NR 511 /NR511 MIDTERM EXAM 2024 ACTUAL 2 VERSIONS WITH OVER 350 QUESTIONS WITH DETAILED VERIFIED ANSWERS AND RATIONALES/ BRAND NEW!! /A+ GRADE ASSURED

You are the nurse practitioner caring for Martha, a 47-yearold accountant. You have made a diagnosis of acute sinusitis based on Martha's history and the fact that she complains of pain behind her eye. Which sinuses are affected? 1.Maxillary. 2.Ethmoid. 3.Frontal. 4.Sphenoid - ...ANSWER...ethmoid Rationale: With ethmoid sinus problems, the pain is felt behind the eye and high on the nose A 25-year-old client who plays in a band complains that he finds it difficult to understand his fellow musicians at the end of a night of performing, a problem that is compounded by the noisy environment of the club. These symptoms are most characteristic of which of the following? 1.Sensorineural loss. 2.Conductive loss. 3.Tinnitus. 4.Vertigo. - ...ANSWER...sensorineural hearing loss Rationale: Sensorineural loss comes from exposure to loud noises, inner ear infections, tumors, congenital and familial disorders, and aging. The results of the Weber and Rinne tests will assist in the diagnosis Mandy, 44, was given a diagnosis of flu 1 day ago and wants to start on the "new flu medicine" right away. What do you tell her? 1."The medication is effective only if started within the first 72 hours after symptoms begin." 2."If you treat a cold, it goes away in 7 days; if you don't treat it, it goes away in 1 week." 3."The medicine has not proven its effectiveness." 4. "I'll start you on oseltamivir (Tamiflu) today. It may shorten the course of the disease and perhaps lessen the severity of your symptoms." - ...ANSWER..."I'll start you on oseltamivir (Tamiflu) today. It may shorten the course of the disease and perhaps lessen the severity of your symptoms. Rationale: Two antiviral drugs, oseltamivir (Tamiflu), a pill taken by mouth, and zanamivir (Relenza), an inhaled medication, are particularly effective against the influenza viruses that cause the flu. If the virus causing the flu is type A influenza, the client may benefit from either one of these drugs Marjorie, age 37, has asthma and has been told she has nasal polyps. What do you tell her about them? 1.Nasal polyps are usually precancerous. 2.Nasal polyps are benign growths. 3.The majority of nasal polyps are neoplastic. 4.They are probably inflamed turbinates, not polyps, because polyps are infrequent in clients with asthma. - ...ANSWER...Nasal polyps are benign growths Rationale: Nasal polyps are benign growths that occur frequently in clients with sinus problems, asthma, and allergic rhinitis. Polyps are neither neoplastic growths nor precancerous, but they do have the potential to affect the flow of air through the nasal passages. Clients who have asthma and have nasal polyps may have an associated allergy to aspirin, a syndrome that is referred to as Samter triad Nystatin (Mycostatin) is ordered for Michael, a 56-year-old banker who has an oral fungal infection. What instructions for taking the medication do you give Michael? 1."Dilute the oral medication with one tablespoon of water for easier digestion." 2."Take the medication with meals so that it's absorbed better." 3."Swish and swallow the medication." 4."Apply the medication only to the lesions. - ...ANSWER..."Swish and swallow the medication." Rationale: When ordering nystatin (Mycostatin) for an oral fungal infection, tell the client to swish the medication in the mouth to coat all the lesions and then to swallow it. Erica, age 39, has a sudden onset of shivering, sweating, headache, aching in the orbits, and general malaise and misery. Her temperature is 102°F. The nurse practitioner diagnosed her with influenza (flu). What is your next course of action? 1.Order amoxicillin (Amoxil) 500 mg every 12 hours for 7 days. 2.Prescribe rest, fluids, acetaminophen (Tylenol), and possibly a decongestant and an antitussive. 3.Order a complete blood count (CBC). 4.Consult with your collaborating physician - ...ANSWER...Prescribe rest, fluids, acetaminophen (Tylenol), and possibly a decongestant and an antitussive. Rationale: Management of flu is generally symptomatic and includes rest, fluids, acetaminophen (Tylenol), and possibly a decongestant and an antitussive. The client should be advised to call or return to the clinic in 4 days if symptoms are not improving April, age 50, presents with soft, raised, yellow plaques on her eyelids at the inner canthi. She is concerned that they may be cancerous skin lesions. You tell her that they are probably: 1.Xanthelasmas. 2.Pingueculae. 3.The result of arcus senilis. 4.Actinic keratoses - ...ANSWER...xanthelasmas Rationale: Xanthelasmas are soft, raised, yellow plaques on the eyelids at the inner canthi. They appear frequently in women, in their 50s. Xanthelasmas occur with both high and normal lipid levels and have no pathological significance Which manifestation is noted with carbon monoxide poisoning? 1.Circumoral pallor of the lips. 2.Cherry-red lips. 3.Cyanosis of the lips. 4.Pale pink lips - ...ANSWER...cherry-red lips Rationale: Cherry-red lips are a manifestation of carbon monoxide poisoning. They also occur with ketoacidosis or acidosis from aspirin poisoning The most common cause of a white pupil (leukokoria or leukocoria) in a newborn is: 1.A congenital cataract. 2.Retinoblastoma. 3.Persistent hyperplastic primary vitreous. 4.Retinal detachment - ...ANSWER...congenital cataract Rationale: The most common cause of a white pupil (leukokoria or leukocoria) in a newborn is a congenital cataract. The incidence may be as high as 1 in every 500 to 1000 live births, and there is usually a family history. Some infants require no treatment; however, in other cases surgery may be performed during the first few weeks of life Ellen, a 56-year-old social worker, is seen by the nurse practitioner for complaints of fever; left-sided facial pain; moderate amounts of purulent, malodorous nasal discharge; and pain and headache when bending forward. The symptoms have been occurring for approximately 6 days. On physical assessment, there is marked redness and swelling of the nasal passages and tenderness/pain on palpation over the cheekbones. The nurse practitioner should suspect: 1.Dental abscess. 2.Acute rhinosinusitis. 3.Chronic rhinosinusitis. 4.Nasal tumor - ...ANSWER...Acute rhinosinusitis Rationale: The client is exhibiting classic characteristics of acute rhinosinusitis