasal stuffiness, lacrimation, red eye, and nausea.

                Bilateral, occipital, or frontal tightness or fullness, with waves of aching pain.

                Hemicranial pain that is accompanied by vomiting and photophobia.

                Steadily worsening pain that interrupts sleep, is exacerbated by orthostatic changes, and may be preceded by nausea and vomiting.

Question 3A 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:

                Primary hyperparathyroidism is treated with Vitamin D restriction

                Primary hyperparathyroidism is treated with parathyroidectomy

                Primary hyperparathyroidism is treated with daily magnesium

                Primary hyperparathyroidism is treated with parenteral parathyroid hormone (PTH)

Question 4At what age is screening most likely to detect scoliosis?

                4 to 6 years

                8 to 10 years

                12 to 14 years

                18 to 20 years

Question 5Potential side effects of levofloxacin include which of the following?

                Confusion

                Hypoglycemia

                Achilles tendon rupture

All of the above

Question 6What intervention does the American College of Rheumatology recommend as first line therapy for osteoarthritis?

                Extensive diagnostic work-up

                NSAIDs at therapeutic doses

                Early joint replacement

                Exercise and weight loss

Question 7A patient has just been diagnosed with Bell’s palsy. He is understandably upset and has questions about the prognosis. You response should be:

                Although most of your symptoms will disappear, some will remain but can usually be camouflaged by altering your hairstyle or growing a beard

                Unfortunately there is no cure but you have a mild case

                The condition is self-limiting and most likely complete recovery will occur

                With suppressive drug therapy you can minimize the symptoms

Question 8 Which of the following patients most warrants screening for hypothyroidism?

                A young adult female with postpartum depression lasting 2 weeks.

A patient taking thyroid replacement preparation.

                A 40 year old male with unexplained tremors.

                An elderly female with recent onset of mental dysfunction.

Question 9Steve, 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?

                Apples

                Peppermint

                Cucumbers

                Popsicles

Question 10Diagnostic evaluation of hypothyroidism reveals:

                Elevated TSH and decreased T4

                Decreased TSH and increased T4

                Decreased TSH and decreased T3

Elevated TSH and increased T4

Question 11The most accurate measure of diabetes control is:

                Avoidance of micro- and macro-vascular complications.

                Insulin sensitivity.

                Early morning glucose levels.

                HgbA1c

Question 12 The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is:

                Rest from activities which may further stress the bone.

                Daily passive range of motion exercises.

                Continuation of the patient’s routine physical activities.

                Application of ice after activity.

Question 13The most effective treatment of non-infectious bursitis includes:

                Systemic antibiotic therapy effective against penicillin resistant Staphylococcus areus.

                Rest, an intra-articular corticosteroid injection, and a concomitant oral NSAID.

                A tapering regimen of oral corticosteroid therapy.

                Frequent active range of joint motion.

Question 14Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond?

                “Caffeine has not effect on osteoporosis.”

                “A high caffeine intake has a diuretic effect that may cause calcium to be excreted more rapidly.”

                “Caffeine affects bone metabolism by altering intestinal absorption of calcium and assimilation of calcium into the bone matrix.”

                “Caffeine increase bone resorption.”

Question 15Diagnostic evaluation for urinary calculi includes:

                Urinalysis and culture

                Non contrast CT

                Serum calcium

                All of the above

Question 16A 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?

                Decrease the evening insulin dose and check capillary blood glucose (CBG) at 2:00 am.

                Instruct the child’s parents on physical activities to help weight loss.

                Increase the evening insulin dose and check CBG at 2:00 am.

                Refer the child for instruction on a strict diabetic diet.

Question 17A 65 year old patient complains of recurrent bilateral temporal headaches, malaise, muscle aches, and low grade fever. The headache is described as superficial tenderness rather than deep pain. Giant cell arteritis is suspected. Appropriate treatment is:

                Refer for temporal artery biopsy and initiation of oral prednisone.

                Aspirin or acetaminophen every 4 hours as needed for pain and fever.

                A daily β-blocker such as propranolol.

                CT scan of the head and lumbar puncture for CSF evaluation.

Question 18The physiological explanation of syncope is:

                Accelerated venous return and increased stroke volume resulting in deactivation of the parasympathetic nervous system.

                A cycle of inappropriate vasodilation, bradycardia, and hypotension.

                A sudden rise in blood pressure due to overly efficient vasoconstriction.

                Emotional stress resulting in hypertension, tachycardia, and increased venous return.

Question 19Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse?

                “What was it you did to make him angry?”

                “You must seek refuge immediately.”

                “I am concerned about your safety.”

                “I am going to call a shelter for you.”

Question 20The primary goals of treatment for patients with alcohol abuse disorder are:

                Reduction in withdrawal symptoms and reduction in desire for alcohol

                Psychotherapeutic and pharmacological interventions to decrease desire for and effects of alcohol

                Abstinence or reduction in use, relapse prevention, and rehabilitation

                Marital satisfaction, improvement in family functioning, and reduction in psychiatric impairment

Question 21A 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?

                1 week

                2 weeks

                4 weeks

                8 weeks

Question 22Which history is commonly found in a patient with glomerulonephritis?

                Beta-hemolytic strep infection

                Frequent urinary tract infections

                Kidney  stones

                Hypotension

Question 23 Risk factors for prostate cancer include all of the following except:

                Family history

                Benign prostatic hypertrophy

                African American race

                Age

Question 24The treatment of choice for chronic bacterial prostatitis (CBP) is:

                Erythromycin 4 times daily for 7 to 10 days

                Doxycycline twice daily for 7 to 10 days

                A fluoroquinolone daily for 3 weeks to 4 months

                Bactrim DS daily for 4 to 16 weeks

Question 25The cardinal sign of infectious arthritis is:

                Affected joint is painful at rest, with movement and weight bearing

                Rapid onset that wakes the patient during the night

                Long history of severe pain with associated joint swelling

                None of the above

Question 26Which factors are associated with high risk for foot complications in a patient with diabetes mellitus?

1.            Obesity

2.            Abnormal nails

3.            Abnormal gait

4.            Poorly controlled lipids

                1, 2, 3

                2, 3, 4

                2, 3

                1, 4

Question 27What diabetic complications result from hyperglycemia?

1.            Retinopathy

2.            Hypertension resistant to treatment

3.            Peripheral neuropathy

4.            Accelerated atherogenesis

                1, 2, 3

                2, 3, 4

                1, 3, 4

                1, 2, 4

Question 28The correct treatment for ankle sprain during the first 48 hours after injury includes:

                Alternating heat and ice, and ankle exercises.

                Resistive ankle exercises, ankle support, and pain relief.

                Rest, elevation, compression, ice and pain relief.

                Referral to an orthopedist after x-rays to rule out fracture.

Question 29Which patient would benefit most from screening for type 2 diabetes?

                A 30 year old female with unintended weight loss.

                A 25 year old male with family history of type 1 diabetes

                An obese female with recurrent vaginitis

                A 50 year oldhyperlipidemic male

Question 30Major depression occurs most often in which of the following conditions?

                Myocardial infarction

                  Parkinson’s disease

                  Stroke

                Alzheimer’s disease

Question 31Which drug category contains the drugs that are the first line Gold standard therapy for COPD?

                Corticosteroids

                Inhaled beta-2 agonist bronchodilators

                Inhaled anticholinergic bronchodilators

                Xanthines

Question 32A thymectomy is usually recommended in the early treatment of which disease?

                  Parkinson’s disease

                Multiple sclerosis

                  Myasthenia gravis

                Huntington’s chorea

Question 33Urine cultures should be obtained for which of the following patients?

                Suspected urinary tract infection in pregnancy

                Febrile patients

                Young men

                All of the above

Question 34Jack, age 55, comes to the office with a blood pressure of 144/98 mm Hg. He states that he did not know if it was ever elevated before. When you retake his blood pressure at the end of the exam, it remains at 144/98. What should your next action be?

                Start him on an ACE Inhibitor

                Start him on a diuretic

                Have him monitor his blood pressure at home

                Try nonpharmacological methods and have him monitor his blood pressure at home

Question 35Diagnostic radiological studies are indicated for low back pain:

                Routinely after 3 weeks of low back pain symptoms.

                To screen for spondylolithiasis in patients less than 20 years of age with 2 weeks of more of low back pain.

                When there is a suspicion of a space-occupying lesion, fracture, cauda equina, or infection.

                As a part of a pre-employment physical when heavy lifting is included in the job description.

Question 36Which of the following accounts for half of the bladder tumors among men and one-third in women?

                Cigarette smoke, both active and passive inhalation

                Chemicals from plastic and rubber

                Chronic use of phenacetin-containing analgesic agents

                Working long hours and not voiding often

Question 37Which of the following is the most common causative organism of nongonococcal urethritis?

                Chlamydia trachomatis

                Ureaplasmaurealyticum

                Mycoplasma hominis

                Trichonomas vaginalis

Question 38A 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:

 Consult with a physician

A 14 day course of ciprofloxacin

 To obtain blood cultures from separate site

Obtain urine cultures, CBC, and initiate antibiotic therapy

Question 39The most common cause of elevated liver function tests is:

                Hepatitis

                Biliary tract obstruction

                Chronic alcohol abuse

                A drug-induced injury

Question 40A nurse practitioner diagnoses a 60 year old male with balanitis. Which disease is commonly associated with balanitis?

                Congestive heart failure (CHF)

                Dyslipidemia

                Erectile dysfunction (ED)

                Diabetes mellitus (DM)

Question 41Legal authority for advanced practice nursing rests with:

                The Health Care Financing Administration

                Federal statutes

                State laws and regulations

                Certifying bodies

Question 42 A patient taking levothyroxine is being over-replaced. What condition is he at risk for?

                Osteoporosis

                Constipation

                Depression

                Exopthalmia

Question 43A 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 increased with flexion and pronation. Range of motion is full The most likely cause of this patient’s pain is:

                Gout

                Epicondylitis

                Osteoarthritis

  Lyme disease

Question 44A positive drawer sign supports a diagnosis of:

 Sciatica

 Cruciate ligament injury

 Meniscal injury

 Patellar ligament injury

Question 45Sam, age 42, has had persistent proteinuria on the previous two office visits. Which action is warranted next?

                Order and intravenous pyelogram

                Admit Sam to the hospital

                Schedule extensive blood work

                Have Sam collect one urine specimen on first arising and then another 2 hours later

Question 46What is the first step in the treatment of uric acid kidney stones?

                Encouraging hydration

                Alkalinizing the urine

                Prescribing allopurinol

                Reducing protein intake

Question 47Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following:

                HbA1C

                2-hour 75 gram oral glucose tolerance test

                C-peptide level

                A and B

                All of the above

Question 48An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days later, he returns to the office complaining of left great toe pain. On exam, the nurse practitioner notes an edematous, erythematous tender left great toe. The likely precipitant of this patient’s pain is:

                Trauma

                Tight shoes

                Arthritis flare

                Hydrochlorothiazide

Question 49A 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?

                Prescribe an alpha adrenergic blocker

                Recommend saw palmetto

 Prescribe an antibiotic

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