NRNP 6531 COMBINED MIDTERM AND FINAL EXAM LATEST ACTUAL EXAM QUESTIONS AND VERIFIED ANSWERS

NRNP 6531 COMBINED MIDTERM AND FINAL EXAM LATEST ACTUAL EXAM QUESTIONS AND VERIFIED ANSWERS Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in? Moderate Persistent Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg daily, and Calcium 1500 mg daily. At today's visit. Her blood pressure is 170/89. According to JNC VIII guidelines, what should you do next to control Harriet's blood pressure? Add thiazide diuretic to Lisinopril 5mg daily What condition is associated with mucus production greater than 3 months per year for at least 2 consecutive years? Chronic Bronchitis Risk factors for acute arterial insufficiency include which of the following? Recent MI, Arterial Fibrillation, and Atherosclerosis A patient has chronic chest pain that occurs after meals and the provider suspects gastroesophageal reflux disease (GERD). The provider prescribes a proton pump inhibitor and after 2 months the patient reports improvement in symptoms. What is the next action in treating this patient? A. Schedule an upper endoscopy B. Continue the proton pump inhibitor C. Refer the patient to a gastroenterologist D. Order esophageal pH monitoring B.PPI A patient comes to an emergency department with chest pain. The patient describes the pain is sharp and stabbing and reports that it has been present for several weeks. Upon questioning, the examiner determines that the pain is worse after eating. The patient reports getting relief after taking a friend's nitroglycerin during one episode. What is the most likely cause of this chest pain? A. Pleural pain B. Cardiac pain C. Aortic dissection pain D. Esophageal pain D. Esophageal pain A patient who has a central line develops respiratory compromise. What is the initial intervention for this patient? A. Obtaining cultures and starting antibiotics B. Lung ultrasonography to determine the cause C. Prompt removal of the central line D. Rapid assessment and resuscitation D. Rapid assessment and resuscitation A patient has a cough and fever and the provider auscultates rales in both lungs that do not clear with cough. The patient reports having a headache and sore throat prior to the onset of coughing. A chest radiograph shows patchy, nonhomogeneous infiltrates. Based on these findings, which organism is the most likely cause of this patient's pneumonia? A. S. pneumonia B. A virus C. Mycoplasma D. Tuberculosis C. Mycoplasma A high school athlete reports recent onset of chest pain that is aggravated by deep breathing and lifting. A 12-lead electrocardiogram in the clinic is normal. The examiner notes localized pain near the sternum that increases with pressure. What will the provider do next? A. Recommend an NSAID B. Prescribe an antibiotic C. Refer to a cardiologist D. Order a chest radiograph A. Recommend an NSAID A patient who was initially treated as an outpatient for pneumonia and then hospitalized for two weeks after no improvement continues to show no improvement after several antibiotic regimens have been attempted. What is the next step in managing this patient? A. Increasing the dose of the antibiotics B. Open lung biopsy C. Performing diagnostic bronchoscopy D. Administration of the pneumonia vaccine C. Performing a diagnostic bronchoscopy A young adult, previously healthy clinic patient has symptoms of pneumonia including high fever and cough. Auscultation reveals rales in the left lower lobe. A chest radiograph is normal. The patient is unable to expectorate sputum. Which treatment is recommended for this patient? A. A respiratory fluoroquinolone antibiotic B. Empiric treatment with a macrolide antibiotic C. Hospitalization for intravenous antibiotics D. A B-lactam antibiotic plus a fluoroquinolone B. Empiric treatment with a macrolide antibiotic Which are causes of pleural effusions? (Select all that apply.) A. Bronchiectasis B. Breast Cancer C. Dehydration D. Congestive Heart failure E. Allergies A. Bronchiectasis B. Breast Cancer D. Congestive Heart failure An adult patient who had pertussis immunizations as a child is exposed to pertussis and develops a runny nose, low-grade fever, and upper respiratory illness symptoms without a paroxysmal cough. What is recommended for this patient? A. Pertussis vaccine booster B. Azithromycin daily for 5 days C. Isolation if paroxysmal cough develops D. Symptomatic care only B. Azithromycin daily for 5 days Which method of treatment is used for traumatic pneumothorax? A. Placement of a small-bore catheter B. Observation for spontaneous resolution C. Needle aspiration of the pneumothorax D. Tube thoracostomy D. Tube thoracostomy An adult develops chronic cough with episodes of wheezing and shortness of breath. The provider performs chest radiography and other tests and rules out infection, upper respiratory, and gastroesophageal causes. Which test will the provider order initially to evaluate the possibility of asthma as the cause of these symptoms? A. Spirometry B. Allergy Testing C. Methacholine Challenge test D. Peak expiratory flow rate A. Spirometry A patient develops acute bronchitis and is diagnosed as having influenza. Which medication will help reduce the duration of symptoms in this patient? A. Trimethoprim-sulfamethoxazole B. Clindamycin C. Azithromycin D. Oseltamivir D. Oseltamivir A patient who has undergone surgical immobilization for a femur fracture reports dyspnea and chest pain associated with inspiration. The patient has a heart rate of 120 beats per minute. Which diagnostic test will confirm the presence of a pulmonary embolism? A. D-dimer B. CT angiography C. Arterial blood gases D. Electrocardiogram B. CT angiography A 65-year-old patient who has not had an influenza vaccine is exposed to influenza and comes to the clinic the following day with fever and watery, red eyes. What will the provider do initially? A. Perform a nasal swab for RT-PCR assay B. Administer LAIV influenza vaccine C. Observe for improvement or worsening for 24 hours D. Begin treatment with an antiviral medication A. Perform a nasal swab for RT-PCR assay A patient complains of shortness of breath when in a recumbent position and reports coughing and pain associated with inspiration. The provider notes distended neck veins during the exam. What is the likely cause of these findings? A. Pulmonary infection B. Congestive heart failure C. Pulmonary embolus D. Hepatic disease B. CHF Other than smoking cessation, which of the following slows the progression of COPD in smokers? Engaging in moderate to high levels of physical activity Management of a patient with hypertension and an abdominal aortic aneurysm would include: Referral to a cardiologist A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with: Systolic heart failure A 20-year-old is diagnosed with mild persistent asthma. What drug combination would be most effective in keeping him symptom-free? A bronchodilator PRN and an inhaled corticosteroid A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory? Inferior wall Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes? Acute bronchitis The most common correlate(s) with chronic bronchitis and emphysema is(are): Cigarette smoke inhalation