 NURSING MISC Predictor Study Guide 2

 NURSING MISC 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 aggressive antibiotic therapy 10.A positive drawer sign support a diagnosis of ate 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? ylic 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? ribe 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) chlorothiazide (HCTZ) and spironolactone (Aldactone) c.Spironolactone (Aldactone) chlorothiazide (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: er he smokes or consumes alcohol on a daily basis other medications have been prescribed for him he takes a daily antihistamine 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 ased 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? cillin (Amoxil) romycin 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 30.Certification for nurse practitioners is offered through: c. national certifying organizations 31.Simple cases of impetigo and folliculitis are usually successfully treated with: mic antibiotics al antibiotics 32.A 43-year-old has chronic gout. He comes to the clinic for the 3rd time in as many months for treatment of an exacerbation. Dietary counseling should include avoidance of all of the following EXCEPT: c. green, leafy vegetables 33.A 57-year-old patient presents for an annual physical exam. He reports having 3 attacks of acute gout during the past year. He does not take any medication except NSAIDs during the attacks which help “a little bit.” The NP would appropriately recommend c. avoidance of dietary purine sources 34.A 43-year-old male presents with a large and painful furuncle, the 3rd one in the past 6 months. The NP should _?_ all of the following EXCEPT: b. prescription of a prophylactic antibiotic 37.A 64-year-old female has sudden onset of right eye pain, blurred vision, and dilated pupil. The most likely diagnosis is acute: b. angle-closure glaucoma 38.A 25-year-old patient presents with complaints of pain and burning in the vulvar area. Upon examination, the NP notices vesicles with an erythematous base arranged ina group on the patient’s labia major. The most likely diagnosis is: d. herpes simplex II 39.An 85 – year-old is diagnosed with shingles. The patient states that she became “miserable” yesterday when the symptoms started. What pharmacologic interventions should the nurse practitioner offer this patient? c. Oral acyclovir (Zovirax) for 7-10 days, NSAIDs, and topical capsaicin cream after resolution of the lesions 40.A 16-year-old presents to the clinic for a scheduled immunization. The patient is unaccompanied by an adult. The NPs action is based on the knowledge that: a.a minor must have the informed consent of a parent or guardian to receive an immunization 41.The mechanism by which nurses are held accountable for practice, based on the quality of nursing car ein a given situation inaccordance with established standards of practice, is: c. peer review 42.A 52- year-old female has a firm, non-tneder, one centimeter mass in the RLQ of her breast. There are no palpable axillary lymph nodes. A mammogram the month before her examination was netative. The most appropriate nurse practitioner action today is to: c. schedule an ultrasound of the breast 43.Which of the following is NOT a characteristic of the S3 heart sound? d. An S3 is fairly common in children, young adults, and females in the last trimester of pregnancy 44.A characteristic of elders which affects the pharmacotherapeutics of drug therapy in that population is an increase in: d. percent of body fat 45.The AUDIT questionnaire is useful to assess: ol use disorders 46.A 32- year-old mother and her 10-year-old child each have a 10 cm round, reddened patch on the trunk. There is central clearing in the lesion. Different lesions run parallel to each other in a Christmas tree pattern. The mother has been treating the “ringworm” with an anti-fungal cream for 7 days without success. The NP best response is: b. No medication will help this to clear. It must clear on its own and may take 4-8 weeks . 47.For the general adult population, total dietary fat intake should be no more than what percent of total calories? c. 30% 48.A 23-year-old female college student is being evaluated by the nurse practitioner for immunization status. She has documentation of completion of IPV, DTaP, and MMR series. She states “I got a shot when I was 12 years old, but none since.” Which vaccine(s) should she receive today? d. Td and HBV 49.Which of the following patients is most likely to have a diagnosis of Type 2 diabetes mellitus? b. A 49-year-old male with impotence and HbAIC 10.0% 50.Which of the following findings is consistent with otitis externa? d. pain 51.The most effective primary prevention of skin cancer is to educate the public about: d. limiting exposure to natural solar radiation 52.Which of the following is NOT a symptom of irritable bowel syndrome? d. Weight loss 53.An 18-year-old woman is taking a combined hormonal oral contraceptive. She should be instructed to use a backup method for the prevention of pregnancy: b. if prescribed topiramate (Topamax) for the treatment of migraines 54.A 50-year old patient has abnormal vaginal bleeding with heavy periods and intermenstrual watery discharge with a small amount of blood. What is the most likely diagnosis? ne fibroids l peri-menopause c. endometrial cancer d. cervical cancer 55.Which agent is most effective for the treatment of nodulocystic acne? d. isotretinoin (Accutane) 56.Which of the following signs and symptoms is typical of hyperthyroidism? intolerance 57.An 83-year-old man has a resting hand tremor. What disease process is this type of tremor is most commonly associated with? a.Multiple sclerosis (MS) b.Parkinson’s disease tic neuropathy 58.A young female reports onset of right flank pain 2 days ago that is now severe. Last night she discovered a “burning rash” in the same area. The NP identifies popular fluid-filled lesions that are confluent and follow a linear distribution along the T-8 dermatome. The NP would appropriately order: c. an oral antiviral d. a topical steroid cream 59.Expected spirometry redings when the patient has chronic emphysema include: d. increased total lung capacity (TLC) 60.Right-sided heart failure is characterized by all of the following clinical findings EXCEPT: Answer: a 4th heart sound 61.Moderate weight loss, particularly of visceral adipose tissue, in patients with Type 2 diabetes mellitus may have all of the following beneficial effects EXCEPT: c. increased lean muscle mass d 62.Nurse practitioner services are filed with Medicare for reimbursement paid by Medicare Part B 63.Which of the following drugs has a beneficial effect on benign prostatic hyperplasia? osin (Cardura) 64.A 46-year-old female has hypertension and is well managed with propranolol (Inderal). Which of the following is a beneficial secondary effect of this drug? d. migraine prophylaxis 65.The finding which is most consistent with a diagnosis of benign prostatic hyperplasia is digital palpation of a prostate gland that is: ged, symmetrical, semi-firm, and non-tender ged, symmetrical, boggy, and exquisitely tender 66.A 20-year-old male complains of a “skin rash” on his knees and elbows. The lesions have silvery scales and are pruritic. A positive Auspitz sign is present. What is the most likely diagnosis? d. psoriasis 67.The daughter of a 75-year-old patient reports that her mother roams the house at night saying she cannot fall asleep. She has fallen twice. Of the following choices, which would be the most appropriate to treat her insomnia? in (Sinequan) 68.A 65-year-old African American patient was screened at his local church for “high cholesterol.” His total cholesterol (no-fasting) was 215 mg/dL (5.6 mmol/L). What action below is most appropriate for the NP? a.Recommend a fasting lipid profile 69.Swan neck and boutonniere deformities are typical clinical findings in the later presentation of: arthritis atoid arthritis 70.A 13- year-old patient complains the he fell while running during football practice. Now his knee hurts and sometimes “locks.” The NP conducts McMurray’s test. Which of the following is TRUE about this test? audible or palpable click is positive for a torn meniscus 71.A hemoglobin AIC level is 7.2 in a patient with Type 2 diabetes mellitus. The patient is currently taking a sulfonylurea medication. Which of the following drug should be added next to the medication regime? d. Metformin (Glucophage) 72.A patient with a diagnosis of giardiasis is being treated with metronidazole (Flagyl). What information would be important to obtain before prescribing this medication? c. if the patient drinks alcohol 73.The nurse practitioner is performing a routine assessment of a 47-year-old female who wants to lose weight She has truncal obesity with relatively slender forearm and lower legs. Her BMI is 38. Upon review of her history, physical examination, and laboratory reports, the nurse practitioner diagnoses “Syndrome X.” This diagnosis is based on the previous findings plus all of the following EXCEPT: d. cardiac arrhythmias 74.A 59-year-old postmenopausal woman has atrophic vaginitis. She has a history of breast cancer at age 40 years. What is the appropriate initial treatment for this patient? d. Topical conjugate estrogen cream 75.The process by which a profession association cofers recognition that a licensed profession has demonstrated mastery of a specialist body of knowledge and skills is termed: c. certification 76.A nurse practitioner has just diagnosed a patient as having acute hepatitis B. The principle which prohibits the nurse practitioner from notifying the patient’s spouse without permission is: d. confidentiality 77.A 43-year-old female patient complains of dull ache around both ankles after a day’s work as a cashier. Her symptoms are relieved by sitting and elevating her legs. She reports ankle edema at the end of the day. What is the most likely cause of these problems? ose veins 78.Which of the following are characteristic of patients with Type 2 diabetes mellitus? 1. Beta cell destruction 2. High body mass 3. Central obesity 4. Unexplained weight loss a. 1,2,3 b. 2,3 c. 1,4 79.The sexual partner of a symptomatic male patient with gonorrhea should be empirically treated: c. with ceftriaxone and doxycycline (Vibramycin) 80.A patient on oral contraceptives complains of breast fullness, tenderness, and some nausea. The patient is concerned. How should the NP manage this? b. change the pill to one containing less estrogen 81.A 62-year-old with Type 2 diabetes mellitus complains of increased nocturia, fatigue, and weakness. His fasting blood glucose is 110 mg/dL (6.2 mmol/L), he is slightly anemic and his serum creatinine level is slightly elevated. All other laboratory tests and physical examination are within normal limits. What is the most likely diagnosis? d. renal insufficiency 82.A 23-year-old female presents with scaly hypo-pigmented macular lesions on her trunk, shoulders, and upper arms. The lesions fluoresce under Wood’s lamp. Appropriate treatment for this condition is: a.Apply selenium sulfide (Versel) lotion and allow to dry for 10 minutes, then rinse off 83.The goals of treatment for patients with alcohol abuse disorder are: c. abstinence or reduction in sue, relapse prevention and rehabilitation d. marital satisfaction, improvement in family functioning, and reduction in psychiatric impairment 84.Which of the following drug classes may potentiate hyperkalemia in a patient taking a potassium- sparing supplement? ide diuretic tensin-converting enzyme inhibitor 85.A patient has laboratory studies performed which demonstrate increased TSH, decreased free T4, and T3. Which symptoms might she complain of? d. hair loss 86.The anatomical site currently believed to be the best location for subcutaneous insulin administration is the c. abdomen 87.Following the finding of prostate gland abnormalities on DRE, the nurse practitioner orders appropriate labs. When preparing to review lab reports with the patient, the NP know all of the following are true EXCEPT: l PSA is 10 mg/ml or less 88.An obese 43-year-old has recurrent superficial fungal skin infections over the past 2 years. Today, she presents with intertriginous candida. Her skin is macerated from frequent rubbing and scratching. The plan of care for this patient should include: mended screening for diabetes mellitus and HIV infection 89.Which statement is true regarding dental health? a.a diet high in sugar has no effect on dental caries iduals with dentures should visit the dentist every 2 years 90.A 51-year-old post-menopausal female, requests guidance regarding osteoporosis risk. The NP would be correct to recommend all of the following EXCEPT: d. weight loss 91.When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action? abdominal x-rays abdominal ultrasound 92.Which of the following is NOT an appropriate treatment for chronic bacterial prostatitis (CBP) d. nitrofurantoin (Macrobid) 93.The first step when taking a patient history is the c. introductory information 94.Characteristics of prescription and OTC drug use in the elder population include all of the following EXCEPT: incidence of drug reactions ple prescribers and polypharmacy 95.The nurse practitioner wants to assess intactness of a patient’s cerebellar function. Which of the following clinical tests will provide information relative to cerebellar function? thesia ognosis c.Romberg 96.A 57-year-old patient with known diverticulosis presents with fever, leukocytosis, and bright red rectal bleeding. The nurse practitioner’s least appropriate action at this time is: d. education regarding low fiber diet 97.A 41-year-old woman presents with multiple painful vesicular lesions in the vulvar area She has been with the sexual partner for 21 years. Which of the following is the MOST likely diagnosis?