Thomas Jefferson University: NU 674/NU674 Exam 1 Fall 2025 | 100% Updated Answers all Correct | Already Graded A.

THOMAS JEFFERSON UNIVERSITY JEFFERSON COLLEGE OF NURSING FALL 2025 NU 674 Exam 1 Your Name: Your ID: Make sure you mark the correct answer clearly. Question #: 1 A patient is assigned a visual acuity of 20/100 in her left eye. Which of the following is true? A. She obtains a 20% correct score at 100 feet. B. She can accurately name 20% of the letters at 20 feet. C. She can see at 20 feet what a normal person could see at 100 feet. D. She can see at 100 feet what a normal person could see at 20 feet. Question #: 2 The advanced practice registered nurse examines a patient with a single, firm, nontender nodule on the upper eyelid. He/she will chart this as A. a hordeolum. a chalazion. blepharitis. conjunctivitis. Attachment: attachment_for_itemid_Question #: 3 The advanced practice registered nurse examines a patient with an acute, focal area of pain, warmth, swellling and edema on the upper eyelid. He/she will chart this as A. a hordeolum. a chalazion blepharitis. conjunctivitis. Attachment: attachment_for_itemid_ Question #: 4 A patient presents to the emergency room for evaluation of "blood in the left eye." The patient denies trauma or injury but has been coughing forcefully with a recent cold. The patient denies visual disturbances, eye pain, or discharge from the eye. On physical examination the advanced practice nurse practitioner notes that pupils are equal, round, and reactive to light, with a visual acuity of 20/20 in each eye and 20/20 bilaterally. There is a homogeneous, sharply demarcated red area at the lateral aspect of the base of the left eye. The cornea is clear. Based on this description the most likely diagnosis is A. conjunctivitis. B. acute iritis. C. corneal abrasion. D. subconjunctival hemorrhage.Question #: 5 A 58-year-old woman presents with a sudden left-sided headache that is most painful in her left eye. Her vision is blurred, and the left pupil is slightly dilated and poorly reactive. The left conjunctiva is markedly injected, and the eyeball is firm. Vision screen with the Snellen chart is 20/30 in the right eye and 20/90 in the left eye. The most appropriate action is A. prompt referral to an ophthalmologist. B. to provide analgesia and repeat the evaluation when the patient is more comfortable. C. to instill a corticosteroid ophthalmic solution. D. to patch the eye and arrange for follow-up in 24 hours. Question #: 6 A 32-year-old patient presents to your office with a 10-day history of left sided facial pain, nasal congestion and thick, green nasal drainage. On physical exam the advanced practice registered nurse notes tenderness percussing over the left maxilla. The most likely diagnosis for this patient is A. otitis media. B. allergic rhinitis. C. acute sinusitis. D. mastoiditis. Question #: 7 A 54-year-old patient presents with sudden onset of sore throat. He has pain with swallowing, but is able to do so. Assessment by the advanced practice nurse practitioner (APRN) reveals tonsillar exudate, anterior cervical lymphadenopathy, presence of a fever and absence of a cough. The APRN will begin treatment for A. Haemophilus influenza. B. Group A beta-hemolytic streptococcus. C. Epstein-Barr virus. D. Rhinovirus.Question #: 8 Current guidelines state that the only indication for antibiotic treatment of a sore throat is A. Rhinovirus. B. Coxsackie disease. C. Group A beta-hemolytic Streptococcus D. Mononucleosis. Question #: 9 A patient presents to the advanced practice registered nurse (APRN) with exudative tonsillitis, palatal petechiae, posterior cervical lymphadenopathy and hepatosplenomegaly. The APRN does a rapid strep test, and the result is positive. The patient has no drug allergies. The APRN will start the patient on A. Penicillin. B. Amoxicillin. C. Cephalexin. D. Acyclovir. Question #: 10 The advanced practice registered nurse will send which patient for immediate imaging? A. The patient with nasal discharge and persistent cough for 10 days B. The patient with purulent eye drainage and lethargy C. The patient with worsening nasal discharge and frontal headache over the last week D. The patient with three days of T102F and purulent nasal dischargeQuestion #: 11 A patient presents to the office with "constant nasal congestion". The advanced practice registered nurse takes a history that includes use of Phenylephrine (Neo-Synephrine) for rhinitis consistently for two years. The most likely diagnosis will be A. rhinitis of viral etiology. B. rhinitis of allergic etiology. C. rhinitis medicamentosum. D. atrophic rhinitis. Question #: 12 A patient presents to the clinic with "nosebleed." Upon assessment, the advanced practice registered nurse (APRN) notes clotted blood and brownish-red throat discoloration. The best action by the APRN is A. continuous pressure for 10-15 minutes superior to the nasal alar cartilage. B. immediate application of silver nitrate to both nares. C. referral to ENT specialist. D. apply topical vasoconstrictor (Afrin) until bleeding subsides. Question #: 13 Select three of the following patient presentations of acute otitis media that can be easily treated by the advanced practice registered nurse with Amoxicillin 80-90 mg/Kg/day A. fiery red tympanic membrane. B. bulging tympanic membrane. C. obscured cone light reflex. D. redness, swelling, pain over mastoid.Question #: 14 The advanced practice registered nurse (APRN) places a wick for antibiotic treatment for a patient with external otitis media. Select three important follow-up teaching points. A. apply the drops to the wick as directed. B. return in 7-10 days for wick removal. C. keep the ear dry. D. use 2% Acetic Acid solution prophylactically after treatment. Question #: 15 The advanced practice registered nurse assesses a 72-year-old patient with gradual, painless, progressive loss of vision. She also admits to change in her color vision and severe glare when driving at night. The most likely cause of this change in vision is A. a cataract. B. macular degeneration. C. open-angle glaucoma. D. retinal detachment. Question #: 16 When treating a child or elderly patient for bacterial conjunctivitis, the preferred treatment is A. Trimethoprim and polymyxin B (Polytrim) drops. B. Moxifloxacin (Vigamox) drops. C. Erythromycin ointment. D. single dose Azithromycin.Question #: 17 Treatment for hordeolum and chalazion may include (Select 4 choices.) A. eyelid hygiene. B. discontinuing use of makeup and contacts. C. warm compresses. D. gentle pressure to extrude contents. E. referral for persistence. Question #: 18 A 43-year-old woman with a history of hypertension and gestational diabetes presents to your office for treatment of her upper respiratory infection symptoms. The advanced practice registered nurse will teach her to avoid what medications when choosing symptomatic treatment? A. Acetaminophen B. Corticosteroid nasal spray C. Pseudoephedrine D. Guaifenesin Question #: 19 An adult male patient is being evaluated by the advanced practice registered nurse (APRN) for a sore throat. He has difficulty swallowing and some mouth pain. On exam, the APRN notes that the mouth, tongue and pharynx are coated with white curd-like plaques that are diffcult to remove and leave a red surface when scraped with a tongue blade. The APRN will A. refer him to an ENT specialist for evaluation. B. prescribe Amoxicillin 500 mg by mouth three times daily for 10 days. C. encourage the patient to have HIV screening. D. recommend a clear liquid diet over the next few days.Question #: 20 A 21-year-old man presents to the advanced practice registered nurse (APRN) with a 2 week history of ear pain and pruritus. On further questioning, he states that he also has ear fullness with trouble hearing. He is a senior in college on a swimming scholarship. He has had these eipsodes in the past but not to this extent. On exam, his tympanic membrane is difficult to visualize, but it is mobile without any inflammation. There is pain on palpation of the tragus and with traction of the pinna. The APRN will treat this patient with A. Hydrocortisone/neomycin/polymixin B B. Amoxicillin C. Amoxicillin/clavulanate D. Tacrolimus cream Question #: 21 An advanced practice registered nurse advises a patient with a significant family history of testicular cancer to perform monthly testicular examinations. What term identifies this measure? A. Health maintenance B. Primary prevention C. Secondary prevention D. Tertiary prevention Question #: 22 An advanced practice registered nurse wants to update his/her knowledge of primary prevention strategies for use with his/her patient population. Which source is most appropriate? A. Department of Health and Human Services (HHS) B. United States Preventive Services Task Force (USPSTF) C. State Department of Health D. Centers for Medicare and Medicaid Services (CMS)Question #: 23 A community is planning a public health program to clean up a toxic waste dump that has been associated with a high prevalence of chronic respiratory diseases in the community. Which of the following categories of public health determinants will be directly affected by this program? A. Health services B. Individual behavior C. Social factors D. Biology and genetics Question #: 24 When working as part of a collaborative care team, which of the following is true? A. The leader of a healthcare team should be the professional with the greatest professional ability B. Each member of the team should retain autonomy for their area of practice C. Accountability for patient outcomes is shared D. Clarity about roles and responsibilities is unimportant in the context of team collaborative care Question #: 25 An advanced practice registered nurse knows that which of the following is responsible for interpreting scope of practice parameters? A. State Medical Licensure Board B. State Board of Nursing C. State Legislature D. Individual nurse practitionerQuestion #: 26 An advanced practice registered nurse (APRN) is interviewing for a new position in an adjacent state. During the interview, the APRN is asked if he/she is certified. What does the interviewer want to know? A. Whether the nurse practitioner has a license granted by the state board of nursing B. Whether the nurse practitioner is able to practice independently C. Whether the nurse practitioner has achieved recognition of certain advanced skills and knowledge D. Whether the nurse practitioner has the ability to prescribe controlled substances Question #: 27 Nonmaleficence is an ethical principle in healthcare. It is best defined as: A. compassion; a desire to do good. B. dedication, fairness, honesty, advocacy, and commitment to patients. C. avoidance of harm. D. equal and fair distribution of resources, based on impartial analysis of benefits. Question #: 28 What was the major impetus for the creation of the nurse practitioner role? A. Need for an expert nurse clinician B. Shortage of primary care physicians C. Trend for specialized nurses to diagnose and manage unstable acute and chronic conditions D. Movement of graduate nursing education to diagnosis and treatment of major illnessesQuestion #: 29 More than 234,000 women receive a diagnosis of breast cancer annually in the United States. Which of the following is a secondary prevention strategy for breast cancer? A. Increased exercise B. Weight loss C. Radical mastectomy D. Screening mammograms Question #: 30 An 82-year-old female presents for a routine follow-up visit. She lives at home and is otherwise healthy. She denies any falls or difficulty with gait or balance. Her daily medications include vitamin D 5000 IU, Calcium 1200 mg, and aspirin 81 mg by mouth daily. What would you include in your anticipatory guidance to reduce the patient's risk of falls? A. Decrease daily medications B. Advise about proper footwear C. Advise moving into an assisted living facility D. Decrease fluid intake Question #: 31 A 62-year-old patient with a 40 pack/year smoking history presents to the advanced practice registered nurse's office with fever, cough with sputum production, and pleuritic chest pain. The patient also has a history of chronic obstructive pulmonary disease (COPD). There is a left lower lobe infiltrate on her chest x-ray. The most likely etiology of this infection is A. Haemophilus influenzae. B. Klebsiella pneumoniae. C. Coccidioides species. D. Mycoplasma pneumonia.Question #: 32 The advanced practice registered nurse (APRN) treated a patient in the office for pneumonia 4 days ago. The patient calls and states that a fever persists and she was awakened today by shortness of breath. The APRN recommends that the patient A. increase her antibiotic dose. B. begin oral steroids. C. be evaluated in the office or emergency room today. D. be referrred to an Infectious Disease specialist. Question #: 33 A patient presents to the advanced practice registered nurse's (APRN) office with cough productive of clear/white sputum production for 5 days. The patient had a low grade fever the first two days of illness, has noted fatigue and has missed work. On physical exam the APRN notes mild expiratory wheezes without rhonchi or crackles. The most likely diagnosis is A. Mycoplasma pneumonia. B. Typical community acquired pneumonia. C. Atypical pneumonia. D. Bronchitis. Question #: 34 A patient presents to the advanced practice registered nurse (APRN) with a history of coughing for 6 weeks. The patient hasn’t felt bad enough to miss work, but is now exhausted and seeking treatment. Which of the following is least likely to be part of the patient's history and office exam? A. Rhonchi B. High fever C. Mild diaphoresis D. FatigueQuestion #: 35 On physical exam, an otherwise healthy 42-year-old patient has wheezes and rhonchi. The advanced practice registered nurse suspects community acquired pneumonia (CAP) and sends the patient for a chest x-ray. The first line therapy for this patient is a A. Fluoroquinolone. B. Penicillin. C. Macrolide. D. Cephalosporin. Question #: 36 The gold standard used by the advanced practice registered nurse to diagnose pneumonia is A. the CURB-65 tool. B. a sputum culture. C. a chest x ray. D. findings on physical exam. Question #: 37 Treatment for acute bronchitis includes (Select 3): A. Antimicrobial therapy B. Cough suppressants C. Hydration D. Inhaled corticosteroidsQuestion #: 38 Which of the following would be appropriate for the advanced practice registered nurse to use in the treatment of a patient with community acquired pneumonia? A. 2-week office follow up B. 7 to12-week repeat chest x ray C. Vaccination for pneumonia and influenza D. All of the above Question #: 39 Most cough in adults is associated with (Select 3) A. asthma. B. GERD. C. postnasal drip. D. pneumonia. Question #: 40 The advanced practice registered nurse (APRN) asks the patient to say 'e' while she ausculates over the chest wall. The APRN hears a nasal quality 'a' over the left lower lobe. The APRN will consider which of the following in her differential? A. Asthma B. Bronchitis C. Chronic Obstructive Pulmonary Disease D. PneumoniaQuestion #: 41 In the empiric treatment of cough in adults the advanced practice registered nurse will include A. antibiotics. B. Dextromethorphan. C. inhaled corticosteroids. D. inhaled cholinergics. Question #: 42 A patient presents to the advanced practice registered nurse's (APRN) office accompanied by a family member. The patient is complaining of dyspnea and has a pulse ox of 86. Assuming all options are available the APRN's priority will be A. calling 911 for transport to the nearest emergency room. B. providing a nebulizer treatment. C. providing supplemental oxygen. D. requesting the family member transport the patient to the nearest emergency room. Question #: 43 An acute cough associated with an infection will most likely persist for up to A. 1 week. B. 1 month. C. 2 months. D. 48 hours after treatment.Question #: 44 How old must a patient be to receive a seasonal influenza vaccine? A. 2 weeks B. 1 month C. 6 months D. 1 year Question #: 45 Treatment of seasonal influenza for patients 2 weeks of age or older can include which of the following? A. Aspirin as needed B. Oseltamivir (Tamiflu) C. Peramivir (Rapivab) D. Zanamivir (Relenza) Question #: 46 Initial treatment of the adult patient with co-morbidities that presents with presumptive symptoms of bronchitis might include (Select 3) A. antibiotics. B. antihistamines. C. antivirals. D. cough suppressant.Question #: 47 An elderly patient with pneumonia may appear with which of the following symptoms first? A. Altered mental status and dehydration B. Fever and chills C. Hemoptysis and dyspnea D. Pleuritic chest pain and cough Question #: 48 A Pneumovax 23 vaccine (PSV23) is recommended for (Select 3) A. high risk children under 2 years old with a history of pneumonia. B. all adults 65 years of age and older. C. anyone 2 through 64 years of age with certain co-morbidities. D. adults 19-64 years of age who smoke or have asthma. Question #: 49 The following should be ordered by the advanced practice registered nurse for the patient that presents complaining of a chronic productive cough (Select 3) A. Chest x-ray B. CT scan C. Sputum culture D. Sputum cytology Question #: 50 The most common cause of community acquired pneumonia is A. Klebsiella. B. Legionella. C. Pseudomonas Aeruginosa. D. Streptococcus Pneumoniae.