NSG 6420 Week 5 Midterm Quiz - A 26-year-old, non-smoker, male

NSG 6420 Week 5 Midterm Quiz (Latest): South University

 

1.            Question :          

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 2.         Question :          

A 74-year-old obese female presents complaining of persistent right upper quadrant pain. She reports that she has not had any prior abdominal surgeries. Which of the following laboratory studies would be most indicative of acute cholecystitis?

 

                                                 C-reactive protein level of 3 mg

                                                 White blood cell count of 11,000

                                                 Direct serum bilirubin level of 0.3 mg/dl

                                                 Serum amylase level of 145 U/L

 

 

Question 3.         Question :          

What is the most common valvular heart disease in the older adult?

 

                                 Aortic regurgitation

                                                 Aortic stenosis

                                                 Mitral regurgitation

                                                 Mitral stenosis

               

Question 4.         Question :          

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 5.         Question :          

A nurse practitioner reports that your patient’s abdominal X-ray demonstrates multiple air-fluid levels in the bowel. This is a diagnostic finding found in:

 

                                                 Appendicitis

                                                 Cholecystitis

                                                Bowel Obstruction

                                                Diverticulitis

 

Question 6.         Question :          

During physical examination of a patient, you note resonance on percussion in the upper lung fields. This is consistent with:

 

                                                 COPD

                                                 Pneumothorax

                                                 A normal finding

                                                 Pleural effusion

               

 

Question 7.         Question :          

Essential parts of a health history include all of the following except:

 

                                                 Chief complaint

                                                 History of the present illness

                                                 Current vital signs

                                IN           All of the above are essential history components

               

Question 8.         Question :          

Your patient complains of a feeling of heaviness in the lower legs daily. You note varicosities, edema, and dusky color of both ankles and feet. Which of the following is the most likely cause for these symptoms?

 

                                                 Femoral vein thrombosis

                                                 Femoral artery thrombus

                                                Venous insufficiency

                                                 Musculoskeletal injury

               

 

Question 9.         Question :          

A key symptom of ischemic heart disease is chest pain. However, angina equivalents may include exertional dyspnea. Angina equivalents are important because:

                                 Women with ischemic heart disease many times do not present with chest pain

                                                 Some patients may have no symptoms or atypical symptoms; diagnosis may only be made at the time of an actual myocardial infarction

                                                 Elderly patients have the most severe symptoms

                                                 A & B only

 

Question 10.      Question :          

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 11.      Question :          

Your patient is a 78-year-old female with a smoking history of 120-pack years. She complains of hoarseness that has developed over the last few months. It is important to exclude the possibility of:

 

                                                 Thrush

                                                 Laryngeal cancer

                                                 Carotidynia

                                                 Thyroiditis

               

 

Question 12.      Question :          

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 13.      Question :          

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 14.      Question :          

Which of the following is not a contributing factor to the development of esophagitis in older adults?

 

                                 Increased gastric emptying time

                                                 Regular ingestion of NSAIDs

                                                 Decreased salivation

                                                 Fungal infections such as Candida

               

 

Question 15.      Question :          

A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The patient reports a smoking history of 2 packs of cigarettes per day since age 16. This would be recorded in the chart as:

 

                                                 50 x 2-pack years

                                                 100-pack years

                                                 50-year, 2-pack history

                                                 100-pack history

 

 

Question 16.      Question :          

Epistaxis can be a symptom of:

 

                                                 Over-anticoagulation

                                                 Hematologic malignancy

                                                 Cocaine abuse

                                                 All of the above

 

 

Question 17.      Question :          

The most common cause of eye redness is:

 

                                 Conjunctivitis

                                                 Acute glaucoma

                                                 Head trauma

                                                 Corneal abrasion

               

 

 

Question 18.      Question :          

Your patient complains of lower abdominal pain, anorexia, extreme fatigue, unintentional weight loss of 10 pounds in last 3 weeks, and you find a positive hemoccult on digital rectal examination. Laboratory tests show iron deficiency anemia. The clinician needs to consider:

 

                                                Diverticulitis

                                                 Colon cancer

                                                 Appendicitis

                                                 Peptic ulcer disease

               

 

Question 19.      Question :          

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

                                                 Colon cancer

               

 

 

Question 20.      Question :          

A 22-year-old female comes to your office with complaints of right lower quadrant abdominal pain, which has been worsening over the last 24 hours. On examination of the abdomen, there is a palpable mass and rebound tenderness over the right lower quadrant. The clinician should recognize the importance of:

 

                                 Digital rectal examination

                                                 Endoscopy

                                                 Pelvic examination

                                                 Urinalysis

               

 

Question 21.      Question :          

Which of the following is the most common cause of heartburn-type epigastric pain?

 

                                 Decreased lower esophageal sphincter tone

                                                 Helicobacter pylori infection of stomach

                                                 Esophageal spasm

                                                Peptic ulcer disease

 

Question 22.      Question :          

Your 35-year-old female patient complains of feeling palpitations on occasion. The clinician should recognize that palpitations are often a sign of:

 

                                                 Anemia

                                                 Anxiety

                                                 Hyperthyroidism

                                                 All of the above

               

Question 23.      Question :          

Mr. A presents to your office complaining of chest pain, mid-sternal and radiating to his back. He was mowing his lawn. He reports the pain lasting for about 8 minutes and went away after sitting down. What is his most likely diagnosis based on his presenting symptoms?

 

                                 Acute MI

                                                 GERD

                                                 Pneumonia

                                                 Angina

               

 

Question 24.      Question :          

Which disease process typically causes episodic right upper quadrant pain, epigastric pain or chest pain that can last 4-6 hours or less, often radiates to the back (classically under the right shoulder blade) and is often accompanied by nausea or vomiting and often follows a heavy, fatty meal.

 

                 Acute pancreatitis

                                                 Duodenal ulcer

                                                 Biliary colic

                                IN           Cholecystitis

               

 

Question 25.      Question :          

A specific exam used to evaluate the gall bladder is:

 

                                                 Psoas sign

                                                 Obturator sign

                                                 Cullens sign

                                                 Murphy’s sign

                               

Question 26.      Question :          

An older patient reports burning pain after ingestion of many foods and large meals. What assessment would assist the nurse practitioner in making a diagnosis of GERD?

 

                                                 Identification of a fluid wave

                                                 Positive Murphy’s sign

                                                 Palpable spleen

                                                 Midepigastric pain that is not reproducible with palpation

               

 

Question 27.      Question :          

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 28.      Question :          

A 20-year-old engineering student complains of episodes of abdominal discomfort, bloating, and episodes of diarrhea. The symptoms usually occur after eating, and pain is frequently relieved with bowel movement. She is on a “celiac diet” and the episodic symptoms persist. Physical examination and diagnostic tests are negative. Colonoscopy is negative for any abnormalities. This is a history and physical consistent with:

 

                                                 Inflammatory bowel disease

                                                 Irritable bowel syndrome

                                                 Giardiasis

                                                Norovirus gastroenteritis

 

Question 29.      Question :          

(*There are multiple questions on this exam related to this scenario. Be sure to read the whole way through to the question.) Mr. Keenan is a 42-year-old man with a mild history of GERD and a remote history of an appendectomy, presenting with an acute onset of significant right upper-quadrant abdominal pain and vomiting. His pain began after a large meal, was unrelieved by a proton-pump inhibitor, was unlike his previous episodes of heartburn, but upon questioning, reports milder, prodromal episodes of similar post-prandial pain. His pain seems to radiate to his back. Despite a family history of cardiac disease, he reports no classic anginal signs or chest pain. He furthermore denies respiratory or pleuritic signs and denies fever, night sweats, and unintended weight loss. Finally, there are no dermatologic signs, nor genitourinary symptoms.

 

Of the following lab studies, which would provide little help in determining your differential diagnosis?

 

                                                 Abdominal plain films

                                                 Liver function tests

                                                 Amylase/lipase

                                IN           Urinalysis

               

Question 30.      Question :          

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