NSG 6998 LEIK FNP – Questions With Fully Explained
Solutions
A 72-year-old woman has been on hydrochlorothiazide 12.5 mg for many
years to control her Stage II hypertension. Her blood pressure (BP) at this
visit is 168/96. She is currently complaining of pain on her right hip and on
both knees. She has increased her dose of ibuprofen (Motrin) from 400 mg 3
times day (TID) to 800 mg TID. She is still in pain and would like something
stronger. Which of the following statements is the best explanation of the
effects of ibuprofen (Motrin) on her disease?
A) It increases the chances of adverse effects to her health
B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of
the diuretic
C) It prolongs the therapeutic effects of hydrochlorothiazide and other
diuretics
D) None of the statements are true Correct Answer - B) It inhibits the
effect of renal prostaglandins and blunts the effectiveness of the diuretic.
NSAIDs and ASA inhibit the vasodilatory effects of prostaglandins, which
predisposes the kidney to ischemia. NSAIDs and diuretics can cause acute
prerenal failure by decreasing renal blood flow.
2. All of the following are infections that affect mostly the labia and vagina
except:
A) Bacterialvaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis Correct Answer - D) Chlamydia trachomatis
Infections that commonly affect the labia and vagina include bacterial
vaginosis, candidiasis, and trichomoniasis. Chlamydia trachomatis commonly
affects the cervix, endometrial lining , fallopian tubes, and pelvic cavity.
The nurse practitioner would test the obturator and iliopsoas muscle to
evaluate for:
,A) Cholecystitis
B) Acute appendicitis
C) Inguinal hernia
D) Gastriculcer Correct Answer - B) Acute appendicitis.
Signs and symptoms of an acute abdomen include invol- untary guarding,
rebound tenderness, boardlike abdomen, and a positive obtu- rator and psoas
sign. A positive obturator sign occurs when pain is elicted by internal rotation
of the right hip from 90 degrees hip/knee flexion. The psoas sign is positive
when pain occurs with passive extension of the thigh while the patient is lying
on his/her side with knees extended, or when pain occurs with active flexion
of his/her thigh at the hip.
Treatment for mild preeclampsia includes all of the following except:
A) Bed rest except for bathroom privileges
B) Close monitoring of weight and blood pressure
C) Close follow-up of urinary protein, serum creatinine, and platelet count
D) A prescription of methyldopa (Aldomet) to control blood pressure
Correct Answer - D) A prescription of methyldopa (Aldomet) to control
blood pressure
Recommended care for women diagnosed with preeclampsia includes bed
rest with bath- room privileges, weight and BP monitoring, and closely
following urine protein and serum protein, creatinine, and platelet counts.
Oral medications are not used as first-line treatment.
All of the following services are covered under Medicare Part A except:
A) Inpatienthospitalizations
B) Medicines administered to a patient while hospitalized
C) Nursing home care
D) Surgeons Correct Answer - C) Nursing home care
Medicare A coverage includes inpatient hospitalization and skilled care given
in a certified skilled nursing facility. Most nursing home care is custodial care
(help with bathing, dressing, using a bathroom, and eating). This care is not
covered by Medicare A.
,A 28-year-old student is seen in the school health clinic with complaints of a
hacking cough that is productive of small amounts of sputum and a runny
nose. He does not take any medications, denies any allergies, and has no
significant medical history. Physical examination reveals a low-grade
temperature of 99.9 degrees Fahrenheit, respirations of 16/min, a pulse of 90
beats per minute, and diffuse fine crackles in the base of the lungs. A chest
radiograph (x-ray) shows diffuse infiltrates on the lower lobe of the right lung.
The total white blood cell count is 10,500/uL. What is the most likely
diagnosis?
A) Streptococcal pneumonia
B) Mycoplasma pneumonia
C) Acute bronchitis
D) Legionnaires disease Correct Answer - B) Mycoplasma pneumonia
Mycoplasma pneumonia is the organism most com- monly seen in children
and young adults. It is easily spread from droplets, from sneezing and
coughing, in close proximity. Diagnosis is based on symptoms and x-ray
results of infiltrates in lower lobes.
A 39-year-old migrant worker presents to the clinic 2.5 days after a purified
protein derivative (PPD) test. What minimum size of induration would be
considered posi- tive for this patient?
A) 3 mm B) 5 mm C) 10 mm D) 15 mm Correct Answer - C) 10 mm
The PPD is administered on the volar aspect of the lower arm and read 48
hours after the test is given. The PPD result must have induration and
measure 10 mm or greater to be positive in a low-risk patient. Induration
(firmness with palpation) must be present. If the site has erythema but no
induration, result would be negative. Color is not important.
All of the following are correct statements regarding the role of the person
named in a durable power of attorney except:
A) The agent's decisions are legally binding
B) The agent can make decisions in other areas of the patient's life such as
financial
issues
, C) The agent can decide for the patient who is on life support when that life
support
can be terminated
D) The patient's spouse has a right to override the agent's decisions Correct
Answer - D) The patient's spouse has a right to override the agent's
decisions
The person named in a durable power of attorney (the agent) is designated by
the patient to make all medical decisions, as well as any decisions regarding
the patient's private affairs in the event that the patient becomes incompetent
and unable to make his/her own decisions. No one has the ability to override
the agent's decision.
All of the following are true statements regarding Munchausen syndrome
except:
A) It is considered a mental illness
B) The patient has a medical illness that causes an anxiety reaction and denial
C) The patient fakes an illness in order to gain attention from health care
providers
D) The patient has an inconsistent medical history along with a past history of
frequent hospitalizations Correct Answer - B) The patient has a medical
illness that causes an anxiety reaction and denial
Munchausen syndrome is a psychiatric disorder in which the patient fakes a
medical illness or disorder to gain attention from health care provid- ers.
These patients commonly use the emergency department frequently to gain
attention.
Which of the following antihypertensive medications should the nurse
practitioner avoid when treating patients with emphysema?
A) Calcium channel blockers
B) Angiotensin-converting enzyme (ACE) inhibitors
C) Beta-blockers
D) Diuretics Correct Answer - C) Beta-blockers
Beta-blockers should be avoided in patients with a history of emphysema.
Studies have shown evidence of a reduction in forced expiratory volume in 1
Solutions
A 72-year-old woman has been on hydrochlorothiazide 12.5 mg for many
years to control her Stage II hypertension. Her blood pressure (BP) at this
visit is 168/96. She is currently complaining of pain on her right hip and on
both knees. She has increased her dose of ibuprofen (Motrin) from 400 mg 3
times day (TID) to 800 mg TID. She is still in pain and would like something
stronger. Which of the following statements is the best explanation of the
effects of ibuprofen (Motrin) on her disease?
A) It increases the chances of adverse effects to her health
B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of
the diuretic
C) It prolongs the therapeutic effects of hydrochlorothiazide and other
diuretics
D) None of the statements are true Correct Answer - B) It inhibits the
effect of renal prostaglandins and blunts the effectiveness of the diuretic.
NSAIDs and ASA inhibit the vasodilatory effects of prostaglandins, which
predisposes the kidney to ischemia. NSAIDs and diuretics can cause acute
prerenal failure by decreasing renal blood flow.
2. All of the following are infections that affect mostly the labia and vagina
except:
A) Bacterialvaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis Correct Answer - D) Chlamydia trachomatis
Infections that commonly affect the labia and vagina include bacterial
vaginosis, candidiasis, and trichomoniasis. Chlamydia trachomatis commonly
affects the cervix, endometrial lining , fallopian tubes, and pelvic cavity.
The nurse practitioner would test the obturator and iliopsoas muscle to
evaluate for:
,A) Cholecystitis
B) Acute appendicitis
C) Inguinal hernia
D) Gastriculcer Correct Answer - B) Acute appendicitis.
Signs and symptoms of an acute abdomen include invol- untary guarding,
rebound tenderness, boardlike abdomen, and a positive obtu- rator and psoas
sign. A positive obturator sign occurs when pain is elicted by internal rotation
of the right hip from 90 degrees hip/knee flexion. The psoas sign is positive
when pain occurs with passive extension of the thigh while the patient is lying
on his/her side with knees extended, or when pain occurs with active flexion
of his/her thigh at the hip.
Treatment for mild preeclampsia includes all of the following except:
A) Bed rest except for bathroom privileges
B) Close monitoring of weight and blood pressure
C) Close follow-up of urinary protein, serum creatinine, and platelet count
D) A prescription of methyldopa (Aldomet) to control blood pressure
Correct Answer - D) A prescription of methyldopa (Aldomet) to control
blood pressure
Recommended care for women diagnosed with preeclampsia includes bed
rest with bath- room privileges, weight and BP monitoring, and closely
following urine protein and serum protein, creatinine, and platelet counts.
Oral medications are not used as first-line treatment.
All of the following services are covered under Medicare Part A except:
A) Inpatienthospitalizations
B) Medicines administered to a patient while hospitalized
C) Nursing home care
D) Surgeons Correct Answer - C) Nursing home care
Medicare A coverage includes inpatient hospitalization and skilled care given
in a certified skilled nursing facility. Most nursing home care is custodial care
(help with bathing, dressing, using a bathroom, and eating). This care is not
covered by Medicare A.
,A 28-year-old student is seen in the school health clinic with complaints of a
hacking cough that is productive of small amounts of sputum and a runny
nose. He does not take any medications, denies any allergies, and has no
significant medical history. Physical examination reveals a low-grade
temperature of 99.9 degrees Fahrenheit, respirations of 16/min, a pulse of 90
beats per minute, and diffuse fine crackles in the base of the lungs. A chest
radiograph (x-ray) shows diffuse infiltrates on the lower lobe of the right lung.
The total white blood cell count is 10,500/uL. What is the most likely
diagnosis?
A) Streptococcal pneumonia
B) Mycoplasma pneumonia
C) Acute bronchitis
D) Legionnaires disease Correct Answer - B) Mycoplasma pneumonia
Mycoplasma pneumonia is the organism most com- monly seen in children
and young adults. It is easily spread from droplets, from sneezing and
coughing, in close proximity. Diagnosis is based on symptoms and x-ray
results of infiltrates in lower lobes.
A 39-year-old migrant worker presents to the clinic 2.5 days after a purified
protein derivative (PPD) test. What minimum size of induration would be
considered posi- tive for this patient?
A) 3 mm B) 5 mm C) 10 mm D) 15 mm Correct Answer - C) 10 mm
The PPD is administered on the volar aspect of the lower arm and read 48
hours after the test is given. The PPD result must have induration and
measure 10 mm or greater to be positive in a low-risk patient. Induration
(firmness with palpation) must be present. If the site has erythema but no
induration, result would be negative. Color is not important.
All of the following are correct statements regarding the role of the person
named in a durable power of attorney except:
A) The agent's decisions are legally binding
B) The agent can make decisions in other areas of the patient's life such as
financial
issues
, C) The agent can decide for the patient who is on life support when that life
support
can be terminated
D) The patient's spouse has a right to override the agent's decisions Correct
Answer - D) The patient's spouse has a right to override the agent's
decisions
The person named in a durable power of attorney (the agent) is designated by
the patient to make all medical decisions, as well as any decisions regarding
the patient's private affairs in the event that the patient becomes incompetent
and unable to make his/her own decisions. No one has the ability to override
the agent's decision.
All of the following are true statements regarding Munchausen syndrome
except:
A) It is considered a mental illness
B) The patient has a medical illness that causes an anxiety reaction and denial
C) The patient fakes an illness in order to gain attention from health care
providers
D) The patient has an inconsistent medical history along with a past history of
frequent hospitalizations Correct Answer - B) The patient has a medical
illness that causes an anxiety reaction and denial
Munchausen syndrome is a psychiatric disorder in which the patient fakes a
medical illness or disorder to gain attention from health care provid- ers.
These patients commonly use the emergency department frequently to gain
attention.
Which of the following antihypertensive medications should the nurse
practitioner avoid when treating patients with emphysema?
A) Calcium channel blockers
B) Angiotensin-converting enzyme (ACE) inhibitors
C) Beta-blockers
D) Diuretics Correct Answer - C) Beta-blockers
Beta-blockers should be avoided in patients with a history of emphysema.
Studies have shown evidence of a reduction in forced expiratory volume in 1
