NURS 6531 FINAL EXAM (2 VERSIONS) & NURS 6531 MIDTERM EXAM

NURS 6531 FINAL EXAM (2 VERSIONS) & NURS 6531 MIDTERM EXAM (2 VERSIONS) (100 CORRECT Q & A IN EACH VERSION, TOTAL: 400 Q & A)

  

NURS 6531 Final Exam / NURS6531 Final Exam (Latest): Walden University

Walden NURS 6531 Final Exam / Walden NURS6531 Final Exam (Latest)

· Question 1

       

When   completing this quiz, did you comply with Walden University’s Code of Conduct   including the expectations for academic integrity?

· Question 2

       

Central obesity, “moon” face, and dorsocervical fat pad   are associated with:

  

A.

 

Metabolic     syndrome

 

B.

 

Unilateral     pheochromocytoma

 

C.

 

Cushing’s     syndrome

 

D.

 

None     of the above

            

· Question 3

       

An elderly man is started on lisinopril and   hydrochlorhiazide for hypertension. Three days later, he returns to the   office complaining of left great toe pain. On exam, the nurse practitioner   notes an edematous, erythematous tender left great toe. The likely   precipitant of this patient’s pain is:

  

A.

 

Trauma

 

B.

 

Tight     shoes

 

C.

 

Arthritis     flare

 

D.

 

Hydrochlorothiazide

            

· Question 4

       

The most effective treatment of non-infectious bursitis   includes:

            

· Question 5

       

What conditions must be met for you to bill “incident to”   the physician, receiving 100% reimbursement from Medicare?

      

Answers:

 

You must initiate the plan     of care for the patient

  

The physician must be     on-site and engaged in patient care

  

You must be employed as an     independent contractor

  

You must be the main health     care provider who sees the patient

            

· Question 6

       

Which of the following is not a risk factor associated   with the development of syndrome X and type 2 diabetes mellitus?

            

· Question 7

       

Which of the following is not a common early sign of   benign prostatic hyperplasia (BPH)?

A.   Nocturia
B. Urgency incontinence
C. Strong urinary stream flow
D. Straining to void

            

· Question 8

       

Steve, age 69, has gastroesophageal reflux disease (GERD).   When teaching him how to reduce his lower esophageal sphincter pressure,   which substances do you recommend that he avoid?

§ Food that is very hot or very cold 

§ Fatty or fried foods 

§ Peppermint or spearmint, including flavoring 

§ Coffee, tea, and soft drinks that contain caffeine 

§ Spicy, highly seasoned foods 

§ Fried foodDT caffeine, chocolate and anticholinergics

            

· Question 9

       

Which drug category contains the drugs that are the first   line Gold standard therapy for COPD?

            

· Question 10

       

The most commonly recommended pharmacological treatment   regimen for low back pain (LBP) is:

            

· Question 11

       

Which of the following is not appropriate suppression   therapy for chronic bacterial prostatitis?

            

· Question 12

       

A patient presents with dehydration, hypotension, and   fever. Laboratory testing reveals hyponatremia, hyperkalemia, and   hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks   later with the same symptoms of hyperpigmentation, weakness, anorexia,   fatigue, and weight loss. What action(s) should the nurse practitioner take?

.A Obtain a   thorough history and physical, and check serum cortisol and ACTH levels.
 

  B. Perform a diet history and check CBC and FBS.
 

  C. Provide nutritional guidance and have the patient return in one month.
 

  D. Consult home health for intravenous administration

                                                

· Question 13

The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is:  

· Question 14

How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout?

· Question 15

       

The intervention known to be most effective in the   treatment of severe depression, with or without psychosis, is:

· Question 16

       

You are assessing a patient after a sports injury to his   right knee. You elicit a positive anterior/posterior drawer sign. This test   indicates an injury to the: he
  A. lateral meniscus
  B. cruciate ligament
  C. medial meniscus
  D. collateral ligament.

            

· Question 17

   

  

A 32 year old female patient presents with fever, chills,   right flank pain, right costovertebral angle tenderness, and hematuria. Her   urinalysis is positive for leukocytes and red blood cells. The nurse   practitioner diagnoses pyelonephritis. The most appropriate management is:

                        

· Question 18

       

A 21-year-old female presents to the office   complaining of urinary frequency and urinary burning. The nurse practitioner   suspects a urinary tract infection when the urinalysis reveals

· Question 19

       

A middle-aged man presents to urgent care complaining of   pain of the medial condyle of the lower humerus. The man works as a carpenter   and describes a gradual onset of pain. On exam, the medial epicondyle is   tender and pain is increased with flexion and pronation. Range of motion is   full The most likely cause of this patient’s pain is: 

                        

· Question 20

       

The initial clinical sign of Dupuytren’s contracture is:

·  

· Question 21

       

The best test to determine microalbuminuria to assist in   the diagnosis of diabetic neuropathy

            

· Question 22

       

What is the first symptom seen in the majority of patients   with Parkinson’s disease?

            

· Question 23

       

The most commonly recommended method for prostate cancer   screening in a 55 year old male is:

            

· Question 24

       

Martin, age 24, presents with an erythematous ear canal,   pain, and a recent history of swimming. What do you suspect?

            

· Question 25

       

Which of   the following symptoms suggests a more serious cause of back pain?

                                    

· Question 26

       

Josh, age 22, is a stock boy and has an acute episode of   low back pain. You order and NSAID and tell him which of the following?

· Question 27

       

A 72 year old female patient reports a 6 month   history of gradually progressive swollen and painful distal interphalangeal   (DIP) joints of one hand. She has no systemic symptoms but the erythrocyte   sedimentation rate (ESR), antinuclear antibody (ANA), and rheumatoid factor   (RF) are all minimally elevated. What is the most likely diagnosis?

· Question 28

       

A patient taking levothyroxine is being   over-replaced. What condition is he at risk for?

            

· Question 29

       

Which of the following is the most common cause of low   back pain?

  

A.

 

Lumbar     disc disease

 

B.

 

Spinal     stenosis

 

C.

 

Traumatic     fracture

 

D.

 

Osteoporosis

            

· Question 30

       

Which is the most common cause of end-stage renal disease   in the United States?

            

· Question 31

       

A 77-year-old female presents to the office complaining a   sudden swelling on her right elbow. She denies fever, chills, trauma, or   pain. The physical exam reveals a non-tender area of swelling over the   extensor surface over the right elbow with evidence of trauma or irritation.   The nurse practitioner suspects:

  

A.

 

Arthritis

 

B.

 

Ulnar     neuritis

 

C.

 

Septic     arthritis

 

D.

 

Olecranon     bursitis

            

· Question 32

       

A 60 year old female patient complains of sudden onset   unilateral, stabbing, surface pain in the lower part of her face lasting a   few minutes, subsiding, and then returning. The pain is triggered by touch or   temperature extremes. Physical examination is normal. Which of the following   is the most likely diagnosis?

            

· Question 33

       

Beth, age 49, comes in with low back pain. An x-ray of the   lumbosacral spine is within normal limits. Which of the following diagnoses   do you explore further?

            

· Question 34

       

A patient exhibits extrapyramidal side effects of   antipsychotic medications. Which of the following symptoms would lead you to   look for another diagnosis?

            

· Question 35

       

Phalen’s test, 90°wrist flexion for 60 seconds, reproduces   symptoms of:

                        

· Question 36

       

Jennifer says that she has heard that caffeine can cause   osteoporosis and asks you why. How do you respond?

· Question 37

       

The most common cause of elevated liver function tests is:

            

· Question 38

       

Reed-Sternberg B lymphocytes are associated with which of   the following disorders:

  

A.

 

Aplastic anemia

 

B.

 

Hodgkin’s lymphoma

 

C.

 

Non Hodgkin’s lymphoma

 

D.

 

Myelodysplastic syndromes

            

· Question 39

       

Which of the following is a potential acquired cause of   thrombophilia?

  

A.

 

Homocysteinuria

 

B.

 

Protein C deficiency

 

C.

 

Factor V Leiden

 

D.

 

Antiphospholipid antibodies

                        

· Question 41

       

A 75-year-old female is diagnosed with primary   hyperparathyroidism and asks the nurse practitioner what the treatment for   this disorder is. The nurse practitioner explains:

  

Primary     hyperparathyroidism is treated with Vitamin D restriction

 

Primary     hyperparathyroidism is treated with parathyroidectomy

 

Primary     hyperparathyroidism is treated with daily magnesium

 

Primary     hyperparathyroidism is treated with parenteral parathyroid hormone (PTH)

                         

· Question 42

       

Diagnostic confirmation of acute leukemia is based on:

·  

· Question 43

       

A 25 year old overweight patient presents with a   complaint of dull achiness in his groin and history of a palpable lump in his   scrotum that “comes and goes”. On physical examination, the nurse   practitioner does not detect a scrotal mass. There is no tenderness, edema,   or erythema of the scrotum, the scrotum does not transilluminate. What is the   most likely diagnosis?

A. Testicular   torsion
 

  B. Epididymitis
 

  C. Inguinal hernia
 

  D. Varicocele

            

· Question 44

       

Dave, age 38, states that he thinks he has an ear   infection because he just flew back from a business trip and feels unusual   pressure in his ear. You diagnose barotrauma. What is your next action?

A. Prescribe nasal steroids and oral decongestants
  B. Prescribe antibiotic eardrops
  C. Prescribe systemic eardrops
  D. Refer David to an ear, nose, and throat specialist

                        

· Question 45

       

Which of the following antibiotics should not be   prescribed for a pregnant woman in the 3rd trimester?

· Question 46

       

The physiological explanation of syncope is:

            

· Question 47

   

  

A 20 year old male patient complains of “scrotal   swelling.” He states his scrotum feels heavy, but denies pain. On   examination, the nurse practitioner notes transillumination of the scrotum.   What is the most likely diagnosis?

            

· Question 48

       

A 32 year old male patient complains of urinary   frequency and burning on urination for 3 days. Urinalysis reveals   bacteriuria. He denies any past history of urinary tract infection. The   initial treatment should be: nclude nitrofurantoin monohydrate/macrocrystals,   trimethoprim-sulfamethoxazole (TMP-SMX), or fosfomycin. 

            

· Question 49

       

Diagnostic radiological studies are indicated for low back   pain:

                        

· Question 50

      

 

Who is at a higher risk for developing nephrolithiasis?

·  

· Question 51

      

 

An 81-year-old female is diagnosed with type 2 diabetes.   When considering drug therapy for this patient, the nurse practitioner is   most concerned with which of the following side effects?

  

A.

 

Weight     gain

 

B.

 

Fracture     risk

 

C.

 

Hypoglycemia

 

D.

 

Weight     loss

                        

· Question 52

       

A 28-year-old female presents to the office requesting   testing for diagnosis of hereditary thrombophilia. Her father recently had a   deep vein thrombosis and she is concerned about her risk factors. The nurse   practitioner explains that:

· Question 53

       

The diagnosis of human papilloma virus (HPV) infection in   males is usually made by:

            

· Question 54

       

Which history is commonly found in a patient with   glomerulonephritis?

            

· Question 55

       

A   patient complains of generalized joint pain and stiffness associated with   activity and relieved with rest. This patient history is consistent with   which of the following disorders?

            

· Question 56

       

The most common presentation of thyroid cancer is:

            

· Question 57

       

The obligatory criteria for diagnosis of muscular   dystrophy (MD) are:

            

· Question 58

       

The diagnosis which must be considered in a patient who   presents with a severe headache of sudden onset, with neck stiffness and   fever, is:

            

· Question 59

       

A 60 year old male patient with multiple health   problems presents with a complaint of erectile dysfunction (ED). Of the   following, which medication is most likely to be causing the problem?

            

· Question 60

       

A 72 year old patient exhibits sudden onset of fluctuating   restlessness, agitation, confusion, and impaired attention. This is   accompanied by visual hallucinations and sleep disturbance. What is the most   likely cause of this behavior?

A. Dementia
 

  C. Parkinson’s disease
 

  D. Depression

            

· Question 61

       

Which of the following set of symptoms should raise   suspicion of a brain tumor?  

            

· Question 62

       

The cornerstone of treatment for   stress fracture of the femur or metatarsal stress fracture is: 

            

· Question 63

       

Sally, a computer programmer, has just been given a new diagnosis   of carpal tunnel syndrome. Your next step is to:

            

· Question 64

       

Marsha presents with symptoms resembling both fibromyalgia   and chronic fatigue syndrome, which have many similarities. Which of the   following is more characteristic of fibromyalgia?

A.   Musculosckeletal pain
  B. Difficulty sleeping
  C. Depression
  D. Fatigue

            

· Question 65

       

The cardinal sign of infectious arthritis is:

             

            

· Question 66

       

Diagnostic evaluation for urinary calculi includes:

                                                

· Question 67

       

Martin, a 58 year old male with diabetes, is at your   office for his diabetes follow up. On examining his feet with monofilament,   you discover that he has developed decreased sensation in both feet. There are   no open areas or signs of infection on his feet. What health teaching should   Martin receive today regarding the care if his feet?

See a   podiatrist yearly; wash your feet daily with
  warm, soapy water and towel dry between the
  toes; inspect your feet daily for any lesions; and
  apply lotion to any dry areas.

· Question 68

       

Potential causes of septic   arthritis include which of the following?

· Question 69

       

Which of the following is the best response to a woman who   has just admitted she is a victim of spousal abuse?

· Question 70

       

A 15 year-old female patient is 5 feet tall and weighs 85   pounds. You suspect anorexia and know that the best initial approach is to:

Having   the client in view of staff for 90 minutes after each meal

            

· Question 71

       

A 63-year-old man presents to the office with hematuria,   hesitancy, and dribbling. Digital rectal exam (DRE) reveals a moderately   enlarged prostate that is smooth. The PSA is 1.2. What is the most   appropriate management strategy for you to follow at this time?

A. Prescribe   an alpha adrenergic blocker.
  B. Recommend saw palmetto.
  C. Prescribe an antibiotic
  D. Refer the client to urology.

                        

· Question 72

       

A patient has been diagnosed with generalized anxiety disorder   (GAD). Which of the following medications may be used to treat generalized   anxiety disorder?

· Question 73

       

A positive drawer sign supports a diagnosis of:

                        

· Question 74

       

Sam, age 67, is a diabetic with worsening renal function.   He has frequent hypoglycemic episodes, which he believes means that his   diabetes is getting “better.” How do you respond?

·  

· Question 75

       

A 14 year old female cheerleader reports gradual and   progressive dull anterior knee pain, exacerbated by kneeling. The nurse   practitioner notes swelling and point tenderness at the tibial tuberosity.   X-ray is negative. What is the most likely diagnosis?

                        

· Question 76

       

A 35 year old male presents with a complaint of low   pelvic pain, dysuria, hesitancy, urgency, and reduced force of stream. The   nurse practitioner suspects acute bacterial prostatitis. Which of the   following specimens would be least helpful for diagnosis?

· Question 77

       

Jack, age 55, comes to the office with a blood pressure of   144/98 mm Hg. He states that he did not know if it was ever elevated before.   When you retake his blood pressure at the end of the exam, it remains at   144/98. What should your next action be?

                        

· Question 78

       

A patient has just been diagnosed with Bell’s palsy. He is   understandably upset and has questions about the prognosis. You response   should be:

·  

· Question 79

       

Martin is complaining of erectile dysfunction. He also has   a condition that has reduced arterial blood flow to his penis. The most   common cause of this condition is:

            

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