Ancc Prep Test2

Front 1

A patient who has diarrhea as the main symptom of IBS may be prescribed all but which of the following?
Lomotil.
Imodium.
Lotronex.
Amitiza.

Back 1

Amitiza This medication is actually recommended for relief of long-term constipation and may make diarrhea worse. The other choices are all anti-diarrheals and may be used to help treat IBS. Lotronex is usually prescribed only when other treatments have not been successful.

Front 2

An elderly patient with hypertension is said to have the condition because of coarctation of the aorta. What test would confirm this?
CT angiography.
24-hour urinary metanephrine and normetanephrine.
Doppler flow study; magnetic resonance angiography.
Estimated GFR.

Back 2

CT angiography The preceding screening tests are used to confirm or refute hypertension due to the following: CT angiography - Coarctation of the aorta 24-hour urinary mentanephrine and normetanephrine - Pheochromocytoma Doppler flow study; magentic resonance angiography - Renovascular hypertension Estimated GFR - Chronic kidney disease

Front 3

The nurse practitioner is aware that hepatitis B is a public health concern. He has the understanding that which of the following groups needs routine hepatitis B (HBsAg) screening?
college students
hospital laboratory workers
pregnant women
recipients of hepatitis B vaccine series

Back 3

Pregnant women

Infants who become infected with HBV have a 25% lifetime chance of developing hepatocellular carcinoma or cirrhosis. This is why pregnant women should be screened for HBV at the first prenatal visit, regardless of their vaccine history.

Front 4

You are counseling a patient with Type II diabetes. The nurse practitioner understands that the macronutrient with the most influence on postprandial glucose levels is:
fat
carbohydrate
fiber
protein

Back 4

Carbohydrate

The macronutrient that has the greatest impact on postprandial glucose levels is carbohydrates. Protein and fiber have little effect on plasma glucose response. Fat is associated with increased risk of cardiovascular disease and does not affect postprandial glucose levels.

Front 5

The FNP has an 11-year-old female patient who has just started menstruating and whose breasts are just beginning to develop. She has a few straight, fine pubic hairs. This patient is in which Tanner stage?
Stage II
Stage III
Stage IV
Stage V

Back 5

Stage II of the Tanner stages is when females develop breast buds and have a few straight, fine pubic hairs. The average age for menarche is 11.8 years.

Front 6

Screening for cancer in the geriatric population includes all of the following recommendations EXCEPT:
prostate cancer
cervical cancer
skin cancer
colon cancer

Back 6

Cervical cancer is not likely in the elderly female. The geriatric population should be screened for heart disease, hearing, vision, and dental problems, hyperlipidemia, hypertension, menopause, osteoporosis, hypothyroidism, and dementia. Cancer screenings include breast, colon, prostate and skin.

Front 7

Which of the following nurse practitioner roles provided the model for other emerging nurse practitioner specialties?
pediatric nurse practitioner
family nurse practitioner
geriatric nurse practitioner
adult nurse practitioner

Back 7

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.

Front 8

In general, family theory serves as a basis for assessing and coming to understand the structure, development and function of families through the process of family assessment. There are several family theories including the communication theory. Which of the following is NOT a part of the communication theory?
The content of messages is time-bound and must be appreciated within context.
Families share common developmental processes with other families.
Lack of clarity in communication may lead to family dysfunction.
Communication conveys values and beliefs between members and the external environment.

Back 8

Families share common developmental processes with other families.

Although this statement is true, it is not a part of the communication theory. It is a part of the developmental theory promoted by Erikson, Piaget and Havinghurst.

Front 9

A female patient is in the office for her annual gynecological exam and she is inquiring about breast self-exam (BSE). Since she has bilateral breast implants, she "does not know what to feel for." The most appropriate response would be:
Acknowledge the difficulty of breast self-exam with implants.
Explain the need for regular mammograms for patients with implants.
Suggest she involve her sexual partner in assessing her breasts.
Review the steps of breast self-exam until she feels comfortable with this process.

Back 9

Review the steps of breast self-exam until she feels comfortable with this process

This patient should be informed about the normal feel of implants and become knowledgeable about the normal feel of her breasts. Mammography is not a substitute for breast self-exam. The remaining answer choices are good suggestions, but not the most appropriate.

Front 10

Teratogens are agents that can cause structural abnormalities during pregnancy. Which of the following is NOT a teratogen?
Cipro
cocaine
aminoglycosides
lithium

Back 10

Cipro

Cipro is a Category D drug where there is evidence of fetal risk but the benefits outweigh the risk. All of the other choices are teratogens along with alcohol, cigarettes, Accutane and lithium.

Front 11

Attachment, in terms of infant psychosocial development, is the enduring and specific affective bond that develops over the first year of life. In an insecure-disorganized attachment the underlying process/emotion is which of the following?
anger
anxiety
confusion/dysfunction
ambivalence

Back 11

confusion/dysfunction

In an insecure-disorganized attachment the underlying process is confusion and dysfunction. In a secure attachment, the underlying emotion is love. In an insecure-avoidant attachment, the underlying emotion is anger. In an insecure-anxious attachment the underlying emotion is anxiety/ambivalence.

Front 12

You are conducting a health assessment with a patient who presents with several symptoms and signs associated with multiple sclerosis. Which of the following tests would be appropriate to order for this patient?
Metabolic panel.
Echocardiogram.
Lumbar puncture.
Blood glucose test.

Back 12

Lumbar puncture To confirm the diagnosis of multiple sclerosis, the patient's cerebral spinal fluid should be collected and analyzed. The lumbar puncture collects this fluid; none of the other tests or procedures listed do.

Front 13

What is NOT true concerning the background and history of managed care?
The passing of the health maintenance organization (HMO) Act of 1973 initiated a change in thinking about how our healthcare system should be structured.
The early structure of managed care was a staff model HMO such as Kaiser-Permanente.
Employers, insurers, and physician groups bought into the concept and helped to further the development of managed care as a way to avoid government regulation.
Managed care of the 1970s was easily accessible, desirable, and relaxed.

Back 13

Managed care of the 1970s was easily accessible, desirable, and relaxed

Managed care of the 1970s was characterized as being a restrictive, not readily accepted, and undesirable insurance plan. The remaining answer choices are true concerning the history of managed care.

Front 14

Which of the following rashes describes the diagnosis of Impetigo?
a raised nodular lesion that is > 1 cm, mobile
raised plaque lesions, > 1 cm, that is silver in color
vesicular fluid filled lesions that are <1 cm
a pustular vesicle-like lesion with purulent content

Back 14

A pustular vesicle-like lesion with purulent content

An epidermal cyst is a raised nodular lesion that is > 1 cm, mobile. Psoriasis is a raised plaque lesion that is > 1 cm and is silver in color. Then, varicella is a vesicular fluid filled lesion that is <1 cm.

Front 15

The leading cause of death in infants under one year of age is which of the following?
unintentional injuries
congenital anomalies
short gestation
SIDS

Back 15

congenital anomalies

The leading cause of death in infants under one year of age is congenital anomalies. Unintentional injuries are the leading cause of death for those over one year of age to 44 years of age.

Front 16

A 15-year-old boy comes to the clinic after having been in a physical fight. He has some minor facial lacerations and a nosebleed. The FNP determines that the nosebleed is a posterior bleed. What is the next step that the FNP should take?
Pack the affected nasal passage and send the patient home with instructions as to when to remove the packing.
Send the patient to the ER.
Try to stop the bleeding and prescribe a nasal decongestant.
none of the above

Back 16

Send the patient to the ER.

Posterior nasal bleeds may hemorrhage. The patient should be sent to the ER.

Front 17

A female patient is post menopausal. How often should she be screened for osteoporosis?
Every two years.
Every year.
Every four years.
Every three years.

Back 17

Every two years The risk of osteoporosis increases with age. Women with risk factors of osteoporosis should be screened every two years. Age and heredity are risk factors.

Front 18

You are conducting an assessment with a patient who reports heavy menstrual bleeding and pelvic pain. A pelvic exam reveals that her uterus is larger than normal. She is not pregnant. Which of the following procedures would you order to confirm a diagnosis of uterine fibroids?
Uterine biopsy.
External sonogram.
Hysterosonogram.
Pelvic X-ray.

Back 18

Hysterosonogram This procedure, in which the uterus is filled with saline and a transvaginal pelvic ultrasound is performed, is often used to diagnose uterine fibroids. If the patient reports other complaints, such as bowel or urinary problems, she may require other tests to rule out other causes.

Front 19

You are instructing a patient with an insulin pump. The nurse practitioner knows that the most frequent complaint of patients who use insulin pumps is:
understanding "sick day" management modifications
mechanical problems with the pump's digital readout
skin and site problems with dressing adhesive not sticking; redness and pain at infusion site
problems with elevated glucose after changing the catheter-type infusion set

Back 19

Skin and site problems with dressing adhesive not sticking; redness and pain at infusion site

Infusion site problems and skin irritation are by far the most frequent complaints of patients who use an insulin pump. These patients also find it more time consuming and costly than regular syringe and needle method. The remaining answer choices are not common complaints.

Front 20

A mother brings her son in for evaluation for attention deficit hyperactivity disorder (ADHD). Which test is helpful in the evaluation of the difference of this and a learning disability?
audiologic and visual testing
standardized IQ achievement test
complete neurologic examination
Denver Developmental Screening Test

Back 20

A standardized IQ achievement test

Children with learning disabilities and ADHD are inattentive, overactive, and impulsive. They do not have lower IQ achievement scores as do children with learning disabilities. A complete exam including hearing and vision screening should be performed before treatment is started.

Front 21

Kurt Lewin’s model of change management can best be described as which of the following?
preparation, change and continuity
grounding, amending and permanence
training, exchanging and connection
unfreezing, moving and refreezing

Back 21

unfreezing, moving and refreezing

The unfreezing stage involves getting to a point of understanding that change is necessary and getting ready to move away from the current comfort zone. Moving is moving towards a new way of being. Refreezing is about establishing stability once the changes have been made.

Front 22

Which of the following topical corticosteroids has the most potency?
hydrocortisone (0.5%, 1%, 2.5%)
Mometasone furoate 0.1% (Elocon ointment)
Desoximetasone 0.25% (Topicort)
Clobetasol propionate 0.05% (Temovate)

Back 22

Clobetasol propionate 0.05% (Temovate)

This topical corticosteroid has super-high potency. It is the most potent of any of the topical steroids listed in the choices. Hydrocortisone has low potency; Elocon ointment has mid-range potency; Topicort has high potency.

Front 23

Breastfeeding women who have a chronic health problem may need daily medication. Which of the following statements in regard to this situation is false?
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 mil

Back 23

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).

Front 24

The “nature” theorist whose theory involved the development of questionnaires as a method for the study of child development via adult retrospective recall is which of the following?
Alfred Binet
Arnold Gesell
G. Stanley Hall
Sigmlund Freud

Back 24

G. Stanley Hall is author of Adolescence a work that first described adolescence as a critical developmental period of “Sturm und Drang” or “Storm and Stress.” He was involved with the development of questionnaires as a method for the study of child development via adult retrospective recall.