NSG 6440 PREDICTOR TEST QUESTIONS AND ANSWERS WITH RATIONALE 100% CORRECT

NSG 6440 PREDICTOR TEST QUESTIONS AND
I1 I1 I1 I1 I1




ANSWERS WITH RATIONALE 100% CORRECT
I1 I1 I1 I1 I1 I1




Predictor6test I1




1) I1




A6156years6old6high6school6student6with6a6mild6sore6throat6and6lowgrade6fever6that6has6persist
ed6for6about636weeks.6She6reports6general6malaise,6fatigue,6and6los
s6of6appetite.6The6NP6suspects6mononucleosis.6Which6of6the6following6is6the6LEAST6appropr
I1




iate6intervention?
I1 I1




a. Palpate6the6lymph6nodes6and6spleen I1




b. Examine6the6posterior6oropharynx6for6petechiae I1




c. Obtain6a6CBC,6throat6culture,6 and6heterophil6antibody6test. I1 I1




I1
d. Obtain6an6urinalyses6and6serum6for6LFTs6and6amylase6 I1




Explanation:6mononucleosis6is6a6symptomatic6infection6caused6by6the6Epstein-
Bar6virus.6Common6is6people615-
246years6of6age.6 Common6signs6and6symptoms6following6incubation6period6(1-
I1




26months)6include6fatigue,6chills,6malaise,6anorexia,6white6tonsillar6exudates6and6lymphadenopat
hy6or6posterior6cervical6region.6Splenomegaly6can6be6present.6A6maculopapular6or6occasionally6a6
I1




petechial6rash6occurs6in6less6than615%6of6patients.6A6diagnosis6is6usually6made6using6the6Monos
I1




pot.6In6addition,6neutropenia6and6lymphocytosis6are6usually6detected6in6the6CBC.
I1 I1




2) A6326years6old6male6patient6complaint6of6urinary6frequency6and6burning6on6urination6for63
I1




6days.6Urinalyses6reveals6bacteriuria6and6positive6nitrites.6He6denies6any6past6hx.6Of6urinary6tract
I1




6infections.6The6initial6treatment6should6be:
I1 I1




a. trimethoprim-sulfamethoxazole6(Bactrim,6Sulfatrim)6for67-106day I1




b. ciprofloxacin6(Cipro)6for63-56days I1




c. Trimethoprim-Sulfamethoxazole6 for636days I1 I1




I1
d. 7506mg6ciprofloxacin6as6a6one-time6dose I1




Explanation:6trimethoprim-
sulfamethoxazole6(TMPS)6is6usually6n6appropriate6medication6to6treat6urinary6tract6infections6in6
most6patients.6 In6the6case6of6community6resistance6to6TMPS
I1 I1 I1




>20%^,6another6medication6should6be6substituted.6
In6men,6the6appropriate6length6of6time6is67106days.6Women6may6be6treated6for636days6for6uncompli
I1




cated6UTI I1




3) Which6agent6is6most6effective6for6the6treatment6of6nodulocystic6acne? a.
I1 I1




Benzoyl6peroxide6(Benzac)
I1 I1




b. Retinoic6acid6(Retin6A) I1




c. Topical6tetracycline I1




I1
d. Isotretinoin)6 I1




Explanation:6Isotretinoin6(Accutane)6is6a6systemic6agent6indicated6for6treatment6with6severe6inf
lammatory6acne.6Guidelines6for6its6use6must6be6clearly6understood6by6the6patient.6A6woman6of6c
I1




1

,hi
ldbearing6age6must6use6an6effective6method6of6contraception6because6isotretinoin6is6teratogenic.6
I1




There6are6many6restrictions6in6prescribing6this6medication6because6of6the6teratogenic6effects6is6gi
I1




v en6during6pregnancy.6Therefore,6it6is6a6pregnancy6category6X.
I1 I1




2

,4) An6186y/o6woman6is6taking6a6combined6hormonal6oral6contraceptive.6She6should6be
I1




6instructed6to6use6a6backup6method6for6the6prevention6of6pregnancy
I1 a.
I1




Throughout6the6week6of6placebo6pills
I1 I1




b. If6prescribed6topiramate6(Topamax)6for6the6treatment6of6migraines.6
I1




3

, c. If6prescribed6amoxicillin/clavulanate6(Augmentin)6for6a6sinus6infection I1




I1
d. if6she6forgets6to6take6a6single6dose6of6the6contraceptive I1




Explanation:6Anticonvulsant6including6phenytoin6(Dilantin),6carbamazepine6(Tegretol),6primido
ne6(Mysoline),6topiramate6(Topamax)6and6oxcarbazepine6(Trileptal)6 reduce6the6effectiveness6of6
I1 I1




contraceptives.6Depo-medroxyprogesterone6acetate6injections6or6levonorgestrel-
I1




6releasing6intrauterine6devices6would6be6a6better6method6of6contraceptive6for6patients6taking6anti

convulsants.6Most6commonly6used6antibiotics6have6not6been6proven6to6reduce6the6effectiveness6
I1




of6contraceptives.6Rifampin6is6an6exception,6and6additional6 ….6Be6used6by6women6taking6this6dru
I1 I1




g6and6using6oral6contraceptives,6transdermal,6or6vaginal6ring6preparations.
I1 I1




Additional6backup6contraception6should6be6used6if6taking6antifungal6agents.6No6additional6protecti
on6is6needed6thought6the6week6of6placebo6pills.6Missing6one6single6dose6of6contraceptive6does6not6
I1




re quire6additional6protection,6missing6more6than6one6doses6does.
I1 I1




5) A6446years6old6female6patient6has6diabetes.6Her6total6cholesterol6(TC)6is62506mg/dl6(6.56m
I1




mol/L),6LDL=61906mg/dL6(4.946mmol/L),6HDL=6256mg/dL6(656mmol/L),6and6triglycerides=6344
I1




6mg/dL6(8.946mmol/L).6What6agent6have6the6greatest6effect6on6improving6her6lipid6profile6and6re
I1




d ucing6morbidity6and6mortality6associates6with6dyslipidemia? a. Niacin6(Niaspan)
I1 I1 I1 I1




b. Atorvastatin6 I1




c. Omega636fatty6acids I1




d. Fenofibrates I1




Explanation:6First6and6foremost,6it6is6essential6to6educate6individuals6on6a6hearthealthy6lifestyle.6
LDL-
I1




C6is6one6of6the6major6culprits6in6the6development6of6atherosclerotic6heart6disease.6The6target6level6
of6LDL-
I1




C6is6between6506to670mg/dl6to6prevent6plaque6formation6in6the6blood6vessels.6Guidelines6strongl
y6recommend6statin6therapy6because6they6primarily6lower6LDL-
I1




C6levels,6but6they6also6have6the6secondary6effects6of6lowering6triglyceride6and6increasing6HDLC6le
I1
vels. I1




6) A6306years6old6female6comes6into6a6clinic6with6classic6signs6and6symptoms6of6appendicitis.
I1




6The6NP6fails6to6refer6the6patient6to6a6surgeon.6The6appendix6ruptures6and6the6woman6die.6This6is

6an6example6of I1




a. Failure6of6diligence I1




b. Professional6liability I1




c. Negligence I1




d. Malpractice6 I1




Explanation:6malpractice,6a6negligence6tort,6occurs6when6a6health6care6professional’s6actions6fall6
b
ellow6the6appropriate6standard6of6care6and6hurts6the6patient.6In6this6case6the6patient6came6with6sing
I1




s6and6symptoms6indicating6appendicitis6and6the6NP6failed6to6refer6the6patient..
I1 I1




7) A6NP6has6recently6been6hired6to6work6in6a6fast6track6facility.6The6NP6employer6asked6if
I1




6she6has6“a6problem6prescribing6medications6for6emergency6contraception.”6The6NP6replies6

affirmatively.6This6is:
I1 I1




4