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100 Cards in this Set
- Front
- Back
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A 12-year-old female child has burned her arm with a curling iron. Her mother brings her into the clinic for care. You make the determination that this is a second-degree burn. What is appropriate management?
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topical silver sulfadiazine (Silvadene) cream
Silver sulfadiazine (Silvadene) is a sulfa drug. Further, silver sulfadiazine (Silvadene) is prescribed for treatment and prevention of infections that may occur with second-degree burns and third-degree burns. |
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The nursing diagnosis is the _____ step of the nursing process.
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Second.
Assessment is the first step of the nursing process. The second step is diagnosis. The diagnosis determines nursing intervention. |
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When the FNP is examining a 12-month-old infant, about how much growth should she expect to see in head circumference, as compared to the infant's head circumference at birth?
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3 cm
6 cm 12 cm 18 cm Explanation: The typical head growth in the first year of life is 12 cm: 6 cm in the first 3 months; 3 cm in the 4th to 6th months; and 3 cm in the 6th to 12th months. Subsequent head growth is about 0.5 cm/year for 2 – 7 year olds and 0.3 cm/ year for 8 – 12 year olds. |
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Francesca is a 34-year-old patient who often suffers from migraine headaches.You want to prescribe a prophylactic treatment for her. Which of the following medications are you most likely to prescribe?
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Sumatriptan
codeine Propranolol Ergotamine/caffeine Explanation: Prophylactic treatment for migraine treatment includes beta-blockers (propranolol) and tricyclic antidepressants, such as amitriptyline. The other choices are abortive treatments for migraines already in progress. |
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Which of the following is an indication for hospitalization for an adult with community-acquired pneumonia?
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age older than 40
PO2 <90 mm Hg respiratory rate greater than 20 breaths per minute no resources for self-care at home Explanation:Correct answer:no resources for self-care at home An adult with no resources for self-care at home might require hospitalization. Those aged 60 and older, those with a PO2 <60 mm Hg, and those with a respiratory rate greater than 30 breaths per minute may also require hospitalization. |
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In which of the following cases is it best to refer a patient with congestive heart failure to a cardiologist?pediatric patientspregnant womanlactating womanall of the aboveHide ExplanationExplanation:Correct answer:all of the above All of the patients in the first three choices should be referred to a cardiologist. Also refer patients if complications or exacerbation is not responsive to treatment.
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pediatric patients pregnant woman lactating woman all of the above Explanation:Correct answer:all of the above All of the patients in the first three choices should be referred to a cardiologist. Also refer patients if complications or exacerbation is not responsive to treatment. |
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A 26 year old female patient reports unusually heavy menstrual bleeding. She says she is soaking through at least one sanitary pad per hour. She does not believe herself to be pregnant. The patient should be further evaluated for all but which of the following?
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Uterine fibroids.
PID. Uterine polyps. Hyperthyroidism. Hide ExplanationExplanation:Correct Answer: Hyperthyroidism Heavy menstrual bleeding is not usually associated with hyperthyroidism -- this condition can actually lead to light menstrual periods. The other choices can all lead to heavy menstrual bleeding. The patient should also have her IUD removed if she has one. |
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Which of the following best describes the presentation of a patient during a myoclonic seizure?
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blank stare lasting 3 – 50 seconds with impaired level of consciousness
awake state or momentary loss of consciousness with abnormal motor behavior lasting seconds to minutes rigid extension of arms and legs followed by sudden jerking movements aura characterized by unusual sense of smell or taste, visual or auditory hallucinations and stomach upset Hide ExplanationExplanation:Correct Answer:awake state or momentary loss of consciousness with abnormal motor behavior lasting seconds to minutesA myoclonic seizure is characterized by an awake state or momentary loss of consciousness with abnormal motor behavior lasting seconds to minutes. One or more muscle groups cause brief jerking contractions of the limbs and trunk, occasionally flinging the patient. |
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Appendicitis is one of the most common causes of acute abdominal pain in all but which of the following age groups?
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0 – 1 year of age
2 – 5 years of age 6 – 11 years of age 12 – 21 years of age Hide ExplanationExplanation:Correct answer:0 – 1 year of age In this age group intussusception, incarcerated hernias, gastroenteritis, and hernia are more common than appendicitis. In all of the other age groups, appendicitis is one of the most common causes of acute abdominal pain. |
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Inconsistencies with history and examination and a positive Waddell sign indicates which of the following?
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vertebral body metastasis
Malingering spinal cord disease osteoarthritis Hide ExplanationExplanation:Correct answer:malingering Malingering behavior is indicated by inconsistencies with history and examination, over-exaggeration of symptoms, conflicting examination results, and a positive Waddell sign. Interpreting inconsistencies or pain behaviors as malingering, however, may not be useful because they could be viewed as a plea for help. |
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When assessing a patient with endometriosis, you might find that the patient experiences all but which of the following symptoms?
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rectal pain
low back pain urinary retention intermenstrual bleeding Hide ExplanationExplanation:Correct answer:urinary retention This is not a likely symptom of endometriosis. Dysuria (painful urination) is a more common symptom. Other symptoms include: dysmenorrhea, pelvic pain, dyspareunia, infertility, and dyschezia. |
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Your patient has recovered from an acute attack of gout. As follow up for this patient you educate him to do all of the following EXCEPT:
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avoid alcohol binges
avoid fasting avoid low-calorie diets limit fluid intake Hide ExplanationExplanation:Correct answer:limit fluid intake You would encourage generous fluid intake for a person with gout. This helps to avoid kidney stones. |
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According to the National Asthma Education and Prevention Program Expert Panel Report 3 (NAEPP EPR-3) all of the following are goals of asthma care EXCEPT:
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minimal or no chronic symptoms such as cough and wheeze
no limitations on activities no or minimal side effects while optimal medications are given fully reverse impaired lung function Hide ExplanationExplanation:Correct answer:fully reverse impaired lung function This is incorrect. The formerly held concept in asthma was that no matter how severe the airway obstruction, the process was fully reversible. The newer disease model acknowledges that continued airway inflammation contributes to significant and potentially permanent airway remodeling and fixed obstruction. The NAEPP EPR-3 goal therefore is to prevent progressive loss of lung function, not fully reverse impaired lung function. |
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You have a patient whom you suspect may have a cardiovascular problem. You understand that evaluation of heart sounds is an important part of the assessment of any patient with a cardiovascular problem. Which of the following best describes the S4 heart sound?
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high-frequency sound heard late in diastole
low-frequency sound heard early in diastole closure of the aortic and pulmonary valves low-frequency sound heard late in diastole Hide ExplanationExplanation:Correct answer:low-frequency sound heard late in diastole The S4 heart sound is a low-frequency sound heard late in diastole. It is rare in infants and children. It is always pathological and it is seen in conditions with decreased ventricular compliance. |
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Ms. Jones has been diagnosed with Tinea pedis. This is an infection of the _____.
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Body.
Hand. Feet. Groin. Hide ExplanationExplanation:Correct answer: Feet Tinea corporis: Fungal infection of body Tinea manuum: Fungal infection of hand Tinea pedis: Fungal infection of feet Tinea cruris: Fungal infection of groin |
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According to the CDC an obese person would have a Body Mass Index (BMI) of:
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greater than or equal to 18.5
greater than or equal to 25 greater than or equal to 30 greater than or equal to 40 Hide ExplanationExplanation:Correct answer:greater than or equal to 30 An obese person would have a Body Mass Index (BMI) of greater than or equal to 30. A person of healthy weight would have a BMI of 18.5 to 24.9. |
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Which of the following theorists developed a model to explain why healthy people do or do not take advantage of screening programs?
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Bandura
Becker Maslow Prochashka & DiClemente Hide ExplanationExplanation:Correct Answer:Becker Becker developed the health belief model which is used to explain why healthy people do or do not take advantage of screening programs. It involves variables such as perceptions of susceptibility and seriousness of a disease, benefits of treatment, perceived barriers to change, and expectations of efficacy. |
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You are performing an assessment. The patient has breath sounds that are hollow, loud, and high. Which of the following is the best way to describe these breath sounds?
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Vesicular.
Stridor. Bronchial. Sibilant. Hide ExplanationExplanation:Correct Answer: Bronchial This patient is exhibiting bronchial breath sounds. These are typically high and loud with a hollow quality. |
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The classic diagnostic triad for cystic fibrosis (CF) includes which of the following?
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elevated sweat chloride concentration
production of abnormally tenacious mucus secretion chronic pulmonary disease all are included Hide ExplanationExplanation:Correct Answer:all are included All of the first three choices are part of the classic diagnostic triad for CF. CF is the most common lethal genetic disease in the United States. It is caused by a defect on chromosome 7, autosomal recessive inheritance pattern. |
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You are evaluating a 35-year-old pregnant female who has an indication for genetic counseling. Why might this be?
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maternal age
increased maternal alpha-fetoprotein drug exposure during the first trimester history of previous stillbirth Hide ExplanationExplanation:The Correct answer is:Maternal ageWomen 35 years of age and older are at high risk for pregnancies involving congenital abnormalities. The remaining answer choices are all reasons for genetic counseling, but to a much lesser degree. |
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When palpating the head and neck of an adult, what would be an abnormal finding?
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Soft lymph nodes.
Palpable lymph nodes. Round lymph nodes. Nonpalpable lymph nodes. Hide ExplanationExplanation:Correct Answer:Palpable lymph nodes.Lymph nodes are not typically palpable in patients over the age of 12. Lymph nodes should also be small, soft, and round. |
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Mr. Montes is a patient who has recently completed antibiotic treatment with sulfa drugs. He comes to the FNP with severe vesicular lesions all over his body with mucosal involvement. Which of the following is the most likely diagnosis with this history and these symptoms?
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erythema multiforme
herpes zoster meningococcemia Stevens-Johnson syndrome Hide ExplanationExplanation:Correct answer:Stevens-Johnson syndrome Stevens-Johnson syndrome is the acute onset of severe vesicular to bullous lesions all over the body. They range from hives to blisters and hemorrhagic lesions. There is also mucosal involvement with blisters. A history of recent antibiotic treatment with sulfas, penicillins, phentoin and other drugs can precede the onset. Erythema multiforme is a milder form of Stevens-Johnson syndrome with no mucosal involvement. |
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Myocardial ischemia may be indicated on an ECG by which of the following?
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ST segment elevation with tall peaked T wave
inverted T wave with T wave depression pathologic “Q” wave no p wave present Hide ExplanationExplanation:Correct answer:inverted T wave with T wave depression Inverted T wave with T wave depression is indicative of myocardial ischemia. Myocardial injury is indicated with ST segment elevation with tall peaked T wave. Myocardial infarction may be indicated by a pathologic “Q” wave. Atrial fibrillation will have no p wave present. |
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Which of the following is NOT one of the Jones criteria for pelvic inflammatory disease?
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upper abdominal rigidity
lower abdominal tenderness cervical motion tenderness adnexal tenderness Hide ExplanationExplanation:Correct answer:upper abdominal rigidity The Jones criteria are the major criteria for PID. Upper abdominal rigidity is not one of these criteria. |
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You would only prescribe a Category D drug for a pregnant woman if the benefits outweigh the risk. Which of the following drugs is a Category D drug?
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Cefalexin
Carbamazepine penicillin Nitrofurantoin Hide ExplanationExplanation:Correct Answer:CarbamazepineCarbamazepine is a category D drug. There is evidence of fetal risk when using this drug. It should only be used if the benefits outweigh the risks. Using carbamazepine can cause congenital malformations and bleeding abnormalities in the newborn. |
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Which condition is difficult to gain a definitive medical diagnosis for which would influence the nursing diagnosis?
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Alzheimer's.
Diabetes. Stroke. Heart disease. Hide ExplanationExplanation:Correct Answer:Alzheimer's.There is no definitive diagnosis for Alzheimer's. The nursing diagnosis for a patient suspected of having Alzheimer's should be similar for patients with cognitive impairment. |
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A 33-year-old female has been previously diagnosed with primary dysmenorrhea and now presents in the office with symptoms including pain. She has tried over the counter ibuprofen and naproxen with no results. How should the nurse practitioner treat or manage her?
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oral contraceptives
B vitamins encourage regular exercise prescription strength naproxen Hide ExplanationExplanation:The Correct answer is:Oral contraceptivesThe primary treatments for dysmenorrhea include NSAIDs and hormonal contraceptives. The general recommendation is to use one agent and add the other if one does not work alone. Both should be considered for women who are symptomatic with one agent only. |
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Which of the following statements concerning urinalysis is least accurate?
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Epithelial cells in large amounts indicate contamination.
Normal white blood cells in urine are ≤ 20 WBCs/μL. Protein in urine indicates kidney damage. Red blood cells are seen in kidney stones and some lower urinary tract infections. Hide ExplanationExplanation:Correct Answer:Normal white blood cells in urine are ≤ 20 WBCs/μL.This is not accurate. Normal white blood cells in urine are <5 WBCs/μL. |
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Which of the following persons is most at risk for Osgood-Schlatter (OS) disease?
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14-year-old male
7-year-old female 5-year-old male 15-year-old female Hide ExplanationExplanation:Correct Answer:14-year-old maleOS disease is most common in athletic adolescents and accounts for approximately 28% of musculoskeletal conditions seen in a primary care office. It is very common in children ages 10 – 14 who are participating in sports on a regular basis. It is more common in males than females. |
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Your 82-year-old patient presents with flu-like symptoms, including fever, chills, and myalgia. You determine she is positive for Lyme disease. Which stage of the disease do the symptoms MOST likely represent?
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Early Localized Disease.
Early Disseminated Disease. Late Disease. None of the above. Hide ExplanationExplanation:Correct Answer:Early Localized Disease.The symptoms associated with Lyme Disease present themselves in three stages. Stage 1 (Early Localized Disease): The most common symptoms are fever, chills, myalgia, and headache, among others. Stage 2 (Early Disseminated Disease): The most common symptoms are fatigue. migratory arthralgia, cranial nerve palsies, and erythema migrans. Stage 3 (Late Disease): The most common symptoms are recurrent pauciarticular arthritis, mood, memory, and sleep problems. |
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You are conducting an assessment with a 41 year old male patient. He reports urinary urgency and occasional incontinence. He also reports pain when urinating, frequent urination at night, and erectile dysfunction. Urinalysis indicates hematuria. Which of the following is the most likely diagnosis for this patient?
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BPH.
Prostate cancer. Bladder cancer. Urinary tract infection. Hide ExplanationExplanation:Correct Answer:Prostate cancer.This patient's symptoms have much in common with those of BPH. However, the presence of blood in the urine is a sign that prostate cancer may be present. Further diagnostics should be performed. |
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Which of the following medications would NOT be appropriate to prescribe for a case of mild acne?
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benzoyl peroxide
isotretinoin erythromycin solution retinoic acid gel Hide ExplanationExplanation:Correct answer:isotretinoin Isotretinoin (Accutane) would not be appropriate to prescribe for a mild case of acne. This treatment, because the drug is extremely teratogenic, is reserved for severe cystic acne. |
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You have a 4-year-old male patient who has been diagnosed with Kawasaki disease. You understand that long-term management of this disease depends on the degree of cardiac involvement. As part of the plan for managing this disease, an echocardiogram would be done how many weeks after diagnosis?
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1
2 - 3 3 - 4 6 - 8 Hide Explanation Explanation: Correct Answer: 6 - 8 All cases of Kawasaki disease are managed in a hospital setting. Patients should be referred to a cardiologist. An echocardiogram would be done in about 6 – 8 weeks to check the degree of cardiac involvement. |
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After thorough testing, the ANP decided it is best to treat his patient with an antipsychotic. Which of these is an example of an antipsychotic?
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Pergolide.
Temazepam. Dibenzothiazepine. Gabapentin. Hide ExplanationExplanation:Correct Answer:Dibenzothiazepine.All of the medications listed can be used in the treatment of neurological disorders, however, they are different classes of drugs.Pergolide - Dopamine AgonistTemazepam - BenzodiazepineDibenzothiazepine - AntipsychoticGabapentin - Anticonvulsant |
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A patient who has recently started taking Cymbalta for depression complains of drowsiness with the drug. Which of the following is an appropriate response to this patient?
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Tell the patient to continue taking the drug in the morning.
The drowsiness will pass with a few weeks. Tell the patient to start taking the drug at mid-day with a full meal. Tell the patient to try taking the drug on an empty stomach. Tell the patient to try taking the drug at bedtime, so that she can sleep when the drug makes her drowsy. Hide ExplanationExplanation:Correct Answer: Tell the patient to try taking the drug at bedtime, so that she can sleep when the drug makes her drowsy Drowsiness is a common side effect of Cymbalta. Some patients may benefit from taking the drug close to bedtime. This allows the patient to sleep when the drug makes him or her drowsy, rather than having to fight daytime drowsiness. |
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You have a patient with impacted cerumen. You realize that there are certain conditions in which irrigation of the ear to remove the cerumen is contraindicated. Which of the following is NOT a contraindication?
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tympanostomy tube
perforated tympanic membrane organic foreign body in ear advanced age Hide ExplanationExplanation:Correct answer:advanced age Advanced age is not a contraindication to irrigation to remove impacted cerumen. Irrigation is done with warm water to dislodge and rinse the cerumen out of the canal. |
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Your patient is an older adult with pernicious anemia. He has a heart condition. You understand that you need to follow-up this client in 48 hours for which of the following reasons?
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A rapid decrease in RBC production can lead to hypovolemia.
There may be neurologic damage. Anemia may become severe. Weight loss is common. Hide ExplanationExplanation:Correct Answer:A rapid decrease in RBC production can lead to hypovolemia.Follow up older adults and clients with cardiac conditions in 48 hours. The reason for this is that a rapid decrease in RBC production can lead to hypovolemia. Consider iron supplementation. Check initial hematologic response in 4 – 6 weeks, then every 6 months for hematocrit, with stool check for occult blood. |
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Which of the following patient with burns is least likely to need hospitalization?
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a patient with second-degree burns on 5% of the body
a patient with electrical burns a patient struck by lightning a patient with circumferential burns Hide ExplanationExplanation:Correct answer:a patient with second-degree burns on 5% of the body All of the choices are patients who should be referred for hospitalization except this one. Other to be hospitalized include all patients with: second-degree burns over more than 10% of the body; second-degree burns on the hands; chemical burns; or inhalation burns. |
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Which of the following drugs is NOT a selective serotonin reuptake inhibitor (SSRI)?
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Fluoxetine
Paroxetine Amitriptyline Sertraline Hide ExplanationExplanation:Correct answer:Amitriptyline Amitriptyline is not an SSRI. It is a tricyclic antidepressant and unlike SSRIs it is not used as a first line of treatment for depression. |
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You have a patient who is experiencing menopause. Which of the following discoveries would cause you the most concern?
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labia and vagina are atrophic and thinner
palpable ovaries urinary incontinence atrophied ovaries Hide ExplanationExplanation:Correct answer:palpable ovaries Palpable ovaries are considered an abnormal finding in menopausal women. After several years of menopause, the ovaries are atrophied and a smaller size. Ovarian cancer must be ruled out when a palpable ovary is found. |
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You 40-year-old female client mentions that her breasts become tender, bloated, and lumpy in the couple of weeks before the onset of menses. She says that the symptoms disappear shortly after onset of menses. Your most likely diagnosis is which of the following?
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Paget’s disease of the breast
possible breast cancer herpetic infection fibrocystic breast Hide ExplanationExplanation:Correct answer:fibrocystic breast The monthly hormonal cycle induces breast tissue to become engorged and painful. This results in fibrocystic breast which is attributed to the surge of progesterone during the luteal phase before menses. Symptoms resolve after menstruation starts. |
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Breastfeeding women who have a chronic health problem may need daily medication. Which of the following statements in regard to this situation is false?
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About 5% of breastfeeding women have a chronic health problem and need daily medication.
Nursing infants usually get about 1%, often less, of the maternal dose. Only a few drugs are contraindicated for a woman who is breastfeeding. The “pump and dump” procedure is a very helpful way to reduce drug levels in a mother’s milk. Hide ExplanationExplanation:Correct answer:The “pump and dump” procedure is a very helpful way to reduce drug levels in a mother’s milk. This is false. The “pump and dump” procedure is a less than helpful way to reduce drug levels in a mother’s milk. It creates an area of lower drug concentration in the empty breast which enables the drug to diffuse from the area of high concentration to the area of low concentration (breast milk). |
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ou have a 62-year-old female patient who is post-menopausal and whom you have diagnosed as having an ovarian cyst. The cyst is 4 cm and the client has no other risk factors. Which of the following actions would you take for this patient?
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Refer for emergency care.
Do nothing. Refer to a surgeon. Recheck her at 6 weeks. Hide ExplanationExplanation:Correct answer:Recheck her at 6 weeks. If the patient is post-menopausal, the cyst is smaller than 5 cm, and the patient does not have any other risk factors, you would recheck her in 6 weeks, and then again at 3 months, and then 6 months. Refer the patient if there is any increase in size of the mass. |
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You have a patient with severe anxiety. You understand that a referral may be necessary in all but which of the following cases?
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The patient develops psychotic paranoid thought processes.
The patient has exhibited diminished problem solving ability. There is no response to standard treatment. Anxiety reaches the panic level. Hide ExplanationExplanation:Correct answer:The patient has exhibited diminished problem solving ability. This is not an indication for referral. Diminished problem solving occurs in a person with moderate anxiety and is not a referral situation. All of the other choices are reasons for referral along with: comorbid psychiatric diagnoses, escalation of symptoms to the point of refusal of treatment, and suicidal or homicidal ideations. |
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Your 10-year-old male patient with ADHD is taking medication for this. He is taking a drug that is not a controlled substance. Which of the following drugs would he be taking to manage his ADHD?
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Concerta
Ritalin Strattera Methylin Hide ExplanationExplanation:Correct Answer:StratteraStrattera is not a controlled substance. Most commonly used agents for ADHD are stimulants which are Schedule II drugs. These substances carry a risk for abuse. |
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You are administering TB tests to a group of people who may have been exposed to the disease. Which of the following would NOT be a positive finding of a TB test?
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more than 5 mm in an HIV infected person
more than 5 mm in a person who has had close contact with someone with active TB more than 10 mm for a healthcare worker more than 10 mm for a healthy male adult Hide ExplanationExplanation:Correct answer:more than 10 mm for a healthy male adult This would not be considered a positive TB test result for a healthy person with no other risks for exposure to TB. More than 15 mm would be a positive finding for this person and all persons. |
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Mitral regurgitation has all of the following characteristics EXCEPT:
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best heard at the apex or apical area
low-pitched radiates to the axilla loud-blowing Hide ExplanationExplanation:Correct answer:low-pitched Mitral regurgitation is a pansystolic murmur that is heard best at the apex or the apical area, radiates to the axilla and is a loud-blowing and high-pitched murmur. The diaphragm of the stethoscope is used to detect mitral regurgitation. |
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The expected course for bacterial conjunctivitis with treatment is which of the following?
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2 – 5 days
5 – 7 days 5 – 14 days 2 – 3 weeks ide ExplanationExplanation:Correct answer:2 – 5 days The expected course with treatment is 2 – 5 days. Without treatment it is 5 – 7 days. |
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You are providing patient education to a patient who has recently been prescribed Coumadin. The patient should be advised to all but which of the following to decrease bleeding risk?
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Use rectal suppositories to help alleviate the constipation that can accompany warfarin.
Limit alcohol consumption.Use a soft-bristled toothbrush. Avoid medication containing aspirin. Hide ExplanationExplanation:Correct Answer: Use rectal suppositories to help alleviate the constipation that can accompany warfarin Rectal suppositories and enemas can actually lead to bleeding. The patient should minimize risk by using a soft toothbrush, avoiding razor blades, and avoiding aspirin. Limiting the consumption of alcohol and certain foods can also minimize the bleeding risk associated with warfarin. |
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Secondary prevention is detection of disease early to minimize bodily damage. Which of the following would be considered secondary prevention measure?
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STD screening
immunization cardiac rehab education Hide ExplanationExplanation:Correct answer:STD screening STD screening is recommended by the CDC for all women between the ages of 20 to 24 years. It is a secondary prevention measure to minimize bodily damage should an STD be discovered. Immunization and education are primary prevention measures; and cardiac rehab is a tertiary prevention measure. |
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Which of the following is NOT one of the types of drugs that have the greatest number of undesirable side-effects in the elderly?
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NSAIDS
diuretics anticholinergics sedatives Hide ExplanationExplanation:Correct Answer:NSAIDS NSAIDS, antihypertensives, central nervous system depressants, and steroids may cause depression in the elderly; however, they are not among the drugs that have the greatest number of undesirable side-effects in the elderly. All of the other three choices do. |
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A Family Nurse Practitioner who has worked for a large hospital as an RN has developed a nurse practitioner managed clinic for hospital employees. She is employed by this hospital still and wants to remain so. How is she described?
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an entrepreneur
an intrapreneur a risk taker a clinical nurse specialist Hide ExplanationExplanation:Correct Answer:an intrapreneurAn intrapreneur is someone who is able to carve out a specialty role within an existing organization or healthcare setting. An entrepreneur is someone who assumes the financial and personal risks of owning a business outside an existing organization, making this an incorrect choice. The remaining answer choices are incorrect as well. |
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Nurse Jeremy is consulting with a patient who was recently discharged from the hospital after being diagnosed with congestive heart failure (CHF). Besides his normal medications, what health measures should Jeremy recommend to aide in his patient's healing?
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Adding over-the-counter supplements.
Increase daily fluid intake. Modified diet and exercise routine. Nothing at all. Hide ExplanationExplanation:Correct Answer:Modified diet and exercise routine.After diagnosis, patients with CHF are instructed to take basic, non-medicinal measures to improve symptoms and prognosis, such as diet modification, increased exercise and weight monitoring. Other medicines or supplements may be prescribed/recommended to work together with these measures, but these therapies will need to be monitored by the patient's HCP to suit each patient. |
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You understand that the complete resolution of symptoms of Osgood-Schlatter disease through physiologic healing takes:
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2 – 4 weeks
12 – 24 months 3 – 6 months 6 – 12 months Hide ExplanationExplanation:Correct answer:12 – 24 months Complete resolution of symptoms of Osgood-Schlatter disease through physiologic healing takes 12 – 24 months. You should work with the client in the meantime to help determine the degree of stress or athletic participation that may be undertaken without significant pain. |
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Mrs. Weiss is a patient whose husband died 2 months ago. She tells you that she is often tearful and anxious, has no appetite, and does not want to socialize with others. You understand that Mrs. Weiss is suffering which of the following types of depression?.
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adjustment disorder depression
dysthymia major depressive disorder minor depressive disorder Hide ExplanationExplanation:Correct answer:adjustment disorder depression Adjustment disorder depression is defined as the onset of depression symptoms in response to an identifiable event within the preceding 3 months, such as the death of a spouse. Adjustment disorder depression does not include posttraumatic stress disorder |
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You have a patient who presents with fever, weight loss, cough, and pleuritic chest pain. She is given a TB skin test. You know that the test is positive if after 48 hours the induration is:
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nonexistent
10 mm or greater in diameter more than 5 mm in diameter less than 5 mm in diameter Hide ExplanationExplanation:Correct answer:10 mm or greater in diameter After being given a TB skin test, the patient must return to have the test site evaluated. If it has an induration of 10 mm or greater in diameter the test is positive. |
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Which of the following is NOT a typical physiologic change during pregnancy?
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Cardiac output decreases by one-third by the last two trimesters.
The heart is displaced upward and to the left in the late second to third trimester. Decreased systolic and diastolic pressure occurs in the first trimester. The thyroid can enlarge by as much as 15%. Hide ExplanationExplanation:Correct answer:Cardiac output decreases by one-third by the last two trimesters. All of the choices are typical physiologic changes during pregnancy except this one. Cardiac outputincreases by one-third by the last two trimesters. |
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Which of the following tests should be ordered to confirm a diagnosis of hypothyroidism?CBC.Blood glucose test.TSH test.Lipid panel.Hide ExplanationExplanation:Correct Answer:TSHThe TSH test analyzes the level of thyroid stimulating hormone. It is useful in diagnosing hypothyroidism, in which the thyroid does not use TSH effectively.
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CBC.
Blood glucose test. TSH test. Lipid panel. Hide ExplanationExplanation:Correct Answer:TSHThe TSH test analyzes the level of thyroid stimulating hormone. It is useful in diagnosing hypothyroidism, in which the thyroid does not use TSH effectively. |
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Drug interactions are common with oral iron therapy. Which of the following drugs is NOT matched with its correct effect when taken with oral iron?
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Levodopa: decreased iron effect
Tetracyclines: decreased tetracycline and iron effect Antacids: decreased iron absorption Caffeine: decreased iron absorption Hide ExplanationExplanation:Correct Answer:Levodopa: decreased iron effectWhen levodopa is taken with oral iron therapy there is the effect of both decreased levodopa and decreased iron. Use of these medications should be separated by as much time as possible and levodopa dosage should be increased if needed. |
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You suspect that your patient is experiencing an ectopic pregnancy. If this diagnosis is correct you would expect to find all of the following in an examination EXCEPT:
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abdominal tenderness
fever hypotension with blood loss tachycardia with blood loss Hide ExplanationExplanation:Correct answer:fever Hypotension and tachycardia may be evident with blood loss. Fever is not expected. Abdominal tenderness is present in 80% to 90% of cases. |
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The condition pictured above is which of the following
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vitiligo
xanthelasma seborrheic keratoses melasma hide ExplanationExplanation:Correct answer:xanthelasma Xanthelasma are raised and yellow soft plaques that are located under the brow on the upper and/or lower lids of the eyes, usually on the nasal side. They may be a sign of hyperlipidemia if the person is younger than 40 years of age. |
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A patient has recovered from gastric bypass surgery. His current complaint is feeling dizzy and sweating a few hours after eating. What is a likely cause for this problem?
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Postprandial hypoglycemia.
Type I diabetes. Hyperglycemia. Lupus. Hide ExplanationExplanation:Correct answer: Postprandial hypoglycemia Hypoglycemia is not always linked to diabetes. It can be caused by another illness or medical condition. postprandial hypoglycemia is a condition that occurs after gastric bypass surgery. The symptoms begin four hours after eating. |
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You are tapping the patient’s facial nerve just anterior to the ear. This produces a spasm of the patient’s facial muscles. You understand that this is known as which of the following?
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Cushing’s syndrome
Somogyi phenomenon chvostek’s sign Trousseau’s sign Hide ExplanationExplanation:Correct answer:Chvostek’s sign This is known as Chvostek’s sign. It is a sign of hypocalcemia. Trousseau’s sign is also a sign of hypocalcemia. It is a carpal spasm elicited by compressing the brachial artery with a blood pressure cuff for 3 minutes. |
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Which of the following symptoms is associated with secondary dysmenorrhea rather than primary dysmenorrhea?
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Pain is crampy.
Pain may occur at any time during the menstrual cycle. Symptoms usually begin several hours before or at the onset of menses. Pain lasts 24 to 72 hours. Hide ExplanationExplanation:Correct answer:Pain may occur at any time during the menstrual cycle. This is a symptom associated with secondary dysmenorrhea. Symptoms are more variable in this type of dysmenorrhea. Associated symptoms depend on the cause. |
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All pregnant women should undergo screening for HBsAg at the first prenatal visit, regardless of HBV vaccine history. This is because infants who have been infected perinatally with HBV have what percentage chance of developing hepatocellular carcinoma or cirrhosis in their lifetime?
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25%
20% 10% 5% Hide ExplanationExplanation:Correct answer:25% Infants who have been infected perinatally with HBV have an estimated 25% lifetime chance of developing hepatocellular carcinoma or cirrhosis. The HBV vaccine is not 100% effective and a woman could have carried HBsAg since before pregnancy. |
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Which of the following tests is federally mandated for infants?
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TSH
Lead screening PKU all of the above Hide ExplanationExplanation:Correct Answer:PKUPKU (phenylketonuria) is a federally mandated test. Severe intellectual disorders may develop if this is not treated early. |
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A sudden and rapid drop in the hemoglobin (< 6 g/dL) along with pallor, clammy skin, tachycardia and hypotension may indicate:
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acute hemorrhage
neutropenia thrombocytopenia vitamin B12 deficiency Hide ExplanationExplanation:Correct answer:acute hemorrhage Acute hemorrhage is indicated by a sudden and rapid drop in the hemoglobin. Signs and symptoms of shock such as pallor, clammy skin, tachycardia and hypotension may also be present. |
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All but which of the following conditions may delay a diagnosis of pneumonia?
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COPD.
Congestive heart failure. Myocardial infarction. Influenza. Hide ExplanationExplanation:Correct Answer: Myocardial infarction A diagnosis of pneumonia may be delayed because the symptoms of the condition are similar to may other conditions. Patients who have congestive heart failure or COPD may have the characteristic cough and wheeze, while influenza may result in coughing, fever, and chills. Myocardial infarction may involve chest pain, but is unlikely to mimic pneumonia. |
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Of the following choices which condition is most likely to have a positive Gram stain, positive U/A, and hyperperfusion on ultrasound?
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testicular tumor
testicular torsion epididymitis UTI Hide ExplanationExplanation:Correct answer:epididymitis Epididymitis is an infectious process of the epididymis. Of the choices it is the most likely to have a positive Gram stain, positive U/A, and hyperperfusion on ultrasound. The symptoms have a gradual onset worsening over time. |
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Of the following, what is the target dosage for an adult patient on Zoloft?
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40 - 60 mg qd.
10 - 20 mg qd. 20 - 80 mg qd. 50 - 200 mg qd. Hide ExplanationExplanation:Correct answer: 50 - 200 mg qd The preceding dosages are associated with the following: Prozac: 20 - 80 mg qd Zoloft: 50 - 200 mg qd Celexa: 40 - 60 mg qd Lexapro: 10 - 20 mg qd |
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In a 74-year-old Caucasian male who has had Type II Diabetes for ten years, a hypoglycemic episode is more likely to exhibit:
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dizziness and weakness
contusions symptoms of compulsive reactions delusional hyperactivity Hide ExplanationExplanation:The Correct answer is:Dizziness and weaknessOlder adults are more likely to have deleterious consequences than younger adults. Younger adults present with tremors, sweating and adrenergic symptoms. Then, older adults tend to have neurological symptoms, like dizziness and weakness. |
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Which of the following heart sounds is caused by the increased resistance from a stiff left ventricle?
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S4 heart sound
S3 heart sound S2 diastole S1 systole Hide ExplanationExplanation:Correct answer:S4 heart sound The S4 heart sound is caused by the increased resistance from a stiff left ventricle. It usually indicates left ventricular hypertrophy. It may be considered as a normal finding in some elderly patients with no heart disease. |
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The nurse practitioner assessing vision and the visual fields tests which cranial nerve (CN):
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I
II III IV hide ExplanationExplanation:Correct Answer:IICN I is the olfactory nerve, which contributes to the sense of smell. CN II is the optic nerve that is vital to vision and visual fields. CN III is the oculomotor nerve, which involves movement and actions. CN IV is the trochlear nerve that innervates the superior oblique muscle of the eye. |
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Unless contraindicated, which of the following types of drugs is most commonly prescribed for clients with systolic dysfunction in congestive heart failure?
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calcium channel blockers
ACE inhibitors beta blockers all of the above Hide ExplanationExplanation:Correct answer:ACE inhibitors ACE (angiotensin-converting enzyme) inhibitors decrease mortality and prolong survival in clients with CHF. They should be prescribed for all clients with systolic dysfunction unless contraindicated. |
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Your patient has episodes of blank staring lasting 3 – 50 seconds accompanied by impaired level of consciousness. You understand that this is an indication of which of the following types of seizures?
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tonic-clonic
absence simple partial myoclonic Hide ExplanationExplanation:Correct answer:absence Absence or petit mal seizures are characterized by blank staring lasting 3 – 50 seconds accompanied by impaired level of consciousness. The usual age of the onset of this type of seizure is 3 – 15 years. |
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A 7-year-old child is brought to the emergency room with a sore throat and high fever. He is restless and drooling a lot. After assessing the child you suspect epiglottitis. Which of the following actions would not be a part of your care plan for this child?
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Employ measures to decrease agitation.
Order intubation or tracheostomy. Have the child lie down on the examining table to rest. Administer IV antibiotics. Hide ExplanationExplanation:Correct Answer:Have the child lie down on the examining table to rest. A child with epiglottitis should remain in an upright position. He should not lie down. This may further obstruct his airway. The priority of care is always a patent airway open and clear. |
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In a patient with carpal tunnel syndrome, other than limiting the offending activity, which of the following would be used to treat the patient if he or she does not respond to the usual conservative therapy?
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corticosteroid injection into the carpal tunnel at 6-week intervals
volar splint in a neutral position surgery to release the transverse carpal ligament none of the above Hide ExplanationExplanation:Correct answer:surgery to release the transverse carpal ligament Surgery to release the transverse carpal ligament is a last resort measure for those patients who do not respond to conservative therapy. About 10% of patients do not respond, however, because of nerve damage or new pressure within the carpal tunnel that results from recurrent compression caused by scar formation. |
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Which of the following nurse practitioner roles provided the model for other emerging nurse practitioner specialties?
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pediatric nurse practitioner
family nurse practitioner geriatric nurse practitioner adult nurse practitioner Hide ExplanationExplanation:Correct answer:pediatric nurse practitioner The first NP program established in 1964 through the collaborative effort of Loretta Ford and Henry K. Silver provided the model for other emerging nurse practitioner specialties. The role of the NP continues to expand. |
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You are evaluating the pulse oximetry reading of your patient. You understand that a pulse oximetry of less than what percent indicates the need for supplemental oxygen therapy?
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98%
95% 94% 90% Hide ExplanationExplanation:Correct Answer:90%Pulse oximetry determines oxygen saturation. Less than 90% indicates the need for supplemental oxygen therapy. |
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Epiphysitis or apophysitis of the knee is more commonly referred to as which of the following?
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osteoporosis
McMurray’s disease Osgood-Schlatter disease arthritis Hide ExplanationExplanation:Correct answer:Osgood-Schlatter disease Osgood-Schlatter disease is a condition that involves inflammation and pain over the tibial tuberosity. It is most common in athletic adolescents or preadolescents and accounts for approximately 28% of musculoskeletal conditions seen in a primary care office. |
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Of the following patients who suffer from inflammatory bowel disease (IBD), which one are you least likely to refer to an internist or gastroenterologist?
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newly diagnosed patient
patient who needs screening for colorectal cancer patient with uncontrollable symptoms patient with familial tendency Hide ExplanationExplanation:Correct Answer:patient with familial tendencyThis patient is the least likely to be referred of the choices given. You would also refer a patient with acute exacerbation of symptoms. |
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A mother brings her 6-month old child into the clinic for a well-baby check. The mother is concerned about her child’s teething. The FNP might tell her all of the following about teething EXCEPT:
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Eruption typically begins at approximately 9 months of age.
Signs of teething include local sensitivity and inflammation. The child may have increased drooling and biting. There is no evidence that teething causes fever, diarrhea or other systemic illnesses. Hide ExplanationExplanation:Correct answer:Eruption typically begins at approximately 9 months of age. This is incorrect. Eruption typically begins at approximately 6 months of age. |
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A 50-year-old woman who has just been diagnosed with end-stage renal failure tells the FNP that she would like to have a DNR order. The first thing that the FNP should do is which of the following?
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have the patient sign a DNR order immediately
ask the patient to share her feelings about the diagnosis call in the hospital chaplain report to the patient’s physician Hide ExplanationExplanation:Correct answer:ask the patient to share her feelings about the diagnosis The FNP should first determine why the patient wants this DNR order. Asking the patient to share her feelings about the diagnosis will also establish a better line of communication between the patient and the FNP. |
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You are treating a 22-year-old male who complains with bilateral itchy eyes with excessive tearing. On examination, you note that clear nasal discharge is present along with ropelike eye discharge. The nurse practitioner knows that this is most consistent with inflammation caused by a (an):
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injury
bacterium virus allergen injurybacteriumvirusallergenHide ExplanationExplanation:The Correct answer is:AllergenAllergens cause allergic rhinitis and conjunctivitis. Common triggers are pollens, mold spores and other local environmental factors. Further, symptoms include itchy, watery eyes, excessive tearing, clear nasal discharge and drainage, eye discharge that is ropelike and sneezing. Hide ExplanationExplanation:The Correct answer is:AllergenAllergens cause allergic rhinitis and conjunctivitis. Common triggers are pollens, mold spores and other local environmental factors. Further, symptoms include itchy, watery eyes, excessive tearing, clear nasal discharge and drainage, eye discharge that is ropelike and sneezing. |
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What is the first-line drug intervention in an anaphylactic episode?
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oral prednisone therapy
parenteral epinephrine inhaled epinephrine oral diphenhydramine Hide ExplanationExplanation:The Correct answer is:Parenteral epinephrineParenteral epinephrine and parenteral diphenhydramine are priority medication interventions in anaphylaxis. Oral prednisone is often given once the patient is stable to decrease the inflammatory response. Inhaled epinephrine is not standard of care. Oral diphenhydramine may be used after stabilization for symptom relief purposes. |
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The FNP has a 21-year-old female patient with a history of seizures. She is married and taking oral contraceptives until she is ready to start a family. Which of the following medications may lead to contraceptive failure?
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phenytoin
clonazepam carbamazepine gabapentin Hide ExplanationExplanation:Correct Answer:carbamazepine When taken with birth control pills, carbamazepine induces estrogen metabolism. This can lead to contraceptive failure. |
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Which of the following would NOT be consistent with a diagnosis of asthma?
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recurrent cough
chest tightness symptoms influenced by strong emotions slow breathing Hide ExplanationExplanation:Correct answer:slow breathing This is not consistent with a diagnosis of asthma. Rapid breathing is common as is recurrent wheezing and cough or wheeze after exercise. |
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After thorough examination and testing of your elderly patient, it is determined that she has T3 breast cancer. What does this mean?
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Tumor more than 2 cm but not more than 5 cm in greatest dimension.
Tumor more than 5 cm in greatest dimension. No evidence of primary tumor. Tumor 2 cm or less in greatest dimension. Hide ExplanationExplanation:Correct answer: Tumor more than 5 cm in greatest dimension T0 - No evidence of primary tumor. T1 - Tumor 2 cm or less in greatest dimension. T2 - Tumor more than 2 cm but no more than 5 cm in greatest dimension. T3 - Tumor more than 5 cm in greatest dimension. |
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All of the following are contraindications for use of hormone replacement therapy (HRT) EXCEPT:
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cardiac disease
unexplained vaginal bleeding recent vascular thrombotic incident gastric bypass surgery Hide ExplanationExplanation:Correct answer:gastric bypass surgery This is not a contraindication for use of HRT. All of the other choices are contraindications along with a recent heart attack, carcinoma of the breast, active or chronic liver disease or dysfunction, and a history of varicose veins. |
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Lori is a 35-year-old female who has been diagnosed with endometriosis. She tells you that she knows nothing about this condition. You educate her about the disease by telling her all but which of the following?
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All racial, ethnic, and socioeconomic groups are affected.
It affects 5% to 15% of women of reproductive age. The pathophysiology of endometriosis is not fully understood. Endometrial implants are limited to the pelvis. Hide ExplanationExplanation:Correct answer:Endometrial implants are limited to the pelvis. This is the least accurate statement. Although most aberrant endometrial implants are scattered through the pelvis, implants have been identified in the lungs and brains. |
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An elderly patient is diagnosed with hyperlipidemia. The NP is prescribing a medication that may have the following effects on her LDL, HDL and Triglyceride levels: LDL-10 to 20% decrease, HDL - 3 to 5% increase and Triglyceride - May increase. Which of the following drugs is the NP MOST likely prescribing?
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Lipitor.
Gemfibrozil. Nicotinic acid. Colestipol. Hide ExplanationExplanation:Correct Answer:Colestipol. The expected outcomes of the preceding medications are as follows: Lipitor: LDL: 20-60% decrease HDL: 5-15% increase Triglyceride: 10-40% decrease Gemfibrozil: LDL: 5-15% decrease HDL: 14-20% increase Triglyceride: 20-50% decrease Nicotinic acid: LDL: 10-25% decrease HDL: 15-35% increase Triglyceride: 20-50% decrease Colestipol: LDL: 10-20% decrease HDL: 3-5% increase Triglyceride: May increase |
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Which of the following statements about acute myelogenous leukemia (AML) is least accurate?
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It accounts for 75% of all childhood leukemias.
There is a relatively constant incidence of AML from birth through adolescence. The ratio of AML to ALL (acute lymphocytic leukemia) is 1:4. It is an abnormal proliferation of immature myeloid stem cells in the bone marrow. Hide ExplanationExplanation:Correct answer:It accounts for 75% of all childhood leukemias. This is the least accurate statement. AML accounts for 15% to 20% of childhood leukemia. ALL accounts for 75% to 80% of all childhood leukemias. |
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Which of the following is true of normal bowel sounds?
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They will vary in pitch and intensity.
They will be uniformly quite loud. They will sound like splashing. They will be uniformly low and rumbling. Hide ExplanationExplanation:Correct Answer: They will vary in pitch and intensity It is normal for healthy bowel sounds to vary in pitch and intensity. They will be gurgling or bubbling. Splashing may indicate an obstruction. |
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All but which of the following are potential treatments for a patient with venereal warts?
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Cryosurgery.
Watchful waiting. IV antibiotics. Laser surgery. Hide ExplanationExplanation:Correct Answer: IV antibiotics Antibiotics are not effective against venereal warts, which are virally caused. Patients may be advised to use "watchful waiting," a period where no other treatment is used, in case warts go away on their own. Cryosurgery and laser surgery are also used to remove venereal warts in some patients. |
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A patient who has brought his children in to be vaccinated against chicken pox should be made aware that all but which of the following may occur?
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Fever.
Mild skin rash. Soreness at the injection site. Autism. Hide ExplanationExplanation:Correct Answer: Autism Though there has been considerable controversy over the role of vaccines in autism, currently scientific evidence does not support a link. The parent should be advised that his children may experience fever, soreness at the injection site, or a mild rash after receiving the vaccine. These side effects are not considered cause for concern. |
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You are performing a hearing test on your patient by placing a tuning fork first on the mastoid process and then on the front of the ear, timing each area. This test is which of the following?
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Weber test
Snellen test Rinne test McMurray test Hide ExplanationExplanation:Correct answer:Rinne test The Rinne test is done by placing a tuning fork first on the mastoid process and then on the front of the ear, timing each area. A normal finding would be if air conduction lasts longer than bone conduction. |
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As part of the treatment plan for your elderly patient, you recommend she see a Proctocologist. What body part(s) will this doctor evaluate?
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ENT.
Feet. Colon / Rectum / Anus. Lungs / Respiratory. Hide ExplanationExplanation:Correct answer: Colon / Rectum / Anus Otorhinolarngologist - Ear / Nose / Throat (ENT) Podiatrist - Feet Proctocologist - Colon / Rectum / Anus Pulmonogist - Lungs / Respiratory |
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Mrs. White is a 55-year-old female who has been suffering from gastroenteritis. You explain to her that which of the following factors in her history increases her susceptibility to gastroenteritis?
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acidity of the stomach
normal motility of the GI tract normal bacterial flora of the intestine gastric surgery Hide ExplanationExplanation:Correct Answer:gastric surgeryGastric surgery increases a person’s susceptibility to gastroenteritis. Increased age, loss of normal gastric acidity, and poor physical condition can also increase susceptibility. |
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A new mother is concerned that her infant is not taking in enough formula at each of his feedings. You tell her that infants need approximately 3 ounces of fluid for every pound of body weight per day. The infant weighs 8 lbs. What amount of formula should this baby be taking every 4 hours?
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6 oz.
4 oz. 8 oz. 5 oz. Hide ExplanationExplanation:Correct answer:4 oz. This infant is being fed every 4 hours. That is 6 feedings per day. A baby who weighs 8 lbs. should be taking in 24 oz. of fluid per day. With 6 feedings per day this amounts to 4 oz. per feeding. |
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A male patient is in the office with a deep cough, which worsens at night, as well as wheezing and mucoid sputum production. A diagnosis of bronchitis is made. Which of the following is NOT a good management technique?
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Tell the patient to avoid antihistamines.
Cough suppressants are encouraged in all cases. Tell the patient to stop smoking. Antibiotic treatment is not recommended in uncomplicated acute bronchitis. Hide ExplanationExplanation:The Correct answer is:Cough suppressants are encouraged in all casesCough suppressants should be avoided except if the patient is unable to sleep due to irritating cough. |
