Walden NRNP6531 2021 April Week 3 Knowledge Check Latest

NRNP6531 Advanced Practice Care of Adults Across the Lifespan

Week 3 Knowledge Check

Question 1 Your well-nourished 75-year-old patient has come into the office for a physical exam and states that she recently had two nosebleeds. She does not take any anticoagulants, and you have ruled out any coagulopathies. The most likely cause of these nosebleeds is:

a.  Sex hormones

b. Trauma or inflammation

c. A dietary change

d. Scurvy

Question 2 Sylvia, age 83, presents with a 3 day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect?

a. Varicella

b. Herpes zoster

c. Syphilis

d. Rubella

Question 3 Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order?

a. Aspirin

b. NSAIDs

c. Opioids

d. Antihistamines

Question 4 If a patient presents with a deep aching, red eye and there is no discharge, you should suspect:

a. Iritis

b. Allergic conjunctivitis

c. Viral conjunctivitis

d. Bacterial conjunctivitis

Question 5 A 19 year old basketball player complains of itching in the crural folds, buttocks, and upper thighs. The lesions are well demarcated and are half-moon shaped. The area is red, irritated, and there are small breaks in the skin from scratching. What is this patient’s diagnosis and how should it be treated?

a. Tinea cruris; treat with a topical antifungal cream

b. Eczema; treat with a topical steroid

c. Scabies; treat with permethrin cream

d. Syphilis; treat with penicillin

Question 6 The Centor criteria for diagnosis of Group A B-hemolytic streptococcus includes which of the following?

Fever history

Tender, swollen anterior cervical lymph nodes

Positive rapid antigen detection test

A and B only

A, B, and C

Question 7 Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by:

a. Herpes simplex

b. Aphthous ulcers

c. Candidiasis

d. Oral cancer

Question 8 Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to:

a. Quit smoking

b. Maintain aggressive hypertension therapy

c. Stick to a low-fat, low-sodium diet

d. Continue with his exercise program

Question 9 Which of the following statements about malignant melanomas is true?

a. They usually occur in older adult males

b. The patient has no family history of melanoma

c. They are common in blacks

d. The prognosis is directly related to the thickness of the lesion

Question 10 A 45 year old with diabetes has had itching and burning lesions between her toes for 2 months. Scrapings of the lesions confirm the diagnosis tinea pedis. What is the best initial treatment option for this patient?

Prescribe an antifungal powder for application between her toes and in her shoes and a topical prescription strength antifungal cream for other affected areas. Monitor for a secondary bacterial infection.

Prescribe an oral antifungal for 4 to 12 weeks. Monitor BUN and creatinine at 1 week, 2 weeks, and every month thereafter.

Prescribe an oral antifungal for 4 to 12 weeks. Monitor liver enzymes, BUN, and creatnine at 1 week, 2 weeks, and every month thereafter.

Prescribe a prescription strength antifungal/steroid combination cream. Monitor for a secondary bacterial infection.

Question 11 Medicare is a federal program administered by the Centers for Medicare and Medicaid Services (CMS). The CMS has developed guidelines for Evaluation and Management coding, which all providers are expected to follow when coding patient visits for reimbursement. Which of the following is an important consideration regarding billing practices?

a. It is important to “undercode” so that one does not get charged with Medicare fraud

b. The practice of “overcoding” is essential in this age of decreasing reimbursements

c. Failing to bill for billable services will lead to unnecessarily low revenues

d. Time spent with the patient is a very important determinant of billing

Question 12 Sarah has allergic rhinitis and is currently being bothered by nasal congestion. Which of the following meds ordered for allergic rhinitis would be most appropriate?

An antihistamine intranasal spray

A decongestant nasal spray

Ipratropium

Omalizumab

Question 13 Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect?

a. Cataracts

b. Glaucoma

c. Retinal detachment

d. Iritis

Question 14 What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?

a. You must initiate the plan of care for the patient

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

c. You must be employed as an independent contractor

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

Question 15 Which of the following is a predisposing condition for furunculosis?

a. Diabetes mellitus

b. Hypertension

c. Peripheral vascular disease

d. Chronic fatigue syndrome

Question 16 A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner ly tells him:

a. “It is the most common cause of death in patients with skin cancer.”

b. “It can be cured with surgical excision or radiation therapy.”

c. “It is a slow growing skin cancer that rarely undergoes malignant changes.”

d. “It can be cured using 5-flurouracil cream twice daily for 2 to 4 weeks.”

Question 17 A 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

Stiffness in the right shoulder

Change in sleeping habits

Question 18 Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?

a. Pharmacological therapy

b. A labyrinthectomy

c. A vestibular neurectomy

d. Wearing an earplug in the ear with the most hearing loss

Question 19 Your 31-year-old patient, whose varicella rash just erupted yesterday, asks you when she can go back to work. What do you tell her?

a. Once all the vesicles are crusted over

b. When the rash is entirely gone

c. Once you have been on medication for at least 48 hours

d. Now, as long as you stay away from children and pregnant women

Question 20 Marvin has sudden eye redness that occurred after a strenuous coughing episode. You diagnose a sub conjunctival  hemorrhage. Your next step is to

a. Refer him to an ophthalmologist

b. Order antibiotics

c. Do nothing other than provide reassurance

d. Consult with your collaborating physician