Nr 511 / Nr511 Differential Diagnosis And Primary Care Practicum. Final Exam. Questions With 100% Correct Answers. Latest 2023/2024

Sandra, age 63, says that her previous doctor never discussed why he took her off hormone replacement therapy (HRT) 3 years ago. Her last menstrual period was at age 49, and she started HRT that same year. You share with her some of the results of the Women's Health Initiative (WHI). Which statement regarding the study is true? Julia, age 60, asks you about taking alendronate (Fosamax). What do you tell her about using this medication? Which of the following terms describes the bluish or purplish discoloration of the vulva, vagina, and a portion of the cervix that occurs in pregnancy? The Joneses are thinking about going for infertility counseling because they have been married for 5 years and have been unable to conceive. They ask you whether the man or the woman is usually the cause of infertility. What do you tell them about the etiology of infertility? Jake, age 62, has a low International Prostate Symptom Score for lower urinary tract symptoms associated with his benign prostatic hyperplasia (BPH). The nurse practitioner should recommend: During a pelvic examination, you ask Mrs. Krane, age 54, to perform a Valsalva maneuver (ie, forcibly exhaling while keeping the mouth and nose closed). While doing this strain maneuver, a pouching is seen on the anterior wall of the vagina. This is indicative of: Jennifer, age 27, is complaining of lower abdominal pain. After doing some laboratory studies, you find leukocytosis, an elevated erythrocyte sedimentation rate, and an elevated C-reactive protein level. Which of the following is the most appropriate diagnosis? Marsha, age 42, is having chronic abnormal uterine bleeding (AUB) and cannot take oral contraceptives (OCs) due to a history of a deep vein thrombosis (DVT). Management includes which medication? Sidney, age 72, presents to the clinic with complaints of a weak urine stream, hesitancy, and painful ejaculation. On digital rectal examination, you note that his prostate is boggy. The most common cause of his symptoms is: Bernard, age 59, presents to the emergency department with a diagnosis of priapism. Despite application of cold compresses and pain medications, relief is unsuccessful. What is the treatment of choice? Herb, a 47-year-old with diabetes, is complaining of a rash on his penis. Before examining him, you suspect that he may have: A male patient presents to the clinic for evaluation of infertility. Subjectively, the patient complains of pain and fullness of the testes and states, "My testicles feel like a bag of worms." On physical examination, the nurse practitioner notes tortuous veins posterior to and above the testes that extend up into the external inguinal ring. Based on the preceding assessment, the nurse practitioner refers the patient to surgery for a diagnosis of: A 26-year-old female comes to your office to discuss birth control options. Her history includes migraine headaches with aura while on combination oral contraceptives in the past. She does not want to become pregnant. Which of the following birth control options would be the best choice for her? Darcy, age 57, is to undergo a core needle biopsy for a suspicious breast mass. This procedure includes: Removal of a large core of tissue from the lesion for histological evaluation utilizing a large-gauge cutting needle A patient is being treated for erectile dysfunction. The patient is morbidly obese and is also being treated for cardiovascular disease and coagulopathy. Which of the following medications would be contraindicated? You are referring a 73-year-old client for management of his prostate cancer with hormonal therapy. It is understood that goserelin acetate (Zoladex) acts as a method of androgen ablation by: A 17-year-old female patient requests to start medroxyprogesterone acetate (Depo-Provera) injections as her method of birth control. She discloses that she has had 4 sexual partners in the past year. Her last menstrual period was 12 days ago, and she had unprotected intercourse 3 days ago. The appropriate management for this patient would be to: Tommy, age 15, comes to the clinic in acute distress with "belly pain." When obtaining his history, the nurse practitioner (NP) finds that he fell off his bike this morning and has vomited. Upon closer examination, the NP determines the belly pain to be left-sided groin pain or pain in his left testicle. He is afebrile and reports no dysuria. Which of the following diagnoses is most likely? Julia is nursing her 8-week-old baby and states that he is very irritable and sleeps poorly. What medication or substance do you ask her if she is taking or using? A 21-year-old woman comes to your office and reports a history of genital warts. In reference to the human papillomavirus (HPV) vaccination (ie, Gardasil, Gardasil 9, and Cervarix), she should be educated that: Roger, a healthy 68-year-old man, comes in to see you with a complaint of sudden episodes of an urgent need to void. He has had several episodes of moderate amounts of unintentional urine loss during these times. Other than these episodes, he is voiding in amounts "normal" for him, with no leakage when he coughs or sneezes. The practitioner's initial diagnosis is which type of incontinence? Josh and Martha have 5 children and do not want any more. Josh said he heard about a no-scalpel vasectomy (NSV) and asks the nurse practitioner how it works. What would be the best response? Susan, age 28, is 9 months pregnant and asks you about using umbilical cord blood after birth for newborn DNA identification. What do you tell her? Sarah, age 29, complains of premenstrual syndrome (PMS). She states she was told that changing her diet might help in managing some of the symptoms. What change in her diet do you recommend? Increased intake of complex carbohydrates Reiter syndrome is a complication of: Max, age 70, is obese. He is complaining of a bulge in his groin that has been there for months. He states that it is not painful, but it is annoying. The practitioner notes that the origin of the swelling is above the inguinal ligament and directly behind and through the external ring. This finding is most indicative of a(n): On physical exam, Judy has pubic hair that spreads over her mons pubis with a slight lateral spread. In addition, her breast development shows breast enlargement with secondary mound formation by the developing areolae. Which Tanner stage best describes Judy's development? The best method to diagnose uterine polyps is a: Regular testicular self-exams have not been studied enough to show if they lower the risk of dying from testicular cancer. This is why the American Cancer Society and other agencies do not have a recommendation about regular testicular self-exams for all men. Still, some practitioners do recommend that all men examine their testicles monthly after reaching puberty. If you are teaching a patient how to do a testicular self-examination, which of the following do you tell him? John asks for a prescription for sildenafil (Viagra). He says that the only medication he takes is isosorbide mononitrate (Monoket) oral tablets and that he has diabetes that he controls with diet alone. What should the nurse practitioner tell him?