nrnp6665 midterm exam 2022 100% graded
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• Question 1
0 out of 0 points
When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
• Question 2
The most common cancer found on the auricle is:
Basal cell carcinoma
Squamous cell carcinoma
Acral-lentiginous melanoma
• Question 3
1 out of 1 points
0 out of 1 points
Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?
Answers: Xanthines
Antihistimine
s Steroids
Anticholinerg ics
• Question 4
0 out of 1 points
A 47 year old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On examination, external hemorrhoids are noted. How should the nurse practitioner proceed?
Answers: Instruct the patient on measures to prevent hemorrhoids such as bowel habits and diet.
Order a topical hemorrhoid cream along with a stool softener.
Refer the patient for a barium enema and sigmoidoscopy.
Refer the patient for a surgical hemorrhoidectomy.
• Question 5
0 out of 1 points
Which of the following patient characteristics are associated with chronic bronchitis?
Answers:
Overweight, cyanosis, and normal or slightly increased respiratory rate
Underweight, pink skin, and increased respiratory rate
Overweight, pink skin, and normal or slightly increased respiratory rate
Normal weight, cyanosis, and greatly increased respiratory rate
• Question 6
1 out of 1 points
A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent care with new onset left lower quadrant pain. Her current medications include omeprazole 20 milligrams po daily, lisinopril 20 milligrams po daily, simvastatin 20 milligrams po daily, and prednisone 12 milligrams po daily. The nurse practitioner suspects acute diverticulitis and possibly an abscess. The most appropriate diagnostic test for this patient at this time is:
Answers: CBC/dif
Erythrocyte sedimentation rate
Abdominal ultrasound
CT scan
• Question 7
1 out of 1 points
A patient reports “something flew in my eye” about an hour ago while he was splitting logs. If there were a foreign body in his eye, the nurse practitioner would expect to find all except:
Answers:
Purulent drainage
Tearing Photophobia
A positive fluorescein stain
• Question 8
1 out of 1 points
A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect:
Answers: Viral conjunctivitis Common pink eye
Gonococcal conjunctivitis
Allergic conjunctivitis
• Question 9
0 out of 1 points
A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 diferent thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect:
Answers: A common case of shingles and prescribe an analgesic and an antiviral agent
A complicated case of shingles and prescribe acyclovir, an analgesic, and a topical cortisone cream
Herpes zoster and consider that this patient may be immunocompromised
A recurrence of chickenpox and treat the patient’s symptoms
• Question 10
Which type of lung cancer has the poorest prognosis?
Answers: Adenocarcinoma
Epidermoid carcinoma
Small cell carcinoma
Large cell carcinoma
• Question 11
0 out of 1 points
1 out of 1 points
An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3– 4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has:
Answers: Acute diarrhea
Chronic diarrhea Irritable bowel
Functional bowel disease
• Question 12
1 out of 1 points
Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect?
Answers: An allergic reaction
Relapsing polychondritis
Lymphocytoma cutis
Systemic lupus
erythematosus
• Question 13
1 out of 1 points
Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes?
Answers: Chronic sinusitis
Acute bronchitis Bacterial pneumonia
Acute exacerbation of chronic bronchitis
• Question 14
0 out of 1 points
Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations afect her activities and they occur at least twice weekly and may last for days. She is afected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in?
Answers: Mild intermittent
Mild persistent
Moderate
persistent
• Question 15
0 out of 1 points
Which of the following is the most appropriate therapeutic regimen for an adult patient with no known allergies diagnosed with group A B-hemolytic strep?
Answers:
Penicillin V 500 milligrams PO every 8 hours for 10 days
Ampicillin 250 milligrams PO twice a day for 10 days
Clarithromycin 500 milligrams po daily for 7 days
None of the above
• Question 16
0 out of 1 points
A cashier complains of dull ache and pressure sensation in her lower legs. It is relieved by leg elevation. She occasionally has edema in her lower legs at the end of the day. What is the most likely cause of these problems?
insufficiency
Answers: Congestive heart failure
Varicose veins
Deep vein thrombosis
Arterial insufficiency
• Question 25
1 out of 1 points
A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with:
Answers: Mitral regurgitation
Systolic heart failure
Cardiac myxoma
Diastolic heart failure
• Question 26
1 out of 1 points
Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized?
Answers:
Multilobar involvement on chest x-ray with the inability to take oral medications
Alert and oriented, slightly high but stable vital signs, and no one to take care of her at home
Sputum and gram positive organisms
A complete blood count showing leukocytosis
• Question 27
0 out of 1 points
A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him:
Answers: “It is the most common cause of death in patients with skin cancer.”
“It can be cured with surgical excision or radiation therapy.”
“It is a slow growing skin cancer that rarely undergoes malignant changes.”
“It can be cured using 5-flurouracil cream twice daily for 2 to 4 weeks.”
• Question 28
1 out of 1 points
Expected spirometry readings when the patient has chronic emphysema include:
Answers: Decreased residual volume (RV)
Increased vital capacity (VC)
Increased forced expiratory volume (FEV-1)
Increased total lung capacity (TLC)
• Question 29
1 out of 1 points
An 80-year-old male admits to difficulty swallowing during the review of systems. The nurse practitioner recognizes the diferential diagnosis for this patient’s dysphagia is:
Answers: Esophageal cancer
Chest pain GERD
A and C
All of the above
• Question 30
0 out of 1 points
A 40 year old female with history of frequent sun exposure presents with a multicolored lesion on her back. It has irregular borders and is about 11mm in diameter. What should the nurse practitioner suspect?
Answers: Squamous cell carcinoma
Malignant melanoma
A common nevus
Basal cell carcinoma
• Question 31
1 out of 1 points
Which of the following is not a goal of treatment for the patient with cystic fibrosis?
Answers: Prevent intestinal obstruction
Provide adequate nutrition
Promote clearance of secretions
Replace water-soluble
vitamins
• Question 39
Which of the following statements about malignant melanomas is true?
Answers: They usually occur in older adult males
The patient has no family history of melanoma They are common in blacks
The prognosis is directly related to the thickness of the lesion
• Question 40
1 out of 1 points
Sheila, age 78, presents with a chief complaint of waking up during the night coughing. You examine her and find an S3 heart sound, pulmonary crackles that do not clear with coughing, and peripheral edema. What do you suspect?
Answers: Asthma Nocturnal
allergies
Valvular disease
Heart failure
• Question 41
0 out of 1 points
Which antibiotic would be the most efective in treating community acquired pneumonia (CAP) in a young adult without any comorbid conditions?
Answers: Erythromycin
Clarithromycin (Biaxin)
Doxycycline (Vibramycin)
Penicillin
• Question 42
1 out of 1 points
Which of the following dermatologic vehicles are the most efective in absorbing moisture and decreasing friction?
Answers:
Powde rs
Gels
Cream s
Lotion
• Question 43
1 out of 1 points
A 70 year old patient presents with a slightly raised, scaly, erythematous patch on her forehead. She admits to having been a “sun worshiper.” The nurse practitioner suspects actinic keratosis. This lesion is a precursor to:
Answers:
Squamous cell carcinoma
Basal cell carcinoma
Malignant melanoma
Acne vulgaris
• Question 44
1 out of 1 points
An elderly patient is being seen in the clinic for complaint of “weak spells” relieved by sitting or lying down. How should the nurse practitioner proceed with the physical examination?
Selected
Answer: Compare the patient’s blood pressure lying first, then sitting, and then standing.
Answers: Assist the patient to a standing position and take her blood pressure.
Assess the patient’s cranial nerves.
Compare the patient’s blood pressure lying first, then sitting, and then standing.
Compare the amplitude of the patient’s radial and pedal pulses.
• Question 45
1 out of 1 points
What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery?
Answers:
Ursodiol Ibuprofen
Prednisone
Surgery is the only answer
• Question 46
0 out of 1 points
A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is:
Answers: Staphylococcus aureus
Group A beta hemolytic streptococcus
Haemophilus influenza
Pseudomonas aeruginosa
• Question 47
Which of the following is not a symptom of irritable bowel syndrome?
Answers: Painful diarrhea Painful constipation
Cramping and abdominal pain
Weight loss
• Question 48
0 out of 1 points
1 out of 1 points
A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed?
Answers:
Any recent trauma Difficulty swallowing
Stifness in the right shoulder
Change in sleeping habits
• Question 49
0 out of 1 points
Marvin, age 56, is a smoker with diabetes. He has just been diagnosed as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis?
Answers: ACE Inhibitor
Beta Blocker
Calcium channel blocker
Diuretic
• Question 50
1 out of 1 points
The diferential diagnosis for a patient complaining of a sore throat includes which of the following?
Answers: Gonococcal infection
Thrush Leukoplakia B only
A, B, and C
• Question 51
0 out of 1 points
A patient presents to the primary care provider complaining of a rash on his right forehead that started yesterday and is burning and painful. The physical exam reveals an erythematous, maculopapular rash that extends over the patient’s right eye to his upper right forehead. Based on the history and examination, the most likely cause of this patient’s symptoms is:
Answers: Rhus dermatitis
Ophthalmic zoster
Chemosis
Optic neuritis
• Question 52
0 out of 1 points
Before initiating an HMG CoA-reductase inhibitor for hyperlipidemia, the nurse practitioner orders liver function studies. The patient’s aminotransferase (ALT) is elevated. What laboratory test(s) should be ordered?
Answers:
Serologic markers for hepatitis Serum bilirubin
Serum cholesterol with HDL and LDL
A liver biopsy
• Question 53
1 out of 1 points
A patient with elevated lipids has been started on lovastatin. After 3 weeks of therapy, he calls to report generalized muscle aches. The nurse practitioner should suspect:
Answers: A drug interaction
Hepatic dysfunction
Hypersensitivity to lovastatin
Rhabdomyolysis
• Question 54
Treatment of acute vertigo includes:
1 out of 1 points
Answers:
Bedrest and an antihistamine
Fluids and a decongestant
A sedative and decongestant
Rest and a low sodium diet
• Question 63
Appropriate therapy for peptic ulcer disease (PUD) is:
use
Answers: Primarily by eradication of infection
Based on etiology
Aimed at diminishing prostaglandin synthesis
Dependent on cessation of NSAID use
• Question 64
0 out of 1 points
Shirley, age 58, has been a diabetic for 7 years. Her blood pressure is normal. Other than her diabetes medications, what would you prescribe today during her routine office visit?
Answers: A calcium channel blocker
A beta blocker
An ACE Inhibitor
No hypertension medication
• Question 65
1 out of 1 points
Medicare is a federal program administered by the Centers for Medicare and Medicaid Services (CMS). The CMS has developed guidelines for Evaluation and Management coding, which all providers are expected to follow when coding patient visits for reimbursement. Which of the following is an important consideration regarding billing practices?
Answers: It is important to “undercode” so that one does not get charged with Medicare fraud
The practice of “overcoding” is essential in this age of decreasing reimbursements
Failing to bill for billable services will lead to unnecessarily low revenues
Time spent with the patient is a very important determinant of billing
• Question 66
1 out of 1 points
A 2 year old presents with a white pupillary reflex. What is the most likely cause of this finding?
Answers: Viral conjunctivitis
Glaucoma
Corneal abrasion
Retinoblastom
a
• Question 67
0 out of 1 points
Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?
Answers: Pharmacological therapy
A labyrinthectomy
A vestibular neurectomy
Wearing an earplug in the ear with the most hearing loss
• Question 68
Which of the following is not a risk factor for coronary arterial insufficiency?
Answers: Hyperhomocystein emia
Smoking Genetic factors
Alcohol ingestion
• Question 69
1 out of 1 points
An 18-year-old female presents to the urgent care center complaining of severe pruritus in both eyes that started 2 days ago. Associated symptoms include a headache and fatigue. On examination, the nurse practitioner notes some clear discharge from both
eyes and some erythema of the eyelids and surrounding skin. Which of the following is the most likely cause of this patient’s symptoms?
Answers:
Allergic conjunctivitis
Bacterial conjunctivitis
Gonococcal conjunctivitis
Viral conjunctivitis
• Question 70
0 out of 1 points
A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most efective in keeping him symptom-free?
Answers: A long-acting bronchodilator
An inhaled corticosteroid and cromolyn
Theophylline and a short acting bronchodilator
A bronchodilator PRN and an inhaled
corticosteroid
• Question 71
0 out of 1 points
Acute rheumatic fever is an inflammatory disease which can follow infection with:
Streptococcus
Answers:
Group A Streptococcus
Staphlococcus areus
Β-hemolytic Streptococcus
Streptococcus pyogenes
• Question 72
0 out of 1 points
A 60 year old male diabetic patient presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which “is better.” His temperature is 100°F and pulse is 102 bpm. The most appropriate initial action is to:
Answers: Start an oral antibiotic, refer the patient to a dentist immediately, and follow up within 3 days
Order mandibular x-rays and question the patient about physical abuse
Start an oral antibiotic, mouth swishes with an oral anti-infective, and an analgesic
Initiate a parenteral antibiotic and consider hospital admission
• Question 73
1 out of 1 points
If a patient presents with a deep aching, red eye and there is no discharge, you should suspect:
Answers:
Iritis Allergic
conjunctivitis
Viral conjunctivitis
Bacterial conjunctivitis
• Question 74
1 out of 1 points
The National Cholesterol Education Program’s Adult Treatment Panel III recommends that the goal for low density lipoproteins in high risk patients be less than:
mg/dL
Answers: 160
mg/dL
130
mg/dL
100
mg/dL
70
mg/dL
• Question 75
1 out of 1 points
A patient presents with classic symptoms of gastroesophageal reflux disease (GERD). He is instructed on life style modifications and drug therapy for 8 weeks. Three months lat
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