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NR511 Midterm Exam 2018

Question

Question 1.Question : Which of the following is a crucial element of developing a guideline?

Creating a physician expert panel

Reviewing the literature with ratings of available evidence

Conducting an external review of a guideline

Developing evidence-based tables

Question 2.Question : African American patients seem to have a negative reaction to which of the following asthma medications?

Inhaled corticosteroids

Long-term beta-agonist bronchodilators

Leukotriene receptor agonists

Oral corticosteroids

Question 3.Question : Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?

The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the distant spread cannot be evaluated.

The cancer is in situ; it is spreading into the lymph nodes, but the spread cannot be evaluated otherwise.

The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.

The cancer is about 5 cm in size; nearby lymph nodes cannot be evaluated; and there is no evidence of distant spreading.

Question 4.Question : Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

Meclizine

Diphenhydramine

Diamox

Promethazine

Question 5.Question : Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a:

Filiform/digitate wart

Dysplastic cervical lesion

Condyloma acuminata

Koilocytosis

Question 6.Question : Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?

Dementia

Alzheimer’s disease

Parkinson’s disease

Delirium

Question 7.Question : You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?

“Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow.”

“Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow.”

“Drive to the emergency room now.”

“Call 911.”

Question 8.Question : A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?

NSAIDs

Beets

Vitamin A

Red meat

Question 9.Question : Which of the following is an example of tertiary prevention in a patient with chronic renal failure?

Fluid restriction

Hemodialysis 4 days a week

High-protein diet

Maintenance of blood pressure at 120/80

Question 10.Question : Which of the following conditions is associated with cigarette smoking?

Glaucoma

Increased sperm quality

Bladder cancer

Eczema

Question 11.Question : A chronic cough lasts longer than:

3 weeks

1 month

6 months

1 year

Question 12.Question : The ‘freezing phenomenon’ is a cardinal feature of?

Parkinson’s disease

Alzheimer’s disease

A CVA

Bell’s palsy

Question 13.Question : When administered at the beginning of an attack, oxygen therapy may help this kind of headache?

Tension

Migraine

Cluster

Stress

Question 14.Question : Which ethnic group has the highest lung cancer incidence and mortality rates?

African American men

Scandinavian men and women

Caucasian women

Asian men

Question 15.Question : The most significant precipitating event leading to otitis media with effusion is:

Pharyngitis

Allergies

Viral upper respiratory infection (URI)

Perforation of the eardrum

Question 16.Question : Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:

Severe asthma

A common valvular lesion

Severe hypertension

A prosthetic heart valve

Question 17.Question : A 34-year-old patient was treated for a UTI and has not responded to antibiotic therapy. Which of the following actions should be taken next?

Send a urine specimen for microscopy and evaluate for fungal colonies.

Increase the dose of antibiotic.

Order a cytoscopy.

Order a different antibiotic.

Question 18.Question : Which statement best describes a carotid bruit?

It is felt with the middle three fingers over the carotid artery.

A bruit becomes audible when the lumen is narrowed to 1 mm or less.

A low-pitched bruit is a medical emergency.

The higher the pitch of the bruit, the higher the degree of stenosis.

Question 19.Question : Which statement is true regarding chloasma, the ‘mask of pregnancy’?

It is caused by a decrease in the melanocyte-stimulating hormone during pregnancy.

This condition only occurs on the face.

Exposure to sunlight will even out the discoloration.

It is caused by increased levels of estrogen and progesterone.

Question 20.Question : Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

“You must be under a lot of stress lately.”

“It is hereditary. Did your father experience this also?”

“The cause is unknown, but we suspect it is due to an immunologic mechanism.”

“We’ll have to do some tests.”

Question 21.Question : A blood pressure (BP) of 150/90 is considered:

Stage 2 hypertension

Hypertensive

Normal in healthy older adults

Acceptable if the patient has DM

Question 22.Question : When teaching post MI patients about their NTG tablets, the clinician should stress that the tablets should remain in the light-resistant bottle in which they are packaged and should not be put in another pill box or remain in areas that are or could become warm and humid. Once opened, the bottle must be dated and discarded after how many months?

1 month

3 months

6 months

As long as the tablets are kept in this special bottle, they will last forever.

Question 23.Question : Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?

He should stop smoking today.

He should stop smoking tomorrow.

His quit date should be in 1 week.

He will be ready to quit after the first 30 days.

Question 24.Question : When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

Spores

Leukocytes

Pseudohyphae

Epithelial cells

Question 25.Question : The hallmark of an absence seizure is:

No activity at all

A blank stare

Urine is usually voided involuntarily

The attack usually lasts several minutes

Question 26.Question : Which medication used for scabies is safe for children 2 months and older?

Permethrin cream

Lindane

Crotamiton lotion and cream

Ivermectin

Question 27.Question : The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?

Viral conjunctivitis

Keratoconjunctivitis

Bacterial conjunctivitis

Allergic conjunctivitis

Question 28.Question : Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?

“Most patients have complete recovery in 3 to 6 months.”

“Unfortunately, you’ll probably have a small amount of residual damage.”

“Don’t worry, I’ll take care of everything.”

“You may have a few more episodes over the course of your lifetime but no permanent damage.”

Question 29.Question : How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate?

Every 3 months

Every 6 months

Annually

Whenever there is a problem

Question 30.Question : Immunizations are an example of which type of prevention?

Primary

Secondary

Tertiary

Question 31.Question : The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?

Repeat the test.

Refer to a nephrologist.

Measure the serum protein.

Obtain a blood urea nitrogen (BUN) and creatinine.

Question 32.Question : Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing?

CN V

CN VII

CN IX

CN X

Question 33.Question : Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer?

Kidneys, ureter, bladder x-ray

Cystoscopy with biopsy

Magnetic resonance imaging

Urine tumor marker (NMP22)

Question 34.Question : The “B” in the ABCDEs of assessing skin cancer represents:

Biopsy

Best practice

Boundary

Border irregularity

Question 35.Question : Which statement is true regarding driving and patients with a seizure disorder?

Once diagnosed with a seizure disorder, patients must never drive again.

After being seizure free for 6 months, patients may drive.

Each state has different laws governing driving for individuals with a seizure disorder.

These persons may drive but never alone.

Question 36.Question : Which high-density lipoprotein (HDL) level is considered cardioprotective?

Greater than 30

Greater than 40

Greater than 50

Greater than 60

Question 37.Question : The most common cause of CAP is?

Streptococcus pneumoniae

Klebsiella pneumoniae

Legionella pneumoniae

Pseudomonas aeruginosa

Question 38.Question : Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?

Serum calcium

Electrocardiogram (ECG)

Thyroid-stimulating hormone test

Complete blood cell count

Question 39.Question : A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?

The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.

Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.

A throat culture should be performed to confirm the results of the rapid strep test.

The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.

Question 40.Question : Patients with acute otitis media should be referred to a specialist in which of the following situations?

Concurrent vertigo or ataxia

Failed closure of a ruptured tympanic membrane

If symptoms worsen after 3 or 4 days of treatment

All of the above

Question 41.Question : Which of the following tests is most useful in determining renal function in a patient suspected of CRF?

BUN and creatinine

Electrolytes

Creatinine clearance

Urinalysis

Question 42.Question : Marci has a wart on her hand. She says she heard something about “silver duct tape therapy.” What do you tell her about his?

It is an old wives’ tale.

It is used as a last resort.

Salicylic acid is more effective.

It is a simple treatment that should be tried first.

Question 43.Question : What is the first-line recommended treatment against Group A b-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?

Penicillin

Quinolone

Cephalosporin

Macrolide

Question 44.Question : Which of the following is an example of sensorineural hearing loss?

Perforation of the tympanic membrane

Otosclerosis

Cholesteatoma

Presbycusis

Question 45.Question : Which of the following is “a linear crack extending from the epidermis to the dermis?”

An ulcer

A fissure

Lichenification

An excoriation

Question 46.Question : A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?

The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.

The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.

Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist.

Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.

Question 47.Question : The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?

IgA

IgE

IgG

IgM

Question 48.Question : A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses?

Pancreatitis

Peptic ulcer disease

Diverticulitis

All of the above

Question 49.Question : Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?

B-type natriuretic peptide

C-reactive protein

Serum albumin

Erythrocyte sedimentation rate

Question 50.Question : You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?

Baker phenomenon

Arnold reflex

Cough reflex

Tragus reflex

Question 1: The most cost-effective screening test for determining HIV status is which of the following?

Western blot

Enzyme-linked immunosorbent assay

Venereal Disease Research Laboratory test

Viral load

Question 2.Question : Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process?

Erythrocyte sedimentation rate

White blood cell count

Polymorphonuclear cells

C-reactive protein (CRP)

Question 3.Question : Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?

GABA

Acetylcholine

Dopamine

Serotonin

Question 4.Question : Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:

Ecchymosis, edema, and erythema over the lateral epicondyle

Pain at the elbow with resisted movements at the wrist and forearm

Inability to supinate and pronate the arm

Inability to flex or extend the elbow against resistance

Question 5.Question : Which of the following statements concerning the musculoskeletal examination is true?

The uninvolved side should be examined initially and then compared to the involved side.

The part of the body that is causing the patient pain should be examined first.

When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain.

Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

Question 6.Question : Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Decreased C-reactive protein

Hyperalbuminemia

Morning stiffness

Weight gain

Question 7.Question : Which causes the greatest percentage of mammalian bites?

Dogs

Cats

Humans

Rodents

Question 8.Question : A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first?

Transvaginal ultrasound

Endometrial biopsy

MRI

Abdominal computed tomography scan

Question 9.Question : A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate?

“Control of glucose will help postpone or delay complications.”

“Regularly checking blood sugar will help establish a routine.”

“Monitoring glucose will promote a sense of control.”

All of the above

Question 10.Question : A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next?

Serum calcium

TSH

Electrolytes

Urine specific gravity

Question 11.Question : Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?

Insulin

Metformin

Glucotrol

Precose

Question 12.Question : During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

An enlarged rubbery gland

A hard irregular gland

A tender gland

A boggy gland

Question 13.Question : Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step?

Remove the insect with tweezers.

Immobilize the insect with 2% lidocaine.

Sedate Eddie with diazepam.

Shine a light in the ear for the insect to “find its way out.”

Question 14.Question : What is the most common cause of microcytic anemia?

Anemia of chronic disease

Sideroblastic anemia

Iron-deficiency anemia

Thalassemia

Question 15.Question : An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses?

Benign prostatic hyperplasia (BPH)

Parkinson’s disease

Prostate cancer

All of the above

Question 16.Question : Early rheumatoid disease is characterized by:

Pain and swelling in both small and large peripheral joints

Rigid joints with diminished range of motion

Joint swelling and immobility on rising

A cardiac rub or pulmonary friction rub

Question 17.Question : A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do?

Make an immediate referral for an orthopedic evaluation without further assessment.

Tell her that it takes time for these bruises to improve, so she should be patient.

Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint.

Send her to the emergency room for reduction of this obvious wrist fracture.

Question 18.Question : The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:

1 month

3 months

6 months

12 months

Question 19.Question : A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?

The scrotum will be dark.

The scrotum will appear light pink or yellow.

The scrotum will appear milky white.

The internal structures will be clearly visible.

Question 20.Question : According to Kübler-Ross, the stages of grief occur in which order?

Anger, denial, depression, bargaining, acceptance

Anger, denial, bargaining, acceptance, depression

Denial, anger, depression, bargaining, acceptance

Denial, anger, bargaining, depression, acceptance

Question 21.Question : Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate?

A favorable prognostic trend

Disease progression

The need to be more aggressive with Reuben’s

medications

The eradication of the HIV

Question 22.Question : The exanthem of Lyme disease is:

Erythema infectiosum

Laterothoracic exanthem

Erythema migrans

Morbilli exanthem

Question 23.Question : You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is:

Articular

Inflammatory

Nonarticular

A and B

Question 24.Question : What is the recommended daily calcium intake for adults over the age of 50 with low bone mass?

1,200 mg/day

1,000 mg/day

1,300 mg/day

1,500 mg/day

Question 25.Question : When assessing a woman for infertility, which of the following tests should be done first?

Analysis of partner’s sperm

Magnetic resonance imaging (MRI)

Hysterosalpingogram

Estrogen level

Question 26.Question : Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

Superficial burns

Superficial partial-thickness burns

Deep partial-thickness burns

Full-thickness burns

Question 27.Question : A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination?

Human papillomavirus (HPV)

Endometrial hyperplasia

Vagismus

Polycystic ovarian syndrome

Question 28.Question : As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin?

Two

Three

Four

Five

Question 29.Question : Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?

Morning stiffness and limited mobility of the lumbar spine

Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

Fever, chills, and elevated erythrocyte sedimentation rate

Pathologic fractures, severe night pain, weight loss, and fatigue

Question 30.Question : A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?

Testosterone level

Prostate-specific antigen

Nocturnal penile tumescence and rigidity

Prolactin level

Question 31.Question : The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective?

“I’ll take my pill at least 30 minutes before breakfast.”

“I’ll take my Glucotrol before bedtime.”

“It is important to take my medication right after I eat.”

“Since I only like to eat two meals a day, I can take the pill between my meals.”

Question 32.Question : In the United States, what is the second most common connective tissue disease and the most destructive to the joints?

Osteoarthritis

Systemic lupus erythematosus (SLE)

Rheumatoid arthritis

Sjögren’s syndrome

Question 33.Question : The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?

Acetylcholine

Gamma-aminobutyric acid (GABA)

Dopamine

Serotonin

Question 34.Question : A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action?

Refer to a urologist immediately.

Obtain a computed tomography (CT) scan.

Instruct the patient to elevate the scrotum.

Prescribe ibuprofen.

Question 35.Question : Which of the following medications can cause hyperglycemia?

Prednisone

Metformin

Synthroid

Cephalexin

Question 36.Question : During treatment for anaphylaxis, what site is used for the initial injection of epinephrine?

Abdomen

Upper lateral thigh

Deltoid

Question 37.Question : It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period?

Before the initiation of treatment

1 to 2 weeks after the initiation of treatment

When switching to a different medication

1 to 2 weeks after tapering off medications

Question 38.Question : What is the most common cause of secondary amenorrhea?

Pregnancy

Pituitary dysfunction

Inadequate estrogen levels

Genetic disorders

Question 39.Question : Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration?

Sertraline

Fluoxetine

Citoprolam

Imipramine

Question 40.Question : The goals of the 15-minute hour approach include:

Enhance self-esteem, expand behavioral repertoire, prevent dire consequences, and reestablish premorbid levels of functioning

Emerge with a higher level of functioning and commitment to long-term psychotherapy

Accept need for antidepressant therapy and psychiatric referral; share concerns with primary care clinician

Improve family functioning and sexual performance as well as accept need for antidepressant medication

Question 41.Question : John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

Valgus stress test

McMurray circumduction test

Lachman test

Varus stress test

Question 42.Question : The cardinal subjective symptom of sickle cell crisis is which of the following?

Pain

Nausea

Light-headedness

Palpitations

Question 43.Question : A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which of the following pelvic pathologies is the most common cause of dysmenorrhea?

Pelvic inflammatory disease

Endometriosis

Sexually transmitted infections

Ovarian cyst

Question 44.Question : Which arthropod bite can contain cytotoxic and haemolytic toxins that may destroy tissue?

Tick

Brown recluse spider

Wasp

Stinging caterpillar

Question 45.Question : Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equine compression. Which of the following is a sign or symptom of cauda equina compression?

Gastrocnemius weakness

A reduced or absent ankle reflex

Numbness in the lateral foot

Paresthesia of the perineum and buttocks

Question 46.Question : A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the following tests is essential before prescribing any oral contraceptive?

Pregnancy test

Complete blood cell count

Thyroid-stimulating hormone

Urine dip for protein

Question 47.Question : A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin?

Ketoacidosis

Cirrhosis

Hypoglycemic episodes

All of the above

Question 48.Question : The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants?

SSRIs are more effective than TCAs.

SSRIs take less time to work than TCAs.

SSRIs have a more favorable side-effect profile than

TCAs.

SSRIs are not lethal in overdose.

Question 49.Question : Which type of bone marrow transplant is obtained from an identical twin?

Autogenic

Autologous

Allogeneic

Syngeneic

Question 50.Question : Pink, cherry red tissues and skin may result from which type of poisoning?

Arsenic

Lead

Carbon monoxide

Strychnine

Question 51.Question : Basic human needs are identified as:

Autonomy and feeling valued by others

Exhilaration and productivity

Spirituality

Career success and material rewards

Question 52.Question : The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

Overweight

Mild obesity

Moderate obesity

Morbid obesity

Question 53.Question : A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular selfexamination (TSE). Which of the following should be examination (TSE). Which of the following should be included in the list of differential diagnoses?

Testicular cancer

Inguinal hernia

Varicocele

All of the above

Question 54.Question : What is the treatment of choice for a patient diagnosed with testicular cancer?

Radical orchidectomy

Lumpectomy

Radiation implants

All of the above

Question 55.Question : Which method is used to remove heavy metals, such as lead, that are ingested as poisons?

Chelation

Dialysis

Gastric lavage

Bowel irrigation

Question 56.Question : A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

“It is probably just a cyst because that is the most common breast mass.”

“We will order a mammogram and ultrasound to help establish a diagnosis.”

“We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”

“Because your lump is painful, it is most likely not cancer.”

Question 57.Question : A 36-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?

Fluconazole

Estrogen vaginal cream

Metronidazole

Doxycycline

Question 58.Question : The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs?

“You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.”

“You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication.”

“You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.”

“It is important to take NSAIDs on an empty stomach in order to increase absorption.”

Question 59.Question : A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting of a joint, is more likely related to which musculoskeletal injury?

A sprain

A strain

A partial fracture

A fracture

Question 60.Question : Which type of heat-related illness involves a core body temperature of at least 104.9°F, acute mental status temperature of at least 104.9°F, acute mental status changes, absent sweat, and tachypnea?

Heat cramps

Heat syncope

Heat exhaustion

Heat stroke

Question 61.Question : Which of the following may be used to evaluate a person’s suicide risk?

CAGE

SANE

SAD PERSONAS

DIGFAST

Question 62.Question : One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular structure?

Bone

Synovium

Tendons

Fascia

Question 63.Question : After returning from visiting his grandchildren in England, George, age 59, complains of a flulike illness, including fever, chills, and myalgia. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?

A viral syndrome

Lyme disease

Rocky Mountain spotted fever

Relapsing fever

Question 64.Question : A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expect as a manifestation of the disease?

Sinus bradycardia

Atrial fibrillation

Supraventricular tachycardia

U waves

Question 65.Question : Which of the following tests is essential for a 46-year-old woman who the clinician suspects is perimenopausal?

Pregnancy

Estrogen level

Progesterone level

LH level

Question 66.Question : After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?

Elevated TSH

Normal TSH

Low TSH

Undetectable TSH

Question 67.Question : A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment?

No treatment at this time

Diet and exercise for 6-week trial

Diet, exercise, and oral medication

Diet, exercise, and exogenous insulin

Question 68.Question : Which of the following should be considered in a patient presenting with erectile dysfunction?

Diabetes mellitus

Hypertension

Atherosclerosis

All of the above

Question 69.Question : Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome?

Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel.

Only people with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.

An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.

Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.

Question 70.Question : A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea?

Ceftriaxone

Doxycycline

Acyclovir

Metronidazole

Question 71.Question : Which of the following statements is true regarding the treatment of carpal tunnel syndrome?

The goal of treat

NR511 Midterm Exam

NR511 Midterm Exam 2018

Question 1: The most cost-effective screening test for determining HIV status is which of the following?

Western blot

Enzyme-linked immunosorbent assay

Venereal Disease Research Laboratory test

Viral load

Question 2.Question : Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process?

Erythrocyte sedimentation rate

White blood cell count

Polymorphonuclear cells

C-reactive protein (CRP)

Question 3.Question : Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?

GABA

Acetylcholine

Dopamine

Serotonin

Ecchymosis, edema, and erythema over the lateral epicondyle

Pain at the elbow with resisted movements at the wrist and forearm

Inability to supinate and pronate the arm

Inability to flex or extend the elbow against resistance

Question 5.Question : Which of the following statements concerning the musculoskeletal examination is true?

The uninvolved side should be examined initially and then compared to the involved side.

The part of the body that is causing the patient pain should be examined first.

When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain.

Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

Question 6.Question : Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Decreased C-reactive protein

Hyperalbuminemia

Morning stiffness

Weight gain

Question 7.Question : Which causes the greatest percentage of mammalian bites?

Dogs

Cats

Humans

Rodents

Transvaginal ultrasound

Endometrial biopsy

MRI

Abdominal computed tomography scan

Question 9.Question : A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate?

“Control of glucose will help postpone or delay complications.”

“Regularly checking blood sugar will help establish a routine.”

“Monitoring glucose will promote a sense of control.”

All of the above

Serum calcium

TSH

Electrolytes

Urine specific gravity

Question 11.Question : Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?

Insulin

Metformin

Glucotrol

Precose

Question 12.Question : During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

An enlarged rubbery gland

A hard irregular gland

A tender gland

A boggy gland

Question 13.Question : Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step?

Remove the insect with tweezers.

Immobilize the insect with 2% lidocaine.

Sedate Eddie with diazepam.

Shine a light in the ear for the insect to “find its way out.”

Question 14.Question : What is the most common cause of microcytic anemia?

Anemia of chronic disease

Sideroblastic anemia

Iron-deficiency anemia

Thalassemia

Benign prostatic hyperplasia (BPH)

Parkinson’s disease

Prostate cancer

All of the above

Question 16.Question : Early rheumatoid disease is characterized by:

Pain and swelling in both small and large peripheral joints

Rigid joints with diminished range of motion

Joint swelling and immobility on rising

A cardiac rub or pulmonary friction rub

Make an immediate referral for an orthopedic evaluation without further assessment.

Tell her that it takes time for these bruises to improve, so she should be patient.

Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint.

Send her to the emergency room for reduction of this obvious wrist fracture.

1 month

3 months

6 months

12 months

The scrotum will be dark.

The scrotum will appear light pink or yellow.

The scrotum will appear milky white.

The internal structures will be clearly visible.

Question 20.Question : According to Kübler-Ross, the stages of grief occur in which order?

Anger, denial, depression, bargaining, acceptance

Anger, denial, bargaining, acceptance, depression

Denial, anger, depression, bargaining, acceptance

Denial, anger, bargaining, depression, acceptance

Question 21.Question : Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate?

A favorable prognostic trend

Disease progression

The need to be more aggressive with Reuben’s

medications

The eradication of the HIV

Question 22.Question : The exanthem of Lyme disease is:

Erythema infectiosum

Laterothoracic exanthem

Erythema migrans

Morbilli exanthem

Articular

Inflammatory

Nonarticular

A and B

Question 24.Question : What is the recommended daily calcium intake for adults over the age of 50 with low bone mass?

1,200 mg/day

1,000 mg/day

1,300 mg/day

1,500 mg/day

Question 25.Question : When assessing a woman for infertility, which of the following tests should be done first?

Analysis of partner’s sperm

Magnetic resonance imaging (MRI)

Hysterosalpingogram

Estrogen level

Question 26.Question : Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

Superficial burns

Superficial partial-thickness burns

Deep partial-thickness burns

Full-thickness burns

Human papillomavirus (HPV)

Endometrial hyperplasia

Vagismus

Polycystic ovarian syndrome

Question 28.Question : As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin?

Two

Three

Four

Five

Morning stiffness and limited mobility of the lumbar spine

Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

Fever, chills, and elevated erythrocyte sedimentation rate

Pathologic fractures, severe night pain, weight loss, and fatigue

Question 30.Question : A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?

Testosterone level

Prostate-specific antigen

Nocturnal penile tumescence and rigidity

Prolactin level

Question 31.Question : The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective?

“I’ll take my pill at least 30 minutes before breakfast.”

“I’ll take my Glucotrol before bedtime.”

“It is important to take my medication right after I eat.”

“Since I only like to eat two meals a day, I can take the pill between my meals.”

Question 32.Question : In the United States, what is the second most common connective tissue disease and the most destructive to the joints?

Osteoarthritis

Systemic lupus erythematosus (SLE)

Rheumatoid arthritis

Sjögren’s syndrome

Question 33.Question : The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?

Acetylcholine

Gamma-aminobutyric acid (GABA)

Dopamine

Serotonin

Question 34.Question : A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action?

Refer to a urologist immediately.

Obtain a computed tomography (CT) scan.

Instruct the patient to elevate the scrotum.

Prescribe ibuprofen.

Question 35.Question : Which of the following medications can cause hyperglycemia?

Prednisone

Metformin

Synthroid

Cephalexin

Question 36.Question : During treatment for anaphylaxis, what site is used for the initial injection of epinephrine?

Abdomen

Upper lateral thigh

Deltoid

Before the initiation of treatment

1 to 2 weeks after the initiation of treatment

When switching to a different medication

1 to 2 weeks after tapering off medications

Question 38.Question : What is the most common cause of secondary amenorrhea?

Pregnancy

Pituitary dysfunction

Inadequate estrogen levels

Genetic disorders

Question 39.Question : Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration?

Sertraline

Fluoxetine

Citoprolam

Imipramine

Question 40.Question : The goals of the 15-minute hour approach include:

Enhance self-esteem, expand behavioral repertoire, prevent dire consequences, and reestablish premorbid levels of functioning

Emerge with a higher level of functioning and commitment to long-term psychotherapy

Accept need for antidepressant therapy and psychiatric referral; share concerns with primary care clinician

Improve family functioning and sexual performance as well as accept need for antidepressant medication

Valgus stress test

McMurray circumduction test

Lachman test

Varus stress test

Question 42.Question : The cardinal subjective symptom of sickle cell crisis is which of the following?

Pain

Nausea

Light-headedness

Palpitations

Question 43.Question : A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which of the following pelvic pathologies is the most common cause of dysmenorrhea?

Pelvic inflammatory disease

Endometriosis

Sexually transmitted infections

Ovarian cyst

Question 44.Question : Which arthropod bite can contain cytotoxic and haemolytic toxins that may destroy tissue?

Tick

Brown recluse spider

Wasp

Stinging caterpillar

Gastrocnemius weakness

A reduced or absent ankle reflex

Numbness in the lateral foot

Paresthesia of the perineum and buttocks

Question 46.Question : A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the following tests is essential before prescribing any oral contraceptive?

Pregnancy test

Complete blood cell count

Thyroid-stimulating hormone

Urine dip for protein

Ketoacidosis

Cirrhosis

Hypoglycemic episodes

All of the above

SSRIs are more effective than TCAs.

SSRIs take less time to work than TCAs.

SSRIs have a more favorable side-effect profile than

TCAs.

SSRIs are not lethal in overdose.

Question 49.Question : Which type of bone marrow transplant is obtained from an identical twin?

Autogenic

Autologous

Allogeneic

Syngeneic

Question 50.Question : Pink, cherry red tissues and skin may result from which type of poisoning?

Arsenic

Lead

Carbon monoxide

Strychnine

Question 51.Question : Basic human needs are identified as:

Autonomy and feeling valued by others

Exhilaration and productivity

Spirituality

Career success and material rewards

Question 52.Question : The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

Overweight

Mild obesity

Moderate obesity

Morbid obesity

Testicular cancer

Inguinal hernia

Varicocele

All of the above

Question 54.Question : What is the treatment of choice for a patient diagnosed with testicular cancer?

Radical orchidectomy

Lumpectomy

Radiation implants

All of the above

Question 55.Question : Which method is used to remove heavy metals, such as lead, that are ingested as poisons?

Chelation

Dialysis

Gastric lavage

Bowel irrigation

Question 56.Question : A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

“It is probably just a cyst because that is the most common breast mass.”

“We will order a mammogram and ultrasound to help establish a diagnosis.”

“We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”

“Because your lump is painful, it is most likely not cancer.”

Fluconazole

Estrogen vaginal cream

Metronidazole

Doxycycline

“You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.”

“You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication.”

“You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.”

“It is important to take NSAIDs on an empty stomach in order to increase absorption.”

Question 59.Question : A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting of a joint, is more likely related to which musculoskeletal injury?

A sprain

A strain

A partial fracture

A fracture

Heat cramps

Heat syncope

Heat exhaustion

Heat stroke

Question 61.Question : Which of the following may be used to evaluate a person’s suicide risk?

CAGE

SANE

SAD PERSONAS

DIGFAST

Bone

Synovium

Tendons

Fascia

A viral syndrome

Lyme disease

Rocky Mountain spotted fever

Relapsing fever

Question 64.Question : A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expect as a manifestation of the disease?

Sinus bradycardia

Atrial fibrillation

Supraventricular tachycardia

U waves

Question 65.Question : Which of the following tests is essential for a 46-year-old woman who the clinician suspects is perimenopausal?

Pregnancy

Estrogen level

Progesterone level

LH level

Question 66.Question : After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?

Elevated TSH

Normal TSH

Low TSH

Undetectable TSH

No treatment at this time

Diet and exercise for 6-week trial

Diet, exercise, and oral medication

Diet, exercise, and exogenous insulin

Question 68.Question : Which of the following should be considered in a patient presenting with erectile dysfunction?

Diabetes mellitus

Hypertension

Atherosclerosis

All of the above

Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel.

An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.

Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.

Question 70.Question : A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea?

Ceftriaxone

Doxycycline

Acyclovir

Metronidazole

Question 71.Question : Which of the following statements is true regarding the treatment of carpal tunnel syndrome?

The goal of treatment is to prevent flexion and extension movements of the wrist.

Splints are used in carpal tunnel syndrome, because they allow for free movement of the fingers and thumb while allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position.

Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.

All of the above

Question 72.Question : Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this patient?

Elevated uric acid level

Elevated blood urea nitrogen

Decreased urine pH

Decreased C-reactive protein

Question 73.Question : Which of the following data is indicative of testicular torsion?

Absent cremasteric reflex

Pain relieved on testicular elevation

Testicle very low in the scrotum

Swollen scrotum with “red dot sign”

Question 74.Question : A patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer her, the clinician must understand that exercise has what effect on the patient with type 2 diabetes?

Reduces postprandial blood glucose

Reduces triglycerides and increases high-density lipoprotein (HDL)

Reduces total cholesterol

All of the above

Question 75.Question : A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the vaginal bleeding. Which of the following tests should be the first priority?

Pregnancy test

Pelvic ultrasound

Endometrial biopsy

Platelet count

Question 76.Question : What is the most common cause of generalized musculoskeletal pain in women ages 20 to 55?

Chronic fatigue syndrome (CFS)

Anemia

Fibromyalgia syndrome (FMS)

Sports-related injuries

Question 77.Question : If the international normalized ratio (INR) result is above the therapeutic range in a patient with atrial fibrillation on warfarin, what might the clinician do?

Stop the warfarin for 1 week, and then repeat the INR.

Withhold one or more days of anticoagulant therapy.

Restart therapy at a lower dose immediately.

The prothrombin time and INR should be reevaluated within 1 month of the dosage adjustments.

Question 78.Question : A 32-year-old woman is seen in the clinic because she has been unable to get pregnant after 12 months of unprotected sex. In order to determine the cause of the infertility, the clinician should question her about which of these possible causes?

Pelvic inflammatory disease

Oral contraceptive use for 15 years

Early menarche

Diet high in soy protein

Question 79.Question : Which of the following statements concerning the treatment of fibromyalgia syndrome is true?

There is currently no cure for the disorder; however, patients should be made aware that symptom relief is possible.

Treatment is directed toward controlling discomfort, improving sleep, and maintaining function.

Fibromyalgia syndrome can be difficult to manage, requiring a variety of approaches and multiple medications.

All of the above

Question 80.Question : The clinician should prescribe an antibiotic that covers which of these organisms for a patient with acute prostatitis?

Gram-positive cocci

Gram-negative cocci

Gram-positive bacillus

Gram-negative bacillus

Question 81.Question : Which household solution should be used to clean a bathroom if sharing with a friend who has HIV?

100% bleach

50% bleach and 50% vinegar

Nine parts H2O to one part bleach

The friend must have his or her own bathroom.

Question 82.Question : Sandra is 42 years old and has just been diagnosed with leukemia. She is complaining of bone and joint pain. Which type of leukemia is most likely the culprit?

Acute lymphocytic leukemia

Acute myelogenous leukemia

Chronic myelogenous leukemia

Chronic lymphocytic leukemia

Question 83.Question : Which of the following is identified as an eating disorder in which a person craves food substitutes, such as clay, ice chips, and cotton, and is considered an objective finding associated with severe iron deficiency?

Ferritin

Porter’s syndrome

Hypochromasia

Pica

Question 84.Question : The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit?

High sensitivity thyroid-stimulating hormone (TSH) and free T4

Free T4 and serum calcium

Free T3 and T4

TSH and thyroxin antibodies

Question 85.Question : The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been effective?

“As long as I don’t need glasses, I don’t have to worry about going blind.”

“I know I need to have my eyes checked every year.”

“My optometrist checks my eyes.”

“I will see my eye doctor when my vision gets blurry.”

Question 86.Question : Triggering factors for acute exacerbations of which of the following conditions include exposure to ultraviolet (UV)-B and UV-A rays?

Rheumatoid arthritis

Scleroderma

SLE

Sjögren’s syndrome

Question 87.Question : Which of the following characteristics separates anaphylaxis from a vasovagal reaction?

Bradycardia

Extreme diaphoresis

Severe bronchoconstriction

Hypotension

Question 88.Question : Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The clinician has explained to Mr. Jackson that the goals for managing osteoarthritis include controlling pain, maximizing functional independence and mobility,

minimizing disability, and preserving quality of life. Mr. Jackson explains to the clinician that his first choice would be to use complementary therapies to control his condition and asks what therapies are most effective in treating osteoarthritis. What would be the most appropriate response from the clinician?

“Complementary therapies should be considered only if surgical interventions are not successful.”

“I am unfamiliar with the available complementary therapies for osteoarthritis and prefer to discuss more mainstream treatments, such as NSAIDs and physical therapy, to manage your condition.”

“I would be happy to discuss all the treatment options available to you. Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being studied for use in the treatment of osteoarthritis and have shown promise when used with standard medical therapy.”

“It would be crazy to use complementary therapies to treat such a serious condition.”

Question 89.Question : One benefit of motivational interviewing (MI) is:

It assumes that ambivalence is a normal part of the change process.

It can be utilized during routine office visits.

It is a therapeutic technique which is not necessarily time intensive.

All are benefits of MI.

Question 90.Question : What percentage of burns is involved using the rule of nines if both front legs are burned?

18%

24%

36%

Question 91.Question : Women are at the highest risk for developing postpartum depression for up to how long after childbirth?

2 weeks

1 month

3 months

6 months

Question 92.Question : Which statement about HIV postexposure prophylaxis (PEP) for health-care workers is the most accurate?

PEP should be started within hours of exposure.

PEP should be started within 72 hours of exposure.

Renal and hepatic function tests should be done 6 weeks after beginning PEP.

PEP will prevent potential hepatitis C infection if present.

Question 93.Question : The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an xray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane’s description of her injury. Which of the following clues in Diane’s examination or history would alert the clinician to the need for obtaining radiographs?

Inability to bear weight immediately after the injury

Development of marked ankle swelling and discoloration after the injury

Crepitation with palpation or movement of the ankle

All of the above

Question 94.Question : A vegetarian patient with gout asks the clinician about food he should avoid. The clinician should advise the patient to avoid which of the following foods?

Rice

Carrots

Spinach

Potatoes

Question 95.Question : A patient with a basilar skull fracture may experience an impaired downward gaze or diplopia from which affected cranial nerve?

CN II

CN III

CN IV

CN V

Question 96.Question : A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack?

Pheochromocytoma

Hyperthyroidism

Cardiac arrhythmias

All of the above

Question 97.Question : Which test is used to confirm a diagnosis of epididymitis?

Urinalysis

Gram stain of urethral discharge

Complete blood cell count with differential

Ultrasound of the scrotum

Question 98.Question : BATHEing the patient refers to:

A technique used in primary care to get the patient to accept the need for psychological or psychiatric referral.

A technique used to facilitate cultural understandingc.

A technique used to perform psychotherapyd.

A technique that is a quick screen for psychiatric issues and interventions for psychological problems

Question 99. Question :BATHEing the patient is an advanced practice nursingintervention that allows the practitioner to:

Develop a therapeutic relationship without “owning” the patient’s problem

Conduct psychological counseling within the context of the primary care encounter

Focus on the “process” and not the assessment

Make the patient and family happier

Question 100. Question A 45-year-old woman is seen in the clinic with abnormaluterine bleeding and pain during intercourse. The clinicianshould consider which of the following diagnoses? Leiomyoma

Pregnancy

Ovarian cancer

All of the above

MN551 Unit 10 Final Exam

MN551 Unit 10 Final Exam

Question

During an examination, the nurse observes a female patient’s vestibule and expects to see the:

A ) urethral meatus and vaginal orifice.

B) vaginal orifice and vestibular (Bartholin) glands.
C) urethral meatus and paraurethral (Skene) glands.
D) paraurethral (Skene) and vestibular (Bartholin) glands.
During a speculum inspection of the vagina, the nurse would expect to see what at the end of the vaginal canal?
A) Cervix
B) Uterus
C) Ovaries
D) Fallopian tubes
The uterus is usually positioned tilting forward and superior to the bladder. This position is known as:
A) anteverted and anteflexed.
B) retroverted and anteflexed.

C retroverted and retroflexed.

D)superiorverted and anteflexed.

An 11-year-old girl is in the clinic for a sports physical. The nurse notices that she has begun to develop breasts, and during the conversation the girl reveals that she is worried about her development. The nurse should use which of these techniques to best assist the young girl in understanding the expected sequence for development? The nurse should:
A) use the Tanner’s table on the five stages of sexual development.
B) describe her development and compare it with that of other girls her age.
C) use Jacobsen’s table on expected development on the basis of height and weight data.
D) reassure her that her development is within normal limits and should tell her not to worry about the next step.
A woman who is 8 weeks pregnant is in the clinic for a checkup. The nurse reads on her chart that her cervix is softened and looks cyanotic. The nurse knows that the woman is exhibiting _____ sign and _____ sign.
A) Tanner’s; Hegar’s
B) Hegar’s; Goodell’s
C) Chadwick’s; Hegar’s
D) Goodell’s; Chadwick’s
A woman who is 22 weeks pregnant has a vaginal infection. She tells the nurse that she is afraid that this infection will hurt the fetus. The nurse knows that which of these statements is true?
A) If intercourse is avoided, then the risk for infection is minimal.
B) A thick mucus plug forms that protects the fetus from infection.
C) The acidic pH of vaginal secretions promotes the growth of pathogenic bacteria.
D) The mucus plug that forms in the cervical canal is a good medium for bacterial growth.
The changes normally associated with menopause occur generally because the cells in the reproductive tract are:

A)aging.

B)becoming fibrous.

C)estrogen dependent.

D)able to respond to estrogen.

The nurse is reviewing the changes that occur with menopause. Which of these are changes associated with menopause?
A) Uterine and ovarian atrophy along with thinning vaginal epithelium
B) Ovarian atrophy, increased vaginal secretions, and increasing clitoral size
C) Cervical hypertrophy, ovarian atrophy, and increased acidity of vaginal secretions
D) Vaginal mucosa fragility, increased acidity of vaginal secretions, and uterine hypertrophy
A 54-year-old woman who has just completed menopause is in the clinic today for a yearly physical examination. Which of these statements should the nurse include in patient education? “A postmenopausal woman:
A) is not at any greater risk for heart disease than a younger woman is.”
B) should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions.”
C) has only stopped menstruating; there really are no other significant changes with which she should be concerned.”
D) is likely to have difficulty with sexual pleasure as a result of drastic changes in the female sexual response cycle.”
A woman is in the clinic for an annual gynecologic examination. The nurse should plan to begin the interview with the:
A) menstrual history because it is generally nonthreatening.
B) obstetric history because it is the most important information.
C) urinary system history because there may be problems in this area as well.
D) sexual history because it will build rapport to discuss this first.
A patient has had three pregnancies and two live births. The nurse would record this information as gravida _____, para _____, AB _____.
A) 2; 2; 1
B) 3; 2; 0
C) 3; 2; 1
D) 3; 3; 1
During the interview with a female patient, the nurse gathers data that indicate that the patient is perimenopausal. Which of these statements made by this patient leads to this conclusion?

A)”I have noticed that my muscles ache at night when I go to bed.”

B) “I will be very happy when I can stop worrying about having a period.”
C) “I have been noticing that I sweat a lot more than I used to, especially at night.”
D) “I have only been pregnant twice, but both times I had breast tenderness as my first symptom.”
A 50-year-old woman calls the clinic because she has noticed some changes in her body and breasts and wonders if they could be due to the hormone replacement therapy (HRT) she started 3 months ago. The nurse should tell her:
A) “Hormone replacement therapy is at such a low dose that side effects are very unusual.”
B) “Hormone replacement therapy has several side effects, including fluid retention, breast tenderness, and vaginal bleeding.”
C) “It would be very unusual to have vaginal bleeding with hormone replacement therapy, and I suggest you come in to the clinic immediately to have this evaluated.”

D)”It sounds as if your dose of estrogen is too high; I think you may need to decrease the amount you are taking and then call back in a week.”

A 52-year-old patient states that when she sneezes or coughs she “wets herself a little.” She is very concerned that something may be wrong with her. The nurse suspects that the problem is:
A) dysuria.
B) stress incontinence.
C) hematuria.
D) urge incontinence.
During the interview a patient reveals that she has some vaginal discharge. She is worried that it may be a sexually transmitted infection. The nurse’s most appropriate response to this would be:
A) “Oh, don’t worry. Some cyclic vaginal discharge is normal.”
B) “Have you been engaging in unprotected sexual intercourse?”
C) “I’d like some information about the discharge. What color is it?”
D) “Have you had any urinary incontinence associated with the discharge?”
A woman states that 2 weeks ago she had a urinary tract infection that was treated with an antibiotic. As a part of the interview, the nurse should ask, “Have you noticed:
A) a change in your urination patterns?”
B) any excessive vaginal bleeding?”
C) any unusual vaginal discharge or itching?”
D) any changes in your desire for intercourse?”
Which statement would be most appropriate when the nurse is introducing the topic of sexual relationships during an interview?

A)”Now it is time to talk about your sexual history. When did you first have intercourse?”

B) “Women often feel dissatisfied with their sexual relationships. Would it be okay to discuss this now?”
C) “Often women have questions about their sexual relationship and how it affects their health. Do you have any questions?”
D) “Most women your age have had more than one sexual partner. How many would you say you have had?”
A 22-year-old woman has been considering using oral contraceptives. As a part of her history, the nurse should ask:
A) “Do you have a history of heart murmurs?”
B) “Will you be in a monogamous relationship?”
C) “Have you thought this choice through carefully?”
D) “If you smoke, how many cigarettes do you smoke per day?”
A married couple has come to the clinic seeking advice on pregnancy. They have been trying to conceive for 4 months and have not been successful. What should the nurse do first?
A) Ascertain whether either of them has been using broad-spectrum antibiotics.
B) Explain that couples are considered infertile after 1 year of unprotected intercourse.
C) Immediately refer the woman to an expert in pelvic inflammatory disease—the most common cause of infertility.
D) Explain that couples are considered infertile after 3 months of engaging in unprotected intercourse and that they will need a referral to a fertility expert.
A nurse is assessing a patient’s risk of contracting a sexually transmitted infection (STI). An appropriate question to ask would be:
A) “You know that it’s important to use condoms for protection, right?”
B) “Do you use a condom with each episode of sexual intercourse?”
C) “Do you have a sexually transmitted infection?”
D) “You are aware of the dangers of unprotected sex, aren’t you?”
When the nurse is interviewing a preadolescent girl, which opening statement would be least threatening?
A) “Do you have any questions about growing up?”
B) “What has your mother told you about growing up?”
C) “When did you notice that your body was changing?”
D) “I remember being very scared when I got my period. How do you think you’ll feel?”
When the nurse is discussing sexuality and sexual issues with adolescents, a permission statement helps to convey that it is normal to think or feel a certain way. Which of these is the best example of a permission statement?
A) “It is okay that you have become sexually active.”
B) “Often girls your age have questions about sexual activity. Have you any questions?”
C) “If it is okay with you, I’d like to ask you some questions about your sexual history.”
D) “Often girls your age engage in sexual activity. It is okay to tell me if you have had intercourse.”
The nurse is preparing to interview a postmenopausal woman. Which of these statements is true with regard to the history of a postmenopausal woman?
A) The nurse should ask a postmenopausal woman if she ever has vaginal bleeding.
B) Once a woman reaches menopause, the nurse does not need to ask any further history questions.
C) The nurse should screen for monthly breast tenderness.
D) Postmenopausal women are not at risk for contracting sexually transmitted infections and thus these questions can be omitted.
During the examination portion of a patient’s visit, she will be in lithotomy position. Which statement below reflects some things that the nurse can do to make this more comfortable for her?
A) Ask her to place her hands and arms behind her head.
B) Elevate her head and shoulders to maintain eye contact.
C) Allow her to choose to have her feet in the stirrups or have them resting side by side on the edge of the table.
D) Allow her to keep her buttocks about 6 inches from the edge of the table to prevent her from feeling as if she will fall off.
An 18-year-old patient is having her first pelvic examination. Which action by the nurse is appropriate?
A) Invite her mother to be present during the examination.
B) Avoid the lithotomy position this first time because it can be uncomfortable and embarrassing.
C) Raise the head of the examination table and give her a mirror so that she can view the exam.
D) Drape her fully, leaving the drape between her legs elevated to avoid embarrassing her with eye contact.
The nurse has just completed an inspection of a nulliparous woman’s external genitalia. Which of these would be a description of a finding within normal limits?
A) Redness of the labia majora
B) Multiple nontender sebaceous cysts
C) Discharge that is sticky and yellow-green
D) Gaping and slightly shriveled labia majora
The nurse is preparing for an internal genitalia examination of a woman. Which order of the examination is correct?
A) Bimanual, speculum, rectovaginal
B) Speculum, rectovaginal, bimanual
C) Speculum, bimanual, rectovaginal
D) Rectovaginal, bimanual, speculum
During an internal examination of a woman’s genitalia, the nurse will use which technique for proper insertion of the speculum?
A) Instruct the woman to bear down, open the speculum blades, and apply in a swift, upward movement.
B) Insert the blades of the speculum on a horizontal plane, turning them to a 30-degree angle while continuing to insert them. Ask the woman to bear down after the speculum is inserted.
C) Instruct the woman to bear down, turn the width of the blades horizontally, and insert the speculum at a 45-degree angle downward toward the small of the woman’s back.
D) Lock the blades open by turning the thumbscrew. Once the blades are open, apply pressure to the introitus and insert the blades at a 45-degree angle downward to bring the cervix into view.
The nurse is examining a 35-year-old female patient. During the history, the nurse notices that she has had two term pregnancies, and both babies were delivered vaginally. During the internal examination the nurse observes that the cervical os is a horizontal slit with some healed lacerations and that the cervix has some nabothian cysts that are small, smooth, and yellow. In addition, the nurse notices that the cervical surface is granular and red, especially around the os. Finally, the nurse notices the presence of stringy, opaque, odorless secretions. Which of these findings are abnormal?
A) Nabothian cysts are present.
B) The cervical os is a horizontal slit.
C) The cervical surface is granular and red.
D) Stringy and opaque secretions are present.
A patient calls the clinic for instructions before having a Papanicolaou (Pap) smear. The most appropriate instructions from the nurse are:
A) “If you are menstruating, please use pads to avoid placing anything into the vagina.”
B) “Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment.”
C) “If you suspect that you have a vaginal infection, please gather a sample of the discharge to bring with you.”
D) “We would like you to use a mild saline douche before your examination. You may pick this up in our office.”
During an examination, which tests will the nurse collect to screen for cervical cancer?
A) Endocervical specimen, cervical scrape, and vaginal pool
B) Endocervical specimen, vaginal pool, and acetic acid wash
C) Endocervical specimen, KOH preparation, and acetic acid wash
D) Cervical scrape, acetic acid wash, saline mount (“wet prep”)
When performing the bimanual examination, the nurse notices that the cervix feels smooth and firm, is round, and is fixed in place (does not move). When cervical palpation is performed, the patient complains of some pain. The nurse’s interpretation of these results should be which of these?
A) These findings are all within normal limits.
B) The cervical consistency should be soft and velvety—not firm.
C) The cervix should move when palpated; an immobile cervix may indicate malignancy.
D) Pain may occur during palpation of the cervix.
The nurse is palpating a female patient’s adnexa. The findings include a firm, smooth uterine wall; the ovaries are palpable and feel smooth and firm. The fallopian tube is firm and pulsating. The nurse’s most appropriate course of action would be to:
A) tell the patient that her examination was normal.
B) give her an immediate referral to a gynecologist.
C) suggest that she return in a month for a recheck to verify the findings.
D) tell the patient that she may have an ovarian cyst that should be evaluated further.
A 65-year-old woman is in the office for routine gynecologic care. She had a complete hysterectomy 3 months ago after cervical cancer was detected. The nurse knows that which of these statements is true with regard to this visit?
A) Her cervical mucosa will be red and dry looking.
B) She will not need to have a Pap smear done.
C) The nurse can expect to find that her uterus will be somewhat enlarged and her ovaries small and hard.
D) The nurse should plan to lubricate the instruments and the examining hand well to avoid a painful examination.
The nurse is preparing to examine the external genitalia of a school-age girl. Which of these positions would be most appropriate in this situation?
A) In the parent’s lap
B) In a frog-leg position on the examining table
C) In the lithotomy position with the feet in stirrups
D) Lying flat on the examining table with legs extended
When assessing a newborn infant’s genitalia, the nurse notices that the genitalia are somewhat engorged. The labia majora are swollen, the clitoris looks large, and the hymen is thick. The vaginal opening is difficult to visualize. The infant’s mother states that she is worried about the labia being swollen. The nurse should reply:
A) “This is a normal finding in newborns and should resolve within a few weeks.”

B “This could indicate an abnormality and may need to be evaluated by a physician.”

C) “We will need to have estrogen levels evaluated to make sure that they are within normal limits.”
D) “We will need to keep close watch over the next few days to see if the genitalia decrease in size.”
During a vaginal examination of a 38-year-old woman, the nurse notices that the vulva and vagina are erythematous and edematous with thick, white, curdlike discharge adhering to the vaginal walls. The woman reports intense pruritus and thick white discharge from her vagina. The nurse knows that these history and physical examination findings are most consistent with which of these conditions?
A) Candidiasis
B) Trichomoniasis
C) Atrophic vaginitis
D) Bacterial vaginosis
A 22-year-old woman is being seen at the clinic for problems with vulvar pain, dysuria, and fever. On physical examination, the nurse notices clusters of small, shallow vesicles with surrounding erythema on the labia. There is also inguinal lymphadenopathy present. The most likely cause of these lesions is:
A) pediculosis pubis.
B) contact dermatitis.
C) human papillomavirus.
D) herpes simplex virus type 2.
When performing an external genitalia examination of a 10-year-old girl, the nurse notices that there is no pubic hair, and the mons and the labia are covered with fine vellus hair. These findings are consistent with stage _____ of sexual maturity, according to the Sexual Maturity Rating scale.
A) 1
B) 2
C) 3
D) 4
A 46-year-old woman is in the clinic for her annual gynecologic examination. She voices a concern about ovarian cancer because her mother and sister died of it. The nurse knows that which of these statements is correct regarding ovarian cancer?
A) Ovarian cancer rarely has any symptoms.
B) The Pap smear detects the presence of ovarian cancer.
C) Women at high risk for ovarian cancer should have annual transvaginal ultrasonography for screening.
D) Women over age 40 years should have a thorough pelvic examination every 3 years.
During a bimanual examination, the nurse detects a solid tumor on the ovary that is heavy and fixed, with a poorly defined mass. This finding is suggestive of:
A) an ovarian cyst.
B) endometriosis.
C) ovarian cancer.
D) an ectopic pregnancy.
A 25-year-old woman comes to the emergency department with a sudden fever of 101° F and abdominal pain. Upon examination, the nurse notices that she has rigid, boardlike lower abdominal musculature. When the nurse tries to perform a vaginal examination, the patient has severe pain when the uterus and cervix are moved. The nurse knows that these signs and symptoms are suggestive of:
A) endometriosis.
B) uterine fibroids.
C) ectopic pregnancy.
D) pelvic inflammatory disease.
During an external genitalia examination of a woman, the nurse notices several lesions around the vulva. The lesions are pink, moist, soft, and pointed papules. The patient states that she is not aware of any problems in that area. The nurse recognizes that these lesions may be:
A) syphilitic chancre.
B) herpes simplex virus type 2 (herpes genitalis).
C) human papillomavirus (HPV), or genital warts.
D) pediculosis pubis (crab lice).
During an examination, the nurse would expect the cervical os of a woman who has never had children to appear:
A) stellate.
B) small and round.
C) as a horizontal irregular slit.
D) everted.
A woman has just been diagnosed with HPV, or genital warts. The nurse should counsel her to receive regular examinations because this virus makes her at a higher risk for _____ cancer.
A) uterine
B) cervical
C) ovarian
D) endometrial
During an internal examination, the nurse notices that the cervix bulges outside the introitus when the patient is asked to strain. The nurse will document this as:
A) uterine prolapse, graded first degree.
B) uterine prolapse, graded second degree.
C) uterine prolapse, graded third degree.
D) a normal finding.
A 35-year-old woman is at the clinic for a gynecologic examination. During the examination, she asks the nurse, “How often do I need to have this Pap test done?” Which reply by the nurse is correct?

A)”It depends. Do you smoke?”

B)”This will need to be done annually until you are 65.”

C)”If you have 2 consecutive normal Pap tests, then you can wait 5 years between tests.”

D)”After age 30, if you have 3 consecutive normal Pap tests, then you may be screened every 2 to 3 years.”

The nurse is palpating an ovarian mass during an internal examination of a 63-year-old woman. Which findings of the mass’s characteristics would suggest the presence of an ovarian cyst? Select all that apply.
A) Heavy and solid
B) Mobile and fluctuant

C)Mobile and solid

D) Fixed
E) Smooth and round
F) Poorly defined

HealthCare Information Systems (7pgs)

Questions:

How proper use of Information Systems can enhance Health Care?

Millennium development goals report

Instructions for developing the MDGs Report HLTH 4380 Fall 2018 In this Project, we will use the United Nations Millennium Declaration document called Millennium Development Goals (MDGs) adopted by world leaders at the dawn of the 21st century as our guide. The Millennium Development Goals (MDGs) are eight international development goals that were established following the Millennium Summit of the United Nations in 2000, and subsequent adoption of the United Nations Millennium Declaration. Although these Goals have universal appeal, they are readily applicable to mainly developing countries and Middle-income countries of the world. Of course they have some relevance to the United States, but you are not required to make any comparison with US or any other industrialized country. The idea of including this part of the project is for us to examine the global perspectives of public health and the extent to which world leaders (governments, civil society groups, NGOs) in low-resource settings are affected by the poor health vulnerabilities and efforts being made by countries to improve population health. The MDGs has eight goals with targets and indicators; and range from halving extreme poverty rates to halting the spread of HIV/AIDS and providing universal primary education by the target date of 2015. I have provided the eight goals below: 1. To eradicate extreme poverty and hunger 2. To achieve universal primary education 3. To promote gender equality and empower women 4. To reduce child mortality 5. To improve maternal health 6. To combat HIV/AIDS, malaria, and other diseases 7. To ensure environmental sustainability 8. To develop a global partnership for development These goals have been reviewed in July 2015, and a new development plan Agenda 2030 Sustainable Development Goals has been put in place. I have posted a copy of final review of the MDGs document on Blackboard (under MDG Assignment Resources). Your role is to select TWO GOALS from the MDGs and two specific countries outside the United States and other industrialized countries to assess the extent to which your selected countries did in achieving the goal by July 2015 (the target and indicators for that MDG goals you picked by July of 2015). You may include what the country need to do as part of your postMDG steps. The post MDG’s are Sustainable Development Goals (SDGs) MDG Expectation: Visit the web link of countries you have selected for this project. You can just google by typing “your selected country and MDG report.” For example, if I selected Ghana, I will google “Ghana MDG report” and you will find all MDG reports for Ghana in different years. Select the three most current reports of the respective country selected. The link below is for the assessment of UN member’s countries progress towards achievement of MDG’s. Assess (based on your chosen goals and targets for the MDG’s) whether the country (of your interest) is likely to meet those MDG’s (for that country) by 2015 according to your specific objective /goals. Critically evaluate whether your specific community or your country of interest will meet respective goals and objectives as well as the accompanying dates. Prepare a six page comparative analytic report that includes the information below (you may additional information for extra credit): • Short definition or description of your Goals (from the MDGs) for the two countries, and a briefly descriptions of each country’s background context. The context of each country is important for understanding why or why not the results achieved in the manner in they have been reported. • Most important issue each country addressed in each Goal. • Individuals most affected by this objective (age, gender, ethnicity, etc.) and a country of your interest. • Ethnic/racial groups most affected • Value of addressing this Goal and consequences of not meeting your objective • Most interesting data to use to gain more attention to this objective or Goal • Details of community and national efforts to address this issue and any local data that you may be able to secure. There is detailed information on the MDG’s and what countries are doing to achieve a specific goal. Make sure to select a peer reviewed publication and cite appropriately. Please, refer to this website for additional information on MDGs: http://www.healthpolicyinitiative.com/index.cfm?id=onlineCDs&groupID=7 3 Note that the MDG’s are primarily United Nations target to improve health and social wellbeing of populations of the world (mainly outside the United States). The US uses the Healthy People as a national guide for improving health and social outcomes. Healthy People are a set of goals and objectives spanning a 10-year period, designed to guide national health promotion and disease prevention efforts for the population in the United States. Prepare a critical and detailed six-page report to address those issues. You will utilize and cite, according to the APA Style and Format (6th edition). Make sure that you have at least seven additional references aside the Healthy People 2020 and MDGs documents. My suggestions when writing this paper is to avoid direct quoting from any source (even those you will cite those sources). I strongly recommend that you paraphrase and cite appropriately instead of direct quoting.

BSBSUS401 Implement & monitor environmentally sustainable work practices

What is the purpose of National Greenhouse & Energy Reporting Legislation?

What is the purpose of Environment Protection & Biodiversity Conservation Legislation?
What is the Kyoto Protocol?
Who has the prime responsibility for environmental protection?
How do organisations know how to behave ethically in regards to sustainability?

Activity 2.

What process might an assessor follow when analysing procedures to ensure compliance with

environmental regulations?
How might an assessor conduct an assessment?

Activity 3.

What is resource efficiency?
What is an Environmental Management System?
How can a work group be engaged in disseminating environmental and resource efficiency information?

Activity 4.

Explain the differences between qualitative and quantitative information.
What do you think are the advantages of presenting analysed data in graphical format, rather than a written report?
Your organisation is interested in analysing and organising information about the amount of paper it uses. Convert the data provided into a format that is easily used.

Activity 5.

What are the goals of resource usage assessments? Give at least 6 examples.
List the steps (in order) that need to be taken when carrying out a resource usage assessment.

Activity 6.

Identify 5 benefits of environmental purchasing.

Activity 7.

How can organisations ensure that work processes meet environmental requirements and identify areas in which changes need to be made? Give at least 6 examples.
What is problem solving in the context of environmental work processes and what is its aim/s?

Activity 8.

List at least 5 various ways that organisations can access stakeholder input.

Activity 9.

What are the advantages of joining an industry association? List two examples.
What are the advantages of joining an environmental program? Give 2 examples.
What is the hierarchy of control?
Rearrange the controls in their correct order, as specified in the hierarchy of control:

Administration, Elimination, Engineering, Personal Protective Equipment (PPE), and Substitution.

Activity 11.

What are Key Performance Indicators (KPIs)?
What five criteria should be met when creating targets?
Identify what is wrong with the following targets and rewrite them so they conform to SMART criteria.
The Absolute Advertising Agency will reduce its paper waste.
The Fish Factory will reduce its energy consumption to zero in the next month.

Activity 12.

Identify five things a business could do to reduce its energy consumption.
Identify five things an organisation could do to reduce its waste.

Activity 13.

Identify the four steps of the continuous improvement cycle.
Identify five things an organisation can do to improve the performance of its employees.

Activity 14.

Explain why it is a good idea to integrate environmental procedures and practices with pre-existing organisation procedures and practices.
What needs to be done when existing procedures or work practices are changed or new procedures and work practices are introduced?

Activity 15.

Define the term “Engagement”.

Engagement is the emotional commitment the employee has to the organization and its goals. It relates to a state of involvement and participation.

Why is it important to ensure that employees do not become disengaged?
What are the benefits of having a diverse team?

Activity 16.

List at least six people/groups who might make up an organisations stakeholders.
Each stakeholder will have different areas of expertise. Complete the table by providing reasons that an organisation should seek suggestions & ideas about their environmental and resource efficiency management for each of the listed stakeholders.

Activity 17.

A school is thinking about installing low-flush toilets in all of its bathrooms and air hand-driers to replace paper towel dispensers. Purchasing new toilets for the entire school will cost $22,000. It will need to employ plumbers to fit the toilets at a cost of $9,500. It is estimated that this will save the school $16,000 in water consumption fees. The hand driers will cost $13,500. The cost of employing electricians to install the hand driers will come to $4,400. As the school will no longer have to purchase paper towels, it will save $7,300 per year. It also estimates it will save $1,000 a year in cleaning costs, as the bathrooms will take less time to clean, and bins will need to be emptied less frequently. The school will incur additional electricity costs of $1,700 per year, however. Calculate the combined payback period for the installation of low flush toilets and air hand driers.

Activity 18.

Determine whether the following statements are true or false.

Activity 19.

Place the steps, which need to be observed when creating an environment report in their correct order.

Communicate with the audience to understand their concerns, questions, expectations & interests.
Create performance Indicators.
Decide how you are going to publish report.
Gather the data and evaluate it.
Identify the data you will need to produce the report.
Identify key environmental aspects that need to be covered by the report.
Identify the target audience for your report.
Make improvements to reporting procedures for future reports.
Obtain Feedback.
Produce, publish and distribute the report.

Identify 5 benefits of creating and distributing an environmental report.

Activity20.

Why is it important to carry out regular evaluations of environmental management systems/ strategies and improvement plans?

Activity 21.

List 5 reasons that efficiency targets should be/ might need to be regularly reviewed.

Activity 22.

Identify the characteristics of an effective reward system. Give 4 examples.

Question 1.

What methods can be used to convey information and identify sustainability improvements?

Question 2.

What are the essential features of a non-compliance form that could be used by employees to report any non-compliance issues?

Question 3.

What is the effect of environmental regulations and legislation on business?

Question 4.

What common environmental and energy efficiency issues can you think of?

Question5.

What benchmarks might be used for environmental & resource sustainability?

List at least 8 examples of techniques or tools that can be used to achieve efficiency.

Question 6.

Define the term “Sustainability” and explain how it relates to resource usage.

Question 7.

What are the steps in creating an Environment Management System (EMS)?

Question 8.

How do sustainable businesses foster ethical behaviours in staff and management?

Summative Assessment 2

Project 1.

Essay Question –write a response to the following quote from Unlimited Sustainable Development Solutions.

Organisations today are being asked to address an increasingly complex set of environmental issues. As noted in the quote:

“Sustainability is achieved when we understand the economic, environmental, and social consequences of our actions and make deliberate choices that allow all people to lead healthy, productive and enjoyable lives”.

Your response should include a discussion of:

Complex environmental issues.
Methods of measuring an organisation’s environmental impact.
Methods of managing an organisation’s environmental impact.
Methods of reducing an organisation’s environmental impact.

Project 2.

Youare the supervisor of a group of 15 workers in a business involved in an industry of your choice. You have been asked to plan and organise a number of work group activities in relation to measuring current resource use and devising strategies to improve usage.

Identify a minimum of 3 appropriate work group activities and provide an overview of what is involved with each activity.
Develop a plan to monitor resource use and improvements for environmental performance as a result of the activities undertaken by your work group.

Millennium development goals

Pick two MDGs

Evaluate the progress with a case study of two developing countries.

HSA 505 Case Study 3 Missed Opportunities

Due Week 9 and worth 200 points

Read the case study titled “Missed Opportunities”, located in the online course shell.

Write a four to six (4-6) page paper in which you:

Examine the pros and cons from the perspective of Crestview Hospital of the placement of its new billboard directly adjacent to Briarwood Medical Center. Interpret the reaction of customers and other community stakeholders to the billboard postings.
Use competitive marketing entry strategies to suggest the action that Briarwood Hospital should undertake to counter the messages in the new Crestview Hospital Billboard postings.
Recommend the marketing communication strategy or strategies that both Crestview and Briarwood Hospitals should employ. Justify why the Governing Board of both hospitals should take a proactive role in promoting and implementing effective marketing strategies.
Assess the value of the various marketing research tool(s) that Briarwood and Crestview hospital could use to promote effective marketing communication strategies. Justify your response.
Use at least five (5) quality academic resources. Note: Wikipedia and other Websites do not qualify as academic resources.

Your assignment must follow these formatting requirements:

Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

Evaluate marketing research tools involved in the marketing process.
Formulate competitive market entry strategies based on analysis of global markets that comply to initiatives in the health care industry.
Determine the marketing communications strategy used in health care services.
Use technology and information resources to research issues in health services strategic marketing.
Write clearly and concisely about health services strategic marketing using proper writing mechanics.

HSA 599 week 5 Case Study – GE Healthcare (A): Innovating for Emerging Markets

HSA 599 week 5 Case Study – GE Healthcare (A): Innovating for Emerging Markets

Read the case study titled “GE Healthcare (A): Innovating for Emerging Markets” located in the XanEdu case pack (Link Below)

Write a three to four (3-4) page paper in which you:

Determine two (2) emerging trends in the external environment that prompted General Electric (GE) Healthcare to develop a new strategy for the production and marketing of a low cost Electroencephalography (EEG) machine in bottom of the pyramid markets (BOP).
Examine two (2) internal barriers GE Healthcare faced when developing its BOP market in India and determine the manner in which they hindered GE Healthcare’s growth in this market segment.
Analyze two (2) of the significant external barriers that GE Healthcare faced when trying to meet its marketing goals in the Indian market. Propose two (2) ways to address these barriers.
Analyze the specific steps GE took in developing its strategy to grow its BOP market. Determine the manner in which those actions apply to the principles of strategic thinking and strategic planning.
Determine the manner in which GE Healthcare’s strategy to improve its position in BOP markets contributed to the organization’s value chain in both emerging and developed markets.

Your assignment must follow these formatting requirements:

Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.

Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

Differentiate between strategic management, strategic thinking, strategic planning, and managing strategic momentum.
Analyze the significance of the external environment’s impact on health care organizations.
Examine the role of internal environmental analysis in identifying the basis for sustained competitive advantage.
Examine the organizational value chain, including the components of the service delivery and support activities.
Examine barriers to new product development that comply with initiatives in the health care industry.
Use technology and information resources to research issues in the strategic management of health care organizations.
Write clearly and concisely about strategic management of health care organizations using proper writing mechanics.

Grading for this assignment will be based on answer quality, logic / organization of the paper, and language and writing skills, using the following rubric.

Week 2 – Healthy People 2020

After reviewing the Healthy People 2020 website, discuss the concept of MAP-IT. Choose a health topic of your choice to briefly discuss how MAP-IT can be implemented in the community of your choice.
Topic: Affordable Medication Program

Length: Minimum of two full pages of text in length. Please ensure you cite your references in APA format. Please ensure you cite your references in APA format with a minimum of 3 references

https://www.healthypeople.gov/2020/tools-and-resources/Program-Planning

Influences of Health Care Research

Identify one innovation that has been developed in the past 20 years that has influenced the health care industry, such as: Telemedicine Organ transplants Write a 700- to 1,050-word paper that discusses the following: Explain how evidence-based research influences the health care industry. Compare external influences on health care research. Cite 3 peer-reviewed, scholarly, or similar references to support your paper. Format your paper according to APA guidelines.

Human Resource Management Overview

Assignment 1: Human Resource Management Overview

Due Week 4 and worth 200 points

Using the course readings, articles, and your personal experiences, address the role of human resource management.

Write a six to eight (6-8) page paper in which you:

1.Determine key roles that human resource management plays in the health care field..

2.Evaluate three to five (3-5) functions of human resource management in terms of their level of support to the health care field, and then select which one you believe is the primary function in furthering the health care field..

3.Analyze the role of human resource management in an organization’s strategic plan..

4.Use at least three (3) quality academic resources in this assignment. Note: Wikipedia and other Websites do not qualify as academic resources..

Your assignment must follow these formatting requirements:

Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions..
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length..

The specific course learning outcomes associated with this assignment are:

Appraise the aspects of managing human resources (HR) in health care organizations. .
Use technology and information resources to research issues in health care human resources management..
Write clearly and concisely about health care human resources management using proper writing mechanics..

MN568 Unit 10 Final latest 2017

MN568 Unit 10 Final latest 2017

Question 1 2 / 2 points

Which statement about confusion is true?

Question options:

a) Confusion is a disease process.
b) Confusion is always temporary.
c) Age is a reliable predictor of confusion.
d) Polypharmacy is a major contributor to confusion in older adults.

Question 2 0 / 2 points

Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

Question options:

a) Meclizine
b) Diphenhydramine
c) Diamox
d) Promethazine

Question 3 2 / 2 points

The hallmark of an absence seizure is:

Question options:

a) No activity at all
b) A blank stare
c) Urine is usually voided involuntarily
d) The attack usually lasts several minutes

Question 4 2 / 2 points

How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate?

Question options:

a) Every 3 months
b) Every 6 months
c) Annually
d) Whenever there is a problem

Question 5 2 / 2 points

Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)?

Question options:

a) A teenage male
b) A 65-year-old male
c) A 25-year-old female
d) A 60-year-old female

Question 6 2 / 2 points

Which of the following is a specific test to MS?

Question options:

a) Magnetic resonance imaging (MRI)
b) Computed tomography (CT) scan
c) A lumbar puncture
d) There is no specific test.

Question 7 2 / 2 points

Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

Question options:

a) Cholinesterase inhibitors
b) Anxiolytics
c) Antidepressants
d) Atypical antipsychotics

Question 8 2 / 2 points

Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery?

Question options:

a) Epidural hematoma
b) Subdural hematoma
c) Subarachnoid hematoma
d) Intraparenchymal hemorrhage

Question 9 2 / 2 points

Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing?

Question options:

a) CN V
b) CN VII
c) CN IX
d) CN X

Question 10 2 / 2 points

Which statement best describes a carotid bruit?

Question options:

a) It is felt with the middle three fingers over the carotid artery.
b) A bruit becomes audible when the lumen is narrowed to 1 mm or less.
c) A low-pitched bruit is a medical emergency.
d) The higher the pitch of the bruit, the higher the degree of stenosis.

Question 11 2 / 2 points

Which patient is more likely to have a cluster headache?

Question options:

a) A female in her reproductive years
b) A 40-year-old African American male
c) A 55-year-old female who drinks 10 cups of coffee daily
d) A 45-year-old male awakened at night

Question 12 2 / 2 points

Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?

Question options:

a) Dementia
b) Alzheimer’s disease
c) Parkinson’s disease
d) Delirium

Question 13 2 / 2 points

Which type of meningitis is more benign, self-limiting, and caused primarily by a virus?

Question options:

a) Purulent meningitis
b) Chronic meningitis
c) Aseptic meningitis
d) Herpes meningitis

Question 14 2 / 2 points

Which is the most sensitive neuroimaging test to evaluate patients with encephalitis?

Question options:

a) MRI
b) CT
c) Electroencephalogram (EEG)
d) An initial lumbar puncture

Question 15 2 / 2 points

What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?

Question options:

a) A stabbing pain on one small area of the body
b) A vesicular skin lesion on one side of the body
c) A pain that is worse upon awakening
d) A lesion on the exterior ear canal

Question 16 1 / 1 point

Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?

Question options:

a) “Most patients have complete recovery in 3 to 6 months.”
b) “Unfortunately, you’ll probably have a small amount of residual damage.”
c) “Don’t worry, I’ll take care of everything.”
d) “You may have a few more episodes over the course of your lifetime but no permanent damage.”

Question 17 2 / 2 points

Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him:

Question options:

a) “L-dopa is neuroprotective.”
b) “The primary goal of therapy is to replace depleted stores of dopamine.”
c) “This is the only drug that can provide symptomatic benefit.”
d) “This is the initial monotherapy drug.”

Question 18 2 / 2 points

Which of the following signs is seen in a patient with more advanced PD?

Question options:

a) Resting tremor
b) Bradykinesia
c) Rigidity
d) Postural instability

Question 19 2 / 2 points

Which of the following is the most commonly experienced symptom of migraine?

Question options:

a) Light sensitivity
b) Pulsatile pain
c) Sound sensitivity
d) Experiencing an aura

Question 20 2 / 2 points

Which of the following characteristics differentiates peripheral vertigo from central vertigo?

Question options:

a) The duration of central vertigo is shorter than that of peripheral vertigo.
b) There is an auditory-associated symptom with peripheral vertigo and a visual-associated symptom with central vertigo.
c) Central vertigo is positional, and peripheral vertigo is not.
d) The onset of central vertigo is more sudden than that of peripheral vertigo.

Question 21 2 / 2 points

Carotid endarterectomy should be considered only for symptomatic patients with greater than what percentage of stenosis?

Question options:

a) Greater than 25%
b) Greater than 50%
c) Greater than 75%
d) Only for 100% occlusion

Question 22 2 / 2 points

What antiplatelet agent is most widely used for secondary prevention of stroke?

Question options:

a) Aspirin
b) Ticlopidine
c) Clopidogrel
d) Aspirin and clopidogrel

Question 23 2 / 2 points

Which adjunctive diagnostic test should be used in the work-up of a patient with suspected Creutzfeldt-Jakob disease or transient epileptic amnesia?

Question options:

a) MRI
b) CT
c) Cerebrospinal fluid analysis
d) EEG

Question 24 2 / 2 points

Which herbal preparation may cause delirium and should be avoided in an elderly patient?

Question options:

a) Sam-e
b) Saint John’s Wort
c) Melatonin
d) Saw Palmetto

Question 25 0 / 2 points

Which of the following activities is part of the functional activities questionnaire?

Question options:

a) Asking the patient to unravel a Rubik’s cube
b) Determining if the patient can drive on the highway
c) Asking the patient about a news event from the current week
d) Seeing if the patient can keep his or her home clean

Question 26 2 / 2 points

About 90% of all headaches are?

Question options:

a) Tension
b) Migraine
c) Cluster
d) Without pathological cause

Question 27 2 / 2 points

Which statement is true regarding driving and patients with a seizure disorder?

Question options:

a) Once diagnosed with a seizure disorder, patients must never drive again.
b) After being seizure free for 6 months, patients may drive.
c) Each state has different laws governing driving for individuals with a seizure disorder.
d) These persons may drive but never alone.

Question 28 2 / 2 points

Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help given intravenously once a month?

Question options:

a) Glatiramer acetate
b) Natalizumab
c) Fingolimod
d) Glucocorticoids

Question 29 2 / 2 points

The ‘freezing phenomenon’ is a cardinal feature of?

Question options:

a) Parkinson’s disease
b) Alzheimer’s disease
c) A CVA
d) Bell’s palsy

Question 30 2 / 2 points

A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as?

Question options:

a) Spinothalamic dysfunction
b) Ratcheting
c) Cogwheeling
d) Hand tremors

Question 31 2 / 2 points

Clinical features of insidious onset, slow progression, and a lack of other findings to explain the symptoms are fairly diagnostic of which condition?

Question options:

a) Guillain-Barré syndrome
b) Parkinson’s disease
c) Alzheimer’s disease
d) Huntington’s disease

Question 32 1 / 1 point

Which condition is characterized by the impaired ability to learn new information along with either a cognitive disturbance in language, function, or perception?

Question options:

a) Guillain-Barré syndrome
b) Parkinson’s disease
c) Alzheimer’s disease
d) Delirium

Question 33 2 / 2 points

A score of 20 to 25 on this test indicates early-stage Alzheimer’s disease:

Question options:

a) SLUMS
b) MoCA
c) FAST
d) MMSE

Question 34 2 / 2 points

Intravenous thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset?

Question options:

a) 1 hour
b) 3 hours
c) 6 hours
d) 12 hours

Question 35 2 / 2 points

When administered at the beginning of an attack, oxygen therapy may help this kind of headache?

Question options:

a) Tension
b) Migraine
c) Cluster
d) Stress

Question 36 2 / 2 points

The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?

Question options:

a) Acetylcholine
b) Gamma-aminobutyric acid (GABA)
c) Dopamine
d) Serotonin

Question 37 2 / 2 points

The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:

Question options:

a) 1 month
b) 3 months
c) 6 months
d) 12 months

Question 38 1 / 1 point

A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack?

Question options:

a) Pheochromocytoma
b) Hyperthyroidism
c) Cardiac arrhythmias
d) All of the above

Question 39 2 / 2 points

Which of the following is considered first-line treatment for panic disorders?

Question options:

a) Benzodiazepines
b) Selective serotonin reuptake inhibitors (SSRIs)
c) Tricyclic antidepressants
d) Cognitive behavioral therapy

Question 40 1 / 1 point

Which of the following symptoms is not part of the diagnostic criteria for post-traumatic stress disorder (PTSD)?

Question options:

a) Hypersomnolence
b) Blunted feelings
c) Loss of interest in significant activities
d) Intrusive recurrent recollections of the event

Question 41 2 / 2 points

Which of the following neuroendocrine abnormalities is implicated in depression?

Question options:

a) Decrease in adrenal size
b) Increased cortisol and corticotrophin-releasing hormone
c) An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing hormone
d) Increased inhibitory response of glucocorticoids to dexamethasone

Question 42 2 / 2 points

The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants?

Question options:

a) SSRIs are more effective than TCAs.
b) SSRIs take less time to work than TCAs.
c) SSRIs have a more favorable side-effect profile than TCAs.
d) SSRIs are not lethal in overdose.

Question 43 2 / 2 points

After discontinuing fluoxetine, how long must a person wait before starting a monoamine oxidase inhibitor?

Question options:

a) 2 weeks
b) 3 weeks
c) 4 weeks
d) 5 weeks

Question 44 2 / 2 points

It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period?

Question options:

a) Before the initiation of treatment

b) 1 to 2 weeks after the initiation of treatment

c) When switching to a different medication

d) 1 to 2 weeks after tapering off medications

Question 45 2 / 2 points

A patient is experiencing extrapyramidal side effects from his antipsychotic medications. The clinician would most likely take which of the following approaches to treating these side effects?

Question options:

a) Give the patient a “drug holiday” until the symptoms resolve and then restart the medication.

b) Switch the patient to a different antipsychotic.

c) Treat the patient with anticholinergics.

d) Treat the patient with anticonvulsants.

Question 46 1 / 1 point

According to Kübler-Ross, the stages of grief occur in which order?

Question options:

a) Anger, denial, depression, bargaining, acceptance

b) Anger, denial, bargaining, acceptance, depression

c) Denial, anger, depression, bargaining, acceptance

d) Denial, anger, bargaining, depression, acceptance

Question 47 1 / 1 point

The clinician is educating a patient about the effects of marijuana. The patient stated she has been smoking for years and believes the use does not interfere with her life. What is a significant long-term sequelae of marijuana use that the clinician should educate this patient about?

Question options:

a) Memory impairment

b) Sexual dysfunction

c) Dry mouth

d) There are no long-term consequences of marijuana use.

Question 48 2 / 2 points

Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?

Question options:

a) GABA

b) Acetylcholine

c) Dopamine

d) Serotonin

Question 49 2 / 2 points

What blood alcohol level corresponds with the signs of stupor and confusion?

Question options:

a) 0.05

b) 0.1

c) 0.2

d) 0.3

Question 50 2 / 2 points

Rapid eye movement (REM) sleep occurs how frequently during non-REM sleep?

Question options:

a) Every 30 minutes

b) Every 60 minutes

c) Every 90 minutes

d) Every 180 minutes

Question 51 2 / 2 points

Which of the following is a laboratory finding commonly found in patients with anorexia nervosa?

Question options:

a) Hypercholesterolemia

b) Hypermagnesmia

c) Leukocytosis

d) Decreased TRH

Question 52 2 / 2 points

Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration?

Question options:

a) Sertraline

b) Fluoxetine

c) Citoprolam

d) Imipramine

Question 53 2 / 2 points

Which of the following would be important to monitor in a child receiving methylphenidate for treatment of attention deficit-hyperactivity disorder (ADHD)?

Question options:

a) Liver function

b) Vision

c) Growth parameters

d) Renal function

Question 54 2 / 2 points

It is important for the clinician to discuss the long-term effects of sexual assault with survivors. Which of the following is the most common long-term effect of sexual assault?

Question options:

a) Depression

b) Obsessive-compulsive disorder

c) Substance abuse

d) PTSD

Question 55 2 / 2 points

Women are at the highest risk for developing postpartum depression for up to how long after childbirth?

Question options:

a) 2 weeks

b) 1 month

c) 3 months

d) 6 months

Question 56 2 / 2 points

Which is the most prevalent psychiatric condition in the United States?

Question options:

a) Depression

b) Anxiety

c) Substance-related addictions

d) Gambling

Question 57 1 / 1 point

What is recorded as clinical category two of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision)?

Question options:

a) Clinical disorder or focus of clinical attention

b) Personality or environmental problems

c) Environmental and psychosocial stressors

d) Global assessment of functioning

Question 58 2 / 2 points

Which of the following may be used to evaluate a person’s suicide risk?

Question options:

a) CAGE

b) SANE

c) SAD PERSONAS

d) DIGFAST

Question 59 2 / 2 points

Assessing for adherence with prescribed medications and developing a plan for what to do if they are stopped is a major treatment issue for which of the following diagnostic groups?

Question options:

a) ADHD

b) Bipolar

c) Depression

d) Anxiety

Question 60 1 / 1 point

Bipolar disorder requires differential diagnosis from all of the following except?

Question options:

a) Substance abuse and medication effects

b) Medical and neurological disorders

c) Cluster B personality disorders and depression

d) Obsessive-compulsive disorder

Question 61 1 / 1 point

The use of benzodiazepines in the patient with generalized anxiety disorder and comorbid depression can exacerbate depressive symptoms.

Question options:

a) True

b) False

Question 62 1 / 1 point

Depressive episodes associated with bipolar disorder are treated the same as major depressive disorder.

Question options:

a) True

b) False

Question 63 1 / 1 point

Women in abusive relationships have a greater chance of being killed by their batterers when they leave the relationship than women who stay.

Question options:

a) True

b) False

Question 64 1 / 1 point

Adults must show childhood onset of symptoms to receive a diagnosis of ADHD.

Question options:

a) True

b) False

Question 65 1 / 1 point

Parkinson’s disease and dementing illnesses may commonly manifest depressive symptoms.

Question options:

a) True

b) False

Question 66 1 / 1 point

The best predictor of suicide risk is a history of suicide attempts.

Question options:

a) True

b) False

Question 67 1 / 1 point

A no-suicide contract can prevent a suicide attempt.

Question options:

a) True

b) False

Question 68 1 / 1 point

Depression is the most chronic disabling and economically catastrophic medical disorder of the severe mental illnesses.

Question options:

a) True

b) False

Question 69 1 / 1 point

Clozapine (Clozaril) requires laboratory monitoring at specified frequencies with results reported to a national registry.

Question options:

a) True

b) False

Question 70 1 / 1 point

When combined with certain other medications, serotonin-specific antidepressants can have significant liver P450-interaction effects.

Question options:

a) True

b) False

Question 71 1 / 1 point

A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination?

Question options:

a) Human papillomavirus (HPV)

b) Endometrial hyperplasia

c) Vagismus

d) Polycystic ovarian syndrome

Question 72 2 / 2 points

A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea?

Question options:

a) Ceftriaxone

b) Doxycycline

c) Acyclovir

d) Metronidazole

Question 73 1 / 1 point

A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease has she most probably been exposed to?

Question options:

a) Gonorrhea

b) HPV

c) Chlamydia

d) Trichomonas

Question 74 1 / 1 point

A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear.Which of the following diagnoses is associated with this finding?

Question options:

a) Trichomonas

b) Bacterial vaginosis

c) HPV

d) Herpes simplex virus

Question 75 2 / 2 points

Which of the following medications is the treatment of choice for trichomonas?

Question options:

a) Metronidazole

b) Ceftriaxone

c) Diflucan

d) Doxycycline

Question 76 1 / 1 point

A 36-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?

Question options:

a) Fluconazole

b) Estrogen vaginal cream

c) Metronidazole

d) Doxycycline

Question 77 2 / 2 points

Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a:

Question options:

a) Filiform/digitate wart

b) Dysplastic cervical lesion

c) Condyloma acuminata

d) Koilocytosis

Question 78 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 79 2 / 2 points

Of the following types of cellulitis, which is a streptococcal infection of the superficial layers of the skin that does not involve the subcutaneous layers?

Question options:

a) Necrotizing fasciitis

b) Periorbital cellulitis

c) Erysipelas

d) “Flesh-eating” cellulitis

Question 80 2 / 2 points

The forced vital capacity is decreased in:

Question options:

a) Asthma

b) Chronic bronchitis

c) Emphysema

d) Restrictive disease

Question 81 2 / 2 points

The most common cause of CAP is?

Question options:

a) Streptococcus pneumoniae

b) Klebsiella pneumoniae

c) Legionella pneumoniae

d) Pseudomonas aeruginosa

Question 82 2 / 2 points

Which of the following is a possible consequence of sleep apnea?

Question options:

a) Asthma

b) Increased white blood cells

c) Insulin resistance

d) Hyperactivity

Question 83 2 / 2 points

The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?

Question options:

a) IgA

b) IgE

c) IgG

d) IgM

Question 84 2 / 2 points

A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?

Question options:

a) The scrotum will be dark.

b) The scrotum will appear light pink or yellow.

c) The scrotum will appear milky white.

d) The internal structures will be clearly visible.

Question 85 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 86 2 / 2 points

A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system?

Question options:

a) The cancer involves the seminal vesicles.

b) There is metastatic disease to regional lymph nodes.

c) The cancer is confined to the capsule.

d) There is metastasis to distant organs.

Question 87 1 / 1 point

A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects?

Question options:

a) Risk of osteoporosis

b) May have hot flushes

c) May have impotence

d) All of the above

Question 88 1 / 1 point

A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE).Which of the following should be included in the list of differential diagnoses?

Question options:

a) Testicular cancer

b) Inguinal hernia

c) Varicocele

d) All of the above

Question 89 1 / 1 point

What is the treatment of choice for a patient diagnosed with testicular cancer?

Question options:

a) Radical orchidectomy

b) Lumpectomy

c) Radiation implants

d) All of the above

Question 90 1 / 1 point

A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?

Question options:

a) Every month

b) Every 3 to 4 months

c) Every 6 to 12 months

d) Every year

Question 91 2 / 2 points

Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

Question options:

a) “You must be under a lot of stress lately.”

b) “It is hereditary. Did your father experience this also?”

c) “The cause is unknown, but we suspect it is due to an immunologic mechanism.”

d) “We’ll have to do some tests.”

Question 92 2 / 2 points

Which of the following is “a linear crack extending from the epidermis to the dermis?”

Question options:

a) An ulcer

b) A fissure

c) Lichenification

d) An excoriation

Question 93 2 / 2 points

A bulla is:

Question options:

a) A vesicle larger than 1 cm in diameter

b) An elevated solid mass with a hard texture; the shape and borders can be regular or irregular

c) A superficial elevated lesion filled with purulent fluid

d) Thinning of the skin (epidermis and dermis) that appears white or translucent

Question 94 1 / 1 point

A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds.What should you do?

Question options:

a) Make an immediate referral for an orthopedic evaluation without further assessment.

b) Tell her that it takes time for these bruises to improve, so she should be patient.

c) Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint.

d) Send her to the emergency room for reduction of this obvious wrist fracture.

Question 95 1 / 1 point

Osteoarthritis is primarily a noninflammatory condition.

Question options:

a) True

b) False

Question 96 1 / 1 point

The presence of a positive rheumatoid factor is always indicative of rheumatoid arthritis.

Question options:

a) True

b) False

Question 97 2 / 2 points

Which of the following medications can cause hyperglycemia?

Question options:

a) Prednisone

b) Metformin

c) Synthroid

d) Cephalexin

Question 98 2 / 2 points

Which of the following is diagnostic for diabetes mellitus?

Question options:

a) A1C 7.0 on one occasion

b) Fasting blood sugar (FBS) of 100 mg/dL on two occasions

c) Random glucose of 200 mg/dL on two occasions

d) Two-hour post-load plasma glucose of 300 mg/dL on one occasion

Question 99 2 / 2 points

Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?

Question options:

a) Insulin

b) Metformin

c) Glucotrol

d) Precose

Question 100 1 / 1 point

A 35-year-old woman presents with symptoms of hypoglycemia.There is no history of diabetes mellitus. Which of the following should be included in the differential diagnosis?

Question options:

a) Anxiety disorder

b) Pheochromocytoma

c) Psychosis

d) All of the above

MN568 Unit 8 Exam latest 2017

MN568 Unit 8 Exam latest 2017

Question 1 2 / 2 points

Osteoarthritis is primarily a noninflammatory condition.

Question options:

a) True

b) False

Question 2 2 / 2 points

Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?

Question options:

a) Insulin

b) Metformin

c) Glucotrol

d) Precose

Question 3 2 / 2 points

After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

Question options:

a) Suggest she use a heating pad to improve circulation.

b) Refer to a podiatrist for a foot care treatment plan.

c) Send her for acupuncture treatments.

d) All of the above

Question 4 2 / 2 points

Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?

Question options:

a) Morning stiffness and limited mobility of the lumbar spine

b) Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

c) Fever, chills, and elevated erythrocyte sedimentation rate

d) Pathologic fractures, severe night pain, weight loss, and fatigue

Question 5 2 / 2 points

John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain.The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

Question options:

a) Valgus stress test

b) McMurray circumduction test

c) Lachman test

d) Varus stress test

Question 6 2 / 2 points

The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort.Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs?

Question options:

a) “You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.”

b) “You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication.”

c) “You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.”

d) “It is important to take NSAIDs on an empty stomach in order to increase absorption.”

Question 7 2 / 2 points

The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an x-ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane’s description of her injury. Which of the following clues in Diane’s examination or history would alert the clinician to the need for obtaining radiographs?

Question options:

a) Inability to bear weight immediately after the injury

b) Development of marked ankle swelling and discoloration after the injury

c) Crepitation with palpation or movement of the ankle

d) All of the above

Question 8 2 / 2 points

The clinician finds numerous nodules on the thyroid of a 65-year-old woman. The clinician suspects thyroid cancer. Which of the following data would be most significant for this patient?

Question options:

a) A history of tonsillectomy in the 1940s

b) Recent exposure to mumps

c) Vegetarian diet

d) Allergy to iodine

Question 9 2 / 2 points

A vegetarian patient with gout asks the clinician about food he should avoid. The clinician should advise the patient to avoid which of the following foods?

Question options:

a) Rice

b) Carrots

c) Spinach

d) Potatoes

Question 10 2 / 2 points

One of the most frequent presenting signs/symptoms of osteoporosis is:

Question options:

a) Goiter

b) Abnormal serum calcium

c) Elevated urine biochemical markers

d) Bony fracture

Question 11 2 / 2 points

After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?

Question options:

a) Elevated TSH

b) Normal TSH

c) Low TSH

d) Undetectable TSH

Question 12 2 / 2 points

Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Question options:

a) Decreased C-reactive protein

b) Hyperalbuminemia

c) Morning stiffness

d) Weight gain

Question 13 2 / 2 points

The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective?

Question options:

a) “I’ll take my pill at least 30 minutes before breakfast.”

b) “I’ll take my Glucotrol before bedtime.”

c) “It is important to take my medication right after I eat.”

d) “Since I only like to eat two meals a day, I can take the pill between my meals.”

Question 14 2 / 2 points

The presence of a positive rheumatoid factor is always indicative of rheumatoid arthritis.

Question options:

a) True

b) False

Question 15 2 / 2 points

Which of the following statements is true regarding the treatment of carpal tunnel syndrome?

Question options:

a) The goal of treatment is to prevent flexion and extension movements of the wrist.

b) Splints are used in carpal tunnel syndrome, because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position.

c) Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.

d) All of the above

Question 16 2 / 2 points

Which of the following medications can cause hyperglycemia?

Question options:

a) Prednisone

b) Metformin

c) Synthroid

d) Cephalexin

Question 17 2 / 2 points

Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?

Question options:

a) Gastrocnemius weakness

b) A reduced or absent ankle reflex

c) Numbness in the lateral foot

d) Paresthesia of the perineum and buttocks

Question 18 2 / 2 points

You are performing muscle strength testing on a patient presenting with musculoskeletal pain and find that the patient has complete ROM with gravity eliminated. Which numeric grade of muscle strength would you give this patient?

Question options:

a) 1

b) 2

c) 3

d) 4

e) 5

Question 19 2 / 2 points

A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate?

Question options:

a) “Control of glucose will help postpone or delay complications.”

b) “Regularly checking blood sugar will help establish a routine.”

c) “Monitoring glucose will promote a sense of control.”

d) All of the above

Question 20 2 / 2 points

Which of the following is diagnostic for diabetes mellitus?

Question options:

a) A1C 7.0 on one occasion

b) Fasting blood sugar (FBS) of 100 mg/dL on two occasions

c) Random plasma glucose greater than or equal to 200 in a person with symptoms of hyperglycemia

d) Two-hour post-load plasma glucose of 300 mg/dL on one occasion

Question 21 2 / 2 points

A patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer her, the clinician must understand that exercise has what effect on the patient with type 2 diabetes?

Question options:

a) Reduces postprandial blood glucose

b) Reduces triglycerides and increases high-density lipoprotein (HDL)

c) Reduces total cholesterol

d) All of the above

Question 22 0 / 2 points

A 35-year-old woman presents with symptoms of hypoglycemia.There is no history of diabetes mellitus. Which of the following should be included in the differential diagnosis?

Question options:

a) Anxiety disorder

b) Pheochromocytoma

c) Psychosis

d) All of the above

Question 23 2 / 2 points

The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been effective?

Question options:

a) “As long as I don’t need glasses, I don’t have to worry about going blind.”

b) “I know I need to have my eyes checked every year.”

c) “My optometrist checks my eyes.”

d) “I will see my eye doctor when my vision gets blurry.”

Question 24 2 / 2 points

Question options:

a) Make an immediate referral for an orthopedic evaluation without further assessment.

b) Tell her that it takes time for these bruises to improve, so she should be patient.

c) Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint.

d) Send her to the emergency room for reduction of this obvious wrist fracture.

Question 25 2 / 2 points

A patient with type 1 diabetes comes to the clinic complaining of feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first?

Question options:

a) Check his blood sugar.

b) Have him drink 4 ounces of juice.

c) Call 911.

d) Ask him about his usual eating habits.

Question 26 2 / 2 points

The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit?

Question options:

a) High sensitivity thyroid-stimulating hormone (TSH) and free T4

b) Free T4 and serum calcium

c) Free T3 and T4

d) TSH and thyroxin antibodies

Question 27 2 / 2 points

A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes.Which of the following tests should be ordered next?

Question options:

a) Serum calcium

b) TSH

c) Electrolytes

d) Urine specific gravity

Question 28 2 / 2 points

Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and limited movement in her right shoulder. She denies any history of trauma. Her examination reveals a 75% reduction in both active and passive ROM of the right shoulder. Mrs. Gray also is experiencing tenderness with motion and pain at the deltoid insertion. Her medical history is significant for type 1 diabetes mellitus and hypertension. Her social history reveals that she is a secretary and that she is right-handed. Based on her examination and medical history, you suspect adhesive capsulitis, or “frozen shoulder.” Which clue in Mrs. Gray’s history supports this diagnosis?

Question options:

a) History of hypertension

b) Her affected shoulder is also her dominant arm.

c) Her history of diabetes mellitus

d) Her work as a secretary predisposes her to repetitive motions.

Question 29 2 / 2 points

What is the recommended daily calcium intake for adults over the age of 50 with low bone mass?

Question options:

a) 1,200 mg/day

b) 1,000 mg/day

c) 1,300 mg/day

d) 1,500 mg/day

Question 30 2 / 2 points

A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expect as a manifestation of the disease?

Question options:

a) Sinus bradycardia

b) Atrial fibrillation

c) Supraventricular tachycardia

d) U waves

Question 31 2 / 2 points

You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is:

Question options:

a) Articular

b) Inflammatory

c) Nonarticular

d) A and B

Question 32 2 / 2 points

Which of the following statements concerning the treatment of fibromyalgia syndrome is true?

Question options:

a) There is currently no cure for the disorder; however, patients should be made aware that symptom relief is possible.

b) Treatment is directed toward controlling discomfort, improving sleep, and maintaining function.

c) Fibromyalgia syndrome can be difficult to manage, requiring a variety of approaches and multiple medications.

d) All of the above

Question 33 2 / 2 points

Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:

Question options:

a) Ecchymosis, edema, and erythema over the lateral epicondyle

b) Pain at the elbow with resisted movements at the wrist and forearm

c) Inability to supinate and pronate the arm

d) Inability to flex or extend the elbow against resistance

Question 34 2 / 2 points

Mrs. Allen is a 60-year-old woman who has been diagnosed with osteoporosis. She is very concerned about the risk of breast cancer associated with hormone replacement therapy and is wondering what other treatments are available to her. The clinician explains that bisphosphonates are another class of drugs used in the prevention and treatment of osteoporosis. What teaching should the clinician give Mrs. Allen in regard to taking bisphosphonates?

Question options:

a) Taking bisphosphonates can result in hypercalcemia, so calcium intake should be decreased while taking this class of drugs.

b) There is potential for upper GI irritation, so these medications are contraindicated in people with abnormalities of the esophagus or delayed esophageal emptying.

c) This class of drugs can be taken at any time of the day without regard to meals.

d) None of the above

Question 35 2 / 2 points

The clinician suspects that a client has patellar instability. In order to test for this, the client is seated with the quadriceps relaxed, and the knee is placed in extension. Next the patella is displaced laterally, and the knee flexed to 30°. If instability is present, this maneuver displaces the patella to an abnormal position on the lateral femoral condyle, and the client will perceive pain. Testing for patellar instability in this way is known as:

Question options:

a) Apprehension sign

b) Bulge sign

c) Thumb sign

d) None of the above

Question 36 2 / 2 points

Normal estrogen function is important for preventing osteoporosis in both men and women. Estrogen works to prevent osteoporosis in which of the following ways?

Question options:

a) By decreasing the erosive activity of osteoclasts

b) By promoting osteoclastogenesis

c) By inhibiting osteoclast apoptosis

d) All of the above

Question 37 2 / 2 points

Which of the following tests should you order to confirm Mr.W’s diagnosis?

Question options:

a) Bone scan

b) Computed tomography (CT) scan

c) X-ray of the foot

d) Culture of the ulcer

Question 38 2 / 2 points

One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular structure?

Question options:

a) Bone

b) Synovium

c) Tendons

d) Fascia

Question 39 2 / 2 points

Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this patient?

Question options:

a) Elevated uric acid level

b) Elevated blood urea nitrogen

c) Decreased urine pH

d) Decreased C-reactive protein

Question 40 2 / 2 points

Urine-free cortisol is one of four diagnostic tests recommended for Cushing’s syndrome.

Question options:

a) True

b) False

Question 41 2 / 2 points

Joyce is seen in the clinic complaining of vague symptoms of nervousness and irritability. She says that her hair will not hold a permanent wave anymore. On physical examination, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis should include which of the following conditions?

Question options:

a) Myxedema

b) Thyrotoxicosis

c) Cushing’s syndrome

d) Pan-hypopituitarism

Question 42 0 / 2 points

How often should the clinician examine the feet of a person with diabetes?

Question options:

a) Once a year

b) Every 6 months

c) Every 3 months

d) Every visit

Question 43 2 / 2 points

A BMI of 29 kg/m2 is considered obesity.

Question options:

a) True

b) False

Question 44 2 / 2 points

Jennifer is an 18-year-old who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited ROM in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

Question options:

a) Posterior dislocations are more common than anterior dislocations.

b) There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.

c) Recurrent dislocations are uncommon and would require great force to result in injury.

d) Surgery is most commonly the treatment of choice.

Question 45 2 / 2 points

The clinician should question the patient with suspected gout about use of which of these medications?

Question options:

a) Low-dose aspirin

b) Thiazide diuretics

c) Ethambutol

d) All of the above

Question 46 2 / 2 points

Metformin is the first line of pharmacologic treatment for type 2 DM.

Question options:

a) True

b) False

Question 47 2 / 2 points

Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome?

Question options:

a) Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel.

b) Only people with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.

c) An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.

d) Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.

Question 48 2 / 2 points

Fruit juice with added sugar is the treatment of choice for anyone experiencing hypoglycemia.

Question options:

a) True

b) False

Question 49 2 / 2 points

The patient is prescribed radioactive iodine (RAI) and asks the clinician how this drug works. The clinician’s response should include which of the following data?

Question options:

a) RAI prevents the peripheral conversion of T4 to T3.

b) RAI binds free T4.

c) RAI destroys thyroid tissue.

d) RAI reduces freely circulating iodine.

Question 50 2 / 2 points

Lifestyle modification is the treatment of choice for metabolic syndrome.

Question options:

a) True

b) False

MN568 Unit 6 Exam latest 2017

MN568 Unit 6 Exam latest 2017

Question 1 2 / 2 points

A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses?

Question options:

a) Pancreatitis

b) Peptic ulcer disease

c) Diverticulitis

d) All of the above

Question 2 2 / 2 points

Which of the following would be an appropriate treatment for a patient with mild BPH?

Question options:

a) Refer to a urologist for surgery.

b) Prescribe a trial of tamsulosin.

c) Recommend cranberry supplements.

d) Reevaluate symptoms in 1 to 3 months.

Question 3 2 / 2 points

The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?

Question options:

a) Repeat the test.

b) Refer to a nephrologist.

c) Measure the serum protein.

d) Obtain a blood urea nitrogen (BUN) and creatinine.

Question 4 2 / 2 points

Which is the most potent and irritating dose of tretinoin?

Question options:

a) 0.05% liquid formulation

b) 0.1% cream

c) 1% foam

d) 0.02% cream

Question 5 2 / 2 points

Which of the following clinical manifestations are consistent with a patient in ARF?

Question options:

a) Pruritis

b) Glycosuria

c) Irritability

d) Hypotension

Question 6 2 / 2 points

Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?

Question options:

a) Keratosis pilaris

b) Dennie’s sign

c) Keratoconus

d) Pityriasis alba

Question 7 2 / 2 points

The patient with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6 months. The clinician should assess this patient for which of these side effects?

Question options:

a) Erectile dysfunction

b) Glaucoma

c) Hypotension

d) Headache

Question 8 2 / 2 points

When using the microscope for an intravaginal infection, you see something translucent and colorless. What do you suspect?

Question options:

a) A piece of hair or a thread

b) Hyphae

c) Leukocytes

d) Spores

Question 9 2 / 2 points

Your patient is in her second trimester of pregnancy and has a yeast infection. Which of the following is a treatment that you usually recommend/order in nonpregnant patients, but is listed as a Pregnancy category D?

Question options:

a) Vagistat vaginal cream

b) Monistat combination pack

c) Terazol vaginal cream

d) Diflucan, 150 mg

Question 10 2 / 2 points

A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?

Question options:

a) NSAIDs

b) Beets

c) Vitamin A

d) Red meat

Question 11 2 / 2 points

Which of the following tests is most useful in determining renal function in a patient suspected of CRF?

Question options:

a) BUN and creatinine

b) Electrolytes

c) Creatinine clearance

d) Urinalysis

Question 12 2 / 2 points

Eighty percent of men have noticeable hair loss by what age?

Question options:

a) 35

b) 50

c) 70

d) 85

Question 13 0 / 2 points

When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes.What do you suspect they are?

Question options:

a) Spores

b) Leukocytes

c) Pseudohyphae

d) Epithelial cells

Question 14 2 / 2 points

Which of the following information is essential before prescribing Bactrim DS to a 24-year-old woman with a UTI?

Question options:

a) Last menstrual period

b) Method of birth control

c) Last unprotected sexual contact

d) All of the above

Question 15 2 / 2 points

What is the treatment of choice for a patient diagnosed with testicular cancer?

Question options:

a) Radical orchidectomy

b) Lumpectomy

c) Radiation implants

d) All of the above

Question 16 2 / 2 points

Which test is used to confirm a diagnosis of epididymitis?

Question options:

a) Urinalysis

b) Gram stain of urethral discharge

c) Complete blood cell count with differential

d) Ultrasound of the scrotum

Question 17 2 / 2 points

Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this?

Question options:

a) Bullous impetigo

b) Staphylococcal scalded skin syndrome (SSSS)

c) Nonbullous impetigo

d) Ecthyma

Question 18 2 / 2 points

An example of ecchymosis is:

Question options:

a) A hematoma

b) A keloid

c) A bruise

d) A patch

Question 19 2 / 2 points

An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses?

Question options:

a) Benign prostatic hyperplasia (BPH)

b) Parkinson’s disease

c) Prostate cancer

d) All of the above

Question 20 0 / 2 points

A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?

Question options:

a) Testosterone level

b) Prostate-specific antigen

c) Nocturnal penile tumescence and rigidity

d) Prolactin level

Question 21 2 / 2 points

A 35-year-old man presents with complaints of painful erections, and he notices his penis is crooked when erect. What is the most likely diagnosis?

Question options:

a) Peyronie’s disease

b) Damage to the pudendal artery

c) Scarring of the cavernosa

d) All of the above

Question 22 2 / 2 points

Question options:

a) The cancer involves the seminal vesicles.

b) There is metastatic disease to regional lymph nodes.

c) The cancer is confined to the capsule.

d) There is metastasis to distant organs.

Question 23 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 24 2 / 2 points

Tinea unguium is also known as:

Question options:

a) Onychomycosis

b) Tinea versicolor

c) Tinea manuum

d) Tinea corporis

Question 25 2 / 2 points

The patient is diagnosed with acute renal failure (ARF).Which of the following data obtained from the history should alert the provider that this is a case of prerenal azotemia?

Question options:

a) Recent heat stroke

b) Nephrolithiasis

c) Recent infection where gentamicin was used in treatment

d) All of the above

Question 26 2 / 2 points

Which of the following statements is accurate when you are removing a seborrheic keratosis lesion using liquid nitrogen?

Question options:

a) Do not use lidocaine as it may potentiate bleeding.

b) Pinch the skin taut together.

c) Use gel foam to control bleeding.

d) This should be performed by a dermatologist only.

Question 27 2 / 2 points

A patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication?

Question options:

a) Diarrhea

b) Parkinson’s disease

c) Closed-angle glaucoma

d) Breast cancer

Question 28 2 / 2 points

Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

Question options:

a) “You must be under a lot of stress lately.”

b) “It is hereditary. Did your father experience this also?”

c) “The cause is unknown, but we suspect it is due to an immunologic mechanism.”

d) “We’ll have to do some tests.”

Question 29 2 / 2 points

A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects?

Question options:

a) Risk of osteoporosis

b) May have hot flushes

c) May have impotence

d) All of the above

Question 30 2 / 2 points

Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition?

Question options:

a) There are round, hypopigmented macules on his back.

b) Josh has red papules on his face.

c) There are crusted plaques in Josh’s groin area.

d) There are white streaks on his neck.

Question 31 2 / 2 points

The most common precancerous skin lesion found in Caucasians is:

Question options:

a) A skin tag

b) Actinic keratosis

c) A melanoma

d) A basal cell lesion

Question 32 2 / 2 points

Which scalp problem can be caused by a fever and certain drugs?

Question options:

a) Telogen effluvium (TE)

b) Trichotillomania

c) Psoriasis

d) Alopecia areata

Question 33 2 / 2 points

A 46-year-old man presents with urinary hesitancy and low back pain. He has no history of UTI. Digital rectal examination (DRE) reveals a normal prostate, and a diagnosis of prostatodynia is made. Which is the appropriate treatment?

Question options:

a) Terazosin 2 mg PO once a day

b) Ice pack to the scrotal area

c) Saw palmetto 320 mg per day

d) All of the above

Question 34 2 / 2 points

A 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis?

Question options:

a) Lower urinary tract infection

b) Chlamydia infection

c) Candidiasis

d) Pyelonephritis

Question 35 2 / 2 points

Which of the following foods should be limited in a patient with CRF?

Question options:

a) Milk

b) Bananas

c) Soy sauce

d) All of the above

Question 36 2 / 2 points

An example of a primary skin lesion is a/an:

Question options:

a) Bulla

b) Scale

c) Excoriation

d) Fissure

Question 37 2 / 2 points

A 76-year-old man is seen in the office for complaints of urinary incontinence. The clinician should explore which of these causes of incontinence in men?

Question options:

a) Urethral polyps

b) Urinary tract infection (UTI)

c) Anticholinergic medication

d) All of the above

Question 38 2 / 2 points

A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which of the following questions should be asked?

Question options:

a) “Do you have a history of liver disease?”

b) “What medications are you currently taking?”

c) “Have you noticed swelling in your ankles?”

d) All of the above

Question 39 2 / 2 points

A 78-year-old man is diagnosed with Stage D bladder cancer and asks the provider what that means. Which is the best response?

Question options:

a) “There is no such thing as Stage D cancer.”

b) “You have cancer that has spread to the surrounding tissue.”

c) “Your cancer has spread to other organs.”

d) “Your cancer can be cured by removing your bladder.”

Question 40 2 / 2 points

Treatment for epididymitis includes which of the following?

Question options:

a) Warm sitz baths

b) Scrotal elevation

c) Masturbation

d) All of the above

Question 41 2 / 2 points

A patient is seen in the office complaining of severe flank pain. The clinician should assess this patient for which risk factor for kidney stones?

Question options:

a) Hypertension

b) Constipation

c) Tubal ligation

d) Diabetes

Question 42 2 / 2 points

A 63-year-old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis?

Question options:

a) Psychogenic nocturia

b) Urethral polyp

c) Irritative posterior urethral lesion

d) Benign prostatic hypertrophy

Question 43 0 / 2 points

A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?

Question options:

a) Every month

b) Every 3 to 4 months

c) Every 6 to 12 months

d) Every year

Question 44 2 / 2 points

Mark has necrotizing fasciitis of his left lower extremity.Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria?

Question options:

a) Staphylococcal aureus

b) Clostridium perfringens

c) S. pyrogenes

d) Streptococcus

Question 45 2 / 2 points

Ian, age 62, presents with a wide, diffuse area of erythematous skin on his lower left leg that is warm and tender to palpation.There is some edema involved. You suspect:

Question options:

a) Necrotizing fasciitis

b) Kaposi’s sarcoma

c) Cellulitis

d) A diabetic ulcer

Question 46 2 / 2 points

Why do people of African descent have a lower incidence of non-melanoma skin cancer?

Question options:

a) They have an increased number of melanocytes.

b) Their darker skin protects from ultraviolet radiation.

c) Their skin is thicker.

d) Their immune system is stronger.

Question 47 2 / 2 points

A 23-year-old sexually active man is seen in the clinic with unilateral painful testicular swelling, and he is diagnosed with epididymitis.In order to prescribe the correct drug, the clinician must understand that which of these is the most common causative organism?

Question options:

a) Escherichia coli

b) Staphylococcus aureus

c) Chlamydia trachomatis

d) Pseudomonas aeruginosa

Question 48 2 / 2 points

When instructing your elderly client about treating her xerosis, what do you tell her?

Question options:

a) A daily hot bath may help the associated pruritus.

b) Rub the skin briskly to make sure it is completely dry after bathing.

c) Only take short tepid showers.

d) Use a gel that is alcohol-based after bathing to soften the skin.

Question 49 2 / 2 points

Which of the following instructions should be given to the patient with nephrolithiasis?

Question options:

a) Take ibuprofen, 600 mg every 8 hours.

b) Take Tums? for stomach upset.

c) Drink more black tea.

d) Increase intake of vegetables, like spinach.

Question 50 2 / 2 points

The 56-year-old man with chronic prostatitis should be treated with trimethoprim 80 mg-sulfamethoxazole 400 mg (TMP-SMX, Bactrim) for how long?

Question options:

a) 3 to 7 days

b) 14 to 21 days

c) 3 to 6 weeks

d) 6 to 12 weeks

MN568 Unit 4 Exam

MN568 Unit 4 Exam latest 2017

Question 1 0 / 2 points

Mr. J. K., 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had intermittent heartburn for several months and takes Tums® with temporary relief. He has been waking during the night with a burning sensation in his chest. Which additional information would lead you to believe that gastroesophageal reflux disease (GERD) is the cause of his pain?

Question options:

a) The pain seems better when he smokes to relieve his nerves.

b) Coffee and fried foods don’t bother him,

c) He wakes at night coughing with a bad taste in his mouth.

d) All of the above

Question 2 2 / 2 points

A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis?

Question options:

a) Very early

b) 3 to 4 hours after perforation

c) Late in inflammation

d) Appendicitis never presents with vague pain.

Question 3 2 / 2 points

A patient is seen with complaints of diarrhea. Which of the following should be included in the patient’s differential diagnosis?

Question options:

a) Gastroenteritis

b) Inflammatory bowel disease

c) Lactase deficiency

d) All of the above

Question 4 0 / 2 points

If chest pain can be alleviated with time, analgesics, and heat applications, what might the differential diagnosis be?

Question options:

a) Peptic ulcer

b) Hiatal hernia

c) Costochondritis

d) Pericarditis

Question 5 2 / 2 points

A patient is seen in the office with complaints of six to seven liquid bowel movements per day. Which of the following assessment findings would lead the NP to a diagnosis of inflammatory bowel disease?

Question options:

a) Intermittent constipation with periods of diarrhea

b) Wakens at night with diarrhea

c) History of international travel

d) All of the above

Question 6 2 / 2 points

In which type of arterioventricular (AV) block does the pulse rate (PR) interval lengthen until a beat is dropped?

Question options:

a) First-degree AV block

b) Second-degree Mobitz I AV block

c) Second-degree Mobitz II AV block

d) Third-degree AV block

Question 7 2 / 2 points

For the best therapeutic effect after a myocardial infarction (MI), thrombolytics should be administered within the first 3 hours (ideally 30 minutes) of symptom onset. Studies have shown, however, that thrombolytic therapy can be of benefit up to how many hours after the initial presentation of MI symptoms?

Question options:

a) 6 hours

b) 8 hours

c) 10 hours

d) 12 hours

Question 8 2 / 2 points

Which of the following is associated with celiac disease (celiac sprue)?

Question options:

a) Malabsorption

b) Constipation

c) Rectal bleeding

d) Esophageal ulceration

Question 9 2 / 2 points

A 46-year-old female patient is seen in the clinic with abdominal pain. Which of the following tests is essential for this patient?

Question options:

a) CBC with differential

b) Urine human chorionic gonadotropin

c) Barium enema

d) Computed tomography of the abdomen

Question 10 2 / 2 points

Which high-density lipoprotein (HDL) level is considered cardioprotective?

Question options:

a) Greater than 30

b) Greater than 40

c) Greater than 50

d) Greater than 60

Question 11 2 / 2 points

A 28-year-old patient is seen with complaints of diarrhea.Which of the following responses to the history questions would help the primary care physician (PCP) establish the diagnosis of irritable bowel syndrome?

Question options:

a) Feels relief after a bowel movement

b) Sometimes is constipated

c) Does not defecate in the middle of the night

d) All of the above

Question 12 2 / 2 points

Which heart sound may be heard with poorly controlled hypertension, angina, and ischemic heart disease?

Question options:

a) A physiologic split S2

b) A fixed split S2

c) S3

d) S4

Question 13 2 / 2 points

A patient is diagnosed with GERD, and his endoscopic report reveals the presence of Barrett’s epithelium. Which of the following should the PCP include in the explanation of the pathology report?

Question options:

a) This is a premalignant tissue.

b) This tissue is resistant to gastric acid.

c) This tissue supports healing of the esophagus.

d) All of the above

Question 14 0 / 2 points

A patient is seen with dark-colored urine, and the urine dipstick reveals a high level of bilirubin. Which of the following could be a cause of this problem?

Question options:

a) Increased breakdown of red blood cells

b) Inadequate hepatocyte function

c) Biliary obstruction

d) All of the above

Question 15 2 / 2 points

Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?

Question options:

a) B-type natriuretic peptide

b) C-reactive protein

c) Serum albumin

d) Erythrocyte sedimentation rate

Question 16 2 / 2 points

Your patient with permanent afib asks when he can discontinue his warfarin. You tell him:

Question options:

a) When your internalized normalized ratio reaches 3.0, you can stop taking your warfarin permanently.

b) When you no longer feel ill

c) One month after your symptoms dissipate

d) You’ll probably be on it indefinitely.

Question 17 2 / 2 points

Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?

Question options:

a) Serum calcium

b) Electrocardiogram (ECG)

c) Thyroid-stimulating hormone test

d) Complete blood cell count

Question 18 2 / 2 points

Which of the following statements about dabigatran is true?

Question options:

a) It is difficult to keep the patient in therapeutic range.

b) Anticoagulation cannot be immediately reversed.

c) It allows for the use of tPA if the patient has a stroke despite anticoagulation.

d) None of the statements are true.

Question 19 2 / 2 points

A 25-year-old accountant is seen in the clinic complaining of crampy abdominal pain after meals. She is often constipated and takes laxatives, which are followed by a couple of days of diarrhea. She temporarily feels better after a bowel movement. She states she is embarrassed by flatulence and has abdominal distension. She has had no weight loss or blood in her stool. This problem has gone on for about 6 months. What should the next step be?

Question options:

a) Obtain a complete history.

b) Order a barium enema.

c) Schedule a Bernstein’s test.

d) Prescribe a trial of antispasmodics.

Question 20 2 / 2 points

A 35-year-old female patient is seen in the clinic complaining of abdominal pain. Which of the following should be included in the history and physical examination?

Question options:

a) Digital rectal exam

b) Pelvic exam

c) Sexual history

d) All of the above

Question 21 2 / 2 points

A 28-year-old patient is seen in the clinic with colicky abdominal pain particular with meals. She has frequent constipation, flatulence, and abdominal distension. Which of the data make a diagnosis of diverticulitis unlikely?

Question options:

a) Her age

b) Frequent constipation

c) Flatulence

d) Colicky abdominal pain

Question 22 2 / 2 points

Nitroglycerine (NTG) is given for a patient having ischemic chest pain. One tablet or one spray should be used under the tongue every 5 minutes for three doses. What should be done if the pain has not been relieved after three doses?

Question options:

a) 911 should be called, and the patient should be transported immediately to the emergency department.

b) One more dose of NTG may be tried.

c) The person should be given two aspirin to chew.

d) A portable defibrillator should be located to ascertain the cardiac rhythm.

Question 23 2 / 2 points

A patient is seen in the clinic with right upper quadrant pain that is radiating to the middle of the back. The NP suspects acute cholelithiasis. The NP should expect which of the following laboratory findings?

Question options:

a) Decreased alanine aminotransferase and decreased aspartate aminotransferase

b) Elevated alkaline phosphatase

c) Elevated indirect bilirubin

d) Decreased white blood cells

Question 24 2 / 2 points

A patient is diagnosed with giardia after a backpacking trip in the mountains. Which of the following would be an appropriate treatment?

Question options:

a) Vancomycin

b) Penicillin

c) Metronidazole

d) Bactrim

Question 25 2 / 2 points

A 21-year-old student presents with complaints of fatigue, headache, anorexia, and a runny nose, all of which began about 2 weeks ago. She started taking vitamins and over-the-counter cold preparations but feels worse.The smell of food makes her nauseated. Her boyfriend had mononucleosis about a month ago, and she wonders if she might have it also. Examination reveals cervical adenopathy and an enlarged liver and spleen. Which of the following labs would be most helpful in the differential diagnosis at this point?

Question options:

a) Stool culture

b) Liver enzymes

c) Antihepatitis D virus

d) Thyroid-stimulating hormone test

Question 26 2 / 2 points

Statins are approved for which age group?

Question options:

a) Children over the age of 2

b) Children over the age of 6

c) Children over the age of 10

d) Only adolescents and adults

Question 27 2 / 2 points

When teaching post MI patients about their NTG tablets, the clinician should stress that the tablets should remain in the light-resistant bottle in which they are packaged and should not be put in another pill box or remain in areas that are or could become warm and humid. Once opened, the bottle must be dated and discarded after how many months?

Question options:

a) 1 month

b) 3 months

c) 6 months

d) As long as the tablets are kept in this special bottle, they will last forever.

Question 28 2 / 2 points

Mary has hypertension and previously had a stroke. Which hypertensive drug would you order for her?

Question options:

a) Angiotensin converting enzyme inhibitor

b) Calcium channel blocker

c) Angiotensin II receptor blocker

d) Beta blocker

Question 29 2 / 2 points

What value on the ankle-brachial index diagnoses peripheral artery disease?

Question options:

a) Less than 0.25

b) Less than 0.50

c) Less than 0.90

d) Greater than 1

Question 30 2 / 2 points

Which group would most benefit from statins?

Question options:

a) Those with a low density lipoprotein-cholesterol greater than 100 mg/dL

b) Individuals with clinical arteriosclerotic cardiovascular disease

c) Individuals with a 10-year risk greater than 10%

d) Individuals of all ages with diabetes mellitus (DM)

Question 31 2 / 2 points

Which type of angina do you suspect in Harvey, who complains of chest pain that occurs during sleep and most often in the early morning hours?

Question options:

a) Stable angina

b) Unstable angina

c) Variant (Prinzmetal’s angina)

d) Probably not angina but hiatal hernia

Question 32 2 / 2 points

The American College of Cardiology/American Heart Association states which of the following regarding the use of non-statin lipid-lowering agents?

Question options:

a) Nicotinic acid derivatives are effective for lowering LDL and triglycerides (TGs).

b) Bile acid sequestrates increase HDL.

c) Cholesterol absorption inhibitors decrease LDL.

d) There is no sufficient evidence to use non-statin lipid-drugs.

Question 33 2 / 2 points

A patient comes to the office complaining of constipation.The patient lists all of the following medications. Which drug could be responsible for the constipation?

Question options:

a) Multivitamin

b) Magnesium hydroxide

c) Pepto-Bismol

d) Ibuprofen

Question 34 2 / 2 points

You just started Martha on HTN therapy. The Eighth Joint National Committee recommends that if her goal BP is not reached in what length of time, you should increase the initial drug or add a second drug to it?

Question options:

a) 1 month

b) 3 months

c) 6 months

d) 1 year

Question 35 2 / 2 points

The patient with GERD should be instructed to eliminate which of these activities?

Question options:

a) Swimming

b) Weight lifting

c) Golfing

d) Walking

Question 36 2 / 2 points

A patient has acute pancreatitis with seven of the diagnostic criteria from Ranson’s criteria. In order to plan care, the NP must understand that this criteria score has which of the following meanings?

Question options:

a) A high mortality rate

b) An increased chance of recurrence

c) A 7% chance of the disease becoming chronic

d) All of the above

Question 37 2 / 2 points

A Delta wave on the ECG may be present in which condition?

Question options:

a) Prinzmetal’s angina

b) Bundle branch block

c) Wolff-Parkinson-White syndrome

d) Aortic stenosis

Question 38 2 / 2 points

Lifestyle modifications to manage hypertension (HTN) include:

Question options:

a) Maintaining a body mass index of 17

b) Restricting dietary sodium to 2 grams per day

c) Engaging in exercise or physical activity for 90 minutes a day

d) Limiting beer intake to 24 ounces per day

Question 39 2 / 2 points

Which pain characteristic is usually indicative of cardiac pathology?

Question options:

a) Fleeting

b) Moving

c) Diffuse

d) Localized

Question 40 2 / 2 points

Which ECG change is typical of cardiac ischemia?

Question options:

a) T-wave inversion

b) ST-segment elevation

c) Significant Q wave

d) U-wave

Question 41 0 / 2 points

A 29-year-old Englishman is seen in the office with complaints of pain in his chest and belly. He has been suffering the pain for 2 weeks and gets temporary relief from Alka-Seltzer®. The burning pain wakes him at night and radiates up to his chest. Which factor favors a diagnosis of gastric ulcer?

Question options:

a) His gender

b) His age

c) His use of Alka-Seltzer

d) His ethnic origin

Question 42 2 / 2 points

Which murmurs are usually ‘watch and wait’?

Question options:

a) Systolic murmurs

b) Diastolic murmurs

c) They both are dangerous and need immediate attention.

d) You can ‘watch and wait’ for both of them.

Question 43 2 / 2 points

A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her physical examination is remarkable for left lower quadrant tenderness. At this time, which of the following should be considered in the differential diagnosis?

Question options:

a) Endometriosis

b) Colon cancer

c) Diverticulitis

d) All of the above

Question 44 2 / 2 points

George, age 64, has cardiovascular disease (CVD), a total cholesterol of 280 mg/dL, and a systolic BP of 158. He is being treated for hypertension.You are doing a Framingham Risk Assessment on him. Which assessment factor would give him the highest number of points on the scale?

Question options:

a) His age

b) His cholesterol level

c) His systolic BP

d) The fact that he is on antihypertensive medication

Question 45 2 / 2 points

The nurse practitioner (NP) suspects a patient has a peptic ulcer. Which of the following items on the history would lead the NP to this conclusion?

Question options:

a) Use of NSAIDs

b) Cigarette smoker

c) Ethanol consumption

d) All of the above

Question 46 2 / 2 points

In the CHADS2 Index for the stroke risk score for AF, the‘A’ stands for:

Question options:

a) Anticoagulation

b) Autoimmune disease

c) Age

d) Antihypertension

Question 47 2 / 2 points

Jamie, age 55, has just started on a statin after having his liver function tests (LFTs) come back normal. He now asks you how often he has to have the LFTs repeated. What do you tell him?

Question options:

a) Initially in 6 weeks

b) Every 3 months

c) Every 6 months

d) It’s no longer necessary for his statin regimen.

Question 48 0 / 2 points

Which of the following dietary instructions should be given to a patient with GERD?

Question options:

a) Eliminate coffee.

b) Drink peppermint tea to relieve stomach distress.

c) Recline and rest after meals.

d) Limit the amount of antacids.

Question 49 2 / 2 points

Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:

Question options:

a) Severe asthma

b) A common valvular lesion

c) Severe hypertension

d) A prosthetic heart valve

Question 50 2 / 2 points

You are assessing Sigred for metabolic syndrome. Which of her parameters is indicative of this syndrome?

Question options:

a) Her waist is 36 inches.

b) Her triglyceride level is 140 mg/dL.

c) Her BP is 128/84.

d) Her fasting blood sugar (BS) is 108 mg/dL.

MN568 Unit 2 Exam

MN568 Unit 2 Exam latest 2017

Question 1 0 / 2 points

Acute angle-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure?

Question options:

a) 0 to 7 mm Hg

b) 8 to 21 mm Hg

c) 22 to 40 mm Hg

d) 40 to 80 mm Hg

Question 2 0 / 2 points

Which obstructive lung disease is classified as reversible?

Question options:

a) Asthma

b) Chronic bronchitis

c) Emphysema

d) COPD

Question 3 0 / 2 points

A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?

Question options:

a) The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.

b) The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.

c) Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist.

d) Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.

Question 4 2 / 2 points

Heart valve damage resulting from acute rheumatic fever is a long-term sequelae resulting from infection with which of the following pathogens?

Question options:

a) Coxsackievirus

b) Cytomegalovirus

c) Francisella tularensis

d) Group A streptococcus

Question 5 2 / 2 points

The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection?

Question options:

a) HSV type 2

b) HIV

c) Pneumonia

d) Syphilis

Question 6 0 / 2 points

Your patient is on Therabid for his asthma. You want to maintain his serum levels between:

Question options:

a) 0 to 5 mcg/mL

b) 5 to 10 mcg/mL

c) 5 to 15 mcg/mL

d) 10 to 20 mcg/mL

Question 7 0 / 2 points

African American patients seem to have a negative reaction to which of the following asthma medications?

Question options:

a) Inhaled corticosteroids

b) Long-term beta-agonist bronchodilators

c) Leukotriene receptor agonists

d) Oral corticosteroids

Question 8 2 / 2 points

Which of the following statements is true concerning the use of bilberry as a complementary therapy for cataracts?

Question options:

a) The body converts bilberry to vitamin A, which helps to maintain a healthy lens.

b) Bilberry blocks an enzyme that leads to sorbitol accumulation that contributes to cataract formation in diabetes.

c) Bilberry boosts oxygen and blood delivery to the eye.

d) Bilberry is a good choice for patients with diabetes as it does not interact with antidiabetic drugs.

Question 9 2 / 2 points

Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?

Question options:

a) He should stop smoking today.

b) He should stop smoking tomorrow.

c) His quit date should be in 1 week.

d) He will be ready to quit after the first 30 days.

Question 10 2 / 2 points

The forced vital capacity is decreased in:

Question options:

a) Asthma

b) Chronic bronchitis

c) Emphysema

d) Restrictive disease

Question 11 2 / 2 points

A patient with hypertension comes in and insists that one of his new medications is causing him to cough. When looking at his list of medications, you think the cough must be from:

Question options:

a) Metoprolol

b) Clopidogrel

c) Tadalafil

d) Captopril

Question 12 0 / 2 points

You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?

Question options:

a) “Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow.”

b) “Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow.”

c) “Drive to the emergency room now.”

d) “Call 911.”

Question 13 2 / 2 points

Which of the following statements regarding pulmonary function is true?

Question options:

a) Cigarette smoking accelerates the decline in pulmonary function tenfold.

b) Smoking cessation can reverse most pathological changes.

c) Cigarette smoking decreases mucus production.

d) There is a normal age-related decline in pulmonary function.

Question 14 0 / 2 points

You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?

Question options:

a) Baker phenomenon

b) Arnold reflex

c) Cough reflex

d) Tragus reflex

Question 15 0 / 2 points

Nathan, a 32-year-old policeman, has a 15-pack-a-year history of smoking and continues to smoke heavily. During every visit, he gets irate when you try to talk to him about quitting. What should you do?

Question options:

a) Hand him literature about smoking cessation at every visit.

b) Wait until he is ready to talk to you about quitting.

c) Document in the record that he is not ready to quit.

d) Continue to ask him at every visit if he is ready to quit.

Question 16 2 / 2 points

Which immunoglobulin mediates the type 1 hypersensitivity reaction involved in allergic rhinitis?

Question options:

a) IgA

b) IgE

c) IgG

d) IgM

Question 17 2 / 2 points

Which of the following conditions is associated with cigarette smoking?

Question options:

a) Glaucoma

b) Increased sperm quality

c) Bladder cancer

d) Eczema

Question 18 0 / 2 points

Which ethnic group has the highest lung cancer incidence and mortality rates?

Question options:

a) African American men

b) Scandinavian men and women

c) Caucasian women

d) Asian men

Question 19 2 / 2 points

Which information should be included when you are teaching your patient about the use of nicotine gum?

Question options:

a) The gum must be correctly chewed to a softened state and then placed in the buccal mucosa.

b) Patients should not eat for 30 minutes prior to or during the use of the gum.

c) Initially, one piece is chewed every 30 minutes while awake.

d) Acidic foods and beverages should be encouraged during nicotine therapy.

Question 20 2 / 2 points

Julie has a postnasal drip along with her cough. You assess her for:

Question options:

a) Asthma

b) Sinusitis

c) Allergic or vasomotor rhinitis

d) Influenza

Question 21 2 / 2 points

Cydney presents with a history of asthma. She has not been treated for a while. She complains of daily but not continual symptoms, greater than 1 week and at nighttime. She has been using her rescue inhaler. Her FEV1 is 60% to 80% predicted. How would you classify her asthma severity?

Question options:

a) Mild intermittent

b) Mild persistent

c) Moderate persistent

d) Severe persistent

Question 22 2 / 2 points

A chronic cough lasts longer than:

Question options:

a) 3 weeks

b) 1 month

c) 6 months

d) 8 weeks

Question 23 0 / 2 points

Severe pain associated with acute otitis media signifies perforation of the tympanic membrane.

Question options:

a) True

b) False.

Question 24 0 / 2 points

As diabetic retinopathy progresses, the presence of ‘cotton wool’ spots can be detected. Cotton wool spots refer to:

Question options:

a) Nerve fiber layer infarctions

b) Blood vessel proliferation

c) Venous beading

d) Retinal hemorrhage

Question 25 2 / 2 points

Which of the following is a possible consequence of sleep apnea?

Question options:

a) Asthma

b) Increased white blood cells

c) Insulin resistance

d) Hyperactivity

Question 26 2 / 2 points

Marta is taking TB drugs prophylactically. How do you instruct her to take them?

Question options:

a) Take them on an empty stomach to facilitate absorption.

b) Take them with aspirin (ASA) to prevent flushing.

c) Take them with ibuprofen to prevent a headache.

d) Take them with food to prevent nausea.

Question 27 0 / 2 points

Sam, age 78, presents to the clinic with respiratory symptoms. His pulmonary function tests are as follows: a normal total lung capacity, a decreased PaO2, and an increased PaCO2. On assessment, you auscultate coarse crackles and forced expiratory wheezes. What is your diagnosis?

Question options:

a) Asthma

b) Emphysema

c) Chronic bronchitis

d) Influenza

Question 28 0 / 2 points

Which subtype of cataracts is characterized by significant nearsightedness and a slow indolent course?

Question options:

a) Nuclear cataracts

b) Cortical cataracts

c) Posterior cataracts

d) Immature cataracts

Question 29 0 / 2 points

Otitis media is considered chronic when:

Question options:

a) Inflammation persists more than 3 months with intermittent or persistent otic discharge.

b) There are more than six occurrences of otitis media in a 1-year period.

c) Otitis media does not resolve after two courses of antibiotics.

d) All of the above

Question 30 0 / 2 points

Which of the following is an example of sensorineural hearing loss?

Question options:

a) Perforation of the tympanic membrane

b) Otosclerosis

c) Cholesteatoma

d) Presbycusis

Question 31 0 / 2 points

A patient presents with the following signs and symptoms: gradual onset of low-grade fever, marked fatigue, severe sore throat, and posterior cervical lymphadenopathy. Based on the signs and symptoms alone, which of the following conditions is most likely the cause?

Question options:

a) Gonorrhea

b) Mononucleosis

c) Influenza

d) Herpes zoster

Question 32 0 / 2 points

You are using the CURB-65 clinical prediction tool to decide whether Mabel, whom you have diagnosed with community-acquired pneumonia (CAP), should be hospitalized or treated at home. Her score is 3. What should you do?

Question options:

a) Consider home treatment.

b) Plan for a short inpatient hospitalization.

c) Closely supervise her outpatient treatment.

d) Hospitalize and consider admitting her to the intensive care unit.

Question 33 2 / 2 points

The most significant precipitating event leading to otitis media with effusion is:

Question options:

a) Pharyngitis

b) Allergies

c) Viral upper respiratory infection (URI)

d) Perforation of the eardrum

Question 34 2 / 2 points

Patients with acute otitis media should be referred to a specialist in which of the following situations?

Question options:

a) Concurrent vertigo or ataxia

b) Failed closure of a ruptured tympanic membrane

c) If symptoms worsen after 3 or 4 days of treatment

d) All of the above

Question 35 2 / 2 points

Marci has been started on a tuberculosis (TB) regimen.Because isoniazid (INH) may cause peripheral neuropathy, you consider ordering which of the following drugs prophylactically?

Question options:

a) Pyridoxine

b) Thiamine

c) Probiotic

d) Phytonadione

Question 36 2 / 2 points

The barrel chest characteristic of emphysema is a result of:

Question options:

a) Chronic coughing

b) Hyperinflation

c) Polycythemia

d) Pulmonary hypertension

Question 37 0 / 2 points

A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?

Question options:

a) The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.

b) Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.

c) A throat culture should be performed to confirm the results of the rapid strep test.

d) The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.

Question 38 0 / 2 points

Your patient states he has a strep throat infection. Which of the following symptoms makes you consider a viral etiology instead?

Question options:

a) Fever

b) Headache

c) Exudative pharyngitis

d) Rhinorrhea

Question 39 0 / 2 points

Which statement about adenocarcinoma of the lung is accurate?

Question options:

a) It is the least common type of lung cancer, representing approximately 5% to 10% of cases.

b) It is the most prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35% to 40% of all tumors.

c) It is more common in men than in women and occurs almost entirely in cigarette smokers.

d) It is aggressive, with rapid growth and early local and distant metastases via the lymphatic and blood vessels.

Question 40 0 / 2 points

A patient presents to the clinician complaining of ear pain.On examination, the clinician finds that the patient has tenderness on traction of the pinna as well as when applying pressure over the tragus. These findings are classic signs of which condition?

Question options:

a) Otitis media

b) Meniere’s disease

c) Tinnitus

d) Otitis externa

Question 41 2 / 2 points

Supplemental oxygen for how many hours per day has been shown to improve the mortality associated with COPD?

Question options:

a) 3 to 5 hours

b) 6 to 10 hours

c) 11 to 14 hours

d) 15 to 18 hours

Question 42 0 / 2 points

Which of the following medications used in the treatment of glaucoma works by constricting the pupils to open the angle and allow aqueous fluid to escape?

Question options:

a) Pilocarpine

b) Timolol

c) Brinzolamide

d) Acetazolamide

Question 43 2 / 2 points

You are in the park playing with your children when you see that your friend is screaming for help. Her toddler has fallen and there is a stick lodged in his eye. The child is kicking and screaming and grabbing for the stick. You:

Question options:

a) instruct his mother to hold him securely and not allow him to touch the stick, then carefully remove the stick from the eye.

b) stabilize the foreign object and accompany the mother and child to the local ER.

c) find a water fountain, hold the child to the water, and flush the eye.

d) call 911.

Question 44 2 / 2 points

You have a patient who is a positive for Strep on rapid antigen testing (rapid strep test). You order amoxacillin after checking for drug allergies (patient is negative) but he returns 3 days later, reporting that his temperature has gone up, not down (101.5 F in office). You also note significant adenopathy, most notably in the posterior and anterior cervical chains, some hepatomegaly, and a diffuse rash. You decide:

Question options:

a) to refer the patient.

b) that he is having an allergic response and needs to be changed to a macrolide antibiotic.

c) that his antibiotic dosage is not sufficient and should be changed.

d) that he possibly has mononucleosis concurrent with his strep infection.

Question 45 2 / 2 points

Fluctuations and reductions in estrogen may be a contributing factor in which type of rhinitis?

Question options:

a) Vasomotor rhinitis

b) Rhinitis medicamentosum

c) Atrophic rhinitis

d) Viral rhinitis

Question 46 2 / 2 points

In which of the following situations would referral to a specialist be needed for sinusitis?

Question options:

a) Recurrent sinusitis

b) Allergic sinusitis

c) Sinusitis that is refractory to antibiotic therapy

d) All of the above

Question 47 0 / 2 points

The clinician is assessing a patient complaining of hearing loss. The clinician places a tuning fork over the patient’s mastoid process, and when the sound fades away, the fork is placed without restriking it over the external auditory meatus. The patient is asked to let the clinician know when the sound fades away. This is an example of which type of test?

Question options:

a) Weber test

b) Schwabach test

c) Rinne test

d) Auditory brainstem response (ABR) test

Question 48 0 / 2 points

Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than:

Question options:

a) 4 weeks

b) 8 weeks

c) 12 weeks

d) 16 weeks

Question 49 2 / 2 points

Most nosocomial pneumonias are caused by:

Question options:

a) Fungi

b) Viruses

c) Gram-negative bacteria

d) Pneumococcal pneumonia

Question 50 2 / 2 points

Joyce is taking a long-acting beta agonist for her asthma.What additional medication should she be taking?

Question options:

a) Inhaled corticosteroid

b) Leukotriene receptor antagonist

c) Systemic corticosteroid

d) Methyl xanthenes

NR 511 Week 4 Midterm Exam Version 4

NR 511 Week 4 Midterm Exam Version 4

Question 1. Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall.

She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

Posterior dislocations are more common than anterior dislocations.

There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.

Recurrent dislocations are uncommon and would require a greater force to result in injury.

Surgery is most commonly the treatment of choice.

Question.2 In the United States, what is the second most common connective tissue disease and the most destructive to the joints?

Osteoarthritis

Systemic lupus erythematosus (SLE)

Rheumatoid arthritis

Sjögren’s syndrome

Question.3 Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease?

a.Elevated thyroid-stimulating hormone (TSH)

b.Elevated T4

c.Elevated TRH

d.All of the above

Question.4 Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?

Benzodiazepinesb.

Antipsychoticsc.

Anticonvulsantsd.

Antidepressants

Question.5 When may confidentiality be overridden?

When personal information is available on the computer

When a clinician needs to share information with a billing company

When an insurance company wants to know the results of a breast cancer gene testX

When a patient has a communicable disease

Question.6 What percentage of burns is involved using the rule of nines if both front legs are burned?

18%

24%

36%

Question.7 The clinician should question the patient with suspected gout about use of which of these medications that may be a risk factor?

Low-dose aspirin

Thiazide diuretics

Ethambutol

All of the above

Question.8 Women are at the highest risk for developing postpartum depression for up to how long after childbirth?

2 weeks

1 month

3 months

6 months

Question.9 Which ethical principle reflects respect for all persons and their self-determination?

Autonomy

Beneficence

Justice

Veracity

Question.10 George, aged 59, complains of a flulike illness, including fever, chills, and myalgia after returning from visiting his grandchildren in New England. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?

a. A viral syndromes
b. Lyme disease
c. Rocky Mountain spotted fever
d. Relapsing fever

Question.11 A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?

Pregnancy test.

Endometrial biopsy

Pelvic ultrasound

Platelet count

Question.12 Which of the following statements is true regarding the treatment of carpal tunnel syndrome?

a. The goal of treatment is to prevent flexion and extension movements of the wrist.
b. Splints are used in carpal tunnel syndrome because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position.
c. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.
d. All of the above

Question.13 During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

a. An enlarged rubbery gland

b. A hard irregular gland

c. A tender gland
d. A boggy gland

Question.14 Which drug commonly prescribed …. partial- and full-thickness thermal injuries?

Clotrimazole cream (Lotrimen)

Mafenide acetate (Sulfamylon)

Silver nitratex

Silver sulfadiazine (Silvadene)

Question.15 A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

“It is probably just a cyst, because that is the most common breast mass.

“We will order a mammogram and ultrasound to help establish a diagnosis.”

“We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”

“Because your lump is painful, it is most likely not cancer.”

Question.16 After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

Suggest she use a heating pad to improve circulation

Refer to a podiatrist for a foot care treatment plan

Send her for acupuncture treatments

All of the above

Question.17 Which of the following medications is the treatment of choice for trichomonas?

Metranidazole

Ceftriaxone

Diflucan

Doxycycline

Question.18 Most adult poisonings are:

intentional and self-inflicted.

accidental.

caused by someone wishing to do harm to the person.

not attributed to any reason.

Question.19 Which solution should be used when irrigating lacerated tissue over a wound on the arm?

Dilute povidone-iodine solutionx

Hydrogen peroxide (H2O2)

Saline solution infused with an antibiotic

Saline irrigation or soapy water

Question.20 A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?

Sinus bradycardia

Atrial fibrillation

Supraventricular tachycardia

U waves

Question.21 What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?

A stabbing pain on one small area of the body

A vesicular skin lesion on one side of the body

A pain that is worse upon awakening

A lesion on the exterior ear canal

Question.22 Which patient is more likely to have a cluster headache?

A female in her reproductive years

A 40-year-old African American male

A 55-year-old female who drinks 10 cups of coffee daily

A 45-year-old male awakened at night

Question.23 If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?

Permanent tissue damage may occur, resulting in necrosis to that body part.

The area will be super sensitive.

The area is prone to a repeat frostbite.

The area is as susceptible as any other area.

Question.24 The current goal of treatment for a patient with HIV infection is which of the following?

Viral suppression of HIV to undetectable levels in the peripheral blood

Compete eradication of the virus

Encouraging the person to have no contact with uninfected individuals

Complete abstinence

Question.25 The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

Overweight

Mild obesity

Moderate obesity

Morbid obesity

Question.26 The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs to manage his pain?

You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.

You should start with the lowest dose that is effective in managing your pain in order to avoid developing tolerance to the medication.

You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.

It is important to take NSAIDs on an empty stomach in order to increase absorption.

Question.27 In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the “C” of LACE represents?

Commitment

Consensusx

Certification

Collaboration

Question.28 Which of the following statements is true concerning the management of the client with a herniated disc?

Muscle relaxants and narcotics can be used to control moderate painbut should be discontinued after 3 weeks of use.

An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred.

Intolerable pain for more than a 3-month period is an indication for surgical intervention.

All of the above

Question.29 Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

Superficial burns

Superficial partial-thickness burns

Deep partial-thickness burns

Full-thickness burns

Question.30 CPT coding offers the uniformed language used for reporting medical services and procedures performed by physician and non physician practitioners. Clinicians are paid based on calculated resource costs that are calculated based on practice components. Which of the following are part of the components used to calculate the per CPT code payment rate?

a. Clinician education loans

b. Clinician practice liability and malpractice expense

c. Clinician reported cost reduction efforts

d. Clinician volume of patients treated

Question.31 Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point?

10%

x 20%

30%

50%

Question.32 A bulla is:

A vesicle larger than 1 cm in diameter.

An elevated solid mass with a hard texture, and the shape and borders can be regular or irregular.

A superficial elevated lesion filled with purulent fluid.

Thinning of the skin (epidermis and dermis) that appears white or translucent.

Question.33 Clinicians who learn how to code and document Evaluation and Management (E&M) and clinician services will be more successful in gaining timely payment for care delivery. Which or the following Centers for Medicare and Medicaid Services (CMS) practices are designed to financially penalize clinicians who do not bill according to CMS guidelines?

Audits and probes

Add-on codes

Modifier codes

HAC guidelines

Question 34. Which characteristic of delirium helps to distinguish delirium from dementia?

Abrupt onset

Impaired attention

Affective changes

Delusions

Question.35 Which of the following statements is true concerning the musculoskeletal exam?

The uninvolved side should be examined initially and compared to the involved side.

The part of the body that is causing the patient pain should be examined first.

The patient should not be asked to perform active range-of-motion (ROM) exercises whenever possible to avoid causing pain.

Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

Question.36 A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnoses?

Testicular cancer

Inguinal hernia

Varicocele

All of the above

Question.37 When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

Spores

Leukocytes

Pseudohyphae

Epithelial cells

Question.38 Which of the following is a role of the advanced practice nurse in palliative cancer care?

Detecting cancer in asymptomatic patients or those with specific symptoms

Arranging for follow-up care, including psychosocial and spiritual support

Identifying and managing complications of care

All of the above

Question.39 Immunizations are an example of which type of prevention?

Primary

Secondary

Tertiary

Question.40 Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines?

Propranolol

Timolol

Ergotamine

Topiramate

Question.41 A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?

Human papillomavirus (HPV)

Endometrial hyperplasia

Vagismus

Polycystic ovarian syndrome

Question. 42 How often should the clinician examine the feet of a person with diabetes?

Once a year

Every 6 months

Every 3 months

Every visit

Question.43 A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding?

Trichomonas

Bacterial vaginosis

Human papillomavirus (HPV)

Herpes simplex virus (HSV)

Question.44 After 6 months of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?

Elevated thyroid-stimulating hormone (TSH)

Normal TSH

Low TSH

Undetectable TSH

Question.45 The main mechanism for avoiding a lawsuit involves:

Good liability insurance

A collaborating physician

Good documentation

Open communication skills

Question.46 The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:

1 month.

3 months.

6 months.

12 months.

Question. 47 What is the treatment of choice for a patient diagnosed with testicular cancer?

Radical orchidectomy

Lumpectomy

Radiation implants

All of the above

Question. 48 Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? Gastrocnemius weakness

A reduced or absent ankle reflex

Numbness in the lateral foot

Paresthesia of the perineum and buttocks

Question.49 Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

Cholinesterase inhibitors

Anxiolytics

Antidepressants

Atypical antipsychotics

Question.50 Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Decreased C-reactive protein

Hyperalbuminemia

Morning stiffness

Weight gain

NAPSRx Final Exam

1. How are drugs sorted into therapeutic groups and classes?

A. first by the conditions that they are used to treat. and then by their mechanisms of action

B. first by their mechanisms of action. and then by their therapeutic effects

C. first by their side effects. and then by their therapeutic effects

D. first by their toxicity. and then by their effectiveness

2. Bone marrow transplants…

A. require that the patient first undergo chemotherapy or radiation to kill the diseased stem cells and promote white blood cell production.

B. are a type of stem cell therapy. unless patient’s own cells are reinjected.

C. are always a type of stem cell therapy.

D. can help people with leukemia. a condition in which the body does not produce enough white blood cells.

3. What does AMA stand for?

A. American Medical Academy

B. American Medical Accreditation

C. American Medical Association

D. Association of Medical Assistants

4. What section of a drug’s package insert describes situations in which the drug should not be used because the risks outweigh the therapeutic benefits?

A. adverse reactions

B. contraindications

C. overdosage

D. warning/precautions

5 What is tertiary care?

A. adding medications together to achieve a better clinical effect

B. highly specialized medical and surgical care provided by a large medical center for unusual or complex medical problems

C. receiving medical or surgical care that does not require an overnight stay in the treatment facility

D. seeing a physician for routine checkups and general healthcare

6. Which of the following is NOT one of the stages in the classic approach to brand development strategy covered in your manual?

A. brand personality

B. brand positoning

C. brand quality

D. brand values

7 What are vasodilators used to do?

A. decrease vascular resistance and increase blood flow

B. mimic pathogens to stimulate the immune system

C. narrow the blood vessels

D.stimulate the CNS to make the heart beat faster

8. What is the name of the condition that occurs after a specific dose of a drug is given at such regular intervals that absorption and elimination (and therefore drug plasma concentration) have become fairly constant?

A. homeostasis

B. steady state

C. titration

D. tolerance

9. Which statement is TRUE about ocular administration?

A. Ocular administration is primarily for drugs that must cross the blood-brain barrier.

B. Ocular administration is used primarily to treat the eye.

C. Ocular administration is used when a drug must enter the bloodstream immediately.

D. Ocular administration is used when a drug must produce immediate effects on the brain or spinal cord.

10. Which entities invest’s the most money in pharmaceutical R&D?

A. Canadian pharmaceutical companies

B. the NIH

C. the U.S. Government

D. U.S. pharmaceutical companies

11. How are most drugs excreted?

A. via the bloodstream

B. via the heart

C. via the kidneys

D. via the skin

12. Over the last few decades, what has happened to legal limitations on sales’ reps discussions about off label uses?

A. Limitations have decreased.

B. Limitations have increased significantly.

C. Limitations have increased slightly.

D. Limitations have remained about the same.

13. Answer: Branding name

14. What does it mean if two drugs are at parity?

A. Both drugs are essentially in a neutral position.

B. Both drugs are generics.

C. Both drugs have exclusive preferred status.

D. The two drugs are bioequivalent.

15 Who is most likely to benefit from electronic sampling programs?

A. Everyone would benefit equally from electronic sampling programs

B. physicians in hospitals who are too busy to see representatives

C. physicians in rural areas who are not as frequently visited by representatives

D. physicians in urban areas who are too busy to see representatives

16. When referring to medication dosage, which abbreviation means “one-half’:

A. MS

B. OH

C. SM

D. SS

17 What is an internist?

A. a physician who practices internal medicine

B. a physician’s intern

C. a type of oncologist who specializes in chemotherapy

D. an internal sales representative

18. Which of the following is a type of white blood cell?

A. erythrocytes

B. insulin

C. Lymphocytes

D.HCs

19. Why are novice sales representatives often placed in charge of negotiating MCO formularies?

A. to become more familiar with the healthcare industry

B. to become more familiar with their territories

C. P&T committees are more receptive to new faces.

D. They are not. This job is usually reserved for more experienced reps.

20. What distinguishes pharmacodynamics from pharmacokinetics?

A. Pharmacodynamics studies a drug’s ex vivo effects.

B. Pharmacodynamics studies how drugs affect the body.

C. Pharmacodynamics studies the how the body affects drugs.

D. Pharmacodynamics studies the time required for a drug’s absorption.

21 What proportion of the drugs tested on human subjects are eventually approved by the FDA?

A. about 20%

B. about 60%

C. about 70%

D. about 95%

22. According to a study discussed in your manual, how do most physicians prefer to receive their drug samples?

A. by borrowing them from hospitals

B. by ordering them over the Internet

C. by trading them for services

D. directly from sales representatives

23. Which of the following is an example of a central value?

A. I buy Advil to show that I’m a modern consumer.

B. I like Advil because we were both born in the 80s.

C. I prefer Advil because I like the flavor.

D. I prefer Advil because it’s easier to swallow.

24. Which of the following specialties likely has the MOST emergency calls?

A. cardiology

B. psychiatry

C. urology

D. All specialists have the same number of emergency calls.

25. What affects the rate of active transport?

A. the availability of carriers. but not energy

B. the availability of energy. but not carriers

C. the availability of carriers and energy

D. neither the availability of carriers nor the availability of energy

26. Over the last few decades, what has happened to the FDA approval time for new drugs?

A. It has been lengthened to ensure safer drug products.

B. It has been lengthened to limit DTC marketing

C. It has been shortened to improve drug quality

D. It has been shortened to reduce the cost of new drug development.

27. Which of the following would NOT help improve compliance?

A. patients liking their providers

B. patients using only one pharmacist

C. pharmacists understanding how generics differ from brand name drugs

D. support groups

28. Which entity chooses a drug’s trade name?

A. the drug’s inventor

B. the drug’s manufacturer

C. the FDA

D. the United States Pharmaceutical Council

29. What type of stem cells are obtained from embryos and can develop into any cell type?

A. multipotent

B. pluripotent

C. totipotent

D. All stem cells can develop into any cell type.

30. As the price a patient pays for a prescription increases, what happens to the likelihood that the patient will fill it?

A. It decreases.

B. It increases.

C. It remains unaffected because the prescription is needed.

D. It remains unaffected because the prescription’s increased cost is offset by its perceived value.

31. Most involuntary movements come from which type of muscle tissue?

A. cardiac and smooth

B. only skeletal

C. skeletal and cardiac

D. skeletal and smooth

32. Which of the following is NOT one of the body’s major organ systems?

A. the cardiovascular system

B. the cellular system

C. the gastrointestinal system

D. the musculoskeletal system

33. How do most drugs exert their primary physiological effects?

A. by activating synapses between different types of tissues

B. by binding to cell receptors that are sensitive to their presence

C. by inhibiting synapses between different types of tissues

D. through genetic mutation

34. What is the most reliable source of information for determining therapeutically equivalent drug products?

A. AMA guide

B. Blue Book

C. FDA drug list

D. Orange Book

35. What does subcutaneous mean?

A. beneath the intervention

B. beneath the muscle tissue

C. beneath the outer skin

D. beneath the suture

36. What should a sales representative do if all of the prime spaces in a drug cabinet are coccupied?

A. ask staff for permission to move some of the other products in the cabinet

B. ask staff for permission to throw away expired products in the cabinet

C. ask the doctor if he still needs some of the other products in the cabinet

D. surreptitiously move your largest competitors’ products out of the way

37. It is inappropriate for physicians’ prescribing behaviors to be educated by their personal tastes and idiosyncrasies

A. TRUE

B. FALSE

38.The FDA defines API as the active__ ingredient in a drug, which produces the desired change in the body.

A. pharmaceutical

B. positive

C. potent

D. primary

39. What are the 2 legal classifications of wholesalers?

A. distributors and supply chains

B. pharmacists and NAMs

C. primary and secondary wholesale distributors

D. retailers and institutions

40.What term describes the usage of a medication for purposes other than the FDA-approved indications on the labeling?

A. contraindicative indication

B. off-indication usage

C or D. off-label

41. What is the acronym for pharmacokinetics?

A. KN

B. PC

C. PK

D. pT

42. The dosage range of a drug that is both safe and beneficial is known as the therapeutic window.

A. TRUE

B. FALSE

43. What is typically NOT a characteristic of a pharmaceutical sales rep?

A. Pharmaceutical sales reps are authentic and real.

B. Pharmaceutical sales reps are creative.

C. Pharmaceutical sales reps are focused.

D. Pharmaceutical sales reps are not concerned about competitors.

44. What entity grants drug patents?

A. the FDA

B. the FDA if the drug is over-the-counter and the U.S. Patent and Trademark Office if the drug is prescription

C. the FDA if the drug is prescription and the U.S. Patent and Trademark Office if the drug is over-the-counter

D. the U.S. Patent and Trademark Office

45. Which of the following refers to all active and inert pharmaceutical ingredients in a drug, including fillers and colors?

A. formulation

B. mycoplasma

C. peptide

D. saccharide

46. What is the difference between potency and efficacy?

A. Doctors prefer more potent drugs.

B. Drug manufacturers prefer more potent drugs.

C. Potency refers to the drug’s effectiveness. while efficacy refers to its strength.

D. Potency refers to the drug’s strength, while efficacy refers to its effectiveness.

47. What is the minimum level of education required for a nurse practitioner?

A. a certification program

B. an associate’s degree

C. a bachelor’s degree

D. a graduate degree

48. How many names must a drug have?

A. at most three

B. at least three

C. at most five

D. at least five

49. How has a longer development time increased the cost of bringing a new drug to market?

Answer: Increasing the cost of capital

50. Senior citizens consume over times as many pharmaceuticals as people under 65.

A. three

B. five

C. ten

D. fifteen

51. What agency regulates the distribution and use of narcotics?

A. DEA

B. FTC

C. OIG

D.TSA

52. What is passive diffusion?

A. a type of pinocytosis

B. membrane transport via vesicles

C. the use of energy to help a substance pass from a low concentration gradient to a high one

D. when a substance freely moves through a membrane from a high concentration gradient to a low one

53. What are the MAIN categories of drugs under FDA jurisdiction?

A. active drugs and active placebos

B. biopharmaceuticals and nutraceuticals

C. non-prescription and nutraceuticals

D. prescription and non prescription

54. Answer: Oxytocin

55. What are all metabolites?

A. active substances

B. inactive substances

C. injections

D. products of metabolism

56. When a drug is administered orally, where does first-pass metabolism occur?

A. intestine

B. liver

C. pancreas

D. stomach

57. What is the medical term for swelling?

A. assay

B. edema

C. instillation

D. protease

58. Which of the following is NOT part of the Seven Step Cascade of Emotion?

A. be a consultant. not a rep

B. identify what your product does

C. reflect

D. visualize the power of 10

59. Which part of a clinical research paper is frequently referred to as the road map?

A. abstract

B. findings

C. letter to the editor

D . methods

60. Which of the following is a main active ingredient in lung surfactants?

A. animal lung extract

B. germicides

C. sympathomimetic drugs

D. theophylline

61. What does parenteral mean?

A. child prescriptions

B. injection

C. oral

D. tablet

62. Which term denotes a type of substance that enhances the action of a drug or antigen?

A. adjuvant

B. indicated

C. ligase

D peptide

63. If a sales representative’s product is placed on the second tier of a standard three-tier formulary, which of the following is most likely true?

A. It has not been reviewed by the P&T committee.

B. It is in a neutral position unless it is at parity with other drugs.

C. It probably has exclusive preferred status if it is not at parity with any other drugs.

D. It will essentially sell itself if it is granted exclusive preferred status.

64. Which of the following is NOT one of the four basic transport mechanisms?

A. active transport

B. homeostasis

C. passive diffusion

D. pinocytosis

65. Which statement accurately describes a relationship between drug agonists and antagonists?

A. Agonists and antagonists can be used together.

B. Agonists and antagonists should not be used together.

C. Antagonist drugs activate receptors. while agonists block access to receptors.

D. Antagonists are endogenous whereas agonists are man-made.

66. What is the study of the effects and movement of drugs in the human body?

A. anatomy

B. antology

C. clinical pharmacology

D. pathology

67. According to your manual, what is a common complaint that physicians have about traditional sampling methods?

A. that drug sample supply is too unpredictable

B. that patients are less likely to take free samples because they think they are lower quality

C. that patients do not like seeing drug representatives in their offices

D. that they receive too many drug samples

68. Which of these entities is formed by two or more hospitals or other healthcare entities to negotiate reduced rates with its aggregated purchasing power?

A. GPO

B. In-state wholesaler

C. PPO

D. RPO

69. What is another name for a drug derived from a biologic compound?

A. large molecule

B. oligonucleotide

C. orgaanism

D. small molecule

70. What is the most common policy regarding pharmaceutical reps dispensing drug samples in hospitals?

A. By federal law. drug sampling is permitted in all hospitals.

B. By federal law. it is up to individual physicians. not the hospital.

C. Drug sampling is encouraged. but not required.

D. Drug sampling is often forbidden.

71 Which of the following would help you build trust with a physician?

A. asking if he or she is having any problems with the managed care coverage of your products

B. repeating a question you already asked

C. surprising the office staff with a new poster in the break room

D. None of these would help you build trust with a physician.

72. What term denotes the difference between the usual effective dose and the dose that induces severe or life-threatening side effects?

A. dose-response relationship

B. margin of safety

C. the placebo effect

D. therapeutic window

73. What are excipients?

A. a type of cell receptor to which antagonists bind to decrease the effects of the body’s natural agonists

B. another term for generic equivalents

C. sites of action besides the target sites of action

D. the inert ingredients in a drug formulation

74. What is another term for the AWP?

A. dock-to-dock price

B. float price

C. list price

D. non-stock price

75. Which of these is the most likely use for a uterotonic agent?

A. to induce labor

B. to make the urine more alkaline

C. to supplement oral food intake

D. to treat hyperthyroidism

76. As of November 2013, which of these countries has legalized DTC advertising of prescription drugs?

A. Canada

B. Japan

C. Spain

D. none of these

77. Why are oral drugs often taken on an empty stomach?

A. to be more wholly absorbed by the stomach

B. to minimize absorption by the intestine

C. to minimize nausea

D. to pass through the stomach more quickly

78. What is one factor that differentiates community health centers from hospitals?

A. Community health center formularies are more restrictive.

B. Community health centers have higher reimbursement rates.

C. Newer brand name drugs are easier to access at community health centers.

D. None of these

79. How does drug sampling provide a social benefit?

A. Doctors donate their unused drug samples to charities.

B. Doctors often use drug samples to treat patients who otherwise could not afford it.

C. It allows patients to try out different prescription medications before consulting with physicians.

D. Drug sampling provides a social benefit in all of these ways.

80. Which medical term denotes the use of a stethoscope to listen to the heart?

A. auscultation

B. cardioversion

C. catheterization

D. echocardiography

81. What do enteric coatings do?

A. facilitate vomiting

B. help drugs dissolve in the stomach

C. help drugs enter the bloodstream more quickly

D. prevent dissolution in the stomach

82. What is the duration of exclusivity for orphan drugs?

A. 6 months

B. 1 year

C. 7 years

D. 15 years

83. What do National Account Managers do?

A. act as the sales reps’ primary point of contact with the rest of the corporation

B. manage the FDA approval process

C. negotiate contracts with MCOs and PBMs

D. sell only to pharmacies

84. What does it usually mean if a drug recall is voluntary?

A. Pharmacies may choose whether to return the drug or dispense it.

B. The FDA has determined that the drug is perfectly safe. but ineffective.

C. The manufacturer has recalled the product on its own. but negotiated with the FDA beforehand.

D. The manufacturer has recalled the product without negotiating with the FDA.

85. Which phase of clinical trials is also known as the pivotal phase?

A. Phase I

B. Phase III

C Phase IV

D. Phase IX

86. During which phase of clinical trials is the new drug’s safety and effectiveness first tested in the target group?

A. preclinical

B. Phase I

C. Phase II

D. Phase III

87. How do antacids work?

A. by increasing blood flow to the stomach

B. by lowering gastric pH

C. by raising gastric pH

D. by suppressing cholesterol formation by the liver

88. What is one of the biggest time wasters for a pharmaceutical sales rep?

A. Caterers

B. Pharcists

C. receptionists

D. travel time

89. What happens when equilibrium is reached?

A. equal numbers of molecules cross the membrane in both directions

B. molecules stop moving

C. the concentration gradient decreases indefinitely

D. the concentration gradient increases indefinitely

90. What are the most common vectors used in gene therapy?

A. autologous antigens

B. liposomes

C. naked DNA

D. viruses

91. What is the percentage fee that the dispenser pays the wholesaler for distribution?

A. margin fee

B. recharge

C. standard fee

D. upcharge

92. What is the difference between a chronic (or continuing) reaction, and a delayed reaction?

A. Chronic reactions are exaggerated. whereas delayed reactions are idiosyncratic.

B. Chronic reactions occur only during treatment. whereas delayed reactions only occur during withdrawal.

C. Chronic reactions persist for a long time. whereas delayed reactions take some time to develop.

D. Delayed reactions are always idiosyncratic. but chronic reactions are not.

93 What is clinical effect?

A. federally funded research condition

B. the effect of maximum dosage

C. the response produced by a medication

D. the use of treatment drugs in chemotherapy

94. Which of the following is an example of noncompliance?

A. a patient forgetting to take a drug at a specified time of day

B. a patient taking a drug. but only because it has been court-mandated

C. a pharmacist dispensing a generic equivalent of a drug instead of the brand name

D. a physician refusing to prescribe a drug because he or she does not trust the clinical studies on it

95. What is the average circulation time of blood?

A. about a minute

B. about 5 minutes

C. about 5 to 10 minutes depending on the patient’s age and health conditions

D. about 10 minutes

96. What is one way in which pharmaceutical selling is different from selling in most other industries?

A. In pharmaceutical sales. the decisions-makers. consumers. and payers are usually the same entity.

B. Pharmaceutical selling takes less time because doctors are so busy.

C. Representatives do NOT sell to the end user of the product.

D. Representatives DO sell to the end user of the product.

97. From what types of entities do primary wholesale distributors buy most of their drugs?

A. brokerages

B. buying clubs

C. manufacturers

D. physicians

98.What is the Office of the Inspector General (01G)?

A. a department in pharmaceutical companies

B. an arm of the Department of Health and Human Services

C. an arm of the European Medicines Agency

D an arm of the FDA

99. What are doctors required to consider when deciding whether or not to prescribe a particular drug?

A. quantity of life over quality of life

B. that no drugs with adverse effects should ever be used

C. the inferiority of OTC drugs

D. the severity of the disorder being treated and the effect it has on the patient’s quality of life

100. Which entity assigns a new drug its generic names?

A. the drug’s inventor

B. the Food and Drug Administration

C. the United States Adopted Name Council

D. the United States Pharmaceutical Council

101. Drugs can be used days beyond their expiration date.

A. 2-7 days. depending on the most current monograph.

B. 2-90 days. depending on state laws

C. 7-90 days. depending on the type of drug and its therapeutic class.

D. none of these

102. What is necessary for a drug to be excreted extensively via the kidneys?

A. The drug must be water-soluble. and not bind too tightly to proteins in the bloodstream.

B. The drug must have a phospholipid bilayer and be non-water-soluble.

C. The drug must have a phospholipid bilayer and bind well to proteins in the bloodstream.

D. The drug must not be water-soluble.

103. Which organization or individual initiates the clinical trial and finances the study?

A. clinical research organization

B. investigator

C. researcher

D. sponsor

104. The name describes the atomic or molecular structure of a drug.

A. chemical

B. generic

C. pharmaceutical

D. proprietary

105. Under PhRMA Code, is it acceptable or unacceptable for a pharmaceutical sales rep to take a physician and the physician’s spouse to a fundraising dinner?

A. acceptable if only the physician attends

B. acceptable if only the physician attends. and the total is under $100

C. acceptable if the total is under $100

D. unacceptable

106. The Hatch-Waxman Act is considered the most significant drug-related affecting the pharmaceutical industry since 1962.

A. experiment

B. legislation

C. process

D. research

107. What term denotes the the extent, quality, or degree to which a substance is poisonous or harmful to the body?

A. caliber

B. chronicity

C. indication

D. toxicity

108. What issue has MOST encouraged consumers’ desire to see more OTC medications?

A. a weaker patients’ rights movement

B. lack of insurance coverage

C. less reliance on the Internet

D. proliferation of herbal remedies

109. What is the degree to which a medication produces a therapeutic effect?

A. diffusion

B. efficacy

C. protease

D. vector

110. What is the most important benefit of electronic prescribing?

A. Choice

B. cost

C. inquiries

D. safety

111. When does the FDA regulate generic drugs?

A. only if they are branded generics

B. only if they have been contested

C. always

D never

112. Which phase of trials largely determines the clinical dose?

A. preclinical trials

B. Phase II trials

C. Phase III trials

D. Phase IV trials

113. What is an advantage of inactivated vaccines over attenuated vaccines?

A. Inactivated vaccines are less expensive to prepare.

B. Inactivated vaccines have a higher probability of eliciting the desired immunological response.

C. Inactivated vaccines have a more stable shelf life.

D. Inactivated vaccines only require a single dose.

114. Which medical term denotes a low supply of oxygen due to low blood flow?

A. potentiation

B. ischemia

C. TID

D. titration

115. What are the two main types of prescription drug marketing?

A. (1) marketing to insurance companies. and (2) marketing to pharmacies

B. (1) PBM marketing. and (2) marketing to governments

C. (1) professional physician promotions. and (2) direct-to-consumer advertising

D. (1) publicly-funded marketing. and (2) physician-funded marketing

116. What is the site of delivery for subcutaneous injections?

A. fatty tissue beneath the surface of the skin

B. lymphatic tissue

C. muscle tissue

D. the stomach, via a special type of needle

117. What must be contained in the Description section of a pharmaceutical package insert?

A. adverse effects

B. mechanism of action

C. pharmacokinetics

D. the proprietary name and the established name

118. What is the study of a medication’s effects as it travels through the body?

A. pharmacodynamics

B. pharmacogenetics

C. pharmacogenomics

D. pharmacokinetics

119. Customers purchase products from people they like, trust, and respect. This is called the

A. closing of the sale

B. first time advantage

C. likeability factor

D. power of knowledge

120. What is penicillin’s primary mechanism of action?

A. It disturbs bacterial cell wall synthesis.

B It inhibits the production of viruses.

C. It prevents proper DNA replication.

D. It sends a messenger to the bone marrow to produce extra white blood cells

121. According to your manual, how has the U.S. healthcare marketplace changed in the last few decades?

A. Fewer and fewer prescription drugs have been made available as OTCs.

B. Managed care has been increasingly replaced by more patient-centered approaches.

C. The aging Baby Boomer generation has begun demanding more personalized attention.

D. There has been decreased emphasis on preventive health.

122. How does pharmaceutical marketing help narrow the treatment gap?

A. It encourages patients to take more active roles in their healthcare.

B. It makes doctors more skeptical of the pharmaceutical industry.

C. It makes patients more skeptical of their doctors’ opinions.

D. all of these

123. What do immunosuppressive agents do?

A. decrease risk of infection

B. increase risk of infection

C. reduce the risk of rejection of foreign bodies

D. treat psoriasis

124. What types of drugs are EGFR inhibitors?

A. antineoplastics

B. cardiovascular agents

C. CNS agents

D. mitotic inhibitors

125. Which of the following means outside of the living body?

A. en vivo

B. ex vitro

C. ex vivo

D. intra vivo

126. The FDA requirements for nutraceuticals and medicinal herbs are just as stringent as for pharmaceuticals.

A. TRUE

B. FALSE

127. What is the estimated net gain of private-sector healthcare’s contributions to increased U.S. life expectancy?

A. $5-10 billion

B. $40-50 billion

C. $800-900 billion

D.$ 2-5 trillion

128. Which statement is TRUE regarding post-approval drug monitoring?

A. All side effects are determined during clinical trials.

B. Drug manufacturers are only required to report adverse effects if they are severe or life-threatening.

C. Drug manufacturers are only required to report adverse effects if they have been proven in clinical studies.

D. The FDA can choose to withdraw their approval if new evidence arises.

129. Which term denotes when tolerance to one medication causes increased tolerance to another medication?

A. cell tolerance

B. cross-tolerance

C. indicated tolerance

D. minimized tolerance

130. Patents expire __ years from the date of filing.

A. ten

B. fifteen

C. twenty

D. thirty

131. After a trade-name drug’s patent expires, how may generic versions of it be sold?

A. only under the branded generic name

B. only under the generic name

C. only under the original trade name

D. under the original trade name or a generic name

132. What is required for a new pharmaceutical to be considered a viable therapy?

A. It causes no serious adverse effects.

B. It causes no side effects.

C. It has an active placebo.

D. It is more effective and/or causes fewer serious adverse effects than other drugs on the market.

133. Under the AMA guidelines, who is ultimately responsible for minimizing conflicts of interest?

A. doctors

B. lawyers and office managers

C. pharmaceutical companies

D. sales representatives

134. The act of dispensing a pharmaceutical alternative for the product prescribed is

A. alternative licensure

B. equivalence practice

C. necessitated substitution

D. pharmaceutical substitution

135. What does it mean if a drug is said to have a wide margin of safety?

A. Its safety levels have yet to be adequately verified.

B. Its safety varies widely among different types of patients.

C. There is a greater chance of severe or life-threatening side effects.

D. There is a lower chance of severe or life-threatening side effects.

136. Which of the following is the correct medical acronym for effective dose?

A. DE

B. ED

C. EFD

D. eff D

137. Why is one group of subjects given an active drug, while another group only receives a placebo?

A. to assess patients’ expectations

B. to assess the drug’s effectiveness

C. to assess the professionalism of the study staff

D. to assess the subjects’ demographics

138. A generic version is likely to have some inactive ingredients that are different from those of the original drug.

A. TRUE

B. FALSE

139. Which of the following is an example of a functional value?

A. I drink Coca-Cola because I am a citizen of the world.

B. I drink Coca-Cola because I like looking like a traditionalist.

C. I drink Coca-Cola because I like the taste.

D. I drink Coca-Cola because it is an international brand.

140. Where are most drugs metabolized?

A. interstitial spaces

B. liver

C. stomach

D . the bloodstream

141. What is essential to the ethical requirement that subjects be selected fairly?

A. Selection criteria should be well-supported by documented evidence.

B. Studies should make every attempt to conduct research on subjects who are underprivileged and in need of medical attention.

C. Subjects should be selected based on scientific objectives.

D. all of these

142. Which of the following is the most appropriate salutation for a cover letter if you cannot find a contact name?

A. Dear Personnel Department.

B. Dear Sir or Madam,

C. Dear Sir

D.To Whom It May Concern.

143. What is part of becoming an indispensable pharmaceutical sales rep?

A. asking for feedback

B. giving the doctors anything they ask for to prescribe your products

C. keeping your market share goals the same each term

D. not bothering busy doctors in hospitals

144. Which of the following is NOT typically included in the indications and usage section of the package insert information?

A. diseases or conditions that the drug is approved to treat

B. the drug’s active metabolites

C. the drug’s recommended usual dosage

D. the drug’s usual dosage range

145. Which term denotes the practice of classifying physicians and other potential prescribers by anticipated prescription volume?

A. conditioning

B. deciling

C. detailing

D. private labeling

146. What makes a drug eligible for fast track approval from the FDA?

A. It is a generic that has already been approved as a branded drug.

B. It is a new drug.

C. It is less expensive than what is currently on the market.

D. It treats patients with a serious. life-threatening condition.

147. In the gastrointestinal tract, help break up tablets to ensure full release of the active pharmaceutical ingredient.

A. binders

B. disintegrants

C. dispersing agents

D. lubricants

148. According to your manual, what does the PDRP do?

A. It educates patients on their treatment options.

B. It expands sales representatives’ access to patient information.

C. It improves communication between sales representatives and patients in doctors’ offices.

D. It limits sales representatives’ abilities to see individual physicians’ prescribing data.

149. What are the components of the central nervous system?

A. the brain and sense organs

B. the brain and spinal cord

C. the brain. spinal cord. and peripheral nervous system

D. the spinal cord and sense organs

150. Which term denotes the origin or cause of a medical condition?

A. cytology

B. discovery

C. etiology

D. pathology

151. Patients diagnosed with Type 1 diabetes…

A. …do not produce enough insulin because they do not have enough B cells.

B. …have an autoimmune disease.

C. …produce enough insulin. but it is not as effective.

D. …rely on insulin from porcine sources.

152. Which DTC pharmaceutical marketing tactic is permitted in European countries?

A. disease state ads

B. branded billboards and disease state ads

C. branded highway billboards

D. branded radio ads

153. What is one way in which psychologists DIFFER from psychiatrists?

A. Psychologists are more concerned with subconscious memories than conscious ones.

B. Psychologists deal more with emotional than physical issues.

C. Psychologists deal more with physical issues than emotional ones.

D. Psychologists do not have graduate degrees.

154. What are PBMs?

A. governmental organizations that provide healthcare

B. organizations that design marketing campaigns

C. organizations that negotiate between pharmaceutical companies and large drug purchasers

D. organizations that write FDA new drug applications

155. How does the Hatch-Waxman Act protect research-based drug manufacturers?

A. by limiting the competition

B. by making it easier to bring generic drugs to market

C. by providing a 30-month cooling off period

D. by requiring the FDA to only look at bioavailability studies when approving an ANDA

156. What is the process of adjusting drug doses to achieve the maximum positive therapeutic effects while minimizing adverse or side effects?

A.homeostatic maximization

B.steady state administration

C.Sustained release

D.Titration

157. Which of the following is studied more in pharmacodynamics than in pharmacokinetics?

A. absorption. Distribution metabolism and excretion

B. dose-response effects

C. the transportation of the drug to the specific site for drug-receptor interaction

D. the way the human body deals with a drug after it has been administered

158. How does the healthy human immune system use MHC markers?

A. Substances with MHC markers are discerned as foreign and targeted for destruction.

B. Substances with MHC markers as discerned as foreign and quarantined in the liver.

C. Substances with MHC markers as discerned as foreign and quarantined in the pancreas.

D. Substances without MHC markers are discerned as foreign and targeted for destruction.

159. What is a behind-the-counter drug?

A. an OTC drug that must be closely monitored by the pharmacist

B. another term for a generic prescription drug

C. another term for a prescription drug

D. another term for an OTC drug

160. When do MSLs meet with clinicians?

A. at nearly any stage of the product’s life cycle

B. only after the district’s sales representatives

C. only prior to launch

D. MSLs do not meet with physicians.

NAPSRx Final Exam

1. How are drugs sorted into therapeutic groups and classes?

A. first by the conditions that they are used to treat. and then by their mechanisms of action

B. first by their mechanisms of action. and then by their therapeutic effects

C. first by their side effects. and then by their therapeutic effects

D. first by their toxicity. and then by their effectiveness

2. Bone marrow transplants…

A. require that the patient first undergo chemotherapy or radiation to kill the diseased stem cells and promote white blood cell production.

B. are a type of stem cell therapy. unless patient’s own cells are reinjected.

C. are always a type of stem cell therapy.

D. can help people with leukemia. a condition in which the body does not produce enough white blood cells.

3. What does AMA stand for?

A. American Medical Academy

B. American Medical Accreditation

C. American Medical Association

D. Association of Medical Assistants

4. What section of a drug’s package insert describes situations in which the drug should not be used because the risks outweigh the therapeutic benefits?

A. adverse reactions

B. contraindications

C. overdosage

D. warning/precautions

5 What is tertiary care?

A. adding medications together to achieve a better clinical effect

B. highly specialized medical and surgical care provided by a large medical center for unusual or complex medical problems

C. receiving medical or surgical care that does not require an overnight stay in the treatment facility

D. seeing a physician for routine checkups and general healthcare

6. Which of the following is NOT one of the stages in the classic approach to brand development strategy covered in your manual?

A. brand personality

B. brand positoning

C. brand quality

D. brand values

7 What are vasodilators used to do?

A. decrease vascular resistance and increase blood flow

B. mimic pathogens to stimulate the immune system

C. narrow the blood vessels

D.stimulate the CNS to make the heart beat faster

A. homeostasis

B. steady state

C. titration

D. tolerance

9. Which statement is TRUE about ocular administration?

A. Ocular administration is primarily for drugs that must cross the blood-brain barrier.

B. Ocular administration is used primarily to treat the eye.

C. Ocular administration is used when a drug must enter the bloodstream immediately.

D. Ocular administration is used when a drug must produce immediate effects on the brain or spinal cord.

10. Which entities invest’s the most money in pharmaceutical R&D?

A. Canadian pharmaceutical companies

B. the NIH

C. the U.S. Government

D. U.S. pharmaceutical companies

11. How are most drugs excreted?

A. via the bloodstream

B. via the heart

C. via the kidneys

D. via the skin

12. Over the last few decades, what has happened to legal limitations on sales’ reps discussions about off label uses?

A. Limitations have decreased.

B. Limitations have increased significantly.

C. Limitations have increased slightly.

D. Limitations have remained about the same.

13. Answer: Branding name

14. What does it mean if two drugs are at parity?

A. Both drugs are essentially in a neutral position.

B. Both drugs are generics.

C. Both drugs have exclusive preferred status.

D. The two drugs are bioequivalent.

15 Who is most likely to benefit from electronic sampling programs?

A. Everyone would benefit equally from electronic sampling programs

B. physicians in hospitals who are too busy to see representatives

C. physicians in rural areas who are not as frequently visited by representatives

D. physicians in urban areas who are too busy to see representatives

16. When referring to medication dosage, which abbreviation means “one-half’:

A. MS

B. OH

C. SM

D. SS

17 What is an internist?

A. a physician who practices internal medicine

B. a physician’s intern

C. a type of oncologist who specializes in chemotherapy

D. an internal sales representative

18. Which of the following is a type of white blood cell?

A. erythrocytes

B. insulin

C. Lymphocytes

D.HCs

19. Why are novice sales representatives often placed in charge of negotiating MCO formularies?

A. to become more familiar with the healthcare industry

B. to become more familiar with their territories

C. P&T committees are more receptive to new faces.

D. They are not. This job is usually reserved for more experienced reps.

20. What distinguishes pharmacodynamics from pharmacokinetics?

A. Pharmacodynamics studies a drug’s ex vivo effects.

B. Pharmacodynamics studies how drugs affect the body.

C. Pharmacodynamics studies the how the body affects drugs.

D. Pharmacodynamics studies the time required for a drug’s absorption.

21 What proportion of the drugs tested on human subjects are eventually approved by the FDA?

A. about 20%

B. about 60%

C. about 70%

D. about 95%

22. According to a study discussed in your manual, how do most physicians prefer to receive their drug samples?

A. by borrowing them from hospitals

B. by ordering them over the Internet

C. by trading them for services

D. directly from sales representatives

23. Which of the following is an example of a central value?

A. I buy Advil to show that I’m a modern consumer.

B. I like Advil because we were both born in the 80s.

C. I prefer Advil because I like the flavor.

D. I prefer Advil because it’s easier to swallow.

24. Which of the following specialties likely has the MOST emergency calls?

A. cardiology

B. psychiatry

C. urology

D. All specialists have the same number of emergency calls.

25. What affects the rate of active transport?

A. the availability of carriers. but not energy

B. the availability of energy. but not carriers

C. the availability of carriers and energy

D. neither the availability of carriers nor the availability of energy

26. Over the last few decades, what has happened to the FDA approval time for new drugs?

A. It has been lengthened to ensure safer drug products.

B. It has been lengthened to limit DTC marketing

C. It has been shortened to improve drug quality

D. It has been shortened to reduce the cost of new drug development.

27. Which of the following would NOT help improve compliance?

A. patients liking their providers

B. patients using only one pharmacist

C. pharmacists understanding how generics differ from brand name drugs

D. support groups

28. Which entity chooses a drug’s trade name?

A. the drug’s inventor

B. the drug’s manufacturer

C. the FDA

D. the United States Pharmaceutical Council

29. What type of stem cells are obtained from embryos and can develop into any cell type?

A. multipotent

B. pluripotent

C. totipotent

D. All stem cells can develop into any cell type.

30. As the price a patient pays for a prescription increases, what happens to the likelihood that the patient will fill it?

A. It decreases.

B. It increases.

C. It remains unaffected because the prescription is needed.

D. It remains unaffected because the prescription’s increased cost is offset by its perceived value.

31. Most involuntary movements come from which type of muscle tissue?

A. cardiac and smooth

B. only skeletal

C. skeletal and cardiac

D. skeletal and smooth

32. Which of the following is NOT one of the body’s major organ systems?

A. the cardiovascular system

B. the cellular system

C. the gastrointestinal system

D. the musculoskeletal system

33. How do most drugs exert their primary physiological effects?

A. by activating synapses between different types of tissues

B. by binding to cell receptors that are sensitive to their presence

C. by inhibiting synapses between different types of tissues

D. through genetic mutation

34. What is the most reliable source of information for determining therapeutically equivalent drug products?

A. AMA guide

B. Blue Book

C. FDA drug list

D. Orange Book

35. What does subcutaneous mean?

A. beneath the intervention

B. beneath the muscle tissue

C. beneath the outer skin

D. beneath the suture

36. What should a sales representative do if all of the prime spaces in a drug cabinet are coccupied?

A. ask staff for permission to move some of the other products in the cabinet

B. ask staff for permission to throw away expired products in the cabinet

C. ask the doctor if he still needs some of the other products in the cabinet

D. surreptitiously move your largest competitors’ products out of the way

37. It is inappropriate for physicians’ prescribing behaviors to be educated by their personal tastes and idiosyncrasies

A. TRUE

B. FALSE

38.The FDA defines API as the active__ ingredient in a drug, which produces the desired change in the body.

A. pharmaceutical

B. positive

C. potent

D. primary

39. What are the 2 legal classifications of wholesalers?

A. distributors and supply chains

B. pharmacists and NAMs

C. primary and secondary wholesale distributors

D. retailers and institutions

40.What term describes the usage of a medication for purposes other than the FDA-approved indications on the labeling?

A. contraindicative indication

B. off-indication usage

C or D. off-label

41. What is the acronym for pharmacokinetics?

A. KN

B. PC

C. PK

D. pT

42. The dosage range of a drug that is both safe and beneficial is known as the therapeutic window.

A. TRUE

B. FALSE

43. What is typically NOT a characteristic of a pharmaceutical sales rep?

A. Pharmaceutical sales reps are authentic and real.

B. Pharmaceutical sales reps are creative.

C. Pharmaceutical sales reps are focused.

D. Pharmaceutical sales reps are not concerned about competitors.

44. What entity grants drug patents?

A. the FDA

B. the FDA if the drug is over-the-counter and the U.S. Patent and Trademark Office if the drug is prescription

C. the FDA if the drug is prescription and the U.S. Patent and Trademark Office if the drug is over-the-counter

D. the U.S. Patent and Trademark Office

45. Which of the following refers to all active and inert pharmaceutical ingredients in a drug, including fillers and colors?

A. formulation

B. mycoplasma

C. peptide

D. saccharide

46. What is the difference between potency and efficacy?

A. Doctors prefer more potent drugs.

B. Drug manufacturers prefer more potent drugs.

C. Potency refers to the drug’s effectiveness. while efficacy refers to its strength.

D. Potency refers to the drug’s strength, while efficacy refers to its effectiveness.

47. What is the minimum level of education required for a nurse practitioner?

A. a certification program

B. an associate’s degree

C. a bachelor’s degree

D. a graduate degree

48. How many names must a drug have?

A. at most three

B. at least three

C. at most five

D. at least five

49. How has a longer development time increased the cost of bringing a new drug to market?

Answer: Increasing the cost of capital

50. Senior citizens consume over times as many pharmaceuticals as people under 65.

A. three

B. five

C. ten

D. fifteen

51. What agency regulates the distribution and use of narcotics?

A. DEA

B. FTC

C. OIG

D.TSA

52. What is passive diffusion?

A. a type of pinocytosis

B. membrane transport via vesicles

C. the use of energy to help a substance pass from a low concentration gradient to a high one

D. when a substance freely moves through a membrane from a high concentration gradient to a low one

53. What are the MAIN categories of drugs under FDA jurisdiction?

A. active drugs and active placebos

B. biopharmaceuticals and nutraceuticals

C. non-prescription and nutraceuticals

D. prescription and non prescription

54. Answer: Oxytocin

55. What are all metabolites?

A. active substances

B. inactive substances

C. injections

D. products of metabolism

56. When a drug is administered orally, where does first-pass metabolism occur?

A. intestine

B. liver

C. pancreas

D. stomach

57. What is the medical term for swelling?

A. assay

B. edema

C. instillation

D. protease

58. Which of the following is NOT part of the Seven Step Cascade of Emotion?

A. be a consultant. not a rep

B. identify what your product does

C. reflect

D. visualize the power of 10

59. Which part of a clinical research paper is frequently referred to as the road map?

A. abstract

B. findings

C. letter to the editor

D . methods

60. Which of the following is a main active ingredient in lung surfactants?

A. animal lung extract

B. germicides

C. sympathomimetic drugs

D. theophylline

61. What does parenteral mean?

A. child prescriptions

B. injection

C. oral

D. tablet

62. Which term denotes a type of substance that enhances the action of a drug or antigen?

A. adjuvant

B. indicated

C. ligase

D peptide

63. If a sales representative’s product is placed on the second tier of a standard three-tier formulary, which of the following is most likely true?

A. It has not been reviewed by the P&T committee.

B. It is in a neutral position unless it is at parity with other drugs.

C. It probably has exclusive preferred status if it is not at parity with any other drugs.

D. It will essentially sell itself if it is granted exclusive preferred status.

64. Which of the following is NOT one of the four basic transport mechanisms?

A. active transport

B. homeostasis

C. passive diffusion

D. pinocytosis

65. Which statement accurately describes a relationship between drug agonists and antagonists?

A. Agonists and antagonists can be used together.

B. Agonists and antagonists should not be used together.

C. Antagonist drugs activate receptors. while agonists block access to receptors.

D. Antagonists are endogenous whereas agonists are man-made.

66. What is the study of the effects and movement of drugs in the human body?

A. anatomy

B. antology

C. clinical pharmacology

D. pathology

67. According to your manual, what is a common complaint that physicians have about traditional sampling methods?

A. that drug sample supply is too unpredictable

B. that patients are less likely to take free samples because they think they are lower quality

C. that patients do not like seeing drug representatives in their offices

D. that they receive too many drug samples

68. Which of these entities is formed by two or more hospitals or other healthcare entities to negotiate reduced rates with its aggregated purchasing power?

A. GPO

B. In-state wholesaler

C. PPO

D. RPO

69. What is another name for a drug derived from a biologic compound?

A. large molecule

B. oligonucleotide

C. orgaanism

D. small molecule

70. What is the most common policy regarding pharmaceutical reps dispensing drug samples in hospitals?

A. By federal law. drug sampling is permitted in all hospitals.

B. By federal law. it is up to individual physicians. not the hospital.

C. Drug sampling is encouraged. but not required.

D. Drug sampling is often forbidden.

71 Which of the following would help you build trust with a physician?

A. asking if he or she is having any problems with the managed care coverage of your products

B. repeating a question you already asked

C. surprising the office staff with a new poster in the break room

D. None of these would help you build trust with a physician.

72. What term denotes the difference between the usual effective dose and the dose that induces severe or life-threatening side effects?

A. dose-response relationship

B. margin of safety

C. the placebo effect

D. therapeutic window

73. What are excipients?

A. a type of cell receptor to which antagonists bind to decrease the effects of the body’s natural agonists

B. another term for generic equivalents

C. sites of action besides the target sites of action

D. the inert ingredients in a drug formulation

74. What is another term for the AWP?

A. dock-to-dock price

B. float price

C. list price

D. non-stock price

75. Which of these is the most likely use for a uterotonic agent?

A. to induce labor

B. to make the urine more alkaline

C. to supplement oral food intake

D. to treat hyperthyroidism

76. As of November 2013, which of these countries has legalized DTC advertising of prescription drugs?

A. Canada

B. Japan

C. Spain

D. none of these

77. Why are oral drugs often taken on an empty stomach?

A. to be more wholly absorbed by the stomach

B. to minimize absorption by the intestine

C. to minimize nausea

D. to pass through the stomach more quickly

78. What is one factor that differentiates community health centers from hospitals?

A. Community health center formularies are more restrictive.

B. Community health centers have higher reimbursement rates.

C. Newer brand name drugs are easier to access at community health centers.

D. None of these

79. How does drug sampling provide a social benefit?

A. Doctors donate their unused drug samples to charities.

B. Doctors often use drug samples to treat patients who otherwise could not afford it.

C. It allows patients to try out different prescription medications before consulting with physicians.

D. Drug sampling provides a social benefit in all of these ways.

80. Which medical term denotes the use of a stethoscope to listen to the heart?

A. auscultation

B. cardioversion

C. catheterization

D. echocardiography

81. What do enteric coatings do?

A. facilitate vomiting

B. help drugs dissolve in the stomach

C. help drugs enter the bloodstream more quickly

D. prevent dissolution in the stomach

82. What is the duration of exclusivity for orphan drugs?

A. 6 months

B. 1 year

C. 7 years

D. 15 years

83. What do National Account Managers do?

A. act as the sales reps’ primary point of contact with the rest of the corporation

B. manage the FDA approval process

C. negotiate contracts with MCOs and PBMs

D. sell only to pharmacies

84. What does it usually mean if a drug recall is voluntary?

A. Pharmacies may choose whether to return the drug or dispense it.

B. The FDA has determined that the drug is perfectly safe. but ineffective.

C. The manufacturer has recalled the product on its own. but negotiated with the FDA beforehand.

D. The manufacturer has recalled the product without negotiating with the FDA.

85. Which phase of clinical trials is also known as the pivotal phase?

A. Phase I

B. Phase III

C Phase IV

D. Phase IX

86. During which phase of clinical trials is the new drug’s safety and effectiveness first tested in the target group?

A. preclinical

B. Phase I

C. Phase II

D. Phase III

87. How do antacids work?

A. by increasing blood flow to the stomach

B. by lowering gastric pH

C. by raising gastric pH

D. by suppressing cholesterol formation by the liver

88. What is one of the biggest time wasters for a pharmaceutical sales rep?

A. Caterers

B. Pharcists

C. receptionists

D. travel time

89. What happens when equilibrium is reached?

A. equal numbers of molecules cross the membrane in both directions

B. molecules stop moving

C. the concentration gradient decreases indefinitely

D. the concentration gradient increases indefinitely

90. What are the most common vectors used in gene therapy?

A. autologous antigens

B. liposomes

C. naked DNA

D. viruses

91. What is the percentage fee that the dispenser pays the wholesaler for distribution?

A. margin fee

B. recharge

C. standard fee

D. upcharge

92. What is the difference between a chronic (or continuing) reaction, and a delayed reaction?

A. Chronic reactions are exaggerated. whereas delayed reactions are idiosyncratic.

B. Chronic reactions occur only during treatment. whereas delayed reactions only occur during withdrawal.

C. Chronic reactions persist for a long time. whereas delayed reactions take some time to develop.

D. Delayed reactions are always idiosyncratic. but chronic reactions are not.

93 What is clinical effect?

A. federally funded research condition

B. the effect of maximum dosage

C. the response produced by a medication

D. the use of treatment drugs in chemotherapy

94. Which of the following is an example of noncompliance?

A. a patient forgetting to take a drug at a specified time of day

B. a patient taking a drug. but only because it has been court-mandated

C. a pharmacist dispensing a generic equivalent of a drug instead of the brand name

D. a physician refusing to prescribe a drug because he or she does not trust the clinical studies on it

95. What is the average circulation time of blood?

A. about a minute

B. about 5 minutes

C. about 5 to 10 minutes depending on the patient’s age and health conditions

D. about 10 minutes

96. What is one way in which pharmaceutical selling is different from selling in most other industries?

A. In pharmaceutical sales. the decisions-makers. consumers. and payers are usually the same entity.

B. Pharmaceutical selling takes less time because doctors are so busy.

C. Representatives do NOT sell to the end user of the product.

D. Representatives DO sell to the end user of the product.

97. From what types of entities do primary wholesale distributors buy most of their drugs?

A. brokerages

B. buying clubs

C. manufacturers

D. physicians

98.What is the Office of the Inspector General (01G)?

A. a department in pharmaceutical companies

B. an arm of the Department of Health and Human Services

C. an arm of the European Medicines Agency

D an arm of the FDA

99. What are doctors required to consider when deciding whether or not to prescribe a particular drug?

A. quantity of life over quality of life

B. that no drugs with adverse effects should ever be used

C. the inferiority of OTC drugs

D. the severity of the disorder being treated and the effect it has on the patient’s quality of life

100. Which entity assigns a new drug its generic names?

A. the drug’s inventor

B. the Food and Drug Administration

C. the United States Adopted Name Council

D. the United States Pharmaceutical Council

101. Drugs can be used days beyond their expiration date.

A. 2-7 days. depending on the most current monograph.

B. 2-90 days. depending on state laws

C. 7-90 days. depending on the type of drug and its therapeutic class.

D. none of these

102. What is necessary for a drug to be excreted extensively via the kidneys?

A. The drug must be water-soluble. and not bind too tightly to proteins in the bloodstream.

B. The drug must have a phospholipid bilayer and be non-water-soluble.

C. The drug must have a phospholipid bilayer and bind well to proteins in the bloodstream.

D. The drug must not be water-soluble.

103. Which organization or individual initiates the clinical trial and finances the study?

A. clinical research organization

B. investigator

C. researcher

D. sponsor

104. The name describes the atomic or molecular structure of a drug.

A. chemical

B. generic

C. pharmaceutical

D. proprietary

105. Under PhRMA Code, is it acceptable or unacceptable for a pharmaceutical sales rep to take a physician and the physician’s spouse to a fundraising dinner?

A. acceptable if only the physician attends

B. acceptable if only the physician attends. and the total is under $100

C. acceptable if the total is under $100

D. unacceptable

106. The Hatch-Waxman Act is considered the most significant drug-related affecting the pharmaceutical industry since 1962.

A. experiment

B. legislation

C. process

D. research

107. What term denotes the the extent, quality, or degree to which a substance is poisonous or harmful to the body?

A. caliber

B. chronicity

C. indication

D. toxicity

108. What issue has MOST encouraged consumers’ desire to see more OTC medications?

A. a weaker patients’ rights movement

B. lack of insurance coverage

C. less reliance on the Internet

D. proliferation of herbal remedies

109. What is the degree to which a medication produces a therapeutic effect?

A. diffusion

B. efficacy

C. protease

D. vector

110. What is the most important benefit of electronic prescribing?

A. Choice

B. cost

C. inquiries

D. safety

111. When does the FDA regulate generic drugs?

A. only if they are branded generics

B. only if they have been contested

C. always

D never

112. Which phase of trials largely determines the clinical dose?

A. preclinical trials

B. Phase II trials

C. Phase III trials

D. Phase IV trials

113. What is an advantage of inactivated vaccines over attenuated vaccines?

A. Inactivated vaccines are less expensive to prepare.

B. Inactivated vaccines have a higher probability of eliciting the desired immunological response.

C. Inactivated vaccines have a more stable shelf life.

D. Inactivated vaccines only require a single dose.

114. Which medical term denotes a low supply of oxygen due to low blood flow?

A. potentiation

B. ischemia

C. TID

D. titration

115. What are the two main types of prescription drug marketing?

A. (1) marketing to insurance companies. and (2) marketing to pharmacies

B. (1) PBM marketing. and (2) marketing to governments

C. (1) professional physician promotions. and (2) direct-to-consumer advertising

D. (1) publicly-funded marketing. and (2) physician-funded marketing

116. What is the site of delivery for subcutaneous injections?

A. fatty tissue beneath the surface of the skin

B. lymphatic tissue

C. muscle tissue

D. the stomach, via a special type of needle

117. What must be contained in the Description section of a pharmaceutical package insert?

A. adverse effects

B. mechanism of action

C. pharmacokinetics

D. the proprietary name and the established name

118. What is the study of a medication’s effects as it travels through the body?

A. pharmacodynamics

B. pharmacogenetics

C. pharmacogenomics

D. pharmacokinetics

119. Customers purchase products from people they like, trust, and respect. This is called the

A. closing of the sale

B. first time advantage

C. likeability factor

D. power of knowledge

120. What is penicillin’s primary mechanism of action?

A. It disturbs bacterial cell wall synthesis.

B It inhibits the production of viruses.

C. It prevents proper DNA replication.

D. It sends a messenger to the bone marrow to produce extra white blood cells

121. According to your manual, how has the U.S. healthcare marketplace changed in the last few decades?

A. Fewer and fewer prescription drugs have been made available as OTCs.

B. Managed care has been increasingly replaced by more patient-centered approaches.

C. The aging Baby Boomer generation has begun demanding more personalized attention.

D. There has been decreased emphasis on preventive health.

122. How does pharmaceutical marketing help narrow the treatment gap?

A. It encourages patients to take more active roles in their healthcare.

B. It makes doctors more skeptical of the pharmaceutical industry.

C. It makes patients more skeptical of their doctors’ opinions.

D. all of these

123. What do immunosuppressive agents do?

A. decrease risk of infection

B. increase risk of infection

C. reduce the risk of rejection of foreign bodies

D. treat psoriasis

124. What types of drugs are EGFR inhibitors?

A. antineoplastics

B. cardiovascular agents

C. CNS agents

D. mitotic inhibitors

125. Which of the following means outside of the living body?

A. en vivo

B. ex vitro

C. ex vivo

D. intra vivo

126. The FDA requirements for nutraceuticals and medicinal herbs are just as stringent as for pharmaceuticals.

A. TRUE

B. FALSE

127. What is the estimated net gain of private-sector healthcare’s contributions to increased U.S. life expectancy?

A. $5-10 billion

B. $40-50 billion

C. $800-900 billion

D.$ 2-5 trillion

128. Which statement is TRUE regarding post-approval drug monitoring?

A. All side effects are determined during clinical trials.

B. Drug manufacturers are only required to report adverse effects if they are severe or life-threatening.

C. Drug manufacturers are only required to report adverse effects if they have been proven in clinical studies.

D. The FDA can choose to withdraw their approval if new evidence arises.

129. Which term denotes when tolerance to one medication causes increased tolerance to another medication?

A. cell tolerance

B. cross-tolerance

C. indicated tolerance

D. minimized tolerance

130. Patents expire __ years from the date of filing.

A. ten

B. fifteen

C. twenty

D. thirty

131. After a trade-name drug’s patent expires, how may generic versions of it be sold?

A. only under the branded generic name

B. only under the generic name

C. only under the original trade name

D. under the original trade name or a generic name

132. What is required for a new pharmaceutical to be considered a viable therapy?

A. It causes no serious adverse effects.

B. It causes no side effects.

C. It has an active placebo.

D. It is more effective and/or causes fewer serious adverse effects than other drugs on the market.

133. Under the AMA guidelines, who is ultimately responsible for minimizing conflicts of interest?

A. doctors

B. lawyers and office managers

C. pharmaceutical companies

D. sales representatives

134. The act of dispensing a pharmaceutical alternative for the product prescribed is

A. alternative licensure

B. equivalence practice

C. necessitated substitution

D. pharmaceutical substitution

135. What does it mean if a drug is said to have a wide margin of safety?

A. Its safety levels have yet to be adequately verified.

B. Its safety varies widely among different types of patients.

C. There is a greater chance of severe or life-threatening side effects.

D. There is a lower chance of severe or life-threatening side effects.

136. Which of the following is the correct medical acronym for effective dose?

A. DE

B. ED

C. EFD

D. eff D

137. Why is one group of subjects given an active drug, while another group only receives a placebo?

A. to assess patients’ expectations

B. to assess the drug’s effectiveness

C. to assess the professionalism of the study staff

D. to assess the subjects’ demographics

138. A generic version is likely to have some inactive ingredients that are different from those of the original drug.

A. TRUE

B. FALSE

139. Which of the following is an example of a functional value?

A. I drink Coca-Cola because I am a citizen of the world.

B. I drink Coca-Cola because I like looking like a traditionalist.

C. I drink Coca-Cola because I like the taste.

D. I drink Coca-Cola because it is an international brand.

140. Where are most drugs metabolized?

A. interstitial spaces

B. liver

C. stomach

D . the bloodstream

141. What is essential to the ethical requirement that subjects be selected fairly?

A. Selection criteria should be well-supported by documented evidence.

B. Studies should make every attempt to conduct research on subjects who are underprivileged and in need of medical attention.

C. Subjects should be selected based on scientific objectives.

D. all of these

142. Which of the following is the most appropriate salutation for a cover letter if you cannot find a contact name?

A. Dear Personnel Department.

B. Dear Sir or Madam,

C. Dear Sir

D.To Whom It May Concern.

143. What is part of becoming an indispensable pharmaceutical sales rep?

A. asking for feedback

B. giving the doctors anything they ask for to prescribe your products

C. keeping your market share goals the same each term

D. not bothering busy doctors in hospitals

144. Which of the following is NOT typically included in the indications and usage section of the package insert information?

A. diseases or conditions that the drug is approved to treat

B. the drug’s active metabolites

C. the drug’s recommended usual dosage

D. the drug’s usual dosage range

145. Which term denotes the practice of classifying physicians and other potential prescribers by anticipated prescription volume?

A. conditioning

B. deciling

C. detailing

D. private labeling

146. What makes a drug eligible for fast track approval from the FDA?

A. It is a generic that has already been approved as a branded drug.

B. It is a new drug.

C. It is less expensive than what is currently on the market.

D. It treats patients with a serious. life-threatening condition.

147. In the gastrointestinal tract, help break up tablets to ensure full release of the active pharmaceutical ingredient.

A. binders

B. disintegrants

C. dispersing agents

D. lubricants

148. According to your manual, what does the PDRP do?

A. It educates patients on their treatment options.

B. It expands sales representatives’ access to patient information.

C. It improves communication between sales representatives and patients in doctors’ offices.

D. It limits sales representatives’ abilities to see individual physicians’ prescribing data.

149. What are the components of the central nervous system?

A. the brain and sense organs

B. the brain and spinal cord

C. the brain. spinal cord. and peripheral nervous system

D. the spinal cord and sense organs

150. Which term denotes the origin or cause of a medical condition?

A. cytology

B. discovery

C. etiology

D. pathology

151. Patients diagnosed with Type 1 diabetes…

A. …do not produce enough insulin because they do not have enough B cells.

B. …have an autoimmune disease.

C. …produce enough insulin. but it is not as effective.

D. …rely on insulin from porcine sources.

152. Which DTC pharmaceutical marketing tactic is permitted in European countries?

A. disease state ads

B. branded billboards and disease state ads

C. branded highway billboards

D. branded radio ads

153. What is one way in which psychologists DIFFER from psychiatrists?

A. Psychologists are more concerned with subconscious memories than conscious ones.

B. Psychologists deal more with emotional than physical issues.

C. Psychologists deal more with physical issues than emotional ones.

D. Psychologists do not have graduate degrees.

154. What are PBMs?

A. governmental organizations that provide healthcare

B. organizations that design marketing campaigns

C. organizations that negotiate between pharmaceutical companies and large drug purchasers

D. organizations that write FDA new drug applications

155. How does the Hatch-Waxman Act protect research-based drug manufacturers?

A. by limiting the competition

B. by making it easier to bring generic drugs to market

C. by providing a 30-month cooling off period

D. by requiring the FDA to only look at bioavailability studies when approving an ANDA

156. What is the process of adjusting drug doses to achieve the maximum positive therapeutic effects while minimizing adverse or side effects?

A.homeostatic maximization

B.steady state administration

C.Sustained release

D.Titration

157. Which of the following is studied more in pharmacodynamics than in pharmacokinetics?

A. absorption. Distribution metabolism and excretion

B. dose-response effects

C. the transportation of the drug to the specific site for drug-receptor interaction

D. the way the human body deals with a drug after it has been administered

158. How does the healthy human immune system use MHC markers?

A. Substances with MHC markers are discerned as foreign and targeted for destruction.

B. Substances with MHC markers as discerned as foreign and quarantined in the liver.

C. Substances with MHC markers as discerned as foreign and quarantined in the pancreas.

D. Substances without MHC markers are discerned as foreign and targeted for destruction.

159. What is a behind-the-counter drug?

A. an OTC drug that must be closely monitored by the pharmacist

B. another term for a generic prescription drug

C. another term for a prescription drug

D. another term for an OTC drug

160. When do MSLs meet with clinicians?

A. at nearly any stage of the product’s life cycle

B. only after the district’s sales representatives

C. only prior to launch

D. MSLs do not meet with physicians.

Walden NURS6501 Week 7 Quiz

Question 1

A 52-year-old male IV drug user was diagnosed with hepatitis C 5 years ago. He is now experiencing impaired blood clotting. The nurse suspects a decrease in which of the following vitamins?

a. K

b. D

c. E

d. B12

Question 2

A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has?

a. Sideroblastic anemia

b. Hemolytic anemia

c. Pernicious anemia

d. Iron deficiency anemia

Question 3

For a patient experiencing hypersplenism, the nurse expects the erythrocytes to be:

a. Proliferated

b. Activated

c. Sequestered

d. Infected

Question 4

A nurse is caring for a patient who cannot clot. Which end product of the clotting cascade is this patient unable to make?

A. Collagen

B. Fibrinogen

C. Thrombin

D. Fibrin

Question 5

A 45-year-old male is diagnosed with macrocytic, normochromic anemia. The nurse suspects the most likely cause of this condition is:

a. Defective DNA synthesis

b. Abnormal synthesis of hemoglobin

c. Defective use of vitamin C

d. Blocked protein synthesis

Question 6

A 62-year-old female tells her health care provider she has been experiencing regular night sweats that cause her to wake up drenched. She also remarks that she has been unintentionally losing weight. Physical exam reveals enlarged lymph nodes on her neck that do not appear to be painful. She should be screened for which of the following cancers?

a. Epstein-Barr virus

b. Hodgkin lymphoma

c. Acute leukemia

d. Burkitt lymphoma

Question 7

A nurse checks individuals with liver disease for clotting problems because:

a. The liver is often the site of platelet pooling.

b. Clotting factors are produced in the liver.

c. High levels of bilirubin interfere with the clotting system.

d. Treatment medications for liver failure cause fibrinolysis.

Question 8

A 60-year-old female emphysema patient experiences a rapid and pounding heart, dizziness, and fatigue with exertion. Which of the following respiratory assessment findings indicate the respiratory system is compensating for the increased oxygen demand?

a. Bronchoconstriction

b. Increased rate and depth of breathing

c. Dyspnea

d. Activation of the renin-angiotensin response

Question 9

A hematologist is discussing hematopoiesis. Which information should be included? ________ participate in hematopoiesis.

a. Colony-stimulating factors (CSFs)

b. Eosinophils

c. Basophils

d. Neutrophils

Question 10

While checking lab results, the nurse remembers the normal leukocyte count is:

a. 1,000-2,000/mm3

b. 5,000-10,000/mm3

c. 4.2-6.2 million/mm3

d. 1.2-2.2 million/mm3

Question 11

A 65-year-old male experienced loss of appetite, weight loss, lemon-yellow skin, liver enlargement, and a beefy red tongue shortly before his death. Autopsy suggested pernicious anemia, and the cause of death would most likely reveal:

a. Brain hypoxia

b. Liver hypoxia

c. Heart failure

d. Kidney failure

Question 12

A 34-year-old male presents in the emergency room with extreme fatigue and shortness of breath. His skin and sclera appear to have a yellowish discoloration. These assessment findings are consistent with which type of anemia?

a. Posthemorrhagic anemia

b. Iron deficiency anemia

c. Aplastic anemia

d. Hemolytic anemia

Question 13

The people from which country have the lowest risk for Hodgkin lymphoma?

a. United States

b. Japan

c. Denmark

d. Great Britain

Question 14

After initial compensation, what hemodynamic change should the nurse monitor for in a patient who has a reduction in the number of circulating erythrocytes?

a. Increased viscosity of blood

b. Decreased cardiac output

c. Altered coagulation

d. Hyperdynamic circulatory state

Question 15

Thrombocytopenia may be:

a. Transient or consistent

b. Normal or abnormal

c. Congenital or acquired

d. Active or inactive

Question 16

A group of cells isolated in the laboratory have membrane-bound granules in their cytoplasm and they show phagocytic activity.Which of the following cells is most similar?

a. Monocyte

b. Macrophage

c. Lymphocyte

d. Eosinophils

Question 17

A nurse monitors for the most common childhood cancer, which is:

a. Non-Hodgkin lymphoma

b. Chronic myelocytic leukemia (CML)

c. Hodgkin lymphoma

d. Acute lymphoblastic leukemia (ALL)

Question 18

A 25-year-old female has a heavy menses during which she loses a profuse amount of blood.Which of the following adaptations should the nurse expect?

a. Movement of fluid into the cell

b. Decreased cardiac output

c. Decreased oxygen release from hemoglobin

d. Peripheral vasoconstriction

Question 19

A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?

a. Iron deficiency anemia

b. Pernicious anemia

c. Sideroblastic anemia

d. Hemolytic anemia

Question 20

A staff member wants to know where the greatest proportion of iron is located. How should the nurse respond? The greatest proportion of total body iron is located in the:

a. Erythrocytes

b. Spleen pulp

c. Bone marrow

d. Liver tissue

Question 21

A 67-year-old female has chronic gastrointestinal bleeding.A nurse recalls the primary cause of her anemia is:

a. Vitamin B12 deficiency

b. Iron deficiency

c. Folate deficiency

d. Bone marrow failure

Question 22

During an infection, the nurse assesses the lymph nodes.Lymph nodes enlarge and become tender because:

a. Lymphocytes are rapidly dividing.

b. Edema accumulates within the fibrous capsule.

c. Microorganisms are accumulating.

d. The nodes are not functioning properly.

Question 23

How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?

a. Administer radioactive cobalamin and measure its excretion in the urine.

b. Measure antigen-antibody immune complexes.

c. Measure serum ferritin and total iron-binding capacity.

d. Administer folate and evaluate folate content in a blood serum sample.

Question 24

A 5-year-old female is diagnosed with acute leukemia. The nurse will most likely treat this patient with:

a. Bone marrow transplant

b. Immunotherapy

c. Chemotherapy

d. Localized radiation therapy

Question 25

A 35-year-old male with hyperthyroidism begins treatment to decrease thyroid activity. A nurse monitors for which of the following conditions that could result secondary to the treatment?

a. Eosinophilia

b. Basophilia

c. Monocytosis

d. Lymphocytosis

Question 26

While reviewing lab results, the nurse recalls the most abundant cells in the blood are:

a. Leukocytes

b. Lymphocytes

c. Erythrocytes

d. Thrombocytes

Question 27

A 10-year-old male presents with abdominal swelling, night sweats, fever, and weight loss. He is diagnosed with Burkitt lymphoma. Upon obtaining the history, which of the following is the most likely cause?

a. Cytomegalovirus (CMV)

b. Adenovirus

c. Human papillomavirus (HPV)

d. Epstein-Barr virus (EBV)

Question 28

A 15-year-old male is diagnosed with infectious mononucleosis. When the patient asks how he got this disease, how should the nurse respond? The most likely cause is:

a. Lymph node enlargement.

b. Fever and sore throat

c. Rash on the trunk and extremities

d. Fatigue

e. Enlargement of liver and spleen

Question 29

A nurse is teaching the staff about platelets. Which information should the nurse include? In addition to playing a role in hemostasis, platelets have the ability to:

a. Stimulate bone marrow production of erythrocytes

b. Release biochemical mediators of inflammation

c. Undergo cell division in response to bleeding

d. Activate a humoral response

Question 30

A 20-year-old female undergoes lab testing for anemia.Results show high iron, bilirubin, and transferrin and low hemoglobin and hematocrit. Which of the following is the most likely diagnosis to be documented on the chart?

a. Pernicious anemia

b. Folate deficiency anemia

c. Iron deficiency anemia

d. Sideroblastic anemia

Question 31

A 45-year-old female undergoes a splenectomy to remove a tumor. Which of the following assessment finding is most likely to occur following surgery?

a. Leukocytosis

b. Hypoglycemia

c. Decreased red blood cell count

d. Decreased platelets

Question 32

When a nurse is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the nurse calls these erythrocytes:

a. Hyperchromic

b. Hypochromic

c. Macrocytic

d. Microcytic

Question 33

In disseminated intravascular coagulation (DIC), the nurse assesses for active bleeding after intravascular clotting because:

a. Prothrombin is activated.

b. Clotting factors are depleted.

c. Inflammatory mediators are released.

d. Tissue factor (TF) is inactivated.

Question 34

A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?

a. Hyperactivity

b. Spoon-shaped nails

c. Gait problems

d. Petechiae

Question 35

The nurse will check which of the following tests to directly measure iron stores?

a. Serum ferritin

b. Transferrin saturation

c. Bone marrow biopsy

d. Total iron-binding capacity

PAD 599 Competency Assessment

Question 1
1. A process-oriented definition of “democracy” emphasizes
equality of result.
the ways in which government works,
that everyone is equal.
the ambiguity of the term “democracy.”
1 points
Question 2
1. Benchmarking performance improvement programs means
targeted specific programs or functions.
achieved some dramatic results.
attempted to combine reduction of costs with increases in quality and timeliness.
using standards and points of comparisons
1 points
Question 3
1. The idea of equality in American democratic thought generally refers to
equality of talent and ability.
equality of material possessions as an ideal.
an equal claim to life, liberty and the pursuit of happiness.
the idea that the integrity of the individual is of supreme importance.
1 points
Question 4
1. The unusual visibility of the public administrator
is rooted in the public purposes that are pursued.
is rooted in the tendency toward corruption.
is similar to the business administrator’s visibility.
does not affect efficiency and responsiveness issues.
1 points
Question 5
1. Which of the following is NOT a principle of New Public Management?
organizations need to be mission-driven
organizations need to be incentive-based.
organizations need to be centralized.
organizations need to be responsive inter-organizational networks
1 points
Question 6
1. In a democratic society, which is NOT a characteristic of pluralistic decision making?
is a common feature of government.
involves the participation by many groups and officials in governmental decisions.
is a distinguishing feature that differentiates public and business administration.
reduces the accountability of public officials
1 points
Question 7
1. The Office of Management and Budget is
a feature of each state’s budget-making apparatus.
concerned solely with evaluation of the fiscal efficiency of management practices.
located in the Congress as an advisory body.
the White House office charged with the actual preparation of the executive budget proposal that is conveyed to Congress.
1 points
Question 8
1. An example of “clientele support” is
the American Association of Retired Persons’ lobbying of Congress in support of Social Security Administration budgets.
when the supervisors of the budget officer support that person.
the National Rifle Association’s lobbying of Congress in support of better urban transportation systems.
When the budget officer enjoys the support of the chief executive.
1 points
Question 9
1. As a management tool, the budget steps include
proposal, amendment, passage.
incremental, rational, bargained agreements.
budget formation, approval, execution, and audit.
committee hearings, mark-up, and report of budgets.
1 points
Question 10
1. Fiscal policy is concerned principally with
the amount of money in circulation in the economy.
funding of government programs.
the impact of government taxation and expenditures of the economy.
the business cycle.
1 points
Question 11
1. A grant by the federal government to a state or locality may be in the form of a block grant, which is
funding provided for a specific purpose or project.
for any purpose officials may select (within the law).
funding provided for a general program or functional area.
funding for a specific city block or neighborhood.
1 points
Question 12
1. About half of all local government revenue is obtained from the ______.
property tax
income tax
sales tax
payroll tax
1 points
Question 13
1. Internal sources of bureaucratic power include
clientele groups.
information and expertise.
vague legislative enactments.
power-hungry administrators.
1 points
Question 14
1. The writing of vague policy and law by the Congress implies what for government agencies?
Highly restricted agency action.
The lack of administrative discretion.
A highly accountable government agency.
An opportunity for government agencies to shape policy through implementation.
1 points
Question 15
1. The strong mayor system of city government
is rarely used in larger American cities.
provides for the mayor to have a great deal of administrative and budgetary authority.
is most common in small mid-western towns.
does not give city councils policymaking authority
1 points
Question 16
1. Inputs into the systems model of politics and policy include
Laws, regulations, and decisions.
Election results, public opinion, communication to elected officials, and personal experiences of decision makers.
Rules developed by administrative agencies.
None of the above.
1 points
Question 17
1. Any issue, problem or idea that could be considered in the policy process that does not fall outside various social and political norms in a particular society is found on the
agenda universe.
systemic agenda.
institutional agenda.
decision agenda.
1 points
Question 18
1. Public agencies
write public policy proposals.
do not provide testimony in support of policy proposals.
have no role in formulating public policy.
are not involved in the policy process
1 points
Question 19
1. Public policies are
the laws.
made only in Congress.
never made by public administrators.
authoritative statements by legitimate governmental actors about public problems.
1 points
Question 20
1. Viewing public service in an ethical dimension involves recognition that actions taken by public administrators to carry out public policy
include an effort to discover or clarify the public interest.
are always subject to examination by legislators.
will always involve moral dilemmas.
are amoral, since they involve power.
1 points
Question 21
1. The Pendleton Act of 1883 prohibited
active participation in political campaigns by federal employees.
political contributions by any federal employee.
state employees from engaging in election campaign work.
federal employees from serving as delegates to a party convention.
1 points
Question 22
1. The tension between efficiency and responsiveness is rooted in
issues of effectiveness versus equity.
issues of bureaucracy versus democracy.
responsibility and irresponsibility.
federalism
1 points
Question 23
1. The idea that a bureaucracy of professionals, who follow the mandates of a legislature, can meet the administrative requirements of a democracy is called the doctrine of
hierarchical organization.
the spoils system.
neutral competency.
the iron law of oligarchy.
1 points
Question 24
1. When the administrator attempts to make a judgment concerning the desires of the public with respect to his/her tasks, this is an example of_____.
objective responsibility
subjective responsibility
representative bureaucracy
participatory decision making
1 points
Question 25
1. A way of insuring administrative responsiveness that focuses on strict legislative supervision and tightly drawn statutes is ______.
subjective responsibility
representative bureaucracy
objective responsibility
participatory decision making
1 points
Question 26
1. The cost-effectiveness approach involves
a focus on identifying the impacts of alternative proposals.
translating “effective” approaches into their dollar values.
avoiding the use of dollar values in assessing either the effectiveness or costs associated with a proposal.
identifying the critical path in a project.
1 points
Question 27
1. A common limitation of quantitative techniques for selecting a policy alternative is
the difficulty of assigning dollar value to such variables as pain, suffering, and lives saved.
the inability to take account of the effects of inflation.
lack of access to computers.
the lack of quantitative methods
1 points
Question 28
1. In the effort to contract out governmental activities
non-governmental organizations have taken on governmental roles.
no new ethical questions concerning the motives of service-providers are raised.
existing mechanisms for control and accountability will continue to work well.
little challenge to issues of democratic values is involved.
1 points
Question 29
1. Which of the following is NOT a problem faced by researchers involved in the conduct of a true experiment in a social program?
identifying the treatment or intervention
difficulty in establishing two comparable groups, one experimental, the other a control group.
ethical concern for the fate of participants in the experimental group.
establishing randomness in assignment of persons to the experimental or control group.
1 points
Question 30
1. In an experiment, the control group is
the recipient of intervention or treatment.
unnecessary.
unknown to the experimenter.
not the recipient of intervention or treatment.
1 points
Question 31
1. Someone studying the number of lives saved as a result of the national government’s automobile safety regulations would conduct
an outcomes evaluation.
a process evaluation.
an experiment.
intensive interviews.
1 points
Question 32
1. The compilation of all federal rules currently in effect is:
Code of Federal Regulations
U.S. Code
Federal Register
U.S. Code Annotated
1 points
Question 33
1. The U.S. Supreme Court has held that local zoning regulations are constitutional if:
They bear a rational relation to the health and safety of the community
They are uniformly applied throughout the state
They do not restrict commercial development
Owners are paid fair market value compensation if the uses of their property are restricted
1 points
Question 34
1. Which of the following most accurately describes how to read a statute:
All relevant statutory provisions will be collected into a single section
Although there may be multiple publications containing statutes only the official publication will always be up to date
Internet versions are always more reliable than the print versions
Both print and Internet versions should be checked for later changes
1 points
Question 35
1. On what basis did the U.S. Supreme Court find that the Equal Protection Clause applied to the federal government?
The express terms of the Constitution
Combined with due process it is part of basic fairness
The Ninth Amendment
The Sixth Amendment
1 points
Question 36
1. To what extent must criminal trials be open to the public?
They may be closed only to protect a compelling governmental interest in a manner narrowly tailored to that purpose
They may never be closed
They may be closed at the judge’s discretion
They may be closed except for a right of press access
1 points
Question 37
1. Corpus Juris Secundum is:
A legal encyclopedia with broad coverage of most legal subjects
An Internet update service
The principle that an opinion should be followed unless the law has changed
The principle that statutes should always be double-checked
1 points
Question 38
1. An agency rule that explains an agency’s understanding of the law or its regulations is known as:
Substantive
Interpretive
Procedural
Appellate
1 points
Question 39
1. POSDCORB
is an acronym developed by Woodrow Wilson
refers to the functions of public management.
refers to the functions of the post office.
is a type of organizational structure
1 points
Question 40
1. Arbitration in labor-management negotiations
uses a neutral third party to negotiate a settlement.
uses a third party to investigate and issue specific recommendations concerning a settlement.
is a fact-finding process, normally followed by binding recommendations.
does not occur in the governmental sector.
1 points
Question 41
1. Mediation in labor management negotiations
uses a neutral third party to negotiate a settlement.
uses a third party to investigate and issue specific recommendations concerning a settlement.
is a fact-finding process, normally followed by binding recommendations.
does not occur in the governmental sector.
1 points
Question 42
1. In recent years state and local merit systems in the personnel function
have contracted as a result of due process requirements based on court decisions.
have become weaker as a result of pressure from the federal government.
have been strengthened as a result of expanding public employee due process protection provided by courts.
have been dominated by political party machines.
1 points
Question 43
1. The Pendleton Act provided for
establishment of a Human Rights Commission.
mandated federal employee contributions to election campaigns.
merit-based selection of government employees.
the spoils system
1 points
Question 44
1. Employers are responsible for the acts of their employees’ negligence:
Only if the employee’s act was intentional
Only if the employer failed to give warnings of foreseeable harm
If the negligent act was within the scope of authority associated with the work
Only if the negligent act was not within the scope of authority associated with the work
1 points
Question 45
1. One of the main criticisms of globalization is that it
makes the powerful more powerful and wealthy.
actually makes everyone less well off.
outsources jobs from developing to developed countries.
prevents poorer countries from expanding their economies.
1 points
Question 46
1. Democratic peace theory asserts that
there is a connection between regime type and war.
the balance of power in the international system is predictive of conflict.
countries with stagnant economies are more likely to engage in war.
religious fundamentalism is an important factor behind conflict.
1 points
Question 47
1. A primary objective for both insurgency and guerilla warfare is to
defeat the enemy on the field of battle.
raise the costs of conflict as higher than any benefit to the attacker.
force the intervention of the UN to end the conflict.
use high-tech weapons against the attacker.
1 points
Question 48
1. International politics is an area in which vital decisions are made based on
understandings of cause and effect.
fear and misunderstanding.
political will.
moral guidance.
1 points
Question 49
1. The U.S. government wants China to allow its currency to increase in value in order to
raise the value of the U.S. dollar.
help moderate the American trade deficit with China.
lower American interest rates.
create competitive devaluation.
1 points
Question 50
1. The evolution of today’s international system has been dominated by
the expansion of colonialism.
the development of a system of sovereign states in Europe and its spread to the rest of the world.
the establishment of the United Nations and its growing influence.
the development of the Cold War in the twentieth century.

Walden NURS6501 Week 8

Walden NURS6501 Week 8 Quiz latest

Question 1

A 40-year-old female presents complaining of pain near the midline in the epigastrium. Assuming the pain is caused by a stimulus acting on an abdominal organ, the pain felt is classified as:

a. Visceral
b. Somatic
c. Parietal
d. Referred

Question 2

An 8-week-old male was recently diagnosed with cystic fibrosis. Which of the following digestive alterations would be expected?

a. Insufficient bile production
b. Gastric atrophy
c. Hypersecretion of stomach acid
d. Nutrient malabsorption

Question 3

In alcoholic cirrhosis, hepatocellular damage is caused by:

a. acetaldehyde accumulation.
b. bile toxicity.
c. acidosis.
d. fatty infiltrations.

Question 4

Where does the nurse expect the obstruction to be in a patient with extrahepatic portal hypertension?

a. Sinusoids
b. Bile ducts
c. Hepatic portal vein
d. Hepatic artery

Question 5

Kwashiorkor is a severe dietary deficiency of:

a. fat-soluble vitamins.
b. carbohydrates.
c. protein.
d. calcium and magnesium.

Question 6

A 27-year-old male presents with fever, GI bleeding, hepatomegaly, and transient joint pain. He reports that as a child he received blood transfusions following a motor vehicle accident. He also indicates he was vaccinated against hepatitis B. Which of the following types of hepatitis does the clinician think he most likely has?

a. A
b. B
c. C
d. D

Question 7

Prolonged diarrhea is more serious in children than adults because:

a. children have lower adipose reserves.
b. fluid reserves are lower in children.
c. children have a lower metabolic rate.
d. children are more resistant to antimicrobial therapy.

Question 8

A 40-year-old male develops an intestinal obstruction related to protrusion of the intestine through the inguinal ring. This condition is referred to as:

a. Intussusception
b. A volvulus
c. A hernia
d. Adhesions

Question 9

A 60-year-old male presents with GI bleeding and abdominal pain. He reports that he takes NSAIDs daily to prevent heart attack. Tests reveal that he has a peptic ulcer. The most likely cause of this disease is:

a. Increasing subepithelial bicarbonate production
b. Accelerating the H+ (proton) pump in parietal cells
c. Inhibiting mucosal prostaglandin synthesis
d. Stimulating a shunt of mucosal blood flow

Question 10

Acute pancreatitis often manifests with pain to which of the following regions?

a. Right lower quadrant
b. Right upper quadrant
c. Epigastric
d. Suprapubic

Question 11

A 60-year-old male is diagnosed with cancer of the esophagus. Which of the following factors most likely contributed to his disease?

a. Reflux esophagitis
b. Intestinal parasites
c. Ingestion of salty foods
d. Frequent use of antacids

Question 12

The primary complication of enterocolitis associated with Hirschsprung disease is related to which finding?

a. Fecal impaction
b. Pancreatic insufficiency
c. Hyperactive peristalsis
d. Ileal atresia

Question 13

The most common cause of chronic vascular insufficiency among the elderly is:

a. Anemia
b. Aneurysm
c. Lack of nutrition in gut lumen
d. Atherosclerosis

Question 14

The most common clinical manifestation of portal hypertension is _____ bleeding.

a. rectal
b. duodenal
c. esophageal
d. intestinal

Question 15

A 54-year-old male is diagnosed with peptic ulcer disease.This condition is most likely caused by:

a. Hereditary hormonal imbalances with high gastrin levels
b. Breaks in the mucosa and presence of corrosive secretions
c. Decreased vagal activity and vascular engorgement
d. Gastric erosions related to high ammonia levels and bile reflux

Question 16

The cardinal sign of pyloric stenosis caused by ulceration or tumors is:

a. Constipation
b. Diarrhea
c. Vomiting
d. Heartburn

Question 17

A 55-year-old male died in a motor vehicle accident. Autopsy revealed an enlarged liver caused by fatty infiltration, testicular atrophy, and mild jaundice secondary to cirrhosis. The most likely cause of his condition is:

a. Bacterial infection
b. Viral infection
c. Alcoholism
d. Drug overdose

Question 18

Manifestations associated with hepatic encephalopathy from chronic liver disease are the result of:

a. hyperbilirubinemia and jaundice.
b. fluid and electrolyte imbalances.
c. impaired ammonia metabolism.
d. decreased cerebral blood flow.

Question 19

The most common disorder associated with upper GI bleeding is:

a. diverticulosis.
b. hemorrhoids.
c. esophageal varices.
d. cancer.

Question 20

A 3-month-old female develops colicky pain, abdominal distention, and diarrhea after drinking cow’s milk. The best explanation for her symptoms is:

a. Deficiency of bile that stimulates digestive secretions and bowel motility
b. Excess of amylase, which increases the breakdown of starch and causes an osmotic diarrhea
c. Overgrowth of bacteria from undigested fat molecules, which leads to gas formation and de creased bowel motility
d. Excess of undigested lactose in her digestive tract, resulting in increased fluid movement into the digestive lumen and increased bowel motility

Question 21

A 55-year-old female has general symptoms of gallstones but is also jaundiced. IV cholangiography would most likely reveal that the gallstones are obstructing the:

a. Intrahepatic bile canaliculi
b. Gallbladder
c. Cystic duct
d. Common bile duct

Question 22

A 1-week-old female is brought to her pediatrician for abdominal distention and unstable temperature. Physical examination reveals bradycardia and apnea. Tests reveal hypoxic injury to the bowel resulting in bacterial invasion and perforation. This condition is referred to as:

a. Infective enteropathy
b. Necrotizing enterocolitis (NEC)
c. Mucoviscidosis
d. Ileus

Question 23

For the patient experiencing esophageal reflux, the nurse would expect which sphincter to be malfunctioning?

a. Pyloric
b. Lower esophageal
c. Upper esophageal
d. Gastric

Question 24

Cholecystitis is inflammation of the gallbladder wall usually caused by:

a. accumulation of bile in the hepatic duct.
b. obstruction of the cystic duct by a gall-stone.
c. accumulation of fat in the wall of the gallbladder.
d. viral infection of the gallbladder.

Question 25

A 6-month-old male infant is brought to the ER after the sudden development of abdominal pain, irritability, and vomiting followed by passing of “currant jelly” stool. Ultrasound reveals intestinal obstruction in which the ileum collapsed through the ileocecal valve and invaginated into the large intestine. This type of obstruction is referred to as:

a. Prolapse
b. Pyloric stenosis
c. Intussusception
d. Imperforation

Question 26

A 22-year-old male underwent brain surgery to remove a tumor. Following surgery, he experienced a peptic ulcer. His ulcer is referred to as a(n) _____ ulcer.

a. Infectious
b. Cushing
c. Ischemic
d. Curling

Question 27

Chronic gastritis is classified according to the:

a. severity.
b. location of lesions.
c. patient’s age.
d. signs and symptoms.

Question 28

Reflux esophagitis is defined as a(n):

a. Immune response to gastroesophageal reflux
b. Inflammatory response to gastroesophageal reflux
c. Congenital anomaly
d. Secretory response to hiatal hernia

Question 29

The cardinal signs of small bowel obstruction are:

a. Vomiting and distention
b. Diarrhea and excessive thirst
c. Dehydration and epigastric pain
d. Abdominal pain and rectal bleeding

Question 30

The nurse assessing the patient with biliary atresia would expect to find which primary clinical manifestation?

a. Anemia
b. Jaundice
c. Hypobilirubinemia
d. Ascites

Question 31

A 20-year-old male was recently diagnosed with lactose intolerance. He eats an ice cream cone and develops diarrhea. His diarrhea can be classified as _____ diarrhea.

a. Motility
b. Hypotonic
c. Secretory
d. Osmotic

Question 32

Which of the following symptoms would help a health care provider distinguish between ulcerative colitis and Crohn disease?

a. Pattern of remission/exacerbations
b. Abdominal pain
c. Malabsorption
d. Diarrhea

Question 33

A 45-year-old male complains of heartburn after eating and difficulty swallowing. He probably has:

a. Pyloric stenosis
b. Hiatal hernia
c. Gastric cancer
d. Achalasia

Question 34

The exocrine portion of the pancreas contains:

a. alpha cells.
b. beta cells.
c. acinar cells.
d. islets of Langerhans.

Question 35

Outbreaks of hepatitis _____ often occur in young children attending day care centers and can be attributed to poor hand washing.

a. A
b. B
c. C
d. D

Walden NURS6501 Week 7 Quiz

Question 1

A 52-year-old male IV drug user was diagnosed with hepatitis C 5 years ago. He is now experiencing impaired blood clotting. The nurse suspects a decrease in which of the following vitamins?

a. K
b. D
c. E
d. B12
Question 2

A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has?

a. Sideroblastic anemia
b. Hemolytic anemia
c. Pernicious anemia
d. Iron deficiency anemia
Question 3

For a patient experiencing hypersplenism, the nurse expects the erythrocytes to be:

a. Proliferated
b. Activated
c. Sequestered
d. Infected
Question 4

A nurse is caring for a patient who cannot clot. Which end product of the clotting cascade is this patient unable to make?

A. Collagen
B. Fibrinogen
C. Thrombin
D. Fibrin

Question 5

A 45-year-old male is diagnosed with macrocytic, normochromic anemia. The nurse suspects the most likely cause of this condition is:

a. Defective DNA synthesis
b. Abnormal synthesis of hemoglobin
c. Defective use of vitamin C
d. Blocked protein synthesis
Question 6

a. Epstein-Barr virus
b. Hodgkin lymphoma
c. Acute leukemia
d. Burkitt lymphoma

Question 7

A nurse checks individuals with liver disease for clotting problems because:

a. The liver is often the site of platelet pooling.
b. Clotting factors are produced in the liver.
c. High levels of bilirubin interfere with the clotting system.
d. Treatment medications for liver failure cause fibrinolysis.

Question 8

a. Bronchoconstriction
b. Increased rate and depth of breathing
c. Dyspnea
d. Activation of the renin-angiotensin response

Question 9

A hematologist is discussing hematopoiesis. Which information should be included? ________ participate in hematopoiesis.

a. Colony-stimulating factors (CSFs)
b. Eosinophils
c. Basophils
d. Neutrophils

Question 10

While checking lab results, the nurse remembers the normal leukocyte count is:

a. 1,000-2,000/mm3
b. 5,000-10,000/mm3
c. 4.2-6.2 million/mm3
d. 1.2-2.2 million/mm3

Question 11

a. Brain hypoxia
b. Liver hypoxia
c. Heart failure
d. Kidney failure

Question 12

a. Posthemorrhagic anemia
b. Iron deficiency anemia
c. Aplastic anemia
d. Hemolytic anemia

Question 13

The people from which country have the lowest risk for Hodgkin lymphoma?

a. United States
b. Japan
c. Denmark
d. Great Britain
Question 14

After initial compensation, what hemodynamic change should the nurse monitor for in a patient who has a reduction in the number of circulating erythrocytes?

a. Increased viscosity of blood
b. Decreased cardiac output
c. Altered coagulation
d. Hyperdynamic circulatory state
Question 15

Thrombocytopenia may be:

a. Transient or consistent
b. Normal or abnormal
c. Congenital or acquired
d. Active or inactive
Question 16

A group of cells isolated in the laboratory have membrane-bound granules in their cytoplasm and they show phagocytic activity.Which of the following cells is most similar?

a. Monocyte
b. Macrophage
c. Lymphocyte
d. Eosinophils

Question 17

A nurse monitors for the most common childhood cancer, which is:

a. Non-Hodgkin lymphoma
b. Chronic myelocytic leukemia (CML)
c. Hodgkin lymphoma
d. Acute lymphoblastic leukemia (ALL)

Question 18

A 25-year-old female has a heavy menses during which she loses a profuse amount of blood.Which of the following adaptations should the nurse expect?

a. Movement of fluid into the cell
b. Decreased cardiac output
c. Decreased oxygen release from hemoglobin
d. Peripheral vasoconstriction
Question 19

A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?

a. Iron deficiency anemia
b. Pernicious anemia
c. Sideroblastic anemia
d. Hemolytic anemia

Question 20

A staff member wants to know where the greatest proportion of iron is located. How should the nurse respond? The greatest proportion of total body iron is located in the:

a. Erythrocytes
b. Spleen pulp
c. Bone marrow
d. Liver tissue

Question 21

A 67-year-old female has chronic gastrointestinal bleeding.A nurse recalls the primary cause of her anemia is:

a. Vitamin B12 deficiency
b. Iron deficiency
c. Folate deficiency
d. Bone marrow failure
Question 22

During an infection, the nurse assesses the lymph nodes. Lymph nodes enlarge and become tender b

because:

Lymphocytes are rapidly dividing.
b. Edema accumulates within the fibrous capsule.
c. Microorganisms are accumulating.
d. The nodes are not functioning properly.

Question 23

How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?

Administer radioactive cobalamin and measure its excretion in the urine.
b. Measure antigen-antibody immune complexes.
c. Measure serum ferritin and total iron-binding capacity.
d. Administer folate and evaluate folate content in a blood serum sample.

Question 24

A 5-year-old female is diagnosed with acute leukemia. The nurse will most likely treat this patient with:

Bone marrow transplant
b. Immunotherapy
c. Chemotherapy
d. Localized radiation therapy
Question 25

A 35-year-old male with hyperthyroidism begins treatment to decrease thyroid activity. A nurse monitors for which of the following conditions that could result secondary to the treatment?

Eosinophilia
b. Basophilia
c. Monocytosis
d. Lymphocytosis
Question 26

While reviewing lab results, the nurse recalls the most abundant cells in the blood are:

Leukocytes
b. Lymphocytes
c. Erythrocytes
d. Thrombocytes

Question 27

Cytomegalovirus (CMV)
b. Adenovirus
c. Human papillomavirus (HPV)
d. Epstein-Barr virus (EBV)

Question 28

A 15-year-old male is diagnosed with infectious mononucleosis. When the patient asks how he got this disease, how should the nurse respond? The most likely cause is:

Lymph node enlargement.
b. Fever and sore throat
c. Rash on the trunk and extremities
d. Fatigue
e. Enlargement of liver and spleen

Question 29

A nurse is teaching the staff about platelets. Which information should the nurse include? In addition to playing a role in hemostasis, platelets have the ability to:

Stimulate bone marrow production of erythrocytes
b. Release biochemical mediators of inflammation
c. Undergo cell division in response to bleeding
d. Activate a humoral response

Question 30

Pernicious anemia
b. Folate deficiency anemia
c. Iron deficiency anemia
d. Sideroblastic anemia

Question 31

A 45-year-old female undergoes a splenectomy to remove a tumor. Which of the following assessment finding is most likely to occur following surgery?

Leukocytosis
b. Hypoglycemia
c. Decreased red blood cell count
d. Decreased platelets

Question 32

When a nurse is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the nurse calls these erythrocytes:

Hyperchromic
b. Hypochromic
c. Macrocytic
d. Microcytic
Question 33

In disseminated intravascular coagulation (DIC), the nurse assesses for active bleeding after intravascular clotting because:

Prothrombin is activated.
b. Clotting factors are depleted.
c. Inflammatory mediators are released.
d. Tissue factor (TF) is inactivated.
Question 34

A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?

Hyperactivity
b. Spoon-shaped nails
c. Gait problems
d. Petechiae

Question 35

The nurse will check which of the following tests to directly measure iron stores?

Serum ferritin
b. Transferrin saturation
c. Bone marrow biopsy
d. Total iron-binding capacity

Walden NURS6501 Week 7 Quiz

Question 1

A 52-year-old male IV drug user was diagnosed with hepatitis C 5 years ago. He is now experiencing impaired blood clotting. The nurse suspects a decrease in which of the following vitamins?

K
b. D
c. E
d. B12
Question 2

A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has?

Sideroblastic anemia
b. Hemolytic anemia
c. Pernicious anemia
d. Iron deficiency anemia
Question 3

For a patient experiencing hypersplenism, the nurse expects the erythrocytes to be:

Proliferated
b. Activated
c. Sequestered
d. Infected
Question 4

A nurse is caring for a patient who cannot clot. Which end product of the clotting cascade is this patient unable to make?

Collagen
B. Fibrinogen
C. Thrombin
D. Fibrin

Question 5

A 45-year-old male is diagnosed with macrocytic, normochromic anemia. The nurse suspects the most likely cause of this condition is:

Defective DNA synthesis
b. Abnormal synthesis of hemoglobin
c. Defective use of vitamin C
d. Blocked protein synthesis
Question 6

Epstein-Barr virus
b. Hodgkin lymphoma
c. Acute leukemia
d. Burkitt lymphoma

Question 7

A nurse checks individuals with liver disease for clotting problems because:

The liver is often the site of platelet pooling.
b. Clotting factors are produced in the liver.
c. High levels of bilirubin interfere with the clotting system.
d. Treatment medications for liver failure cause fibrinolysis.

Question 8

Bronchoconstriction
b. Increased rate and depth of breathing
c. Dyspnea
d. Activation of the renin-angiotensin response

Question 9

A hematologist is discussing hematopoiesis. Which information should be included? ________ participate in hematopoiesis.

Colony-stimulating factors (CSFs)
b. Eosinophils
c. Basophils
d. Neutrophils

Question 10

While checking lab results, the nurse remembers the normal leukocyte count is:

1,000-2,000/mm3
b. 5,000-10,000/mm3
c. 4.2-6.2 million/mm3
d. 1.2-2.2 million/mm3

Question 11

Brain hypoxia
b. Liver hypoxia
c. Heart failure
d. Kidney failure

Question 12

Posthemorrhagic anemia
b. Iron deficiency anemia
c. Aplastic anemia
d. Hemolytic anemia

Question 13

The people from which country have the lowest risk for Hodgkin lymphoma?

United States
b. Japan
c. Denmark
d. Great Britain
Question 14

After initial compensation, what hemodynamic change should the nurse monitor for in a patient who has a reduction in the number of circulating erythrocytes?

Increased viscosity of blood
b. Decreased cardiac output
c. Altered coagulation
d. Hyperdynamic circulatory state
Question 15

Thrombocytopenia may be:

Transient or consistent
b. Normal or abnormal
c. Congenital or acquired
d. Active or inactive
Question 16

A group of cells isolated in the laboratory have membrane-bound granules in their cytoplasm and they show phagocytic activity.Which of the following cells is most similar?

Monocyte
b. Macrophage
c. Lymphocyte
d. Eosinophils

Question 17

A nurse monitors for the most common childhood cancer, which is:

Non-Hodgkin lymphoma
b. Chronic myelocytic leukemia (CML)
c. Hodgkin lymphoma
d. Acute lymphoblastic leukemia (ALL)

Question 18

A 25-year-old female has a heavy menses during which she loses a profuse amount of blood.Which of the following adaptations should the nurse expect?

Movement of fluid into the cell
b. Decreased cardiac output
c. Decreased oxygen release from hemoglobin
d. Peripheral vasoconstriction
Question 19

A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?

Iron deficiency anemia
b. Pernicious anemia
c. Sideroblastic anemia
d. Hemolytic anemia

Question 20

A staff member wants to know where the greatest proportion of iron is located. How should the nurse respond? The greatest proportion of total body iron is located in the:

Erythrocytes
b. Spleen pulp
c. Bone marrow
d. Liver tissue

Question 21

A 67-year-old female has chronic gastrointestinal bleeding.A nurse recalls the primary cause of her anemia is:

Vitamin B12 deficiency
b. Iron deficiency
c. Folate deficiency
d. Bone marrow failure
Question 22

During an infection, the nurse assesses the lymph nodes.Lymph nodes enlarge and become tender because:

Lymphocytes are rapidly dividing.
b. Edema accumulates within the fibrous capsule.
c. Microorganisms are accumulating.
d. The nodes are not functioning properly.

Question 23

How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?

Administer radioactive cobalamin and measure its excretion in the urine.
b. Measure antigen-antibody immune complexes.
c. Measure serum ferritin and total iron-binding capacity.
d. Administer folate and evaluate folate content in a blood serum sample.

Question 24

A 5-year-old female is diagnosed with acute leukemia. The nurse will most likely treat this patient with:

Bone marrow transplant
b. Immunotherapy
c. Chemotherapy
d. Localized radiation therapy
Question 25

A 35-year-old male with hyperthyroidism begins treatment to decrease thyroid activity. A nurse monitors for which of the following conditions that could result secondary to the treatment?

Eosinophilia
b. Basophilia
c. Monocytosis
d. Lymphocytosis
Question 26

While reviewing lab results, the nurse recalls the most abundant cells in the blood are:

Leukocytes
b. Lymphocytes
c. Erythrocytes
d. Thrombocytes

Question 27

Cytomegalovirus (CMV)
b. Adenovirus
c. Human papillomavirus (HPV)
d. Epstein-Barr virus (EBV)

Question 28

A 15-year-old male is diagnosed with infectious mononucleosis. When the patient asks how he got this disease, how should the nurse respond? The most likely cause is:

Lymph node enlargement.
b. Fever and sore throat
c. Rash on the trunk and extremities
d. Fatigue
e. Enlargement of liver and spleen

Question 29

A nurse is teaching the staff about platelets. Which information should the nurse include? In addition to playing a role in hemostasis, platelets have the ability to:

Stimulate bone marrow production of erythrocytes
b. Release biochemical mediators of inflammation
c. Undergo cell division in response to bleeding
d. Activate a humoral response

Question 30

Pernicious anemia
b. Folate deficiency anemia
c. Iron deficiency anemia
d. Sideroblastic anemia

Question 31

A 45-year-old female undergoes a splenectomy to remove a tumor. Which of the following assessment finding is most likely to occur following surgery?

Leukocytosis
b. Hypoglycemia
c. Decreased red blood cell count
d. Decreased platelets

Question 32

When a nurse is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the nurse calls these erythrocytes:

Hyperchromic
b. Hypochromic
c. Macrocytic
d. Microcytic
Question 33

In disseminated intravascular coagulation (DIC), the nurse assesses for active bleeding after intravascular clotting because:

Prothrombin is activated.
b. Clotting factors are depleted.
c. Inflammatory mediators are released.
d. Tissue factor (TF) is inactivated.
Question 34

A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?

Hyperactivity
b. Spoon-shaped nails
c. Gait problems
d. Petechiae

Question 35

The nurse will check which of the following tests to directly measure iron stores?

Serum ferritin
b. Transferrin saturation
c. Bone marrow biopsy
d. Total iron-binding capacity

PAD 599 Competency Assessment

NURS6521 Week 2 Quiz latest 2017

Question 1 A patient has been prescribed a Scheduled 5 drug, an example of this drug is A.Antianxiety

B.Narcotic Analgesics

C.Barbituates

D.Antitussives

Question 2 A nurse has just completed a medication history on a newly admitted patient. In order to complete medication reconciliation for this patient the nurse will

A.Provide instructions pertaining to each medication the patient is currently taking and thenadd the medications ordered during the hospitalization.

B.compare the medications ordered by the health care provider with the list of medicationsobtained from the patient and communicate discrepancies to the health care provider.

C.explain to the patient the pharmacokinetics of each drug he will be taking in the hospital. D.determine the best pharmacy for the patient to buy his medications

Question 3 A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a

C-I drug.
C-II drug.
C-III drug.
C-IV drug

Question 4 A nurse works in a private hospital and needs to administer some narcotic drugs to one of her patients. Which of the following should the nurse consider when administering narcotics to patients in a hospital setting?

Narcotics are banned in private settings and cannot be used.
Narcotics can be used in the hospital after obtaining written approval from the Joint Commission for Accreditation of Hospitals and Healthcare Organizations(JCAHO).
Narcotics to be used in the hospital are dispensed only with a written prescription.
Narcotics can be used in the hospital according to patient preferences

Question 5 Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. This is scheduled drug

A.Schedule 1

B.Schedule 2

C.Schedule 3

D.Schedule 4

Question 6 A nurse receives an order to administer a critically ill patient two drugs immediately (stat). The nurse begins the process by

A.washing his or her hands before handling the medications.

B.consulting a drug guide for compatibility.

C.identifying the patient by checking the armband and asking the patient to state his name.

D.questioning the patient concerning allergies.

Question 7 A nurse working for a drug company is involved in phase III drug evaluation studies. Which of the following might the nurse be responsible for during this stage of drug development?

Working with animals who are given experimental drugs
Monitoring drug effects in patients who are selected to participate in a study, whohave the disease that the drug is meant to treat
Administering investigational drugs to patients
Informing healthy, young volunteer participants of possible risks that could occurfrom taking an experimental drug

Question 8 Federal legislation dictates a lengthy and rigorous process of testing for new drugs. What is the primary purpose of this testing process?

To protect state and federal departments from legal liability
To maximize autonomy and treatment options for citizens
To facilitate the efficiency of health care delivery
To ensure the safety of the public

Question 9 These drugs have a potential for abuse, but the potential is lower than for drugs on Schedule 2. These drugs contain a combination of controlled and noncontrolled substances. Use of these drugs can cause a moderate to low physiologic dependence and a higher psychological dependence. A verbal order can be given to the pharmacy and the prescription can be refilled up to five times within 6 months. Examples include certain narcotics (codeine) and nonbarbiturate sedatives. This is scheduled drug

Schedule 3
Schedule 4
Schedule 5
Schedule 2

Question 10 Which of the following patients should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

A 47-year-old female with hypertension
A 52-year-old male with adult-onset diabetes
A 17-year-old female with symptoms of an upper respiratory infection
A 62-year-old male with gout

Question 11 Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use.They may be obtained for “investigational use only” by applying to the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this?

Schedule 1
Schedule 2
Schedule 3
Schedule 4

Question 12 A patient has taken an overdose of a vitamin/mineral supplement containing magnesium. The nurse will be sure to assess

blood pressure.
body temperature.
fluid intake.
skin changes

Question 13 A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply.

A.Is there a need for the drug in treating the presenting problem?

B.Is this the best drug for the presenting problem?

C.Can the patient take the prescribed drug?

None of the above

Question 14 A nurse is caring for a 46-year-old patient of Chinese origin who has bipolar disorder. The physician has prescribed lithium carbonate (Eskalith) to treat the disorder. The nurse is aware that the lithium dose will likely be given in a

higher-than-normal dose.
weight-based protocol dose.
lower-than-normal dose.
child’s dose

Question 15 The nurse practitioner orders Amoxicillin 250 mg/5 ml tid for 10 days? The nurse practitioner would expect the pharmacist to fill the prescription bottle with how many ml?

50 ml
100 ml
120 ml
150 ml

Question 16 A patient will begin three new medications as part of her treatment plan. The nurse practitioner understands that proper disposal of medications is key when the nurse practitioner states

Many medications can be potentially harmful if taken by someone other than the person the medication was prescribed.
Consult with several pharmacists to determine the cost of each drug.
educate the patient to discard syringes in recycle bin
consult with the physician concerning choice of medications for the patient.

Question 17 A nurse is providing a patient with a list of drugs as a part of the patient’s plan of care. Which of the following drug nomenclatures should the nurse use to list the drugs?

The drugs’ chemical names
The drugs’ generic names
The drugs’ trade names
The drugs’ biologic names

Question 18 A nurse is providing care for a 71-year-old woman who was sponsored to emigrate from Mexico to the United States 6 months ago. Earlier this week, the woman slipped while getting off a bus and fractured her hip. How should the woman’s nurse best exemplify cultural competence in the care of this patient?

Ensure that the woman receives care solely from Spanish-speaking caregivers.
Consider dimensions of the woman’s cultural background when planning care.
Integrate teaching about American culture when interacting with the patient.
Address the woman’s children first when explaining her care and changes in her health status.

Question 19 Which of the following serves to protect the public by ensuring the purity of a drug and its contents?

American Pharmaceutical Association
United States Adopted Names Council
Nursing drug guides
Federal legislation

Question 20 A nurse is admitting a Mexican woman to the hospital who cannot speak or understand English. The patient is alone, and there is no interpreter available. When trying to communicate with the patient the nurse will

Speak loudly
Exaggerate her mouth movements
Use nonverbal language
Speak fast

Question 21 A patient comes to primary clinic for strep throat. A throat swab culture is sent to lab. What information is required for the nurse practitioner to disclose on lab transmittal?

National Provider Identification (NPI)

B.Centers for Medicare & Medicaid Services (CMS)

C.Health Insurance Portability and Accountability Act of 1996 (HIPPA)

D.None of the above

Question 22 A Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe’s medicine man perform a ritual before the patient goes to surgery. The nurse’s response to this request should be

“I’m sorry, but that will not be possible.”
“I will need to inform the doctor and see if he will allow this.”
“As long as the ritual does not interfere with the patient’s preoperative care, it will be okay.”
“I don’t think that will help, but you have the right to perform the ritual.”

Question 23 A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that

under the Combat Methamphetamine Abuse Act, pseudoephedrine now requires a prescription.
drugs containing pseudoephedrine are available without a prescription but are kept off pharmacy shelves.
she must be prepared to show identification when buying a drug that contains pseudoephedrine.
pseudoephedrine is being phased out of the marketplace in order to combat illegal use.

Question 24 A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive

a higher-than-normal dose of drugs that bind to acid glycoproteins.
a lower-than-normal dose of drugs that bind to acid glycoproteins.
the recommended normal dose of drugs that bind to acid glycoproteins.
one half the recommended dose of drugs that bind to acid glycoproteins.

Question 25 A nurse is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up. This area of study is called

pharmacotherapeutics.
pharmacodynamics.
pharmacoeconomics.
pharmacogenomics

NUR6550 Final Exam

The Valsalva maneuver and the squat-to-stand maneuver are likely to increase the sound of a cardiac murmur associated with which of these conditions?

Which of the following conditions may result in lower extremity edema?

Nephrotic syndrome

Decompensated congestive heart failure

Cirrhosis

Renal failure

Deep venous thrombosis

Late-stage pregnancy

All of the above

Art Bakke is a 46-year-old male who is being treated for an acute myocardial infarction. He has now developed significant dyspnea at rest and, per physical exam, has coarse rales involving the lower 2/3 of the lung fields bilaterally. You suspect acute pulmonary edema due to papillary-muscle rupture and acute mitral-valve regurgitation.

Question: Which of the following physical findings would support this diagnostic hypothesis?

A palpable diastolic murmur maximal in the second intercostal space (ICS) at the left sternal border

A harsh, rumbling, diastolic murmur heard maximally in the fourth ICS at the left sternal border

A holosystolic systolic murmur heard maximally in the fifth ICS at the midclavicular line

The most common ECG finding in a patient with a cardiomyopathy is an ST-elevation MI.

True

False

Nina Martinez is a 70-year-old female who experienced an episode of acute pulmonary edema following an endovascular aneurysm repair. She was discharged on furosemide 60 mg daily and instructed to follow up with cardiology. She is now seen in the office at 2 weeks post discharge. Her metabolic panel includes the following lab values:

Na 126 mEq/L
K 4.0 mEq/L
Cl 93 mEq/L
CO2 28 mEq/L
BUN 40 mg/dL
Cr 1.3 mg/dL

Question: This patient has which of the following abnormalities as a likely consequence of diuretic overuse?

Hyponatremia

Hypokalemia

Metabolic acidosis

Which of the following are primary cardiomyopathy categories, as described by the World Health Organization (WHO) in 1995?

Dilated cardiomyopathy

Symbol Hypertrophic cardiomyopathy (HCM)

Symbol Restrictive cardiomyopathy

Symbol Arrhythmogenic right ventricular dysplasia

Symbol Unclassified

All of the above

What is the most common cause of sudden cardiac death in young people?

What is the most common cause of sudden cardiac death in young people?

Myocardial infarction

Hypertrophic cardiomyopathy

Supraventricular tachycardia

Arrhythmogenic right ventricular dysplasia; aka arrhythmogenic right ventricular cardiomyopathy (ARVC)

Which of the following are treatment options for a patient who presents with peripartum cardiomyopathy while still carrying the fetus? (Select all that apply.)

ACE inhibitors

Induction if stable

Emergent cesarean section if unstable

Digoxin

Nitroglycerin

What are the 3 major clinical complications related to cardiomyopathies?

Arrhythmias; including ventricular tachycardia and ventricular fibrillation

Thromboembolic complications; including DVT, PE, and ventricular thrombi

Acute pulmonary edema

Some patients with primary cardiomyopathies remain asymptomatic throughout their lifetime.

True

False

A 38-year -old woman comes to the emergency department complaining of a rapid heartbeat, tremors, and chest tightness. She reports earlier in the day she was feeling a migraine starting so she took a pill given to her by her friend who also experiences migraines. Her medical history reveals that she is currently taking a monoamine oxidase inhibitor for depression. Which migraine medication did she most likely take?

Acetaminophen and caffeine (Excedrin ® Migraine)

Naproxen sodium (Aleve ® )

Almotriptan (Axert ® )

Butalbital, acetaminophen and caffeine (Fioricet ® )

You are seeing a 68-year-old woman for treatment of an uncomplicated urinary tract infection (UTI). She has well-controlled hypertension, type 2 diabetes mellitus, and dyslipidemia and takes an angiotensin-converting enzyme inhibitor (ACEI), statin, biguanide, and low-dose aspirin (ASA). She worked in a dry cleaning facility until approximately 8 years ago. During her evaluation, she mentions that she sometimes has difficulty understanding conversation, especially in noisy environments. This is likely a:

Drug-related reaction.

Consequence of occupational chemical exposure.

Early sign of dementia.

Normal age-related change in hearing

While evaluating a 33-year-old female with a 2-day history of dysuria, which of the following findings in urinalysis is most suggestive of urinary tract infection (UTI) caused by a Gram-negative organism?

Nitrites

30 mg/dL protein

Epithelial cells

pH>8

All of the following are examples of primary prevention strategies except:

Counseling an elderly patient prior to discharge about fall risk at home and how to prevent falls through adequate illumination.

Performing a hemoglobin A1C for all patients admitted to the hospital.

Conducting a study to identify the leading cause of mortality in teenagers and how to reduce risk.

Immunizing all adults ?60 years with zoster vaccine.

A 23-year-old woman is being evaluated for an upper respiratory tract infection. As you prepare for auscultation, the patient states “I have a benign murmur that has been with me my whole life”. Anticipating a physiologic murmur, you would expect which of the following characteristics?

Usually obliterates S2.

Becomes softer when going from a supine to standing position.

Occurs late in systole.

Has localized area of auscultation

You see a 73-year-old woman with a 40 pack- year smoking history, chronic obstructive pulmonary disease (COPD) and peripheral arterial disease (PAD) who presents with an ulcer on the sole of her left foot. The ulcer has an irregular edge and pale base and a punched out appearance, with the surrounding skin white and shiny. The patient states that the pain is worse at night in bed and when the legs are elevated. The most likely diagnosis is:

Pressure ulcer

Pyoderma gangrenosum

Venous ulcer

Arterial ulcer

You see a 76-year-old woman living at home who is accompanied by her home care provider. She has COPD and type 2 diabetes mellitus. An example of a secondary prevention strategy is:

Administering the seasonal influenza vaccine.

Screening for physical or financial abuse/Checking her blood glucose level.

Checking her blood pressure.

Adjusting her insulin dosing regimen.

A 43-year-old woman is being evaluated in the emergency department with a complaint of a severe headache. She describes a unilateral, pulsing headache that was preceded by a gradual onset of paresthesia affecting the ipsilateral face and arm. The patient stated she noticed a “funny smell” prior to the symptoms starting. This description is most typical of:

Migraine with aura.

Cluster headache.

Transient ischemic attack.

Tension-type headache.

You see a 54-year-old man living in subsidized housing with a history of hypertension. He states that he stopped taking his blood pressure medication about 4 months ago because of costs. He is concerned because his blood pressure is high whenever he checks it, though he does not report any symptoms. His BP at this visit is 196/104 mm Hg. Upon examination of this patient, you would expect to detect an S 4 sound heard during:

Early systole.

Late systole.

Early diastole.

Late diastole.

32-year-old man requires evaluation for hepatitis infection prior to taking a job as a restaurant cook. He presents with the following laboratory results:

Hepatitis A Panel Hepatitis B Panel Hepatitis C Panel

Anti-HAV Negative HBsAg Negative Anti-HCV Positive

IgM Negative Anti-HBc Negative HCV RNA Negative

IgM NegativeAnti-HBs Positive

You recognize the patient is susceptible to:

Hepatitis A and B

Hepatitis B and C

Hepatitis B only

Hepatitis A only

When evaluating illness symptoms in older patients, the disease will often present differently from younger adults due to:

The likelihood of polypharmacy.

Decreased compensatory mechanisms in the elderly.

An increased physiologic response to illness in the elderly.

Presence of comorbid conditions.

When prioritizing risk factors for bacterial endocarditis, the nurse practitioner knows who among the following patients has the highest risk.

A 55-year-old man with 3-vessel coronary artery bypass grafts with stents.

A 23-year-old woman with mitral valve prolapse without tissue redundancy.

A 65-year-old man with nonobstructive cardiomyopathy.

A 75-year-old woman with a nonorganic prosthetic aortic valve.

The legal authority for NPs to perform healthcare services as defined by state law is called:

Duty of care.

Non-malfeasance.

Autonomy.

Scope of practice.

When developing a management plan for patients with genitourinary infections, which of the following would you most likely recommend for follow-up imaging following resolution of their infection?

A 27-year-old nonpregnant woman with acute, uncomplicated urinary tract infection (UTI).

A 38-year-old nonpregnant woman with 2 acute, uncomplicated UTIs in the past 9 months.

A 57-year-old man with acute bacterial prostatitis.

A 43-year-old man with type 2 diabetes mellitus and recurrent pyelonephritis.

The NP is called to evaluate Jane, a 43-year- old woman, who presents with a diffuse maculopapular rash that began on the trunk but now covers the entire body, including the palms and soles. The rash is not itchy but wart-like sores are present in the mouth and genital area as well as skin folds. Initial evaluation reveals generalized lymphadenopathy and a low-grade fever, and she complains of lethargy and headache. The patient reports that she had a painless genital ulcer that healed on its own about 3 weeks earlier. Which of the following is the most likely diagnosis?

Primary syphilis.

Secondary syphilis.

Genital herpes.

Gonorrhea.

A 27-year-old man presents with a chief concern of an abnormal mass within his left scrotum. He describes it as feeling like a “bag of worms” and is present when he is standing but disappears when he lies down. His past medical history is unremarkable and his BMI is 29 kg/m 2 . He has been in a monogamous relationship for the past 4months. The most likely diagnosis is:

Testicular torsion.

Syphilis.

Varicocele.

Testicular cancer.

An 18-year-old man is being evaluated for a severe exacerbation of asthma. He is currently taking an inhaled corticosteroid, a long- acting beta-agonist, and a short-acting beta-agonist on an as needed basis. The most important component of the initial assessment includes a(n):

Continuous pulse oximetry reading

Peak expiratory flow reading

Chest X-ray

Arterial Blood Gas

A 67-year-old man is being evaluated for shortness of breath. His medical history reveals that he experienced a myocardial infarction about 2 years ago and a history of hypertension, which is well controlled by diet.. Otherwise, his medical history is unremarkable. Which of the following would you expect to find on electrocardiogram (ECG)?

T wave inversion.

Pathologic Q wave.

ST segment elevation.

Tall R wave.

A 74-year-old male with asymptomatic atrial fibrillation underwent electrical cardioversion that successfully restored the heart’s rhythm. Which of the following medications can be considered for the purpose of maintaining the heart’s rhythm?

Sotalol (Betapace ® )

Digoxin (Lanoxin ® )

Dabigatran (Pradaxa ® )

Enalapri

A 14-year-old male is brought in for evaluation after he reportedly collapsed during a tennis match, though he quickly regained consciousness. His medical history is otherwise unremarkable. You suspect hypertrophic cardiomyopathy. Which of the following heart murmur characteristics would support the diagnosis?

Occurs late in systole.

Widely split S?.

Becomes louder when going from a supine to standing position.

Murmur follows mid-systolic click.

You see a 64-year-old man with an area of erythema concentrated on the left side of his neck with clusters of vesicles forming a line. He reported pain in the area a couple of days before the eruption of the lesions. He states that he recently initiated biologic therapy for rheumatoid arthritis. Which of the following is the most likely diagnosis?

Impetigo.

Herpes zoster.

Drug-related adverse reaction.

Viral exanthem.

An NP’s duty of care can be established:

Only in the setting of a healthcare institution (e.g., hospital, clinic, etc.).

When the NP gives professional advice or treatment in any setting.

Only when a fee is charged, either to the patient or third-party payer, for services.

Only when both the NP and patient acknowledge a patient-provider relationship.

In managing a 58-year- old woman who is admitted for deep vein thrombosis, caution should be used with which of the following medications due to a risk of drug-induced thrombocytopenia?

Warfarin (Coumadin®)

Clopidogrel (Plavix®)

Dabigatran (Pradaxa®)

Unfractionated heparin

An 84-year-old female patient is admitted from a local long-term care facility (illnes). The patient is normally awake, alert, and oriented. She resides in the LTCF because she has not fully recovered from a broken hip resulting from a fall 4 months ago; otherwise she is in relatively good health. She can walk short distances with a walker, though she primarily stays in a wheelchair. Today, however, the nursing staff found her to be acutely confused and unable to ambulate without falling. She was transferred to the emergency department for evaluation. Initial laboratory testing must include:

2 sets of blood cultures.

Serum thyroid stimulating hormone (TSH) level.

Urinalysis.

Lumbar puncture.

A 23-year-old college student presents with a 2-day history of severe sore throat and difficulty eating or drinking due to trouble swallowing. A physical examination reveals exudative pharyngitis and minimally tender anterior and posterior cervical lymphadenopathy. The NP suspects infectious mononucleosis and would expect which of the following laboratory findings?

Neutrophilia with reactive forms.

Thrombocytosis.

Lymphocytosis with atypical lymphocytes.

Diminished ALT/AST levels.

“Incident-to” services are defined as those which are “an integral, although incidental, part of the physician’s personal professional services in the course of diagnosis or treatment of an injury or illness”. As long as certain criteria are met, “incident to” billing is an option in all of the following settings except:

Office visits.

Hospital.

Nursing home.

Home visits.

A 78-year- old male is being treated for a hypoglycemic episode. He has a long history of type 2 diabetes mellitus as well as congestive heart failure and COPD. He is currently taking basal insulin with a sulfonylurea. What is the acceptable A1C goal for this patient?

≤ 6.5%

≤ 7.0%

≤ 8.0%

≤ 9.0%

You see a 74- year-old male who is accompanied by his granddaughter who lives with him. He has hypertension, a prior myocardial infarction, long-standing type 2 diabetes, and recently underwent a lower limb amputation secondary to diabetes. He is currently taking an ACE inhibitor, statin, low-dose aspirin, biguanide, and insulin. The granddaughter reports that since the amputation, her grandfather sometimes becomes withdrawn, irritable and moody for no apparent reason, does not want to participate in the typical activities he enjoys, and often does not appear to eat much during the day. She also states that he often complains of being tired but normally wakes up in the early morning hours. The most appropriate action is to evaluate the patient for:

Dementia.

Depression.

Delirium.

Drug interaction.

You see a 58-year-old man who complains of a persistent dry, hacking cough. He reports that he recently started taking a medication to treat high blood pressure. He is most likely taking a(n):

Angiotensin-converting enzyme (ACE) inhibitor

Alpha-adrenergic antagonist

Angiotensin receptor blocker

Beta-adrenergic antagonist

A 77-year-old woman is accompanied by her husband for evaluation. She is currently being treated with metoprolol (Lopressor ® ) for hypertension and digoxin (Lanoxin ® ) for atrial fibrillation. He reports that his wife is becoming increasingly forgetful over the past year, failing to note important family events such as birthdays, and sometimes becomes confused with driving directions to familiar locations. She has no previous psychiatric history. The most likely diagnosis is:

Parkinson’s disease.

Delirium.

Dementia.

Early stage of congestive heart failure.

Mrs. Conner is a 76- year-old woman living in a long-term care facility and has been bedridden with a respiratory infection for the past 4 days. She is brought in for evaluation and you note signs of dehydration as well as a section of epidermal skin loss about 3 cm in diameter on her right hip. The dermal layer appears intact. This would be considered a pressure ulcer of Stage:

Which of the following represents the highest level of scientific evidence when evaluating clinical research?

A randomized controlled trial.

Systematic review/ Meta-analysis of randomized controlled troals.

Observational study.

Cohort study.

A 64-year- old woman with chronic kidney disease presents with a chief complaint of lethargy. His hemogram is as follows:

-Hemoglobin (Hg)=9.9 g/dL (12–14 g/dL

-Hematocrit (Hct)=30% (36%–42%)

-Mean cell volume (MCV)=81 fL (80–96 fL

-Reticulocytes=0.7% (1%–2%)

These findings are most consistent with:

Iron deficiency anemia.

Anemia of chronic disease.

Folate deficiency anemia.

Thalassemia trait.

You see a 68-year-old woman who is being treated for moderate depression. She complains that her medication is causing symptoms of dry mouth and constipation. She is most likely taking which of the following medications?

Venlafaxine (Effexor ® )

Citalopram (Celexa ® )

Fluoxetine (Prozac ® )

Nortriptyline (Pamelor ® )

All of the following persons are eligible for Medicare services except:

A 74-year-old ex-smoker with COPD and high income from assets.

A 69-year-old undocumented resident in the US with atrial fibrillation.

A 62-year-old with a permanent physical disability due to a motor vehicle accident.

A 72-year-old permanent legal resident (non-US citizen) with type 1 diabetes mellitus.

When initiating therapy with spironolactone for a patient who is also on an ACE inhibitor, you advise the patient to return in 5 days to check which of the following laboratory parameters?

Sodium

Calcium

Potassium

Chloride

When considering an end-of-life decision for a terminally ill person with Alzheimer-type dementia who can no longer communicate, all of the following can be used as an advanced directive except:

Testimony from a family member or close friend

A living will.

A “do not resuscitate” order.

A durable power of attorney for healthcare.

Which of the following types of clinical studies represents the lowest level of evidence used to guide medical decisions?

Clinical experience of renowned expert in field.

Non-randomized controlled study.

Observational study.

Case-control study.

Which of the following electrocardiogram (ECG) changes do you expect to find in a person with myocardial ischemia?calcium

Pathologic Q wave

Tall R wave

T wave inversion

ST segment elevation

Which of the following statements is false regarding end-of-life decision-making for a patient that is hopelessly and terminally ill?

A durable power of attorney for healthcare can be used to authorize another person to make healthcare decisions.

A videotaped or audiotaped discussion with the patient can include advanced directives.

Advanced directives are legally binding and recognized in all 50 states.

Living wills and do not resuscitate orders are examples of advanced directives.

The nurse practitioner is evaluating a 19-year- old male suffering from a severe headache. He has a history of headaches that tend to occur in clusters over a few days. He has unsuccessfully tried several therapeutic modalities. A positive response to which of the following interventions supports the diagnosis of cluster headache?

Oxygen therapy.

Beta-adrenergic blockade.

Tricyclic antidepressant.

Dietary reduction of amines.

All of the following are required Medicare terms and conditions for paying NP services except:

The services are within the NP’s scope of practice as defined by state law.

The services performed are those for which a physician would be able to bill Medicare. The services are performed in collaboration with a physician.

Separate charges are billed for NP services and facility charges.

A 28- year- old male with asthma presents with a chief complaint that he has to use his rescue inhaler multiple times each day. An evaluation reveals that he has moderate-to-severe asthma and requires Step 4 treatment. An appropriate regimen would include:

Low-dose inhaled corticosteroid (ICS)

Medium-dose ICS

Medium-dose ICS plus a long-acting beta?-agonist (LABA)

High-dose ICS plus LABA plus omalizumab (Xolair ® )

A 62-year-old woman presents in the emergency department complaining of severe toe pain that originated overnight. She has a history of renal disease and is currently taking a thiazide diuretic. Her BMI is 37 kg/m 2 . In considering a diagnosis of acute gouty arthritis, the nurse practitioner knows that the best diagnostic indicator is:

Serum uric acid.

Joint X-ray.

Erythrocyte sedimentation rate (ESR).

Analysis of joint aspirate for urate crystals.

Which of the following is the most appropriate antibiotic for a 57-year-old man with acute bacterial rhinosinusitis and who has type 2 diabetes mellitus, COPD and a beta-lactam allergy?

Cephalexin (Keflex ® ).

Amoxicillin-clavulanate (Augmentin ® ).

Trimethoprim with or without sulfamethoxazole (Primsol ® , Bactrim ® ).

Levofloxacin (Levaquin ® )

Community Health Project

Review your state public health department and environmental quality departments online to identify vector-related diseases affecting your community.

In a report format of 1,250-1,500 words, address the following:

Describe the health concerns of the community.
Identify current environmental risk assessment methods which apply to public health issues.
Suggest a modifier or new prevention or intervention program based on your research.
Create a sample program budget.
Complete a SWOT analysis of the proposed program.

APA format is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Community Health Project

Review your state public health department and environmental quality departments online to identify vector-related diseases affecting your community.

In a report format of 1,250-1,500 words, address the following:

Describe the health concerns of the community.
Identify current environmental risk assessment methods which apply to public health issues.
Suggest a modifier or new prevention or intervention program based on your research.
Create a sample program budget.
Complete a SWOT analysis of the proposed program.

APA format is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

NUR6550 Final Exam

The Valsalva maneuver and the squat-to-stand maneuver are likely to increase the sound of a cardiac murmur associated with which of these conditions?

Which of the following conditions may result in lower extremity edema?

Nephrotic syndrome

Decompensated congestive heart failure

Cirrhosis

Renal failure

Deep venous thrombosis

Late-stage pregnancy

All of the above

Art Bakke is a 46-year-old male who is being treated for an acute myocardial infarction. He has now developed significant dyspnea at rest and, per physical exam, has coarse rales involving the lower 2/3 of the lung fields bilaterally. You suspect acute pulmonary edema due to papillary-muscle rupture and acute mitral-valve regurgitation.

Question: Which of the following physical findings would support this diagnostic hypothesis?

A palpable diastolic murmur maximal in the second intercostal space (ICS) at the left sternal border

A harsh, rumbling, diastolic murmur heard maximally in the fourth ICS at the left sternal border

A holosystolic systolic murmur heard maximally in the fifth ICS at the midclavicular line

The most common ECG finding in a patient with a cardiomyopathy is an ST-elevation MI.

True

False

Nina Martinez is a 70-year-old female who experienced an episode of acute pulmonary edema following an endovascular aneurysm repair. She was discharged on furosemide 60 mg daily and instructed to follow up with cardiology. She is now seen in the office at 2 weeks post discharge. Her metabolic panel includes the following lab values:

Na 126 mEq/L
K 4.0 mEq/L
Cl 93 mEq/L
CO2 28 mEq/L
BUN 40 mg/dL
Cr 1.3 mg/dL

Question: This patient has which of the following abnormalities as a likely consequence of diuretic overuse?

Hyponatremia

Hypokalemia

Metabolic acidosis

Which of the following are primary cardiomyopathy categories, as described by the World Health Organization (WHO) in 1995?

Dilated cardiomyopathy

Symbol Hypertrophic cardiomyopathy (HCM)

Symbol Restrictive cardiomyopathy

Symbol Arrhythmogenic right ventricular dysplasia

Symbol Unclassified

All of the above

What is the most common cause of sudden cardiac death in young people?

What is the most common cause of sudden cardiac death in young people?

Myocardial infarction

Hypertrophic cardiomyopathy

Supraventricular tachycardia

Arrhythmogenic right ventricular dysplasia; aka arrhythmogenic right ventricular cardiomyopathy (ARVC)

Which of the following are treatment options for a patient who presents with peripartum cardiomyopathy while still carrying the fetus? (Select all that apply.)

ACE inhibitors

Induction if stable

Emergent cesarean section if unstable

Digoxin

Nitroglycerin

What are the 3 major clinical complications related to cardiomyopathies?

Arrhythmias; including ventricular tachycardia and ventricular fibrillation

Thromboembolic complications; including DVT, PE, and ventricular thrombi

Acute pulmonary edema

Some patients with primary cardiomyopathies remain asymptomatic throughout their lifetime.

True

False

A 38-year -old woman comes to the emergency department complaining of a rapid heartbeat, tremors, and chest tightness. She reports earlier in the day she was feeling a migraine starting so she took a pill given to her by her friend who also experiences migraines. Her medical history reveals that she is currently taking a monoamine oxidase inhibitor for depression. Which migraine medication did she most likely take?

Acetaminophen and caffeine (Excedrin ® Migraine)

Naproxen sodium (Aleve ® )

Almotriptan (Axert ® )

Butalbital, acetaminophen and caffeine (Fioricet ® )

You are seeing a 68-year-old woman for treatment of an uncomplicated urinary tract infection (UTI). She has well-controlled hypertension, type 2 diabetes mellitus, and dyslipidemia and takes an angiotensin-converting enzyme inhibitor (ACEI), statin, biguanide, and low-dose aspirin (ASA). She worked in a dry cleaning facility until approximately 8 years ago. During her evaluation, she mentions that she sometimes has difficulty understanding conversation, especially in noisy environments. This is likely a:

Drug-related reaction.

Consequence of occupational chemical exposure.

Early sign of dementia.

Normal age-related change in hearing

While evaluating a 33-year-old female with a 2-day history of dysuria, which of the following findings in urinalysis is most suggestive of urinary tract infection (UTI) caused by a Gram-negative organism?

Nitrites

30 mg/dL protein

Epithelial cells

pH>8

All of the following are examples of primary prevention strategies except:

Counseling an elderly patient prior to discharge about fall risk at home and how to prevent falls through adequate illumination.

Performing a hemoglobin A1C for all patients admitted to the hospital.

Conducting a study to identify the leading cause of mortality in teenagers and how to reduce risk.

Immunizing all adults ?60 years with zoster vaccine.

A 23-year-old woman is being evaluated for an upper respiratory tract infection. As you prepare for auscultation, the patient states “I have a benign murmur that has been with me my whole life”. Anticipating a physiologic murmur, you would expect which of the following characteristics?

Usually obliterates S2.

Becomes softer when going from a supine to standing position.

Occurs late in systole.

Has localized area of auscultation

You see a 73-year-old woman with a 40 pack- year smoking history, chronic obstructive pulmonary disease (COPD) and peripheral arterial disease (PAD) who presents with an ulcer on the sole of her left foot. The ulcer has an irregular edge and pale base and a punched out appearance, with the surrounding skin white and shiny. The patient states that the pain is worse at night in bed and when the legs are elevated. The most likely diagnosis is:

Pressure ulcer

Pyoderma gangrenosum

Venous ulcer

Arterial ulcer

You see a 76-year-old woman living at home who is accompanied by her home care provider. She has COPD and type 2 diabetes mellitus. An example of a secondary prevention strategy is:

Administering the seasonal influenza vaccine.

Screening for physical or financial abuse/Checking her blood glucose level.

Checking her blood pressure.

Adjusting her insulin dosing regimen.

A 43-year-old woman is being evaluated in the emergency department with a complaint of a severe headache. She describes a unilateral, pulsing headache that was preceded by a gradual onset of paresthesia affecting the ipsilateral face and arm. The patient stated she noticed a “funny smell” prior to the symptoms starting. This description is most typical of:

Migraine with aura.

Cluster headache.

Transient ischemic attack.

Tension-type headache.

You see a 54-year-old man living in subsidized housing with a history of hypertension. He states that he stopped taking his blood pressure medication about 4 months ago because of costs. He is concerned because his blood pressure is high whenever he checks it, though he does not report any symptoms. His BP at this visit is 196/104 mm Hg. Upon examination of this patient, you would expect to detect an S 4 sound heard during:

Early systole.

Late systole.

Early diastole.

Late diastole.

32-year-old man requires evaluation for hepatitis infection prior to taking a job as a restaurant cook. He presents with the following laboratory results:

Hepatitis A Panel Hepatitis B Panel Hepatitis C Panel

Anti-HAV Negative HBsAg Negative Anti-HCV Positive

IgM Negative Anti-HBc Negative HCV RNA Negative

IgM NegativeAnti-HBs Positive

You recognize the patient is susceptible to:

Hepatitis A and B

Hepatitis B and C

Hepatitis B only

Hepatitis A only

When evaluating illness symptoms in older patients, the disease will often present differently from younger adults due to:

The likelihood of polypharmacy.

Decreased compensatory mechanisms in the elderly.

An increased physiologic response to illness in the elderly.

Presence of comorbid conditions.

When prioritizing risk factors for bacterial endocarditis, the nurse practitioner knows who among the following patients has the highest risk.

A 55-year-old man with 3-vessel coronary artery bypass grafts with stents.

A 23-year-old woman with mitral valve prolapse without tissue redundancy.

A 65-year-old man with nonobstructive cardiomyopathy.

A 75-year-old woman with a nonorganic prosthetic aortic valve.

The legal authority for NPs to perform healthcare services as defined by state law is called:

Duty of care.

Non-malfeasance.

Autonomy.

Scope of practice.

When developing a management plan for patients with genitourinary infections, which of the following would you most likely recommend for follow-up imaging following resolution of their infection?

A 27-year-old nonpregnant woman with acute, uncomplicated urinary tract infection (UTI).

A 38-year-old nonpregnant woman with 2 acute, uncomplicated UTIs in the past 9 months.

A 57-year-old man with acute bacterial prostatitis.

A 43-year-old man with type 2 diabetes mellitus and recurrent pyelonephritis.

The NP is called to evaluate Jane, a 43-year- old woman, who presents with a diffuse maculopapular rash that began on the trunk but now covers the entire body, including the palms and soles. The rash is not itchy but wart-like sores are present in the mouth and genital area as well as skin folds. Initial evaluation reveals generalized lymphadenopathy and a low-grade fever, and she complains of lethargy and headache. The patient reports that she had a painless genital ulcer that healed on its own about 3 weeks earlier. Which of the following is the most likely diagnosis?

Primary syphilis.

Secondary syphilis.

Genital herpes.

Gonorrhea.

A 27-year-old man presents with a chief concern of an abnormal mass within his left scrotum. He describes it as feeling like a “bag of worms” and is present when he is standing but disappears when he lies down. His past medical history is unremarkable and his BMI is 29 kg/m 2 . He has been in a monogamous relationship for the past 4months. The most likely diagnosis is:

Testicular torsion.

Syphilis.

Varicocele.

Testicular cancer.

An 18-year-old man is being evaluated for a severe exacerbation of asthma. He is currently taking an inhaled corticosteroid, a long- acting beta-agonist, and a short-acting beta-agonist on an as needed basis. The most important component of the initial assessment includes a(n):

Continuous pulse oximetry reading

Peak expiratory flow reading

Chest X-ray

Arterial Blood Gas

A 67-year-old man is being evaluated for shortness of breath. His medical history reveals that he experienced a myocardial infarction about 2 years ago and a history of hypertension, which is well controlled by diet.. Otherwise, his medical history is unremarkable. Which of the following would you expect to find on electrocardiogram (ECG)?

T wave inversion.

Pathologic Q wave.

ST segment elevation.

Tall R wave.

A 74-year-old male with asymptomatic atrial fibrillation underwent electrical cardioversion that successfully restored the heart’s rhythm. Which of the following medications can be considered for the purpose of maintaining the heart’s rhythm?

Sotalol (Betapace ® )

Digoxin (Lanoxin ® )

Dabigatran (Pradaxa ® )

Enalapri

A 14-year-old male is brought in for evaluation after he reportedly collapsed during a tennis match, though he quickly regained consciousness. His medical history is otherwise unremarkable. You suspect hypertrophic cardiomyopathy. Which of the following heart murmur characteristics would support the diagnosis?

Occurs late in systole.

Widely split S?.

Becomes louder when going from a supine to standing position.

Murmur follows mid-systolic click.

You see a 64-year-old man with an area of erythema concentrated on the left side of his neck with clusters of vesicles forming a line. He reported pain in the area a couple of days before the eruption of the lesions. He states that he recently initiated biologic therapy for rheumatoid arthritis. Which of the following is the most likely diagnosis?

Impetigo.

Herpes zoster.

Drug-related adverse reaction.

Viral exanthem.

An NP’s duty of care can be established:

Only in the setting of a healthcare institution (e.g., hospital, clinic, etc.).

When the NP gives professional advice or treatment in any setting.

Only when a fee is charged, either to the patient or third-party payer, for services.

Only when both the NP and patient acknowledge a patient-provider relationship.

In managing a 58-year- old woman who is admitted for deep vein thrombosis, caution should be used with which of the following medications due to a risk of drug-induced thrombocytopenia?

Warfarin (Coumadin®)

Clopidogrel (Plavix®)

Dabigatran (Pradaxa®)

Unfractionated heparin

An 84-year-old female patient is admitted from a local long-term care facility (illnes). The patient is normally awake, alert, and oriented. She resides in the LTCF because she has not fully recovered from a broken hip resulting from a fall 4 months ago; otherwise she is in relatively good health. She can walk short distances with a walker, though she primarily stays in a wheelchair. Today, however, the nursing staff found her to be acutely confused and unable to ambulate without falling. She was transferred to the emergency department for evaluation. Initial laboratory testing must include:

2 sets of blood cultures.

Serum thyroid stimulating hormone (TSH) level.

Urinalysis.

Lumbar puncture.

A 23-year-old college student presents with a 2-day history of severe sore throat and difficulty eating or drinking due to trouble swallowing. A physical examination reveals exudative pharyngitis and minimally tender anterior and posterior cervical lymphadenopathy. The NP suspects infectious mononucleosis and would expect which of the following laboratory findings?

Neutrophilia with reactive forms.

Thrombocytosis.

Lymphocytosis with atypical lymphocytes.

Diminished ALT/AST levels.

“Incident-to” services are defined as those which are “an integral, although incidental, part of the physician’s personal professional services in the course of diagnosis or treatment of an injury or illness”. As long as certain criteria are met, “incident to” billing is an option in all of the following settings except:

Office visits.

Hospital.

Nursing home.

Home visits.

A 78-year- old male is being treated for a hypoglycemic episode. He has a long history of type 2 diabetes mellitus as well as congestive heart failure and COPD. He is currently taking basal insulin with a sulfonylurea. What is the acceptable A1C goal for this patient?

≤ 6.5%

≤ 7.0%

≤ 8.0%

≤ 9.0%

You see a 74- year-old male who is accompanied by his granddaughter who lives with him. He has hypertension, a prior myocardial infarction, long-standing type 2 diabetes, and recently underwent a lower limb amputation secondary to diabetes. He is currently taking an ACE inhibitor, statin, low-dose aspirin, biguanide, and insulin. The granddaughter reports that since the amputation, her grandfather sometimes becomes withdrawn, irritable and moody for no apparent reason, does not want to participate in the typical activities he enjoys, and often does not appear to eat much during the day. She also states that he often complains of being tired but normally wakes up in the early morning hours. The most appropriate action is to evaluate the patient for:

Dementia.

Depression.

Delirium.

Drug interaction.

You see a 58-year-old man who complains of a persistent dry, hacking cough. He reports that he recently started taking a medication to treat high blood pressure. He is most likely taking a(n):

Angiotensin-converting enzyme (ACE) inhibitor

Alpha-adrenergic antagonist

Angiotensin receptor blocker

Beta-adrenergic antagonist

A 77-year-old woman is accompanied by her husband for evaluation. She is currently being treated with metoprolol (Lopressor ® ) for hypertension and digoxin (Lanoxin ® ) for atrial fibrillation. He reports that his wife is becoming increasingly forgetful over the past year, failing to note important family events such as birthdays, and sometimes becomes confused with driving directions to familiar locations. She has no previous psychiatric history. The most likely diagnosis is:

Parkinson’s disease.

Delirium.

Dementia.

Early stage of congestive heart failure.

Mrs. Conner is a 76- year-old woman living in a long-term care facility and has been bedridden with a respiratory infection for the past 4 days. She is brought in for evaluation and you note signs of dehydration as well as a section of epidermal skin loss about 3 cm in diameter on her right hip. The dermal layer appears intact. This would be considered a pressure ulcer of Stage:

Which of the following represents the highest level of scientific evidence when evaluating clinical research?

A randomized controlled trial.

Systematic review/ Meta-analysis of randomized controlled troals.

Observational study.

Cohort study.

A 64-year- old woman with chronic kidney disease presents with a chief complaint of lethargy. His hemogram is as follows:

-Hemoglobin (Hg)=9.9 g/dL (12–14 g/dL

-Hematocrit (Hct)=30% (36%–42%)

-Mean cell volume (MCV)=81 fL (80–96 fL

-Reticulocytes=0.7% (1%–2%)

These findings are most consistent with:

Iron deficiency anemia.

Anemia of chronic disease.

Folate deficiency anemia.

Thalassemia trait.

You see a 68-year-old woman who is being treated for moderate depression. She complains that her medication is causing symptoms of dry mouth and constipation. She is most likely taking which of the following medications?

Venlafaxine (Effexor ® )

Citalopram (Celexa ® )

Fluoxetine (Prozac ® )

Nortriptyline (Pamelor ® )

All of the following persons are eligible for Medicare services except:

A 74-year-old ex-smoker with COPD and high income from assets.

A 69-year-old undocumented resident in the US with atrial fibrillation.

A 62-year-old with a permanent physical disability due to a motor vehicle accident.

A 72-year-old permanent legal resident (non-US citizen) with type 1 diabetes mellitus.

When initiating therapy with spironolactone for a patient who is also on an ACE inhibitor, you advise the patient to return in 5 days to check which of the following laboratory parameters?

Sodium

Calcium

Potassium

Chloride

When considering an end-of-life decision for a terminally ill person with Alzheimer-type dementia who can no longer communicate, all of the following can be used as an advanced directive except:

Testimony from a family member or close friend

A living will.

A “do not resuscitate” order.

A durable power of attorney for healthcare.

Which of the following types of clinical studies represents the lowest level of evidence used to guide medical decisions?

Clinical experience of renowned expert in field.

Non-randomized controlled study.

Observational study.

Case-control study.

Which of the following electrocardiogram (ECG) changes do you expect to find in a person with myocardial ischemia?calcium

Pathologic Q wave

Tall R wave

T wave inversion

ST segment elevation

Which of the following statements is false regarding end-of-life decision-making for a patient that is hopelessly and terminally ill?

A durable power of attorney for healthcare can be used to authorize another person to make healthcare decisions.

A videotaped or audiotaped discussion with the patient can include advanced directives.

Advanced directives are legally binding and recognized in all 50 states.

Living wills and do not resuscitate orders are examples of advanced directives.

The nurse practitioner is evaluating a 19-year- old male suffering from a severe headache. He has a history of headaches that tend to occur in clusters over a few days. He has unsuccessfully tried several therapeutic modalities. A positive response to which of the following interventions supports the diagnosis of cluster headache?

Oxygen therapy.

Beta-adrenergic blockade.

Tricyclic antidepressant.

Dietary reduction of amines.

All of the following are required Medicare terms and conditions for paying NP services except:

The services are within the NP’s scope of practice as defined by state law.

The services performed are those for which a physician would be able to bill Medicare. The services are performed in collaboration with a physician.

Separate charges are billed for NP services and facility charges.

A 28- year- old male with asthma presents with a chief complaint that he has to use his rescue inhaler multiple times each day. An evaluation reveals that he has moderate-to-severe asthma and requires Step 4 treatment. An appropriate regimen would include:

Low-dose inhaled corticosteroid (ICS)

Medium-dose ICS

Medium-dose ICS plus a long-acting beta?-agonist (LABA)

High-dose ICS plus LABA plus omalizumab (Xolair ® )

A 62-year-old woman presents in the emergency department complaining of severe toe pain that originated overnight. She has a history of renal disease and is currently taking a thiazide diuretic. Her BMI is 37 kg/m 2 . In considering a diagnosis of acute gouty arthritis, the nurse practitioner knows that the best diagnostic indicator is:

Serum uric acid.

Joint X-ray.

Erythrocyte sedimentation rate (ESR).

Analysis of joint aspirate for urate crystals.

Which of the following is the most appropriate antibiotic for a 57-year-old man with acute bacterial rhinosinusitis and who has type 2 diabetes mellitus, COPD and a beta-lactam allergy?

Cephalexin (Keflex ® ).

Amoxicillin-clavulanate (Augmentin ® ).

Trimethoprim with or without sulfamethoxazole (Primsol ® , Bactrim ® ).

Levofloxacin (Levaquin ® )

NSG6420 Week 8 Quiz Latest 2017

Question 1. Which of the following best describes the pain associated with osteoarthritis?

Constant, burning, and throbbing with an acute onset

Dull and primarily affected by exposure to cold and barometric pressure

Begins upon arising and after prolonged weight bearing and/or use of the joint

Begins in the morning and limits continued ambulation

Question 2. Your 63-year-old Caucasian woman with polymyalgia rheumatica (PMR) will begin treatment with corticosteroids until the condition has resolved. You look over her records and it has been 2 years since her last physical examination and any laboratory or diagnostic tests as she relocated and had not yet identified a health-care provider. In prioritizing your management plan, your first orders should include:

Recommending she increase her dietary intake of Calcium and Vitamin D

Ordering once a year bisphosphonate and a proton pump inhibitor

Participate in a fall prevention program

Dual-energy X-ray (DEXA) scan and updating immunizations

Question 3. In providing health teaching related to dietary restrictions, the nurse practitioner should advise a patient with gout to avoid which of the following dietary items:

Green leafy vegetables

Beer, sausage, fried seafood

Sugar

Gluten and bread items

Question 4. A 33-year-old female reports general malaise, fatigue, stiffness, and pain in multiple joints of the body. There is no history of systemic disease and no history of trauma. On physical examination, the patient has no swelling or decreased range of motion in any of the joints. She indicates specific points on the neck and shoulders that are particularly affected. She complains of tenderness upon palpation of the neck, both shoulders, hips, and medial regions of the knees. The clinician should include the following disorder in the list of potential diagnoses:

Osteoarthritis

Rheumatoid arthritis

Fibromyalgia

Polymyalgia rheumatica

Question 5. A 46-year-old female complains of fatigue, general malaise, and pain and swelling in her hands that has gradually worsened over the last few weeks. She reports that pain, stiffness, and swelling of her hands are most severe in the morning. On physical examination, you note swelling of the metacarpophalangeal joints bilaterally. These are common signs of:

Osteoarthritis

Rheumatoid arthritis

Scleroderma

Sarcoidosis

Question 6. Which of the following statements about osteoarthritis is true?

It affects primarily weight-bearing joints

It is a systemic inflammatory illness

The metacarpal phalangeal joints are commonly involved

Prolonged morning stiffness is common

Question 7. The most appropriate first-line treatment for an acute gout flare is (assuming no kidney disease or elevated bleeding risk):

Indomethacin 50 mg thrice daily for 2 days; then 25 mg thrice daily for 3 days

Doxycycline 100 mg twice daily for 5 days

Prednisolone 35 mg four times a day for 5 days

Ice therapy

Question 8. A 34-year-old female presents with fever, general malaise, fatigue, arthralgias and rash for the last 2 weeks. On physical examination, you note facial erythema across the nose and cheeks. Serum diagnostic tests reveal positive antinuclear antibodies, anti-DNA antibodies, elevated C-reactive protein and erythrocyte sedimentation rate. The clinician should include the following disorder in the list of potential problems:

Fibromyalgia

Sarcoidosis

Systemic lupus erythematosus

Rheumatoid arthritis

Question 9. Your 66-year-old male patient has recently started treatment for metabolic syndrome and is currently taking the following medications: an ACE inhibitor and beta blocker for treatment of hypertension. He is also taking a statin medication, simvastatin for hyperlipidemia, and a biguanide, metformin, for type 2 diabetes. The patient complains of myalgias of the legs bilaterally and blood work shows elevated serum creatine kinase. Which of the medications can cause such a side effect?

Beta blocker

ACE inhibitor

Statin medication

Metformin

Question 10. A 20-year-old male construction worker is experiencing new onset of knee pain. He complains of right knee pain when kneeling, squatting, or walking up and down stairs. On physical examination, there is swelling and crepitus of the right knee and obvious pain with resisted range of motion of the knee. He is unable to squat due to pain. Which of the following disorders should be considered in the differential diagnosis?

Joint infection

Chondromalacia patella

Prepatellar bursitis

All of the above

Question 11. A 17-year-old male complains of severe right knee pain. He was playing football when he heard a “pop” at the moment of being tackled and his knee “gave away” from under him. On physical examination, there is right knee swelling and decreased range of motion. There is a positive anterior drawer sign. These findings indicate:

Knee ligament injury

Osgood-Schlatter disease

Prepatellar bursitis

Chondromalacia patella

Question 12. A 55-year-old patient complains of lower back pain due to heavy lifting at work yesterday. He reports weakness of the left leg and paresthesias in the left foot. On physical examination, the patient has diminished ability to dorsiflex the left ankle. Which of the following symptoms should prompt the clinician to make immediate referral to a neurosurgeon?

Straight leg raising sign

Lumbar herniated disc on X-ray

Loss of left sided patellar reflex

Urinary incontinence

Question 13. Your patient is a 43-year-old female golfer who complains of arm pain. On physical examination, there is point tenderness on the elbow and pain when the patient is asked to flex the wrist against the clinician’s resistance. These are typical signs of:

Carpal tunnel syndrome

Osteoarthritis of the wrist

Epicondylitis

Cervical osteoarthritis

Question 14. Which of the following describes the pathology of De Quervain’s tenosynovitis?

Irritation of a tendon located on the radial side of the wrist, near the thumb

Impingement of the median nerve, causing pain in the palm and fingers

Fluid-filled cyst that typically develops adjacent to a tendon sheath in the wrist

Ulnar nerve compression at the olecranon process

Question 15. What is the most common cause of hip pain in older adults?

Osteoporosis

Osteoarthritis

Trauma due to fall

Trochanteric bursitis

Question 16. A 43-year-old female was in a bicycling accident and complains of severe pain of the right foot. The patient limps into the emergency room. On physical examination, there is no point tenderness over the medial or lateral ankle malleolus. There is no foot tenderness except at the base of the fifth metatarsal bone. According to the Ottawa foot rules, should an X-ray of the feet be ordered?

Yes, there is tenderness over the fifth metatarsal

No, there is not tenderness over the navicular bone

Yes, the patient cannot bear weight on the foot

A and C

Question 17. 38-year-old Asian male, Mr. Chen, with past medical history significant for prehypertension who has recently taken up softball presents with three to five weeks of shoulder pain when throwing overhead. Ice minimally alleviates pain. Medications: Naproxen minimally alleviates shoulder pain. Allergies: Penicillin-associated rash. Family history: Brother has rheumatoid arthritis.

Which of the following musculoskeletal causes of shoulder pain would merit urgent diagnosis and management?

Adhesive capsulitis

Septic subacromial bursitis

Impingement of the supraspinatus tendon

Calcific tendinopathy

Question 18. If Mr. Chen had restricted passive as well as active ROM of the shoulder, what problems involving the shoulder might you consider?

Adhesive capsulitis

Rotator cuff tear

Tendinopathy of the long head of the biceps

Rotator cuff impingment

Question 19. What is the essential dynamic stabilizer of the shoulder joint?

Labrum

Rotator muscle group

Glenohumeral ligaments

Teres major muscle

Question 20. Given Mr. Chen’s repetitive overhead activities, some injury to his rotator cuff muscle group is most likely. Of the following exam findings, which one would not support the diagnosis of rotator cuff tendinopathy?

Positive Apley’s Scratch test

Weakness and pain with empty can testing

Limited active ROM

Inability to raise arm above his head

NSG6420 Week 7 Quiz

NSG6420 Week 7 Quiz Latest 2017

Question 1.When a patient presents with a skin-related complaint, it is important to first:

Fully inspect all skin lesions before asking the patient how the lesion in question developed

Obtain a full history about the development of the skin lesion prior to the physical examination

Complete a full physical examination of the body prior to inspecting the skin lesion

Examine the skin lesion without hearing a health history in order to not prejudice the diagnosis

Question 2. Which of the following dermatological conditions results from reactivation of the dormant varicella virus?

Tinea versicolor

Seborrheic keratosis

Verruca

Herpes zoster

Question 3. An older adult male presents with pain in his right chest wall for the past 48 hours. Upon examination, the nurse practitioner notices a vesicular eruption along the dermatome and identifies this as herpes zoster. The NP informs the gentleman that:

All symptoms should disappear within three days

Oral medications can dramatically reduce the duration and intensity of his symptoms

He has chickenpox and can be contagious to his grandchildren

He has a sexually transmitted disease

Question 4. A 70-year-old white male comes to the clinic with a slightly raised, scaly, pink, and irregular lesion on his scalp. He is a farmer and works outside all day. You suspect actinic keratosis, but cannot rule out other lesions. What recommendation would you give him?

Ignore the lesion, as it is associated with aging.

Instruct him to use a nonprescription hydrocortisone cream to dry up the lesion.

Perform a biopsy or refer to a dermatologist.

Advise him to use a dandruff shampoo and return in one month if the lesion has not gone away.

Question 5. The appearance of a 2-10 cm. herald patch with subsequent development of parallel oval lesions on the trunk in a christmas tree distribution involving the upper arms and upper legs are common in:

Pityriasis Rosea

Shingles

Psoriasis

Lymes Disease

Question 6. Mr. Fitzgerald is a 68-year-old previously healthy man with a history of significant sun exposure who presents with a progressively enlarging 18 x 16 mm erythematous pruritic oval patch on his left forearm that has been present for three to four years. Your differential would include all of the following EXCEPT:

Fungal skin infection

Eczema

Seborrheic Keratosis

Squamous cell carcinoma of the skin

Question 7. What kind of lesions are caused by the herpes simplex virus?

Scales

Vesicles

Plaques

Urticaria

Question 8. Among the following conditions, which needs to be treated with systemic antifungal agents?

Tinea pedis/tinea magnum

Tinea corporis/tinea cruris

Tinea capitis/Tinea unguium (onychomycosis)

Tinea pedis /tinea faciale

Question 9. Which lesions are typically located along the distribution of dermatome?

Scabies

Herpes zoster

Tinea

Dyshidrosis

Question 10. A smooth round nodule with a pearly gray border and central induration best describes which skin lesion?

Seborrheic keratosis

Malignant melanoma

Herpes zoster

Basal cell carcinoma

Question 11. Cellulitis is a deep skin infection involving the dermis and subcutaneous tissues. The nurse practitioner suspects cellulitis in a 70-year-old Asian diabetic male presenting with reddened edematous skin around his nares. Which statement below will the nurse practitioner use in her decision-making process for the differential diagnosis pertaining to reddened edematous skin?

Cellulitis is two times more common in women

Facial cellulitis is more common in people >55

There is low incidence of cellulitis in patients with diabetes

Cellulitis is only a disease of the lower extremities of patients with known arterial insufficiency

Question 12. Folliculitis is most commonly due to:

Contact dermatitis

Varicella zoster

Dermatophytes

Staphylococcal infection

Question 13. The anti-inflammatory properties of topical corticosteroids result in part from their ability to induce vasoconstriction to the small blood vessels in the upper dermis. Of the following, which is the most potent topical corticosteroid?

Hydrocortisone 2.5%

Triamcinolone acetonide 0.1%

Betamethasone dipropionate 0.05%

Alclometasone dipropionate 0.05%

Question 14. Which of the following descriptions accurately documents cellulitis?

Cool, erythematous, shiny hairless extremity with decreased pulse

Scattered, erythematous ring-like lesions with clear centers

Clearly demarcated, raised erythematous area of face

Diffusely inflamed skin that is warm and tender to palpation

Question 15. Asymmetrical bi-color lesion with irregular border measuring 8 mm is found on the right lower arm of an adult patient. This assessment finding is consistent with:

Melanoma

Basal cell carcinoma

Leukoplakia

Senile lentigines

Question 16. Which of the following descriptions best illustrates assessment findings consistent with tinea capitis?

Circular erythematous patches with papular, scaly annular borders and clear discharge

Inflamed scaly dry patches with broken hairs

Web lesions with erythema and scaling borders

Scaly pruritic erythematous lesions on inguinal creases

Question 17. A patient has a tender, firm, nodular cystic lesion on his scalp that produces cheesy discharge with foul odor. This is most likely a:

Bacterial folliculitis

Basal cell carcinoma

Bullous impetigo

Epidermoid cyst

Question 18. Patient presents with complaint of a “swollen node” under his arm. The area is tender and the node has progressed in size over the past few days. Which of the following should be included in your differential diagnosis?

Hidradenitis suppurativa

Epidermoid cyst

Furuncle

Both A and C

Question 19. A patient suffered a laceration of the shin three days ago, and today presents with a painful, warm, red swollen region around the area. The laceration has a purulent exudate. The clinician should recognize that the infected region is called:

Contact dermatitis

Folliculitis

Hidradenitis suppurativa

Cellulitis

Question 20. A woman complains of malaise and arthralgias. You note a butterfly-shaped, macular, erythematous rash across her cheeks and nose. These conditions are common in:

Psoriasis

Lichen planus

Systemic lupus erythematosus

Erythema nodosum

NSG6420 Week 6 Quiz

NSG6420 Week 6 Quiz Latest 2017

Question 1.Which ethnic group has the highest incidence of prostate cancer?

Asians

Hispanics

African Americans

American Indians

Question 2.Men with an initial PSA level below 2.5 ng/ml can reduce their screening frequency to what intervals?

Every 6 months

Yearly

Every 2 years

Every 2 to 4 years

Question 3. Your 55-year-old male patient presents to your office with complaints of sudden development of severe right-sided, colicky lower abdominal pain. He cannot sit still on the examining table. The patient has previously been in good health. On physical examination, there are no signs of peritoneal inflammation. A urine sample reveals hematuria and crystalluria. Which is the next diagnostic test that should be done immediately?

Ultrasound of the abdomen

Abdominal X-ray

Digital rectal examination

Spiral CT scan

Question 4. The most common complication of an untreated urinary obstruction due to a ureteral calculus is:

Ureteral rupture

Hydronephrosis

Kidney mass

Renal artery stenosis

Question 5. A 43-year-old male patient complains of right-sided abdominal and pain in the back in the right costovertebral angle region, fever, chills, dysuria, and nausea. On physical examination, there is 102 degree fever, tachycardia, and right costovertebral angle tenderness to percussion. The most likely condition is:

Lower urinary tract infection

Nephrolithiasis

Hydronephrosis

Pyelonephritis

Question 6. On a physical examination for employment, a 45-year-old male shows no significant findings and takes no medications. Past medical history and surgery are unremarkable. On urinalysis, hematuria is present. The urinalysis is repeated on another day and still reveals microscopic hematuria. It is important to recognize that painless hematuria can be diagnostic of:

Urinary tract infection

Bladder cancer

Nephrolithiasis

Pyelonephritis

Question 7. On DRE, you note that a 45-year-old patient has a firm, smooth, non-tender but asymmetrically shaped prostate. The patient has no symptoms and has a normal urinalysis. The patient’s PSA is within normal limits for the patient’s age. The clinician should:

Refer the patient for transrectal ultrasound guided prostate biopsy

Obtain an abdominal X-ray of kidneys, ureter, and bladder

Recognize this as a normal finding that requires periodic follow up

Obtain urine culture and sensitivity for prostatitis

Question 8. Age-related changes in the bladder, urethra, and ureters include all of the following in older women except:

Increased estrogen production’s influence on the bladder and ureter

Decline in bladder outlet function

Decline in ureteral resistance pressure

Laxity of the pelvic muscle

Question 9. Mr. Jones is a 68-year-old retired Air Force pilot that has been diagnosed with prostate cancer in the past week. He has never had a surgical procedure in his life and seeks clarification on the availability of treatments for prostate cancer. He asks the nurse practitioner to tell him the side effects of a radical prostatectomy. Which of the following is not a potential side effect of this procedure?

Urinary incontinence

Impotence

Dribbling urine

Selected low back pain

Question 10. Your 77-year-old patient complains of frequent urination, hesitation in getting the stream started, and nocturnal frequency of urination that is bothersome. On DRE, there is an enlarged, firm, non-tender, smooth prostate. The clinician should recognize these as symptoms of:

Urethritis

Benign prostatic hyperplasia

Prostatitis

Prostate cancer

Question 11. Your 24-year-old female patient complains of dysuria as well as frequency and urgency of urination that develops the day after she uses her diaphragm. Urine culture reveals a bacterial count of 100 CFU/mL. These signs and symptoms indicate:

Upper urinary tract infection

Normal bacteriuria

Lower urinary tract infection

Urethritis

Question 12. A 79-year-old man is being evaluated for frequent urinary dribbling without burning. Physical examination reveals a smooth but slightly enlarged prostate gland. His PSA level is 3.3 ng/ml. The patient undergoes formal urodynamic studies, and findings are as follows: a decreased bladder capacity of 370 ml; a few involuntary detrusor contractions at a low bladder volume of 246 mL; an increased postvoid residual urine volume of 225 ml; and a slightly decreased urinary flow rate. Which of the following is not consistent with a normal age-associated change?

PSA level of 3.3 ng/ml

Decreased bladder capacity

Involuntary detrusor contradictions

Increased postvoid residual urine volume

Question 13. Mrs. L. Billings is a 77-year-old Caucasian female who has a history of breast cancer. She has been in remission for 6 years. As her primary care provider, you are seeing her for follow-up of her recent complaint of intermittent abdominal pain of a 3-month duration and some general malaise. Given the brief history above, what will you direct your assessment at during physical examination?

Examination of her thyroid to rule out thyroid nodules that may contribute to her feeling fatigued.

Auscultation of her abdomen for abnormal bowel sounds to rule out peritonitis.

Thorough abdominal and gynecological exam to rule out masses and identify any tenderness.

A rectal examination to rule out colon cancer as a secondary site for breast cancer.

Question 14. A 27-year-old male comes in to the clinic for symptoms of dysuria, urinary frequency, as well as urgency and perineal pain. Transrectal palpation of the prostate reveals a very tender, boggy, swollen prostate. The clinician should recognize these as signs of:

Prostatitis

Prostate cancer

Urethritis

Benign prostatic hyperplasia

Question 15. Which of the following males would be at greatest risk for testicular cancer?

John, a 52-year-old, married African American Attorney who lives in Detroit, MI

Jacob, a 22-year-old, homosexual male, who works as an accountant, resides in Cumming GA, and has a history of cryptorchidism

Andy, a 27-year-old, Caucasian, single male who resides in Waukesha, WI and works as a maintenance mechanic

Ryan, a 34-year-old healthy, married man from Sweden, who works as a Registered Nurse in Boston, MA

Question 16. A 43-year-old male patient complains of right-sided abdominal and pain in the back in the right costovertebral angle region, fever, chills, dysuria, and nausea. On physical examination, there is 102 degree fever, tachycardia, and right costovertebral angle tenderness to percussion. The most likely condition is:

Lower urinary tract infection

Pyelonephritis

Nephrolithiasis

Hydonephrosis

Question 17. Which of the following disorders can cause urinary incontinence?

Cystocele

Overactive bladder

Uterine prolapse

All of the above

Question 18. Your 18 year old sexually active patient presents with sudden right sided groin pain that is sharp and constant. Inspection of his genitals reveals a swollen and erythematous right scrotum. His right testicle is exquisitely tender, swollen and has no palpable masses. Elevation of the testis results in no reduction in pain. The left scrotum and the testicle are normal. Epididymis and other scrotal contents were within normal limits. The scrotum does not transilluminate. Cremasteric reflex is present on the left side but absent on the right. There is no penile discharge, inguinal lymphadenopathy, or hernias.

Based on the history and physical exam your immediate concern is for:

Torsion

Infection

Cancer

Rupture

Question 19. The Prehn sign is utilized to distinguish epididymitis from testicular torsion. Epididymitis is considered when the Prehn sign is positive. When is the Prehn sign determined to be positive?

Pain is relieved by lifting of the testicle.

Tenderness is limited to the upper pole of the testis.

Lightly stroking or pinching the superior medial aspect of the thigh causes testicular retraction.

A small bluish discoloration is visible through the skin in the upper pole.

Question 20. Which of the following exam findings makes the diagnosis of testicular tumor more likely?

A scrotal mass that is accompanied by exquisite tenderness.

Testicular swelling is mostly fluid and transilluminates easily

A testicular mass that is non-tender to palpation

Dilated and tortuous veins in the pampiniform plexus

NSG6420 Week 5 Midterm Quiz

NSG6420 Week 5 Midterm Quiz Latest 2017

Question 1: Which of the following symptoms is common with acute otitis media?

Bulging tympanic membrane

Bright light reflex of tympanic membrane

Increased tympanic membrane mobility

All of the above

Question 2. The cytochrome p system involves enzymes that are generally:

Inhibited by drugs

Induced by drugs

Inhibited or induced by drugs

Associated with decreased liver perfusion

Question 3. In AR disorders, carriers have:

Two mutated genes; one from each parent that cause disease

A mutation on a sex chromosome that causes a disease

A single gene mutation that causes the disease

One copy of a gene mutation but not the disease

Question 4. A 56-year-old male complains of anorexia, changes in bowel habits, extreme fatigue, and unintentional weight loss. At times he is constipated and other times he has episodes of diarrhea. His physical examination is unremarkable. It is important for the clinician to recognize the importance of:

CBC with differential

Stool culture and sensitivity

Abdominal X-ray

Colonoscopy

Question 5. Which of the following findings should trigger an urgent referral to a cardiologist or neurologist?

History of bright flash of light followed by significantly blurred vision

History of transient and painless monocular loss of vision

History of monocular severe eye pain, blurred vision, and ciliary flush

All of the above

Question 6. In examination of the nose, the clinician observes gray, pale mucous membranes with clear, serous discharge. This is most likely indicative of:

Bacterial sinusitis

Allergic rhinitis

Drug abuse

Skull fracture

Question 7. An 82-year-old female presents to the emergency department with epigastric pain and weakness. She admits to having dark, tarry stools for the last few days. She reports a long history of pain due to osteoarthritis. She self-medicates daily with ibuprofen, naprosyn, and aspirin for joint pain. On physical examination, she has orthostatic hypotension and pallor. Fecal occult blood test is positive. A likely etiology of the patient’s problem is:

Mallory-Weiss tear

Esophageal varices

Gastric ulcer

Question 1. Susan P., a 60-year-old woman with a 30 pack year history, presents to your primary care practice for evaluation of a persistent, daily cough with increased sputum production, worse in the morning, occurring over the past three months. She tells you, “I have the same thing, year after year.” Which of the following choices would you consider strongly in your critical thinking process?

Seasonal allergies

Acute bronchitis

Bronchial asthma

Chronic bronchitis

Question 2. A patient presents complaining of a 5 day history of upper respiratory symptoms including nasal congestion and drainage. On the day the symptoms began he had a low-grade fever that has now resolved. His nasal congestion persisted and he has had yellow nasal drainage for three days associated with mild headaches. On exam he is afebrile and in no distress. Examination of his tympanic membranes and throat are normal. Examination of his nose is unremarkable although a slight yellowish-clear drainage is noted. There is tenderness when you lightly percuss his maxillary sinus. What would your treatment plan for this patient be?

Observation and reassurance

Treatment with an antibiotic such as amoxicillin

Treatment with an antibiotic such as a fluoroquinoline or amoxicillin-clavulanate

Combination of a low dose inhaled corticosteroid and a long acting beta2 agonist inhaler.

Question 3.Emphysematous changes in the lungs produce the following characteristic in COPD patients?

Asymmetric chest expansion

Increased lateral diameter

Increased anterior-posterior diameter

Pectus excavatum

Question 4. When palpating the posterior chest, the clinician notes increased tactile fremitus over the left lower lobe. This can be indicative of pneumonia. Areas of increased fremitus should raise the suspicion of conditions resulting in increased solidity or consolidation in the underlying lung tissue, such as in pneumonia, tumor, or pulmonary fibrosis. In the instance of an extensive bronchial obstruction:

No palpable vibration is felt

Decreased fremitus is felt

Increased fremitus is felt

Vibration is referred to the non-obstructed lobe

Question 5. Your patient presents with complaint of persistent cough. After you have finished obtaining the History of Present Illness, you realize that the patient may be having episodes of wheezing, in addition to his cough. The most common cause of cough with wheezing is asthma. What of the following physical exam findings will support your tentative diagnosis of asthma?

Clear, watery nasal drainage with nasal turbinate swelling

Pharyngeal exudate and lymphadenopathy

Clubbing, cyanosis and edema.

Diminished lung sounds with rales in both bases

Question 6.Which of the following imaging studies should be considered if a pulmonary malignancy is suspected?

Computed tomography (CT) scan

Chest X-ray with PA, lateral, and lordotic views

Ultrasound

Positron emission tomography (PET) scan

Question 7. A 26-year-old, non-smoker, male presented to your clinic with SOB with exertion. This could be due to:

Exercise-induced cough

Bronchiectasis

Alpha-1 deficiency

Pericarditis

Question 8. Upon assessment of respiratory excursion, the clinician notes asymmetric expansion of the chest. One side expands greater than the other. This could be due to:

Pneumothorax

Pleural effusion

Pneumonia

Pulmonary embolism

Question 9. A 72-year-old woman and her husband are on a cross-country driving vacation. After a long day of driving, they stop for dinner.Midway through the meal, the woman becomes very short of breath, with chest pain and a feeling of panic. Which of the following problems is most likely?

Pulmonary edema

Heart failure

Pulmonary embolism

Pneumonia

Question 10. A cough is described as chronic if it has been present for:

2 weeks or more

8 weeks or more

3 months or more

6 months or more

Question 11. Testing is necessary for the diagnosis of asthma because history and physical are not reliable means of excluding other diagnoses or determining the extent of lung impairment. What is the study that is used to evaluate upper respiratory symptoms with new onset wheeze?

Chest X-ray

Methacholine challenge test

Spirometry, both with and without bronchodilation

Ventilation/perfusion scan

Question 12. In classifying the severity of your patient presenting with an acute exacerbation of asthma. You determine that they have moderate persistent symptoms based on the report of symptoms and spirometry readings of the last 3 weeks. The findings that support moderate persistent symptoms include:

Symptoms daily with nighttime awakening more than 1 time a week. FEV1 >60%, but predicted <80%. FEV1/FVC reduced 5%

Symptoms less than twice a week and less than twice a week nighttime awakening. FEV1 >80% predicted. FEV1/FVC normal

Symptoms more than 2 days a week, but not daily. Nighttime awakenings 3-4 times a month. FEV1 >80% predicted. FEV1/FVC normal

Symptoms throughout the day with nighttime awakenings every night. FEV1< 60% predicted. FEV1/FVC reduced >5%

Question 13. The following criterion is considered a positive finding when determining whether a patient with asthma can be safely monitored and treated at home:

Age over 40

Fever greater than 101

Tachypnea greater than 30 breaths/minute

Productive cough

Question 14. Medications are chosen based on the severity of asthma. Considering the patient that is diagnosed with moderate persistent asthma, the preferred option for maintenance medication is:

High-dose inhaled corticosteroid and leukotriene receptor antagonist

Oral corticosteroid—high and low dose as appropriate

Short acting beta2 agonist inhaler and theophylline

Low dose inhaled corticosteroid and long acting beta2 agonist inhaler

Question 15. A 75-year-old patient with community-acquired pneumonia presents with chills, productive cough, temperature of 102.1, pulse 100, respiration 18, BP 90/52, WBC 12,000, and blood urea nitrogen (BUN) 22 mg/dl. He has a history of mild dementia and his mental status is unchanged from his last visit. These findings indicate that the patient:

Can be treated as an outpatient

Requires hospitalization for treatment

Requires a high dose of parenteral antibiotic

Can be treated with oral antibiotics

Question 16. Which of the following is considered a “red flag” when diagnosing a patient with pneumonia?

Fever of 102

Infiltrates on chest X-ray

Pleural effusion on chest X-ray

Elevated white blood cell count

Question 17. A 23-year-old patient who has had bronchiectasis since childhood is likely to have which of the following:

Barrel-shaped chest

Clubbing

Pectus excavatum

Prolonged capillary refill

Question 18. Your patient has just returned from a 6-month missionary trip to Southeast Asia. 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:

Legionnaires’ disease

Malaria

Tuberculosis

Pneumonia

Question 19. A 76-year-old patient with a 200-pack year smoking history presents with complaints of chronic cough, dyspnea, fatigue, hemoptysis, and weight loss over the past 2 months. The physical exam reveals decreased breath sounds and dullness to percussion over the left lower lung field. The chest X-ray demonstrates shift of the mediastinum and trachea to the left. These are classic signs of:

Lung cancer

Tuberculosis

Pneumonia

COPD

Question 20. A 24-year-old patient presents to the emergency department after sustaining multiple traumatic injuries after a motorcycle accident.Upon examination, you note tachypnea, use of intercostal muscles to breathe, asymmetric chest expansion, and no breath sounds over the left lower lobe. It is most important to suspect:

Pulmonary embolism

Pleural effusion

Pneumothorax

Fracture of ribs

NSG6420 Week 2

NSG6420 Week 2 Quiz latest 2017

Question 1. An 86-year-old patient who wears a hearing aid complains of poor hearing in the affected ear. In addition to possible hearing aid malfunction, this condition is often due to:

Acoustic neuroma

Cerumen impaction

Otitis media

Ménière’s disease

Question 2. In examination of the nose, the clinician observes gray, pale mucous membranes with clear, serous discharge. This is most likely indicative of:

Bacterial sinusitis

Allergic rhinitis

Drug abuse

Skull fractur

Question 3. A 45 year old patient presents with ‘sore throat’ and fever for one week. After a quick strep screen you determine the patient has Strep throat. You know that streptococcal pharyngitis should be treated with antibiotics to prevent complications and to shorten the course of disease. Which of the following antibiotics should be considered when a patient is allergic to Penicillin?

Amoxicillin

EES (erythromycin)

Bicillin L-A

Dicloxacillin

Question 4. Presbycusis is the hearing impairment that is associated with:

Physiologic aging

Ménière’s disease

Cerumen impaction

Herpes zoster

Question 5. Epistaxis can be a symptom of:

Over-anticoagulation

Hematologic malignancy

Cocaine abuse

All of the above

Question 6. Your patient has been using chewing tobacco for 10 years. On physical examination, you observe a white ulceration surrounded by erythematous base on the side of his tongue. The clinician should recognize that very often this is:

Malignant melanoma

Squamous cell carcinoma

Aphthous ulceration

Behcet’s syndrome

Question 7. A 26 year old patient presents with cough and general malaise for 3 days. They note that their eyes have been watering clear fluid and a ‘runny nose’ since yesterday. They note they ‘feel miserable’ and demand something to make them feel better. What would be the best first plan of treatment?

Saline nasal spray for congestion and acetaminophen as needed for pain.

Z-pack (azithromycin) for infection and Cromolyn nasal for congestion

Hydrococone/acetaminophen as needed for pain and Guaifensin for congestion

Cephalexin for infection and Cromolyn ophthalmic for congestion

Question 8. Which of the following findings should trigger an urgent referral to a cardiologist or neurologist?

History of bright flash of light followed by significantly blurred vision

History of transient and painless monocular loss of vision

History of monocular severe eye pain, blurred vision, and ciliary flush

All of the above

Question 9. Dizziness that is described as “lightheaded” or, “like I’m going to faint,” is usually caused by inadequate cerebral perfusion and is classified as?

Presyncope

Disequilibrium

Vertigo

Syncope

Question 10. It is important to not dilate the eye if ____ is suspected.

Cataract

Macular degeneration

Acute closed-angle glaucoma

Chronic open-angle glaucoma

Question 11. Mr. GC presents to the clinic with nausea and vomiting for 2 days, prior to that time he reports occasional ‘dizziness’ that got better with change in position. He denies a recent history of URI or any history of headaches or migraines. What would the most likely diagnosis be?

Vestibular neruitis

Benign paroxysmal positional vertigo

Vestibular migraine

Benign hypertensive central vertigo

Question 12. Which of the following patients with vertigo would require neurologic imaging?

A 68-year-old woman with a history of hypertension and sudden acute onset constant vertigo. She has right nystagmus that changes direction with gaze and that does not disappear when she focuses.

A 45-year-old man with recurrent episodes of brief intense vertigo every time he turns his head rapidly. He has no other neurologic signs or symptoms. He has a positive Dix-Hallpike maneuver.

A 66-year-old man with recurrent episodes of vertigo associated with tinnitus and hearing loss. His head thrust test is positive.

A 28-year-old otherwise well woman with new onset constant vertigo with no other neurologic symptoms. On physical exam, she has unidirectional nystagmus that disappears when her gaze is fixed.

Question 13.A patient presents with eye redness, scant discharge, and a gritty sensation. Your examination reveals the palpable preauricular nodes, which are most likely with:

Bacterial conjunctivitis

Allergic conjunctivitis

Chemical conjunctivitis

Viral conjunctivitis

Question 14. In assessing the eyes, which of the following is considered a “red flag” finding when associated with eye redness?

History of prior red-eye episodes

Grossly visible corneal defect

Exophthalmos

Photophobia

Question 15. A 64-year-old male presents with erythema of the sclera, tearing, and bilateral pruritus of the eyes. The symptoms occur intermittently throughout the year and he has associated clear nasal discharge. Which of the following is most likely because of the inflammation?

Bacterium

Allergen

Virus

Fungi

Question 16. Patients that have atopic disorders are mediated by the production of Immunoglobulin E (IgE) will have histamine stimulated as an immediate phase response. This release of histamine results in which of the following?

Sinus pain, increased vascular permeability, and bronchodilation

Bronchospasm, vascular permeability, and vasodilatation

Contraction of smooth muscle, decreased vascular permeability, and vasoconstriction

Vasodilatation, bronchodilation, and increased vascular permeability

Question 17. You have a patient complaining of vertigo and want to know what could be the cause. Knowing there are many causes for vertigo, you question the length of time the sensation lasts. She tells you several hours to days and is accompanied by tinnitus and hearing loss. You suspect which of the following conditions?

Ménière’s disease

Benign paroxysmal positional vertigo

Transient ischemic attack (TIA)

Migraine

Question 18. In examining the mouth of an older adult with a history of smoking, the nurse practitioner finds a suspicious oral lesion. The patient has been referred for a biopsy to be sent for pathology. Which is the most common oral precancerous lesion?

Fictional keratosis

Keratoacanthoma

Lichen planus

Leukoplakia

Question 19. Rheumatic heart disease is a complication that can arise from which type of infection?

Epstein-Barr virus

Diphtheria

Group A beta hemolytic streptococcus

Streptococcus pneumoniae

Question 20. A patient complains of fever, fatigue, and pharyngitis. On physical examination there is pronounced cervical lymphadenopathy.Which of the following diagnostic tests should be considered?

Mono spot

Strep test

Throat culture

All of the above

NSG6420 Week 1

NSG6420 Week 1 Quiz latest 2017

Question 1. The major impact of the physiological changes that occur with aging is:

Reduced physiological reserve

Reduced homeostatic mechanisms

Impaired immunological response

All of the above

Question 2. Men have faster and more efficient biotransformation of drugs and this is thought to be due to:

Less obesity rates than women

Prostate enlargement

Testosterone

Less estrogen than women

Question 3. The cytochrome p system involves enzymes that are generally:

Inhibited by drugs

Induced by drugs

Inhibited or induced by drugs

Associated with decreased liver perfusion

Question 4. Functional abilities are best assessed by:

Self-report of function

Observed assessment of function

A comprehensive head-to-toe examination

Family report of function

Question 5. Iron Deficiency Anemia (IDA) is classified as a microcytic, hypochromic anemia. This classification refers to which of the following laboratory data?

Hemoglobin and Hematocrit

Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH)

Serum ferritin and serum iron

Total iron binding capacity and transferrin saturation

Question 6. When interpreting laboratory data, you would expect to see the following in a patient with Anemia of Chronic Disease (ACD):

Hemoglobin <12 g/dl, MCV decreased, MCH decreased

Hemoglobin >12 g/dl, MCV increased, MCH increased

Hemoglobin <12 g/dl, MCV normal, MCH normal

Hemoglobin >12 g/dl, MCV decreased, MCH increased

Question 7. The pathophysiological hallmark of ACD is:

Depleted iron stores

Impaired ability to use iron stores

Chronic unable bleeding

Reduced intestinal absorption of iron

Question 8. The main focus of treatment of patients with ACD is:

Replenishing iron stores

Providing for adequate nutrition high in iron

Management of the underlying disorder

Administration of monthly vitamin B12 injections

Question 9. In addition to the complete blood count (CBC) with differential, which of the following laboratory tests is considered to be most useful in diagnosing ACD and IDA?

Serum iron

Total iron binding capacity

Transferrin saturation

Serum ferritin

Question 10. Symptoms in the initial human immunodeficiency virus (HIV) infection include all of the following except:

Sore throat

Fever

Weight loss

Headache

Question 11. Essential parts of a health history include all of the following except:

Chief complaint

History of the present illness

Current vital signs

All of the above are essential history components

Question 12.Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or patients?

Clinical practice guideline

Clinical decision rule

Clinical algorithm

Clinical recommendation

Question 13. The first step in the genomic assessment of a patient is obtaining information regarding:

Family history

Environmental exposures

Lifestyle and behaviors

Current medications

Question 14.In autosomal recessive (AR) disorders, individuals need:

Only one mutated gene on the sex chromosomes to acquire the disease

Only one mutated gene to acquire the disease

Two mutated genes to acquire the disease

Two mutated genes to become carriers

Question 15. In AR disorders, carriers have:

Two mutated genes; two from one parent that cause disease

A mutation on a sex chromosome that causes a disease

A single gene mutation that causes the disease

One copy of a gene mutation but not the disease

Question 16. A woman with an X-linked dominant disorder will:

Not be affected by the disorder herself

Transmit the disorder to 50% of her offspring (male or female)

Not transmit the disorder to her daughters

Transmit the disorder to only her daughters

Question 17. According to the Genetic Information Nondiscrimination Act (GINA):

Nurse Practitioners (NPs) should keep all genetic information of patients confidential

NPs must obtain informed consent prior to genetic testing of all patients

Employers cannot inquire about an employee’s genetic information

All of the above

Question 18. Which of the following would be considered a “red flag” that requires more investigation in a patient assessment?

Colon cancer in family member at age 70

Breast cancer in family member at age 75

Myocardial infarction in family member at age 35

All of the above

Question 19. Your 2-year-old patient shows facial features, such as epicanthal folds, up-slanted palpebral fissures, single transverse palmar crease, and a low nasal bridge. These are referred to as:

Variable expressivity related to inherited disease

Dysmorphic features related to genetic disease

De novo mutations of genetic disease

Different penetrant signs of genetic disease

Question 20.In order to provide a comprehensive genetic history of a patient, the NP should:

Ask patients to complete a family history worksheet

Seek out pathology reports related to the patient’s disorder

Interview family members regarding genetic disorders

All of the above

NR 511 Week 4

NR 511 Week 4 Midterm Exam Version 5

Question 1: How often should the clinician examine the feet of a person with diabetes?

Once a year
b. Every 6 months
c. Every 3 months
d. Every visit

Question 2: Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

Cholinesterase inhibitors
b. Anxiolytics
c. Antidepressants
d. Atypical antipsychotics

Question 3: Most adult poisonings are:

intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.

Question 4: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

“It is probably just a cyst, because that is the most common breast mass.”
b. “We will order a mammogram and ultrasound to help establish a diagnosis.”
c. “We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”
d. “Because your lump is painful, it is most likely not cancer.”

Question 5: Which of the following is a specific test for multiple sclerosis (MS)?

Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.

Question 6: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

Suggest she use a heating pad to improve circulation
b. Refer to a podiatrist for a foot care treatment plan
c. Send her for acupuncture treatments
d. All of the above

Question 7: Which characteristic of delirium helps to distinguish delirium from dementia?

Abrupt onset
b. Impaired attention
c. Affective changes
d. Delusions

Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?

Decrease in level of consciousness (LOC)
b. Headache
c. Nausea
d. Widening pulse pressure

Question 9: Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

Posterior dislocations are more common than anterior dislocations.
b. There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.
c. Recurrent dislocations are uncommon and would require a greater force to result in injury.
d. Surgery is most commonly the treatment of choice.

Question 10: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain

Question 11: The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

Overweight
Mild obesity
Moderate obesity
d. Morbid obesity

Question 12: The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods?

Rice
b. Carrots
c. Spinach
d. Potatoes

Question 13: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?

Human papillomavirus (HPV)
b. Endometrial hyperplasia
c. Vagismus
d. Polycystic ovarian syndrome

Question 14: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?

Benzodiazepines
b. Antipsychotics
c. Anticonvulsants
d. Antidepressants

Question 15: What is the treatment of choice for a patient diagnosed with testicular cancer?

Radical orchidectomy
Lumpectomy
Radiation implants
d. All of the above

Question 16: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?

Gonorrhea
b. Human papillomavirus (HPV)
c. Chlamydia
d. Trichomonas

Question 17: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?

Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral

Question 18: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

Spores
Leukocytes
Pseudohyphae
d. Epithelial cells

Question 19: Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point?

10%
20%
30%
d. 50%

Question 20: John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

Valgus stress test
b. McMurray circumduction test
c. Lachman test
d. Varus stress test

Question 21: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

An enlarged rubbery gland
A hard irregular gland
A tender gland
d. A boggy gland

Question 22: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?

Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks

Question 23: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:

1 month.
b. 3 months.
c. 6 months.
d. 12 months.

Question 24: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?

Sinus bradycardia
Atrial fibrillation
Supraventricular tachycardia
d. U waves

Question 25: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

Superficial burns
b. Superficial partial-thickness burns
c. Deep partial-thickness burns
d. Full-thickness burns

Question 26: Immunizations are an example of which type of prevention?

Primary
b. Secondary
c. Tertiary

Question 27: If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?

Permanent tissue damage may occur, resulting in necrosis to that body part.
b. The area will be super sensitive.
c. The area is prone to a repeat frostbite.
d. The area is as susceptible as any other area.

Question 28: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?

Pregnancy test
Pelvic ultrasound
Endometrial biopsy
d. Platelet count

Question 29: Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines?

Propranolol
Ergotamine
b. Timolol
Topiramate

Question 30: A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment?

Tricyclic antidepressants
b. Capsacin cream
c. Vitamin B12 injections
d. Insulin

NR 511 Week 4 Midterm Exam Version 3

Question 1: In an outpatient setting, what is the most common reason for a malpractice suit?

Failure to treat a condition
b. Failure to diagnose correctly
c. Ordering the wrong medication
d. Failure to manage care

Question 2: How often should the clinician examine the feet of a person with diabetes?

Once a year
b. Every 6 months
c. Every 3 months
d. Every visit

Question 3: Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

Cholinesterase inhibitors
b. Anxiolytics
c. Antidepressants
d. Atypical antipsychotics

Question 4: Which of the following medications is the treatment of choice for trichomonas?

Metranidazole
Ceftriaxone
Diflucan
d. Doxycycline

Question 5: Most adult poisonings are:

intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.

Question 6: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

“It is probably just a cyst, because that is the most common breast mass.”
b. “We will order a mammogram and ultrasound to help establish a diagnosis.”
c. “We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”
d. “Because your lump is painful, it is most likely not cancer.”

Question 7: Which of the following is a specific test for multiple sclerosis (MS)?

Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.

Question 8: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

Suggest she use a heating pad to improve circulation
b. Refer to a podiatrist for a foot care treatment plan
c. Send her for acupuncture treatments
d. All of the above

Question 9: Which characteristic of delirium helps to distinguish delirium from dementia?

Abrupt onset
b. Impaired attention
c. Affective changes
d. Delusions

Question 10: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?

Decrease in level of consciousness (LOC)
b. Headache
c. Nausea
d. Widening pulse pressure

Question 11: Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

Posterior dislocations are more common than anterior dislocations.
b. There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.
c. Recurrent dislocations are uncommon and would require a greater force to result in injury.
d. Surgery is most commonly the treatment of choice.

Question 12: In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the “C” of LACE represents?

Commitment
Consensus
Certification
d. Collaboration

Question 13: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Decreased C-reactive protein
b. Hyperalbuminemia
c. Morning stiffness
d. Weight gain

Question 14: Which of the following statements is true concerning the musculoskeletal exam?

The uninvolved side should be examined initially and compared to the involved side.
b. The part of the body that is causing the patient pain should be examined first.
c. The patient should not be asked to perform active range-of-motion (ROM) exercises whenever possible to avoid causing pain.
d. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

Question 15: The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

Overweight
Mild obesity
Moderate obesity
d. Morbid obesity

Question 16: S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician suspect in the initial test results for this patient?

Elevated uric acid level
b. Elevated blood urea nitrogen (BUN)
c. Decreased urine pH
d. Decreased C-reactive protein (CRP)

Question 17: Which of the following statements is true regarding the treatment of carpal tunnel syndrome?

The goal of treatment is to prevent flexion and extension movements of the wrist.
b. Splints are used in carpal tunnel syndrome because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position.
c. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.
d. All of the above

Question 18: The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods?

Rice
b. Carrots
c. Spinach
d. Potatoes

Question 19: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?

Human papillomavirus (HPV)
b. Endometrial hyperplasia
c. Vagismus
d. Polycystic ovarian syndrome

Question 20: Which patient is more likely to have a cluster headache?

A female in her reproductive years
b. A 40-year-old African American male
c. A 55-year-old female who drinks 10 cups of coffee daily
d. A 45-year-old male awakened at night

Question 21: A sunscreen with a sun-protection factor (SPF) of at least what number will block most harmful ultraviolet (UV) radiation?

4
8 d
10
d. 15

Question 22: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?

Benzodiazepines
b. Antipsychotics
c. Anticonvulsants
d. Antidepressants

Question 23: What is the treatment of choice for a patient diagnosed with testicular cancer?

Radical orchidectomy
Lumpectomy
Radiation implants
d. All of the above

Question 24: Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him:

“L-dopa is neuroprotective.”
b. “The primary goal of therapy is to replace depleted stores of dopamine.”
c. “This is the only drug that can provide symptomatic benefit.”
d. “This is the initial monotherapy drug.”

Question 25: A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?

The scrotum will be dark.
b. The scrotum will appear light pink or yellow.
c. The scrotum will appear milky white.
d. The internal structures will be clearly visible.

Question 26: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?
a. Gonorrhea
b. Human papillomavirus (HPV)
c. Chlamydia
d. Trichomonas

Question 27: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?
a. Conjugated estrogen 0.625 mg/day oral
b. Estradiol 7.5 mcg/24 hr vaginal ring
c. Medroxyprogesterone 10 mg/day oral
d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral

Question 28: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

Spores
Leukocytes
Pseudohyphae
Epithelial cells

Question 29: A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnoses?
a. Testicular cancer

Inguinal hernia
Varicocele
d. All of the above

Question 30: The clinician should Question: the patient with suspected gout about use of which of these medications that may be a risk factor?

Low-dose aspirin
Thiazide diuretics
Ethambutol
d. All of the above

Question 31: What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?
a. A stabbing type of pain on one small area of the body
b. A vesicular skin lesion on one side of the body
c. A pain that is worse upon awakening
d. A lesion on the exterior ear canal

Question 32: Which ethical principle reflects respect for all persons and their self-determination?
a. Autonomy

Beneficence
Justice
d. Veracity

Question 33: Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point?

10%
20%
30%
d. 50%

Question 34: John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

Valgus stress test
b. McMurray circumduction test
c. Lachman test
d. Varus stress test

Question 35: Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease?
a. Elevated thyroid-stimulating hormone (TSH)
b. Elevated T4
c. Elevated TRH
d. All of the above

Question 36: Which drug commonly prescribed for burns is active against a wide spectrum of microbial pathogens and is the most frequently used agent for partial- and full-thickness thermal injuries?
a. Clotrimazole cream (Lotrimen)
b. Mafenide acetate (Sulfamylon)
c. Silver nitrate
d. Silver sulfadiazine (Silvadene)

Question 37: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

An enlarged rubbery gland
A hard irregular gland
A tender gland
d. A boggy gland

Question 38: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?
a. Gastrocnemius weakness
b. A reduced or absent ankle reflex
c. Numbness in the lateral foot
d. Paresthesia of the perineum and buttocks

Question 39: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:

1 month.
b. 3 months.
c. 6 months.
d. 12 months.

Question 40: The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs to manage his pain?

You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.
b. You should start with the lowest dose that is effective in managing your pain in order to avoid developing tolerance to the medication.
c. You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.
d. It is important to take NSAIDs on an empty stomach in order to increase absorption.

Question 41: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?

Sinus bradycardia
Atrial fibrillation
Supraventricular tachycardia
d. U waves

Question 42: Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?
a. Morning stiffness and limited mobility of the lumbar spine
b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain
c. Fever, chills, and elevated erythrocyte sedimentation rate
d. Pathologic fractures, severe night pain, weight loss, and fatigue

Question 43: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?
a. Superficial burns
b. Superficial partial-thickness burns
c. Deep partial-thickness burns
d. Full-thickness burns

Question 44: Immunizations are an example of which type of prevention?

Primary
b. Secondary
c. Tertiary

Question 45: If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?

Permanent tissue damage may occur, resulting in necrosis to that body part.
b. The area will be super sensitive.
c. The area is prone to a repeat frostbite.
d. The area is as susceptible as any other area.

Question 46: In the United States, what is the second most common connective tissue disease and the most destructive to the joints?

Osteoarthritis
b. Systemic lupus erythematosus (SLE)
c. Rheumatoid arthritis (RA)
d. Sjogren’s syndrome

Question 47: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?
a. Pregnancy test

Pelvic ultrasound .
Endometrial biopsy
d. Platelet count

Question 48: A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding?
a. Trichomonas
b. Bacterial vaginosis
c. Human papillomavirus (HPV)
d. Herpes simplex virus (HSV)

Question 49: Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines?

Propranolol
Timolol
Ergotamine
d. Topiramate

Question 50: A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment?

Tricyclic antidepressants
b. Capsacin cream
c. Vitamin B12 injections
d. Insulin

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