WALDEN UNIVERSITY NUR 6531 EXAM
PAPER COMPLETE QUESTIONS
CORRECT ANSWERS
◉ A patient expresses concern that she is at risk for breast cancer. To
best assess the risk for this patient, what is the best initial action?
a. Ask if there is a family history of breast cancer.
b. Gather and record a three-generation pedigree.
c. Order a genetic test for the breast cancer gene.
d. Recommend direct-to-consumer genetic testing.. Answer: ANS: B
The three-generation pedigree is the best way to evaluate genetic
risk. Asking about a family history is not a systematic risk
assessment and does not specify who in the family has the history or
whether there is a pattern. Genetic testing and direct-to-consumer
(DTC)
genetic testing are not the initial actions when assessing genetic
risk.
◉ A patient asks about direct-to-consumer (DTC) genetic testing.
What will the provider tell the patient? p. 42
a. It is not useful for identifying genetic diseases.
b. Much of the information does not predict disease risk.
c. The results are shared with the patient's insurance company.
,d. The results must be interpreted by a provider.. Answer: ANS: B
DTC testing gives a lot of information, but much of it does not
contribute to disease prediction, since mutations are not necessarily
related to specific diseases. The tests are useful but must be
interpreted accurately. The results are confidential and do not have
to be interpreted by a provider.
◉ What is an important part of patient care that can minimize the
risk of a formal patient complaint even when a mistake is made? p.
49
a. Ensuring informed consent for all procedures
b. Maintaining effective patient communication
c. Monitoring patient compliance and adherence
d. Providing complete documentation of visits. Answer: ANS: B
Effective patient communication is key to building trust and rapport
and ineffective communication is a predictor for malpractice claims.
The other items are important aspects of care and may help the
provider during the investigation of a claim, but do not minimize
the risk.
◉ What are some causes for failures or delays in diagnosing patients
resulting in malpractice claims? (Select all that apply.)
a. Failing to recognize a medication complication
b. Failing to request appropriate consultations
,c. Improper performance of a treatment
d. Not acting on diagnostic test results
e. Ordering a wrong medication. Answer: ANS: B, D
Failing to obtain consultations when indicated or not acting on
diagnostic test results can lead to diagnosis-related failures. Failing
to recognize medication complications and ordering a wrong
medication lead to medication prescribing allegations. Improper
performance of a treatment can lead to treatment-related
malpractice claims.
◉ A primary care provider is performing a Tzanck test to evaluate
possible herpes simplex lesions. To attain accurate results, the
provider will perform what intervention? p. 232
a. Blanch the lesions while examining them with a magnifying glass.
b. Gently scrape the lesions with a scalpel onto a slide.
c. Perform a gram stain of exudate from the lesions.
d. Remove the top of the vesicles and obtain fluid from the lesions..
Answer: ANS: D
The Tzanck test requires removing the tops from vesicular lesions in
order to obtain fresh fluid from the base of the lesions. Blanching of
blue to red lesions under a microscope helps to evaluate whether
blood is in the capillaries of the lesions. Scraping lesions onto a slide
is done to evaluate the presence of hyphae and spores common with
candidiasis or fungal
, infections. Gram staining is performed to distinguish gram-positive
from gram-negative organisms in suspected bacterial infections.
◉ When examining a patient's skin, a practitioner uses dermoscopy
for what purpose? p. 232 (Select all that apply.)
a. Accentuating changes in color of pathologic lesions by
fluorescence
b. Assessing changes in pigmentation throughout various lesions
c. Determining whether lesion borders are regular or irregular
d. Differentiating fluid masses from cystic masses in the epidermis
e. Visualizing skin fissures, hair follicles, and pores in lesions.
Answer: ANS: B, C, E
Dermoscopy is used to visualize the epidermis and superficial
dermis and can reveal changes in pigmentation throughout lesions,
whether borders are regular or irregular, and the various fissures,
follicles, and pores present in lesions. The Wood's light, or black
light, is used to fluoresce lesions to accentuate changes in color. A
direct light source is useful for
differentiating fluid masses from cystic masses.
◉ A patient has actinic keratosis and the provider elects to use
cryosurgery to remove the lesions. How will the provider administer
this procedure? p. 234
a. Applying one or two freeze-thaw cycles to each lesion
b. Applying two or more freeze-thaw cycles to each lesion
PAPER COMPLETE QUESTIONS
CORRECT ANSWERS
◉ A patient expresses concern that she is at risk for breast cancer. To
best assess the risk for this patient, what is the best initial action?
a. Ask if there is a family history of breast cancer.
b. Gather and record a three-generation pedigree.
c. Order a genetic test for the breast cancer gene.
d. Recommend direct-to-consumer genetic testing.. Answer: ANS: B
The three-generation pedigree is the best way to evaluate genetic
risk. Asking about a family history is not a systematic risk
assessment and does not specify who in the family has the history or
whether there is a pattern. Genetic testing and direct-to-consumer
(DTC)
genetic testing are not the initial actions when assessing genetic
risk.
◉ A patient asks about direct-to-consumer (DTC) genetic testing.
What will the provider tell the patient? p. 42
a. It is not useful for identifying genetic diseases.
b. Much of the information does not predict disease risk.
c. The results are shared with the patient's insurance company.
,d. The results must be interpreted by a provider.. Answer: ANS: B
DTC testing gives a lot of information, but much of it does not
contribute to disease prediction, since mutations are not necessarily
related to specific diseases. The tests are useful but must be
interpreted accurately. The results are confidential and do not have
to be interpreted by a provider.
◉ What is an important part of patient care that can minimize the
risk of a formal patient complaint even when a mistake is made? p.
49
a. Ensuring informed consent for all procedures
b. Maintaining effective patient communication
c. Monitoring patient compliance and adherence
d. Providing complete documentation of visits. Answer: ANS: B
Effective patient communication is key to building trust and rapport
and ineffective communication is a predictor for malpractice claims.
The other items are important aspects of care and may help the
provider during the investigation of a claim, but do not minimize
the risk.
◉ What are some causes for failures or delays in diagnosing patients
resulting in malpractice claims? (Select all that apply.)
a. Failing to recognize a medication complication
b. Failing to request appropriate consultations
,c. Improper performance of a treatment
d. Not acting on diagnostic test results
e. Ordering a wrong medication. Answer: ANS: B, D
Failing to obtain consultations when indicated or not acting on
diagnostic test results can lead to diagnosis-related failures. Failing
to recognize medication complications and ordering a wrong
medication lead to medication prescribing allegations. Improper
performance of a treatment can lead to treatment-related
malpractice claims.
◉ A primary care provider is performing a Tzanck test to evaluate
possible herpes simplex lesions. To attain accurate results, the
provider will perform what intervention? p. 232
a. Blanch the lesions while examining them with a magnifying glass.
b. Gently scrape the lesions with a scalpel onto a slide.
c. Perform a gram stain of exudate from the lesions.
d. Remove the top of the vesicles and obtain fluid from the lesions..
Answer: ANS: D
The Tzanck test requires removing the tops from vesicular lesions in
order to obtain fresh fluid from the base of the lesions. Blanching of
blue to red lesions under a microscope helps to evaluate whether
blood is in the capillaries of the lesions. Scraping lesions onto a slide
is done to evaluate the presence of hyphae and spores common with
candidiasis or fungal
, infections. Gram staining is performed to distinguish gram-positive
from gram-negative organisms in suspected bacterial infections.
◉ When examining a patient's skin, a practitioner uses dermoscopy
for what purpose? p. 232 (Select all that apply.)
a. Accentuating changes in color of pathologic lesions by
fluorescence
b. Assessing changes in pigmentation throughout various lesions
c. Determining whether lesion borders are regular or irregular
d. Differentiating fluid masses from cystic masses in the epidermis
e. Visualizing skin fissures, hair follicles, and pores in lesions.
Answer: ANS: B, C, E
Dermoscopy is used to visualize the epidermis and superficial
dermis and can reveal changes in pigmentation throughout lesions,
whether borders are regular or irregular, and the various fissures,
follicles, and pores present in lesions. The Wood's light, or black
light, is used to fluoresce lesions to accentuate changes in color. A
direct light source is useful for
differentiating fluid masses from cystic masses.
◉ A patient has actinic keratosis and the provider elects to use
cryosurgery to remove the lesions. How will the provider administer
this procedure? p. 234
a. Applying one or two freeze-thaw cycles to each lesion
b. Applying two or more freeze-thaw cycles to each lesion
