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NSG6001 FINAL EXAM FOR ADVANCED NURSING PRACTICE A+ GUARANTEED 1. John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John t

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NSG6001 FINAL EXAM FOR ADVANCED NURSING PRACTICE A+ GUARANTEED 1. John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear? - ANSWER McMurray circumduction test 2. Which of the following statements is true concerning the management of the client with a herniated disc? - ANSWER Intolerable pain for more than a 3-month period is an indication for surgical Intervention 3. Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5- S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? - ANSWER Saddle area anesthesia 4. Fred has been diagnosed with a trigger finger of the ring finger. Which of the following management strategies is appropriate? - ANSWER Local anesthetic injection into the tendon sheath 5. Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and limited movement in her right shoulder. She denies any history of trauma. Her examination reveals a 75% reduction in both active and passive ROM of the right shoulder. Mrs. Gray also is experiencing tenderness with motion and pain at the deltoid insertion. Her medical history is significant for type 1 diabetes mellitus and hypertension. Her social history reveals that she is a secretary and that she is right-handed. Based on her examination and medical history, you suspect adhesive capsulitis, or "frozen shoulder." - ANSWER Which clue in Mrs. Gray's history supports this diagnosis? Her history oftype 1 diabetes 6. You are performing muscle strength testing on patient presenting w/musculoskeletal pain and find that the patient has complete ROM but cannot move it above gravity. Which numeric grade of muscle strength would you give this patient? - ANSWER 2 7. A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria? - ANSWER NSAIDS 8. The clinician has instructed Sirius, a 23-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs? - ANSWER "You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage. 9. One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which ofthe following is an example of an articular structure? - ANSWER Synovium 10. Gail, a 35-year-old female patient, is seen in the clinic in the morning. She complains of abrupt onset of nausea, vomiting, colicky abdominal cramps, and profuse watery diarrhea that began last night. Her vitals are BP: 110/70, HR: 110, temperature: 99°F, RR: 12. She recently came back from a vacation in Switzerland, ate leftovers for dinner last night, and had a cold 2 weeks ago. Which of the following is the most probable cause of her condition? - ANSWER Staphylococcus 11. Cameron, 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had intermittent heartburn for several months and takes antacids with temporary relief. He has been waking during the night with a burning sensation in his chest. Which additional information would lead you to believe that gastroesophageal reflux disease (GERD) is the cause of his pain? - ANSWER He wakes at night coughing with a bad taste in his mouth. 12. Hannah is a patient that just had an appendectomy after a diagnosis of appendicitis and had no complications. Which of the following patient education points is correct? - ANSWER Your diet will be advanced when bowel sounds return." 13. Which of the following patients should be referred to a hepatologist? - ANSWER Patient with persistent elevation of HBsAg 14. A 29-year-old is seen in the office with complaints of pain in his chest and belly. He quit smoking 6 months ago. He has been suffering the pain for 2 weeks and gets temporary relief from Alka-Seltzer® and Pepto-Bismol®. The burning pain wakes him at night and radiates up to his chest. Which factor favors a diagnosis of gastric ulcer? - ANSWER His use of Alka-Seltzer 15. Which of the following causes of gastrointestinal bleeding is found in the lower gastrointestinal tract? - ANSWER Meckel's diverticulum 16. A 21-year-old student presents with complaints of fatigue, headache, anorexia, and a runny nose, all of which began about 2 weeks ago. She started taking vitamins and over-the-counter cold preparations but feels worse. The smell of food makes her nauseated. Her boyfriend had mononucleosis about 1 month ago, and she wonders if she might have it also. Examination reveals cervical adenopathy and an enlarged liver and spleen. Which of the following labs would be most helpful in the differential diagnosis at this point? - ANSWER Antihepatitis D virus 17. A patient presents with symptoms of infectious mononucleosis. Which lab chemistry test should the clinician order? - ANSWER Heterophile antibody test 18. A patient is seen in the clinic with right upper quadrant pain that is radiating to the middle of the back. The NP suspects acute cholelithiasis. The NP should expect which of the following laboratory findings? - ANSWER Elevated alkaline phosphatase 19. Which of the following are included in Ranson's criteria for assessing the severity of pancreatitis at the time of diagnosis? - ANSWER Base deficit greater than 4 mEq/L 20. Donna is a 36-year-old African American woman with chronic pancreatitis. Which of the following are necessary to manage her condition? - ANSWER A low-fat diet of less than 50 g of fat per day 21. Which of the following diagnostic tests is ordered for a cecal volvulus bowel obstruction? - ANSWER Barium enema 22. Which of the following is part of the treatment plan for the patient with IBS? - ANSWER High-fiber diet 23. Leslie is a 35-year-old Caucasian woman who presents with weakness, anorexia, weight loss, and fatigue. Her history is significant for inflammatory bowel disease, Hashimoto's thyroiditis, and cigarette smoking. Which of the following pieces of her history leads the clinician to believe she has primary sclerosing cholangitis? - ANSWER Inflammatory bowel disease 24. Carl has been diagnosed with Wilson's disease. Which of the following should be included in his dietary education? - ANSWER Limit shrimp intake. 25. Ron has cirrhosis and now presents with altered mental status after increasing protein intake because he was trying to increase muscle mass. Which of the following diseases should the clinician be concerned about? - ANSWER Hepatic encephalopathy 26. The clinician is speaking with Bernadette, who has recently been diagnosed with urinary incontinence. She has had this condition for a number of years, she is 5 feet 5 inches, and she weighs 140 pounds. Which of the following should the health-care provider be aware of? - ANSWER Bernadette may be suffering from depression and may need a psychiatric consult. 27. Which of the following patients is most likely to have urge incontinence? - ANSWER Devon, a 40-year-old male with a history of multiple sclerosis 28. A 27-year-old female presents with a chief complaint of burning and pain on urination. She has no previous history of urinary tract infection (UTI). What are some additional symptoms consistent with a diagnosis of lower UTI? - ANSWER Blood in urine and frequency 29. A 30-year-old patient presents with pain on urination. The urine microscopy of clean-catch urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis? - ANSWER Lower urinary-tract infection

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1



NSG6001 FINAL EXAM FOR ADVANCED
NURSING PRACTICE A+ GUARANTEED

1. John is a 16-year-old boy who presents to the emergency room after hurting
his knee in a football game. He described twisting his knee and then being
unable to extend it completely. John tells the clinician that he heard a pop
when the injury occurred and has been experiencing localized pain. The
clinician suspects a meniscal tear. Which test would be most appropriate to
assess for the presence of a meniscal tear? - ANSWER McMurray
circumduction test

2. Which of the following statements is true concerning the management of the
client with a herniated disc? - ANSWER Intolerable pain for more than a 3-
month period is an indication for surgical Intervention

3. Janet is a 30-year-old who has recently been diagnosed with a herniated disc
at the level of L5- S1. She is currently in the emergency room with suspicion
of cauda equina compression. Which of the following is a sign or symptom
of cauda equina compression? - ANSWER Saddle area anesthesia

4. Fred has been diagnosed with a trigger finger of the ring finger. Which of
the following management strategies is appropriate? - ANSWER Local
anesthetic injection into the tendon sheath

5. Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and
limited movement in her right shoulder. She denies any history of trauma.
Her examination reveals a 75% reduction in both active and passive ROM of
the right shoulder. Mrs. Gray also is experiencing tenderness with motion
and pain at the deltoid insertion. Her medical history is significant for type 1
diabetes mellitus and hypertension. Her social history reveals that she is a
secretary and that she is right-handed. Based on her examination and
medical history, you suspect adhesive capsulitis, or "frozen shoulder." -
ANSWER Which clue in Mrs. Gray's history supports this diagnosis? Her
history oftype 1 diabetes

, 2


6. You are performing muscle strength testing on patient presenting
w/musculoskeletal pain and find that the patient has complete ROM but
cannot move it above gravity. Which numeric grade of muscle strength
would you give this patient? - ANSWER 2

7. A patient is seen in the clinic with hematuria confirmed on microscopic
examination. The clinician should inquire about the ingestion of which of
these substances that might be the cause of hematuria? - ANSWER NSAIDS

8. The clinician has instructed Sirius, a 23-year-old patient with low back
strain, to use NSAIDs to manage his symptoms of pain and discomfort.
Which of the following statements would be most appropriate when teaching
Sam about the use of NSAIDs? - ANSWER "You should start with the
lowest dose that is effective in managing your pain, because long-term use
of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and
hemorrhage.

9. One of the initial steps in assessing patients with musculoskeletal complaints
is to determine whether the complaint is articular or nonarticular in origin.
Which ofthe following is an example of an articular structure? - ANSWER
Synovium
10.Gail, a 35-year-old female patient, is seen in the clinic in the morning. She
complains of abrupt onset of nausea, vomiting, colicky abdominal cramps,
and profuse watery diarrhea that began last night. Her vitals are BP: 110/70,
HR: 110, temperature: 99°F, RR: 12. She recently came back from a
vacation in Switzerland, ate leftovers for dinner last night, and had a cold 2
weeks ago. Which of the following is the most probable cause of her
condition? - ANSWER Staphylococcus

11.Cameron, 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He
reports that he has had intermittent heartburn for several months and takes
antacids with temporary relief. He has been waking during the night with a
burning sensation in his chest. Which additional information would lead you
to believe that gastroesophageal reflux disease (GERD) is the cause of his
pain? - ANSWER He wakes at night coughing with a bad taste in his mouth.

12.Hannah is a patient that just had an appendectomy after a diagnosis of
appendicitis and had no complications. Which of the following patient
education points is correct? - ANSWER Your diet will be advanced when
bowel sounds return."

, 3



13.Which of the following patients should be referred to a hepatologist? -
ANSWER Patient with persistent elevation of HBsAg

14.A 29-year-old is seen in the office with complaints of pain in his chest and
belly. He quit smoking 6 months ago. He has been suffering the pain for 2
weeks and gets temporary relief from Alka-Seltzer® and Pepto-Bismol®.
The burning pain wakes him at night and radiates up to his chest. Which
factor favors a diagnosis of gastric ulcer? - ANSWER His use of Alka-
Seltzer

15.Which of the following causes of gastrointestinal bleeding is found in the
lower gastrointestinal tract? - ANSWER Meckel's diverticulum

16.A 21-year-old student presents with complaints of fatigue, headache,
anorexia, and a runny nose, all of which began about 2 weeks ago. She
started taking vitamins and over-the-counter cold preparations but feels
worse. The smell of food makes her nauseated. Her boyfriend had
mononucleosis about 1 month ago, and she wonders if she might have it
also. Examination reveals cervical adenopathy and an enlarged liver and
spleen. Which of the following labs would be most helpful in the differential
diagnosis at this point? - ANSWER Antihepatitis D virus

17.A patient presents with symptoms of infectious mononucleosis. Which lab
chemistry test should the clinician order? - ANSWER Heterophile antibody
test

18.A patient is seen in the clinic with right upper quadrant pain that is radiating
to the middle of the back. The NP suspects acute cholelithiasis. The NP
should expect which of the following laboratory findings? - ANSWER
Elevated alkaline phosphatase

19.Which of the following are included in Ranson's criteria for assessing the
severity of pancreatitis at the time of diagnosis? - ANSWER Base deficit
greater than 4 mEq/L

20.Donna is a 36-year-old African American woman with chronic pancreatitis.
Which of the following are necessary to manage her condition? - ANSWER
A low-fat diet of less than 50 g of fat per day

, 4


21.Which of the following diagnostic tests is ordered for a cecal volvulus bowel
obstruction? - ANSWER Barium enema

22.Which of the following is part of the treatment plan for the patient with IBS?
- ANSWER High-fiber diet

23.Leslie is a 35-year-old Caucasian woman who presents with weakness,
anorexia, weight loss, and fatigue. Her history is significant for
inflammatory bowel disease, Hashimoto's thyroiditis, and cigarette smoking.
Which of the following pieces of her history leads the clinician to believe
she has primary sclerosing cholangitis? - ANSWER Inflammatory bowel
disease

24.Carl has been diagnosed with Wilson's disease. Which of the following
should be included in his dietary education? - ANSWER Limit shrimp
intake.

25.Ron has cirrhosis and now presents with altered mental status after
increasing protein intake because he was trying to increase muscle mass.
Which of the following diseases should the clinician be concerned about? -
ANSWER Hepatic encephalopathy

26.The clinician is speaking with Bernadette, who has recently been diagnosed
with urinary incontinence. She has had this condition for a number of years,
she is 5 feet 5 inches, and she weighs 140 pounds. Which of the following
should the health-care provider be aware of? - ANSWER Bernadette may be
suffering from depression and may need a psychiatric consult.

27.Which of the following patients is most likely to have urge incontinence? -
ANSWER Devon, a 40-year-old male with a history of multiple sclerosis

28.A 27-year-old female presents with a chief complaint of burning and pain on
urination. She has no previous history of urinary tract infection (UTI). What
are some additional symptoms consistent with a diagnosis of lower UTI? -
ANSWER Blood in urine and frequency

29.A 30-year-old patient presents with pain on urination. The urine microscopy
of clean-catch urine shows greater than 10 leukocytes/mL, and a dipstick is
positive for nitrites. What is the probable diagnosis? - ANSWER Lower
urinary-tract infection
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