NURS-6531 Adv. Practice Care of Adults Midterm Exam
| User |
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| Course |
NURS-6531N-8,Adv. Practice Care of Adults.2018 Summer Qtr 05/29-08/19-PT27 |
| Test |
Midterm Exam |
| Status |
Needs Grading |
| Attempt Score |
0 out of 100 points |
| Time Elapsed |
1 hour, 53 minutes out of 1 hour and 50 minutesOVER TIME |
| Results Displayed |
All Answers, Submitted Answers, Correct Answers |
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When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? NURS-6531 Adv. Practice Care of Adults Midterm Exam |
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| Selected Answer: |
Yes |
| Answers: |
Yes |
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No |
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1 out of 1 points
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The most common cancer found on the auricle is: |
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| Selected Answer: |
Basal cell carcinoma |
| Answers: |
Actinic keratosis |
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Basal cell carcinoma |
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Squamous cell carcinoma |
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Acral-lentiginous melanoma |
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0 out of 1 points
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Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient? |
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| Selected Answer: |
Anticholinergics |
| Answers: |
Xanthines |
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Antihistimines |
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Steroids |
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Anticholinergics |
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0 out of 1 points
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A 47 year old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On examination, external hemorrhoids are noted. How should the nurse practitioner proceed? |
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| Selected Answer: |
Instruct the patient on measures to prevent hemorrhoids such as bowel habits and diet. |
| Answers: |
Instruct the patient on measures to prevent hemorrhoids such as bowel habits and diet. |
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Order a topical hemorrhoid cream along with a stool softener. |
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Refer the patient for a barium enema and sigmoidoscopy. |
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Refer the patient for a surgical hemorrhoidectomy. |
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0 out of 1 points
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Which of the following patient characteristics are associated with chronic bronchitis? |
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| Selected Answer: |
Underweight, pink skin, and increased respiratory rate |
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Overweight, cyanosis, and normal or slightly increased respiratory rate |
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Underweight, pink skin, and increased respiratory rate |
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Overweight, pink skin, and normal or slightly increased respiratory rate |
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Normal weight, cyanosis, and greatly increased respiratory rate |
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1 out of 1 points
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A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent care with new onset left lower quadrant pain. Her current medications include omeprazole 20 milligrams po daily, lisinopril 20 milligrams po daily, simvastatin 20 milligrams po daily, and prednisone 12 milligrams po daily. The nurse practitioner suspects acute diverticulitis and possibly an abscess. The most appropriate diagnostic test for this patient at this time is: |
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| Selected Answer: |
CT scan |
| Answers: |
CBC/diff |
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Erythrocyte sedimentation rate |
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Abdominal ultrasound |
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CT scan |
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1 out of 1 points
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A patient reports “something flew in my eye” about an hour ago while he was splitting logs. If there were a foreign body in his eye, the nurse practitioner would expect to find all except: |
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| Selected Answer: |
Purulent drainage |
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Purulent drainage |
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Tearing |
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Photophobia |
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A positive fluorescein stain |
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1 out of 1 points
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A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect: |
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| Selected Answer: |
Gonococcal conjunctivitis |
| Answers: |
Viral conjunctivitis |
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Common pink eye |
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Gonococcal conjunctivitis |
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Allergic conjunctivitis |
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0 out of 1 points
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A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 different thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect: |
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| Selected Answer: |
A complicated case of shingles and prescribe acyclovir, an analgesic, and a topical cortisone cream |
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A common case of shingles and prescribe an analgesic and an antiviral agent |
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A complicated case of shingles and prescribe acyclovir, an analgesic, and a topical cortisone cream |
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Herpes zoster and consider that this patient may be immunocompromised |
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A recurrence of chickenpox and treat the patient’s symptoms |
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0 out of 1 points
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Which type of lung cancer has the poorest prognosis? |
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| Selected Answer: |
Adenocarcinoma |
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Adenocarcinoma |
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Epidermoid carcinoma |
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Small cell carcinoma |
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Large cell carcinoma |
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1 out of 1 points
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An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3–4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has: |
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| Selected Answer: |
Chronic diarrhea |
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Acute diarrhea |
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Chronic diarrhea |
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Irritable bowel |
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Functional bowel disease |
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1 out of 1 points
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Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect? |
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| Selected Answer: |
Systemic lupus erythematosus |
| Answers: |
An allergic reaction |
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Relapsing polychondritis |
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Lymphocytoma cutis |
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Systemic lupus erythematosus |
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1 out of 1 points
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Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes? |
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| Selected Answer: |
Acute bronchitis |
| Answers: |
Chronic sinusitis |
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Acute bronchitis |
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Bacterial pneumonia |
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Acute exacerbation of chronic bronchitis |
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0 out of 1 points
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Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in? |
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| Selected Answer: |
Mild persistent |
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Mild intermittent |
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Mild persistent |
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Moderate persistent |
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0 out of 1 points
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Which of the following is the most appropriate therapeutic regimen for an adult patient with no known allergies diagnosed with group A B-hemolytic strep? |
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| Selected Answer: |
None of the above |
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Penicillin V 500 milligrams PO every 8 hours for 10 days |
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Ampicillin 250 milligrams PO twice a day for 10 days |
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Clarithromycin 500 milligrams po daily for 7 days |
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None of the above |
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0 out of 1 points
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A cashier complains of dull ache and pressure sensation in her lower legs. It is relieved by leg elevation. She occasionally has edema in her lower legs at the end of the day. What is the most likely cause of these problems? |
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| Selected Answer: |
Arterial insufficiency |
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Congestive heart failure |
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Varicose veins |
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Deep vein thrombosis |
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Arterial insufficiency |
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1 out of 1 points
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Which statement below is correct about pertussis? |
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| Selected Answer: |
It is also called whooping cough |
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It is also called whooping cough |
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It begins with symptoms like strep throat |
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It lasts about 3 weeks |
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It occurs most commonly in toddlers and young children |
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0 out of 1 points
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Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis? |
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| Selected Answer: |
Asthma |
| Answers: |
Pneumonia |
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Asthma |
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Sinusitis |
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Pertussis |
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1 out of 1 points
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A 70 year old patient presents with left lower quadrant (LLQ) abdominal pain, a markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition? |
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| Selected Answer: |
Diverticulitis |
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Diverticulosis |
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Diverticula |
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Diverticulitis |
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Diverticulum |
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1 out of 1 points
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Sylvia, age 83, presents with a 3 day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect? |
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| Selected Answer: |
Herpes zoster |
| Answers: |
Varicella |
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Herpes zoster |
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Syphilis |
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Rubella |
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0 out of 1 points
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A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is: |
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| Selected Answer: |
Medications |
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Alcohol |
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Gallstones |
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Medications |
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Pregnancy |
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1 out of 1 points
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When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action? |
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| Selected Answer: |
Order an abdominal ultrasound |
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Order abdominal x-rays |
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Order an abdominal ultrasound |
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Refer the patient to a surgeon for evaluation |
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Prescribe pain medication |
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0 out of 1 points
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A false-positive result with the fecal occult blood test can result from: |
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| Selected Answer: |
stool that has been stored before testing |
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ingestion of large amounts of vitamin C |
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a high dietary intake of rare cooked beef |
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a colonic neoplasm that is not bleeding |
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stool that has been stored before testing |
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0 out of 1 points
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A 76-year-old male complains of weight loss, nausea, vomiting, abdominal cramping and pain. Physical findings include an abdominal mass and stool positive for occult blood. The nurse practitioner pain suspects a tumor in the small intestine. The best diagnostic test for this patient is: |
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| Selected Answer: |
Colonoscopy |
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Colonoscopy |
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Small bowel follow-through |
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Barium enema |
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CT abdomen |
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1 out of 1 points
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A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with: |
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| Selected Answer: |
Systolic heart failure |
| Answers: |
Mitral regurgitation |
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Systolic heart failure |
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Cardiac myxoma |
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Diastolic heart failure |
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1 out of 1 points
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Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized? |
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| Selected Answer: |
Multilobar involvement on chest x-ray with the inability to take oral medications |
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Multilobar involvement on chest x-ray with the inability to take oral medications |
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Alert and oriented, slightly high but stable vital signs, and no one to take care of her at home |
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Sputum and gram positive organisms |
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A complete blood count showing leukocytosis |
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0 out of 1 points
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A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him: |
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| Selected Answer: |
“It is the most common cause of death in patients with skin cancer.” |
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“It is the most common cause of death in patients with skin cancer.” |
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“It can be cured with surgical excision or radiation therapy.” |
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“It is a slow growing skin cancer that rarely undergoes malignant changes.” |
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“It can be cured using 5-flurouracil cream twice daily for 2 to 4 weeks.” |
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1 out of 1 points
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Expected spirometry readings when the patient has chronic emphysema include: |
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| Selected Answer: |
Increased total lung capacity (TLC) |
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Decreased residual volume (RV) |
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Increased vital capacity (VC) |
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Increased forced expiratory volume (FEV-1) |
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Increased total lung capacity (TLC) |
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1 out of 1 points
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An 80-year-old male admits to difficulty swallowing during the review of systems. The nurse practitioner recognizes the differential diagnosis for this patient’s dysphagia is: |
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| Selected Answer: |
A and C |
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Esophageal cancer |
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Chest pain |
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GERD |
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A and C |
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All of the above |
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0 out of 1 points
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A 40 year old female with history of frequent sun exposure presents with a multicolored lesion on her back. It has irregular borders and is about 11mm in diameter. What should the nurse practitioner suspect? |
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| Selected Answer: |
Basal cell carcinoma |
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Squamous cell carcinoma |
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Malignant melanoma |
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A common nevus |
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Basal cell carcinoma |
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1 out of 1 points
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Which of the following is not a goal of treatment for the patient with cystic fibrosis? |
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| Selected Answer: |
Replace water-soluble vitamins |
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Prevent intestinal obstruction |
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Provide adequate nutrition |
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Promote clearance of secretions |
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Replace water-soluble vitamins |
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1 out of 1 points
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The nurse practitioner is performing a physical exam on a middle-aged African-American man. Which of the following areas is a common site for melanomas in African-Americans and other dark-skinned individuals? |
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| Selected Answer: |
B and C |
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Scalp |
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Nails |
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Feet |
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B and C |
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All of the above |
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1 out of 1 points
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An adult presents with tinea corporis. Which item below is a risk factor for its development? |
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| Selected Answer: |
Topical steroid use |
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Topical steroid use |
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Topical antibiotic use |
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A recent laceration |
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Cold climates |
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0 out of 1 points
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A patient has experienced nausea and vomiting, headache, malaise, low grade fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is elevated with a shift to the left. He is requesting medication for diarrhea. What is the most appropriate response? |
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| Selected Answer: |
Order stool cultures. |
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Prescribe loperamide (Immodium) or atropine-diphenoxylate (Lomotil) and a clear liquid diet for 24 hours. |
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Prescribe a broad-spectrum antibiotic such as ciprofloxacin (Cipro), and symptom management. |
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Offer an anti-emetic medication such as ondansetron (Zofran) and provide oral fluid and electrolyte replacement instruction. |
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Order stool cultures. |
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1 out of 1 points
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Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order? |
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| Selected Answer: |
Antihistamines |
| Answers: |
Aspirin |
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NSAIDs |
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Opioids |
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Antihistamines |
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0 out of 1 points
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Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is: |
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| Selected Answer: |
Peripheral edema |
| Answers: |
Peripheral edema |
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Weight gain |
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Shortness of breath |
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Nocturnal dyspnea |
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1 out of 1 points
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A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe? |
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| Selected Answer: |
Amoxicillin |
| Answers: |
Ibuprofen |
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Erythromycin |
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Amoxicillin |
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Acetaminophen |
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1 out of 1 points
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A 70 year old man who walks 2 miles every day complains of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 2 mile walk. What question asked during the history, if answered affirmatively, would suggest a diagnosis of arteriosclerosis obliterans? |
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| Selected Answer: |
“Is your leg pain relieved by rest?” |
| Answers: |
“Are you wearing your usual shoes?” |
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“Do you also have chest pain when you have leg pain?” |
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“Is your leg pain relieved by rest?” |
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“Do you ever have the same pain in the other leg?” |
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0 out of 1 points
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Which of the following statements about malignant melanomas is true? |
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| Selected Answer: |
They usually occur in older adult males |
| Answers: |
They usually occur in older adult males |
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The patient has no family history of melanoma |
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They are common in blacks |
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The prognosis is directly related to the thickness of the lesion |
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1 out of 1 points
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Sheila, age 78, presents with a chief complaint of waking up during the night coughing. You examine her and find an S3 heart sound, pulmonary crackles that do not clear with coughing, and peripheral edema. What do you suspect? |
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| Selected Answer: |
Heart failure |
| Answers: |
Asthma |
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Nocturnal allergies |
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Valvular disease |
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Heart failure |
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0 out of 1 points
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Which antibiotic would be the most effective in treating community acquired pneumonia (CAP) in a young adult without any comorbid conditions? |
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| Selected Answer: |
Doxycycline (Vibramycin) |
| Answers: |
Erythromycin |
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Clarithromycin (Biaxin) |
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Doxycycline (Vibramycin) |
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Penicillin |
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1 out of 1 points
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Which of the following dermatologic vehicles are the most effective in absorbing moisture and decreasing friction? |
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| Selected Answer: |
Powders |
| Answers: |
Powders |
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Gels |
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Creams |
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Lotion |
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1 out of 1 points
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A 70 year old patient presents with a slightly raised, scaly, erythematous patch on her forehead. She admits to having been a “sun worshiper.” The nurse practitioner suspects actinic keratosis. This lesion is a precursor to: |
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| Selected Answer: |
Squamous cell carcinoma |
| Answers: |
Squamous cell carcinoma |
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Basal cell carcinoma |
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Malignant melanoma |
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Acne vulgaris |
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1 out of 1 points
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An elderly patient is being seen in the clinic for complaint of “weak spells” relieved by sitting or lying down. How should the nurse practitioner proceed with the physical examination? |
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| Selected Answer: |
Compare the patient’s blood pressure lying first, then sitting, and then standing. |
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Assist the patient to a standing position and take her blood pressure. |
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Assess the patient’s cranial nerves. |
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Compare the patient’s blood pressure lying first, then sitting, and then standing. |
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Compare the amplitude of the patient’s radial and pedal pulses. |
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1 out of 1 points
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What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery? |
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| Selected Answer: |
Ursodiol |
| Answers: |
Ursodiol |
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Ibuprofen |
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Prednisone |
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Surgery is the only answer |
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0 out of 1 points
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A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is: |
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| Selected Answer: |
Staphylococcus aureus |
| Answers: |
Staphylococcus aureus |
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Group A beta hemolytic streptococcus |
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Haemophilus influenza |
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Pseudomonas aeruginosa |
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0 out of 1 points
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Which of the following is not a symptom of irritable bowel syndrome? |
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| Selected Answer: |
Painful diarrhea |
| Answers: |
Painful diarrhea |
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Painful constipation |
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Cramping and abdominal pain |
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Weight loss |
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1 out of 1 points
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A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed? |
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| Selected Answer: |
Any recent trauma |
| Answers: |
Any recent trauma |
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Difficulty swallowing |
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Stiffness in the right shoulder |
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Change in sleeping habits |
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0 out of 1 points
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Marvin, age 56, is a smoker with diabetes. He has just been diagnosed as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis? |
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| Selected Answer: |
ACE Inhibitor |
| Answers: |
ACE Inhibitor |
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Beta Blocker |
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Calcium channel blocker |
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Diuretic |
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1 out of 1 points
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The differential diagnosis for a patient complaining of a sore throat includes which of the following? |
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| Selected Answer: |
A, B, and C |
| Answers: |
Gonococcal infection |
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Thrush |
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Leukoplakia |
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B only |
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A, B, and C |
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0 out of 1 points
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A patient presents to the primary care provider complaining of a rash on his right forehead that started yesterday and is burning and painful. The physical exam reveals an erythematous, maculopapular rash that extends over the patient’s right eye to his upper right forehead. Based on the history and examination, the most likely cause of this patient’s symptoms is: |
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| Selected Answer: |
Rhus dermatitis |
| Answers: |
Rhus dermatitis |
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Ophthalmic zoster |
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Chemosis |
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Optic neuritis |
NURS-6531 Adv. Practice Care of Adults Midterm Exam |
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0 out of 1 points
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Before initiating an HMG CoA-reductase inhibitor for hyperlipidemia, the nurse practitioner orders liver function studies. The patient’s aminotransferase (ALT) is elevated. What laboratory test(s) should be ordered? |
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| Selected Answer: |
Serum cholesterol with HDL and LDL |
| Answers: |
Serologic markers for hepatitis |
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Serum bilirubin |
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Serum cholesterol with HDL and LDL |
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A liver biopsy |
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1 out of 1 points
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A patient with elevated lipids has been started on lovastatin. After 3 weeks of therapy, he calls to report generalized muscle aches. The nurse practitioner should suspect: NURS-6531 Adv. Practice Care of Adults Midterm Exam |
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| Selected Answer: |
Rhabdomyolysis |
| Answers: |
A drug interaction |
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Hepatic dysfunction |
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Hypersensitivity to lovastatin |
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Rhabdomyolysis |
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1 out of 1 points
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Treatment of acute vertigo includes: |
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| Selected Answer: |
Bedrest and an antihistamine |
| Answers: |
Bedrest and an antihistamine |
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Fluids and a decongestant |
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A sedative and decongestant |
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Rest and a low sodium diet |
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1 out of 1 points
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Treatment of H.pylori includes which of the following? |
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| Selected Answer: |
A, B, and C |
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Proton pump inhibitor |
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Antibiotic therapy |
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Bismuth subsalicylate |
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A and B |
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A, B, and C |
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1 out of 1 points
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Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect? NURS-6531 Adv. Practice Care of Adults Midterm Exam |
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| Selected Answer: |
Retinal detachment |
| Answers: |
Cataracts |
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Glaucoma |
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Retinal detachment |
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Iritis |
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1 out of 1 points
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In order to decrease deaths from lung cancer: |
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| Selected Answer: |
Patients should be counseled to quit smoking |
| Answers: |
All smokers should be screened annually |
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All patients should be screened annually |
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Only high risk patients should be screened routinely |
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Patients should be counseled to quit smoking |
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1 out of 1 points
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John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia? |
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| Selected Answer: |
Every 5 years |
| Answers: |
Every 5 years |
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Every 2 years |
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Every year |
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Whenever blood work is done |
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1 out of 1 points
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Mort is hypertensive. Which of the following factors influenced your choice of using an alpha blocker as the antihypertensive medication? |
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| Selected Answer: |
Mort has benign prostatic hyperplasia |
| Answers: |
Mort is black |
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Mort also has congestive heart failure |
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Mort has benign prostatic hyperplasia |
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Mort has frequent migraine headaches |
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1 out of 1 points
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John, age 59, presents with recurrent, sharply circumscribed red papules and plaques with a powdery white scale on the extensor aspect of his elbows and knees. What do you suspect? |
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| Selected Answer: |
Psoriasis |
| Answers: |
Actinic keratosis |
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Eczema |
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Psoriasis |
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Seborrheic dermatitis |
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1 out of 1 points
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Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg daily, and Calcium 1500 mg daily. At today’s visit. Her blood pressure is 170/89. According to JNC VIII guidelines, what should you do next to control Harriet’s blood pressure? NURS-6531 Adv. Practice Care of Adults Midterm Exam |
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| Selected Answer: |
Add a thiazide diuretic to the Lisinopril 5mg daily |
| Answers: |
Increase her Lisinopril to 20mg daily |
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Add a thiazide diuretic to the Lisinopril 5mg daily |
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Discontinue the Lisinopril and start a combination of ACE Inhibitor and calcium channel blocker |
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Discontinue the Lisinopril and start a diuretic |
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0 out of 1 points
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An active 65-year-old man under your care has known acquired valvular aortic stenosis and mitral regurgitation. He also has a history of infectious endocarditis. He has recently been told he needs elective replacement of his aortic valve. When he comes into the office you discover that he has 10 remaining teeth in poor repair. Your recommendation would be to: |
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| Selected Answer: |
coordinate with his cardiac and oral surgeons to have the tooth extractions and valve replacement done at the same time to reduce the risk of anesthetic complications. |
| Answers: |
defer any further dental work until his valve replacement is completed |
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instruct him to have dental extraction done cautiously, having no more than 2 teeth per visit removed. |
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suggest he consult with his oral surgeon about having all the teeth removed at once and receiving appropriate antibiotic prophylaxis |
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coordinate with his cardiac and oral surgeons to have the tooth extractions and valve replacement done at the same time to reduce the risk of anesthetic complications. |
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0 out of 1 points
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Appropriate therapy for peptic ulcer disease (PUD) is: |
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| Selected Answer: |
Dependent on cessation of NSAID use |
| Answers: |
Primarily by eradication of infection |
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Based on etiology |
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Aimed at diminishing prostaglandin synthesis |
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Dependent on cessation of NSAID use |
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1 out of 1 points
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Shirley, age 58, has been a diabetic for 7 years. Her blood pressure is normal. Other than her diabetes medications, what would you prescribe today during her routine office visit? |
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| Selected Answer: |
An ACE Inhibitor |
| Answers: |
A calcium channel blocker |
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A beta blocker |
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An ACE Inhibitor |
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No hypertension medication |
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1 out of 1 points
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Medicare is a federal program administered by the Centers for Medicare and Medicaid Services (CMS). The CMS has developed guidelines for Evaluation and Management coding, which all providers are expected to follow when coding patient visits for reimbursement. Which of the following is an important consideration regarding billing practices? |
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| Selected Answer: |
Failing to bill for billable services will lead to unnecessarily low revenues |
| Answers: |
It is important to “undercode” so that one does not get charged with Medicare fraud |
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The practice of “overcoding” is essential in this age of decreasing reimbursements |
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Failing to bill for billable services will lead to unnecessarily low revenues |
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Time spent with the patient is a very important determinant of billing |
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1 out of 1 points
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A 2 year old presents with a white pupillary reflex. What is the most likely cause of this finding? |
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| Selected Answer: |
Retinoblastoma |
| Answers: |
Viral conjunctivitis |
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Glaucoma |
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Corneal abrasion |
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Retinoblastoma |
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- NURS-6531 Adv. Practice Care of Adults Midterm ExamQuestion 67
0 out of 1 points
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Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo? |
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| Selected Answer: |
A labyrinthectomy |
| Answers: |
Pharmacological therapy |
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A labyrinthectomy |
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A vestibular neurectomy |
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Wearing an earplug in the ear with the most hearing loss |
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0 out of 1 points
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Which of the following is not a risk factor for coronary arterial insufficiency? |
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| Selected Answer: |
Hyperhomocysteinemia |
| Answers: |
Hyperhomocysteinemia |
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Smoking |
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Genetic factors |
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Alcohol ingestion |
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1 out of 1 points
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An 18-year-old female presents to the urgent care center complaining of severe pruritus in both eyes that started 2 days ago. Associated symptoms include a headache and fatigue. On examination, the nurse practitioner notes some clear discharge from both eyes and some erythema of the eyelids and surrounding skin. Which of the following is the most likely cause of this patient’s symptoms? |
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| Selected Answer: |
Allergic conjunctivitis |
| Answers: |
Allergic conjunctivitis |
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Bacterial conjunctivitis |
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Gonococcal conjunctivitis |
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Viral conjunctivitis |
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0 out of 1 points
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A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most effective in keeping him symptom-free? |
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| Selected Answer: |
A long-acting bronchodilator |
| Answers: |
A long-acting bronchodilator |
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An inhaled corticosteroid and cromolyn |
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Theophylline and a short acting bronchodilator |
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A bronchodilator PRN and an inhaled corticosteroid |
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0 out of 1 points
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Acute rheumatic fever is an inflammatory disease which can follow infection with: |
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| Selected Answer: |
Β-hemolytic Streptococcus |
| Answers: |
Group A Streptococcus |
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Staphlococcus areus |
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Β-hemolytic Streptococcus |
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Streptococcus pyogenes |
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- NURS-6531 Adv. Practice Care of Adults Midterm ExamQuestion 72
0 out of 1 points
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A 60 year old male diabetic patient presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which “is better.” His temperature is 100°F and pulse is 102 bpm. The most appropriate initial action is to: |
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| Selected Answer: |
Start an oral antibiotic, mouth swishes with an oral anti-infective, and an analgesic |
| Answers: |
Start an oral antibiotic, refer the patient to a dentist immediately, and follow up within 3 days |
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Order mandibular x-rays and question the patient about physical abuse |
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Start an oral antibiotic, mouth swishes with an oral anti-infective, and an analgesic |
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Initiate a parenteral antibiotic and consider hospital admission |
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1 out of 1 points
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If a patient presents with a deep aching, red eye and there is no discharge, you should suspect: |
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| Selected Answer: |
Iritis |
| Answers: |
Iritis |
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Allergic conjunctivitis |
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Viral conjunctivitis |
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Bacterial conjunctivitis |
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1 out of 1 points
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The National Cholesterol Education Program’s Adult Treatment Panel III recommends that the goal for low density lipoproteins in high risk patients be less than: |
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| Selected Answer: |
100 mg/dL |
| Answers: |
160 mg/dL |
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130 mg/dL |
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100 mg/dL |
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70 mg/dL |
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1 out of 1 points
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A patient presents with classic symptoms of gastroesophageal reflux disease (GERD). He is instructed on life style modifications and drug therapy for 8 weeks. Three months later he returns, reporting that he was “fine” as long as he took the medication. The most appropriate next step is: |
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| Selected Answer: |
Investigation with endoscopy, manometry, and/or pH testing |
| Answers: |
Referral for surgical intervention such as a partial or complete fundoplication |
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Dependent upon how sever the practitioner believes the condition |
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To repeat the 8 week course of drug therapy while continuing lifestyle modifications |
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Investigation with endoscopy, manometry, and/or pH testing |
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- NURS-6531 Adv. Practice Care of Adults Midterm ExamQuestion 76
0 out of 1 points
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Group A β-hemolytic streptococcal (GABHS) pharyngitis is most common in which age group? |
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| Selected Answer: |
Under 3 years of age |
| Answers: |
Under 3 years of age |
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Preschool children |
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6 to 12 years of age |
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Adolescents |
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0 out of 1 points
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The most appropriate treatment for a child with mild croup is: |
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| Selected Answer: |
A decongestant |
| Answers: |
A bronchodilator |
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An antibiotic |
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A decongestant |
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A cool mist vaporizer |
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0 out of 1 points
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|
A child complains that his “throat hurts” with swallowing. His voice is very “throaty” and he is hyperextending his neck to talk. Examination reveals asymmetrical swelling of his tonsils. His uvula is deviated to the left. What is the most likely diagnosis? |
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| Selected Answer: |
Epiglottitis |
| Answers: |
Peritonsillar abscess |
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Thyroiditis |
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Mononucleosis |
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Epiglottitis |
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1 out of 1 points
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Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication? |
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| Selected Answer: |
It is not effective during an acute asthma attack. |
| Answers: |
It is not effective during an acute asthma attack. |
|
It may take 2 to 3 days to begin working. |
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This drug works within 10 minutes. |
|
This drug may be used by patients 6 years and older. |
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0 out of 1 points
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Which intervention listed below is safe for long term use by an adult with constipation? |
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| Selected Answer: |
Stool softeners |
| Answers: |
Bulk-forming agents |
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Stool softeners |
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Laxatives |
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Osmotic agents |
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1 out of 1 points
|
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A 40 year old presents with a hordeolum. The nurse practitioner teaches the patient to: |
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| Selected Answer: |
Apply a topical antibiotic and warm compresses. |
| Answers: |
Apply a topical antibiotic and warm compresses. |
|
Apply cool compresses and avoid touching the hordeolum. |
|
Use an oral antibiotic and eye flushes. |
|
Apply light palpation to facilitate drainage. |
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1 out of 1 points
|
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Sarah has allergic rhinitis and is currently being bothered by nasal congestion. Which of the following meds ordered for allergic rhinitis would be most appropriate? |
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| Selected Answer: |
A decongestant nasal spray |
| Answers: |
An antihistamine intranasal spray |
|
A decongestant nasal spray |
|
Ipratropium |
|
Omalizumab |
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|
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|
1 out of 1 points
|
|
|
What is the Gold standard for the diagnosis of asthma? |
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| Selected Answer: |
Spirometry |
| Answers: |
Patient’s perception of clogged airways |
|
Validated quality-of-life questionnaires |
|
Bronchoscopy |
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Spirometry |
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0 out of 1 points
|
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|
A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough? |
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| Selected Answer: |
Methyldopa |
| Answers: |
Methyldopa |
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Enalapril |
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Amlodipine |
|
Hydrochlorothiazide |
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|
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|
1 out of 1 points
|
|
|
Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by: |
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| Selected Answer: |
Candidiasis |
| Answers: |
Herpes simplex |
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Aphthous ulcers |
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Candidiasis |
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Oral cancer |
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1 out of 1 points
|
|
|
Risk factors for acute otitis media (AOM) include all of the following except: |
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| Selected Answer: |
African-American ethnicity |
| Answers: |
Household cigarette smoke |
|
Group daycare attendance |
|
Sibling history of acute otitis media |
|
African-American ethnicity |
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|
|
|
- NURS-6531 Adv. Practice Care of Adults Midterm Exam Question 87
1 out of 1 points
|
|
|
Which of the following can result from chronic inflammation of a meibomian gland? |
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| Selected Answer: |
A chalazion |
| Answers: |
A chalazion |
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Uveitis |
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Keratitis |
|
A pterygium |
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|
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|
0 out of 1 points
|
|
|
What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare? |
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| Selected Answer: |
You must initiate the plan of care for the patient |
| Answers: |
You must initiate the plan of care for the patient |
|
The physician must be on-site and engaged in patient care |
|
You must be employed as an independent contractor |
|
You must be the main health care provider who sees the patient |
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|
1 out of 1 points
|
|
|
Of the following choices, the least likely cause of cough is: |
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|
|
| Selected Answer: |
Acute pharyngitis |
| Answers: |
Asthma |
|
Gastroesophageal reflux |
|
Acute pharyngitis |
|
Allergic rhinitis |
|
|
|
|
1 out of 1 points
|
|
|
The most common correlate(s) with chronic bronchitis and emphysema is(are): |
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|
|
| Selected Answer: |
Cigarette smoking |
| Answers: |
Familial and genetic factors |
|
Cigarette smoking |
|
Air pollution |
|
Occupational environment |
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|
|
|
0 out of 1 points
|
|
|
Which choice below is least effective for alleviating symptoms of the common cold? |
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|
|
| Selected Answer: |
Topical decongestants |
| Answers: |
Antihistamines |
|
Oral decongestants |
|
Topical decongestants |
|
Antipyretics |
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|
|
|
0 out of 1 points
|
|
|
When teaching a patient with hypertension about restricting sodium, you would include which of the following instructions? |
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|
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| Selected Answer: |
Diets with markedly reduced intakes of sodium may be associated with other beneficial effects beyond blood pressure control |
| Answers: |
Diets with markedly reduced intakes of sodium may be associated with other beneficial effects beyond blood pressure control |
|
Sodium restriction can cause serious adverse effects |
|
A goal of 3 g of sodium chloride or 1.2 g of sodium per day is easily achievable |
|
Seventy-five of sodium intake is derived from processed foods |
|
|
|
|
- NURS-6531 Adv. Practice Care of Adults Midterm Exam Question 93
1 out of 1 points
|
|
|
Which of the following heart murmurs warrants the greatest concern? |
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|
|
| Selected Answer: |
Diastolic murmur |
| Answers: |
Systolic murmur |
|
Venous hum murmur |
|
Diastolic murmur |
|
Flow murmur |
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|
|
|
1 out of 1 points
|
|
|
A patient presents with an inflamed upper eyelid margin. The conjunctiva is red and there is particulate matter along the upper eyelid. The patient complains of a sensation that “there is something in my eye.” What is the diagnosis and how should it be treated? |
|
|
|
| Selected Answer: |
Blepharitis; treat with warm compresses and gentle debridement with a cotton swab |
| Answers: |
Hordeolum; treat with a topical antibiotic and warm compress |
|
Conjunctivitis; treat with topical antibiotic and warm compresses |
|
Blepharitis; treat with warm compresses and gentle debridement with a cotton swab |
|
Chalazion; refer to an ophthalmologist for incision and drainage |
|
|
|
|
1 out of 1 points
|
|
|
A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory? |
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|
| Selected Answer: |
Inferior wall |
| Answers: |
Inferior wall |
|
Anterior wall |
|
Apical wall |
|
Lateral wall |
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|
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|
0 out of 1 points
|
|
|
The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The least likely diagnosis for this patient is: |
|
|
|
| Selected Answer: |
Otitis media with effusion |
| Answers: |
Acute otitis media (AOM) |
|
Otitis media with effusion |
|
Mucoid otitis media |
|
Serous otitis media |
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|
|
|
0 out of 1 points
|
|
|
Alan, age 54, notices a bulge in his midline every time he rises from bed in the morning. You tell him it is a ventral hernia, also known as: |
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|
|
| Selected Answer: |
incisional hernia |
| Answers: |
inguinal hernia |
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epigastric hernia |
|
umbilical hernia |
|
incisional hernia |
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|
|
|
1 out of 1 points
|
|
|
A 58-year-old man is diagnosed with Barrett’s esophagus after an endoscopy. He has no known allergies. Which of the following medications is MOST appropriate to treat this patient’s disorder? |
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| Selected Answer: |
Omeprazole |
| Answers: |
Omeprazole |
|
Ranitidine |
|
An antacid |
|
None of the above |
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|
|
|
- NURS-6531 Adv. Practice Care of Adults Midterm Exam Question 99
1 out of 1 points
|
|
|
Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to: |
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|
|
| Selected Answer: |
Quit smoking |
| Answers: |
Quit smoking |
|
Maintain aggressive hypertension therapy |
|
Stick to a low-fat, low-sodium diet |
|
Continue with his exercise program |
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|
|
|
1 out of 1 points
|
|
|
Risk factors for acute arterial insufficiency include which of the following? |
|
|
|
| Selected Answer: |
All of the above |
| Answers: |
Recent myocardial infarction |
|
Atrial fibrillation |
|
Atherosclerosis |
|
All of the above |
|
|
|
|
1 out of 1 points
|
|
|
Impetigo and folliculitis are usually successfully treated with: |
|
|
|
| Selected Answer: |
Topical antibiotics |
| Answers: |
Systemic antibiotics |
|
Topical antibiotics |
|
Topical steroid creams |
|
Cleansing and debridement |
|
|
|
|
NURS-6531 Adv. Practice Care of Adults Midterm Exam