CEA advanced Nursing Practice Quiz
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When evaluating a 78-year-old man, the PMHNP notices the patient
frequently leans in with the right side of his head and frequently asks
for things to be repeated. His daughter is very worried that he has
dementia or depression because he has also become increasingly
isolated, as well as increasingly irritable as he believes people are
yelling at him out of frustration of not being heard. The daughter is
tearful, anxious, and frustrated. What should the PMHNP do first?
Order a CT scan of the head
Separate the patient from the daughter and interview him alone
Examine the patient's ear canals
Provide anticipatory guidance regarding aging parents to the
daughter
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Ans: Examine the patient's ear canals
A 35-year-old man diagnosed with bipolar disorder mentions to his
PMHNP that he had felt a lump on his left testicle. He is concerned
he has not had a physical exam in 10 years. What is the best action
by the PMHNP?
Explore the reason for not having had a physical in so long
Refer him to his primary care provider
Perform a urogenital exam and order an ultrasound
Refer him to urology
Ans: Explore the reason for not having had a physical in so long
In observing the appearance of the patient with depression and a
history of systemic lupus erythematosus, the PMHNP notices a lesion
on the neck of the patient about the size of a pencil eraser, flush
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with the skin, uniformly colored, with discrete borders, and consistent
texture. The PMHNP should:
Refer the patient to oncology
Watch and wait
Refer the patient to rheumatology
Refer the patient to dermatology
Ans: Watch and wait
Which of the following best represent the physical exam maneuver
known as Murphy's sign?
While supine, ask the patient to grasp her knee while tucking 1 leg
up to the chest. A positive test occurs when pain prohibits elevation
of the ipsilateral leg.