NR 511 Final practice questions with accurate solutions
Final |Exam |Practice |Questions
Question |1. |Matthew, |age |52, |is |a |chef |who |just |severed |2 |of |his |fingers |with |a |meat |cutter. |You |would
|recommend |that |he:
1. Wrap |the |severed |fingers |tightly |in |a |dry |towel |for |transport |to |the |emergency |department |with |him.
2. Leave |the |severed |fingers |at |the |scene |because |fingers |cannot |be |reattached.
3. Immediately |freeze |the |severed |fingers |for |reattachment |in |the |near |future.
4. Wrap |the |fingers |in |a |clean, |damp |cloth; |seal |them |in |a |plastic |bag; |and |place |the |bag |in |an |ice |water
|bath. |Rationales
Option |1:
Severed |fingers |should |be |wrapped |in |a |clean, |damp |cloth; |sealed |in |a |plastic |bag; |and |placed |in |an |ice |water
|bath. |Option |2:
Severed |fingers |can |be |reattached |after |1 |to |2 |days—or |more—if |properly
|stored. |Option |3:
Severed |fingers |should |be |wrapped |in |a |clean, |damp |cloth; |sealed |in |a |plastic |bag; |and |placed |in |an |ice |water
|bath, |not |frozen |or |kept |at |body |temperature.
Option |4:
If |a |client |has |severed |his |fingers, |the |fingers |should |be |wrapped |in |a |clean, |damp |cloth; |sealed |in |a |plastic |bag;
|placed |in |an |ice |water |bath; |and |transported |to |the |emergency |room |along |with |the |client.
The |valgus |stress |test, |varus |stress |test, |Lachman |test, |and |thumb |sign |are |all |considered |standard |tests |to
|check |the |integrity |of |the |ligaments |of |the |knee. |Which |test |would |the |nurse |practitioner |choose |to |assess
|the |anterior |cruciate |ligament |(ACL), |which |is |the |most |commonly |involved |structure |in |severe |knee
|injury?
1. Valgus |stress |test.
2. Varus |stress |test.
3. Lachman |test.
4. Thumb |sign.
P |a |g |e | 1 || |
145
,|Rationales
|Option |1:
The |valgus |stress |test |assesses |stability |of |the |medial |collateral |ligament |(MCL).
|Option |2:
The |varus |stress |test |assesses |stability |of |the |lateral |collateral |ligament |(LCL).
|Option |3:
The |Lachman |test |assesses |the |ACL.
|Option |4:
The |thumb |sign |assesses |the |posterior |cruciate |ligament |(PCL).
Lillian, |age |70, |was |told |that |she |has |osteoporosis. |When |she |asks |you |what |this |is, |you |respond |that
|osteoporosis:
1. Develops |when |loss |of |bone |occurs |more |rapidly |than |new |bone |growth.
2. Is |a |degenerative |joint |disease |characterized |by |loss |of |cartilage |in |certain |joints.
3. Is |a |chronic |inflammatory |disorder |that |affects |multiple |joints.
P |a |g |e | 2 || |
145
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NR |511/NR |511 |Final |practice |questions.
4. Is |a |bone |disorder |that |has |to |do |with |inadequate |mineralization |of |the
|bones. |Rationales
Option |1:
Osteoporosis |develops |when |bone |resorption |occurs |more |rapidly |than |bone |deposition.
|Option |2:
Osteoarthritis |is |a |degenerative |joint |disease |characterized |by |degeneration |and |loss |of |articular |cartilage |in
|synovial |joints.
Option |3:
Rheumatoid |arthritis |is |a |chronic, |systemic |inflammatory |disorder |characterized |by |persistent |synovitis |of
|multiple |joints.
Option |4:
Osteomalacia |is |a |metabolic |bone |disorder |characterized |by |inadequate |mineralization |of |the |bone |matrix, |often
|caused |by |vitamin |D |deficiency.
Mike, |age |42, |a |golf |pro, |has |had |chronic |back |pain |for |many |years. |His |workup |reveals |that |it |is |not |the
|result |of |a |degenerative |disk |problem. |His |back |“goes |out” |about |twice |per |year, |and |he |is |out |of |work
|for |about |a |week |each |time. |Which |of |the |following |should |the |nurse |practitioner |advise |him |to |do?
1. Consider |changing |careers |to |something |less |physical.
2. Begin |a |planned |exercise |program |to |strengthen |back |muscles.
3. Make |an |appointment |with |a |neurosurgeon |for |a |surgical |consultation.
4. Start |on |a |daily |low-dose |narcotic |to |take |away |the
|pain. |Rationales
Option |1:
Suggesting |a |career |change |should |be |considered |only |in |cases |of |disability |or |inability |to |safely |continue |one’s
current |employment.
Option |2:
In |this |case, |Mike |may |benefit |from |a |regular |planned |exercise |program |to |strengthen |his |back |muscles |and
|attempt |to |reduce |the |probability |of |future |episodes |of |back |pain.
Option |3:
Surgery |is |recommended |only |for |clients |with |low |back |pain |caused |by |degenerative |disk |disorders, |and |then
|only |when |severe |neurologic |involvement |has |occurred. |Surgery |benefits |only |approximately |1% |of |people |with
|low |back |problems.
Option |4:
Narcotic |pain |medications |are |not |considered |first-line |treatment |for |mechanical |back
|pain. |Course |Topic: |Musculoskeletal |Problems |Concept(s): |21820Cognitive |Level: |Analysis
|[Analyzing]
Janine, |age |69, |has |class |III |rheumatoid |arthritis. |According |to |the |American |Rheumatism |Association, |which
|of |the |following |describes |her |ability |to |function?
1. Adequate |for |normal |activities |despite |a |handicap |of |discomfort |or |limited |motion |of |one |or |more |joints.
2. Largely |or |wholly |incapacitated, |bedridden, |or |confined |to |a |wheelchair, |permitting |little |or |no |self-care.
3. Completely |able |to |carry |out |all |usual |duties |without |handicap.
4. Adequate |to |perform |only |a |few |or |none |of |the |duties |of |usual |occupation |or |self-
care. |Rationales
Option |1:
P |a |g |e | 3 || |
145
, 3
NR |511/NR |511 |Final |practice |questions.
Class |II |refers |to |the |client |whose |function |is |adequate |for |normal |activities |despite |a |handicap |of |discomfort |or
|limited |motion |of |one |or |more |joints.
Option |2:
Class |IV |refers |to |the |client |who |is |largely |or |wholly |incapacitated, |bedridden, |or |confined |to |a |wheelchair,
|permitting |little |or |no |self-care.
Option |3:
Class |I |refers |to |the |client |who |can |carry |out |all |usual |duties |without |handicap.
|Option |4:
The |American |Rheumatism |Association |has |established |functional |classes |I |to |IV |to |describe |a |client’s |ability
|to |accomplish |activities |of |daily |living. |Because |Janine |is |class |III, |her |function |would |be |adequate |to |perform
|only |a |few |or |none |of |the |duties |of |usual |occupation |or |self-care.
For |an |adult |patient |with |a |knee |injury, |the |nurse |practitioner |orders |a |nonsteroidal |anti-inflammatory |drug
|(NSAID) |to |be |taken |on |a |routine |basis |for |the |next |2 |weeks. |Patient |teaching |should |include |which |of
|the |following?
1.
“You |may |take |this |medication |on |an |empty |stomach |as |long |as |you |eat |within |two |to |three |hours |of |taking |it.”
2.
“If |one |pill |does |not |seem |to |help, |you |can |double |the |dose |for |subsequent |doses.”
3.
“If |you |notice |nausea, |vomiting, |or |black |or |bloody |stools, |take |the |next |dose |with |a |glass |of |milk |or |a |full |meal.”
4.
“If |you |have |additional |pain, |an |occasional |acetaminophen |(Tylenol) |is |permitted |in |between |the |usual |doses |of |the
NSAID.”
Rationales
|Option |1:
When |teaching |clients |about |NSAIDs, |tell |them |not |to |take |these |drugs |on |an |empty |stomach |but |to |take |them
|with |food |or |milk.
Option |2:
Clients |should |be |taught |to |never |take |more |than |the |prescribed |dose |of |an |NSAID |due |to |the |likelihood |of
|increasing |the |chances |of |gastrointestinal |(GI) |and |kidney |damage.
Option |3:
When |teaching |clients |about |NSAIDs, |tell |them |to |stop |the |medication |and |call |immediately |if |they |notice |any
|nausea, |vomiting, |coffee-grounds |emesis, |black |stools, |or |blood |in |the |stool.
Option |4:
If |the |client |is |having |additional |pain, |acetaminophen |(Tylenol) |may |be |taken |in |conjunction |with |an |NSAID
|because |it |is |not |an |NSAID |and |will |not |potentiate |gastric |bleeding.
Sean, |a |factory |line |worker, |has |osteoarthritis |(OA) |of |the |right |hand. |According |to |the |American |College |of
|Rheumatology |(ACR), |the |guidelines |for |pharmacologic |treatment |include:
1. Acetaminophen, |tramadol, |and |intra-articular |corticosteroid |injections.
2. Oral |nonsteroidal |anti-inflammatory |drugs |(NSAIDs), |tramadol, |and |articular |corticosteroid |injections.
3. Acetaminophen, |topical |capsaicin, |and |topical |nonsteroidal |anti-inflammatory |drugs |(NSAIDs).
4. Topical |capsaicin, |topical |nonsteroidal |anti-inflammatory |drugs |(NSAIDs), |and |oral
|NSAIDs. |Rationales
P |a |g |e | 4 || |
145
Final |Exam |Practice |Questions
Question |1. |Matthew, |age |52, |is |a |chef |who |just |severed |2 |of |his |fingers |with |a |meat |cutter. |You |would
|recommend |that |he:
1. Wrap |the |severed |fingers |tightly |in |a |dry |towel |for |transport |to |the |emergency |department |with |him.
2. Leave |the |severed |fingers |at |the |scene |because |fingers |cannot |be |reattached.
3. Immediately |freeze |the |severed |fingers |for |reattachment |in |the |near |future.
4. Wrap |the |fingers |in |a |clean, |damp |cloth; |seal |them |in |a |plastic |bag; |and |place |the |bag |in |an |ice |water
|bath. |Rationales
Option |1:
Severed |fingers |should |be |wrapped |in |a |clean, |damp |cloth; |sealed |in |a |plastic |bag; |and |placed |in |an |ice |water
|bath. |Option |2:
Severed |fingers |can |be |reattached |after |1 |to |2 |days—or |more—if |properly
|stored. |Option |3:
Severed |fingers |should |be |wrapped |in |a |clean, |damp |cloth; |sealed |in |a |plastic |bag; |and |placed |in |an |ice |water
|bath, |not |frozen |or |kept |at |body |temperature.
Option |4:
If |a |client |has |severed |his |fingers, |the |fingers |should |be |wrapped |in |a |clean, |damp |cloth; |sealed |in |a |plastic |bag;
|placed |in |an |ice |water |bath; |and |transported |to |the |emergency |room |along |with |the |client.
The |valgus |stress |test, |varus |stress |test, |Lachman |test, |and |thumb |sign |are |all |considered |standard |tests |to
|check |the |integrity |of |the |ligaments |of |the |knee. |Which |test |would |the |nurse |practitioner |choose |to |assess
|the |anterior |cruciate |ligament |(ACL), |which |is |the |most |commonly |involved |structure |in |severe |knee
|injury?
1. Valgus |stress |test.
2. Varus |stress |test.
3. Lachman |test.
4. Thumb |sign.
P |a |g |e | 1 || |
145
,|Rationales
|Option |1:
The |valgus |stress |test |assesses |stability |of |the |medial |collateral |ligament |(MCL).
|Option |2:
The |varus |stress |test |assesses |stability |of |the |lateral |collateral |ligament |(LCL).
|Option |3:
The |Lachman |test |assesses |the |ACL.
|Option |4:
The |thumb |sign |assesses |the |posterior |cruciate |ligament |(PCL).
Lillian, |age |70, |was |told |that |she |has |osteoporosis. |When |she |asks |you |what |this |is, |you |respond |that
|osteoporosis:
1. Develops |when |loss |of |bone |occurs |more |rapidly |than |new |bone |growth.
2. Is |a |degenerative |joint |disease |characterized |by |loss |of |cartilage |in |certain |joints.
3. Is |a |chronic |inflammatory |disorder |that |affects |multiple |joints.
P |a |g |e | 2 || |
145
, 2
NR |511/NR |511 |Final |practice |questions.
4. Is |a |bone |disorder |that |has |to |do |with |inadequate |mineralization |of |the
|bones. |Rationales
Option |1:
Osteoporosis |develops |when |bone |resorption |occurs |more |rapidly |than |bone |deposition.
|Option |2:
Osteoarthritis |is |a |degenerative |joint |disease |characterized |by |degeneration |and |loss |of |articular |cartilage |in
|synovial |joints.
Option |3:
Rheumatoid |arthritis |is |a |chronic, |systemic |inflammatory |disorder |characterized |by |persistent |synovitis |of
|multiple |joints.
Option |4:
Osteomalacia |is |a |metabolic |bone |disorder |characterized |by |inadequate |mineralization |of |the |bone |matrix, |often
|caused |by |vitamin |D |deficiency.
Mike, |age |42, |a |golf |pro, |has |had |chronic |back |pain |for |many |years. |His |workup |reveals |that |it |is |not |the
|result |of |a |degenerative |disk |problem. |His |back |“goes |out” |about |twice |per |year, |and |he |is |out |of |work
|for |about |a |week |each |time. |Which |of |the |following |should |the |nurse |practitioner |advise |him |to |do?
1. Consider |changing |careers |to |something |less |physical.
2. Begin |a |planned |exercise |program |to |strengthen |back |muscles.
3. Make |an |appointment |with |a |neurosurgeon |for |a |surgical |consultation.
4. Start |on |a |daily |low-dose |narcotic |to |take |away |the
|pain. |Rationales
Option |1:
Suggesting |a |career |change |should |be |considered |only |in |cases |of |disability |or |inability |to |safely |continue |one’s
current |employment.
Option |2:
In |this |case, |Mike |may |benefit |from |a |regular |planned |exercise |program |to |strengthen |his |back |muscles |and
|attempt |to |reduce |the |probability |of |future |episodes |of |back |pain.
Option |3:
Surgery |is |recommended |only |for |clients |with |low |back |pain |caused |by |degenerative |disk |disorders, |and |then
|only |when |severe |neurologic |involvement |has |occurred. |Surgery |benefits |only |approximately |1% |of |people |with
|low |back |problems.
Option |4:
Narcotic |pain |medications |are |not |considered |first-line |treatment |for |mechanical |back
|pain. |Course |Topic: |Musculoskeletal |Problems |Concept(s): |21820Cognitive |Level: |Analysis
|[Analyzing]
Janine, |age |69, |has |class |III |rheumatoid |arthritis. |According |to |the |American |Rheumatism |Association, |which
|of |the |following |describes |her |ability |to |function?
1. Adequate |for |normal |activities |despite |a |handicap |of |discomfort |or |limited |motion |of |one |or |more |joints.
2. Largely |or |wholly |incapacitated, |bedridden, |or |confined |to |a |wheelchair, |permitting |little |or |no |self-care.
3. Completely |able |to |carry |out |all |usual |duties |without |handicap.
4. Adequate |to |perform |only |a |few |or |none |of |the |duties |of |usual |occupation |or |self-
care. |Rationales
Option |1:
P |a |g |e | 3 || |
145
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NR |511/NR |511 |Final |practice |questions.
Class |II |refers |to |the |client |whose |function |is |adequate |for |normal |activities |despite |a |handicap |of |discomfort |or
|limited |motion |of |one |or |more |joints.
Option |2:
Class |IV |refers |to |the |client |who |is |largely |or |wholly |incapacitated, |bedridden, |or |confined |to |a |wheelchair,
|permitting |little |or |no |self-care.
Option |3:
Class |I |refers |to |the |client |who |can |carry |out |all |usual |duties |without |handicap.
|Option |4:
The |American |Rheumatism |Association |has |established |functional |classes |I |to |IV |to |describe |a |client’s |ability
|to |accomplish |activities |of |daily |living. |Because |Janine |is |class |III, |her |function |would |be |adequate |to |perform
|only |a |few |or |none |of |the |duties |of |usual |occupation |or |self-care.
For |an |adult |patient |with |a |knee |injury, |the |nurse |practitioner |orders |a |nonsteroidal |anti-inflammatory |drug
|(NSAID) |to |be |taken |on |a |routine |basis |for |the |next |2 |weeks. |Patient |teaching |should |include |which |of
|the |following?
1.
“You |may |take |this |medication |on |an |empty |stomach |as |long |as |you |eat |within |two |to |three |hours |of |taking |it.”
2.
“If |one |pill |does |not |seem |to |help, |you |can |double |the |dose |for |subsequent |doses.”
3.
“If |you |notice |nausea, |vomiting, |or |black |or |bloody |stools, |take |the |next |dose |with |a |glass |of |milk |or |a |full |meal.”
4.
“If |you |have |additional |pain, |an |occasional |acetaminophen |(Tylenol) |is |permitted |in |between |the |usual |doses |of |the
NSAID.”
Rationales
|Option |1:
When |teaching |clients |about |NSAIDs, |tell |them |not |to |take |these |drugs |on |an |empty |stomach |but |to |take |them
|with |food |or |milk.
Option |2:
Clients |should |be |taught |to |never |take |more |than |the |prescribed |dose |of |an |NSAID |due |to |the |likelihood |of
|increasing |the |chances |of |gastrointestinal |(GI) |and |kidney |damage.
Option |3:
When |teaching |clients |about |NSAIDs, |tell |them |to |stop |the |medication |and |call |immediately |if |they |notice |any
|nausea, |vomiting, |coffee-grounds |emesis, |black |stools, |or |blood |in |the |stool.
Option |4:
If |the |client |is |having |additional |pain, |acetaminophen |(Tylenol) |may |be |taken |in |conjunction |with |an |NSAID
|because |it |is |not |an |NSAID |and |will |not |potentiate |gastric |bleeding.
Sean, |a |factory |line |worker, |has |osteoarthritis |(OA) |of |the |right |hand. |According |to |the |American |College |of
|Rheumatology |(ACR), |the |guidelines |for |pharmacologic |treatment |include:
1. Acetaminophen, |tramadol, |and |intra-articular |corticosteroid |injections.
2. Oral |nonsteroidal |anti-inflammatory |drugs |(NSAIDs), |tramadol, |and |articular |corticosteroid |injections.
3. Acetaminophen, |topical |capsaicin, |and |topical |nonsteroidal |anti-inflammatory |drugs |(NSAIDs).
4. Topical |capsaicin, |topical |nonsteroidal |anti-inflammatory |drugs |(NSAIDs), |and |oral
|NSAIDs. |Rationales
P |a |g |e | 4 || |
145
