NRNP-6565-4-Syntesis Advanced Nursing Practice Care-2021-Fall-QTR-Term-wks-1-thru-11-(08/30/2021-11/14/2021)-PT27
Take Test: Exam – Week 10
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
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
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
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
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
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 |
Metabolic syndrome is characterized by all the following traits except
Obesity | ||
Hypertension | ||
Dyslipidemia | ||
Hypoglycemia |
D
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
Acanthosis nigricans is associated with all the following except:
Diabetes | ||
Metabolic syndrome | ||
Obesity | ||
Cancer of bladder |
D
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
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
The Influenza vaccine should be given annually. True or False?
True
False
A
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
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
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
Hemoglobin A1C is the average glucose level of what length of time?
1 month | ||
2 months | ||
3 months | ||
4 months |
C
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
Bupropion (Wellbutrin) is contraindicated in patients with anorexia/bulimia because of the potential for increasing the seizure threshold.
True
False
A
Patients with bipolar disorder may have all the following except:
Delusions | ||
Hallucinations | ||
Lower rates of substance abuse | ||
A & B only |
C
________________vaccine is given in two separate doses to prevent Shingles.
A. | Shingrix | |
B. | Pneumococcal | |
C. | Influenza | |
D. | TDAP |
A
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
Which of the following glands is responsible for calcium balance in the body?
Posterior pituitary | ||
Parathyroid glands | ||
Thyroid gland | ||
Pineal gland |
B
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
The use of steroids in the treatment of fungal infections will worsen the infection.
True
False
A
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
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
One of the most common side effects of SSRIs is:
Nausea | ||
Ataxia | ||
Erectile dysfunction | ||
Seizures
C |
Which of the following are non-antibiotic strategies to prevent UTIs?
Estrogen therapy | ||
Cranberry juice/extract | ||
Methenamine salts | ||
Lactobacillus | ||
All of the above |
D
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
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
All of the following are pharmacological treatments for osteoporosis except:
Biphosphates | ||
Thyroid stimulating hormone | ||
Tamoxifen | ||
Parathyroid hormone analog |
B
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
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
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
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
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
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
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
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
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
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
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
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
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
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
Cellulitis is usually caused by a gram-negative bacterium.
True
False
B
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
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
Pneumonia vaccine should be given annually. True or False?
True
False
B
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
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
Folliculitis is most commonly due to:
Staphylococcal infection | ||
Dermatophytes | ||
Varicella zoster | ||
E coli |
A
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
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
Bacterial vaginosis has all the following signs/symptoms except:
Fish-like odor | ||
Milk-like discharge | ||
Non-itchy vulva | ||
Red vulvovaginal |
D
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
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
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
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
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
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
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
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
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
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
True
False
A
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
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
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 |
If the TSH is decreased then the patient needs to be worked up for hypothyroidism.
True
False
b
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
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
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