Questions with Verified Rationalized Answers
100% Guarantee Pass score of 700 points
Consist of 150 Questions with Answers
1. A 40-year-old woman with type 2 diabetes presents to the clinic with con- cerns of
spiking blood sugar between lunch and dinner. She states she is on a rapid-acting
insulin sliding scale and long-acting insulin. Which change should be implemented to
help prevent or curb this glycemic spike?
A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
D.
Prescribe a dose of neutral protamine Hagedorn insulin with dinner
Answer> Add a dose of mealtime insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly dosed with meals
@LECTJULIESOLUTIONSSTUVIA
,and as a sliding scale regimen based on a patient's glucose prior to eating (preprandial). It
is the appropriate insulin to add as a mealtime dose when patients experience blood
glucose spikes between meals because of its short-acting proper-
ties. Peak time action of insulin aspart is 2 hours with initial effect within the first 30
minutes, making it an ideal choice to control expected postprandial glycemic spikes
2. Which of the following conditions is associated with an increased risk for
conductive hearing loss?
A.
Acoustic neuroma
B.
Ménière disease
C.
Otitis media
D.
Presbycusis
Answer> Otitis media
Causes of conductive hearing loss are otitis media (C), otitis externa, foreign objects in the
ear canal, impacted ear wax, tumors, congenital anomalies, discontinuity
of middle ear bones, cholesteatoma, and tympanic membrane rupture. Sound normally
travels down the ear canal to vibrate the eardrum (tympanic membrane). The eardrum is
connected to three middle ear bones (malleus, incus, and stapes), which transmit the sound
into the inner ear (cochlea). The cochlea is the organ that changes sound vibrations into a
@LECTJULIESOLUTIONSSTUVIA
,nerve signal that travels to the brain. The four types of hearing loss are conductive,
sensorineural, mixed, and retrocochlear. Conductive hearing loss occurs when sound
cannot effectively reach the inner ear due to issue in the outer ear and middle ear.
3. A 23-year-old patient who is pregnant at 28 weeks gestation presents to the clinic
for a routine prenatal checkup. Which fundal height measurement would warrant a
more conclusive assessment with an ultrasound?
A.
26 cm
B.
29 cm
C.
30 cm
D.
31 cm
Answer> 31 cm
After 20 weeks gestation, the fundal height should be measured with a measuring tape in
centimeters and should match the gestational age. It can be > or < 2 centimeters and still be
within normal limits. A fundal height of 26-30 cm is a normal finding in a patient who is 28
weeks gestation. A result of 31 cm (D) is larger than expected and should be further
evaluated with an ultrasound.
4. A 4-year-old boy presents with ear pain and an erythematous, bulging tympanic
@LECTJULIESOLUTIONSSTUVIA
, membrane on examination. The nurse practitioner diagnoses him with acute otitis
media. Which of the following are the three most common bacterial pathogens
associated with acute otitis media in children?
A.
Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pneumoniae
B.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus
C.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus
pneumoniae
D.
Nontypeable Haemophilus influenzae, Staphylococcus aureus, Streptococ- cus
pneumoniae
Answer> Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus
pneumoniae
Acute otitis media is commonly encountered by primary care nurse practitioners.
Typically, children present with otalgia and have a bulging tympanic membrane on
examination. Many times, children also have a preceding viral upper respi- ratory
infection, resulting in the colonization of bacteria in the middle ear and leading to a
bacterial infection. Ear infections can be caused by bacterial and viral pathogens. The
most common bacterial pathogens isolated from middle ear fluid
are nontypeable Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus
pneumoniae (C). The most common viral pathogens include respiratory syncytial virus,
@LECTJULIESOLUTIONSSTUVIA