NRNP 6531 Final Exam

NRNP 6531 Final Exam

The nurse practitioner provides a program on nutrition for older adults to a group at a community church. Which of the following is a reason to educate this group about nutrition?

	1.	The risks of developing nutritional difficulties are multifactorial.
	2.	Only internal conditions affect nutritional status.
	3.	Only external conditions affect nutritional status.
	4.	Older adults have a decreased risk of developing nutritional deficiencies.

Jean is a breast cancer patient given 2 to 3 years of survival. Her condition is up and down. Which of the following types of care is indicated for the patient? NRNP 6531 Final Exam

	1.	Naturopathic care
	2.	Complementary care
	3.	Maintenance care
	4.	Palliative care

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Which of the following statements is true relating the diagnosis of Parkinson’s disease (PD)?

		The disease should be addressed aggressively using all medications to minimize progression
		Drug therapy focuses on correcting the imbalance of dopamine and acetylcholine.
		Exercise is a contraindication to avoid falls.
		Anxiety is common in PD and can contribute to worsening of symptoms

 

Geriatric patients in end-of-life conditions suffer from many symptoms. The most prevalent symptoms include delirium, dyspnea, and pain. Which of the following is a common additional symptom for patients in end-of-life conditions?

	1.	Insomnia
	2.	Speech impairment
	3.	Hearing impairment
	4.	Tremors

 

Mrs. Morgan is an 70-year-old female who comes to the emergency department with complaints of  pain in her lower leg that is aggravated by movement. Which early treatment does the nurse practitioner implement?

		Rest, ice application to affected area,  elevation of the leg
		Heat application to the affected area, opioid medication, compression dressing
		Opioid medication, compression dressing, ice application to the affected area
		Physical therapy, compression dressing, heat to the affected area

 

Women developing ovarian cancer may be asymptomatic, making it hard to detect until the condition has worsened. Which of the following is the best initial diagnostic tool for suspected ovarian cancer?

	1.	Transvaginal ultrasonography
	2.	Pelvic examination
	3.	Laparoscopy
	4.	MRI of the abdomen with contrast

David is 66 years old male who presents with complaints of right sided abdominal swelling, weight loss, and skin discoloration.   What initial tests should the NP order to assess for cancer of the liver?

		CBC,  AST, ALT, Ultrasound
		CBC, Chem-12, contrast MRI of the abdomen
		Abdominal X-ray, CBC, lipid profile
		Contrast MRI of the abdomen

 

Ms. Jenny is 72 years old and has managed her type 2 diabetes for 30 years. This condition is costly to her in more than one way. Which complications are common?

	1.	Financial challenges NRNP 6531 Final Exam.
	2.	Good visual acuity.
	3.	Good renal functioning.
	4.	Increased circulation to lower extremities.

 

Tanya came in for an office visit due to recurrent epistaxis. She also has a diagnosis of systemic lupus erythematosus. CBC with peripheral blood smear was performed and confirmed that she has idiopathic thrombocytopenic purpura (ITP). Which of the following is true relating to the condition of ITP?

		Patients 65 years or older have a higher risk of bleeding and mortality.
		ITP etiology is known.
		ITP affects men more than women
		ITP is more common in children.

 

Mr. Sparks is an 88-year-old patient who was recently an inpatient for pneumonia and was bedridden for 1 week. He is now presenting dysuria, suprapubic tenderness accompanied by fever, and increased confusion. Based on his recent history, which of the following conditions may be developing?

	1.	Cystitis
	2.	Distended bladder
	3.	Prostate stones
	4.	Subacute prostatitis

 

Jordan is a 75-year-old patient diagnosed with chronic lymphatic leukemia (CLL). All of the following statements are TRUE about CLL EXCEPT:. 

		CLL treatment is divided into induction and post-remission or consolidation therapy
		CLL is a disease of the older adult
		CLL manifests symptoms of fatigue, feeling of fullness in the abdomen, and weight loss
		CLL is a common type of adult leukemia in the Western world

 

The treatment of acute lymphoblastic leukemia (ALL) consists of the control of bone marrow and systemic disease. Which of the following therapies eliminates any leukemic cells that may remain?

	1.	Consolidation therapy
	2.	Maintenance therapy
	3.	Induction remission
	4.	Central nervous system (CNS) prophylaxis

 

Some common medications, including Metformin, can interfere with the absorption of vitamin B12

True

False

TRUE

Mr. Jameson, 75 years old, comes to the clinic with complaints of severe sharp epigastric pain that radiates to his back. He has been nauseous and has vomited three times today. The nurse practitioner suspects which of the following?

	1.	Appendicitis
	2.	Gastrointestinal influenza
	3.	Acute pancreatitis
	4.	Insulin shock

 

Mrs. C. presents for her annual physical exam.   She complains of episodes of abdominal cramps and diarrhea that comes and goes.    What is the next best action for the nurse practitioner to take?

	1.	Assess triggers for each episode and the sequence of symptoms.
	2.	Conducting a complete urological examination.
	3.	Order ultrasound of the abdomen
	4.	Complete physical exam

 

During a breast examination, the NP should ask the patient if she has had any history of breast trauma since that is a known risk factor for the development of breast cancer NRNP 6531 Final Exam.

True

False

FALSE

The nurse practitioner is working in a clinic dedicated to patients over age 65 years. The nurse practitioner observes several common characteristics in the posture of elderly patients. Which of the following is common?

	1.	Increase in the length of the trunk in relationship to the upper extremities.
	2.	Head tips backward.
	3.	Disappearance of bony prominences.
	4.	IncreasBe in the range of motion (ROM).

 

Symptoms of Acute Lymphocytic Leukemia can include joint pain, enlarged lymph nodes, and abdominal swelling

True

False

TRUE

Which of the following statements is true for untreated symptomatic cystitis?

	1.	Untreated symptomatic cystitis can lead to pneumonia.
	2.	Untreated symptomatic cystitis can resolve on its own.
	3.	Untreated symptomatic cystitis can lead to pyelonephritis, sepsis, shock, and death.
	4.	Untreated symptomatic cystitis can lead to prostatitis, vaginitis, and sepsis.

 

Mr. Epstein developed a sudden onset of severe headache, weakness on one side of his body, difficulty speaking, and loss of balance. He was immediately admitted to the hospital with the diagnosis of hemorrhagic stroke. Which of the following is the manifestation of a hemorrhagic stroke?

	1.	Leak or rupture in an artery wall.
	2.	Leak or rupture in a venous wall.
	3.	Blockage in the heart.
	4.	Blockage of an artery.

 

Peripheral neuropathy is a disorder of the peripheral nervous system resulting in sensory, motor, and autonomic dysfunction. Which of the following conditions are the treatable causes of peripheral neuropathy?

		Radiculopathy and traumatic brain injury
		Alcohol use and diabetes
		Radiculopathy and alcohol use
		Traumatic brain injury and diabetes

 

An 80-year-old woman comes to see the nurse practitioner and complains that she does not seem to be able to tolerate some foods as she once did. The nurse practitioner knows that aging can contribute to which of the following? NRNP 6531 Final Exam

	1.	Bone loss in the mouth, causing teeth to be loose.
	2.	Oral mucosa thickening and inhibiting saliva production.
	3.	An increase in secretion of hydrochloric acid in the stomach.
	4.	A decline in liver function.

 

While conducting a health assessment, the nurse practitioner asks about the three pillars of food security. This includes which of the following?

	1.	Food allocation.
	2.	Food availability.
	3.	Food that is inexpensive.
	4.	Food freshness.

 

Acute myeloid leukemia (AML) is a rare and diverse group of diseases. Which of the following statements is true regarding AML?

	1.	AML has no CNS involvement.
	2.	Laboratory evaluation includes urinalysis.
	3.	Initial work-up is to assess and characterize the disease based on prior exposure.
	4.	Comorbidities do not apply in the diagnosis of AML.

 

Physiological changes of aging and multiple comorbidities influence the dying process. The growing acceptance of hospice and palliative care is creating a more natural dying experience. Which of the following is true regarding the process of death?

	1.	Urinalysis is usually performed as a diagnostic test for further infection.
	2.	Age has no bearing on the risk of death.
	3.	The meaning and experience of death are often influenced by society.
	4.	The meaning and experience of death are often influenced by one’s culture and ethnicity.

 

Which of the following is a neurological disorder characterized by leg cramping, pulling, and tugging sensations, and may have a genetic component?

	1.	Radiculopathy
	2.	Nerve compression
	3.	Restless legs syndrome (RLS)
	4.	Sleep impairment

 

Mrs. Smith, 80 years old, has been vomiting and having bouts of loose stools for several days. She is taking several medications that are prescribed. The nurse practitioner conducts a medication review because:

	1.	An accounting of all prescribed and over-the-counter (OTC) medications may uncover reasons for her symptoms.
	2.	There could be drug–drug interactions leading to her symptoms.
	3.	Side effects of the gastrointestinal tract are not seen in many medications.
	4.	The administration of some of her medications may be appropriate NRNP 6531 Final Exam.

 

Direct injury to the femur and osteoporosis can contribute to the development of a femoral neck  fracture in an older adult.

True

False

TRUE

Pain is categorized into different types. Which of the following type of pain originates in the thoracic, abdominal, and pelvic viscera and presents diffused pain that often radiates?

	1.	Neuropathic pain
	2.	Somatic pain
	3.	Visceral pain
	4.	Mixed pain

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Mr. Smith comes to the health-care clinic with a presenting symptom of not urinating as much as usual. The nurse practitioner assesses Mr. Smith by asking which of the following?

	1.	How much do you drink per day?
	2.	Is your urine a clear yellow color?
	3.	Do you experience urgency and frequency of urination?
	4.	What medications have you taken recently or are you currently taking?

 

Ginger is a 65-year-old woman who is suspected of having a brain tumor. The NP orders diagnostic testing for thyroid-stimulating hormone (TSH) and magnetic resonance imaging (MRI) to confirm this. Which of the following statements is true regarding a brain tumor?

	1.	Photophobia and headaches are rare presenting symptoms of a brain tumor.
	2.	A brain tumor can be a malignant or benign neoplasm.
	3.	The etiology of brain tumors is often known.
	4.	Brain tumors occur more commonly in females than males.

 

Maria is a 58-year-old woman experiencing itching, discomfort, and bleeding after intercourse. Which of the following conditions may be developing in the patient?

	1.	Atrophic vaginitis
	2.	Vaginal cancer
	3.	Fibroadenoma
	4.	Cystitis

 

A  67 year old patient complains of  headaches, changes in mental function, language deficits, and visual problems.  Potential differential diagnosis for this patient includes all of the following EXCEPT:

		Stroke
		Subdural hematoma
		Brain tumor
		Venous insufficiency

 

Motor function of the older adult should include body position, involuntary movement, muscle tone, and muscle strength to rule out benign motor function

True

False

True

Which of the following conditions presents nonproliferating lesions and does not affect future cancer risk?

	1.	Atypical lobular hyperplasia
	2.	Fat necrosis
	3.	Radial scar
	4.	Papilloma

 

Part of the abdominal examination the nurse practitioner will conduct is the assessment of skin color. As the nurse practitioner assesses the abdominal skin, the findings include which of these signs that are concerning?

	1.	Generalized pinkness.
	2.	Bluish discoloration on the flanks.
	3.	Yellow tint around the lower left quadrant.
	4.	Blue in the upper left quadrant.

 

What diagnostic tests would the NP order to confirm the diagnosis of pancreatitis?

		BUN, Creatinine, Blood sugar
		Amylase and lipase
		Abdominal CT
		Abdominal MRI

 

Mrs. Cassidy is a 76-year-old woman who comes to see her nurse practitioner for pain in her right thigh. The nurse practitioner assesses that Mrs. Smith has bruises on her thigh and muscle weakness distally, near the knee. The nurse practitioner suspects which of the following?

	1.	Musculoskeletal lesions
	2.	Tendon rupture
	3.	Gout
	4.	Arthritis

 

The nurse practitioner explains to older adults that physiological changes can affect nutritional status, changes such as:

	1.	An increased sense of smell
	2.	An increased sense of taste.
	3.	An increased production of saliva.
	4.	Dental issues.

 

Pain is a common end-of-life symptom in the older adult.

True

False

True

Mr. Fitzgerald has seizure conditions due to a recent accident causing traumatic brain injury (TBI).    The NP would include which of the following in the patient’s treatment plan?

	1.	Discontinuing seizure medication at one year post TBI injury
	2.	Family education on patient care during a seizure
	3.	Annual EEG for all patients on seizure medication
	4.	Referral for group therapy.

 

Mr. King a 57-year-old male, is being seen in the clinic for complaints of pain in his thigh. There is swelling in the soft tissue, dislocation, altered ROM, bruising, local tenderness, and pain with any motion. The nurse practitioner suspects which of the following?NRNP 6531 Final Exam

		ACL tear
		achilles rupture
		femoral neck fracture
		pelvic fracture

 

Mr. Abrahams, a 69-year-old Caucasian male, presents with an inability to move his right arm sufficiently. The nurse practitioner tells him that she will perform a physical examination and order tests to rule out which of the following?

	1.	Gout
	2.	Rheumatoid arthritis (RA)
	3.	Muscle weakness from a systemic condition
	4.	Osteoarthritis (OA)

 

Vegetarians and those who abuse alcohol are at risk for vitamin B12 deficiency

True

False

TRUE

Thom is 60 years old and has been treated for nonalcoholic fatty liver disease (NAFLD) for over 10 years. He still suffers from fatigue, abdominal pain, and an enlarged liver. The nurse practitioner discusses which of the following plans to assist him in managing his disease?

		Weight loss program and anti-lipid medications
		Avoid hepatitis A and B vaccines and avoid alcohol
		Avoid hepatitis A and B vaccines and anti-lipid medications
		Alcohol intake does not affect this disease and a weight loss program

 

Ellen is a 57-year-old woman diagnosed with iron-deficiency anemia (IDA). Her physician orders further diagnostic tests to rule out which of the following?

	1.	HIV
	2.	Malignancy
	3.	Gastritis
	4.	Stroke

 

The genitourinary and reproductive systems undergo many age-related changes. Which of the following statements is true about these changes?

	1.	The older male patient undergoes more gradual changes than does the older female patient.
	2.	The older female patient undergoes more gradual changes than does the older male patient.
	3.	Older male and female patients undergo the same changes.
	4.	The older male patient undergoes less gradual changes than those of the older female patient.

 

Marie is a fibromyalgia sufferer. Her treatment program includes pain relief, antidepressant medications, and an exercise program. From which of the following types of pain might she be suffering?

	1.	Neuropathic pain
	2.	Somatic pain
	3.	Visceral pain
	4.	Mixed pain

 

The main laboratory clinical manifestations of cystitis are pyuria and bacteriuria

True

False

TRUE

An 80 years old  female is diagnosed with Clostridium difficile-associated diarrhea (CDAD) and is questioning the NP about how she was exposed to the disease.   All of the following are correct EXCEPT:

		Patients can be exposed in the hospital and community setting
		Inflammatory bowel disease and compromised immunity can lead to CDAD
		The source of CDAD is currently unknown
		Risk factors include antibiotic exposure, being an older adult, and church or synagogue exposure.

 

Chronic inflammation and smoking are are contributing factors to the development of Acute Lymphocytic Leukemia

True

False

TRUE

Mr. Watson, a 77-year-old man, is being seen for his annual physical examination. His serum level of vitamin D is 40 nmol/L. The nurse practitioner explains that this may due to which of the following physiological changes in aging?NRNP 6531 Final Exam

	1.	His dislike of milk.
	2.	Tastes buds on the tongue not sensing taste as well.
	3.	His gastrointestinal (GI) tract not absorbing dairy as it did when he was younger.
	4.	The decline in the skin’s ability to metabolize vitamin D.

 

When other symptoms are presented with atrophic vaginitis, a biopsy is used as the diagnostic test to rule out which of the following diagnoses?

		UTI, sexually transmitted infection, squamous cell hyperplasia
		Sexually transmitted infection, squamous cell hyperplasia, Lichen sclerosis
		squamous cell hyperplasia, Lichen sclerosis, Lichen planus
		Lichen sclerosis, Lichen planus, UTI

 

A 66 year old patient with rheumatoid arthritis is seeking medication for pain control and that will alter the course of the disease.  What medication should the NP order?

		Corticosteroids
		NSAIDS
		Acetaminophen
		Biological disease-modifying antirheumatic drugs (DMARDs)

 

A clinician is performing sensory assessment on a patient presenting signs and symptoms of neurological disease. During the assessment, the clinician notices that the patient has a decreased sense of both pain and temperature. Which of the following may be affected?

	1.	Spinothalamic tract
	2.	Cranial nerve VII
	3.	Posterior column
	4.	Posterior horn

 

Which of the following is the best statement regarding dyspnea?

	1.	Smoking causes dyspnea.
	2.	Dyspnea is one of the most common reasons for visits to the emergency room for individuals with advanced disease.
	3.	Dyspnea is a rare symptom as patients approach the end of life.
	4.	Females are more likely to develop symptoms of dyspnea. NRNP 6531 Final Exam