Questions with Verified Rationalized Answers
100% Guarantee Pass score of 700 points
Consist of 150 Questions with Answers
1. A 40-year-old woman with type 2 diabetes presents to the clinic with con-
cerns of spiking blood sugar between lunch and dinner. She states she is
on a rapid-acting insulin sliding scale and long-acting insulin. Which change
should be implemented to help prevent or curb this glycemic spike?
A.
Add a dose of mealtime insulin aspart (Novolog) at lunch
B.
Add insulin detemir (Levemir) at night
C.
Increase her insulin glargine (Lantus)
D.
Prescribe a dose of neutral protamine Hagedorn insulin with dinner
Answer> Add a dose of mealtime insulin aspart (Novolog) at lunch
Insulin aspart (Novolog) (A) is a rapid acting insulin that is commonly dosed with
,meals and as a sliding scale regimen based on a patient's glucose prior to eating
(preprandial). It is the appropriate insulin to add as a mealtime dose when patients
experience blood glucose spikes between meals because of its short-acting proper-
ties. Peak time action of insulin aspart is 2 hours with initial effect within the first 30
minutes, making it an ideal choice to control expected postprandial glycemic spikes
2. Which of the following conditions is associated with an increased risk for
conductive hearing loss?
A.
Acoustic neuroma
B.
Ménière disease
C.
Otitis media
D.
Presbycusis
Answer> Otitis media
Causes of conductive hearing loss are otitis media (C), otitis externa, foreign objects
in the ear canal, impacted ear wax, tumors, congenital anomalies, discontinuity
of middle ear bones, cholesteatoma, and tympanic membrane rupture. Sound
normally travels down the ear canal to vibrate the eardrum (tympanic membrane).
The eardrum is connected to three middle ear bones (malleus, incus, and stapes),
which transmit the sound into the inner ear (cochlea). The cochlea is the organ that
changes sound vibrations into a nerve signal that travels to the brain. The four types
,of hearing loss are conductive, sensorineural, mixed, and retrocochlear. Conductive
hearing loss occurs when sound cannot effectively reach the inner ear due to issue
in the outer ear and middle ear.
3. A 23-year-old patient who is pregnant at 28 weeks gestation presents to the
clinic for a routine prenatal checkup. Which fundal height measurement would
warrant a more conclusive assessment with an ultrasound?
A.
26 cm
B.
29 cm
C.
30 cm
D.
31 cm
Answer> 31 cm
After 20 weeks gestation, the fundal height should be measured with a measuring
tape in centimeters and should match the gestational age. It can be > or < 2
centimeters and still be within normal limits. A fundal height of 26-30 cm is a normal
finding in a patient who is 28 weeks gestation. A result of 31 cm (D) is larger than
expected and should be further evaluated with an ultrasound.
4. A 4-year-old boy presents with ear pain and an erythematous, bulging
, tympanic membrane on examination. The nurse practitioner diagnoses him
with acute otitis media. Which of the following are the three most common
bacterial pathogens associated with acute otitis media in children?
A.
Moraxella catarrhalis, Staphylococcus aureus, Streptococcus pneumoniae
B.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus
aureus
C.
Nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus
pneumoniae
D.
Nontypeable Haemophilus influenzae, Staphylococcus aureus, Streptococ-
cus pneumoniae
Answer> Nontypeable Haemophilus influenzae, Moraxella catarrhalis,
Streptococcus pneumoniae
Acute otitis media is commonly encountered by primary care nurse practitioners.
Typically, children present with otalgia and have a bulging tympanic membrane
on examination. Many times, children also have a preceding viral upper respi-
ratory infection, resulting in the colonization of bacteria in the middle ear and
leading to a bacterial infection. Ear infections can be caused by bacterial and viral
pathogens. The most common bacterial pathogens isolated from middle ear fluid
are nontypeable Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus