NRNP6540 midterm exam latest 2021 all 100 answers

Question 1

Geriatric assessments can be challenging for the health-care provider due to delay of recognition and/or reporting of symptoms by the patient. Which of the following best describes what is used by health-care providers to address this differential?

 

1.           Clinical decision-making tools.

 

2.           When symptoms were noticed.

 

3.           Change in function and impact of symptoms.

 

4.           Symptoms from comorbidities.

Question 2

 

The nurse practitioner is managing a 68 year old patient with a AAA and urgent hypertension.   What IV anti hypertensive medication should be used to rapidly and consistently lower blood pressure?

 

              metroprolol, amiodarone, nitroglycerine

 

              diltiazem, metoprolol,  nitroprusside

 

              esmolol, nitroprusside, diltiazem

 

              nicardipine, esmolol, nitroglycerine

Question 3

Which of the following terms refers to conditions that have multiple underlying factors and may involve multiple organs?

 

1.           Multifaceted syndrome

 

2.           Aging syndrome

 

3.           CFM syndrome

 

4.           Geriatric syndrome

Question 4

Oral cancer is a malignant tumor presented by a nonhealing sore in the mouth or lip that causes difficulty chewing or swallowing. Which of the following statements applies to an oral cancer diagnosis?

 

1.           It cannot be prevented.

 

2.           It involves unexplained lymph node swelling in the head and neck area.

 

3.           It is three times more likely in women than men.

 

4.           It involves unexplained lymph node swelling in the axillary area.

Question 5

Mr. Osorio is a 65-year-old male who recently retired because of a medical condition. He has good family support and is very motivated to start a wellness program to prevent worsening of his condition. These factors are an example of:

 

1.           Barriers

 

2.           Incentives

 

3.           Positive self-efficacy

 

4.           Facilitators

Question 6

Mr. Thomas comes in for a health examination with his nurse practitioner. When the nurse practitioner measures his blood pressure, the systolic is 150 mm and the diastolic is 80 mm. When Mr. Thomas asks if that is a good pressure for him, the nurse practitioner responds:

 

1.           It is normal for your age.

 

2.           Isolated hypertension is usually identified by a systolic blood pressure (SBP) higher than 160 mm Hg.

 

3.           When evaluating blood pressure, a higher diastolic blood pressure (DBP) is risky.

 

4.           There is a risk of a cardiovascular event for you with an SBP of 150 mm Hg.

Question 7

Understanding that the current life expectancy is 79 years, the nurse practitioner plans a patient’s health promotion while considering which of the following?

 

              Patient's health belief, goals, and benefit of treatment

 

              Extending life, religious community involvement, and present level of function

 

              Aggressive treatment of primary health condition

 

              Current level of physical activity and independence.

uestion 8

For which of the following evaluations should the patient be referred when sleep impairment is involved with chronic rhinitis?

 

1.           Obstructive sleep apnea

 

2.           Pharmacological therapy

 

3.           Acupuncturist evaluation

 

4.           Massage therapy

Question 9

Many adults find reasons or barriers for not being able to exercise. Which of the following is an example of a patient barrier?

 

1.           Good health, no functional limitations.

 

2.           Insurance incentive.

 

3.           High body mass index (BMI).

 

4.           Frequent contact with prescriber.

Question 10

Which of the following is the focus of additional studies about the relationship between physical activities and cognitive changes?

 

1.           Diet and supplements

 

2.           Provider and patients

 

3.           Social support and patients

 

4.           Medical conditions and medications

uestion 11

Wandering in older adults can occur with disorientation or cognitive impairment and is characterized as locomotion in a seemingly aimless pattern. From which of the following conditions can wandering arise? Select all that apply.

 

1.           Pneumonia

 

2.           Delirium

 

3.           Mood disorder

 

4.           Dementia

 

5.           Vertigo

Question 12

Challenges to increasing physical activity are different for everyone. For instance, some patients may be experiencing depression or loss, some may have had significant life changes, and others may be dealing with functional limitations. As relates to increasing physical activity, these are examples of what?

 

1.           Patient excuses

 

2.           Patient facilitators

 

3.           Patient ignorance regarding what to do

 

4.           Patient barriers

Question 13

Bertha is an 85-year-old grandmother who has multiple morbidities. Family members report that Bertha is not eating much and does not seem as active as usual. They want the nurse practitioner to order tests to identify what is happening to her. The nurse practitioner considers which of the following before ordering any tests? Select all that apply.

 

1.           Will the test results alter any of the diagnoses that she is currently addressing?

 

2.           Will the results alter management of her health regimen?

 

3.           What is the cost/benefits ratio?

 

4.           Is the test the least invasive?

 

5.           Is this testing acceptable to the patient?

Question 14

Ms. Samuels, 74 years old, comes to the clinic with concerns about her breathing. She states that she is having trouble with mucus collection and difficulty coughing it out and wants to know why?   The nurse practitioner tells the patient:

 

              Lung tissue becomes less flexible as you age and mucous becomes thicker due to decreased body water

 

              Lung volumes increase as you age making exhaling more difficult

 

              Cough reflex becomes more sensitive and more effective

 

              Increased permeability between the alveoli and blood vessels increase mucous production

Question 15

An older woman is seen in the ambulatory clinic for a routine checkup. The patient asks about results of her blood work compared to last year’s results. How is it best for the clinician to respond?

 

              They probably will not change since you have no new diseases

 

              Blood work results may change due to aging or medications you take

 

              Blood work is not a reliable indicator of your health

 

              There is likely no significant differences as your body remains stable in its functioning.

Question 16

In conducting a CGA, the nurse practitioner looks for any impairments in communication with the patient. The assessment includes:

 

1.           Interviewing prior to the physical examination.

 

2.           Asking questions of the accompanying family member.

 

3.           Reading the history forms provided by the patient after the examination.

 

4.           Observing physical impairments.

Question 17

A family member comes into the clinician’s office with her older mother, the patient. In the process of the examination, the nurse practitioner identifies the patient as “frail older adult.” The family member asks what that means. The nurse practitioner explains that this refers to:

 

1.           Someone who is prone to pathological fractures.

 

2.           An older person already exhibiting signs of decline.

 

3.           An older person who has lost height and is under 5 feet tall.

 

4.           An older person being susceptible to infections.

uestion 18

The nurse practitioner conducts a comprehensive geriatric assessment of the older individual because:

 

1.           Health of older people is affected by several factors.

 

2.           A focused assessment will provide depth of specific information.

 

3.           A comprehensive assessment will provide more subjective information.

 

4.           A comprehensive assessment will result in a list of current and prior medications taken.

Question 20

In the assessment for peripheral vascular disorders, the clinician should begin with which of the following after the general history and physical examination?

 

1.           Auscultation of the carotid arteries bilaterally.

 

2.           Palpation of the carotid arteries bilaterally.

 

3.           Inspection of the carotid arteries bilaterally.

 

4.           Order diagnostic testing.

Question 19

For individuals over 65 years old, the most common morbidities are related to:

 

              Heart disease, cancer, arthritis, and stroke

 

              COPD, autoimmune disease,  diabetes, and thyroid disease

 

              Autoimmune disease, heart disease, stroke, and diabetes

 

              Thyroid disease, autoimmune disease, arthritis, and cancer

uestion 21

Which of the following is the correct term for the eye condition that presents a sterile mass on the eyelid that is painless and has no reddening?

 

1.           Blepharitis

 

2.           Entropion

 

3.           Hordeolum

 

4.           Chalazion

Question 23

The nurse practitioner and a student are examining the apical pulse of an 82-year-old man. The student perceives that there is an S4 sound. The nurse practitioner interprets that this is likely:

 

1.           An early ventricular filling.

 

2.           Heart blockage.

 

3.           Mitral regurgitation.

 

4.           Normal, due to the man’s age.

uestion 22

Mrs. Khan is 89 years old and is reported to have bouts of agitation. The nurse practitioner is counseling her family that these periods of agitation can be triggered by which of the following?

 

1.           Silence and soft music.

 

2.           Dim lights.

 

3.           Approaches from other people.

 

4.           A feeling of appetite satiety.

Question 24

Mrs. Williams is 76 years old and comes in to have a wound checked on her right leg. She fell a month ago and the wound has not healed. She is concerned that something is wrong. The nurse practitioner examines the wound and sees that it has been cleaned properly and has no signs of infection. The edges are approximated, but the skin around the wound is red and tender to touch. The best response regarding Mrs. Williams’ concern is:

 

1.           Wound healing for older people may take up to four times longer than it does for younger people.

 

2.           Let us talk about what you are eating.

 

3.           Had you come in earlier, I would have ordered medicine that would have healed that right up.

 

4.           I will order an antibiotic to prevent infection.

Question 25

Mr. Hasam is diagnosed with unstable angina. Which of the following is a contraindication for exercise therapy and prevents patients from joining an exercise program?

 

              uncontrolled hypertension

 

              Hypoxemia

 

              Bradycardia

 

              Chondromalacia

Mrs. Smith, 75 years old, reports that she is weak, has difficulty urinating, and is dehydrated. Although she is afebrile, the nurse conducts a thorough physical examination, including urinalysis and complete blood count (CBC). The total assessment is necessary because:

 

1.           These symptoms may be subtle signs of a variety of diagnoses.

 

2.           The symptoms are vague and may be signs of aging.

 

3.           There may be other signs or symptoms more indicative of the condition.

 

4.           Mrs. Smith may not be reporting all significant information.

Question 27

Mr. Jones, a 70-year-old male, visits the urgent care and presents symptoms of unilateral eye pain, visual blurring with halos around lights, red eye, and photophobia. He also reports nausea and vomiting. Visual acuity shows a loss in the affected eye. He is immediately referred for a complete ophthalmic examination. Which of the following conditions may Mr. Jones be experiencing?

 

1.           Acute glaucoma

 

2.           Conjunctivitis

 

3.           Hyphema

 

4.           Uveitis

Question 28

A patient comes to the health-care provider office for a checkup. The nurse practitioner notes that the patient is 67 years old and is presenting symptoms of dizziness, orthopnea, and edema. The nurse practitioner begins a focused assessment of the:

 

1.           Cardiovascular system.

 

2.           Respiratory system.

 

3.           Neurological system.

 

4.           Reproductive system.

Question 29

The nurse practitioner is concerned with primary prevention strategies. How can the nurse practitioner implement primary prevention strategies for an 80-year-old male patient who smokes?

 

1.           Review home fire safety protocols, including the proper use of smoke alarms, and discuss smoking cessation.

 

2.           Inform him that if he does not stop smoking, the nurse practitioner cannot see him again.

 

3.           Have a conference with his family about his smoking.

 

4.           Plan a family meeting with the patient to discuss benefits of his smoking cessation.

Question 30

Stan is 64 years old and has been feeling weak, lightheaded, and slightly nauseous. He goes to the urgent care center where the nurse practitioner initiates an assessment. Which of the following suggest an arrhythmia?

 

              Left atria enlargement and history of alcohol misuse

 

              Denies any history of heart pounding or racing and syncope

 

              S3 heart sound, lung crackles, and amiodarone toxicity

 

              Bradycardia, lengthened QT interval, and hypertension

Question 31

Mrs. Prentiss is diagnosed with symptomatic AAA. The initial treatment is aggressive blood pressure control. At which of the following readings should mean arterial pressure be maintained?

 

1.           Between 100 and 120 mm Hg.

 

2.           Between 90 and 120 mm Hg.

 

3.           Between 60 and 70 mm Hg.

 

4.           Between 80 and 100 mm Hg.

Question 32

Mrs. Franklin is 92 years old and has a daytime caregiver. Her daughter stays with her during the evening and nighttime. The daughter suspects her mother is being abused. All of the following statements would confirm this for the nurse practitioner EXCEPT:

 

              My mother complains of physical pain and has bruises on her arm.

 

              My mother is losing weight and is always hungry in the evening.

 

              My mother has burn marks on her body in the shape of a cigarette.

 

              My mother forgets my name and the daytime caregivers name

Question 33

The treatment for cellulitis includes which of the following?

 

              Oral antibiotics for mild cellulites

 

              Treatment should not begin until culture and sensitivity results are available

 

              Treatment should be continued for 3 days

 

              Steroids are the treatment of choice

Mrs. Martinez is 75 years old and has had type 2 diabetes for 25 years. She sees her nurse practitioner on a regular basis. Mrs. Smith asks the nurse practitioner why her treatment has not been changed, even though her laboratory values are seemingly out of normal range. Which of the following is the best response? 

 

              We don't change your treatment plan unless you start having complications.

 

              The normal range charts are based on patients younger than 75 years.

 

              Currently, it is too expensive to change your treatment.

 

              Normal values for laboratory tests differ as one gets older.

Question 35

The focus of advanced nurse practitioners is primary care. This is defined as activities that focus on:

 

1.           Preventing the occurrence of a disease or condition.

 

2.           Treating an illness after symptoms appear.

 

3.           Enabling the patient to recover and convalesce.

 

4.           Enriching the patient’s appreciation of life.

Question 36

A 67-year-old female patient comes in for an office visit presenting symptoms of nasal congestion, itching, and sneezing and is diagnosed with rhinitis. Which of the following is true about the types of rhinitis?

 

1.           Allergic rhinitis (AR) is a condition of adulthood and is more common in the older adult.

 

2.           AR develops when the body’s respiratory system becomes sensitized and overreacts to something in the environment.

 

3.           Nonallergic rhinitis (NAR) is most common between ages 10 and 39, declining after age 40.

 

4.           NAR is a condition of adulthood and is more common in the older adult.

Question 37

Which of the following statements best describes “cough”?

 

1.           It is a sign of a life-threatening condition.

 

2.           It is often isolated to the respiratory system.

 

3.           It is often isolated to the immune system.

 

4.           It is often associated with acid reflux.

Question 38

The nurse practitioner sees a patient in the emergency department with reports of chest pain and nausea. To analyze the patient’s condition, what further information is needed?

 

1.           Whether there has been constipation.

 

2.           A description of the pain.

 

3.           Information regarding last food intake.

 

4.           Information regarding urinary difficulties.

Question 39

Mr. Borden is 79 years old and lives with his daughter. The daughter provides excellent care for her father and wants to know which changes in his heart and circulatory system are due to aging and which are due to lifestyle choices. The nurse practitioner replies:

 

1.           The size of the heart increases with age.

 

2.           The left ventricle hypertrophies in response to increasing in age.

 

3.           The activity of the heart decreases in its ability to deal with stress, as well as to provide physical strength as one ages.

 

4.           The patient’s diet affects the ability of the heart to balance blood pressure.

Question 40

Mrs. Keating is a 70-year-old woman suffering from arthritis. She is seeing the nurse practitioner for her regular checkup. For a person with chronic degenerative conditions, which of the following should the nurse suggest for health promotion?

 

1.           Take herbal supplements.

 

2.           Increase physical activity.

 

3.           Take Aleve.

 

4.           Get a massage.

Question 41

The nurse practitioner identifies a late cardiac murmur in an older adult patient.  This type of murmur is most often due to which of the following? 

 

              Papillary muscle dysfunction

 

              Weakening valves

 

              Heart blockage

 

              Mitral stenosis

Question 42

Jason is 80 years old and is experiencing the following: weight gain, tachycardia, neck vein distention, and cognitive impairment. The nurse practitioner assesses for which of the following to support a diagnosis of heart failure?

 

              Split S2, tachycardia,  weight gain

 

              Medially displaced point of maximal impulse, bradycardia, shortness of breath

 

             

Weight gain, tachycardia, and  S4 heart sound

 

              Shortness of breath, bradycardia, S3 heart sound

Question 43

The daughter of a 70-year-old woman asks the nurse practitioner why her mother has had a change in functional ability recently. The mother has regularly been drinking for 40 years, however, her behavior is changing. The nurse practitioner replies that:

 

1.           The concentration of alcohol in her body remains the same as she ages.

 

2.           Her change in behavior has nothing to do with any drugs she is taking.

 

3.           There are different types of alcoholism in older adults, and the change in behavior is related to the specific type.

 

4.           Physical changes due to aging affect the body’s metabolism of alcohol differently.

Question 44

The nurse practitioner is assessing a 69-year-old man for possible bipolar disorder. Which of the following are specific for diagnosing bipolar disorder?

 

              CBC, MRI, and EEG

 

              CMP,  CT Scan, and Mini mental  state exam

 

              Mini mental state exam and St Louis University mental status exam

 

              CT, MRI, and St Louis University mental status exam

Question 45

Adam, 70 years old, is admitted for possible myasthenia gravis (MG). The nurse practitioner knows that MG is commonly seen in women between 20 and 40 years old. Adam, however, is experiencing an ocular form of MG, has dysphonia, and does not have any thymus abnormalities. Adam asks why the nurse practitioner thinks he has MG since he is older and this is a “young person’s disease.” Which of the following is the best response?

 

              Signs and symptoms of illness are the same for each disease regardless of age

 

              Some diseases have different symptoms in different age and gender groups.

 

              I will order a comprehensive group of tests to make sure that you don't have some other disease.

 

              This is a normal presentation of MG in older adults

uestion 46

Mr. Thomas comes in for a health examination appointment with his nurse practitioner. He asks why nurse practitioners are qualified to conduct these evaluations. Which of the following is the nurse practitioner’s best response? The nurse practitioner:

 

1.           Is concerned about health and not disease.

 

2.           Saves the physician time in the office.

 

3.           Can assess for minor conditions and refer to the doctor for other conditions.

 

4.           Is prepared to assess health holistically.

Question 47

Mr. Smoots, 79 years old, is unable to leave his home due to mobility problems. The nurse practitioner conducts a social support assessment because Mr. Smoots:

 

1.           May not want to see anyone.

 

2.           Is not missing the cultural traditions of community activities.

 

3.           Has made frequent appointments for consultation with the practitioner.

 

4.           Looks forward to sharing his loneliness with the nurse practitioner

Question 48

Samuel visits the urgent care facility for sudden symptoms of pain to his lower extremity. The initial diagnosis is acute arterial ischemia. Aside from pain, which other symptoms may arise from this diagnosis?

 

              Pulselessness, pallor, paralysis

 

              Parasthesia, purulence, pulselessness

 

              Purulence, pulselessness, pallor

 

              Pallor, paralysis, purulence

Question 49

Mrs. Johnson is 74 years old and comes to the clinic for an annual checkup. The nurse practitioner addresses the psychosocial needs of older adults and specifically the need for which of the following?

 

1.           Dependence.

 

2.           Dignity, credibility, and respect.

 

3.           Being alone.

 

4.           Not being touched.

uestion 50

In the initial screening for a diagnosis of AAA, which of the following is the best screening test?

 

1.           CT scan

 

2.           Complete blood count (CBC)

 

3.           Ultrasound in the abdominal area

 

4.           Angiography

Question 51

Mrs. Rizzo is an 80-year-old Caucasian female who is presenting symptoms of chest pain, weakness, and lightheadedness. Which of the following may be a possible differential diagnosis of her symptoms?

 

1.           Ischemic colitis

 

2.           Spinal cord compression

 

3.           Diabetic neuropathy

 

4.           Costochondritis

Question 52

Which cranial nerve should be assessed in the examination for disorders of the face?

 

1.           Cranial nerve III

 

2.           Cranial nerve V

 

3.           Cranial nerve VII

 

4.           Cranial nerve IX

uestion 53

Which of the following should nurse practitioners suggest to counter common patient excuses for not exercising?

 

1.           Join a gym.

 

2.           Find an exercise “buddy.”

 

3.           Take a 10-minute walk every day.

 

4.           Go to the YMCA.

Question 54

Monte, 72 years old, is in a rehabilitation center for therapy post-knee replacement. The nurse practitioner is visiting Monte and finds him confused, disoriented, and with speech difficulty. The staff nurse says that his condition changed quickly over the last few hours. The nurse practitioner orders which of the following?

 

              CBC, urinalysis,  PET scan

 

              MRI, chest x-ray, and EEG

 

              CBC, pulse oximetry, CT Scan

 

              CBC, EEG, and MRI

Question 55

Mrs. Williams, 80 years old, asks her nurse practitioner to order a new alternative therapy for her. Mrs. Williams believes that this botanical supplement will provide pain relief for her fibromyalgia. The nurse practitioner explains that this therapy is likely not covered by Medicare because:

 

1.           The botanical is expensive and not approved for use.

 

2.           Medicare only covers treatments that are approved according to the stringent guidelines of the U.S. Preventive Services Task Force (USPSTF).

 

3.           There is no reason to use these botanicals when opioids are proven effective.

 

4.           This botanical is not on the Medicare list of approved medications.

Question 56

Reduction of pain is the main goal for patients suffering from acute joint pain. The mnemonic PRICE is a helpful reminder of the treatment when this occurs. What does the “E” in PRICE stand for?

 

1.           Elevation

 

2.           Emergency

 

3.           Elastic

 

4.           Electrical

uestion 57

Tina is a 60-year-old female presenting symptoms of coughing, shortness of breath, and purulent sputum. She is being treated with antibiotics, use of a nebulizer, and oral steroids. Which of the following conditions could be her diagnosis?

 

1.           Bacterial pneumonia

 

2.           Acute bronchitis

 

3.           Chronic bronchitis

 

4.           GERD

Question 58

Which medical specialist is the best referral for patients with symptomatic AAA?

 

1.           Vascular surgeon

 

2.           Neurosurgeon

 

3.           Cardiologist

 

4.           Internist

Question 59

Mr. James is 91 years old. His daughter notices that he has bruises and lacerations on his arms and reports this to the nurse practitioner, who tells her that older people bruise easily due to their fragile blood vessels. The skin lacerations happen because he has thin skin. Even so, the nurse practitioner assures the daughter that she will investigate further to ensure that he is getting proper care. She says this because she understands that:

 

1.           These markings on the patient’s skin are part of aging skin.

 

2.           Bruises and lacerations can indicate inadequate care.

 

3.           The daughter needs assurance that her father is okay.

 

4.           The patient is being abused.

Question 60

The nurse practitioner assesses a patient’s skin and finds an infectious lesion on the lower leg. The lesion is considered a secondary lesion. The nurse practitioner explains that a secondary lesion is one that:

 

1.           Arises from changes to a primary lesion.

 

2.           Is a complication of an underlying disease.

 

3.           Is difficult to treat.

 

4.           Is a normal sign of aging.

uestion 61

Which of the following statements is true regarding diagnostic testing?

 

1.           A test is ordered for a specific purpose.

 

2.           The most invasive test should be ordered first.

 

3.           There is no need to discuss results with the patient.

 

4.           If a test is needed, it should be ordered regardless of risk to the patient.

Question 62

Which of the following conditions is signaled by symptoms of swelling of the affected body part, usually the limb, because of impaired flow of lymph fluid?

 

1.           Abdominal aortic aneurysm (AAA)

 

2.           Venous ulcers

 

3.           Peripheral vascular disease (PVD)

 

4.           Lymphedema

Question 63

Mr. James is 75 years old and suffering from depression. He tells the nurse practitioner that he is tired of feeling so low. He asks if depression is a normal part of aging. The nurse practitioner tells him that depression is which of the following?

 

              Depression is a normal part of aging due to decreased production of neurotransmitters.

 

              Depression is not a normal part of aging and may be triggered by one life event

 

              Can be related to dietary intake of excess vitamins.

 

              Depression can be caused by the medication you take for heart disease.

Question 64

Jane, 83 years old, comes to the clinic with her daughter for a geriatric assessment. The daughter asks about the necessity of this comprehensive assessment. The clinician explains that a CGA is a multidimensional process to:

 

1.           Identify care needs and plans of care for older people.

 

2.           Acquire information about past medical conditions.

 

3.           Determine which diagnostic tests are necessary.

 

4.           Satisfy requirements of Medicare.

Question 65

A patient complains of dry, irritated, and itchy skin that has not been relieved with over-the-counter medications. On examination, the patient is also found to present cholestasis and jaundice. From which of the following conditions may the patient be suffering?

 

1.           Lice

 

2.           Scabies

 

3.           Pruritus

 

4.           Lichenification

Question 66

Which of the following medical specialists deals with the diagnosing of visual impairments and conditions?

 

1.           Ophthalmologist

 

2.           Optometrist

 

3.           Otolaryngologists

 

4.           Podiatrist

 

 

1 points  

Question 67

The nurse practitioner knows that conducting a comprehensive geriatric assessment (CGA) is more beneficial for which of the following groups?

 

1.           People between 60 and 70 years old.

 

2.           People over 70 years old.

 

3.           People classified as vulnerable older adults.

 

4.           People over 55 years old.

Question 68

Mr. and Mrs. Smith are both 75 years old and are seeing their nurse practitioner for their annual checkups. Mrs. Smith wonders why they each have trouble digesting different foods. It is inconvenient for her to fix different meals that they both can tolerate. The nurse practitioner explains that:

 

1.           Men have more difficulty digesting vegetables.

 

2.           Women have more difficulty digesting dairy products.

 

3.           Men and women have different enzymes in their gastrointestinal tracts.

 

4.           Organ systems progress differently for each person regardless of age.

uestion 69

Ms. Rose, 88 years old, comes to the nurse practitioner with a complaint about a growth on her hand. She wants to have a biopsy done. The nurse practitioner asks the following question:

 

1.           Have you injured your hand recently?

 

2.           Are you using a different detergent?

 

3.           Has this growth changed, bled, or is it painful?

 

4.           Has this growth made it difficult to put on your rings?

Question 70

The nurse practitioner suspects the patient has a  hordeolum.    All of the following should be considered as a differential diagnosis EXCEPT

 

 

              chalazion

 

              orbital cellulites

 

              contact dermatitis

 

              strabismus

Question 71

A 60-year-old male enters the burn center for triage and treatment due to a burn he received at a campfire. His left arm has an area that is erythematous and painful, and another area has a blister. What does the nurse practitioner record as the degree of burn?

 

1.           First degree

 

2.           Second degree

 

3.           First and second degree

 

4.           Second and third degree

Question 72

Which of the following differential diagnoses should be considered with the diagnosis of peripheral arterial disease (PAD)?

 

1.           Marfan syndrome

 

2.           Atelectasis

 

3.           Raynaud’s phenomenon

 

4.           Carpal tunnel syndrome

Question 73

A patient asks the nurse practitioner what is meant by health promotion. Which of the following is the nurse practitioner’s best response? Health promotion:

 

1.           Includes activities that an individual performs proactively to increase health and well-being.

 

2.           Is a process of keeping track of immunizations.

 

3.           Includes a set of programs that help people cope with the disease.

 

4.           Includes strategies that prolong life.

 

Question 75

Which of the following conditions is signaled by bleeding from the nose?

 

1.           Rhinitis

 

2.           Telangiectasia

 

3.           Retinopathy

 

4.           Epistaxis

Question 74

The nurse practitioner is conducting an admitting assessment of a 69-year-old man. He has diminished ability to ambulate and has difficulty with activities of daily living (ADLs). In the interview, the nurse practitioner asks him if he drinks alcohol. He says, “Yes.” The practitioner follows up with a psycho-social evaluation because:

 

1.           Physiological dynamics need to be ruled out as a possible contribution.

 

2.           His drinking may be a function of the environment where he lives.

 

3.           Criteria from the DSM-V is the same for people of any age.

 

4.           His condition could be related to a long-term usage of alcohol or a new occurrence.

Question 76

PVD is a disease that alters blood flow to or from the extremities and vital organs other than the heart. According to studies, which of the following remains the most important risk factor for PVD?

 

1.           Smoking

 

2.           Hypertension

 

3.           Family history

 

4.           Hypercoagulopathy

Question 77

Mary Jane is seeing a nurse practitioner for a CGA and asks which parts of her life will be examined. The nurse practitioner says the domains of the CGA include:

 

1.           Internal organ health.

 

2.           Social habits.

 

3.           Physical and psychological health, as well as other facets of life.

 

4.           History of family illness.

Question 78

Janey, 25 years old, may experience arthritis differently than 65-year-old Mrs. Johnson because:

 

              The body undergoes physiological changes with aging.

 

              A healthy body does not experience significant changes as one gets older.

 

              Older patients do not feel any systemic symptoms, such as malaise and weight loss.

 

              Even though the same joints are usually affected, age makes it feel different.

Question 79

Mr. Williams,75 years old, comes to the urgent care center with complaints of fever, fast heartbeat, a swollen gland under his right arm, and redness in his upper left arm that has hurt for 2 to 3 days. The patient says that he has had the redness in his arm for months without any difficulty. The nurse practitioner suspects which of the following?

 

              Influenza

 

              Cellulitis of upper left arm

 

              Necrotizing fasciitis

 

              Lymphangitis

Question 80

A gerontological patient is being examined for a report of pain in the shoulder. The nurse practitioner completes a thorough systemic examination because:

 

              Older patients may not report all their symptoms that are pertinent to make a diagnosis

 

              Arthritis of the shoulder is accompanied by other neurological symptoms.

 

              Older patients with arthritis often experience pain in lower extremities.

 

              The patient may not report significant signs and symptoms.

 

Question 81

The nurse practitioner knows that risk factors for coronary artery disease (CAD) include atherosclerosis. The nurse practitioner includes teaching on these factors that can be remediated to help prevent CAD:

 

1.           Low blood pressure.

 

2.           Age.

 

3.           Advanced age and male gender.

 

4.           Cholesterol levels and smoking.

Question 82

The nurse practitioner is considering ordering medications to help control an older patient’s agitation. She chooses which of the following?

 

1.           Psychotropic medications

 

2.           Seizure medications

 

3.           Stimulants

 

4.           Depressants