NURS 5463 Exam 2 The University of Texas at Arlington | UPDATED
Questions with 100% Verified Answers
Question:
A 65-year-old male with no prior medical history presents to
the ED with a complaint of low back pain and fatigue x1
month. The pain is constant, a dull ache, does not radiate and
has progressively gotten worse. Lab results: WBC 5,000, Hgb
7.0 g/dL, HCT 30%, MCV 80%, platelets 500,000, creatinine
1.0 mg/dL, BUN 15 mg/dL, Na 135 mEq/L, potassium 3.5
mEq/L, calcium is 10.5 mg/dL, Alkaline Phosphatase is 300
units/L. A lumbar x-ray shows lytic lesions. It is most
important for the AGACNP to perform an exam on which
body part/system? a.) Pulmonary Exam b.) Cardiovascular
exam c.) Rectal Exam d.) Abdominal Exam
Answer:
c.) Rectal Exam Rationale: The patient has many
manifestations which are concerning for a malignant process.
A normocytic anemia in a male is never normal and should
concern the AGACNP for a possible malignancy.
Hypercalcemia with an elevated alkaline phosphatase is
concerning for bone issues and coupled with lytic lesions on
the lumbar vertebrae is very concerning for a malignancy. The
most likely malignancy in this patient is prostate cancer,
therefore the AGACNP should perform a rectal examination
to assess the prostate. Prostate cancer most commonly
metastasizes to the vertebrae.
Question:
A female patient presents to your office for follow up after
having a CT of the abdomen and pelvis completed to evaluate
a complaint of abdominal pain. The CT scan showed liver
lesions consistent with metastatic cancer with an unknown
primary site. Her mother died from colon cancer. Which
,intervention should the AGACNP complete next? a.) Order an
echocardiogram b.) Complete a referral to hospice c.) Refer
for a preoperative cardiac evaluation d.) Refer to GI for a
colonoscopy
Answer:
d.) Refer to GI for a colonoscopy Rationale: The next stage in
this patient's evaluation is to search for the primary cancer
site, obtain a tissue biopsy and assess for any other sites of
metastasis. The most likely location of the primary cancer is
the colon. Colon cancer commonly metastasizes to the liver
and she needs a colonoscopy.
Question:
A 20-year-old male expresses concern about testicular cancer
and wants to know if he should perform testicular self-
examinations. Which response from the AGACNP best
demonstrates their knowledge of current recommendations?
a.) Testicular self-examinations are no longer recommended.
b.) Testicular self-examinations should be done monthly, after
a hot shower. c.) Testicular self-examinations are ineffective,
and your PCP should draw an AFP level. d.) Testicular
examinations should only be done by your primary care
provider.
Answer:
a.) Testicular self-examinations are no longer recommended.
Rationale: Currently the USPSTF, the American Academy of
Physicians and the American Academy of Pediatrics do not
recommend testicular self-examinations because there is no
data to support their effectiveness.
Question:
A 68-year-old female presents to the ED for a complaint of
intermittent vaginal bleeding for the last two months. She is
, post-menopausal and has no other complaints. Vitals and
exam are normal. Which diagnostic test should the AGACNP
order next? a.) CT of the abdomen and Pelvis b.) Gonorrhea
and chlamydia screening c.) Transvaginal Ultrasound d.)
Chest X-ray
Answer:
c.) Transvaginal Ultrasound Rationale: This patient's
symptoms are concerning for endometrial cancer. She
requires a transvaginal US to assess the uterine endometrium.
Question:
A patient with colon cancer is 5 days status post her cycle of
chemotherapy. She presents to the ED with a fever of 101.
Her ANC is 400. Which level of care does this patient
require? a.) Intensive care b.) Medical Floor c.) Step down
unit d.) Discharge home
Answer:
b.) Medical Floor Rationale: Any patient with a fever and
neutropenia should be admitted. There are no clinical
indicators in the question to suggest she needs a step-down
unit or ICU, therefore admission to the medical floor is most
appropriate.
Question:
You are asked to admit a 45-year-old female with a brain
tumor to your service for an altered mental status. The spouse
reports that the patient has been increasingly restless for the
last 3 days and experiencing worsening confusion. An MRI of
the brain completed 1 month ago showed some cerebral
edema secondary to the brain tumor. The ED has only given
her ondansetron (Zofran) for nausea. She is thrashing around
in bed and uncooperative with your examination and nursing
care. What additional medication is most important for the
Questions with 100% Verified Answers
Question:
A 65-year-old male with no prior medical history presents to
the ED with a complaint of low back pain and fatigue x1
month. The pain is constant, a dull ache, does not radiate and
has progressively gotten worse. Lab results: WBC 5,000, Hgb
7.0 g/dL, HCT 30%, MCV 80%, platelets 500,000, creatinine
1.0 mg/dL, BUN 15 mg/dL, Na 135 mEq/L, potassium 3.5
mEq/L, calcium is 10.5 mg/dL, Alkaline Phosphatase is 300
units/L. A lumbar x-ray shows lytic lesions. It is most
important for the AGACNP to perform an exam on which
body part/system? a.) Pulmonary Exam b.) Cardiovascular
exam c.) Rectal Exam d.) Abdominal Exam
Answer:
c.) Rectal Exam Rationale: The patient has many
manifestations which are concerning for a malignant process.
A normocytic anemia in a male is never normal and should
concern the AGACNP for a possible malignancy.
Hypercalcemia with an elevated alkaline phosphatase is
concerning for bone issues and coupled with lytic lesions on
the lumbar vertebrae is very concerning for a malignancy. The
most likely malignancy in this patient is prostate cancer,
therefore the AGACNP should perform a rectal examination
to assess the prostate. Prostate cancer most commonly
metastasizes to the vertebrae.
Question:
A female patient presents to your office for follow up after
having a CT of the abdomen and pelvis completed to evaluate
a complaint of abdominal pain. The CT scan showed liver
lesions consistent with metastatic cancer with an unknown
primary site. Her mother died from colon cancer. Which
,intervention should the AGACNP complete next? a.) Order an
echocardiogram b.) Complete a referral to hospice c.) Refer
for a preoperative cardiac evaluation d.) Refer to GI for a
colonoscopy
Answer:
d.) Refer to GI for a colonoscopy Rationale: The next stage in
this patient's evaluation is to search for the primary cancer
site, obtain a tissue biopsy and assess for any other sites of
metastasis. The most likely location of the primary cancer is
the colon. Colon cancer commonly metastasizes to the liver
and she needs a colonoscopy.
Question:
A 20-year-old male expresses concern about testicular cancer
and wants to know if he should perform testicular self-
examinations. Which response from the AGACNP best
demonstrates their knowledge of current recommendations?
a.) Testicular self-examinations are no longer recommended.
b.) Testicular self-examinations should be done monthly, after
a hot shower. c.) Testicular self-examinations are ineffective,
and your PCP should draw an AFP level. d.) Testicular
examinations should only be done by your primary care
provider.
Answer:
a.) Testicular self-examinations are no longer recommended.
Rationale: Currently the USPSTF, the American Academy of
Physicians and the American Academy of Pediatrics do not
recommend testicular self-examinations because there is no
data to support their effectiveness.
Question:
A 68-year-old female presents to the ED for a complaint of
intermittent vaginal bleeding for the last two months. She is
, post-menopausal and has no other complaints. Vitals and
exam are normal. Which diagnostic test should the AGACNP
order next? a.) CT of the abdomen and Pelvis b.) Gonorrhea
and chlamydia screening c.) Transvaginal Ultrasound d.)
Chest X-ray
Answer:
c.) Transvaginal Ultrasound Rationale: This patient's
symptoms are concerning for endometrial cancer. She
requires a transvaginal US to assess the uterine endometrium.
Question:
A patient with colon cancer is 5 days status post her cycle of
chemotherapy. She presents to the ED with a fever of 101.
Her ANC is 400. Which level of care does this patient
require? a.) Intensive care b.) Medical Floor c.) Step down
unit d.) Discharge home
Answer:
b.) Medical Floor Rationale: Any patient with a fever and
neutropenia should be admitted. There are no clinical
indicators in the question to suggest she needs a step-down
unit or ICU, therefore admission to the medical floor is most
appropriate.
Question:
You are asked to admit a 45-year-old female with a brain
tumor to your service for an altered mental status. The spouse
reports that the patient has been increasingly restless for the
last 3 days and experiencing worsening confusion. An MRI of
the brain completed 1 month ago showed some cerebral
edema secondary to the brain tumor. The ED has only given
her ondansetron (Zofran) for nausea. She is thrashing around
in bed and uncooperative with your examination and nursing
care. What additional medication is most important for the
