NUR 6210 STUDY GUIDE CONTAINING ACCURATE QUESTIONS WITH DETAILED ANSWERS |GRADED A+ SURE TO PASS |

1. Which one of the following conditions is a complication of acute otitis media? (A) Sinusitis (B) Pharyngitis (C) Meningitis (D) Peritonsillar abscess (E) Dacryoadenitis ANSWER C. Meningitis 2. A 17-year-old high school student is complaining of persistent sore throat, fever, and malaise not relieved with penicillin therapy recently prescribed at an urgent care center. As the nurse practitioner, what would you order next? A) A throat culture B) A monospot test C) A rapid antigen test D) A Thayer-Martin plate test ANSWER B) If a client has a persistent sore throat, fever, and malaise not relieved with penicillin therapy, a monospot test should be performed to rule out mononucleosis (Epstein-Barr virus). A throat culture and rapid antigen test are performed to help diagnose group A beta-hemolytic streptococcal infection. A Thayer-Martin plate test is performed to diagnose a gonococcal infection. 3. Which of the following findings is associated with the chronic use of chewing tobacco? A. Cheilosis and xerostomia B. Glossitis C. Geographic Tongue D. Leukoplakia and oral cancer ANSWER D. The Chronic Use of tobacco increases the risk of oral cancer and leukoplakia. Cheilosis is characterized by skin fissures/ maceration in the corner of the mouth, most commonly caused by anemia, bacterial infection, vitamin deficiencies, or oversalivation. Cheilosis skin fissures/ maceration in the corner of the mouth, most commonly caused by anemia, bacterial infection, vitamin deficiencies, or oversalivation. 4. A 70-year-old male patient complains of a bright-red colored spot that has been present in his left eye for 2 days. He denies eye pain, visual changes, or headaches. He has a new-onset cough from a recent viral upper respiratory infection. The only medicine he is taking is Bayer aspirin one tablet a day. Which of the following is most likely? A. Corneal abrasion B. Acute bacterial conjunctivitis C. Acute uveitis D. Subconjunctival hemorrhage ANSWER D. 5. The red reflex examination is used to screen for: A. Cataracts B. Strabismus C. Blindness D. Blinking response a. Cataracts 6. Which bacterium is the most common pathogen seen in otitis externa infections? A. Pseudomonas aeruginosa B. Streptococcus pyogenes C. Haemophilus influenzae D. Moraxella catarrhalis i. Pseudomonas aeruginosa 7. A potential adverse effect of ACEI when used with spironolactone therapy is: A. hypertension B. hyperkalemia C. renal insufficiency D. proteinuria Answer - B. hyperkalemia Rationale: Hyperkalemia with ACEI or ARB is usually seen only with concurrent use of a potassium-sparing diuretic/aldosterone antagonist, such as spironolactone; in advancing renal disease; or in a poor hydration state, including overly aggressive diuretic use. Renal insufficiency can be precipitated by ACEI or ARB therapy; this usually occurs only in the presence of renal artery stenosis or underlying renal disease. 8. Mary, age 56, has been on antihypertensive medication. You have switched her regimen more than once. On some occasions when you see her for blood pressure checks, her blood pressure is fine; on other occasions her blood pressure is out of control. She frequently complains about having to take antihypertensives. She feels she doesn't need them. You suspect she is not taking her medication as ordered. You say: A. "Mary, you must take your medication as instructed." B. "Mary, are you taking you blood pressure medication as prescribed?" C. "Many people find it difficult to remember to take their medication. During this past week, have you missed any of your pills?" D. "Mary, let's talk about the side effects of your medication." Answer: C Rationale: When asked, approximately 50% of non adherent clients will admit to not taking their medication as ordered. Clients who will admit to missing medication generally overestimate the amount of medication they do take. Although the direct approach may be effective, it is more often productive to inquire in a nonthreatening, nonjudgmental manner. It is never helpful or appropriate to adopt a paternalistic attitude with a client, such as saying, "You must do such and such." Likewise, the statement, "let's talk about the side effects of your medication," is based on the practitioner's assumptions about the reasons for the client's behavior. 9. Dana has ischemic arterial ulcers. What is your first priority when counseling her? A. Tell her that increasing coffee intake will stimulate heart rate and circulation. B. Tell her to decrease water intake slightly to improve blood viscosity. C. Tell her to reduce risk factors to improve tissue perfusion. D. Tell her to begin an intense aerobic program. Answer is C: stop smoking, reduce fat intake, avoid restrictive garments, stay hydrated, and avoid caffeine. 10. The purpose of the National Organization of Nurse Practitioner Faculties (NONPF) is to: A. Establish the curriculum of Nurse Practitioner Programs based off specific guidelines B. Outline federal laws pertinent to Nurse Practitioner practice C. Provide Nurse Practitioner educators with up to date resources and information D. Dictate the rules regarding Nurse Practitioner's working in hospitals Answer is C The NONPF's vision statement on their website states: "Our vision is to be the preeminent global leader in providing timely and critical resources for NP educators. We advance innovative models that support NP educational programs to meet the highest quality standards. We unite and lead NP educators in transforming healthcare." 11. Cough, loss of taste, and rash are adverse effects associated with which class of antihypertensives agents? A. Diuretics B. Beta Blockers C. ACE Inhibitors D. Calcium Chanel Blockers Answer: C a. 1. Identify Key Features 2. Adopt a Framework 3. Acquire data 4. Create a problem representation 5. Apply key features to the framework. B) 1. Acquire Data 2. Create a problem representation 3. Adopt a framework 4. Identify key features 5. Apply key features to framework C) 1. Acquire Data 2. Identify Key Features 3. Create a problem representation 4. Adopt a Framework 5. Apply key features to framework D) 1. Identify Key Features 2. . Acquire Data 3. Adopt a framework 4 Apply key features to framework 5. Create a problem representation. Correct Answer C 12. b. 1. Acquire Data 2. Identify Key Features 3. Create a problem representation 4. Adopt a Framework 5. Apply key features to A charitable foundation plans to build a community youth center in a large urban area with a history of gang violence. What tyoe of health prevention activity is being done in this area? A) Primary prevention B) Secondary prevention C) Tertiary prevention D) Health prevention a. Primary prevention Rationale: A community youth center with good staffing can be an effective method of drawing the children out of the streets into a safer environment. It can reduce the risk of children becoming victims of gang violence. In addition, staff members can serve as role models or mentors for the older children. 13. What is the best description of a variable? A) It is an important part of every research study B) It is the probability that a factor is important for the research data C) It is the value or number that occurs most frequently D) it is a condition, characteristic, or factor that is being measured ANSWER D) It is a condition, characteristic, or factor that is being measured. Rationale: A variable is a condition, characteristic, or factor that is being measured. An independent variable is the one being manipulated that is not affected by the others. A dependent variable changes depending on the manipulation of the independent variable. 14. Which of the following statements are false? a. A test with high sensitivity can be used to “rule in” a condition for those who have positive results. b. Specificity measures the proportion of actual negatives that are correctly identified. c. Specificity tests tend to have many false positives. d. A positive specificity test would be used to “rule out” a condition. ANSWER Correct answer is C – specificity false positives are few. C - specificity false positives are FEW 15. True or False: In the 'Assessment' segment of the SOAP note, the problems (diagnoses) should be listed in order of importance. ANSWER True 16. The HPI of the SOAP Documentation contains all of the following EXCEPT: a. 47 year old b. African American c. Woman d. reason for visit e. history of diabetes ANSWER e. past medical history does not belong in the HPI. 17. History of Present Illness should be written in narrative form and in the patient's words. True or False. ANSWER TRUE. The HPI should describe the patient's condition in narrative form and record in the patient's words. 18. Symptoms are objective findings included in the SOAP documentation. True or False? ANSWER FALSE. Symptoms are the patient's subjective description of complaints. SIGNS are objective findings related to the symptoms reported by the patient. 19. The PLAN aspect of the SOAP includes which of the following? a. diagnostic testing b. medication with dosage, route, and duration c. patient education d. differential diagnoses e. all of the above d. a. b. & c. ANSWER D. Diagnostic testing, medications, and patient education are part of the PLAN in SOAP documentation. Differential diagnoses are included in the ASSESSMENT part of SOAP documentation. 20. True or False, what is Diagnostic Reasoning? ANSWER Process by which clinicians are able to methodically collect data, process information in an organized approach, make interpretations about the data, and develop an action/treatment plan True 21. How many models are there of Clinical Reasoning? 2 15 None 4 22. i. Two models of clinical reasoning All of the statements about common health beliefs of many traditional Asian cultures are true except: A) An imbalance of the hot and cold (yin/yang) wital forces can cause illness, and treating hot disease with a "cold" treatment (i.e., certain foods/herbs) can help to restore balance and cure the illness B) If the patient is very ill or dying, immediate family and extended family members will visit the patient daily in shifts to provide emotional support C) Infants and small children may wear an amulet such as a red string on the wrist or a piece of cloth on the neck or the wrist. D) Surgical procedures are regarded as important treatment for many illnesses. ANSWER D) Surgical procedures are regarded as important treatment for many illnesses. Some Asian cultures regard surgery as the last resort and consider loss of blood as depleting the vital forces of the body and causing illness. Western medicine is considered to be "hot" and patients may discontinue or reduce their doses of their medicine without asking. An imbalance of hot and cold (yin/yang) is believed to cause illness. Treating a "yin" disease (common cold) means avoiding eating yin foods (melon, cucumbers) because they will worsen it. Instead, yin diseases are treated with yang food (meat, spicy foods) so that the body becomes more balanced. 23. An elderly Hmong patient, who is originally from Thailand, is seen by the nurse practitioner for a follow-up visit. He is accompanied by his eldest daughter. The patient presented 6 weeks ago with complaints of the recent onset of morning headaches. He was diagnosed with stage 2 hypertension and prescribed hydrochlorothiazide, one 25-mg tablet daily. On this visit, he tells the nurse practitioner that the new medicine cured the headache, so he stopped taking it. What is the best plan to follow during this visit? A) Educate the patient about hypertension, how the medicine works on his body, and the importance of taking his pill daily B) Reassure the patient that he can resume his prescription medicine again the next morning C) Tell the patient that you will lower the dosage of hydrochlorothiazide to 12.5 mg daily D) Speak to the patient in a loud voice and confront him about his behavior ANSWER Answer: A Rationale: When Hmong (an ethnic group prevalent in Thailand, Myanmar, Laos, and Vietnam) see a medical doctor for a symptom, they expected to be treated and "cured" of their illness after one visit. When the symptoms disappear, many will stop taking the medicine. When medication is to be taken on a long term basis, it is important to educate the patient (and the patient's family) about the disease (in this case, hypertension), how the medicine works on the body, and the reason why the patient has to take the medicine as prescribed (in this case, daily). Many Southeast Asians are very polite and consider speaking in a loud voice, staring, or confrontation to be rude behavior. 24. A 15-year old girls who attends a public school is referred tot eh nurse practitioner by on of her teachers. The teen's parent are recently divorces. The teen has been missing school and is falling behind in her schoolwork. After closing the exam room door, the nurse practitioner starts to interview the teen, asking about her moods, her appetite, her sleep, whether she has an plan of hurting herself or others, and other questions. In what type of health prevention activity is the nurse practitioner engaging. A) Primary prevention B) Secondary prevention C) Tertiary prevention D) Dropout prevention program ANSWER B Rationale: The nurse practitioner is evaluating the teenager for major depression. Secondary prevention includes detecting disease at an early stage to halt or slow its progress. All screening tests and labe tests (e.g. mammography, Pap smears) are secondary prevention activities. 25. What is part of cultural humility? A. Self-awareness B. Respectful communication C. Collaborative partnerships D. All of the above Answer: d 26. Where would you document the initiation of pharmacology in your SOAP note? A. Subjective B. Objective C. Assessment D. Plan ANSWER D. The Planning section in a SOAP note includes clinical consultations, patient education, pharmacotherapy, and any diagnostic testing recommended 27. Which of the following is considered by Latinos/Hispanics to be a spiritual illness that can cause symptoms such as loss of appetite, crying, diarrhea, and weakness or death among infant and small children? A) Mal ojo or mal de ojo B) Chronic nightmares C) Trabajo D) Malo a. Mal ojo or mal de ojo. Mal ojo or mal de ojo is a spiritual illness that can cause symptoms such as loss of appetite, crying, diarrhea, colic, fear, weakness, or death. A curandero or curandera is usually consulted and does spiritual cleansing of the patient. It may take several cleansings (limpia) to cure the patient. Trabajo means "work" and malo means "bad" in Spanish: these are included as distractors.