NSG 5003 FINAL EXAM 2 1OO% CORRECT ANSWERS

3. The pathophysiological hallmark of ACD is: 4. Which of the following is the most important question to ask during cardiovascular health history? 5. A 26-year-old, non-smoker, male presented to your clinic with SOB with exertion. This could be due to: 6. Which of the following dermatological conditionsresults from reactivation of the dormant varicella virus? 7. Mr. Jones is a 68-year-old retired Air Force pilot that has been diagnosed with prostate cancer in the past week. He has never had a surgical procedure in his life and seeks clarification on the availability of treatments for prostate cancer. He asks the nurse practitioner to tell him the side effects of a radical prostatectomy. Which of the following is not a potential side effect of this procedure? 8. Presbycusis is the hearing impairment that is associated with: 9. Asymptomatic 1+ bacteriuria is found in a nursing home resident with an indwelling catheter. The nurse practitioner’s initial intervention includes: 10. A 64-year-old male presents with erythema of the sclera, tearing, and bilateral pruritus of the eyes. The symptoms occur intermittently throughout the year and he has associated clear nasal discharge. Which of the following is most likely because of the inflammation? 11. The nurse practitioner is examining a 62-year-old female who has been complaining of lower abdominal pain. Upon auscultation, bowel sounds are high pitched and tinkling. Which of the following terms describes this finding? 12. Which ethnic group has the highest incidence of prostate cancer? 13. A key symptom of ischemic heart disease is chest pain. However, angina equivalents may include exertional dyspnea. Angina equivalents are important because: 14. The nurse practitioner is discussing lifestyle changes with a patient diagnosed with gastroesophageal reflux. What are the nonpharmacological management interventions that should be included? 15. Which lesions are typically located along the distribution of dermatome? 16. Which of the following medications are commonly associated with the side effect of cough? 17. On DRE, you note that a 45-year-old patient has a firm, smooth, non-tender but asymmetrically shaped prostate. The patient has no symptoms and has a normal urinalysis. The patient’s PSA is within normal limits for the patient’s age. The clinician should: 18. Your patient complains of a feeling of heaviness in the lower legs daily. You note varicosities, edema, and dusky color of both ankles and feet. Which of the following is the most likely cause for these symptoms? 19. The most common cause of eye redness is: 20. The aging process causes what normal physiological changes in the heart? 21. Ms. Smith, 37-year-old, comes to the clinic today complaining of dull, throbbing bilateral headaches almost every evening. You suspect she is experiencing: 22. A 59-year-old patient with history of alcohol abuse comes to your office because of ‘throwing up blood”. On physical examination, you note ascites and caput medusa. A likely cause for the hematemesis is: 23. Which of the following is considered a “red flag” when diagnosing a patient with pneumonia? 24. Your patient complains of lower abdominal pain, anorexia, extreme fatigue, unintentional weight loss of 10 pounds in last 3 weeks, and you find a positive hemoccult on digital rectal examination. Laboratory tests show iron deficiency anemia. The clinician needs to consider: 25. You have a patient complaining of vertigo and want to know what could be the cause. Knowing there are many causes for vertigo, you question the length of time the sensation lasts. She tells you several hours to days and is accompanied by tinnitus and hearing loss. You suspect which of the following conditions? 26. In examining the mouth of an older adult with a history of smoking, the nurse practitioner finds a suspicious oral lesion. The patient has been referred for a biopsy to be sent for pathology. Which is the most common oral precancerous lesion? 27. A cough is described as chronic if it has been present for: 28. The first assessment to complete related to the eyes is: 29. The Mini-Cog is a short screening tool used to assess cognition. Which of the following statements pertaining to the test is a true statement? 30. A woman with an X-linked dominant disorder will: 31. Your patient has just returned from a 6-month missionary trip to Southeast Asia. He reports unremitting cough, hemoptysis, and an unintentional weight loss of 10 pounds over the last month. These symptoms should prompt the clinician to suspect: 32. In assessing the eyes, which of the following is considered a “red flag” finding when associated with eye redness? 33. The best evidence rating drugs to consider in a post myocardial infarction patient include: 34. In examination of the nose, the clinician observes gray, pale mucous membranes with clear, serous discharge. This is most likely indicative of: 35. Which of the following findings should trigger an urgent referral to a cardiologist or neurologist? 36. Which symptom is more characteristic of Non-Cardiac chest pain? 37. Aortic regurgitation requires medical treatment for early signs of CHF with: 38. What test is used to confirm the diagnosis of appendicitis? 39. The major impact of the physiological changes that occur with aging is: 40. A smooth round nodule with a pearly gray border and central induration best describes which skin lesion? 41. A 20-year-old engineering student complains of episodes of abdominal discomfort, bloating, and episodes of diarrhea. The symptoms usually occur after eating, and pain is frequently relieved with bowel movement. She is on a “celiac diet” and the episodic symptoms persist. Physical examination and diagnostic tests are negative. Colonoscopy is negative for any abnormalities. This is a history and physical consistent with: 42. Which of the following disorders can cause urinary incontinence? 43. Which of the following drugs would be useful for the nurse practitioner to prescribe for an older adult to prevent gastric ulcers when a nonsteroidal anti-inflammatory drug is used for chronic pain management? 44. Which of the following details are NOT considered while staging asthma? 45. A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The patient reports a smoking history of 2 packs of cigarettes per day since age 16. This would be recorded in the chart as: 46. A clinical clue for suspected renal artery stenosis would be: 47. What is the most common valvular heart disease in the older adult? 48. The cytochrome p system involves enzymes that are generally: 49. Which of the following is the most common cause of heartburn-type epigastric pain? 50. A nurse practitioner reports that your patient’s abdominal X-ray demonstrates multiple air-fluid levels in the bowel. This is a diagnostic finding found in: 51. A patient suffered a laceration of the shin three days ago, and today presents with a painful, warm, red swollen region around the area. The laceration has a purulent exudate. The clinician should recognize that the infected region is called: 52. A 62-year-old client presents with a complaint of fever, pain, and burning on urination. Difficulty urinating with dribbling has been increasing in the past few days. He has a feeling of pressure in his groin. On examination, his prostate is tender, boggy, and warm. A stat urinalysis reveals the presence of leukocytes and bacteria. He is allergic to sulfa drugs. His weight is 70 kg and his last serum creatinine was 1.0. While awaiting the culture and sensitivity, the nurse practitioner begins empiric treatment with which of the following? 53. In teaching an older adult female client with end-stage renal disease her medication regimen, the nurse practitioner must include which of the following pieces of information in the treatment plan? 54. A 46-year-old female complains of fatigue, general malaise, and pain and swelling in her hands that has gradually worsened over the last few weeks. She reports that pain, stiffness, and swelling of her hands are most severe in the morning. On physical examination, you note swelling of the metacarpophalangeal joints bilaterally. These are common signs of: 55. Whenever a patient presents with acute non-traumatic shoulder pain, the clinician should make sure to exclude a: 56. A female patient presents to the clinic with complaints of a severe, throbbing, unilateral headache. She complains of seeing flashes of light prior to the headache. She complains of sound and light sensitivity as well as nausea. The clinician should recognize these as symptoms of: 57. The main focus of treatment of patients with ACD is: 58. The most common neurological cause of seizures in an older adult is: 59. Your 63-year-old Caucasian woman with polymyalgia rheumatica (PMR) will begin treatment with corticosteroids until the condition has resolved. You look over her records and it has been 2 years since her last physical examination and any laboratory or diagnostic tests as she relocated and had not yet identified a health-care provider. In prioritizing your management plan, your first orders should include: 60. Your patient is a 78-year-old female with a smoking history of 120-pack years. She complains of hoarseness that has developed over the last few months. It is important to exclude the possibility of: 61. A 43-year-old female was in a bicycling accident and complains of severe pain of the right foot. The patient limps into the emergency room. On physical examination, there is no point tenderness over the medial or lateral ankle malleolus. There is no foot tenderness except at the base of the fifth metatarsal bone. According to the Ottawa foot rules, should an X-ray of the feet be ordered? 62. When assessing a patient who complains of a tremor, the nurse practitioner must differentiate essential tremor from the tremor of Parkinson’s disease. Which of the following findings are consistent with essential tremor? 63. Folliculitis is most commonly due to: 64. What kind of lesions are caused by the herpes simplex virus? 65. A 65-year-old male complains of a headache that feels “like a knife is cutting into his head.” He also reports feeling right-sided scalp and facial pain and “seeing double” at times. He has a history of hypertension and hyperlipidemia. His medications include beta blocker, statin drug, and an ACE inhibitor. On physical examination, you note palpable tenderness over the right side of the forehead. There are no neurological deficits. Vision is 20/20 with lenses. No weakness of extremities. CN II to XII are intact. The history corresponds to which of the following disorders? 66. Which of the following conditions is the most common cause of nausea, vomiting, and diarrhea? 67. The nurse practitioner orders bilateral wrist X-rays on a 69-year-old gentleman complaining of pain in both wrists for the past 6 weeks not related to any known trauma. The nurse practitioner suspects elderly onset rheumatoid arthritis. The initial radiographic finding in a patient with elderly onset rheumatoid arthritis would be: 68. A common auscultatory finding in advanced CHF is: 69. The three cardinal features of Parkinson’s disease are: 70. In AR disorders, carriers have: 71. A 75-year-old patient complains of pain and paresthesias in the right foot that worsens with exercise and is relieved by rest. On physical examination you note pallor of the right foot, capillary refill of 4 seconds in the right foot, +1 dorsalis pedis pulse in the right foot, and +2 pulse in left foot. Which of the following is a likely cause of the signs and symptoms? 72. Which of the following statements is true concerning anti-arrhythmic drugs? 73. A 23-year-old patient who has had bronchiectasis since childhood is likely to have which of the following: 74. Which of the following is a common trigger of migraine headache? 75. A 55-year-old patient complains of lower back pain due to heavy lifting at work yesterday. He reports weakness of the left leg and paresthesias in the left foot. On physical examination, the patient has diminished ability to dorsiflex the left ankle. Which of the following symptoms should prompt the clinician to make immediate referral to a neurosurgeon? 76. The appearance of a 2-10 cm. herald patch with subsequent development of parallel oval lesions on the trunk in a christmas tree distribution involving the upper arms and upper legs are common in: 77. When interpreting laboratory data, you would expect to see the following in a patient with Anemia of Chronic Disease (ACD): 78. In differentiating a gastric ulcer from a duodenal ulcer, you know that each type of ulcer can present with distinct signs and symptoms. Which of the following pieces of information from the patient’s history is the least useful for you to determine that the patient has a duodenal ulcer? 79. A 43-year-old male patient complains of right-sided abdominal and pain in the back in the right costovertebral angle region, fever, chills, dysuria, and nausea. On physical examination, there is 102 degree fever, tachycardia, and right costovertebral angle tenderness to percussion. The most likely condition is: 80. A careful history of a female client with a chief complaint of intermittent diarrhea reveals that she also experiences bouts of constipation. She has no known allergies and experienced no unintentional weight loss. What is the most likely condition? 81. A 33-year-old female reports general malaise, fatigue, stiffness, and pain in multiple joints of the body. There is no history of systemic disease and no history of trauma. On physical examination, the patient has no swelling or decreased range of motion in any of the joints. She indicates specific points on the neck and shoulders that are particularly affected. She complains of tenderness upon palpation of the neck, both shoulders, hips, and medial regions of the knees. The clinician should include the following disorder in the list of potential diagnoses: 82. A 60-year-old female patient complains of pain in both hands that is worse in the morning. On physical examination, the thumb metacarpophalangeal joint is swollen on both hands. There is swelling of the proximal and distal interphalangeal joints bilaterally. These are typical signs of: 83. A 68-year-old male reports painless rectal bleeding occasionally noted with thin pencil-like stools, but no pain with defection. He has a history of colon polyp removal 10 years ago but was lost to follow-up. The nurse practitioner’s appropriate intervention is: 84. During physical examination of a patient, you note resonance on percussion in the upper lung fields. This is consistent with: 85. Your 70-year-old patient has gastroesophageal reflux disease (GERD). After a trial of lifestyle modifications and antacids, the patient continues to have occasional mild heartburn after occasional meals and at night. The most appropriate next action is: 86. In order to provide a comprehensive genetic history of a patient, the NP should: 87. An 86-year-old patient who wears a hearing aid complains of poor hearing in the affected ear. In addition to possible hearing aid malfunction, this condition is often due to: 88. A 62-year-old woman presents with a recurrent urinary tract infection. She now has a fever of 104°F and severe costovertebral tenderness with pyuria. What is the appropriate diagnosis and intervention for this patient? 89. When counseling clients regarding the use of antidiarrheal drugs such as Imodium anti-diarrheal and Kaopectate, the nurse practitioner advises patients to: 90. What is the most common cause of hip pain in older adults? 91. A 65-year-old woman is accompanied by her daughter for a physical examination. She has mild heart failure and takes digitalis and an ACE inhibitor. As you examine the patient, you note flat affect, hand tremor, and slowed movements. The tremor is worsened at rest. There are no neurologic deficits. Hand grip, sensation of face and extremities, and lower extremity muscle strength are within normal limits and bilaterally equal. DTRs are equal bilaterally. CN II to XII are intact. The mental status exam is normal. These are key signs of: