NRNP 6568 Final Exam

NRNP 6568 Final Exam • Question 1 Release of information (ROI) to third parties requires authorization by the patient or his or her legal representative. True or False? Selected Answer: True Answers: True Fals e When giving patients written information, what is the suggested reading level for that health information? Selected Answer: 5th grade Answers: 10th gra de 7th grad e 1st grad e 5th grade An NP must have a DNP to prescribe controlled substances. True or False? Selected Answer: Fals e Answers: True Fals e DNP stands for Doctor of Nursing Profession Selected Answer: Fals e Answers: True Fals e A well-accepted change theory is the transtheoretical model (TTM), which conceptualizes the process of change in five stages. Pick the answer that lists the five stages in the correct order. Selected Answer: Precontemplation; contemplation; preparation; action; maintenance Answers: Preparation; precontemplation; contemplation; action; maintenance Precontemplation; contemplation; preparation; action; maintenance Action; maintenance; precontemplation; contemplation; preparation Preparation; contemplation; action; maintenance; precontemplation Different states have different titles for NPs. All of the following are recognized titles for Nurse Practitioners EXCEPT: How is the NP titled in your state? Also list the titles for NPs in two neighboring states. Selected Answer: Registered Nurse Practitioner Provider Answers: Advanced Practice Registered Nurse Advanced Registered Nurse Practitioner Certified Nurse Practitioner Registered Nurse Practitioner Provider A 55 year old male was admitted to hospital. The patient's mother wants to know what is happening with her son’s health. The provider begins to share medical information with mom. There is no signed HIPPA waiver in patients chart. This is not a HIPPA violation considering this is the patient’s mother, Selected Answer: Fals e Answers: True Fals e There are several titles for NPs, and some are based on the state requirement. What does ARNP stand for? Selected Answer: Advanced Registered Nurse Practitioner Answers: Adult Registered Nurse Practitioner Advanced Registered Nurse Practitioner Acute Registered Nurse Practitioner Advanced Registered Nurse Provider If an NP is at a social gathering and someone casually asks his/her medical opinion, that NP could be liable if something goes wrong. True or false? Selected Answer: True Answers: True Fals e Telemedicine is defined as Selected Answer: When care is provided remotely and the provider and patient are not physically present with each other Answers: When care is provided remotely and the provider and patient are not physically present with each other When care is provided remotely and the provider and patient are physically present with each other Remote care that is challenging and only used for psychiatric patients Remote care provided to patients by providers and does not require HIPPA compliant video conferencing What is it called when an NP bills for a higher level of visit than actually was conducted? Selected Answer: Upcoding Answers: Billing Productivit y Upcoding Down coding The review of systems (ROS) is documented in the Physical Exam section of the visit. Selected Answer: Fals e Answers: True Fals e An occurrence policy covers any incident that occurred while the NP was insured. A claims made policy covers an NP only when the insurance policy is active, no matter when the incident occurred. Selected Answer: True Answers: True Fals e If an NP is sued, it is important that the NP not call the insurance company immediately so as to prevent the rates from increasing. True or false? Selected Answer: Fals e Answers: True Fals e Standard of care is the use of unreasonable, extraordinary care, skill, and diligence as an NP in the type of patient practice in similar cases. Selected Answer: Fals e Answers: True Fals e A provider may be terribly negligent, but if there is no injury, there is no malpractice. True or False? Selected Answer: True Answers: True Fals e If a patient is dismissed from a practice, it is important that certain rules are followed. A patient should be sent a dismissal letter by First Class mail with return receipt requested. What elements need to be included in the letter? Selected Answer: The last day the practitioner will be available to render medical care, which should be at least 30 days; indication that med refills will be provided during this period; alternative sources of medical care; how to obtain medical records Answers: The last day the practitioner will be available to render medical care, which should be at least 30 days; indication that med refills will be provided during this period; alternative sources of medical care; how to obtain medical records The last day the practitioner will be available to render medical care, which can be immediately; referral information to another provider, and how to obtain medical records Notice of immediate discharge from the practitioners care, prescriptions for 30 days of their medications, and how to obtain medical records The last day the practitioner will be available to render medical care, which should be at least 60 days; indication that med refills will not be provided during this period; referral to new provider; how to obtain medical records There are (fill in a number) levels of evaluation/management visits. Selected Answer: four Answers: thre e four five six If an NP receives a letter from the Board of Nursing with concerns about a license issue, what should the NP do immediately? Selected Answer: Respond to the complaint to the Board of Nursing. Consider contacting a lawyer Answers: Contact his or her malpractice insurance carrier and a lawyer Notify his or her employer Respond to the complaint to the Board of Nursing. Consider contacting a lawyer Disregard the letter and wait for the formal complaint AMA stands for against medical advice. Selected Answer: True Answers: True Fals e • Question 1 1 out of 1 points A 25 patient comes into clinic with white, cottage-cheese like lesions that are easily removed with a swab. The NP recognizes this to be: Selected Answer: Oral thrush Answers: Oral gonorrhea Oral chlamydia • Question 2 Oral thrush Fungal infection 1 out of 1 points Match the definitions using the following three terms: hyposmia; anosmia, parosmia. o Question Correct Match Selected Match Olfactory dysfunction (loss of smell) A. anosmia A. anosmia Smell distortion B. parosmia B. parosmia Diminished sense of smell: C. hyposmia C. hyposmia o All Answer Choices A. anosmia B. parosmia C. hyposmia o • Question 3 1 out of 1 points How does an NP distinguish viral conjunctivitis from bacterial conjunctivitis? Viral conjunctivitis is: Selected Answer: watery discharge, unilateral, older children and adenopathy Answers: mucopurulent discharge, bilateral, and usually seen in preschoolers usually seen in adults, mucopurulent discharge, and unilateral, no adenopathy • Question 4 watery discharge, unilateral, older children and adenopathy watery discharge, adults, unilateral, no adenopathy 1 out of 1 points The NP recognizes common symptoms for allergic rhinitis include: Selected Answer: Runny nose and itchy eyes Answers: Bloody nasal discharge • Question 5 Runny nose and itchy eyes Purulent nasal discharge Cough and fever 1 out of 1 points What is the most important way to control allergic rhinitis? Selected Answer: environmental control Answers: Nasal saline • Question 6 environmental control Benadryl Antihistamines 1 out of 1 points A 15 year old child with sore throat comes to clinic and rapid strep is positive for strep. The NP will more than likely treat patient with: Selected Answer: All of the above Answers: PCN V 500 mg bid x10 days Salt water gargles Throat lozenges • Question 7 All of the above 1 out of 1 points What differentiates chronic rhinosinusitis from allergic rhinitis. Selected Answer: Allergic rhinitis has an acute onset Answers: Allergic rhinitis has persistent nasal blockage Chronic rhinosinusitis is characterized by sneezing and watery eyes • Question 8 Allergic rhinitis has an acute onset Chronic rhinosinusitis typically has a positive family history of similar problems. 1 out of 1 points What is the recommended first-line antibiotic and dosage for children with acute otitis media? Selected Answer: amoxicillin 80-90 mg/kg/day Answers: • Question 9 amoxicillin 80-90 mg/kg/day Ceftin 90 mg/kg/day Penicillin VK 10 mg/kg/day azithromycin 50 mg/kg/day 1 out of 1 points What is normal intraocular pressure? Selected Answer: 10—20 mm hg Answers: 5-8 mm hg 2-4 mm hg 10—20 mm hg 50 mm hg or greater The NP will use what to diagnose a corneal abrasion? Selected Answer: all of the above Answers: fluorescein staining under a cobalt blue light wood lamp all of the above • Question 1 Which of the following can reduce breast cancer risk? Selected Answer: All of the above Answers: Healthy diet Limiting ETOH intake Stop smoking Maintain normal body weight 1 out of 1 points • Question 2 All of the above A, B, & C only 1 out of 1 points Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some rhinitis, and low-grade fever. His likely diagnosis is: Selected Answer: Atypical pneumonia (Walking pneumonia) Answers: Bronchitis • Question 3 Atypical pneumonia (Walking pneumonia) Allergic rhinitis Community acquired bacterial pneumonia 1 out of 1 points Which of the following insulins is a “rapid acting” insulin? Selected Answer: Humalog Answers: Lantus Humulin N Humulin R • Question 4 Humalog 1 out of 1 points Diabetes mellitus causes both microvascular and macrovascular damage. All of the following are indications of microvascular damage except: Selected Answer: Atherosclerosis Answers: Retinopathy Nephropathy Neuropathy • Question 5 Atherosclerosis 1 out of 1 points Jay is a 72 y/o male who comes to the clinic with the following chief complaint: “I have been feeling very tired recently and having trouble breathing when I go upstairs. I noticed that my ankles and feet are swollen and I have been putting on weight.” The most likely diagnosis for this patient is: Selected Answer: Congestive heart failure (CHF) Answers: Acute myocardial infarction (AMI) Infective endocarditis • Question 6 Congestive heart failure (CHF) Dissecting abdominal aortic aneurysm (AAA) 1 out of 1 points Mickey is a 23 y/o male who comes to the clinic with the following complaints: abdominal pain, chest pain, and seizures. In reviewing his record, the NP notices that this is his 20th visit this year. Furthermore, he has had six exploratory surgeries that have discovered nothing of consequence. His most likely diagnosis is: Selected Answer: Munchausen syndrome Answers: • Question 7 Munchausen syndrome Schizophrenia Posttraumatic syndrome Anorexia nervosa 1 out of 1 points Bupropion (Wellbutrin) is contraindicated in patients with anorexia/bulimia because of the potential for increasing the seizure threshold. Selected Answer: True Answers: True Fals e • Question 8 1 out of 1 points Martin is a 41 y/o male who comes to the clinic with the following symptoms: fever, chills, and malaise. On physical exam, the NP notes that he has a new murmur that was not present at his last visit and is aware that he has a prosthetic valve. He also has splinter hemorrhages on his nails, and petechiae on his palate. Based on these finding alone the NP arrives at the following presumed diagnosis: Selected Answer: Infective endocarditis Answers: Congestive heart failure • Question 9 Infective endocarditis Dissecting abdominal aortic aneurysm (AAA) None of the above 0 out of 1 points Martin is a 73 y/o male who has a 50 pack/year history of smoking and comes to the clinic for his annual physical. As you are leading him back to the exam room you note that he has dyspnea with minimal cough, a barrel chest, and appears to have lost weight since his last visit. Your physical exam confirms a 20 lb. weight loss and more noticeable pursed lip breathing. Given Martin’s condition, the first line treatment would be all the following except: Selected Answer: Metaproterenol Answers: Albuterol Salmeterol Levalbuterol Metaproterenol • Question 10 1 out of 1 points Agnes is a 26 y/o female who comes to the clinic with intermittent episodes of moderate to severe cramping in the LLQ. She has bloating that is relieved with defecation. The most likely cause is: Selected Answer: Irritable bowel syndrome Answers: Irritable bowel syndrome Peptic ulcer disease GERD Pancreatitis • Question 11 1 out of 1 points Oral contraceptives can be started anytime in the menstrual cycle. Selected Answer: True Answers: True Fals e • Question 12 0 out of 1 points Jay is a 72 y/o male who comes to the clinic with the following chief complaint: “I have been feeling very tired recently and having trouble breathing when I go upstairs. I noticed that my ankles and feet are swollen and I have been putting on weight.” Treatment for Jay’s diagnosis could include which of the following? Selected Answer: A & C only Answers: Diuretics Calcium channel blockers Beta blockers All of the above A & C only • Question 13 1 out of 1 points Which of the following glands is responsible for calcium balance in the body? Selected Answer: Parathyroid glands Answers: Posterior pituitary Parathyroid glands Thyroid gland Pineal gland • Question 14 Melanoma is the most common type of skin cancer. Selected Answer: Fals 1 out of 1 points e Answers: True Fals e • Question 15 All diastolic murmurs are abnormal. Selected Answer: True Answers: 1 out of 1 points True Fals e • Question 16 St. John’s Wart has all the following potential uses except: Selected Answer: HIV/AIDS Answers: Depression Menopausal symptoms Wound healing HIV/AIDS • Question 17 1 out of 1 points 1 out of 1 points Angela is a 15 y/o who has a distorted perception of her body shape and size. She is currently down to 96 lbs. with a BMI of 17. Your physical exam and history note that she has lanugo, has not had a menses in 4 months, and has a daily history of vomiting and taking laxatives. The most likely diagnosis is: Selected Answer: Anorexia nervosa Answers: Schizophrenia Posttraumatic stress disorder (PTSD) Anorexia nervosa Munchausen syndrome • Question 18 1 out of 1 points Artie is a 21 y/o male who comes to the clinic with a chief complaint of paroxysmal coughing without an apparent cause. He states that this has been going on for about 15 days. He initially had a mild fever and a runny nose. First-line treatment for Artie would include macrolides. Selected Answer: True Answers: True Fals e • Question 19 1 out of 1 points John is a 26 y/o Caucasian male who works as a landscaper for his father’s business. During the past couple of months, he has noticed a small dark popular lesion on his neck. He states that it sometimes bleeds and is a “sore that never heals.” The NP notes that he has a circumscribed 2mm lesion at the base of his neck just below the hairline. The most appropriate treatment for John’s lesion would be: Selected Answer: Mohs surgery Answers: Apply Aldara Cream Electrocautery Mohs surgery “Watch and wait” • Question 20 1 out of 1 points Sara is a 38 y/o multipara who is in her 6th–7th month of pregnancy with her fourth child. She has a new onset of vaginal bleeding that is worsened by intercourse. On external physical exam, you note that her uterus is soft and non-tender to palpation. Knowing that her cervix is not dilated, the most appropriate treatment would be: Selected Answer: Strict bedrest Answers: An emergency room visit Strict bedrest Hospitalization All of the above • Question 21 1 out of 1 points An S3 heart sound can be a normal finding in all the following except: Selected Answer: 40 year old female Answers: Well trained athletes Pregnant women Children 40 year old female • Question 22 1 out of 1 points Sara is a 38 y/o multipara who is in her 6th–7th month of pregnancy with her fourth child. She has a new onset of vaginal bleeding that is worsened by intercourse. On external physical exam, you note that her uterus is soft and non-tender to palpation. If Sara started having uterine cramping, then the most appropriate immediate treatment would be: Selected Answer: Intravenous magnesium Answers: Vaginal exam Ultrasound of the uterus C-section Intravenous magnesium • Question 23 1 out of 1 points Rescue drugs for patients with respiratory problems such as asthma or COPD would include both SABAs and LABAs. Selected Answer: Fals e Answers: True Fals e • Question 24 1 out of 1 points Bonnie is a 76 y/o female patient who resides in a nursing home. She is currently on a 10-day course of Clindamycin for a recurrent bacterial vaginal infection. She has started having 10–15 watery stools per day. The best way to treat Bonnie’s diarrhea is: Selected Answer: Discontinue her Clindamycin Answers: Put her on an antidiarrheal medication Replace lost fluids with an IV Discontinue her Clindamycin Give her an antacid • Question 25 0 out of 1 points Artie, a 36 y/o male, comes to the clinic with chief complaint of: intermittent flank one side flank pain. The pain is an 8 on a scale of 1–10, with 10 being the worst pain he has ever felt. He states the pain lasts from 20–60 minutes and that he must either stand or walk when the pain hits. He also notes that he has blood in his urine. All of the following could be risk factors for Artie except: Selected Answer: A & B only Answers: Family history of identical condition Low fluid intake Gout Arthritis A & B only • Question 26 Antipsychotics lead to an increased risk of metabolic syndrome. Selected Answer: True 1 out of 1 points Answers: True Fals e • Question 27 1 out of 1 points Martin is a 17 y/o male who comes to the clinic with the following chief complaint: “I have pain around my belly button and have had no appetite for the past 24 hours. I have had some nausea and have vomited three times. I have had a low-grade fever also.” During the clinical exam, the NP notices that Martin has some guarding and rebound tenderness in the RLQ. In the physical exam, the NP performs some abdominal maneuvers. What would be the most appropriate maneuvers for Martin’s symptomatology? Selected Answer: A & B only Answers: Psoas sign Obturator sign Rovsing’s sign Murphy’s sign A & B only • Question 28 1 out of 1 points Randy is a 29 y/o African American male who has a body mass index (BMI) of 30, does not exercise, and has evidence of metabolic syndrome. The first line treatment for Randy’s diagnosis would be: Selected Answer: Metformin Answers: Insulin Actos Metformin Glucotrol • Question 29 1 out of 1 points Carlos is a 64 y/o male who has previously been diagnosed as a Category A COPD patient based on Gold guidelines (2017). Treatment for Carlos would include which of the following?