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Exam (elaborations)

CMN 577 UNIT 5 QUESTIONS WITH COMPLETE ANSWERS

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CMN 577 UNIT 5 QUESTIONS WITH COMPLETE ANSWERS

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A 36 year-old male patient, with no known allergies, had a positive urea breath test
indicating infection with H. pylori. The NP orders appropriate therapy for treatment of H.
pylori which includes 10-14 days of:


a) Pantoprazole (Protonix), Clarithromycin, & Amoxicillin
b) Famotidine (Pepcid, Clarithromycin, & Amoxicillin
c) Omeprazole (Prilosec), metronidazole, & Amoxicillin
d) Ranitidine (Zantac), metronidazole, & Augmentin

,Give this one a try later!


*a) Pantoprazole (Protonix), Clarithromycin, & Amoxicillin


McQuaid, K. R. (2015) page 609 states noninvasive testing for H. pylori with
urea breath testing has a sensitivity and specificity of 95%. Page 611 Table 15-10
lists the treatment options for peptic ulcer disease including standard triple
therapy of 10-14 days of treatment with a proton
pump inhibitor, clarithromycin, and amoxicillin (or metronidazole, if penicillin
allergic) at the doses listed in the answer choice.




A ten year old male presents to the clinic, accompanied by his mom. Mom provides the
history, noting that the patient has periods of staring off into space, occurring on a daily
basis, but only lasting a few seconds. The FNP knows that all of the following regarding
this type of seizure are true except:
a. The seizures last between three to ten seconds with 10-200 episodes in a day.
b. Episodes are often triggered by hyperventilation.
c. First line treatment is ethosuxamide.
d. A lumbar puncture is diagnostic for seizure activity.


Give this one a try later!


*d. A lumbar puncture is diagnostic for seizure activity.
Rationale: Lumbar puncture cannot diagnose seizures, only rule out other
underlying problems.




An 11-year-old female develops gross hematuria approximately 10 days after a sore
throat. Her blood pressure is 160/100 and she has 2+ pedal and pre-tibial edema. Which
of the following is the most likely diagnosis?


a. Post-streptococcal Glomerulonephritis

,b. Hemolytic Uremic Syndrome
c. Minimal Change Disease
d. Urinary Tract Infection


Give this one a try later!


*a. Post-streptococcal Glomerulonephritis


Rationale: Rationale: The post-streptococcal GN diagnosis is supported by a
recent history (usually 7-14 days prior) of a group A beta-hemolytic
streptococcal infection of the skin or throat. This infection causes acute kidney
injury. The typical clinical presentation includes gross hematuria, which may
appear as coffee or tea-colored urine, edema, and hypertension. (Hay, Levin,
Deterding, & Abzug, 2014, pp. 757-758).




A patient presents with lab values that include: ALT = 78 and AST = 198. Which of the
following is the most likely cause of these abnormal liver function tests?
a. Daily Acetaminophen use
b. ETOH abuse
c. viral hepatitis
d. statin use


Give this one a try later!


*b. ETOH abuse

Rationale: Abnormal LFTs can be caused by acetaminophen, statins, and viral
hepatitis but is more commonly seen in alcoholic liver disease. In alcoholic
liver disease, both ALT and AST are with the AST being > than the ALT by a
factor of 2 or greater. (Essentials of Diagnosis on page 676, Papadakis &
McPhee).

, The mother of an 11-week-old male presents to the office with her infant for a sick visit.
The mom reports her infant is hungry all the time, but after feeding he has projectile
vomiting. She also states he has been constipated over the last few weeks. Which of the
following is the most likely diagnosis for this patient?


a. hiatal hernia
b. pyloric stenosis
c. GERD
d. intussusception


Give this one a try later!


*b. pyloric stenosis

Rationale: According to Hay Jr., Levin, Deterding & Abzug (2014), projectile
vomiting after eating in infants up to 12 weeks of age is a sign of pyloric
stenosis. It is more common in males. Other signs and symptoms can include
hunger, constipation, as ell as weight loss and dehydration. On exam, there
may be an oval shaped lump in the RUQ of the abdomen on palpation.




Mammogram screenings used to detect a disease process or identify a lesion is what
method of prevention?
a. Primary Prevention
b. Secondary Prevention
c. Tertiary Prevention
d. Quinary Prevention


Give this one a try later!
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