CMN 577 Final Exan Study Guide Highlighted Answers Fall 2020 Unit 7 Questions

CMN 577 Final Exan Study Guide Highlighted Answers Fall 2020 Unit 7 Questions 1. Knowing that treatment for deep vein thrombosis (DVT) involves administration of anticoagulants, which of the following patients can be safely treated for DVT in the outpatient setting? A. an 80-year-old woman who weighs 42 kg B. a 22-year-old man who had an appendectomy 2 days ago C. a 32-year-old woman with peptic ulcer disease D. a 55-year-old man with lung cancer in remission 2. The nurse practitioner is examining a 65-year-old man with a history of type 2 diabetes mellitus and a complaint of cramping pain in his calves when walking. The patient reports the pain is alleviated with rest but returns when the patient must walk again. The nurse practitioner expects to find all of the following on exam consistent with the diagnosis of peripheral artery disease, except: A. weak or absent dorsalis pedis pulses B. large ulcerations at the medial ankles C. bruits over the femoral arteries D. an ABI of 0.6 3. A 43-year-old female presents with complaints of weight gain, constipation, memory fog, and fatigue. Her labs reveal a TSH of 6.7 and Free T4 of 5. Your plan for this patient includes: A. Her labs are within normal range, and no treatment is needed. B. Start her on Synthroid at 1.6mcg/kg/day and recheck labs in 4-6 weeks. C. Instruct her to take her Synthroid on a full stomach for best absorption. D. Start her on Synthroid at 0.8mcg/kg/day and recheck labs in 2 weeks. 4. Cigarette smoking may falsely increase the levels of: A. gamma-glutamyl transpeptidase B. sodium and potassium concentrations C. hepatic enzymes D. serum protein electrophoresis 5. A 75-year-old female patient who is healthy and active reports that she has recently been having trouble getting to the bathroom on time to urinate and also has some leaks when she sneezes or coughs. She reports having to wear an incontinence pad daily. She is very independent and is embarrassed and worried that this is going to affect her lifestyle. As her provider, your best next steps for this patient would be: A. Refer her to urology, her symptoms will only get worse and she will more than likely need surgery B. Suggest bladder training and pelvic floor muscle exercises (Kegel’s) to decrease incidences of stress and urge incontinence C. Prescribe an antimuscarinic agent such as oxybutynin immediately D. Schedule the patient for insertion of a pessary 6. A 40-year-old female waitress presents to the clinic complaining of pain, burning, and tingling in her hands and fingers. She reports the symptoms are most bothersome at night. The NP has carpal tunnel syndrome as a differential diagnosis. All of the following are used to rule in or out this diagnosis EXCEPT: A. Tinel test B. Phalen test C. Spurling test D. Carpal compression test 7. A 66-year-old Hispanic female presents with a two-year history of detrusor overactivity or “urge incontinence. She has been treated by a physical therapist with bladder training therapy for one year, buts fail to provide appropriate relief. The next possible treatment would be: A. Tolterodine 1-2 mg orally 2x daily B. Oxybutynin 2.5 – 5mg orally 2-3x daily C. Refer to OB/Gyn for a pessary fitting D. All of the above 8. A 23-year-old male patient presents to the clinic with complaints of fever, irritative voiding symptoms, and perineal/suprapubic pain for 2 days. On exam, the CBC shows leukocytosis and a left shift. UA is positive for pyuria and bacteriuria. There is no CVA tenderness or painful scrotal enlargement. The NP suspects the patient has which of the following diagnosis? A. Acute Bacterial Prostatitis B. Chronic Bacterial Prostatitis C. Acute Epididymitis D. Prostatodynia 9. A 24-year-old female who identifies as a lesbian, presents for her annual wellness visit. She has multiple female sexual partners. She did not receive the HPV vaccine and has not had a cervical cancer screening since she was 21 years old. Which of the following is not recommended in the treatment plan for this patient? A. HPV vaccination series B. Papanicolaou (PAP) smear with HPV co-testing C. Chlamydia trachomatis and Neisseria gonorrhea testing D. Screen for Intimate Partner Violence (IPV) 10. All of the following can help reduce the risk of adolescents developing STIs EXCEPT: A. a monogamous sexual relationship with one partner B. the use of a condom C. abstinence D. birth control 11. A 57-year-old female comes into the clinic with complaints of hot flashes and vaginal dryness. She is a smoker and has hypertension. When giving her hormone replacement options, the NP informs her best option is: A. Oral estrogen B. Oral estrogen with progesterone C. Estradiol injections D. Transdermal estrogen 12. When evaluating a patient with intermittent claudication, the Nurse Practitioner would expect to find all the following except: A. Diminished femoral pulses B. An ankle-brachial index of 1.0 C. Reproducible pain in the calf muscles when walking D. An ankle-brachial index of 0.8 13. A 17-year-old sexually active female presents to the clinic with complaints of vaginal pruritis, dysuria, and a thick, greenish, malodorous discharge. After further testing, it is confirmed that she is positive for Trichomoniasis. Which of the following treatment options would the NP choose for this patient? A. Ceftriaxone, 250 mg IM x 1 and Azithromycin, 1 g orally as single dose B. Metronidazole, 2 g orally as single dose C. Azithromycin, 1 g orally as single dose D. Benzathine penicillin G, 2.4 million units IM 14. A woman presents to the clinic at 12 weeks gestation. She has a history of preeclampsia with a previous pregnancy. The NP should consider prescribing which of the following? A. low salt diet B. vitamin C C. hydrochlorothiazide D. low dose aspirin 15. Jane is 26 weeks pregnant. Her 50-g one-hour oral glucose tolerance test results at 164 mg/dL. What is the NP’s next step? A. start Jane on metformin B. start Jane on insulin C. order a 100-g oral glucose tolerance test D. inform Jane that her results are normal 16. A 50-year-old white male presents to the clinic for a recheck of his recent acute attack of Gouty Arthritis. He explains that the gouty attacks occur as a painful, red, and swollen right great toe. He states this has happened several times this year. He was treated for the acute attack, but he is interested in having a medication to take every day to keep this from happening so much. PMH for this patient includes moderate kidney disease. Which is the best way to prescribe Colchicine for this patient? A. Colchicine 1.2mg po x 1, then 0.6mg po BID. B. Colchicine 1.2mg po q day. C. Colchicine 0.6mg po QOD. D. Colchicine 0.6mg po BID.