NRNP6531 Final Exam Latest 2022

NRNP 6531 Final Exam

Question 1A 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?

 Any recent trauma

         Difficulty swallowing

         Stifness in the right shoulder

         Change in sleeping

Question 2In the outpatient office setting, the most common reason for a malpractice suit is failure to: Properly refer

Diagnose correctly in a timely

fashion

Obtain informed consent

 Manage fractures and trauma     

Question 3Reed-Sternberg B lymphocytes are associated with which of the following disorders:              

Aplastic anemia

Hodgkin's lymphoma

Non Hodgkin's lymphoma

  Myelodysplastic syndromes

Question 4The initial clinical sign of Dupuytren's contracture is:                                                                     Pain with ulnar deviation

Painless nodule on palmer fascia

Pain and numbness in the ring finger

Inability to passively extend

finger

Question 5 Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia?

Musculoskeletal pain

Difficulty sleeping

Depression

Fatigue

Question 6 A child with type 1 diabetes mellitus has experienced excessive hunger, weight gain and increasing hyperglycemia. The Somogyi effect is suspected. What steps should be taken to diagnose and treat this condition?

Decrease the evening insulin dose and check capillary blood glucose (CBG) at 2:00 am.

Instruct the child's parents on physical activities to help weight loss.

Increase the evening insulin dose and check CBG at 2:00 am.

Refer the child for instruction on a strict diabetic diet.

Question 7The 4 classic features of Parkinson's disease are:        

Mask-like facies, dysarthria, excessive salivation, and dementia.

Tremor at rest, rigidity, bradykinesia, and postural disturbances.

Depression, cognitive impairment, constipation and shuffling gait.

Tremor with movement, cogwheeling, repetitive movement, and multi-system atrophy.

Question 8 What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?

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 9The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is:

Rest from activities which may further stress the bone.

Daily passive range of motion exercises.

Continuation of the patient's routine physical activities.

Application of ice after activity.

Question 10 Which of the following antibiotics should not be prescribed for a pregnant woman in the 3rd trimester?

Trimethoprim- sulfamethoxazole

Erythromycin

Cefuroxime

Levofloxacin

Question 11Which is the most common cause of end-stage renal disease in the United States? 

Diabetic nephropathy

Chronic renal failure secondary to vascular disorders

Acute tubular necrosis

Kidney trauma

Question 12A typical description of a tension headache is:           

Periorbital pain, sudden onset, often explosive in quality, and associated with nasal stuffiness, lacrimation, red eye, and nausea.

Bilateral, occipital, or frontal tightness or fullness, with waves of aching pain.

Hemicranial pain that is accompanied by vomiting and photophobia.

  Steadily worsening pain that interrupts sleep, is exacerbated by orthostatic changes,      and may be preceded by nausea and vomiting.

Question 13  A patient taking levothyroxine is being over-replaced. What condition is he at risk for?       

Osteoporo sis

Constipati on

Depression

 Exopthalmi a

Question 14 Which of the following medications increase the risk for metabolic syndrome?        

Antihistamines

Proton pump inhibitors

Protease inhibitors

A and C

All of the above

Question 15 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:

Lateral meniscus

Cruciate ligament

Medical meniscus

 Collateral ligament

Question 16 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:

Gout

Epicondylitis

Osteoarthri tis

 Lyme      disease

Question 17 The organism most often associated with prostatitis is:        

Klebsiella

Neiserria gonorrhoaes

Chlamydia trachomatis

E.Coli

Question 18  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?

Prescribe systemic antibiotics

Prescribe antibiotic ear drops

Prescribe nasal steroids and oral decongestants

 Refer him to an ear, nose, and throat      specialist

Question 19 Maria, age 17, was raped when she was 13 year old. She is now experiencing sleeping problems, flashbacks, and depression. What is your initial diagnosis?

Depression

Panic disorder

Anxiety

 Post-traumatic stress      disorder

Question 20 What diabetic complications result from hyperglycemia?    

1.            Retinopathy

2.            Hypertension resistant totreatment

3.            Peripheralneuropathy

4.            Acceleratedatherogenesis

1, 2,  3

2, 3, 4

1, 3, 4

1, 2, 4

Question 21 Prolonged PT suggests:       

Platelet abnormality

Abnormality in intrinsic coagulation pathway

Abnormality in extrinsic coagulation pathway

None of the above

Question 22 Patient report of bladder dysfunction, saddle anesthesia, and motor weakness of limbs.

History of significant trauma relative to the patient's age.

Decreased reflexes, strength, and sensation in the lower extremities.

Patient report of pain with the crossed straight leg raise.