NSG 6340 PREDICTOR STUDY GUIDE 2

NSG 6340 PREDICTOR STUDY GUIDE 2 1. A 37-year-old female patient with a history of a single episode of depression and frequent complaints of PMS is being treated for hypothyroidism. Today she complains of poor concentration and fatigue. Initially, the NP should: a. Question her further 3. Which of the following is an example of secondary prevention? a. Annual influenza vaccination 7. A 35-year old female with a history of mitral valve prolapse is scheduled for routine dental cleaning. According to the 2007 American Association’s guideline for endocarditis prophylaxis, what would you advise this patient? a. She does not need prophylaxis for any dental procedure b. 8. A patient recovering from a recent stroke is starting anticoagulant therapy. The nurse practitioner should teach the patient to avoid all of the following EXCEPT: a. b. milk and milk products 9. A patient presents with periorbital erythema and edema, fever, and nasal drainage. The nurse practitioner should a. start aggressive antibiotic therapy 10. A positive drawer sign support a diagnosis of b. cruciate ligament injury 11. A 50-year-old patient with diabetes complains of pain bilaterally in her lower legs while walking. The pain disappears at rest. What else would you expect to identify on her lower extremities. b. peripheral artery insufficiency 12. A 16-year-old athlete complains of pain underneath his heel every time he walks. There is a verrucous surface level with the skin of the heel. What pharmacologic interventions should the nurse practitioner prescribe for this patient? a. salicylic acid plasters 13. A -year-old with Type I diabetes has had itching and burning lesions between her toes for 6 months. Scrapings of the lesion confirm the diagnosis of tinea pedis. What is the best treatment option for this patient? a. prescribe an anti-fungal powder for application between her toes and in her shoes and a topical prescription strength anti-fungal cream for other affected areas. Monitor for a secondary bacterial infection. c. Prescribe an oral anti-fungal for 4 to 12 weeks. Monitor liver enzymes, BUN and creatinine at one week, 2 weeks, and every month thereafter. d. Prescribe a prescription strength antifungal/steroid combination cream. Monitor for a secondary bacterial infection. 14. What is an appropriate drug for prophylactic treatment of migraine headaches in a 21-year-old female? a. Sumatriptan (Imitrex) b. propranolol (Inderal) c. ibuprofen (Motrin) d. dihydroergotamine (DHE) 15. Which of the following are the classic features of ulcerative colitis? a. RLQ pain, frequently accompanied by a palpable mass, fever, and leukopenia b. Massive painful hematemesis, occasionally accompanied by melena c. Rapidly progressive dysphagia to solid foods, anoriexia, and weight loss out of proportion to the dysphagia d. Remission and exacerbations of bloody diarrhea, tenesmus, fecal incontinence, abdominal pain, and . 16. Which drugs below would be expected to produce the least amount of hypokalemia? a. Furosemide (Lasix) b. hydrochlorothiazide (HCTZ) and spironolactone (Aldactone) c. Spironolactone (Aldactone) d. hydrochlorothiazide (HCTZ) 17. What information should patients with diabetes and their families receive about hypoglycemia? a. Hypoglycemia is very rare b. Hypoglycemia requires professional medical treatment c. Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly d. Hypoglycemia occurs only as a result of overdose of insulin 18. A 60-year-old male patient with a past history of glaucoma and frequent sinusitis presents today with hypertension. On his last 2 visits to the clinic his blood pressures were 150-160/90-98. The nurse practitioner decides to treat the hypertension with long-acting propranolol (Inderal). Before prescribing it, the nurse practitioner should ask: a. whether he smokes or consumes alcohol on a daily basis b. what other medications have been prescribed for him c. if he takes a daily antihistamine d. if other family members are hypertensive 19. Which of the following is NOT associated with Type 2 diabetes mellitus? a. Gestational diabetes, birth of a macrosomic infant b. Hispanic, African-American, or Native American descent c. Alcohol or other drug abuse d. Obesity, hypertension, hypertriglyceridemia 20. A 35-year-old male presents with a severe unilateral headache over his left eye. He says it started about one hour ago and has rapidly gotten worse. He gives a history of similar headaches over the past 2 years. Physical examination is negative except for left eye lacrimation. What is the most likely diagnosis? c. Cluster headache d. Classic migraine headache 21. A 16-year-old sexually active female present to the clinic. She has never had vaccination for hepatitis A or B, she has had one MMR immunization, and her last tetanus vaccination was 4 years ago. Which vaccination would be contraindicated without further testing? c. MMR 22. A 15-year-old male presents with abdominal pain that began in the peri-umbilical area then localized to the right lower quadrant. He complains of nausea, vomiting, anorexia, and low-grade fever. A complete blood count (CBC) reveals moderate leukocytosis. What is the most likely diagnosis? d. Acute appendicitis 23. A 25-year-old hypertensive patient has a BMI of 16. His blood pressure is 165/100. There is an audible bruit in his left upper abdominal quadrant. He probably has: a. Essential hypertension b. Secondary hypertension 24. Which of the following is the most common presenting sign of substance abuse in adolescents? d. changes in behavior 25. Therapeutic international normalized ratio (INR) for a patient takein warfarin (Coumadin) for chronic atrial fibrillation is expected to be a. increased 26. A 199-year-old female reports that she is having “panic attacks.” The NP knows that panic attacks are characterized by d. sudden onset of intense fear or terror 27. A 25-year-old complains of fever and throat pain. The tonsils have exudate bilaterally. The patient describes having an anaphylactic reaction to penicillin in the past. What antibiotic should the NP prescribe if she believes the causative agent is bacterial? a. amoxicillin (Amoxil) b. erythromycin 28. A diagnostic finding of Hodgkin’s lymphoma is the presence of b. Reed-Sternberg cells 29. With a history of ankle sprain, the nurse practitioner would most likely elicit a history of d. ankle inversion