HESI EXIT EXAM|EXPLORE NEW 110 ACTUAL QUESTIONS AND ANSWERS|2ND ATTEMPT | 100% CORRECT.

HESI EXIT EXAM|EXPLORE NEW 110 ACTUAL QUESTIONS AND ANSWERS|2ND ATTEMPT | 100% CORRECT. 1. Researchers compared meal frequency and physical activity of 80 pregnant women, 40 who experienced preterm labor and 40 who did not experience preterm labor, women wo experienced preterm labor were 3.57 times more likely to skip meals than those who did not experience preterm labor. Amount of walking was significantly less in the preterm labor group that it was in the group without preterm labor. Based on the findings of this study what action should the APRN take when teaching prenatal patients self-care during pregnancy? a. Obtain a diet history for the past week from each of the prenatal patients b. Encourage patients who are in their first trimester to trail for a walking marathon. c. Determine the patient’s attitudes about diet and exercise during pregnancy d. Describe the benefits of eating small, frequent meals throughout the day 2. A 70 years old male complains of blurring in his right eye without pain or erythema and tells the APRN that he feels like a dark veil is covering his eye. Which action should the APRN implement? a. Schedule a dilated eye examination with his optometrist. b. Irrigate the affected eye with sterile normal saline c. Prescribe antibiotic eye drops, four times a day for 7 days. d. Refer immediately for an ophthalmologist appointment 3. What information should the APRN include in a newborn education class for parents of uncircumcised male infants? a. Cleanse the ureteral area daily with an antiseptic solution b. Avoid foreskin manipulation and cleanse penis and coronal area daily c. Retract the foreskin daily until he is able to perform his own hygiene. d. Apply zinc oxide (Desitin) to lubricate foreskin for retraction. 4. A 3 days old newborn is spitting up large amounts of Similac (A nonfat cow’s milk formula, made by Ross Laboratories) after each feeding. What formula option should the APRN recommended that the parents use to feed this child? a. Enfamil, a nonfat cow’s milk formula, by Mead-Johnson b. Isomil, a soy protein isolate formula, by Ross Laboratories. c. Good Nature, a non-fat cow’s milk formula, by Carnation d. Baby formula, a hydrolyzed whey weight product, by Gerber. 5. Which findings in a 7 months old infant are most indicative of intussusception? a. Normal bowel movement and high fever b. Red jelly-like stools and projectile vomiting c. Right upper quadrant olive shaped mass and profuse diarrhea d. Right upper quadrant mass and episodes of severe crying 6. Which assessment finding indicates to the APRN that a 6-grade girl needs to be screened for type II Diabetes a. She has a large open sore on the foot. b. She has dark creases on the back of her neck c. She lost 10 lbs. in the last month d. She is 5’2” tall and weighs 81 kg. 7. Which initial activities should the APRN recommend for a patient with acute low back pain and no neurological deficits or other suspicious findings? a. Use of back exercise machines and stretching exercises daily for 6 weeks b. Complete bed rest for 4 to 6 days followed by one week of physical therapy c. Strengthening exercises for the trunk muscles initially to build endurance d. Low stress exercise and return to normal activities of daily living as soon as possible 8. An infant who has experienced recurrent episodes of respiratory tract infection between the age of 5 to 6 months is brought to the clinic. The mother is crying and wants to know why her baby is always sick. What additional information should the APRN obtains first. a. Review the infant’s history of vaccination b. Analyze the infant’s complete blood count and differential count c. Ask the mother if the infant is in a day care center d. Determine when the mother stopped breastfeeding the infant. 9. A 45 years old male patient with known coronary artery disease presents with severe headache, elevated blood pressure of 180/95, and tachycardia of 120 beats/minute. Which class of medication should the APRN prescribe best for this client? a. Calcium Channel Blocker (CCB) b. Beta Blocker c. Diuretic d. Angiotensin converting enzyme inhibitor (ACEI) 10. The APRN is interviewing an elderly man who has bilateral cataracts. The patient asks for catch question to be repeated and states he has difficulty hearing. Which psychological effect should the APRN suspect the patient is experiencing? a. Anxiety and fear b. Social Isolation c. Frustration d. Cognitive impairment 11. An old male patient, who denies any recent injury is seen by the APRN because of an acutely painful gouty big toe. Which medication should the APRN prescribe? a. AIDS and cephalexin b. AIDS and colchicine c. Prednisone and acetaminophen with codeine d. Probenecid and allopurinol 12. Regarding the pharmacologic therapy of Parkinson’s disease, what principle should guide drug selection? a. The dopamine antagonist levodopa-carbidopa (Sinemet) is useful as monotherapy for early Parkinson’s disease. b. The anticholinergic drug Benztropine (Cogentin) is very effective in producing muscle relaxation and improving bradykinesia. c. The monoamine Oxidase B Inhibitor Selegiline (Eldepryl) should not be administered concurrently with dopamine agonist containing levodopa. d. The drug Amantadine (Symmetrel) is ineffective for relieving Parkinson’s tremors. 13. A 26 years old male client is seen the APRN because started with dysuria and frequency that has been intensifying over the past two weeks. The physical exam reveals a tender swollen scrotum, urethral discharge, and pyuria with urinalysis positive. The APRN prescribes Ceftriaxone (Rocephin) 250 mg IM in a single dose for a positive culture for Chlamydia. Which additional prescription should the APRN prescribe? a. Doxycycline (Vibramycin) 100 mg PO twice a day for 10 days b. Oxybuyinin (Ditropan) 5 mg PO three times a day for 10 days c. Metronidazole (Flagyl) 250 mg PO three times a day for 7 days d. Nitrofurantoin (Macrodantin)100 mg PO four times a day for 14 days. 14. The Nurse Executive ask the education department to develop a course on jurisprudence for the nursing staff. Which agency should the educators review to develop the curriculum? a. The National Council of State Boards of Nursing b. The State Legislature c. The State Board of Nursing d. The Department of Health and Human Services 15. A 13 years old African American teenager presents to the clinic with a chief complaint of hair loss with small bold spots. Which question about grooming best demonstrates the APRN knowledge of cultural practice in this group? a. Do you straighten your hair? b. What shampoo do you use? c. Do you wear a head covering? d. Are you using hair pomade? 16. The APRN is providing prenatal counseling to a couple whose only child has cystic fibrosis (CF). What information should the APRN explain to the couple about the risk of having other children with CF? a. Because the couple had one child with cystic fibrosis, other children have reduced risk of manifesting the disease. b. Other children may have incomplete penetrance of the cystic fibrosis trait, and phenotypically be less likely to exhibit disease. c. Cystic fibrosis is a multifactorial genetic disorder, so there is a low risk of subsequent children having the disease. d. Each child has the same risk of inheritance of cystic fibrosis because it is transmitted in an autosomal recessive gene. 17. The APN is assessing a 7- years old girl with right ear pain due to cerumen impaction. The APN expects which results from tuning fork conduction test of the right ear? a. Weber test cause lateralization of sound to the right ear. b. Rinne’s air conduction test is heard longer on the right ear c. Vibratory sensation of right mastoid prominence is prominent. d. Rinne’s air conduction test heard best in to the left ear. 18. The APN is examining a child with suspected pyelonephritis. What symptoms are expected findings for this client? a. Right lower quadrant pain, vomiting, and diarrhea b. Tachycardia, rash, and bilateral flank pain c. Fever, anorexia, and dysuria d. Oliguria, amber-colored urine and constipation. 19. A 10 years old child says, “I am worried because my friend is not telling her mother the truth” The APRN should identify that this statement is consistent with which stage of psychosexual development? a. Phallic b. Latency c. Genital d. Anal 20. The APN is examining a 9 year old who complains of pain and stiffness in the knees, hands, and feel that worsens in the morning and after naps. The child’s eyes are irritated, and the mother is worried about the child having swollen glands and intermittent fevers that are accompanied by a transient maculopapular rash. The APN should refer the child for which type of evaluation? a. Lyme disease b. Mononucleosis c. Juvenile Arthritis d. Food Allergies 21. The APRN is conducting a preadmission physical examination of an older adult who is scheduled for surgery in two days. Which factor put the client at greatest risk for a prolonged hospital stay a. Multiple medications. b. Urinary incontinence’ c. Cognitive impairment d. Two fall in 5 months 22. Pregnant at 24 weeks gestation is seen by the APRN. The pregnant is concerned about receiving an influenza vaccination, which she read on the internet that is mercury poisoning. Which information supported by evidence-based findings should the APRN provide? a. Mercury is a preservative found in multi-dose influenza vials. b. Mercury-free vaccinations are available that do not contain thimerosal c. There is no scientific evidence of mercury problems in vaccine. d. Hand washing is as protective against influenza as the vaccine. 23. During an initial prenatal exam, the APRN notes that a client is positive for chlamydia, negative for PID, and has a thick mucoid discharge at the cervix. What management plan is indicated? a. Initialize therapy with doxycycline Vibramycin) b. Treat the client and all sexual partners. c. Determine if the client is allergic to penicillin (Pen V) d. Treat pain associated with the symptoms. 24. A 15 months old toddler whose diet is lacking in iron- rich foods is screened for iron deficiency anemia at a health department clinic. Per clinic protocol, the APRN routinely treat this form of anemia if the client Hb is less than 2 SD below the mean expected Hb value for the client’s age group. Which laboratory values reflect the probable existence of iron deficiency anemia in this child that requires treatment? a. Hgb 9.5 mg/dl, hypochromic, microcytic. b. Hgb 10 mg/dl, hyperchromic, microcytic c. Hgb 11 ng/dl, hypochromic, microcytic d. Hgb 9 mg/dl, hyperchromic, macrocytic 25. A 47-years old fair skinned female patient is seeing the APRN for a well woman exam, The APRN noted several discrete, smooth-surfaced, dome, shaped, red papules on the patient’s trunk and several light- brown smooth surfaced lesions on the patient’s lower extremities. The patient denies recent changes in the color or shape of the lesions but admits to unprotected sun exposure, including blistering sunburns, during her youth. What is the mostly likely diagnoses for this patient lesions? a. Malignant melanoma and basal cell carcinoma b. Squamous cell carcinoma and dermatosis papulose nigra c. Actinic keratosis and sebaceous hyperplasia d. Cherry angiomas and solar lentigos. 26. A 19- years old male college student presents with sprained ankle incurred while playing basketball, Which instructions should the APRN advise patient to implement after injury? a. Use ice pack for 20 min then discontinue for 30 min and repeat for 24-48 hours b. Alternate heat and cold packs, 20 mins each, for the first 24-48 hours c. Apply heat for the first 12 hours, then ice packs after weight-bearing activities d. Keep ice packs on ankle for the first 12 hours, then heat after weight-bearing activities. 27. ….. 28. A female client reports that her hair is becoming coarse and breaking off, that the outer part of her eyebrows have disappeared, and that her eyes are all puffy. Which follow up question is best for the APRN to ask? a. Have you notice any changes in your fingernails? b. Do you work with hazardous chemicals? c. Is there a history of female baldness in your family? d. Are you under any unusual stress at home or work? 29. An 18 years old nulliparous woman is seen by the APRN for abdominal pain and intermittent dark red vaginal discharge for two days, the client states that her last normal menses was 6 weeks ago,which finding should the APRN detects supports an ectopic pregnancy? a. High serum beta human chorionic gonadotropin (Hcg)LEVEL. b. Enlarged ovaries on vaginal bimanual examination c. Positive Cervical motion tenderness on vaginal exam d. A corpus luteum cyst found by transvaginal ultrasound. 30. The APRN is assessing an older patient who states that continuously has painful, cold feet. Which assessment finding should the APRN identify for differential diagnosis of peripheral vascular disease (PVD)? a. Stasis leg ulcers b. Dermatitis c. Brownish discoloration d. Shiny, hairless skin. 31. A patient tells the APRN that she is experiencing irritation with a thin, grey colored discharge. After collecting a specimen of the drawn mouth slide is prepared for analysis. What should the APRN anticipate finding when results of the wet mount? a. Cottage- cheese-like material is apparent b. Numerous white cells are observed. c. Clue cells are visible on the slide. d. Hyphae are present on the side. 32. A 19-year-old female client complains of breast tenderness before her menstrual period examination, the APRN notes generalized lumpiness in both breast with no discrete masses and no nipple discharge. What action should the APRN take? a. Request a return visit after her menstrual period for a breast re-check b. Schedule a mammogram after her next menstrual period c. Assure the client that her breast are normal, and advise bi-manual evaluations. d. Advise that an ultrasound of the breast is necessary 33. Four clients seek treatment at the clinic for symptoms consistent with urinary tract infection(UTI). Which client should the APRN routinely treat instead of referring to the clinic physician? a. A 17 years old female with hematuria that is not associated with a UTI b. A 9 years old female who complains of pain and burning with urination c. A 3 years old male who has never before been diagnosed with a UTI d. A 13 years old male with persistent proteinuria of greater than a trace. 34. A new born whose mother used cocaine during pregnancy returns to the clinic demonstrating extreme irritability, a shrill cry and frequent vomiting. What action should the APRN implement? a. Change breast feeding to formula Q 2 hours. b. Prescribe a neonatal serum drug screen c. Refer to neonatologist for a neurology workup. d. Recommend wrapping baby snuggly in warm blankets. 35. ….. 36. A patient employed by a large corporation tells the nurse administrator that the company recently dropped traditional fee-for service coverage and substituted an HMO. Which statement by the nurse accurately characterizes the HMO model of healthcare delivery? a. A federally funded program that provides services to all United States Citizens who are 65 years of age and older b. A network of providers who have contracted to provide services to insured individuals at a discounted fee. c. A managed care program allowing health care services from providers within or outside the insurance network. d. An organization of physicians, hospitals, and health professionals who provides services to an enrolled population for a fixed fee. 37. An elderly patient requires a total hip replacement following a traumatic fracture of the right femur in a fall, which prescription should the APRN prescribe in the immediate postoperative period to prevent the complication of DVT? a. Enoxaparin (Lovenox) SQ BID and sequential pneumatic compression. b. Warfarin (Coumadin) 10 mg PO daily and early ambulation c. Heparin 30 mg IV infusion treated to maintain a PTT 80 to 100 seconds. d. Eight units of platelets to be transfused for platelet count less than 60,000 mm3. 38. A 68 years old female patient brings a long list of questions each time she came visit with the nurse manager. Which response is best for the nurse to address this situation and managing the clinic’s schedule? a. Let me highlight your most important questions, and the physician can cover the others next week. b. Since you told me you use a computer, let me give you a list of health information websites. c. Sorry but because of a heavy patient census, the physician cannot answer all your questions today. d. In the future please schedule a 30-min appointment with the receptionist. 39. A 19 years old female is seen by the APRN for follow up a Pap smear results, indicating a high-grade squamous intraepithelial session, endocervical cells presents in adequate smear. Which counseling information should the APN use? a. The Pap smear is normal. Repeat the Pap smear in 1 year unless problems arise. b. The Pap Smear indicates invasive cancer. Refer her to the gynecologic oncologist. c. The Pap Smear shows abnormal cells. Schedule a colposcopic evaluation exam. d. The Pap Smear indicates an inflammatory process. Repeat the Pap smear in 4 months. 40. An adult male comes to the clinic complaining of a sore throat, but denies any upper respiratory symptoms, The APRN determines that the patient has severe pharyngeal erythema, 2+ enlarged tonsils and low grade fever. Findings via rapid strep test indicate the presence of Group A streptococcus. Afetr determining the patient has no drugs allergies, Which antibiotic should the APRN prescribe? a. Penicillin VK 250 mg PO three times a day for 10 days. b. Doxycycline (Vibramycin)100 mg PO twice a day for 10 days. c. Levofloxacin (Levaquin( 500 mg PO daily for 10 days. d. Amoxacillin/Clavulanic (Augmentin) 875 mg PO twice daily for 7 days. 41. The APRN prescribes the Herpes Zoster vaccines (Zostavax) for prevention of shingles in a 60 years old male who has previously had occurrence of shingles on his chest. The APRN should consider wish plan of care? a. Zoster Vaccine (Zostavax) should be given a single 0.65 ml dose b. Varicella Vaccine (VArivax) is an alternative vaccine for Herpes Zoster. c. The case of Herpes Zoster should be reported to public health authorities. d. A booster dose of the vaccine (Zostavax) is recommended in 6 months. 42. A patient with Diabetes Mellitus Type I receives the results of a urinalysis that reveals the presence of microalbuminuria. Which information should the APRN explain to the patient about these findings? a. Determines the presence of nephritic syndrome. b. Calculates the patient’s average blood glucose level. c. Identifies irreversible renal disease. d. Detects early reversible kidney involvement. 43. A 45 years old male patient comes to the clinic stating that he is worried about having cancer. He has noted the presence of bright red blood with his stools intermittently the past weeks, but was too embarrassed to seek medical attention. He denies a family history of cancer, although his father was diagnosed with Crohn’s disease in his late 70’s. Which action should the APRN take? a. Determines if the patient has a history of chronic nausea and diarrhea. b. Call endoscopy department and schedule the patient for a colonoscopy today. c. Obtain blood for complete blood count, ferritin, iron-binding capacity and B12 d. Perform a digital rectal examination and inspect the perirectal area. 44. An elderly male client sees the APRN for treatment of hearing loss. He describes a feeling of fullness in the right ear, and his daughter states her father has not been hard of hearing in the past, but in now unable to hear the television and the volume is turned up very high. What result of the Weber test or Rinne Test should the APRN anticipate? a. Weber: sound is loudest in the lef t ear, confirming a sensorineural hearing loss. b. Rinne: Sound is loudest beside the right ear rather than on the right mastoid, confirming conductive lost. c. Rinne: Sound is lauder on the right mastoid tip than beside the ear, confirming a sensorineural loss. d. Weber: Sound is lauder in the right ear, confirming a conductive hearing loss 45. A 70 years old female who work as a seamstress states that she has been having episodes of redness, tenderness, and impaired dexterity of her fingers. The APRN notes nodules on the distal and proximal joints of her fingers. Based on these findings, the APRN should treat this patient for wich condition? a. Gout b. Osteoporosis c. Rheumatoid arthritis d. Osteoarthritis 46. During a well child visit, the APRN assesses a 7 years old boy with several large irregular shaped, yellowish brown patches over the left buttock and his mother relates that the child fell off a bike 2 weeks ago. What conclusion should the APRN take from this data? a. Evidence of multiple stages of healing b. Findings are consistent with physical abuse. c. History is inconsistent with the developmental age d. Assessment is consistent with the history. 47. The APRN suspects that 13 years old who exhibits restlessness, aggressive behavior at school is manifesting Attention Deficit Hyperactivity Disorder (ADHD). The evaluation plan including administering behavior rationales, scales, physical assessment, and neuropsychologic examinations. Which findings indicate to the APRN needs to perform diagnostic testing prior to administering stimulant or psychotropic agents? a. Astma medication use b. Under weight for height c. History of seizure d. A heart murmur 48. The APRN prescribes laboratory test for a years old who is complaining of chronic fatigue. Which findings should the APRN identifies that is consistent with Hypothyroidism? a. Decreased thyrotropin releasing hormone. b. Decreased antimicrosomal antibodies c. TSH elevated and serum free Thyroxine (T4) decreased d. Both TSH and serum free thyroxine (T4) increased. 49. A male patient who lives with his wife and one year old twin sons presents at the clinic with symptoms of generalized fatigue, loss of appetite, vomiting, diarrhea, and low grade fever for about a week. The patient’s wife urged him to seek treatment because she is afraid that he might make the babies sick, which would cause both of them to miss work because the children couldn’t go to daycare. The patient denies alcohol or IV drug use. Based on the patient’s history and symptoms, what type of hepatitis infection has this patient most likely contracted? a. A b. D c. C d. B 50. An 88 years old male smoker who lives alone in his own residence, and has had chronic emphysema for the past 5 years, presents with a low grade fever, body aches and chills, productive cough that has lasted for approximately 1 week. Which organism is the most common cause of pneumonia in this patient? a. Legionella species b. Chlamydia pneumonia c. Mycoplasma pneumonia d. Haemophilus Influenzae 51. The Nurse Executive is reviewing an incident report filed on an acute care unit. An elderly patient who required frequent monitoring fell and fractured a hip. Which nurse should the Executive recognize as being at greatest risk for a malpractice judgment? a. The supervisor making rounds before the fall who noted that all patients were stable. b. The nurse who transferred the patient to the chair at the time that the fall occurred. c. The nurse assigned to care for the patient who was at lunch at the time of the fall d. A nurse who worked the 7 to 3 shift at the hospital and wrote poor nursing notes. 52. The APRN is examining a pregnant woman at 42 weeks gestation, which is determined from an ultrasound obtained at 18 weeks gestation. The client has lost 3 pounds in the past week, and the cervix is thin and dilated 1 centimeter. What action should the APRN take? a. Schedule gestational age diagnostic ultrasound b. Review the parental chart for confirmation dates c. Refer the client for induction of labor by the physician d. Compute Nagele’s rule to determine gestational days. 53. A mother of 3 years old reports to the APR that she does not feel like the perfect parent. Which conclusion by the APRN is most accurate? a. Abnormal Finding: The mother is engaged in the nursing stage of parenthood b. Normal Finding: The mother is engaged in the authority stage of parenthood c. Normal Finding: The mother is reconciling the image of the child with the actual child d. Abnormal Finding: The mother’s parenting style is permissive 54. In an attempt to address the problem of obesity of middle school students, the APRN wants to gather, data aout students eating habits. The students of middle school are asked to complete a 7 day diet history. Which data gathering technique is most likely to produce the most valid findings? a. A survey that is sent to parents who are asked to return it to an outside researcher b. A paper and pencil survey that is anonymously submitted to the school nurse c. An internet survey that is submitted anonymously by students to the school nurse d. An interview conducted by the school nurse with a random sample of the students. 55. A mother reports that her toddler has developed a “runny nose on the side” the child has no fever, is eating well, and is playing actively. The APRN should provide which primary differential diagnosis? a. Upper respiratory infection b. Seasonal allergic rhinitis c. A cold d. Obstruction 56. A primigravida of 16 weeks gestation tells the APRN “ am really worried because I am not showing belly yet. Measurement of the uterine index is documented at the half way point between the symphysis and mild umbilicus. Based on this assessment, what information should the APRN provide the client? a. The fetus is at 16 weeks gestation 57. A mother who is breastfeeding reports that her 10 week old infant is overly fussy and more frequently during the night. Which finding should the APRN address as the etiology for the infant’s symptoms a. Routine includes two glasses of red wine each evening b. Dietary cravings during a smoking cessation program c. Maternal diet change to high fiber and fresh vegetables d. Sore nipples and curd-like patches in the infant’s mouth 58. A first grade boy complains of a sudden onset of pain in his left eye. He was on the and says, “I got a dirt in my eye” How should the APRN check for a corneal abrasion? a. Determine if the pupils are equal, round, and reactive to ligt b. Using the otoscope, check for the presenceof foreign bodies c. Use an aphthalmoscope to check for presence of a red reflex d. Applying fluorescein stain, examine the eye with a wood’s lamp 59. When performing a functional assessment on an 82 years old patient with a recent which question is most important for the APRN to a. How many times a day do you have a bowel movement b. Do you have any thyroid medication c. Do you wear glasses d. Are you able to dress yourself 60. The APRN is examining a 6 months old infant for well baby check up. Which findings indicates that the fontanels are normal at this infant growth? a. Anterior closed, posterior closed b. Anterior open, posterior closed c. Anterior open, posterior open d. Anterior closed, posterior open 61. The APN is gathering data for the differential diagnosis of acute diarrhea of an 8 month old male infant. Which client history should the APN obtain as best targets celiac disease? a. Have any new foods been added to his diet? b. Are any ancestors from South Africa c. Has he had problems with diarrhea in the past? d. Do any siblings have food allergies? 62. The APRN is teaching normal ground development for her 6 months old daughter. Which statement by the mother indicates that child has reached the appropriate developmental milestone for the age? a. My child seems to cry every time strangers come around b. My child is climbing into the cabinets and its scares me c. I am concerned. My child hasn’t call me “mama” yet. 63. For uncomplicated genital gonococcal infections, The CDC recommends which drug treatment regimen? a. Azithromycin (Zithromax) 250 mg PO daily x 5 days b. Doxycycline (Vibraycin) 100 mg PO BID x 14 days c. Bactrim 160 mg x 3 weeks d. Ceftriaxone 125 mg IM single dosis 64. Woman who is gravida 2, para 1 has been in labor for 10 hours and arrives in to the clinic experiencing intensifying contractions that are occurring every 2 minutes. The APN determines that the patient cervix is 100% effaced, dilated and the fetal head is in the right occipital posterior (ROP). The APn starts a saline lock when client begins screaming for pain medication. Which action should the APN implement first? a. Reposition the patient laterally b. Reinforce relaxation techniques and controlled breathing c. Obtain a precipitation tray and call for transport to L&D d. Apply an external Fetal monitor. 65. The APRN prescribe lipid lowering medication and diet modifications for a patient three months ago, On review of the latest patient related data which findings requires the APRN to take action? a. New onset insomnia from calf pain b. Intermittent episodes of constipation c. Reduction in low density lipoprotein of 65% d. Elevation of liver transaminases of 5% ? 66. When a middle age male client performs range of motion with his left arm the APRN notes that he is able to flex the arm without difficulty, however he is unable o abduct the arm without causing pain. If the APRN passively abducts the arm it falls back in place when released. What do these findings suggest? a. Rotator cuff lesions b. Shoulder dislocation c. Crepitation d. Tennis Elbow 67. The nursing staff in a busy care wishes to adopt a new procedure that is recognizes as a best practice on a healthcare related web page on the internet. What step should the nurses take before initiating a change in the current unit policy? a. Ask the healthcare professionals if they agree with this change in nursing practice on the unit b. Verify the legitimacy of the practice by determining the source of this web page. c. Teach the experienced nurses how to implement the new procedure first. d. Validate the procedure by conducting a study that compares the old with the new. 68. A client at 39 weeks gestation comes to the clinic and tells the APRN that her bag of waters has ruptured. Which finding provides the best determination that the client’s membranes are ruptured? a. Contractions occurring 3 minutes apart. b. A positive Fern test c. An elevated serum white count d. Nitrazine paper that turns blue when placed in vagina. 69. Which pathophysiologic characteristic should the APRN identify in an older patient who is manifesting signs of Alzaimer’s disease? a. Intracranial pressure greater than 30 mmHg b. Obstruction of cerebrospinal fluid (CSF) flow c. Senile plaques and neurofibrillatory tangles d. Marked degeneration of the basal ganglia 70. A teenaged client at 37 weeks gestation has a BP of 184/90, 1+ proteinuria, and a weight gain of 2.5 lbs the past week. Based on this findings, what actions should the APRN take? a. ….. b. ….. c. The symptoms are likely pathogenic in origen, so no more diagnostic testing are needed. d. ….. 71. The APRN diagnoses a child with psoriasis and encourages the child’s parent to allow the child moderate sun exposure. What is the best evaluation to choose this intervention? a. Lesions improve when exposed to ultraviolet light. b. Mild sunburn can cause lesions to worsen c. Exposure to sunlight can prevent recurrence d. Sunlight alleviates psoriasis lesions 72. A 25 years old nulligravida and her 27 years old spouse are seen the APRN because they have not been able to get pregnant for the last 2 years. The wife has regular menstruation every 30 days that last for 4 days. Which intervention should the APRN order next? a. A semen analysis b. A clomiphene challenge test c. A follicle stimulant hormone level d. A post coital test 73. A patient presents with gnawing, mid epigastric pain that occurs 2 hours after eating as well as at night. Based on the pathogenesis of ulcers, which interventions should the APRN implement? a. Educate the patient about reflux caused by alcohol, caffeine and cigarette smoking. b. Test the patient for the presence of Helicobacter Pylori c. Schedule a gastroscopy to determine the presence of stomach ulcers. d. Prescribe a medication other than a non-steroidal antinflamatory agent. 74. A patient 3 years old is being seen in the clinic for a well child visit. The APRN notes that the child skin is dry and scaly but otherwise intact and the child is in good health. Which is the best recommendation for dry skin care? a. Use a soap substitute b. Shampoo hair at end of bath c. Run rapid water for the bath d. Allow extra time for soaking 75. A patient with metastatic cancer is preparing to make decisions about end of life and is completing a durable medical power of attorney, which description is best for the APRN to provide? a. It is a hospital form that is required of all people that are entering a hospital b. It will identify someone that can make decisions for your health care if you are in a coma or vegetative state. c. It is not a legal document, but it will help the healthcare provider know exactly what medical treatments you want. d. It allows you to document your wishes regarding life-sustaining treatment if you can’t speak for yourself 76. A 24 years old is seen the APRN because pernicious anemia. Which high folic acid foods should the APRN teach the client to eat? a. Cottage cheese, skim milk, and yogurt b. Brussels sprouts, lima beans, and potatoes. c. Carrots, salmon, and avocados d. Cereals, nuts and green vegetables 77. A cross sectional design was used to compare the sleep quality of third trimester pregnant women with non-pregnant women. Findings indicated that pregnant suffer significantly more from poor sleep quality than non-pregnant women and that sleep quality of pregnant woman was related to stress and depression. Based on the findings of this study, which intervention should the APRN working in a women’s health clinic implement? a. Develop a counseling program for depressed pregnant women b. Evaluate sleep quality and depression of all pregnant woman. c. Replicate the study using the clinic’s population d. Screen all woman 78. A freshman in collage presents to the woman’s requesting the “morning after pill”, the young woman reports that she was engaged in consensual intercourse this morning when the condom broke. A review of the client’s PMH reveals no contraindications to estrogen use, on the information, what actions should the APRN take? a. Provide the client with information about natural family planning so that this situation can be avoided in the future b. Prescribe post-coital contraception with instructions to take the medication immediately after is obtained c. Advise the client to wait until her next period is due, and if late, return to postcoital contraception. d. Request a pregnancy test and then prescribe postcoital contraception (such as Plan B) to be taken within the next week. X 79. What pharmacological agent should the APRN prescribe to achieve the best results initially in the management of patients with erosive reflux esophagitis? a. Barrier paste medications, such as sucralfate (Carafate) b. Proton pump inhibitors, such as omeprazole (Prilosec) c. The H2 antagonist, such as famotidine (Pepcid) d. Promotility agents, such cisapride (Propulsid) 80. At a parenting class, a mother has concerns that her child does not seen to have any close friends. Which age do children begin to develop friendships? a. Two years b. Twelve mounts c. Eighteen months d. Three years 81. For a menopausal woman, what is the main advantage of administering progestin concurrently with estrogens? a. Relief of depression and insomnia in women with postmenopausal symptoms b. A reduction in endometrial cancer risk in women who have not had a hysterectomy c. A reduction in cardiovascular risk in women with a family history of heart disease. d. Improvement in the bone density in women with a family history of osteoporosis. 82. The APRN is examining an elderly female client and notices that she has a motor dysfunction in her hip region. Which procedure should the APRN consider to perform to further assess for hip dysfunction? a. Abduct and internally rotate each hip while the client is supine b. Have the client balance first on one foot and then the other c. Flex the hip and knee while lying flat with other leg extended d. Ask the patient to stand and bend over the examination table. 83. Which procedures should the APRN recommend for a healthy 67 years old female patient who has not seen a health care provider for an annual physical exam in the past 5 years? a. Papanicolau smear, sigmoidoscopy, thyroid screen b. Papanicolau smear, thyroid exam, chemistry screen c. Papanicolau smear, mammogram, stool for blood d. Mammogram, chemistry screen, sigmoidoscopy 84. A 67 years old female patient presents to the clinic with a glossy red tongue, angular stoma, and dry, cracking lips. Her weight is within normal limits and her skin is dry and intact. A decrease in which laboratory finding is most consistent with this clinical presentation? a. Albumin b. Iron binding Capacity c. B Vitamins d. Vitamin C 85. While conducting a routine health screening the mother of 7 years old reports that her child is having difficulty adjusting to pre-school. The APRN noted several café-au-lait pigmented areas on the child’s trunk. What presumptive diagnosis should the APRN make? a. Neurofibromatosis b. Fetal alcohol syndrome c. Multiple sclerosis d. Williams syndrome 86. The APRN asks a female patient about the……. And she replies, “It will breaks the windows”. What conclusion should be documented according this patient’s response? a. Normal mental status for age b. Impaired concentration c. Impaired memory d. Impaired thinking 87. A client at 12 weeks gestation comes to the ante partum clinic complaining of excessive nausea and vomiting. Based on the following laboratory values: hematocrit 36%, hemoglobin 12 g/dl, fasting serum glucose 73 mg/dl, human chorionic Gonadotropin (HCG) 290, 00 mLu/ml. What test should the APRN prescribe? a. Glycosylated Hemoglobin b. Amniocentesis c. Chorionic Villi sampling d. Ultrasound 88. An older Caucasian adult is at highest risk for poverty substandard house, institionalization based on documented probabilities? a. A 70 years old rural female with Alzaimer’s disease b. A 75 years old urban female with osteoarthritis c. A 70 years old urban male with coronary artery disease d. A 75 years old rural male with a lef t hemispheric stroke. 89. Other than for its use in acute inflammatory conditions, what special use does intravenous indomethacin (Indocin) have? a. To activate uterine contractions and initiate labor in uterine inertia b. To improve renal blood flow in acute renal failure c. As an antidote for acetaminophen toxicity d. For promoting the closure of a patent ductus arteriosus in children 90. A patient presents with watery soft diarrhea after taking a prescribed antibiotic for one week, in a stool culture test which organism should be obtained by the APRN? a. Helicobacter Pylori b. Salmonella Sp c. Clostridium Difficile d. Staphylococcus aureus 91. A 72 years old female patient who has a significant hearing loss is admitted In the hospital with pneumonia. Her family describes their frustration with their mother’s hearing problem and because of the difficulty with communication they often do not include their mother in conversations. What initial action should the APRN take? a. Determine if patient is eligible for Medicare funding for hearing aids b. Refer the patient to the otolaryngologist for an audiometric evaluation c. Explain that hearing problems can cause social isolation in the elderly d. Assess the patient’s external auditory canal for impacted cerumen 92. An older female patient who was exposed to tuberculosis (TB) arrived at the clinic with an acute viral upper respiratory infection (URI) and was given a purified protein derivate test. The PPD was negative 72 hours later. Which treatment plan should the APRN prescribe? a. Sputum for acid fast bacillus analysis times 3 b. Return visit in one year for annual TB skin testing c. Schedule patient for anterior posterior chest x ray. d. Repeat the PPD test in 1 week after URI resolves 93. A 15 years old female adolescent is brought to the clinic by her mother because has never experienced menarche. On examination, the APRN palpates enlarged breast buds, and observes early pubic hair growth and an intact hymen. What cause of delayed development in this female should the APRN conclude? a. Intact Hypothalamic pituitary gonadal axis with delayed maturation b. Central nervous system disorder that elevates GnRH levels c. Disruption of hypothalamic-pituitary-gonadal axis causing PSH/LH deficiencies d. Systemic condition that delays the closure of the epispheal plates 94. In which clinical trial could a placebo be used for the control group? a. A double blinded study for controlling blood glucose in Type I Diabetes b. An efficacy study of new chemotherapy for those with ovarian cancer c. A controlled study of three drugs used to treat urinary tract infections d. A comparison study of four transdermal agents using for smoking cessation. 95. The APRN is instructing the parents about the use of antipyretics for their toddler who has a febrile upper respiratory infection. Which information is most important for the ARNP to recommend the parents to do a. Give acetaminophen and antihistamine preparations at night before hour of sleep b. Alternate acetaminophen and Ibuprofen per label for core temperatures over 102.2 F c. Offer liquids and any foods that the child will accept and tolerate during fever. d. For core body temperature over 104 F, give toped bath and watch for reactions. 96. The APRN is conducting routine employee screening. A new employee ask how long it takes to get rid of marihuana in the body. The APRN should inform patient that recreational drugs such as marihuana, yield positive results for how long after used? a. 1 month b. 2 days c. 24 hours d. 2 weeks 97. What information should the APRN advice when performing nutritional counseling to the mother of a 9 month old infant? a. Give servings that equal the size of the children palm b. Offer popcorn as a low fat snack c. Provide 5 to 8 small meals a day d. Decrease water intake to improve solid food intake. 98. A sexually active adolescent client has symptoms of dysuria with urethral discharge. This urethritis is associated with a Chlamydia infection. What treatment should the APRN prescribe? a. Penicillin G b. Doxycycline c. Ceftriaxone d. Spectinomycin 99. A 19 years old presents to the college campus clinical and asks the APRN if she should be concerned if she contracts gonorrhea. What response should the APRN provide? a. Inquire if she and her partner use condoms during intercourse b. Determine if her male partner has severe burning with urination c. Explain that untreated gonorrhea can cause infertility in women d. Ask the patient if she has a purulent or foul vaginal discharge 100. In the abortive therapy of migraine headaches what condition precludes the use of sumatriptan? a. Migraine accompanied by severe nausea and vomiting b. Migraine in a patient with poorly controlled hypertension c. Headache that is concurrent with a menstrual period d. Headache in a patient with a history of epilepsy 101. A patient’s complete electronical medical record (EMR) is a legal document which should convey which clinical focus? a. Gives insight to the quality of comprehensive hospital care b. Determines direction of care based on patient’s health history c. Provides a story line of all aspects of care given and planned for a patient’s needs d. Contains history of family and patient health and illness through a lifespan. 102. A 20 years old college student comes to the campus health center with a chief complaint of “Strep Throat”. In addition to the painful sore throat, the student symptoms include head ache and fatigue, the APRN performs complete neuro and ENT examination, as well as auscultation of heart and lungs, and palpation of the abdomen. What findings should the APRN expect to confirm based on the client’s history? a. Palatal petechial rash caused by the untreated bacterial upper respiratory tract infection b. Liver enlargement that is likely to persist beyond one month due to concomitant hepatitis c. Adenopathy of the posterior cervical nodes secondary to the streptococcal infection d. Enlarged tonsils and splenomegaly characteristic of infectious viral mononucleosis. 103. An elderly patient who takes Coumadin (Warfarin) daily, request advice regarding a new prescription medication for join pain due to osteoarthritis. Which over the counter medication the APRN advise the patient to take? a. Acetaminophen (Tylenol) b. Aspirin (Buffen) c. Ibuprofen (Motrin) d. Naproxen (Naprosyn) 104. An 17 years old male who has been taking Bactrim for sinusitis presents to the emergency Department with a temperature of 103 F, malaise and hemorrhagic bullae on his lips, mouth and most of his body. Which admitting diagnosis should the APRN make? a. Erysipelas Cellulitis b. Erythema Multiform Minor c. Stevens Johnson Syndrome d. Rocky Mountain Spotted Fever 105. The APRN is assessing the primitive reflexes of a new born who is 6 hours old. Which reflex should the APRN investigate further? a. Palmar grasp b. Moro reflex c. Stepping reflex d. Placing reflex 106. The weight chart documented for a multigravida at 18 to 20 weeks gestation includes these findings: 18 weeks, 155 lbs; 19 weeks, 156 lbs; 20 weeks, 157 lbs. If the client had a normal body mass Index) before pregnancy, what should the APRN tell the client about her weight gain pattern? a. Inform her that her weight gain for the past 3 weeks is on target for this trimester. b. She needs to increase calorie intake to achieve weight goals in the 3rd trimester. c. Have the dietitian counsel the client about nutritional guidelines for the second trimester d. Advise for planned weight loss over one month by reducing carbohydrate intake. 107. The APRN should intervene when wish behavior is because it is a clear violation of the Health Insurance Portability Act (HIPAA)? a. A hospital transporter is reading a patient history and physical while waiting for a patient in a radiology department. b. Two visitors are discussing a hospitalized patient history of drug abuse in the gift shop near the main lobby. c. Two medical residents are overheard talking about a cure for AIDS outside the room of a patient with HIV infection. d. The staff nurse is overheard telling a patient with pancreatitis, “it’s hard to quit drinking but AA helped me” 108. A woman at 20 weeks gestation has a positive urine screen for Group B Streptococus. What action should the APRN take? a. Consult with obstetrician about hospitalized IV penicillin therapy b. Implement the protocol for a 10 day course of antibiotics c. Notify the pediatrician of the Group B streptococcal infection d. Teach the client about signs and symptoms of preterm labor. 109. A 12 years old male client who was playing soccer turned quickly to lock the ball and for stepped his knee. He rates his pain as 6 on scale of 10. The knee is swollen, ROM is limited and walking is difficult. The anterior drawer test is positive. Based on this assessment findings, what actions should the APRN take? a. Refer the patient to an orthopedic surgeon for repair of the torn ACL. b. Tell the client to treat his painful sprain with ice packs and an ace wrap c. Obtain an x ray on the leg to confirm the presence of a stress fracture d. Observe for ecchymosis over the patella resulting from the contusion 110. Which response to a patient by the APRN demonstrates a therapeutic communication technique? a. You seem upset about that b. Why are you so angry c. Let’s review what I said originally d. You need to talk about this now