NURS6531 2021 MAY Final Exam Latest

NURS6531 Primary Care of Adults Across the Lifespan

Final Exam

Question 1 When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

                Yes

                No

Question 2A 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 3A 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 4At what age is screening most likely to detect scoliosis?

                4 to 6 years

                8 to 10 years

                12 to 14 years

                18 to 20 years

Question 5Potential side effects of levofloxacin include which of the following?

                Confusion

                Hypoglycemia

                Achilles tendon rupture

                All of the above

Question 6What intervention does the American College of Rheumatology recommend as first line therapy for osteoarthritis?

                Extensive diagnostic work-up

                NSAIDs at therapeutic doses

                Early joint replacement

                Exercise and weight loss

Question 7A patient has just been diagnosed with Bell’s palsy. He is understandably upset and has questions about the prognosis. You response should be:

                Although most of your symptoms will disappear, some will remain but can usually be camouflaged by altering your hairstyle or growing a beard

                Unfortunately there is no cure but you have a mild case

                The condition is self-limiting and most likely complete recovery will occur

                With suppressive drug therapy you can minimize the symptoms

Question 8Which of the following patients most warrants screening for hypothyroidism?

                A young adult female with postpartum depression lasting 2 weeks.

                A patient taking thyroid replacement preparation.

                A 40 year old male with unexplained tremors.

                An elderly female with recent onset of mental dysfunction.

Question 9Steve, 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?

                Apples

                Peppermint

                Cucumbers

                Popsicles

Question 10Diagnostic evaluation of hypothyroidism reveals:

                Elevated TSH and decreased T4

                Decreased TSH and increased T4

                Decreased TSH and decreased T3

                Elevated TSH and increased T4

Question 11The most accurate measure of diabetes control is:

                Avoidance of micro- and macro-vascular complications.

                Insulin sensitivity.

                Early morning glucose levels.

                HgbA1c

Question 12The 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 13The most effective treatment of non-infectious bursitis includes:

                Systemic antibiotic therapy effective against penicillin resistant Staphylococcus areus.

                Rest, an intra-articular corticosteroid injection, and a concomitant oral NSAID.

                A tapering regimen of oral corticosteroid therapy.

                Frequent active range of joint motion.

Question 14Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond?

                “Caffeine has not effect on osteoporosis.”

                “A high caffeine intake has a diuretic effect that may cause calcium to be excreted more rapidly.”

                “Caffeine affects bone metabolism by altering intestinal absorption of calcium and assimilation of calcium into the bone matrix.”

                “Caffeine increase bone resorption.”

Question 15Diagnostic evaluation for urinary calculi includes:

                Urinalysis and culture

                Non contrast CT

                Serum calcium

                All of the above

Question 16A 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 17A 65 year old patient complains of recurrent bilateral temporal headaches, malaise, muscle aches, and low grade fever. The headache is described as superficial tenderness rather than deep pain. Giant cell arteritis is suspected. Appropriate treatment is:

                Refer for temporal artery biopsy and initiation of oral prednisone.

                Aspirin or acetaminophen every 4 hours as needed for pain and fever.

                A daily β-blocker such as propranolol.

                CT scan of the head and lumbar puncture for CSF evaluation.

Question 18The physiological explanation of syncope is:

                Accelerated venous return and increased stroke volume resulting in deactivation of the parasympathetic nervous system.

                A cycle of inappropriate vasodilation, bradycardia, and hypotension.

                A sudden rise in blood pressure due to overly efficient vasoconstriction.

                Emotional stress resulting in hypertension, tachycardia, and increased venous return.

Question 19

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

                “What was it you did to make him angry?”

                “You must seek refuge immediately.”

                “I am concerned about your safety.”

                “I am going to call a shelter for you.”

Question 20The primary goals of treatment for patients with alcohol abuse disorder are:

                Reduction in withdrawal symptoms and reduction in desire for alcohol

                Psychotherapeutic and pharmacological interventions to decrease desire for and effects of alcohol

                Abstinence or reduction in use, relapse prevention, and rehabilitation

                Marital satisfaction, improvement in family functioning, and reduction in psychiatric impairment

Question 21A patient has been diagnosed with hypothyroidism and thyroid hormone replacement therapy is prescribed. How long should the nurse practitioner wait before checking the patient’s TSH?

                1 week

                2 weeks

                4 weeks

                8 weeks

Question 22Which history is commonly found in a patient with glomerulonephritis?

 

                Beta-hemolytic strep infection

                Frequent urinary tract infections

                Kidney  stones

                Hypotension

 

Question 23

Risk factors for prostate cancer include all of the following except:

                Family history

                Benign prostatic hypertrophy

                African American race

                Age

Question 24

The treatment of choice for chronic bacterial prostatitis (CBP) is:

                Erythromycin 4 times daily for 7 to 10 days

                Doxycycline twice daily for 7 to 10 days

                A fluoroquinolone daily for 3 weeks to 4 months

                Bactrim DS daily for 4 to 16 weeks

Question 25

The cardinal sign of infectious arthritis is:

                Affected joint is painful at rest, with movement and weight bearing

                Rapid onset that wakes the patient during the night

                Long history of severe pain with associated joint swelling

                None of the above

 

Question 26

Which factors are associated with high risk for foot complications in a patient with diabetes mellitus?

1.            Obesity

2.            Abnormal nails

3.            Abnormal gait

4.            Poorly controlled lipids

                1, 2, 3

                2, 3, 4

                2, 3

                1, 4

Question 27

What diabetic complications result from hyperglycemia?

1.           

1.           

1.            Retinopathy

2.            Hypertension resistant to treatment

3.            Peripheral neuropathy

4.            Accelerated atherogenesis

                1, 2, 3

                2, 3, 4

                1, 3, 4

                1, 2, 4

Question 28

The correct treatment for ankle sprain during the first 48 hours after injury includes:

                Alternating heat and ice, and ankle exercises.

                Resistive ankle exercises, ankle support, and pain relief.

                Rest, elevation, compression, ice and pain relief.

                Referral to an orthopedist after x-rays to rule out fracture.

Question 29

Which patient would benefit most from screening for type 2 diabetes?

                A 30 year old female with unintended weight loss.

 

                A 25 year old male with family history of type 1 diabetes

                An obese female with recurrent vaginitis

                A 50 year oldhyperlipidemic male

Question 30

Major depression occurs most often in which of the following conditions?

                    A.    Myocardial infarction

                  Parkinson’s disease

                  Stroke

                Alzheimer’s disease

Question 31

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

                Corticosteroids

                Inhaled beta-2 agonist bronchodilators

                Inhaled anticholinergic bronchodilators

                Xanthines