NR 511 Final Exam 1 Week 8 Year 2022, 100% Correct Questions and Answers for A Grade

NR-511-Differential Diagnosis & Primary Care Practicum Final Exam 1, Week 8 100% Correct Questions and Answers Question 1: The most cost-effective screening test for determining HIV status is which of the following? Question 2:Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process? Question 3 : Cocaine acts as a stimulant by blocking the reuptake of which eurotransmitter? Question 4: Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiate the diagnosis and is most consistent with lateral epicondylitis that differentiates the (tennis elbow) is Question 5:Which of the following statements concerning the musculoskeletal examination is true? Question 6: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? Question 7: Which causes the greatest percentage of mammalian bites? Question 8: A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first? Question 9: A diabetic patient asks the clinician why he needs to check his blood sugar at home even when Question 10: A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next? Question 11: Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy? Question 12: During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? Question 13: Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step? Question 14: What is the most common cause of microcytic anemia? Question 15: An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses? Question 16: Early rheumatoid disease is characterized by: Question 17: A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do? Question 18: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least: Question 19 A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to trans illuminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find? Question 20 According to Kübler-Ross, the stages of grief occur in which order? Question 21 Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate? Question 22 The exanthema of Lyme disease is: Question 23 Complaint. Additionally, there is limited range of motion (ROM) with both active and passive Movement. These findings suggest that the origin of the musculoskeletal complaint is: Question 24 What is the recommended daily calcium intake for adults over the age of 50 with low bone mass? Question 25 When assessing a woman for infertility, which of the following tests should be done first? Question 26 Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact? Question 27 A 23-year-old sexually active woman presents for her first Pap smear. Her history includes multigravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination? Question 28 As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin? Question 29 Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? Question 30 A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis? Question 31 The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective? Question 32 In the United States, what is the second most common connective tissue disease and the most destructive to the joints? Question 33 The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety? Question 34 A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action? Question 35 Which of the following medications can cause hyperglycemia? Question 36 During treatment for anaphylaxis, what site is used for the initial injection of epinephrine? Question 37 It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period? Question 38 What is the most common cause of secondary amenorrhea? Question 39 Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration? Question 40 The goals of the 15-minute hour approach include: Question 41: 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? Question 42 The cardinal subjective symptom of sickle cell crisis is which of the following? Question 43: A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which of the following pelvic pathologies is the most common cause of dysmenorrhea? Question 44: Which arthropod bite can contain cytotoxic and hemolytic toxins that may destroy tissue? Question 45: 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? Question 46: A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the following tests is essential before prescribing any oral contraceptive? Question 47: A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin? Question 48: The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants? Question 49: Which type of bone marrow transplant is obtained from an identical twin? Question 50: Pink, cherry red tissues and skin may result from which type of poisoning? Question 51: Basic human needs are identified as: Question 52 : The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient? Question 53: A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self- examination (TSE). Which of the following should be included in the list of differential diagnoses? Question 54: What is the treatment of choice for a patient diagnosed with testicular cancer? Question 55: Which method is used to remove heavy metals, such as lead, that are ingested as poisons? Question 56: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate? Question 57 : A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate? Question 58: The clinician has instructed Sam, a 25-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? Question 59: A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting of a joint, is more likely related to which musculoskeletal injury? Question 60: Which type of heat-related illness involves a core body temperature of at least 104.9°F, acute mental status changes, absent sweat, and tachypnea? Question 61: Which of the following may be used to evaluate a person's suicide risk? Question 62: One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular structure? Question 63: After returning from visiting his grandchildren in England, George, age 59, complains of a flulike illness, including fever, chills, and myalgia. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering? Answers: a. A viral syndrome b. Lyme disease c. Rocky Mountain spotted fever d. Relapsing fever Question 64: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expect as a manifestation of the disease? Answers: a. Sinus bradycardia b. Atrial fibrillation c. Supraventricular tachycardia d. U waves Question 65: Which of the following tests is essential for a 46-year-old woman who the clinician suspect is perimenopausal? Answers: a. Pregnancy b. Estrogen level c. Progesterone level d. LH level Question 66: After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? Answers: a. Elevated TSH b. Normal TSH c. Low TSH d. Undetectable TSH Question 67 : A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment? Answers: a. No treatment at this time b. Diet and exercise for 6-week trial c. Diet, exercise, and oral medication d. Diet, exercise, and exogenous insulin ________________________________________________________ Question 68 : Which of the following should be considered in a patient presenting with erectile dysfunction? Answers: a. Diabetes mellitus b. Hypertension c. Atherosclerosis d. All of the above _________________________________________________________________________ Question 69 Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome? Answers: a. Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about onehalf the risk of developing carpal tunnel. b. Only people with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel. c. An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel. d. Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance. ________________________________________________________________________ Question 70 : A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea? Answers: a. Ceftriaxone b. Doxycycline c. Acyclovir d. Metronidazole __________________________________________________________________________ Question 71 : Which of the following statements is true regarding the treatment of carpal tunnel syndrome? Answers: a. The goal of treatment is to prevent flexion and extension movements of the wrist. b. Splints are used in carpal tunnel syndrome, because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position. c. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection. d. All of the above _________________________________________________________________________ Question 72: Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this patient? Answers: a. Elevated uric acid level b. Elevated blood urea nitrogen c. Decreased urine pH d. Decreased C-reactive protein __________________________________________________________________________ Question 73 : Which of the following data is indicative of testicular torsion? Answers: a. Absent cremasteric reflex b. Pain relieved on testicular elevation c. Testicle very low in the scrotum d. Swollen scrotum with "red dot sign" __________________________________________________________________________ Question 74 :A patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer her, the clinician must understand that exercise has what effect on the patient with type 2 diabetes? Answers: a. Reduces postprandial blood glucose b. Reduces triglycerides and increases highdensity lipoprotein (HDL) c. Reduces total cholesterol d. All of the above __________________________________________________________________________ Question 75 :A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority? Answers: a. Pregnancy test b. Pelvic ultrasound c. Endometrial biopsy d. Platelet count _________________________________________________________________________ Question 76 : What is the most common cause of generalized musculoskeletal pain in women ages 20 to 55? Answers: a. Chronic fatigue syndrome (CFS) b. Anemia c. Fibromyalgia syndrome (FMS) d. Sports-related injuries _________________________________________________________________________ Question 77 : If the international normalized ratio (INR) result is above the therapeutic range in a patient with atrial fibrillation on warfarin, what might the clinician do? Answers: a. Stop the warfarin for 1 week, and then repeat the INR. b. Withhold one or more days of anticoagulant therapy. c. Restart therapy at a lower dose immediately. d. The prothrombin time and INR should be reevaluated within 1 month of the dosage adjustments. _________________________________________________________________________ Question 77 : If the international normalized ratio (INR) result is above the therapeutic range in a patient with atrial fibrillation on warfarin, what might the clinician do? Answers: a. Stop the warfarin for 1 week, and then repeat the INR. b. Withhold one or more days of anticoagulant therapy. c. Restart therapy at a lower dose immediately. d. The prothrombin time and INR should be reevaluated within 1 month of the dosage adjustments. _________________________________________________________________________ Question 78 : A 32-year-old woman is seen in the clinic because she has been unable to get pregnant after 12 months of unprotected sex. In order to determine the cause of the infertility, the clinician should question her about which of these possible causes? Answers: a. Pelvic inflammatory disease b. Oral contraceptive use for 15 years c. Early menarche d. Diet high in soy _________________________________________________________________________ Question 79 : Which of the following statements concerning the treatment of fibromyalgia syndrome is true? Answers: a. There is currently no cure for the disorder; however, patients should be made aware that symptom relief is possible. b. Treatment is directed toward controlling discomfort, improving sleep, and maintaining function. c. Fibromyalgia syndrome can be difficult to manage, requiring a variety of approaches and multiple medications. d. All of the Above __________________________________________________________________________ Question 80 :The clinician should prescribe an antibiotic that covers which of these organisms for a patient with acute prostatitis? Answers: a. Gram-positive cocci b. Gram-negative cocci c. Gram-positive bacillus d. Gram-negative bacillus _________________________________________________________________________ Question 81 : Which household solution should be used to clean a bathroom if sharing with a friend who has HIV? Answers: a. 100% bleach b. 50% bleach and 50% vinegar c. Nine parts H2O to one part bleach d. The friend must have his or her own bathroom. _________________________________________________________________________ Question 82 : Sandra is 42 years old and has just been diagnosed with leukemia. She is complaining of bone and joint pain. Which type of leukemia is most likely the culprit? Answers: a. Acute lymphocytic leukemia b. Acute myelogenous leukemia c. Chronic myelogenous leukemia d. Chronic lymphocytic leukemia ________________________________________________________________________ Question 83 : Which of the following is identified as an eating disorder in which a person craves food substitutes, such as clay, ice chips, and cotton, and is considered an objective finding associated with severe iron deficiency? Answers: a. Ferritin b. Porter's syndrome c. Hypochromasia d. Pica ______________________________________________________________________________ Question 84 : The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit? Answers: a. High sensitivity thyroid-stimulating hormone (TSH) and free T4 b. Free T4 and serum calcium c. Free T3 and T4 d. TSH and thyroxin ______________________________________________________________________________ Question 85 : The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been effective? Answers: a. "As long as I don't need glasses, I don't have to worry about going blind." b. "I know I need to have my eyes checked every year." c. "My optometrist checks my eyes." d. "I will see my eye doctor when my vision gets blurry." ______________________________________________________________________________ Question 86: Triggering factors for acute exacerbations of which of the following conditions include exposure to ultraviolet (UV)- B and UV-A rays? Answers: a. Rheumatoid arthritis b. Scleroderma c. SLE d. Sjögren's syndrome ______________________________________________________________________________ Question 87 : Which of the following characteristics separates anaphylaxis from a vasovagal reaction? Answers: a. Bradycardia b. Extreme diaphoresis c. Severe bronchoconstriction d. Hypotension ______________________________________________________________________________ Question 88 : Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The clinician has explained to Mr. Jackson that the goals for managing osteoarthritis include controlling pain, maximizing functional independence and mobility, minimizing disability, and preserving quality of life. Mr. Jackson explains to the clinician that his first choice would be to use complementary therapies to control his condition and asks what therapies are most effective in treating osteoarthritis. What would be the most appropriate response from the clinician? Answers: a. "Complementary therapies should be considered only if surgical interventions are not successful." b. "I am unfamiliar with the available complementary therapies for osteoarthritis and prefer to discuss more mainstream treatments, such as NSAIDs and physical therapy, to manage your condition." c. "I would be happy to discuss all the treatment options available to you. Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being studied for use in the treatment of osteoarthritis and have shown promise when used with standard medical therapy." d. "It would be crazy to use complementary therapies to treat such a serious condition." ______________________________________________________________________________ Question 89 One benefit of motivational interviewing (MI) is: Answers: a. It assumes that ambivalence is a normal part of the change process. b. It can be utilized during routine office visits. c. It is a therapeutic technique which is not necessarily time intensive. d. All are benefits of MI. ______________________________________________________________________________ Question 90 : What percentage of burns is involved using the rule of nines if both front legs are burned? Answers: a. 9% b. 18% c. 24% d. 36% ______________________________________________________________________________ Question 91 : Women are at the highest risk for developing postpartum depression for up to how long after childbirth? Answers: a. 2 weeks b. 1 month c. 3 months d. 6 months ______________________________________________________________________________ Question 92 : Which statement about HIV post exposure prophylaxis (PEP) for health-care workers is the most accurate? Answers: a. PEP should be started within hours of exposure. b. PEP should be started within 72 hours of exposure. c. Renal and hepatic function tests should be done 6 weeks after beginning PEP. d. PEP will prevent potential hepatitis C infection if present. ______________________________________________________________________________ Question 93: The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an x- ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane's description of her injury. Which of the following clues in Diane's examination or history would alert the clinician to the need for obtaining radiographs? Answers: a. Inability to bear weight immediately after the injury b. Development of marked ankle swelling and discoloration after the injury c. Crepitation with palpation or movement of the ankle d. All of the above ______________________________________________________________________________ Question 94 : A vegetarian patient with gout asks the clinician about food he should avoid. The clinician should advise the patient to avoid which of the following foods? Answers: a. Rice b. Carrots c. Spinach d. Potatoes ______________________________________________________________________________ Question 95 : A patient with a basilar skull fracture may experience an impaired downward gaze or diplopia from which affected cranial nerve? Answers: a. CN II b. CN III c. CN IV d. CN V ______________________________________________________________________________ Question 96 : A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack? Answers: a. Pheochromocytoma b. Hyperthyroidism c. Cardiac arrhythmias d. All of the above ______________________________________________________________________________ Question 97: Which test is used to confirm a diagnosis of epididymitis? Answers: a. Urinalysis b. Gram stain of urethral discharge c. Complete blood cell count with differential d. Ultrasound of the scrotum ______________________________________________________________________________ Question 98: BATHEing the patient refers to: Answers: a. A technique used in primary care to get the patient to accept the need for psychological or psychiatric referral b. A technique used to facilitate cultural understanding c. A technique used to perform psychotherapy d. A technique that is a quick screen for psychiatric issues and interventions for psychological problems ______________________________________________________________________________ Question 99: BATHEing the patient is an advanced practice nursing intervention that allows the practitioner to: Answers: a. Develop a therapeutic relationship without "owning” the patient's problem b. Conduct psychological counseling within the context of the primary care encounter c. Focus on the "process" and not the assessment d. Make the patient and family happier ______________________________________________________________________________ Question 100 : A 45-year-old woman is seen in the clinic with abnormal uterine bleeding and pain during intercourse. The clinician should consider which of the following diagnoses? Answers: a. Leiomyoma b. Pregnancy c. Ovarian cancer d. All of the above