Advanced Nursing Practice Care-2021-Fall-QTR-Term-wks-1-thru-11-(08/30/2021-11/14/2021)-PT27

NRNP-6565-4-Syntesis Advanced Nursing Practice Care-2021-Fall-QTR-Term-wks-1-thru-11-(08/30/2021-11/14/2021)-PT27 answers

Take Test: Exam – Week 10

Question 1

Osteoporosis is defined as having a T-score of _____ or less than the standard deviation of a healthy individual.

		1
		-1.5
		-2.5
		-3.5

C

Question 2

A smooth round nodule with a pearly gray border and central induration best describes which type of skin lesion? 

		Seborrheic keratosis
		Basal cell carcinoma
		Malignant melanoma
		Herpes zoster

B

Question 3

A 59 year old man with chronic prostatitis should be treated with trimethoprim 80mg-sulfamethoxazole 400mg (TMP-SMX,Bactrim) for how long?

		3 to 7 days
		14-21 days
		3 to 6 weeks
		6 to 12 weeks

D

Question 4

Treatment for H. pylori-negative ulcers includes all the following except:

		Stop NSAIDS
		Stop smoking
		Prilosec for 4–8 weeks
		Triple therapy including Biaxin, Flagyl, and amoxicillin

C

Question 5

Carlos is a 64 y/o male who has previously been diagnosed as a Category A COPD patient based on Gold guidelines (2017). The Category A patient group includes which of the following?

		Minimally symptomatic (low risk of exacerbation)
		More symptomatic (low risk of exacerbation)
		Minimally symptomatic (high risk of exacerbation)
		High risk

A

Question 6

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? 

		It is highly contagious and a mask should be worn
		Treatment regimen is multiple lifetime medications
		Treatment regimen is multiple medications taken daily for a few weeks
		Treatment regimen is complicated and is not indicated unless the patient is symptomatic  C

Question 7

Metabolic syndrome is characterized by all the following traits except

		Obesity
		Hypertension
		Dyslipidemia
		Hypoglycemia

D

Question 8

What is the first line of treatment for eczema? Select all that apply.

	a.	Hydrocortisone 2.5%
	b.	Triamcinolone acetonide
	c.	Oral steroids
	d.	None of the above

A, B, and C

Question 9

Acanthosis nigricans is associated with all the following except:

		Diabetes
		Metabolic syndrome
		Obesity
		Cancer of bladder

D

Question 10

The NP recognizes that potentially inappropriate medications for older adults (Beers List Criteria) may include:

	a.	NSAIDs
	b.	Alpha-blockers
	c.	Zolpidem
	d.	Cardiac drugs
	e.	All of the above

E

Question 11

A 19-year-old bisexual female wants to get tested for HIV. Based on CDC guidelines, what is the appropriate order of testing for HIV?

	a.	HIV-1/HIV-2 antibodies and P24 antigen
	b.	HIV RNA PCR
	c.	HIV-1 RNA
	d.	HIV antibody differentiation immunoassay

A

Question 12

The Influenza vaccine should be given annually. True or False?

 True

 False

A

Question 13

A 32 y/o female comes to the clinic for what she describes as “a dark-colored urine.” During the exam, the NP uses a urine dipstick to test for blood in the urine. Since the result had so many false negative and false positive indicators, the next step would be:

		Urinalysis with microscopy
		Urine culture
		Referral to urologist
		Cystoscopic examination of bladder

A

Question 14

A 35 year-old woman is seen with complaints of vaginal itching, burning, and discharge.  On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae.  Which of the following treatments would be appropriate? 

		Estrogen vaginal cream
		Metronidazole
		Doxycycline
		Fluconazole

D

Question 15

A 32 y/o female comes to the clinic for what she describes as “a dark-colored urine.” During the exam, the NP uses a urine dipstick to test for blood in the urine. In reading the results, he/she discovers the following false negative readings characterized by all the following except:

		High concentration of ascorbic acid
		Dehydration
		High specific gravity
		Prolonged exposure of dipstick to air before testing

D

Question 16

Hemoglobin A1C is the average glucose level of what length of time?

		1 month
		2 months
		3 months
		4 months

C

Question 17

A 36-year-old reports to clinic with complaints of a cough for over 2 weeks. The patient has a history of asthma. The patient is wheezing and has a fever. The patient O2 sat is 95%. You would expect the NP to treat the patient with

	a.	Nebulizer treatment, inhaler, steroid, and antibiotic
	b.	Refer for emergency hospitalization
	c.	Nebulizer treatment only
	d.	IV steroid only

C

Question 18

Bupropion (Wellbutrin) is contraindicated in patients with anorexia/bulimia because of the potential for increasing the seizure threshold.

 True

 False

A

Question 19

Patients with bipolar disorder may have all the following except:

		Delusions
		Hallucinations
		Lower rates of substance abuse
		A & B only

C

Question 20

________________vaccine is given in two separate doses to prevent Shingles.

	A.	Shingrix
	B.	Pneumococcal
	C.	Influenza
	D.	TDAP

A

Question 21

Mr. Richards is a 65 year old caucasian male who presents to your office with complaints of decreased arm swing and cogwheel rigidity.  What conditions are these symptoms a manifestation of? 

		Multiple Sclerosis
		Parkinson’s Disease
		Vascular Dementia
		Rheumatoid Arthritis

B

Question 22

Which of the following glands is responsible for calcium balance in the body?

		Posterior pituitary
		Parathyroid glands
		Thyroid gland
		Pineal gland

B

Question 23

The NP recognizes that the main focus of treatment for Anemia is:

		replenishing iron stores
		management of the underlying disorder
		providing for adequate nutrition high in iron
		administration of monthly vitamin B12 injections

B

Question 24

The use of steroids in the treatment of fungal infections will worsen the infection.

 True

 False

A

Question 25

State laws about NP practice take two forms:

	a.	Regulations and prescriptive authority
	b.	Statutes and Regulations
	c.	Regulations and prescriptive authority
	d.	Regulations and Licensure

B

Question 26

Jason is 72 y/o COPD patient who has a 50-year history of smoking. He now has pneumonia. The most likely causative organism for his pneumonia is:

		Mycoplasma pneumoniae
		Chlamydia pneumoniae
		H. influenzae bacteria
		None of the above

C

Question 27

One of the most common side effects of SSRIs is:

		Nausea
		Ataxia
		Erectile dysfunction
		SeizuresC

Question 28

Which of the following are non-antibiotic strategies to prevent UTIs?

		Estrogen therapy
		Cranberry juice/extract
		Methenamine salts
		Lactobacillus
		All of the above

D

Question 29

A nurse practitioner (NP) is applying for an NPI number. The NP recognizes that the purpose of NPI is to

	a.	A number for ICD-10 code
	b.	A number for Medicare/Medicaid billing
	c.	To reimburse patients for receiving patient care
	d.	To bill to Tricare insurance

D

Question 30

You would recommend the pneumococcal vaccine (Pneumovax) to patients with all of the following conditions except:

	a.	HIV infection
	b.	Asthma
	c.	Sickle Cell anemia
	d.	G6PD-deficiency anemia

D

Question 31

All of the following are pharmacological treatments for osteoporosis except:

		Biphosphates
		Thyroid stimulating hormone
		Tamoxifen
		Parathyroid hormone analog

B

Question 32

An older woman with osteoporosis wants to be treated with Fosamax. The nurse practitioner (NP) recognizes that the patient is not a good candidate for this drug because of

	a.	Stomach/intestinal problems
	b.	Jaw pain
	c.	A and B
	d.	A only

C

Question 33

A nurse practitioner (NP) portfolio should include some but not all of the following:

	a.	Statement of career goals, special interests, transcripts, diploma, letters of recommendation
	b.	Statement of career goals, preferred salary, special interests, diploma, letters of recommendation from professors
	c.	Statement of career goals, special abilities, preferred salary, special interests, diploma
	d.	All of the above

A

Question 34

The NP recognizes that Beta-Blockers are contraindicated in patients with

	a.	Hypertension
	b.	Asthma
	c.	Thyroid disease
	d.	SSRIs
	e.	None of the above

B

Question 35

You are seeing a patient who reports possible symptoms of stress incontinence. Patients with stress incontinence often report urine loss: 

		at night
		with lifting
		associated with a strong sensation of needing to void
		as dribbling after voiding

C

Question 36

Ms. Jacobs, a 67 year old female is being seen today concering her Rheumatoid Arthritis. The best form of aerobic exercise for a patient with severe rheumatoid arthritis is: 

		walking
		swimming
		riding a bicycle
		passive range of motion

B

Question 37

A 27-year-old gay male complains of nodule, sensation of heaviness or aching, one large testicle, and/or testicular tenderness. The NP suspects what condition?

	a.	Prostate Cancer
	b.	Priapism
	c.	Testicular Torsion
	d.	Testicular Cancer

D

Question 38

Amanda was out hiking with her boyfriend in the woods. When she gets home, she notices that she has an inflammatory skin reaction caused by something she picked up in the woods. The next day she sees bright red pruritic lesions on her lower extremities that are moist and painful. Treatment for Amanda’s condition would include which of the following?

		Topical steroids
		Triamcinolone
		Calamine lotion
		Oatmeal baths (Aveeno)
		All of the above
		All of the above except D

E

Question 39

An 88-year-old male says to the nurse practitioner (NP) that “I have never been taken care of by a nurse practitioner.” He asks, what is the difference between an NP and a physician? What is the best response by the NP?

	a.	An NP provides care to patients across the life span, whereas a primary care physician does not provide care across the lifespan.
	b.	An NP provides the same care as a physician and can practice independent of a physician in all 50 states.
	c.	NPs differ from physicians in definition, scope of practice, and education.
	d.	NPs provide much better care than a physician could ever provide because of their educational training.

C

Question 40

Mr.Mims presents with suspected recurrence of diverticulitis. In diverticulitis,  abdominal pain usually presents where in the abdomen? 

		left upper quadrant
		Left lower quadrant
		right upper quadrant
		Right lower quadrant

B

Question 41

A 25-year-old patient reports to clinic with c/o headaches with photophobia and nausea and vomiting. This patient is more likely to be diagnosed with

	a.	Cluster headache
	b.	Muscle tension
	c.	Migraine
	d.	Temporal arteritis

C

Question 42

Statues describing NP scope of practice fall into all but one of the categories:

	a.	Defined by statute.
	b.	Defined by regulation.
	c.	Scope of practice is defined.
	d.	Scope of practice is not defined.

C

Question 43

Since UTIs are never “normal” in a male, what should the NP rule out as the cause of the infection?

		Ureteral stricture
		Acute prostatitis
		STDs
		All of the above
		A & C only

D

Question 44

An NP recognizes that the five major categories of third-party payers are:

	a.	Medicare, Medicaid, self-pay, Indemnity insurance companies, HMOs
	b.	Medicare, Medicaid, self-pay, PPOs, HMOs
	c.	Medicare, Medicaid, Indemnity insurance companies, Managed-care organizations (MCOs)
	d.	Indemnity insurance companies, managed-care organizations, PPOs, HMOs, Self-Pay

C

Question 45

Mr. Trellis is a 65 year-old man who presents with complaints of nocturia. Which of the following should be included in the differential diagnosis? 

		Urethral polyp
		Constipation
		Benign Prostatic Hypertrophy
		Posterial Urethral lesion

C

Question 46

Cellulitis is usually caused by a gram-negative bacterium.

 True

 False

B

Question 47

Juan, an 82 y/o male, is brought to the clinic by his daughter with LLQ pain, anorexia, nausea, and vomiting. Palpation of the abdomen reveals a positive rebound tenderness, positive Rovsing’s sign, and rigid abdomen. The NP in Juan’s case should:

		Refer to ER
		Try an antiemetic
		Draw labs
		Send for a CAT scan

A

Question 48

Mr. Knight, an obese middle-aged client presents with a month of nonproductive irritating cough without fever.  He also reports occasional morning hoarseness.  What should the differential include? 

		Atypical pneumonia
		Peptic ulcer disease
		Gastroesophageal reflux
		Mononucleosis (Epstein-Barr)

C

Question 49

Pneumonia vaccine should be given annually. True or False?

 True

 False

B

Question 50

Ms. Stevens, a 70 year old patient with community acquired pneumonia presents with chills, productive cough, temperature of 102.1, pulse 100, respiration 18, BP 94/52, WBC 12,000, and blood urea nitrogen (BUN) 24mg/dl.  She has a history of mild dementia and his mental status is unchanged from her last visit.  These findings indicate that this patient: 

		Can be treated as an outpatient
		Can be treated with oral antibiotics
		Requires a high dose of parenteral antibiotics
		requires hospitalization for treatment

B

Question 51

Ms. Roberts is being seen today at your office.  She reports symptoms of Allergic Rhinitis.  The NP recognizes that Second-generation antihistamines such as loratadine (Claritin) are prescribed for seasonal allergies because they: 

		Are prescription products and are therefore covered by insurance
		Are more effective than first-generation antihistamines
		are less sedating than first-generation antihistamines
		can be taken with CNS sedatives, such as alcohol

C

Question 52

Folliculitis is most commonly due to: 

		Staphylococcal infection
		Dermatophytes
		Varicella zoster
		E coli

A

Question 53

In pulsus paradoxus, even if the pulse cannot be palpated, it can still be heard by using a BP cuff and stethoscope.

 True

 False

A

Question 54

You are seeing Ms. Ellie,  a 60 year old female with COPD.  She tells you that she has been using albuterol with good relief for shortness of breath. She is using it 3-4 times daily over the past 4 weeks.  How should the NP manage this? 

		Add a long-acting beta agonist
		Encourage its use at the same time every day xTell him to use it only once a day . Add a long-acting beta agonist
		Add an oral steroid
		Add an ace inhibitor

A

Question 55

Bacterial vaginosis has all the following signs/symptoms except:

		Fish-like odor
		Milk-like discharge
		Non-itchy vulva
		Red vulvovaginal

D

Question 56

The NP recognizes that the increased presence of which of the following ina  urinalysis indicates the presence of bacteria or protein, which is seen in severe renal disease and could also indicate urinary calculi? 

		Crystals
		Nitrates
		Casts
		Ketones

B

Question 57

A 25-year-old patient states that he is on an HMO plan. The nurse practitioner (NP) stands for

	a.	Home Management Organizations
	b.	Health Management Organizations
	c.	Health Movement Organizations
	d.	Health Maintenance Organizations

D

Question 58

Mr. Reynolds is a 66 year old male who is a Pastor of a church.  He informs you that he has just returned from a 6 month missionary trip to South Africa.  He reports unremitting cough, hemoptysis, and an unintentional weight loss of 10 pounds over the last month.  These symptoms should prompt the clinician to suspect: 

		Malaria
		Tuberculosis
		Legionnaires’ Disease
		Pneumonia

B

Question 59

Hillary is an 18 y/o Caucasian who comes to the clinic with a chief complaint of hirsutism, acne, and amenorrhea. Her most likely diagnosis is:

		Polycystic ovary syndrome (PCOS)
		Ovarian cancer
		Hyperprolactinemia
		Pregnancy

A

Question 60

Abby is a 63 y/o patient who is known to have atrial fibrillation and has been on Coumadin for 2 years. Her INR is 2.4. This ratio is considered:

		Normal
		High
		Low

A

Question 61

As the NP prepares to manage a patient with Anemia, the NP knows that The pathophysiological hallmark of Anemia of Chronic Disease is:

		Depleted iron stores
		Chronic uncorrectable bleeding
		Impaired ability to use iron stores
		Reduced intestinal absorption of iron

C

Question 62

A nurse practitioner (NP) is concerned about a possible malpractice lawsuit. The plaintiff must prove that all of the following occurred except:

	a.	A duty is owed
	b.	Damage occurred
	c.	Following standard of care
	d.	Caused injury

C

Question 63

The nurse practitioner (NP) recognizes that an example of protecting a patient from harm is

	a.	Instructing a patient to walk .50 miles after appendectomy
	b.	Prescribing opioids for patient with back pain on initial encounter
	c.	Providing care and prescribing medication to a patient without health insurance
	d.	Not prescribing Fosamax to a patient with history of peptic ulcer disease (PUD)

D

Question 64

Medicare Part A covers all the following except:

	a.	Custodial care
	b.	Inpatient psychiatric hospital care
	c.	Skilled nursing facility care
	d.	Inpatient hospital care

A

Question 65

The ANA Code of Ethics for Nurses contains

	a.	State laws and regulations for practice
	b.	The goals, values and ethical precepts that direct the profession of nursing
	c.	Liaison language between the patient and organization
	d.	Negotiable language

B

Question 66

1. pylori is a common cause of both duodenal and gastric ulcers.

 True

 False

A

Question 67

Mr. Johnson is a 50 year old male who is a truck driver.  He presents with concerns of possible kidney stones.  Common symptoms of kidney stones include all of the following except: 

		marked febrile response
		pink, red, or brown urine
		sharp pain in the back or lower abdomen
		pain while urinating

A

Question 68

Ms. Lashley, a 70  year old obese female presents complaining of persistent right upper quadrant pain.  She reports that she has not had any prior abdominal surgeries.  Which of the following laboratory studies would be most indicative of acute cholecystitis? 

		C-reactive protein level of 3 mg
		White blood cell count of 11,000
		Direct serum bilirubin level of 0.3 mg/dl
		Serum amylase level of 145 U/L

D

Question 69

The screening for melanoma includes: (Select all that apply.)

	a.	Asymmetry
	b.	Black texture
	c.	Border irregular
	d.	Color varies in the same region
	e.	Diameter greater than 6 mm
	f.	Change in size

uestion 70

If the TSH is decreased then the patient needs to be worked up for hypothyroidism.

 True

 False

b

Question 71

The diagnosis of a subclinical hypothyroidism would be identified by which lab test results?

		Increased TSH and normal free T4
		Decreased TSH and normal free T4
		Increased TSH and increased free T4
		Decreased TSH and decreased free T4

A

S1 points   

Question 72

The most common way for testing COVID-19 is performed by what route?

	a.	Oral
	b.	Nasopharyngeal
	c.	Blood test
	d.	None of the above

B