NUR 507 FINAL EXAM PRIORITY ONE VERSION 2 424(CORRECTLY ANSWERED)UPDATED

NUR 507 FINAL EXAM PRIORITY ONE VERSION 2 424(CORRECTLY ANSWERED)UPDATED A 20 - year - old female presents to the office and reports a 4 - month history of intermittent upper abdominal pain and burning . It occurs 2 hours after meals . Based on her symptoms , she most likely has : - ANSWER-Duodenal ulcer .A 21-year-old patient reports to the primary care clinic complaining of urinary urgency, frequency and burning. She also reports a small amount of vaginal discharge that contains an odor. It is likely that the NP will perform a vaginal exam at this visit. - ANSWER-true .A 25 year- old female presents to the primary care office with urinary burning and frequency for the last 3 days. She denies any fever, chills, back pain. Her gynecological history is negative and reports no vaginal discharge. The only new information reported is that she recently had sexual intercourse with a new male partner. The NP obtains a urinalysis and determines that the urine contains leukocytes, RBCs, nitrites, and WBCs. No casts are identified. Based on symptom presentation and UA results, the patient can be diagnosed with: - ANSWER-cystitis .A 39 - year - old is diagnosed with a duodenal ulcer . Which of the following behaviors may have contributed to the development of the ulcer ? - ANSWER-Regular NSAID use .A 42-year-old female presents to the primary care clinic with a three- month history of "feeling low", poor energy, inability to concentrate and irritability. She is concerned about her loss of interest in her usual social activities of walking with her friends and participating in her sewing group. She is especially concerned about her recent 15-pound weight gain. Other reported symptoms are frequent headaches, difficulty getting out of bed in the morning, and feeling worthless. She denies suicide ideation. She reports a family history of depression (mother and sister) and denies any consumption of drugs and alcohol. She is divorced and has a grown son who lives approximately one hour away but rarely sees because of his work schedule. The patient is interested in knowing if her symptoms are related to depression. Upon initial evaluation, the NP considers if the patient meets the criteria for MDD by consulting the DS - ANSWER-Depressed mood Fatigue/loss of energy Loss of interest/Anhedonia Feeling worthless or having excessive guilt Insomnia or hypersomnia Poor concentration Recurrent thoughts of death, suicide, a suicide plan or attempt Psychomotor agitation or retardation .A 45-year-old male presents to the primary care office with right flank pain that he describes as unremitting; he also reports nausea and vomiting. The NP performs an exam and observes him writhing in pain on the exam table with the inability to find a comfortable position. He is afebrile, BP 156/88 mmHg and HR 106/min. Right flank is mildly tender on palpation. Abdominal exam is negative for any abnormality. A urinalysis was performed and revealed 1+ blood. Urine microscopy also revealed 10-20 RBCs per high-power field (hpf). A kidney stone is suspected. The patient reports no prior history of a kidney stone. After providing the patient an analgesic, where the patient reported mild relief, the NP had the patient transferred to the emergency room for intravenous fluids, pain management and further work-up for the kidney stone. Upon follow-up in the office a week later, the patient reported that he was diagnosed with - ANSWER-adequate hydration balanced diet .A 50 - year - old is diagnosed with gastroesophageal reflux disease . This condition is caused by : - ANSWER-Loss of muscle tone at the lower esophageal sphincter .A 50 - year - old male reports episodes of frequently recurring crampy abdominal pain , diarrhea , and bloody stools . A possible diagnosis would be : - ANSWER-Ulcerative colitis .A 54-year-old female reports to the primary care office with complaints of frequent urination. She reports that she is "leaking" urine several times a day, especially when she coughs, sneezes, or lifts a heavy object. She indicates that she has not experienced any dysuria or any urgency. The NP looked at the patient's previous urine culture obtained approximately 1 month ago and determined that it was negative. Other than her urinary complaints, she is in otherwise good health. BP 128/76; HR 78 bpm; T 98.6; Ht. 5'4"; Wt: 180lbs.; BMI 30.9. The NP performs a physical exam and all findings are normal. The urinalysis obtained was negative as well. Based on patient's symptoms and negative physical exam, she has a typical 1. blank. The leaking occurs when the abdominal pressure increases during coughing, sneezing, and lifting. We can rule out urge incontinence because the denied urgency with her urination. We could not - ANSWER-1. stress incontinence 2. stress incontinence .A common event during Cellular reproduction resulting in the Constant occurrence of isolated Cancer cells - ANSWER-Cell transformation .A common organism that causes a urinary tract infection include: - ANSWER-Staphylococcus saprophyticus. E coli .A deficiency of intrinsic factor will result in - ANSWER-Pernicious anemia .A goiter may appear in hypothyroidism because of the overproduction of TSH. - ANSWER-True .A lung volume measurement that indicates air trapping in a COPD patient is : - ANSWER-Increase residual volume .A mood disorder is a mental illness that causes the individual to have dramatic shifts in emotions, mood and energy levels. - ANSWER-true .A non - megaloblastic anemia would be caused by - ANSWER-Liver disease .A panic attack involves a very stressful situation where the individual develops an intense fear that something bad will happen. - ANSWER-true .A patient with chronic bronchitis is at risk for developing pneumonia due to : - ANSWER-Mucus plugs .A patient with chronic bronchitis is most likely to experience : - ANSWER-Respiratory acidosis due to inability to exhale CO2 .A patient with Crohn's disease can experience inflammation in the large intestine that mainly affects the mucosa of the bowel - ANSWER-False .A patient with human immunodeficiency virus ( HIV ) was admitted to the acute care facility with difficulty breathing . He is diagnosed with Pneumocytis carinii . Pneumocystis carinii an example of : - ANSWER-A secondary immune disease .A patient with mitral regurgitation would most likely present with - ANSWER-a blowing , holosystolic murmur .A patient with mitral stenosis would most likely present with : - ANSWER-Rumbling , decrescendo diastolic murmur heard at apex of the heart .A patient with normal lungs should be able to exhale what % of the forced vital capacity within the first second - ANSWER-80% .A pre-renal cause of acute renal failure is: - ANSWER-hypotension .a predominant cause of secondary immune deficiencies worldwide - ANSWER-Malnutrition .A pseudo bowel obstruction is due to a myopathy or neuropathy - ANSWER-True .A renal disease most often associated with autoimmunity is : - ANSWER-Glomerulonephritis .A sphincter malfunction that prevents urine from flowing out of the bladder would most likely result in: - ANSWER-overflow incontinence .A strong social network has been proven to lead to a better outcome for individuals with MDD. - ANSWER-true .A subjective finding in interstitial lung disease is rhonchi in the upper posterior airways - ANSWER-False .A symptom of a lower urinary tract infection includes: - ANSWER-urgency .A transferrin deficiency will most likely result in : - ANSWER-Iron - deficiency anemia .A volvulus is the twisting of the bowel - ANSWER-True .active phase - ANSWER-more severe symptoms like delusions, hallucinations, disorganized speech or behavior or catatonic behavior .Acute renal failure - ANSWER-Oliguria (< 30ml/hr). Increased blood urea nitrogen (BUN) and creatinine. Fluid and electrolyte abnormalities. .Adrenal cortex effects - ANSWER-Maintenance of gland size Depletion of ascorbic acid Activation of adenylyl cyclase Conversion of cholesterol to pregnenolone Maintenance of enzymes active in converting pregnenolone to other steroids Accumulation of cholesterol for steroid hormone synthesis Secretion of cortisol and adrenal androgens .Aldosterone promotes sodium reabsorption and potassium excretion in the kidneys. - ANSWER-This statement is true. .Allergic contact dermatitis is an example of hypersensitivity reaction - ANSWER-Type 4 .alpha cells - ANSWER-responsible for secreting glucagon .Although less common , transferrin deficiencies and mitochondrial defects can lead to iron deficiency anemia - ANSWER-True .Amitriptyline (Elavil) is an alpha-agonist that increases synaptic concentration of serotonin and/or norepinephrine. - ANSWER-false (Amitriptyline is a tricyclic anti-depressant) .An adhesion is the least common cause of a bowel obstruction - ANSWER-False .An example of a primary immunodeficiency is : - ANSWER-Chronic Granulomatous Disease