The
first step of the EBP process is to develop a question from the nursing
practice problem of interest.
Select
a practice problem of interest to use as the focus of your research.
Start
with the patient and identify the clinical problems or issues that arise from
clinical care.
Following
the PICOT format, write a PICOT statement in your selected practice problem
area of interest, which is applicable to your proposed capstone project.
Conduct
a literature search to locate research articles focused on your selected
practice problem of interest. This literature search should include both
quantitative and qualitative peer-reviewed research articles to support your
practice problem.
The
PICOT statement will provide a framework for your capstone project (the project
students must complete during their final course in the RN-BSN program of
study).
Select
six peer-reviewed research articles which will be utilized through the next 5
weeks as reference sources. Be sure that some of the articles use qualitative
research and that some use quantitative research. Create a reference list in
which the six articles are listed. Beneath each reference include the article’s
abstract. The completed assignment should have a title page and a reference
list with abstracts.
Suggestions
for locating qualitative and quantitative research articles from credible
sources:
Use
a library database such as CINAHL Complete for your search.
Using
the advanced search page check the box beside “Research Article” in
the “Limit Your Results” section.
When
setting up the search you can type your topic in the top box, then add
quantitative or qualitative as a search term in one of the lower boxes.
Research articles often are described as qualitative or quantitative.
To
narrow/broaden your search, remove the words qualitative and quantitative and
include words that narrow or broaden your main topic. For example: Diabetes and
pediatric and dialysis. To determine what research design was used, review the
abstract and the methods section of the article. The author will provide a
description of data collection using qualitative or quantitative methods.
Prepare
this assignment according to the guidelines found in the APA Style Guide,
located in the Student Success Center. An abstract is not required.
This
assignment uses a rubric. Please review the rubric prior to beginning the
assignment to become familiar with the expectations for successful completion.
You
are not required to submit this assignment to LopesWrite.
2. CMIS 320 project
In this
assignment you will perform the physical design and implementation using SQL
Data Definition Language (DDL) and proceed with populating the Mom and Pop
Johnson Video Store database via Data Manipulation Language (DML) SQL
commands.
For each of
the steps below you may create a separate SQL script file and SPOOL file or you
may want to put the SPOOL output for several steps, from the same SQL script
file, in the same file. Be sure your SPOOL file(s) contains your SQL
statements along with the Oracle responses and/or displayed results. Do
NOT submit your SQL script files. Only submit your output SPOOL files.
Assignment Details
1) Create
Oracle database tables using SQL Data Definition Language (DDL) for each table
listed in the metadata of Project 2. You may need to use a combination of
DROP TABLE, CREATE TABLE, and ALTER TABLE SQL statements. Make sure that
entity and referential integrity are enforced by declaring a primary key for
each table (these may be composite keys) and declaring all appropriate foreign
keys. Your CREATE TABLE and ALTER TABLE statements (if desired) must show
integrity constraints, as appropriate, for NOT NULL, UNIQUE, PRIMARY KEY,
FOREIGN KEY, REFERENCES, and CHECK constraints. Be sure to save your SQL script
file used to create these tables with a .sql extension and your output SPOOL
file with a .lst or .txt extension. You should rerun and test your SQL
script file until it runs without any errors (this is why you’ll want to include
DROP TABLE statements). Submit your SPOOL file showing that all SQL in
your SQL script file worked properly.
2) Populate
each of your tables with at least five valid rows of data each and show the SQL
INSERT statements as you executed them. Populate other tables in your database,
as necessary, to satisfy referential integrity. Save your SQL script file and
SPOOL file with the correct extensions. You should test and rerun your
SQL script file until it runs without any errors. Submit your SPOOL file
showing that all SQL in your SQL script file worked properly.
3) Develop an
SQL script file to perform the following queries and updates. You should test
your SQL script file until it runs without any errors.
Retrieve all
of your customers’ names, account numbers, and addresses (street and zip code
only), sorted by account number.
Retrieve all
of the videos rented in the last 30 days and sort in chronological rental date
order.
Produce a
list of your distributors and all their information sorted in order by company
name.
Update a
customer name to change their maiden name to a married name. You can choose
which row to update. Make sure that you use the primary key column in
your WHERE clause to affect only a specific row. You may want to include
a ROLLBACK statement to undo your data update.
Delete a
customer from the database. You can choose which row to delete. Make sure that
you use the primary key column in your WHERE clause to affect only a specific
row. You may want to include a ROLLBACK statement to undo your data
deletion.
Submit your
SPOOL file(s) showing that all SQL in your SQL script file worked properly.
Show the actual SQL statements executed and the results the SQL produced
below the code by making sure that you have a SET ECHO STATEMENT in your SQL
script file(s).
3.
Liberty HIEU 201 History of Western Civilization Evaluative Essay 1 & 2
Thesis Statement
To evaluate an historical theme using
assigned sources for support.
To compose a properly formatted,
scholarly paper, using the most recent edition of Turabian, Notes-Bibliography.
General Directions:
For this assignment, students will
choose 1 historical theme from the
list below to research throughout the course:
Religion/Philosophy
Literature
Law
Science/Medicine/Technology
Economy/Labor
Students will write 2 analytical essays on their chosen
theme, using the primary sources and topic prompts within the additional
documents.
In Week 3, students will submit a
thesis statement for Evaluative Essay 1 to the instructor for review. This
pre-submission of the thesis statement will not be required for Evaluative
Essay 2.
Evaluative Essay 1 will cover the
period from 3000 BC through AD 476. It is due in Week 4.
Evaluative Essay 2 will cover the
period from 476-1640. It is due in Week 7.
Specific Requirements:
The evaluative essay will consider
assigned sources on the chosen theme, and evaluate those sources using the
topic prompt provided in the additional documents for this assignment.
Format, Length and Organization:
Length: 750-1100 words (roughly
3-4pages, double spaced – not counting footnotes)
Double spaced text, Times New Roman,
size 12 font, standard margins and indentation (see Turabian:
Notes-Bibliography)
The paper should have a title page,
body, and bibliography page
Using Turabian Notes-Bibliography
style, format footnotes for the paper.
Basic Organization (except literature topic, given in
literature document): The paper will consist of an introduction, body and
conclusion:
Introduction should be one paragraph
and should introduce the main argument, ending with a strong thesis statement.
The thesis statement is the ONE SENTENCE argument.
Body of the paper is a few paragraphs
(3-4) developing and supporting the argument, showing comparison and contrast
of the assigned documents, as well as
further analysis and Biblical evaluation. The body of the paper should provide
specific examples and details from the assigned sources.
Conclusion is the final paragraph,
restating the argument and summarizing the main points of the paper, drawing
conclusions for the reader. No new information.
The textbook and lectures can be used
for basic background information, but the majority of supporting details should
be drawn from the assigned sources within each topic document.
For Biblical analysis, you can use
your own Bible, or one of the following websites for finding and using
Scripture verses. Please note that you need to use a standard translation (such
as KJV or ESV) and not a paraphrase Bible (such as the Message).
Note that no citation is needed for common
knowledge information, but specific examples, details, or arguments drawn from
the assigned sources DO need proper source citation.
Martin
Luther nailed the 95 Theses to the
door of the Wittenburg Church in 1517. (common knowledge, no specific citation
needed)
The
Hebrew Old Testament is considered to be a book of folklore, myths and stories
that is useful for some understanding of Hebrew history, but not always
reliable as an historical source since it was written by religious devotees
rather than historians.[1] – citation needed because this expresses a
specific view or argument.
**If
you are unsure of whether or not a citation is needed, it is better to include
the citation than to leave it out. You can also contact your instructor for
assistance.
4. Management
Book Reactions:
Students will find
two to three compelling items within the book and tie it back into what has
been learned in the course. The book reactions should be a minimum of 2 pages
(writing should run onto page three) double spaced with 1” margins and 12-point
font. Feel free to agree or disagree with what was presented in the books, but
make sure to support your argument with information. Long headers at the
beginning of the submission will NOT count towards your page length.
5. I need an essay to
be written over the specified case study. I have attached the case study along
with the directions.
Instruction
Write
a two- to three-page essay. Double spaced, 12-pt font. Identify and discuss 5
nutrition related problems or potential nutrition problems in the Davis family.
Offer recommendations for dealing with the nutrition issue in the context of
the current crisis situation. Use your text book, the PPT lectures, previous
case studies and assignments, reliable websites, and your own critical thinking
skills. No references required.
6.
Your
Smallville client has asked you to gather details to meet IT audit requirements
to determine whether IT services meet the organization’s objectives. Prepare a
report for your Smallville client on IT audit objectives, risk assessment, and
what help you may need from them to complete this task. Review the Gail
Industries Case Study.
Write
a 3- to 4-page report or create a 12- to 16-slide media-rich presentation with
speaker notes in which you: Describe the reasons it is important to conduct
periodic reviews of information systems to determine whether they continue to
meet the organization’s objectives. Discuss the importance of the
organization’s policies and practices as they relate to information systems and
IT infrastructure. Identify strategic and operational objectives for planning
for the audit. Evaluate different risk assessments techniques and monitoring
tools to consider during an audit process. Note: You are preparing for a
systems audit, not a financial audit. Frame your analysis around the systems,
not the accounting or finance aspects directly. Format citations according to
APA guidelines.
7. 10
page Term Paper Greenhouse Gas Emissions and Impact on Climate Change
Instruction
Details
of the Paper: Prepare a 10-15 page paper in Microsoft Word (counts as 15% of
the final grade) in APA format (see writing expectations in the Policies
section) (350 words per page). At a minimum include the following: References
(minimum of 10) You may use resources from the APUS Online Library, any
library, government library, or any peer-reviewed reference (Wikipedia and any
other publicly-reviewed source is not accepted). The paper must by at least 10
pages double-spaced, 1″ margin all around, black 12 point fonts (Times New
Roman or Arial) with correct citations of all utilized references/sources,
(pictures, graphics, etc are extra – allowed but extra for the minimum page
count). The title page and references are also required but don’t count in the
minimum page count. A minimum of 10 references are needed. The paper will be
subjected to checking against plagiarism. The paper must follow acceptable
originality criteria (no more than 15% max total, and 2% per individual source
match are allowed). Save the file using the following file naming convention:
ITMG481_Project_First_Last.doc(x) (where first and last are your first and last
names resp.) and submit the file in this assignment area. Turnitin.com has been
enabled for this assignment so remember that your submission’s file type must
be either doc or docx Outline and Topic are attached. Paper needs to follow the
outline provided as well as include the references already provided.
8. Service and Contracts
Description
Analyze
how physicians and hospitals have negotiated service contracts with third party
payers.
Discuss
how fee for service versus managed care models of reimbursement have
contributed risk avoidance in their contract negotiations.
Recommend
future strategies for physicians and hospitals to effectively negotiate service
delivery contracts. Base the recommendation on your research and readings.
Citations
must appear within the body of your paper to correspond with the references
listed at the end of the paper (i.e., if the resource is included in your
Reference List, the resource must be cited in your paper).
Write a 7–10 page analysis of how the
practices of your own organization (or another organization with which you are
familiar) influence the success of its virtual teams.
You will benefit from taking a close
look at how your own organization fares in terms of addressing critical success
factors for virtual teams, as well as from building an understanding of the
skills needed to participate successfully in virtual team collaboration.
Preparation
In their seminal work, Mastering
Virtual Teams (2011), Duarte and Snyder identify seven critical success factors
in virtual team collaboration:
1. Human resource policies.
2. Training and development.
3. Standard organizational processes.
4. Communication and collaboration technology.
5. Organizational culture.
6. Leadership.
7. Competence (p. 10).
Note: You should be able to find a
number of resources that address these critical success factors through your
research for this assessment.
To prepare for this assessment,
research the seven critical success factors in virtual team collaboration.
Consider your own real-world experiences with these factors in the workplace.
This assessment incorporates multiple
elements. Be sure to thoroughly address each before submitting the assessment.
Use the seven critical success factors
to analyze how the practices of your own organization (or another organization
with which you are familiar) influence the success of its virtual teams. Base
your analysis on your own experience of being a member of a virtual team within
the organization.
Note: If you have not participated in
a virtual team, base your analysis on a hypothetical virtual team experience,
using what you know of your organization’s practices.
In developing this case, it is helpful
to assume that you have been tasked by executive management to conduct an audit
of your organization’s ability to support virtual team collaboration. Your
audit will include a detailed report in each of the seven critical success
factors. Go beyond a description of the “as-is” state for each of
these factors in your audit to evaluate and analyze each of the factors to
identify strengths, weaknesses, opportunities, and threats that the current
state presents to the organization in terms of its ability to support virtual
team collaboration.
Remember that the executive management
of your company is not interested in a report about the criteria
themselves—they are not interested in reading about human resource policies in
the abstract, for example—but about how the organization measures up to the
criteria. Use the success factors to analyze the organization—do not fall into
the trap of writing about the criteria. Use the criteria to describe, analyze,
and evaluate the organization.
Explain how organizational practices
influenced (or might influence) the virtual team’s performance. Address all of
the following:
Human resource policies: Do the
organization’s career development resources address the needs of virtual team
members? Does the organizational reward system recognize the efforts and
successes of those who work virtually? Are rewards given only for results, or
are they also given for effort? Does the organization actively support work
arrangements such as telecommuting?
Training and development: Is there access to technical training for virtual
team members? Is there access to training in the area of working across
cultures? Is there a program of ongoing training as needed? Is there a system
for sharing what has been learned, such as a database?
Standard organizational processes: Are there standard technical processes used
throughout the organization (with regard to virtual teams)? Are there standard
soft processes used throughout the organization? Does the organization support
the ability to adapt processes when necessary? Does the organizational culture
support shared ways of doing business across teams?
Communication and collaboration technology: Are there consistent standards for
electronic communication and collaboration tools across the organization? Does
the organization possess or provide enough resources to purchase and support
state-of-the-art electronic communication and collaboration technology? Do all
employees (across departments and geographic location) have equal access to
electronic communication and collaboration technology?
Organizational culture: Is there trust between the organization, its partners,
and other external stakeholders? Are teamwork and collaboration standard
practices? Are people from different cultures valued?
Leadership: Do leaders allocate enough resources for the training and
technology needed by virtual teams? What level of expectation do leaders set
for virtual team performance? Do leaders model exemplary behavior by working
across boundaries and using technology effectively?
Competence: Are team leaders experienced with working in virtual environments?
Are team members experienced with working in virtual team environments? Are
team leaders experienced in working across both organizational and cultural
boundaries? Are team members experienced in working across both organizational
and cultural boundaries?
Support your analyses with real examples, as well as evidence from your
research and readings.
Additional Requirements
Ensure written communication is free
of errors that detract from the overall message and quality.
Your report should be 7–10 content pages, in addition to a title page and
references page.
Use 12-point, Times New Roman.
Use at least three scholarly resources.
Follow APA rules for attributing sources that support your analysis and
conclusions. As a reminder related to using APA rules to ensure academic
honesty:
When using a direct quote (using exact or nearly exact wording), you must
enclose the quoted wording in quotation marks, immediately followed by an
in-text citation. The source must then be listed in your references page.
When paraphrasing (using your own words to describe a nonoriginal idea), the
paraphrased idea must be immediately followed by an in-text citation and the
source must be listed in your references page.
Suggested Resources
The following optional resources are provided to support you in completing the
assessment or to provide a helpful context.
Purvanova, R. K. (2014). Face-to-face versus virtual teams: What have we really
learned? The Psychologist-Manager Journal, 17(1), 2–29.
Read the case study about using the DMADV approach for designing new housing at the
University of Miami. Write a paper of two to four pages detailing the
DMADV steps for designing a new product/process at your firm. Your approach to
designing the new product/process at your firm should be similar to that in
this case study. Cite your sources in the APA format.
A man is 2,000 m from the base of a tower and is launching a
rocket in the direction of the same tower. When the rocket takes off the change
in the angle between the flight path and the land is represented by Φ(t)
according to time. Knowing that Φ'(t) = Π/3, determine:
1. The height of the rocket when Φ = Π/3 radians.
Please explain how you arrived at your answer.
12. Which formula should be used to
determine the total cost?
The wedding photographer for the Smith/Jones wedding charges
$1,000 for her preparation and first 60 prints. The cost is $2.00 per photo for
photos beyond the first 60. Which formula should be used to determine the total
cost, C, as a function of the number of photos, p, that are purchased, assuming
at least 60 are purchased?
a. C = 1000 p + 2
b. C = 1000(2p – 60)
c. C = 1000 + 2(p – 60)
Please explain your answer.
13. Philip and Claire are
married and file a joint
Question
Individual Tax
Return Problem 4
Required:
Use the following information to complete Phillip and Claire Dunphy’s 2017 federal
income tax return. If any information is missing, use reasonable assumptions
to fill in the gaps. Ignore the alternative minimum tax for this problem.
Any required forms, schedules, and instructions can be found at the IRS website
(www.irs.gov). The instructions can be helpful in completing the forms.
Facts:
Phillip and Claire are married and file a joint return. Phillip is
self-employed as a real estate agent, and Claire is a flight attendant. Phillip
and Claire have three dependent children. All three children live at home with
Phillip and Claire for the entire year.
The Dunphys provide you with the following additional information:
The Dunphys do not want to contribute to the presidential election campaign.
The Dunphys live at 3701 Brighton Avenue, Los Angeles, California 90018.
Phillip’s birthday is 11/5/1971 and his Social Security number is 321-XX-5766.
Claire’s birthday is 5/12/1974 and her Social Security number is 567-XX-1258.
Haley’s birthday is 11/6/2005 and her Social Security number is 621-XX-7592.
Alex’s birthday is 2/1/2007 and her Social Security number is 621-XX-8751.
Luke’s birthday is 12/12/2011 and his Social Security number is 621-XX-9926.
The Dunphys do not have any foreign bank accounts or trusts.
Claire is a flight attendant for Western American Airlines (WAA), where she
earned $57,000 in salary. WAA withheld federal income tax of $6,375, state income
tax of $1,800, Los Angeles city income tax of $675, Social Security tax of
$3,600, and Medicare tax of $825.
Phillip and Claire received $300 of interest from State Savings Bank on a joint
account. They also received a qualified dividend of $395 on jointly owned
stock in Xila Corporation.
Phillip’s full-time real estate business is named “Phillip Dunphy Realty.” His business
is located at 645 Grove Street, Los Angeles, California 90018, and his employer
identification number is 93-3488888. Phillip’s gross receipts during the year
were $730,000. Phillip uses the cash method of accounting for his business.
Phillip’s business expenses are as follows:
Advertising
$ 5,000
Professional dues
800
Professional journals
200
Employee wages
48,000
Insurance on office contents
1,120
Accounting services
2,100
Miscellaneous office expense
500
Utilities and telephone
3,360
Payroll taxes
3,600
Depreciation To be calculated
On March 20, Phillip moved his business out of the old offices at 1103 Allium
Lane into a newly constructed and equipped office on Grove Street. Phillip sold
the old office building and all its furnishings. Phillip’s expenditures for the
new office building are as follows:
Date Acquired
Asset Cost
3/20
Land
$ 300,000
3/20
Office building
2,500,000
3/20
Furniture
200,000
4/1 Computer
system 350,000
6/1
Artwork
150,000
Phillip computes his cost recovery allowance using MACRS. He would like to use
the §179 immediate expensing, but he has elected to not claim any bonus
depreciation. Phillip has never claimed §179 or bonus depreciation before. The
assets Phillip sold on March 20 are as follows:
Date Acquired
Asset
Sales Price Original Cost
Accumulated Depreciation as of Beginning of the Year
[1]
Marvin Perry, et.al., Western
Civilization Vol. 1, MindTap edition, 2-1c. (Note that this is short-form)
Phillip has never sold any assets relating to his business before this
transaction.
The
Dunphys sold 60 shares of Fizbo Corporation common stock on September 3 for $65
a share (minus a $50 total commission). The Dunphys purchased the stock on
November 8, 2016, for $90 a share. They also sold a painting for $13,000 on
March 1. Claire purchased the painting for $20,050 on September 1, 2010, as an
investment.
The
Dunphys filed their 2016 federal, state, and local returns on April 13, 2017.
They paid the following additional 2016 taxes with their returns: federal
income taxes of $630, state income taxes of $250, and city income taxes of $75.
The
Dunphys made timely estimated federal income tax payments of $17,000 each
quarter during 2017. They also made estimated state income tax payments of
$1,000 each quarter and estimated city income tax payments of $300 each
quarter. The Dunphys made all fourth-quarter payments on December 31, 2017.
They would like to receive a refund for any overpayments.
Phillip and Claire have qualifying insurance for purposes of the
Affordable Care Act (ACA).\
14. Facilities Management
As the manager of a resort hotel with 500
guest roomsyou are concerned with your monthly water and sewage bill. The water company uses the graduated billing
schedule listed below. Your operation is currently using 2,500,000 gallons of
water per month. It is time to replace your 3.6 gallon per flush toilets and
you initially decided to install 1.8 gallons per flush high efficiency toilets. The toilet salesperson is recommending that
you install anultra-high efficiency model that used 0.9 gallons per flush. The ultra-high efficiency toilets will cost
you $250more than the high efficiency toilets per toilet, installed. Based on
information your chief engineer found, you estimate that on average every
toilet in an occupied room is flushed 10 times per day. Your average annual occupancy rate is
91.0747%.Assume 30.5 days per month when calculating your monthly water
savings. Based on the information above
and the rate scale below,your ultimate goal is to determine if it is more cost
effective to install the ultra-high efficiency toilets?
Water rates:
monthly charge of $150.00 per month plus usage charge base on the rates
listed below.
Amount
of water used Rate
per 1000 gallons
First
100,000 gallons $6.00
Next
500,000 gallons $5.00
Next
1,000,000 gallons $4.00
Anything
over 1,600,000 gallons $2.00
Sewage rates: monthly charge of $200.00 per
month plus usage charge based on the total water used.
Amount
of sewage produced = Total water
used minus deduct meter
Rate per 1000 gallons is $10.00
Deduct
meter shows a monthly average of 125,000 gallons
Water and sewage rates are expected to rise at
the same rate,2.0202% per month. The owners of the operation expect a monthly
rate of return on their investment of at least 1.0%. Assume that the toilets
will last for 30 years. Assume that you will take out a loan for the
toilets. You must pay 10% down make
payments at the end of each month until the remainder has been paid off, 72
month. The nominal annual interest rate
for the loan is 3.99%. The equation for converting a nominal annual rate to a
monthly rate is:
Give the above
information answer the following questions. You must show ALL your work to
receive credit.
1. How
much will your water usage drop each month (to the nearest gallon) if you
install the ultra-high efficiency
toilets compared to the high efficiency toilets?
(type
your answer here)
2. If
your water usage is for the entire facility is projected to be 2,250,000
gallons if the high efficiency toilets are installed, how much water will be
used each month by your entire facility if you install the ultra-high
efficiency toilets?
(type
your answer here)
3. If
you install the ultra-high efficiency toilets, what will be your average
monthly water and sewage bill (to the nearest dollar) for the entire facility?
Water portion of the bill
(Type
stating amount here)
100,000
x 6.00/1,000 =
(Type
stating amount – 100,000 here)
500,000
x 5.00/1,000 =
(Type
stating amount – 600,000 here)
1,000,000
x 4.00/1,000 =
(Type
stating amount – 1,600,000 here)
(Type
stating amount – 1,600,000 here) x 2.00/1,000 =
0
Total water bill =
Sewage bill =
Total water and sewage bill =
4. What
is the projected savings on your water and sewage bill (to the nearest dollar)
for the entire facilityin present value if you install the ultra-high
efficiency toilets instead of the high efficiency toilets? The projected monthly water and sewage bill
if you add the high efficiency toilets will be $30,000. Make sure you calculate
all interest rates to 4 significant digits, and write all percentages as
decimals.
Equation (variables only): PV =
A =
n =
ieffective =
PV =
PV =
5. How
much more will it cost to install the ultra-high efficiency toilets compared to
installing the high efficiency toilets in present value will it cost (to the
nearest dollar) for the new toilets, installed? Make sure you calculate all interest rates
to 4 significant digits, and write all percentages as decimals.
a. What
will be increase in total price for all the toilets installed if you install
the ultra-high efficiency toilets compared to installing the high efficiency
toilets (to the nearest dollar)?
(type
your answer here)
b. How
much more will the down payment be on the loan if you install the ultra-high
efficiency toilets compared to installing the high efficiency toilets (to the
nearest dollar)?
(type
your answer here)
c. How
much more will your monthly loan payment (to the nearest dollar) be if you
install the ultra-high efficiency toilets compared to installing the high
efficiency toilets?
(type your answer here)
d. How
much will the total cost (to the nearest dollar) in present value for the
toilets installed increase if you install the ultra-high efficiency toilets
compared to installing the high efficiency toilets?
Equation (variables only): PV =
A =
n =
ieffective =
PV =
PV =
6. What
will be your net savings if you install the ultra-high efficiency toilets
compared to installing the high efficiency toilets?
(type
your answer here)
7. Should
you install the high efficiency or ultra-high efficiency toilets?
(type
your answer here)
15. Political Science and Policy response
Question
Assume that you are a Senator within
your home state in which determinate sentencing is currently being practiced;
however, you have introduced a bill to switch to indeterminate sentencing. What
are some of the strengths of indeterminate sentencing that you could use to
persuade your fellow senators?
16. Globalization in the role of Mass
Media in Healthcare and Higher Education
Question
Students will write a paper analyzing
the issues of the Globalization in the role of Mass Media in Healthcare
and Higher Education. This paper should be 2000-2500 words. It should examine relevant
professional issues and real-life dilemmas encountered by members of the topic.
The paper should cite at least seven (7) current sources.
APA Guidelines
Time New Roman
12 pt, Double Spaced
17.
BUILDING AN ETHICS-BASED WORKPLACE CULTURE
Question
Assignment Overview
Ethics Program Implementation
As you can see by your reading, a lot
of energy goes into the implementation of an organizational ethics program. And
Lockheed Martin has clearly allotted considerable resources to assuring their
program is successful. In this assignment we’ll be focusing on what the company
did to ensure the implementation of a successful program that was flexible
enough to accommodate the changing needs of the organization.
Case Assignment
Please address the following questions:
On p. 83 Terris discusses the
company’s ethics code. Why is the code considered important to the
company’s ethics program?
Discuss the importance of ethics
training and employee involvement. What are some of the things Lockheed
does to make the training process interesting and worthwhile?
How does Lockheed measure success with
respect to ethics in the workplace?
What are some of the things Lockheed
does at the operational level to make their ethics program work?
Assignment Expectations
Write a 4- to 5-page paper, not
including title page or references page addressing the issue and upload it by
the end of this module.
Your paper should be double-spaced and
in 12-point type size.
Your paper should have a separate
cover page and a separate reference page. Make sure you cite your
sources.
Use APA style, and proofread your
paper.
Upload your paper by the end of the
module.
18. BUS ADM 600
Question
The analysis of
strategy in the case of Wal-mart 2005.
(20 points)
Please summarize
its company strategies with supporting activities at the corporate,
business, andfunctional level.
Please state how
the corporate level of strategy is connected to the business level.
Stakeholder
Theory of the Firm: Theory and Application
(20 points)
Describe the
stakeholder theory for a RTE breakfast
cereal firm. Who are the major external stakeholders? Who are
the major internal stakeholders?
Imagine you are
the CEO of a ready-to-eat breakfast cereal company such as General
Mills. Recent research has linked diabetes to an artificial
sweetener that your company has been using for the last decade. Please
discuss the likely preference of each stakeholder group. Discuss how you
will go about deciding whether to continue with the same
artificial sweetener or to seek alternative yet more costly
replacements.
External
Analysis: Please describe Porter’s 5-Forces Model in the following order: Power
of Suppliers, Power of Buyers, Substitutes, Barriers to Entry, and Price
Rivalry from the perspective of Coke and Pepsi concentrate producers.
(25 points, 5
points for each force)
For each force be
sure to indicate if the power is HIGH, MODERATE or LOW.
Please be sure to
defend your assessment of each force with evidence.
Internal
Analysis: please list what resources and capabilities qualify as VRIO for the
case of Wal-mart 2005? (20 points)
Please first
describe the question of value, rarity, imitability, and organization.
Please list the
resources and capabilities that you identify from Wal-mart under each of the
question of VRIO model.
Internal
Analysis: Please provide a Value-Chain analysis for the company
of Coca-Cola.
(15 points)
Please
list the primary activities in value chain for a soft drink
company such as Coco-Cola.
Please indicate
whether those primary activities were conducted internally or
outsourced. If outsourced (at certain times or in certain regions), please
state the rationale behind such decision.
BONUS
QUESTION: Competitive Advantages – Value Chain and Economic Value
Creation (10 points)
For Milwaukee
Cheese Company, below are the breakdowns for its cheese production:
• Product priced
at $20/pound
• Raw materials
cost $10/pound
• Manufacturing
cost $1/pound
• Packaging cost
$1/pound
• Distribution
cost $1/pound
• Sales and
Marketing cost $1/pound
• Overhead allocation
$1/pound
• Production
facility rent $3/pound
• Employee pay
$2/pound
Given the
information above, please calculate Milwaukee Cheese Company’s Economic Value
Creation. Please provide all of your work below in calculation.
19. Outline the cybersecurity issues
and vulnerabilities of the petrochemical industry
Question
1. Outline the Cybersecurity issues
and vulnerabilities of the petrochemical industry. Include in your answer
specific actions required to improve the security profile of this industry.
2. Using Clarke’s
assessment from chapter six of Cyber War: The Next Threats to
National Security and What to Do About It, describe America’s
potential best scenario use of “Offensive Cyberwar” to attack other nation’s
infrastructure. Feel free to provide ‘theoretical’ scenarios and
war-gaming actions that would best serve our nation’s efforts for
debilitating a foe’s national infrastructure.
20. Starbuck Corporation Case Anaylsis
Question
This week, we will analyze a
full-length case study, which is about Starbucks Corporation
With more than 25,000 stores in 75
countries and $21 billion in annual revenues, Starbucks is the largest roaster
and retailer of specialty coffee in the world. Howard Schultz’s strategic
leadership was critical in turning Starbucks around. He is now hoping that his
second retirement from the company he built from the ground up will be his
final one. In the meantime, Kevin Johnson, the new CEO, faces several
challenges. In particular, the question of maintaining core competencies and
how to achieve future growth, both domestically and internationally is central
to the case. The case also focuses on diversification, as Starbucks is
branching out in new areas such as menu extensions including offering alcohol
as well as rolling out coffee bars with high-end offerings such as a $12 cup of
coffee.
To-Do
List – Week Six: All assignments are required.
Read
Overview of this case
Reading
Assignments: Starbucks
Corporation
Full-length Case
assignment: Read
‘Starbucks Corporation’ case, and think about the discussion
Discussion questions
How
did Starbucks create its uniqueness in the first place? Why was it so
successful (until the mid-2000s)?
Why
and how did Starbucks lose its uniqueness and struggle in the mid-2000s?
What
strategic initiatives did Howard Schultz put in place to re-create Starbucks’
uniqueness after his return in 2008? Detail each strategic initiative. Explain
why a specific strategic initiative was successful.
Is
Howard Schultz an effective strategic leader? Why or why not? Buttress your
arguments.
How
is Starbucks trying to grow in the future? What are its biggest challenges?
What
recommendations would you give the new Starbucks CEO, Kevin Johnson, to address
the challenges identified in Question 5? Be specific.
After reading the case, you
are expected to submit a written analysis of the case which ranges
from 3-5, typewritten, double-spaced pages. For the analysis, you should
conduct additional research on the cases beyond the information provided in the
case
*Note add references behind sentences
that are used from other sites.
21. Sex Crime Statutes
Research your Louisiana government website to
locate information on a recently adopted sex crime statue in this area.
Write a 550- to 700-word paper in which you
do the following:
Provide
a brief summary of the statute, including the intended category of sexual
offense. Louisiana
Explain
how the statute could impact laws or enforcement in the area.
Provide
a brief history of other statutes that may have led to the creation of the
current statute.
Describe
the range of punishments for violation of the law.
Explain
whether the acts identified in the statute are acts that previously were
considered accepted practice.
Explain
what made this statute a current precedent and if it was derived from a
previous law.
Format your paper consistent with APA
guidelines.
22. Analysis of Ground Rules
Write a
minimum of 3 pages with team experiences you have had in which a team was
effective and another in which it was not. Write a description of these teams
and their tasks, paying particular attention to the behavioral expectations for
which the team members held each other accountable.
Describe how ground rules help an effective team perform and work
well together.
Analyze prospective differences in ground rules for team members
and tensions that may result.
Analyze how differences in unspoken ground rules and team members’
expectations cause conflict and damage performance.
Describe the effect of discussing ground rules as a method of team
learning.
Analyze applications of change management principles.
Describe an effective team from a real-world experience, including
the tasks of the team.
Describe the ground rules applied in an effective team.
Describe an ineffective team from a real-world experience,
including the tasks of the team. Explain the spoken or unspoken ground rules
that describe expectations for behavior in an ineffective team.
23. The Epic of Gilgamesh and Monkey
Compare
the heroes as kings. Monkey as a king of the monkeys has some things in common
with Gilgamesh as a king, e.g. a desire for immortality. When they are good
kings,what virtues do they show?Is one of them better than the other? When they
are not good kings, what feelings do they share? Who has the greatest flaws as
a king?
Please
use quotes from the text.
The
paper should be in MLA guidelines and be around 1000-1250 words
a. Business goals
b. Technical goals
c. User communities and data stores
d. Network applications
6. Current state
of the network
7. Logical design
8. Physical design
9. Results of network design testing
10. Implementation plan with a project schedule
11. Project budget with a return on investment calculation
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.
25. Managerial Accounting
Over the last 50
years the financial reporting systems have dramatically changed and will
continue to change as the financial world faces changes such as globalization,
changing regulations and the increased use of technology. The accounting
profession must be ready to not only face these changes but to also adapt to
them, providing relevant and reliable information to the many internal and
external users of financial and managerial accounting reports.
It is important
to understand the difference between managerial and financial accounting
reports.
You are the chief
executive officer of a multinational corporation that operates wholly owned
subsidiaries in several countries. One of the company’s manufacturing plants is
located in Europe. As CEO, respond to the following questions in 400-600 words:
What
types of internal and external accounting reports will you use in the
process of making decisions?
How
will the reports differ for a multi-national corporation?
26. Resistance
and Communication – Walmart
Write a four to
six (4-6) page paper in which you: (previous paper is attached)
Diagnose
the reasons for resistance to change.
Interpret
the potential causes of resistance in the organization (WALMART). Identify
and describe three (3) potential causes of resistance to your change plan
(better benefits and better training and development programs). Identify
and describe three (3) potential sources of resistance to your change plan
(better benefits and better training and development programs).
Create
a plan for minimizing possible resistance to your change management plan.
Elaborate
on the relationship between resistance to change and communication.
Evaluate
three (3) communication strategies.
Recommend
one (1) communication strategy that would be applicable to your
organization (WALMART). Diagnose why this communication strategy is best
for your organization.
Create
a solid communication plan for your change initiative.
Use
at least four (4) quality academic resources in this assignment. Note: Wikipedia
and other similar Websites do not qualify as academic resources.
Note: If you choose to submit a video
presentation, please also submit a one (1) page summary of your presentation.
If you choose the
written paper, 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.
27. Fraud Prevention and Detection Plan
Scenario
– You went back to your corporate controllership position with Dingwow Inc.
Senior Management has assigned you as the team lead to develop a fraud
prevention and detection plan for the company.
Use the Internet, to research the key elements of a fraud
prevention and detection program, and prepare a plan.
Write an eight to nine (8 – 9) page paper in which you:
Evaluate the key elements that should
be included in the plan, including a justification as to how the element is
likely to protect corporate assets and minimize risk based on your research.
Create an argument to be presented to
the senior leadership in support of a fraud prevention and detection plan,
indicating the consequences of failure to implement the plan. Provide support
for your argument.
Create an approach to identify the
roles and responsibilities of key personnel in the organization, indicating the
significance of each role in the fraud prevention and detection equation.
Provide support for your rationale.
Compare the roles of management,
internal auditors, external auditors, governing bodies, and the board of
directors, and assess how each can contribute to your fraud prevention and
detection plan.
Evaluate the tools that you would
propose to use to make your plan more effective in mitigating or eliminating
fraud and how you would justify the risk / reward ratio of each tool
recommended.
Prepare a fraud prevention and
detection plan based on your findings, indicating how you would communicate the
plan to employees throughout the organization.
Predict the future occurrences of
corporate fraud and the likelihood that it will be detected by regulatory
agencies based on your research. Provide support for your rationale.
Use
at least five (5) quality resources in this assignment.
NOTE:
Wikipedia and similar Websites do NOT
qualify as quality resources.
Your assignment
must follow these formatting requirements:
Be typed, double spaced, using Times
New Roman font (size 12), with 1” margins on all sides; citations and
references must follow APA
The cover page containing the title of
the assignment, and the reference page are NOT
included in the required assignment page length.
The specific
course learning outcomes associated with this assignment are:
Create an approach to implementing a
fraud detection plan.
Research and analyze the impact of
fraud on financial reporting within a corporation.
Examine the role that corporate
governance plays in preventing and detecting fraud.
Research and analyze the impact of
fraud prevention and detection using forensic accounting practices.
Create strategies for communicating
the prevention and detection of fraud.
Use technology and information
resources to research issues in fraud prevention and detection.
Write clearly and concisely about
fraud prevention and detection using proper writing mechanics.
28. Philosophical explication and
analysis of the first chapter of “Being and Some Philosophers” by
Etienne Gilson (refer to instructions for specifications).
Instruction
Prompt:
The goal of this essay is to understand and explicate, in your own words, what
Gilson has to say in the first chapter. This essay should explain the argument
that Gilson makes and comment on the significance of his analysis. In your
essay you will be expected to touch on the following three problems:
1.
What does Gilson mean by the “existential neutrality” of our
conceptual knowledge? How does this frame the problem that Gilson intends to
study in “Being and some Philosophers”?
2.
What is Parmenides’ answer to the question, “what is being”? How is
Plato the heir and continuator of Parmenides?
3.
How does plato give rise to the Neo-Platonic “metaphysics of the
One”? What problems does such a metaphysics pose for a Christian thinker?
Specifications:
This
essay should be 6-8 pages (double spaced), 12 point in the “Times New Roman”
font, with one inch margins, plagiarism free, and proofread. Helpful Tip:
Gilson’s book is a philosophical analysis of the ways that various philosophers
have understood the meaning of being in the Platonic tradition. His goal is to
present not a history of metaphysics, but rather a thinking through of the
views of several historical philosophers.
29. ChE 230Problem Set 3
Optimization
75 Points. You are to optimize a series of two heat
exchangers. The first heat exchanger uses low-pressure steam as a utility. The
second heat exchanger uses medium-pressure steam. The third uses high-pressure
steam. Together, the heat exchangers must bring a 1.5 kg/s stream of Dowtherm
from 25C to 220C. Dowtherm has a heat capacity of 6.0 .
Both types of steam enter as a saturated vapor and leave as a saturated liquid
(so the utility stream does not change temperature). The following table
summarizes the relevant properties:
lps
mps
hps
Temp (C)
160
187
254
Cost
$13.28/GJ
$14.19/GJ
$17.70/GJ
Heat
exchangers are costed by their area. To determine the area, the following
design equation must be used
Where is the heat duty, is the overall heat transfer coefficient (, is the area of the heat exchanger, and is the log-mean temperature difference.
See the following diagram for more
information.
Heat exchangers are costed according to the
following equation
where A is area in m2.
Since there are two intermediate
temperatures, this is a multivariable optimization. You are to optimize this
system two ways:
Set , then minimize
the EAOC with respect to using golden
search. Once you get the optimal, keep that
constant, and minimize the EAOC with respect to , again using
golden search. Repeat this process once more to see if the optimal temperatures
change. This is called a “greedy” optimization. (Greedy because you only look
at one variable over all others at a time.) Was this technique effective for
this system?
Use
a grid search to minimize the EAOC with respect to both temperatures
simultaneously. You can then use solver or fmincon to see how closely the
solutions match.
30. Self-Defense Essay for Criminal
Law
Instruction
Instructions:
You have been asked to give a lecture to a group of first-time gun owners about
self-defense. Explain when force may be used in self-defense. What about deadly
force? How will you instruct the session differently if you are in a
stand-your-ground jurisdiction? -1000 word minimum, 1500 maximum length.
-FORMAT: Set in APA or MLA format, typed in Times New Roman 12-point font, 1”
margins, Double-spaced, Spell-checked, and Proofread. -Plagiarism will not be
tolerated on any assignment. Always cite your sources. -No images. Create a
successful academic prose that is readable, coherent, and grammatically
appropriate for the college level. Begin by introducing the topic.
(Introduction) You will then use a minimum of three (3) resources to gather
facts about the topic. (Body) Finally, you will report your findings.
(Conclusion)
31. Business
When a business is
not focused on sustainability, value may be solely determined outside its
customers’ interest in green behavior. Suppose a restaurant makes a
great-tasting hamburger. Very few of its customers might care whether or not
the restaurant engages in green business practices. However, what if there are
two restaurants that make equally great-tasting burgers, but one is green while
the other is not? Many customers may choose the green business, because the
business adds value to its offerings by engaging in sustainable practices. In
the case of sustainable products, meaning those products made with an effort to
be environmentally and socially responsible, sustainability plays a large role
in the customers’ decisions to buy, and tends to be central to the company’s
brand.
Instruction
Identify
a Saudi business that may not yet be focused on sustainability. Suppose this
company decides it would like to deliver products that are more socially,
environmentally, and economically superior. In a 4-5 page paper, not including
the cover and reference pages, present the company with the total value
proposition from a sustainability perspective. In that total value proposition,
include a discussion of use values and nonuse values for the business’ green
products. How should the business determine WTP, WTA, or consumer surplus? Your
required readings this week provide insight which will aid you in your
analysis. Make sure to cite and reference any information gleaned from those
documents. Additionally, include two current and scholarly sources beyond the
course materials and readings to support your analysis. Current sources are
those published in the most recent five years. Scholarly sources come from
peer’s reviewed journals. Use Saudi Electronic University academic writing
standards and APA style guidelines, citing references as appropriate.
32. Capital Financing
Description
Does
financial innovation in health care improve productivity and consumer
welfare the way technological innovation does? Why or why not?
33. Healthcare and Macroeconomics
Description
Which of the factors given below is more
important in determining how much to spend on medical care:
How
sick people are.
How
much money is available.
Who should be determining which factor is more
important? Why?
34. STAT 3502 C –
Assignment 2 Carleton University Winter 2019
1. (5 points) Let
X be a positive and continuous random variable for which E[X] exists. Show
that: E[X] = Z ∞ 0 (1 − F(x))dx, where F is the cdf of X.
2. Customers
arrive at a checkout counter in a department store according to a Poisson
distribution. Let X be the number of customers arrivals during a one-hour
period such that X ∼ P oisson(λ),
(a) (4 points) Show that Var(X) = λ.
(b) Let λ = 7.
During a given hour, what are the probabilities that:
i. (4 points) no
more than three customers arrive?.
ii. (4 points) at
least two customers arrive?.
iii. (4 points) exactly five customers
arrive?.
3. (6 points)
Past experience shows that the number of accidents per month is modelled by a
random variable N with p(n) = P(N = n) = 1/ (n + 1)(n + 2),
where n = 0, 1,
2, …. Calculate the probability of at least one accident during a particular
month, given that there have been at most five accidents during that month.
4. (6 points) The
annual rainfall (in inches) is normally distributed with µ = 40 and σ = 4.
Assuming rainfalls are independent from year to year, what is the probability
that starting with this year, it will take more than 10 years before a year
occurs having a rainfall of over 50 inches?
5. Headway time (HT) (in seconds) in a traffic
flow (time elapsed between the passage by a fixed point of two successive cars)
has pdf f(x) = αλα (λ + x) α+1 , where x ≥ 0, α > 0, and λ > 0.
(a) (4 points) Check this actually is a pdf.
(b) (4 points)
Compute HT’s cdf.
(c) Let α = 0.5
and λ = 10
i. (4 points) What is the probability of HT
above 7 sec.
ii. (4 points)
What is the probability of HT between 2 and 6 sec?
iii. (5 points)
Find an expression of the (100p)th percentile.
iv. (4 points)
Find the HT’s median.
v. (4 points) 75%
of the HT are below which value?
6. (6 points) * A
baseball team has scheduled its opening game for April 1. If it rains on April
1, the game is postponed and will be played on the next day that it does not
rain. The team purchases insurance against rain. The policy will pay 1000 for
each day, up to 2 days, that the opening game is postponed. The insurance
company determines that the number of consecutive days of rain beginning on
April 1 is a Poisson random variable with mean 0.7. What is the standard
deviation of the amount the insurance company will have to pay?
7. (6 points)
Suppose you throw a die and say that you have success if you get 5 or 6. You
want to get two such successes. What is the probability that you need exactly
10 tries for this?
8. Suppose that
25% of all students at a large public university receive financial aid. If 65
students are sampled,
(a) (5 points)
What is the probability that at most 10 of them receive aid? (Use normal
approximation to binomial).
(b) (5 points)
What is the approximate probability that between 5 and 15 (inclusive) receive
aid.
9. In an assembly-line production of
industrial robots, gearbox assembles can be installed in 1 minute each if holes
have been properly drilled in the boxes and in 10 minutes if the holes must be
redrilled. Twenty gearboxes are in stock, 2 with improperly drilled holes. Five
gearboxes must be selected from the 20 that are available for installation in
the next five robots.
(a) (5 points) Find the probability that all 5
gearboxes will fit properly.
(b) (5 points)
Find the mean, variance and standard deviation of the time it takes to install
these 5 gearboxes. (Hint: Denote by X the number of improperly drilled
gearboxes in the sample of 5, determine the distribution of X, and represent
the total time as a function of X.)
10. (6 points)
The number of years a certain type of TV functions is exponentially distributed
with an average lifetime of 6 years. If Jones buys a used TV (3-year old, say),
what is the probability that it will be working after an additional 6 years?
(Comment: You will find that this probability is the same as the probability
that the TV will function after 6 years from the beginning. That is, the TV
does not actually get old. This is the so-called memoryless property of
exponential distribution.)
Problems marked
by a star are inspired from old actuarial exams.
35. ITS 835 Enterprise Risk Assessment
Final Research Paper
Write a research paper on the topic: What are the main drivers for successful
ERM implementations in organizations?
Your research paper should be
minimally 6 pages (double space, Font – Georgia with font size 12). The
research paper needs to refer to the following sources
Rubino, M.
(2018). A comparison of the Main ERM frameworks: Howq Limitations and Weakness can be Overcome
Implementing IT GOvernance. Internation Journal of Business and Management,
13(12).
In addition the
research paper needs to minimally refer to 3 peer reviewedq journal papers
The following case studies from your
book need to be referenced in your research paper
Chapter 30,
“Alleged Corruption at Chessfield: Corporate Governance and theq Risk Oversight Role of the Board of
Directors”
Chapter 31,
“Operational Risk Management Case Study: Bon Boulangerie”q
Chapter 34,
“Turning Crisis into Opportunity: Building an ERM Program atq General Motors”
In addition you
need to refer to at least two other case studies that we haveq covered so far in the course
The research needs to minimally
discuss the role of the following factors in successful ERM
implementations
Corporate
governance
Risk frameworks
such as COSO, ISO 31000q
Information
Technology
Operational
factors
Please do not describe the case
studies from the book but focus on elaborating on key points and examples from
the case studies that support the research topic.
The bibliography should be included as
a separate page and is not part of the 6 page requirement. Student assignments
will be run through Safe Assignment. Please ensure to check the safe assignment
result prior to submitting
36. HCM 4025
E-Prescribing
E-prescribing is the
transmission of prescription or prescription-related information using
electronic media between a prescriber, dispenser, pharmacy benefit manager, or
health plan, either directly or through an intermediary, including an
e-prescribing network.
In an effort to
understand the benefits and cautions about e-prescribing, conduct thorough
research. For your assignment, create a 4- to 5-page report in Microsoft Word
document consisting of your research findings covering your responses to the
following questions:
Evaluate three pros and three cons of e-prescribing.
Summarize the e-prescription standards as described by the National
Council for Prescription Drug Programs.
Evaluate the projected cost and time savings as estimated by the
United States Department of Health and Human Services.
Comment on the controversy surrounding the 2013 e-prescribing
penalty.
Use the following
resources, and 2 outside resources and your text book for this assignment.
Ratanawongsa, N.,
Lenny L. S. Chan, Fouts, M. M., & Murphy, E. J. (2017). The challenges of
electronic health records and diabetes electronic prescribing: Implications for
safety net care for diverse populations.Journal of Diabetes Research, 2017doi:10.1155/2017/8983237
Juszczyk, D.,
Charlton, J., McDermott, L., Soames, J., Sultana, K., Ashworth, M., . . .
Gulliford, M. C. (2016). Electronically delivered, multicomponent intervention
to reduce unnecessary antibiotic prescribing for respiratory infections in
primary care: A cluster randomized trial using electronic health records-REDUCE
trial study original protocol.BMJ Open, 6(8)
doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1136/bmjopen-2015-010892
Support your
responses with examples in a 3-6 page APA formatted Word Document. Include an
introduction and conclusion. Cite any sources in APA format.
37. M7a3
Assignment 3: Course Project Task XII
Final Submission
It’s now time to complete your
dissertation paper. In the previous modules, you tried different statistical
analyses as possible approaches for your final prospectus.
Now, submit your Final Prospectus
Project including a cover page and the following subheadings:
An abstract of the prospectus project.
Introduction: A one-page overview of
the background theory, definitions, and questions for the study.
Goals: A one-page summary of specific
goals and hypotheses for the study.
Sampling and sample size: In one to
two pages, describe your sample size and the sample. Address the following
points:
Who, how, and how many?
How did you come to these decisions?
How does your proposed sample size
relate to the planned power?
Operational definitions of variables
included in your study, which are as follows.
Independent variables (IVs): What they
are and how are they measured or defined in the actual research operations of
your study? For example, what exactly are the treatments being compared? Give
specifics of how they vary in such things as intensity, content, and length and
cite supportive references for background information including the effect
sizes. This will depend on the number and types of IVs and levels or categories
of each.
Dependent variables (DVs): What they
are and how are they measured in the actual research operations of your study?
How was the measurement technique developed? What are the reliabilities,
validities (citing supportive resources), and level of measurement of each
measure? Is the resulting score a single item score or a composite score? How
do you interpret the score? Are there norms available for interpreting the
score? What were the known relationships between and among the measures prior
to your data collection? Are there covariates (CVs) you plan to use? If so, how
are these measured and what are all the details of these measures (repeat all
the questions for the DVs)? This again will depend on the number of DVs.
However, sufficient information should be given for each to answer all these
questions. This could take several pages.
Procedures: Detail exactly how you
plan to develop measurements (if not already developed) and to obtain
participants or observations. How are your procedures compatible with ethical
and legal standards of research including institutional review board (IRB)
expectations? (This could be two pages long if no new development instrument is
being developed, but it could be longer if you need to detail such things as
these procedures and the establishment of reliability.)
Results: Detail your plans for using
statistical analyses to evaluate each of your research questions or hypotheses.
How will you assemble and prepare your data for SPSS analysis? Given your
statistical analysis(es), how will you do such things as screen data, make any
necessary modifications in the database, and compute composite scores, if
necessary? How will you proceed with your statistical analysis(es)? Give sample
outcome tables (with dummy data) that would be part of what you would be
presenting if you were reporting this as actual study results. Depending on the
study and the statistical methods used, this could be two to three pages long
for each question or hypothesis. However, this is variable.
Discussion: Point out possible
limitations or problems with your design and any ideas for ways to improve on
them. (This could be, at most, two pages long.)
Appendix: Include copies of your test
instruments and/or other supporting information.
Your Final Prospectus Project should
be of 10–15 pages (plus Appendix, if included). Present it in Microsoft Word.
Name your file R7034_M7_A3_LastName_FirstInitial.doc. Submit it to
theSubmissions Area by the due date assigned.
Note:
Your facilitator will assign you one research proposal submitted by a classmate
for peer review in Module 8.
All written assignments and responses
should follow APA rules for attributing sources.
Assignment 3 Grading Criteria Maximum Points Provided an introduction with an adequate
summary of the introductory background theory, definitions, and questions for
the study.8Identified and described specific goals and hypotheses for the
study8Described and justified sampling and sample size.12Identified and
operationally defined all variables to be used or measured in the study and
addressed relevant questions for IVs and DVs12Analyzed and described a plan to
develop measurements and explained how the procedures are compatible with IRB
expectations16Identified and justified statistical analyses to be used to
evaluate each of the research questions or hypotheses.16Provided a discussion
of possible limitations or problems with the design.16Included flawless copies
of test instruments, projected assignment activities with a timeline, and/or
other supporting information.12Wrote in a clear, concise, and organized manner;
demonstrated ethical scholarship in accurate representation and attribution of
sources, displayed accurate spelling, grammar, and punctuation.4Total:104
38. Research Paper
Develop
a Complete Disaster Recovery Plan to be submitted to the executive board of
your company.
Only
MS Word (.doc, .docx) and Adobe Acrobat (PDF) formats are acceptable.
Please
note that this is a formal writing, all references (peer-reviewed) mostly must
be cited appropriately within the text and clearly avoid plagiarism.
The
paper should have a minimum of 10 pages, 1.5 spacing and Times New Roman
font.
A
minimum of 5 peer review references must be provided. Reference style is
APA.
With
also 10 slides of PPT. Slides may also contain visuals and/or graph content to
enhance your presentation. Include speaker notes of at least 50 words per
slide. Use 12-point Times New Roman and APA citations and reference page.
39. Discussions
Discussion Topic 1
During the Great Recession of 2008–2009, (1) what actions would have
been required of Congress and the President had a balanced budget amendment to
the Constitution been ratified? (2) What
impact would that have had on the unemployment rate?
Discussion Topic 2
Explain how decr
Discussion Topic 2
Explain how decreased domestic investments that occur due to a budget deficit will
affect future economic growth.
40. M7a2
Assignment 2: Prospectus Project Task XI
Planning
Discriminant Analysis or Logistic Regression Analysis
In
this project task, you will formulate a research question for your study that
would be compatible with the use of either a discriminant analysis or logistic
regression analysis of selected data.
For
this assignment, write a response to the following points:
Identify one dependent variable (DV) or
criterion variable and three predictor variables from your selected
variable set that would fit the requirements of discriminant analysis or
logistic regression analysis. Create new variables if you don’t have
exactly what you would need to do this type of analysis.
State your research question in a manner
compatible with the selected type of classification analysis.
Elaborate on your design for using
discriminant analysis or logistic regression analysis for your study.
Describe and justify the methods you propose for each of the following
(discuss any possible concerns or limitations in the proposed methods):
Determining sufficient sample
size: Specify considerations for the selected alpha level, desired power,
desired effect size, and the validation checks you may plan.
Selecting a sample: How would
you ensure representativeness?
Performing statistical analyses:
Include the method to be used and validation checks.
Screening data and evaluating
assumptions: Are any data transformations or modifications required? If
yes, describe.
Interpreting the outcomes in
relation to the stated hypothesis(es).
Present
the response in Microsoft Word. Name the file
R7034_M7_A2_LastName_FirstInitial.doc and submit it to the Discussion
Area by the due date assigned.
Through the end of the module, review your
partner’s research question description and design for using a discriminant analysis
or logistic regression analysis. Post a response addressing the following
points:
What are the challenges and strengths in
the design of your partner?
How does the design promote sample
representativeness?
What are your thoughts about the proposed
sample size?
How will the methods for analyses serve
the goals of the study?
All
written assignments and responses should follow APA rules for attributing
sources.
Assignment 2 Grading CriteriaMaximum PointsAccurately
identified one DV or criterion variable and three predictor variables that
would fit the requirements of discriminant analysis or logistic regression
analysis.8Accurately identified and described the research question for design
in a manner compatible with the selected type of classification analysis.8Determined
a procedure for planning a sample size appropriate to the scope of the study
and the alpha level8Identified and clearly described any concerns or
limitations of the plan.8Determined a procedure for sample selection consistent
with the underlying assumptions of representativeness and identified any
concerns and limitations in the plan.8Identified and justified the
classification analysis method to be used and described a technique for
validating the results.8Determined a procedure for data screening and the
evaluation of assumptions and described any data transformations or
modifications required.8Justified a method for interpreting outcomes in
relation to the stated hypothesis(es).8Evaluated and critiqued partner’s plans
indicating strengths and limitations in the design, sample size, sample
selection, and the chosen method of analysis.16Wrote in a clear, concise, and
organized manner; demonstrated ethical scholarship in accurate representation
and attribution of sources, displayed accurate spelling, grammar, and
punctuation.
41. Costing Method
Use the
Internet to research the annual report of at least one (1) merchandising
company. Determine which costing method (Last In First Out [LIFO], First
In First Out [FIFO], or weighted average cost) that is used to record
inventory by your selected company.
Identify the
three (3) primary advantages and three (3) primary disadvantages of using
the costing method (LIFO, FIFO, and weighted average) that is used to
record inventory.
Provide
support for your response.
42. HCM4012
Workforce Shortage
Clickhereto read the health
care workforce shortage and its implications on America’s hospitals, at the
American Hospitals Association’s (AHA) website.
Select a hospital,
which is not more than two hours away from your place of residence. Based on
your readings and understanding, create a 5- to 6-page report in a Microsoft
Word document, that includes:
A plan for a rural,
medium-sized hospital to deal with short- and long-term workforce shortages.
Your plan should
include the following elements:
Introduction
Problem description of the healthcare workforce shortage and its
implications
The aspects that need immediate attention and aspects that need
long-term attention
Provide a rationale on why these aspects need attention
A description of the financial implications for these issues
Evaluation of alternatives with an explanation of the risks
associated with these problems
Your recommendations to solve these problems
An explanation of the methods to measure the success of the
plan
A description of the next steps, if the plan failed
Conclusion
Reference list
To support your work,
use your course and textbook readings and also use the South University Online
Library. As in all assignments, cite your sources in your work and provide
references for the citations in APA format.
Submission Details:
Your assignment should be addressed in an
5- to 6-page document.
Based
on what you read in the text, in at least 150 words, discuss three things you
agree with or disagree with, or a mix of agree/disagree.
Use
at least three key terms in bold from your text in your post.
44. M7a1
Assignment 1: SPSS Discriminant Analysis
While
regression analysis evaluates the ability of multiple predictor variables to
predict values on a single continuous variable, discriminant analysis evaluates
the ability of multiple predictor variables to predict classification on a
single categorical variable. Discriminant analysis can also be viewed as the
reverse of a MANOVA: In MANOVA, the IVs are the groups and the DVs are the
predictors. In DA, the IVs are the predictors and the DVs are the
groups. (In order to avoid semantic confusion, it’s easier to refer to IVs
as the predictors—or discriminating variables—and to DVs as the grouping
variables.)
The
emphases of MANOVA and DA are different. While MANOVA seeks to find a linear
combination of variables that will maximize the test statistic, DA is used to
establish the linear combination of dependent variables that maximally
discriminates among groups. DA is used to predict membership in naturally occurring
groups and to determine if a combination of variables can reliably predict
group membership. Several variables are included in a study to see which ones
best contribute to the discrimination between groups.
As
with factor analysis, discriminant functions are identified through the
analysis, but it remains for the researcher to provide a meaningful
interpretation and labeling of these.
Use
the Discussion
Area to ask for help in completing the tasks from your
classmates and the facilitator; likewise, offer your suggestions to those
asking for help. Participating in this community of scholars will help you
clarify processes, solve problems, and gain the immediate reinforcement you
need to quickly solidify gains that you’re making in working with multiple variables
and advanced statistics.
Open
the Statistical Package for the Social Sciences (SPSS) data file created in M6:
Assignment 1. Use the following variables:
Create
a Grouping Criterion Variable: Using the continuous data for Number of Previous
Hospitalizations, transform this into categorical data by assigning patients to
different categorical groups. You will add a new variable to your data file,
which indicates which group each case falls into. For example, use the
descriptive statistics and frequency information for the number of
hospitalizations to decide your cut-offs for scores to define each group and
then to assign patients to a group such as Group 1 (lower number of
hospitalizations), Group 2 (medium number of hospitalizations), and Group 3
(higher number of hospitalizations) or you may consider quartiles, a median
split, and dividing by standard deviation units. Justify your method.
Select
five (or more, if justified) continuous variables to use as predictor variables
for your analysis. Briefly justify your choices.
Conduct
a discriminant analysis of these data. Use the same methods and choices found
in the textbook’s sample study. Include tests for homogeneity of group
variances.
Save
the SPSS file as R7034_M7_A1_LastName_FirstInitial.sav.
Prepare
a two- to three-page (plus Appendix for tables) response, which presents a
summary report of the following information:
State a research question that could be
studied using the specified variables for a discriminant analysis.
Report the results of prescreens for the
missing data, multivariate outliers (Mahalanobis distance), univariate
normality, and linearity (bivariate scatter plots). Indicate if any
transformations or other decisions are required.
In your Appendix, report group
descriptive statistics, analysis of variance (ANOVA) summary tables,
summary of steps, eigenvalues, Wilks’ lambda table, standardized
discriminant function coefficients, cannonical correlation or structure
matrix, classification of results, and discriminant function means.
Summarize the results of the discriminant
analysis, including an interpretation of discriminant functions. Compare
the outcomes in terms of the research question.
Create
your response in Microsoft Word. Name your file
R7034_M7_A1_LastName_FirstInitial.doc. Submit your response to the Discussion Area
by the
due date assigned.
All
written assignments and responses should follow APA rules for attributing
sources.
Assignment 1 Grading CriteriaMaximum PointsCorrectly
created a nominal variable for number of hospitalizations and assigned cases to
each group.4Identified and justified choice of continuous variables to use as
predictor variables for the DA.4Accurately interpreted the results of
prescreens for the missing data, multivariate outliers, univariate normality,
and linearity.8Conducted discriminant analysis and reported the results
correctly for group descriptive statistics, ANOVA summary tables, summary of
steps, eigenvalues, Wilks’ lambda table, standardized discriminant function
coefficients, correlation coefficients or structure matrix, classification of
results, and discriminant function means.36Presented an informative narrative
summary of the analysis.24Participated actively in the Discussion
Area by asking for or providing clarification of a response,
addressing gaps, offering suggestions, and asking for help, as needed.8Wrote in
a clear, concise, and organized manner; demonstrated ethical scholarship in
accurate representation and attribution of sources, displayed accurate
spelling, grammar, and punctuation.4Total:88
45. PURPOSE-DRIVEN MARKETING Portfolio
Essay
My Portfolio
MARKETING STRATEGY. Imagine you work at a large multi-brand
company of your choosing (e.g., Apple, Nestle, Unilever). (a) BRAND DEVELOPMENT
STRATEGIES. Imagine you are hired as a Brand Manager for any one brand at the
company. Name the brand (e.g., iPhone). Using the slide titled “4 Brand
Development Strategies,” detail 4 pathways to grow the Brand. (i) LINE
EXTENSION. (ii) BRAND EXTENSION. (iii) MULTIBRAND. (iv) NEW BRAND. (v) Rank
order the anticipated success of these 4 strategies and explain your reasoning.
(b) BUSINESS GROWTH STRATEGIES. Flash forward a few years, imagine you are now
promoted to a Vice President position for a region of your choosing. Name the
region (e.g., USA). Using the slide titled “4 Strategies for Growing
Businesses,” detail 4 pathways to grow the Company. (i) MARKET PENETRATION.
(ii) PRODUCT DEVELOPMENT. (iii) MARKET DEVELOPMENT. (iv) DIVERSIFICATION. (v)
Rank order the anticipated success of these 4 strategies and explain your
reasoning.
PURPOSE-DRIVEN INNOVATION. Think of a purpose-driven innovation in each
of the following market categories: (a) TRANSPORTATION, (b) FOOD AND BEVERAGES,
and (c) PERSONAL CARE. Within each category, answer these questions. (i)
CATEGORY INNOVATION. Describe the status quo in the product category, your
purpose, and your innovation. (ii) TARGET MARKET. Identify the consumer segment
who will be the most likely to value your category innovation. Use demographic,
geographic, psychographic, and/or behavioral variables to define this segment.
(iii) ANTICIPATED RESPONSE. Anticipate the response and resistance to your
innovation from other relevant stakeholders (e.g., activists, employees,
communities, governments, journalists). (iv) PROMOTION MIX. Explain how you
would promote this innovation to ensure that it is a success. The slide
entitled “Promotion Mix” could serve as a checklist of options.
MAKING THE PITCH. A key step in any marketing project is
pitching your ideas to your colleagues, bosses, partners, and funders. Watch
any 3 pitches from the TV show Shark Tank on YouTube. You just need to watch
the pitch, not the investor negotiations. (a) LINKS. List weblinks for the 3
pitches you selected. (b) THE LEAST EFFECTIVE. In your opinion, which pitch was
the least effective and why? If you were to redo the least effective pitch,
what would you do differently? (c) THE MOST EFFECTIVE. Which pitch was the most
effective and why? If you were to redo the most effective pitch to make it even
better, what would you do differently? (d) PITCHING EXPERIENCE. Describe any
experience you have had pitching a new idea to a tough audience and what you
learned from the experience. (e) MY PITCH. As an entrepreneur, you are seeking
venture capital for a new business idea. Please write a short elevator pitch.
CAREER ADVANCEMENT. Find 5 different job ads (internships or
permanent jobs) in marketing or other business areas that interest you. Aim for
as much variety as possible. At least one of these jobs should be at a global
company (e.g., Nestle, P&G, Unilever, etc.). At least one of these jobs
should be at a relatively small company in NYC. (a) JOB ADS. Provide web links
to the descriptions of each of these 5 jobs. (b) VALUES-BASED SELECTION. Which of
these jobs most closely aligns with your personal values and how? (c) LIKELY
HURDLES. Identify all the educational, experiential, psychological, and
practical hurdles you might face in securing these jobs. (d) MY NEXT STEPS.
Enumerate the steps that you are going to take to overcome these hurdles and
get these jobs in the next few months.
PROFESSIONAL DEVELOPMENT. (a) COURSE SLIDES. From all the slides
discussed in the course so far, elaborate on 3 course slides that could be helpful for
your personal or professional goals. Describe when, where, and/or how you might
use the slide. (b) CHARACTER STRENGTHS. Describe 3 character strengths that you think you have
improved upon during this course. Describe where you used to be, how you have
progressed, and how you hope to develop next. (c) WELL-BEING PILLARS. Do the pillars of well-being exercise. Identify at
least 3 actionable insights you learn about your current circumstances.
Directions for Portfolios
Each portfolio consists of five projects. The recommended word
count is at minimum 1000 words per project (or 5000 per portfolio). The
projects are purposefully open to customization. Students are free to make
adaptations to match their specific career interests.
Evaluation criteria. The grade is determined as follows: 50% for completion + 50% for
quality. What constitutes high quality in business is necessarily defined by
competition. That said, here are some typical quality markers:
readability;
shorter sentences are generally clearer than longer ones
logic; all of
the assumptions and arguments make sense
concepts and
frameworks from the slides and beyond (e.g., Changing
Minds)
all concepts
and frameworks are explained before they are applied
several
different sources of data and insights from appropriate sources
useful
examples to illustrate the key points
no long quotes,
which signal an inability to synthesize
elegant
presentation, including clear organization and consistent formatting
conceptual
illustrations (e.g., process maps, comparison tables)
photographs
or other images that provide evidence or animate key ideas
Examples. Students who have limited exposure to professional business
reports are encouraged to review examples before producing their own.
Submission checklist. Consider these items before you submit:
Does your
cover page include your own name?
Does your
table of contents list page numbers for each project?
Does each
project begin on a new page?
Are your
sources cited in the text and referenced in a works cited page?
Do your
citations/references use a standard format (e.g., MLA)?
Is most of
the text in a readable 10-12 font size?
Is your text
single-spaced like most professional reports?
Is each part
clearly numbered (1, 2, 3…/a, b, c…/i, ii, iii…)?
Is each part
clearly titled to help guide the reader?
Have you run
a spelling and grammar check?
46. Movie Critical Review
Watch
the following film and write a 2-page reaction paper/review.
Salt of the Earth: https://www.youtube.com/watch?v=n3VPWmqaOb4
47. Case Study
APA STYLE- 2
Pages
Synthesis: Suggest ways
to improve/strengthen your chosen solution (may use information not contained
within the scenario). Scenario: Security at All Pine Medical Center.
Questions:
a. Identify
concepts and ideas from multiple sources that improve or strengthen your
solution.
b.
Identify any new found information and the impact that new information may or
may not have on your solution.
c.
Identify potential missing information and the impact that missing information
may or may not have on your solution.
48. Macro Econ Discussion
Go to the internet and find a news article
published within the last three monthsthat discusses balancing the federal
budget of the U.S. and fiscal policy, summarize key points and post in the
Discussions area. Discuss the current level of the Federal budget deficit
and the implications of the deficit. Support a proposal for addressing
these concerns.
Reflection – the students also should include
a paragraphin the initial
responsein their own words
reflecting on specifically what they learned from the assignment and how they think
they could apply what they learned in the workplace.
49. Research Paper
Develop
a Complete Disaster Recovery Plan to be submitted to the executive board of
your company.
The
paper should have a minimum of 10 pages and APA format. A minimum of 5
peer reviewed references in APA.
50. “Nike Sweatshops: Behind The
Swoosh” (300 Words) Reflection
Watch
the videos below and write a 300-word individual reflection discussing
two most poignant/surprising things you learned from this video.
You can focus on Jim Keady’s story and mission, any new perspectives this opens
for you, and how the issue connects with international business (law) and
corporate social responsibility.
In
this video, Jim Keady, a renowned speaker on social injustice, recounts his
experience living in Indonesia for a month on Nike sweatshop worker
wages.
Using your
Beyond the Book Guide, course materials, and online resources, assume the role
of the office manager and provide the following information for your staff to
ensure they understand the electronic record keeping systems used in the
medical office. What is a practice management system
(PMS) used for in a medical office? How is a PMS related to an electronic
health record (EHR) system? Name 2 uses for computers and software
programs in a medical office in addition to the electronic health record
entries and explain what is meant by a computer back up and why it is important
in a medical office. What is meant by supply chain management and
why is it important in a healthcare organization?
Every college student should at the very least strive to have the following items well planned for this fall sessions when the finals can be a pain. The first is a good timetable which would enable them to plan their time well. Second is a good sleep schedule which would give their bodies energy to handle the pressures that comes with fall finals. The last and most important is – a relievable college homework help website – which in this case is homeworknest.com. Someone would for instance ask … where can I get assignments help this fall semester for pay? Who can Ace My Homework this Fall Semester? Any Website similar to AceMyHomework.com? Is there a website that helps college students with their homework? Can I get Exam help this fall semester at www.homeworknest.com …. Yes, HomeworkNest.com is the best website for college students to pay someone to do their homework. This fall 2018 Finals are scoring straight alpha grades at www.homeworknest.com. At homeworknest.com, college and university students post their homework for free, pick a tutor to handle the assignment and pay later. Homework nest has been voted the best website for college homework help which is not just another studypool or homeworkmarket place but a website where you can find someone to do your homeworkforyou!
Get all Nursing College Homework Help at Homework Nest (www.homeworknest.com) – Voted best for college Homework Help this fall semester! Ace Your Fall Finals Today!
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
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?
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?
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:
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?
IV
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?
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?
IV
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 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?
9%
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
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
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
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
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
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 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
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 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?
9%
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
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
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.
Walden NURS6501 Week 7 Quiz
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
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
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 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
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?
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
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?
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
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
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?
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
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?
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
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:
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?
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
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?
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
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?
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
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.
NURS6521 Week 2 Quiz latest 2017
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
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
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:
1
2
3
4
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
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
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:
1
2
3
4
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
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:
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
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
