NURS 623 Final Exam | Questions with 100% Correct Answers

NURS 623 Final Exam | Questions with 100% Correct Answers The proper order of assessing the abdomen is inspection, auscultation, percussion, palpation. When percussing the abdomen, hyperresonance is present: When there is gaseous distention A 35-year-old female patient is seen in the clinic complaining of abdominal pain. Which of the following should be included in the history and physical exam? A. Digital Rectal Exam B. Pelvic Exam C. Sexual History D. All of the above A 28-year-old patient is seen in the clinic with colicky abdominal pain, particularly with meals. She has frequent constipation, flatulence, and abdominal distension. Which of the data make a diagnosis of diverticulitis unlikely? A. Her age B. Flatulence C. Frequent constipation D. Colicky abdominal pain A 25-year-old accountant is seen in the clinic complaining of crampy abdominal pain after meals. She is often constipated and takes laxatives. Following this, she has diarrhea for a couple of days. She temporarily feels better after a bowel movement. She states she is embarrassed by flatulence and has abdominal distension. She has had no weight loss or blood in her stool. This problem has gone on for about 6 months. What should the next step be? A. Obtain a complete history B. Order a barium enema. C. Schedule a Bernstein's test. D. Prescribe a trial of antispasmodics. A 46-year-old female patient is seen in the clinic with abdominal pain. Which of the following tests is essential for this patient? A. CBC B. Urine HCG C. Barium enema D. CT A patient is seen in the clinic with right upper quadrant (RUQ) pain that is radiating to the middle of the back. The clinician suspects acute cholelithiasis. The clinician should expect which of the following laboratory findings? A. Decreased ALT and AST B. Elevated alkaline phosphatase C. Elevated indirect bili D. Decreased WBC A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her physical exam is remarkable for left lower quadrant (LLQ) tenderness. Which of the following should be considered in the differential diagnosis at this time? A. Endometriosis B. Colon Ca C. Diverticulitis D. All of the above You assess for Cullen's sign in Dan, age 62, after surgery. Cullen's sign may indicate: Intra-abdominal bleeding Marian, age 52, is obese. She complains of a rapid onset of severe right upper quadrant abdominal cramping pain, nausea, and vomiting. Your differential diagnosis might be cholecystitis. Most common cause of constipation lack of dietary fiber (RDA=30g) A patient is seen in the office and is complaining of constipation. The patient lists all of the following medications. Which drug could be responsible for the constipation? Pepto-bismol Which of the following pharmacological agents used to treat constipation may cause flatulence and bloating and requires adequate fluid intake? Bulking agents Which laxative is safe for long-term use? Methylcellulose (Citrucel) Simon states that he is worried because he has a bowel movement only every third day. You respond, There is no such thing as a " normal pattern of defecation" Sigrid, age 82, has irritable bowel, chronic constipation, and diverticulitis. Which pharmacological agent do you recommend? Bulking agents which hepatic enzyme is increased with viral hepatitis, drug or chemical associated hepatitis or non alcoholic fatty liver disease Alanine aminotransferase (ALT). ALT usually increases higher than AST >10times ULN in what conditions viral, drug or chemical associated hepatitis ALT usually increases higher than ALT at 3 times ULN in what conditions Non Alcoholic Fatty Liver Disease Hepatic enzyme is elevated with alcoholic hepatic injury and acetaminophen overdose Asparate aminotransferase (AST) AST & ALT are markedly elevated over 20times normal in what condition Acetaminophen overdose AST is usually higher or lower than ALT in alcoholic hepatic injury AST higher than ALT Which of the following statements is true regarding the treatment of carpal tunnel syndrome? A. Corticosteroid injections are discourage in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, & infection. B. Splints are used in carpal tunnel syndrome because they allow for free movement of the fingers & thumb while maintaining the wrist in a neutral position. C. The goal of treatment is to prevent flexion & extension movements of the wrist D. All the answers During a digital rectal exam on a 75 y/o man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? A. A hard irregular gland B. A tender gland C. An enlarged rubbery gland D. A boggy gland According to Kubler-Ross the stages of grief occur in which order? A. Anger, denial, bargaining, acceptance, depression B. Denial, anger, bargaining, depression, acceptance C. Denial, anger, depression, bargaining, acceptance D. Anger, denial, depression, bargaining, acceptance Mr. Wright is an 85 y/o & newly diagnosed with colon cancer & surgery is indicated. He is mentally alert, however he is refusing to give consent for surgery. As his primary care provider you A. Insist he listen to the advice of the surgeon B. Respect his wishes C. Order a psychiatric consult D. Call his family to have them persuade patient to proceed with surgery Janet is 30y/o woman who has been diagnosed with a herniated disc at the L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? A. Paresthesia of the perineum & buttock B. A reduced or absent ankle reflex C. Numbness in the lateral foot D. Gastrocnemius weakness A 63 y/o man is seen in the clinic with a chief complaint of nocturia. Which of the following should be your differential diagnosis? A. Urethral polyp B. Benign prostatic hypertrophy C. Psychogenic nocturia D. Irritative posterior urethral lesion It is important to educate patients with depression & their family members about reporting signs of increasing depression & suicidal thought. This is especially true during which period? A. 1 to 2 weeks after the initiation of treatment B. 1 to 2 weeks after tapering off medications C. When switching to a different medication D. Before the initiation of treatment The clinician has instructed Scott a 25 y/o patient with low back strain to use NSAIDS to manage his symptoms of pain & discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDS to manage pain? A. You should start with the lowest dose that is effective in managing your pain in order to avoid developing tolerance to the medication B. It is important to take NSAIDs on an empty stomach in order to increase absorption C. Your should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control you pain D. You should start with the lowest dose that is effective in managing your pain, because long term use of NSAIDs can result in gastrointestinal disorders, such as ulcers & hemorrhage What is the treatment of choice for testicular cancer? A. Radiation implants B. Lumpectomy C. Radical orchidectomy D. All the above Which of the following test is most specific to the diagnosis of RA? A. Abnormally high ESR B. Positive ANA titer C. Elevated levels of rheumatoid factor D. Elevated CRP In the elderly, which fracture is associated with the most serious (and often fatal) outcomes? A. Hip B. Wrist C. Spine D. Ankle Which of the following would be an appropriate treatment for a patient with mild BPH? A. Recommend cranberry supplements B. Refer to urologist for surgery C. Prescribe an initial tamsulosin D. Reevaluate in 1 to 3 months In caring for the patient with OA of the knees you advise that A. Applying heat to the knee following exercise will lessen swelling B. Straight leg raising should be avoided C. Quadriceps strengthening exercises should be performed D. You should never exercise again 56 y/o man with chromic prostatitis should be treated with trimethoprim 80mg sulfamethoxazole 400mg (Bactrim) for how long? A. 3 to 6 weeks B. 6 to 12 weeks C. 7-14 days D. 3 to 7 days Which of the following statements is true concerning the treatment of fibromyalgia syndrome? A. fibromyalgia syndrome can be difficult to manage requiring a variety of approaches & multiple medications B. All of the answers C. There is currently no cure for the disorder, however, patients should be made aware that symptom relief is possible D. Treatment is directed toward controlling discomfort improving sleep & maintaining function Women are at the highest risk for developing postpartum depression for up to how long after child birth? A. 1 month B. 2 weeks C. 3 months D. 6 months A patient with complaints of diarrhea is seen. Which of the following should be included in the differential diagnosis list for a patient with diarrhea? A. Lactase deficiency B. Inflammatory bowel disease C. Gastroenteritis D. All of the other answers Which of the following is considered the first-line treatment for panic disorder? A. Tricyclic antidepressants B. Cognitive behavioral therapy C. SSRIs D. Benzodiazepines What is the best way to promote personal behavior change in your patient? A. Prescribe a health promotion treatment plan B. Write an order for treatment plan C. Stress compliance with your treatment plan D. Discuss choices with your patient and let him or her decide what will work best A 42 y/o female patient is seen in the clinic for abdominal pain. Which of the following tests is essential for this patient? A. Barium enema B. Complete blood count with differential C. Urine hCG D. CT of the abdomen Which of the following tests is considered the "gold standard" for definitively diagnosing osteoporosis? A. MRI B. Urinary N-telopeptide assay C. Bone alkaline phosphatase levels D. Bone mass density measurement by densitometry Which of the following statements is true concerning the management of the client with a herniated disc? A. Muscle relaxants & narcotics can be used to control moderate pain, should be discontinued after 3 wks of use B. Intolerable pain for more than a 3 month period is an indication for referral for possible surgical intervention C. An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred D. All of the answers A 22 y/o is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? A. Late in inflammation B. 3-4 hrs after perforation C. Appendicitis never presents with vague pain D. Very early A 28 y/o patient is seen with complaints of diarrhea. Which of the following questions would help the clinician establish the diagnosis of irritable bowel syndrome? A. Sometimes is constipated B. All the answers C. Feels relief after bowel movement D. Does not defecate in the middle of the night In an older adult with impaired renal function the APN would anticipate that there is no need to adjust the antimicrobial dose with the use of A. Ceftriaxone B. Tobramycin