Nrnp 6560 final exam latest real exam 250 questions and correct detailed answers (verified answers) |graded a+|| Walden university

Nrnp 6560 final exam latest 2024- 2025 real exam 250 questions and correct detailed answers (verified answers) |graded a+|| Walden university 1. QUESTION/ANSWER: T. O. is a 31-year-old male patient who is transported to the emergency department via emergency services. He was in a multivehicle accident and was trapped in a crushed car for more than 3 hours. On examination, his right lower extremity is found to be tensely swollen, with 3+ nonpitting edema. The lower leg is profoundly painful with passive range of motion. Given the history and physical findings, the AGACNP recognizes that treatment centers around: Fasciotomy Thrombolytics Surgical reduction Casting 2. QUESTION/ANSWER: While consulting on a patient who is admitted with a chief complaint of abdominal pain, the AGACNP notes that the initial assessment described the pain as “colicky.” This means that the pain: Is a result of gas in the bowel Is intestinal in origin Is characterized by pain-free intervals Is sharp, intense, and nonradiating 3. QUESTION/ANSWER: All of the following are expected findings in a patient with a T10 fracture except: Paraplegia Fecal retention Priapism Inability to move fingers 4. QUESTION/ANSWER: T. O. is a 44-year-old female patient who presents for evaluation of sudden, severe upper abdominal pain. She is clear about the onset, which was profound and occurred approximately one hour ago. She denies that the onset had any relationship to food or eating, and she denies nausea or vomiting. On examination, she is lying on her right side with her hips and knees flexed to draw her knees to her chest. Vital signs are stable, but examination reveals involuntary guarding. The abdomen is painful and tympanic to percussion in all quadrants. CBC reveals a white blood cell count of 15,600/μL. The AGACNP suspects: Dissecting aortic aneurysm Acute pancreatitis Perforated peptic ulcer MalloryWeiss tear 5. QUESTION/ANSWER: The AGACNP is covering an internal medicine service and is paged by staff to see a patient who has just pulled out his ET tube. After the situation has been assessed, it is clear that the patient will go into respiratory failure and likely die if he is not reintubated. The patient is awake and alert and is adamant that he does not want to be reintubated. The AGACNP is concerned that there is not enough time to establish a DNR—the patient needs to be reintubated immediately and already is becoming obtunded. Which ethical principles are in conflict here? Veracity and beneficence Beneficence and nonmalfeasance Autonomy and beneficence Justice and autonomy 1. QUESTION/ANSWER: You are asked to see a 29 year old female complaining of abdominal pain. She states she is experiencing constant RUQ pain that radiates to her back. The pain is not relieved by bowel movements, over the counter antacids or food. Review of initial labs shows elevated amylase and lipase and you diagnose her with acute pancreatitis. Which test will you order next to determine the underlying cause of her pancreatitis? serum cholesterol level blood toxicologyright upper quadrant ultrasound endoscopy 2. QUESTION/ANSWER: Jake is a 32-year-old patient who is recovering from major abdominal surgery and organ resection following a catastrophic motor vehicle accident. Due to the nature of his injuries, a large portion of his jejunum had to be resected. In planning for his recovery and nutritional needs, the AGACNP considers that: He will probably be able to transition to oral nutrition but will have lifetime issues with diarrhea His procedure has put him at significant risk for B12 absorption problems Most jejunum absorption functions will be assumed by the ileum Enteral nutrition will need to be delayed for 3 to 6 months to facilitate adaptation 3. QUESTION/ANSWER: A 32-year-old man comes to the clinic because he has had pain in the back for the past 24 hours. The patient says he first noticed the pain when he awoke in the morning and had difficulty getting out of bed. He had been playing flag football the day before the pain began but did not sustain any injuries during the game. Acetaminophen has provided only minimal relief of the patient's pain. On physical examination, pain is elicited on palpation of the back on the left, lateral to the region of L2-L5. Full range of motion is noted in vertebral flexion, extension, lateral rotation, and lateral bending, with some hesitancy because of pain on the left side. Which of the following is the most appropriate initial step? Anti-inflammatory and muscle relaxant therapy Epidural injection of a corticosteroid MRI of the lumbar spine Strict bed rest and application of moist heat to the lower back 4. QUESTION/ANSWER: On postoperative day 7 following hepatic transplant, the patient evidences signs and symptoms of acute rejection, confirmed by histologic examination. The AGACNP knows that first-line treatment of acute rejection consists of: Cyclosporine Azathioprine Methylpredniso lone Sirolimus 5. QUESTION/ANSWER: H. W. is a 33-year-old female who is being evaluated after a fall from a tree. Anteroposterior and lateral radiographs of the thoracolumbosacral spine are significant for transverse process fractures at T6 and T7. The AGACNP knows that treatment for this likely will include: Observation Hyperextension casting Jewett brace Surgical intervention 6. QUESTION/ANSWER: Acute hepatitis A is usually diagnosed by: By the constitutional symptoms Within 2 weeks of exposure Detection of IgMAnti- HAV Jaundice 7. QUESTION/ANSWER: A 30-year-old male patient presents for evaluation of a lump on his neck. He denies pain, itch, erythema, edema, or any other symptoms. He is ^concerned because it won't ^ go away. He says, “I noticed it a few months ago, then it seemed to disappear, and now it is back.” The AGACNP proceeds with a history and physical exam and concludes which of the following as the leading differential diagnosis? Subclinical infection Non- Hodgkin's lyphoma Catscratch disease Syphilis 8. QUESTION/ANSWER: P. E. is a 61-year-old female who presents for a postoperative visit following a gastric resection after a perforation of peptic ulcer. She reports feeling better, although it is taking longer than she expected. However, she says she is feeling better each day, her appetite is returning, and her incision is healing well. She is being discharged from surgical care and advised to continue her routine health promotion follow-up with her primary care provider. As part of her surgical discharge teaching, the AGACNP counsels P. E. that as a result of her gastric resection she will need lifelong follow-up of: Blood group substances Electrolyt es Vitamin B12 Gastric pH 9. QUESTION/ANSWER: In myelodysplastic syndromes, the primary indications for splenectomy include: Major hemolysis unresponsive to medical management Severe symptoms of massive splenomegaly Sustained leukocyte elevation above 30,000 cells/μL Portal hypertension 10. QUESTION/ANSWER: Which of the following situations constitute a positive screening after a PPD (purified protein derivative) skin test for tuberculosis? A patient without risk factors who has a 13mm PPD skin test A patient with HIV who has a 3mm PPD skin test A homeless patient with a 9mm PPD skin test A patient with intravenous drug abuse (IVDA) who has an 11mm PPD skin test A healthcare worker who has a 6mm PPD skin test 11. QUESTION/ANSWER: When the patient with jaundice is evaluated, a careful history and physical exam often can help differentiate prehepatic, hepatic, and posthepatic causes. When the patient reports dark discoloration of the urine and light discoloration of the stool, the AGACNP is most suspicious for: Viral hepatitis Chronic alcoholism Extrahepatic obstruction Cholestasis 12. QUESTION/ANSWER: Jack R. is a 63-year-old male who is being seen today on rounds after being admitted for profound upper abdominal pain, nausea, and vomiting. He had markedly elevated serum amylase and lipase; he was diagnosed with pancreatitis and admitted for pain management and bowel rest. Today he feels better, but he is upset because he knows that pancreatitis is known as the “alcoholic’s disease.” He makes it clear that he is a religious man and that his religion forbids alcohol; he says he has never had an alcoholic drink in his life. The AGACNP reassures Jack that approximately 40% of cases of pancreatitis are caused by as well as a variety of other things, and that he will have a thorough diagnostic evaluation. hyperlipidemia gallstone disease genetic predisposition hypercalcemia 13. QUESTION/ANSWER: In neurogenic shock, patients are subjected to an abnormal dilation of venules and arterioles in response to failure of the autonomic nervous system. Treatment for neurogenic shock may include all of the following except: Trendelenburg Intravenous fluids Vasodilators Vasoconstrics