NUR 6531 PRIMARY CARE OF ADULTS ACROSS THE LIFESPAN MIDTERM EXAM QUESTIONS & ANSWERS 2023/2024 UPDATE GRADED A+

NUR 6531 PRIMARY CARE OF ADULTS ACROSS THE LIFESPAN MIDTERM EXAM QUESTIONS & ANSWERS 1. What is the purpose of clinical research trials in the spectrum of translational research? Examination of safety and effectiveness of various interventions 2. What is the purpose of Level II research? To describe relationships among characteristics or variables 3. The care provided by APRNs is not limited by setting but by patient care needs. A. B. False 4. APRN Consensus Model/LACE include all except: A. Licensure B. Accreditation C. Certification D. It’s the one that stars with an E (Education) 5. All of the following are core quality competencies expected of APRNs except: A. Uses best evidence to improve care B. Assumes advanced leadership role C. Applies skills in peer review to promote culture of excellence D. Evaluates organizational structures to improved care 6. What was an important finding of the Advisory Board survey of 2014 about primary care preferences of patients? A. Associations with area hospitals B. Costs of ambulatory care C. Ease of access to care. D. The ratio of providers to patients 7. To reduce adverse events associated with care transitions, the Centers for Medicare and Medicaid Service have implemented which policy? A. Mandates for communication among primary caregivers and hospitalists B. Penalties for failure to perform medication reconciliations at time of discharge C. Reduction of payments for patients readmitted within 30 days after discharge D. Requirements for written discharge instructions for patients and d. caregivers 8. Rules proposed by the various State Boards of Nursing must be approved by the state Legislatures. A. True B. False 9. To reduce adverse events associated with care transitions, the Centers for Medicare and Medicaid Service have implemented which policy? 10. What was an important finding of the Advisory Board survey of 2014 about primary care preferences of patients? 11. The Consensus Model for APRN regulation consists of which of the following roles? A. CNM B. CRNA C. APN D. CNS E All the Above A, B & C F. only 12. In reviewing the Total Percentage of Body surface area for adult burn patients each, leg, arm and head are noted evaluated at 9%. A. True B. False 13. What is the initial approach when obtaining a biopsy of a potential malignant melanoma lesion? A. Excisional biopsy B. Punch biopsy C. Shave biopsy D. Wide excision 14. Which of the following are independent practice competencies for APRNs? A. Prescribes medications B. Functions as an independent practitioner C. Employs screening and diagnostic strategies to arrive at diagnoses D. Manages health/illness strategies of patients and families over time. E. All the Above F. A, C & D only 15. A female patient is diagnosed with androgenetic alopecia. Which medication will the primary health care provider prescribe? a. Anthralin b. Cyclosporine c. Finasteride d Minoxidil 16. Agnes is a 72 y/o grandmother who comes to the clinic with an acute onset of severe eye pain. She has been having headaches, nausea and vomiting, and seeing halos around lights. Eye exam reveals cupping of optic nerve the pupil is oval and the cornea is cloudy. Her most likely diagnosis is: 17. Mikey is a 19 y/o male who is brought to the clinic because he has a fever, sore throat, pain on swallowing and mildly enlarged submandibular nodes. The most likely diagnosis for Mikey is: 18. A 50-year-old, previously healthy patient has developed gastritis. What is the most likely cause of this condition? a. H. pylori infection b. NSAID use c. Parasite infestation d. Viral gastroenteritis 19. Which diagnostic test will the provider safely order for a 30-year-old woman reporting right upper quadrant abdominal pain, nausea, and vomiting? a. Abdominal computed tomography (CT) with contrast b. Abdominal ultrasound c. Magnetic resonance imaging (MRI) of the abdomen 20. A patient, who first developed acute diarrhea 2 weeks ago, presents to clinic reporting profuse watery, bloody diarrheal stools 6 to 8 times daily. The provider notes a toxic appearance with moderate dehydration. Which test is indicated to diagnose this problem? a. Qualitative and quantitative fecal fat b. Stool collection for 24-hour stool pH c. Stool sample for C. difficile toxin d. Wright stain of stool for white blood cells 21. A patient with a positive HbeAg indicates the patient has chronic Hepatitis B. A. True B. False 22. Classic pain of acute pancreatitis is severe midgastric pain that refers to the midback. A. True I think B. False 23. A patient with hemoptysis and no other symptoms has a normal chest radiograph (CXR), computed tomography (CT), and fiberoptic bronchoscopy studies. What is the next action in managing this patient? 24. Jeremy is an 18 y/o male who comes to the clinic with a chief complaint of periumbilical pain. Over the past 24 hours he has had bouts of nausea and diarrhea and pain at McBurney’s point. Which of the following assessments would aide in confirming Jeremy’s diagnosis: A. Psoas Sign B. Obturator Sign C. Murphy’s Sign D. All the Above E. A & B only Jeremy's symptoms suggest appendicitis, which is typically characterized by periumbilical pain that later localizes to McBurney's point (the point located roughly between the navel and the right hip). The Psoas sign and Obturator sign are physical examination techniques used to assess for appendicitis. The Psoas sign is positive if there is pain when the right thigh is passively extended with the patient lying on their left side, which indicates irritation to the iliopsoas group of hip flexors in the abdomen. The Obturator sign is positive if there is pain on the internal rotation of the right thigh, indicating irritation to the obturator internus muscle. On the other hand, Murphy's sign is used to assess for cholecystitis (gallbladder disease), not appendicitis. 25. A patient diagnosed with cirrhosis develops ascites. Which medication will be ordered initially to improve symptoms? a. Cephalosporin b. Furosemide c. Lactulose d. Spironolactone 26. Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some rhinitis and low-grade fever. His likely diagnosis is: A. Bronchitis B. Atypical Pneumonia (Walking pneumonia) C. Allergic Rhinitis D. Community acquired bacterial pneumonia 27. Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some rhinitis and low-grade fever. Potential organisms that might have caused Sam’s condition include which of the following: A. Mycoplasma pneumoniae B. Chlamydia pneumoniae C. Legionella pneumonia D. All the above E. None of the above 28. Martin is a 73 y/o male who has a 50 year/pack history of smoking and comes to the clinic for his annual physical. As you are leading him back to the exam room you note that he has dyspnea with minimal cough, a barrel chest, and appears to have lost weight since his last visit. Your physical exam confirms a 20 lb. weight loss, and a more noticeable pursed lip breathing. Your diagnosis is: A. Chronic Bronchitis B. Emphysema C. COPD 29. Mike is a 56 y/o male who lives in an abandoned building. With about 40 other street people. He comes to the clinic with a social worker who describes his symptoms as: a cough, dyspnea, pleuritic chest pain, fever and tachypnea. Your physical exam notes that he has some consolidation in the lower lobes with an audible friction rub. Based on the symptoms described, Mike is likely suffering from pneumonia. Explanation: Pneumonia is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus (purulent material), causing cough with phlegm or pus, fever, chills, and difficulty breathing. The symptoms Mike is experiencing, such as a cough, dyspnea (difficulty breathing), pleuritic chest pain (pain that worsens with breathing or coughing), fever, and tachypnea (rapid breathing), are all common symptoms of pneumonia.