NR 601-Diabetes GYN & GU quiz Already Passed
NR 601-Diabetes GYN & GU quiz Already Passed A 55-year-old women has type 2 DM she had three UTIs in the last 9 months and she is concerned about her kidneys. She has no report of dysuria, frequency or urgency at this time. Which of the following is the best action to follow? : Recheck UA dipstick today According to the sexuality presentation, atrophic vaginitis (AV) Is a contributing factor for frequent UTIs Ms. L 55-year-old women with BMI of 28, has 20-year hx of primary HTN and has been on hydrochlorothiazide 25 mg daily for years with excellent response. During follow up visit Mrs L reports that for the last 6 months she has felt thirsty all of the time even though she drinks at least 10 glasses of water a day. Upon chart review the N notes that the last two fasting blood glucose levels have been 136 mg/dl and 165 mg/dl. The NP checks a random blood glucose, which is 210 mg/dl. What is the next appropriate test? Prescribe Metformin 500 mg PO BID A patient has been prescribed Metformin (Glucophage). One week later he returns with lowered blood sugars but complaints of some loose stools during the week. How should the NP respond? Reassure the patient that this is an anticipated side effect A 60-year-old obese male client has type 2 DM and a lipid panel of TC= 250, HDL = 32, LDL= 165. The NP teaches the patient about his modifiable cardiac risk factors which include: Diabetes, obesity, and hyperlipidemia 7. Lifestyle approaches to postmenopausal symptom management include avoiding sugar, coffee, chocolate and alcohol 9. How does women's anatomy make them more susceptible to UTIs? the urethra is shorter A 48-year-old male patient screened for diabetes has a fasting plasma glucose level of 120 mg/dl. The NP plan includes Educate the patient of lifestyle changes to lower blood glucose 14. A 76-year-old man is seen in the office for c/o urinary incontinence. The clinician should explore which of these causes of incontinence in men? Urinary Tract Infection (UTI) 15. Which of the following maneuvers is contraindicated in acute prostatis? Massaging the infected prostate 26. A 68-year-old women is being worked up for stress incontinence. UA reveals positive leukocyte esterase, positive nitrites, 15 WBCs, no RBS, no protein, no casts. She denies frequency, urgency, suprapubic pressure or urgency. What is the first treatment for her US results? no treatment is necessary 28. A 63-year-old man is seen in the clinic with a c/o nocturia. Which of the following should be included in the differential diagnosis? Benign prostatic hypertrophy (BPH) 31. The 56-year-old man with chronic prostatis should initially be treated with antibiotics for how long? 14 days 32. A 50-year-old female patient screened for diabetes has a fasting plasma glucose level of 124 mg/dl. The NP plan includes repeat fasting plasma glucose in one year 35. According to the sexuality presentation, the biggest barrier to appropriate sexual evaluation in the older patient: Ageist attitudes 36. Mrs. Smith a 65-year-old women presents to the clinic for the first time and c/o UI and dyspareunia, she went through menopause 10 years ago without any hormone replacement therapy and had a hysterectomy for fibroid. Her mother had a hip fracture at 82, pt had mammogram 5 years ago and no known fam hx of breast cancer......you decide to begin topical hormone replacement therapy. Which of the following evaluations would be necessary prior initiating hormone replacement therapy? : Mammogram 38. Any women with a complicated cystitis or symptoms of upper tract disease needs a urine culture and sensitivity test 39. All of the following patients have a risk of adverse reaction from Metformin except: patients with BMI >30 41. Which of the following medications can blunt the signs of hypoglycemia in diabetes? beta blockers 43. What is a sign of insulin resistance that can present in African American patients? Acanthosis Nigricans 44. Age related changes in bladder, urethra and ureters include all of the following in older women except: increased estrogen production's influence on the bladder and ureter 46. Diabetes is the leading cause of: kidney failure 47. A male pt with a BMI of 30 presents to the office for an annual exam. You ordered a CMP as part of routine labs. The fasting glucose was 130. Your next action is: repeat the fasting glucose 48. A pelvic mass in a postmenopausal woman highly suspicious of ovarian cancer 49. A 65-year-old Hispanic woman presents to the office for routine follow up for her DM2. Her routine UA results are as follows: few epithelial cells, negative leukocytes, negative nitrates, negative protein, no ketones. Which test would you order next? 24-hour urine for albumin 51. Which of the following would be an appropriate treatment for a patient with mild BPH? reevaluate symptoms in 1-3 months 53. A 68-year-old women presents with a c/o urine leakage whenever she sneezes, laughs, or strains for the past 4 months. She denies dysuria, frequency and nocturia. US dipsticks is negative for RBCs, leukocytes esterase, nitrites, ketones and urobilinogen. What is the diagnosis? stress incontinence 57. A 51-year-old male pt screened for diabetes has a fasting plasma glucose level of 98 mg/dl. The NP plan includes: repeat fasting plasma glucose in 3 years ncreased risk factors for erectile dysfunction include all EXCEPT: dominant personality 61. An 82-year-old man is seen in the primary care office with complaints of dribbling urine, difficulty starting his stream. Which of the following should be included in the list of differential diagnosis? all of the above (BPH, Parkinson's disease, prostate cancer 62. The patient with BPH is seen for follow up. He has been taking finasteride(Proscar) for 6 months. The clinician should assess this patient for which of the side effects? Erectile dysfunction 64. According to the genitourinary presentation, the number 1 risk factor for urinary incontinence is: AGING 67. You are working up a 52-year-old patient for microscopic hematuria. Your differential diagnosis list includes all of the following EXCEPT renal stenosis 69. A 55-year-old Caucasian man with type 2 DM presents to the clinic a as new pt. he takes metformin 500 mg twice a day. His last Hgb A1C was 7%. He is up to date on eye and foot examinations. His BP is 142/96. According to JNC8, what is the most appropriate medication? lisinopril 72. Jean a 42-year-old, presents to the clinic with c/o dysuria, frequency and strong odor of her urine for 5 days. This is the second occurrence this year. What is the appropriate next step to this patient? order UA and urine culture and sensitivity and treat the patient with antibiotics today 73. All of the following patients should be screened for diabetes EXCEPT: 44-year-old Caucasian with HTN 74. A male patient with a BMI of 33 presents to the office with c/o fatique, excessive hunger and all of the above
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