NURS 640 EXAM 1 ACTUAL EXAM PAPER 2026
FULL QUESTIONS AND CORRECT ANSWERS
ALREADY PASSED
◉ Trichomoniasis. Answer: an STD caused by a microscopic
protozoan that results in infections of the vagina, urethra, and
•Findings -Thin, yellow or yellow-green frothy-Malodorous -Vulvar
irritation worsens following menstruation -May have minimal / no
symptoms-pH>4.5, wet prep: motile T.vaginalis, culture: T.vaginalis
•Testing-Fresh wet mount shows motile trichomonads-Point of care
testing or culture may be available •Treatment-Metronidazole po-
Treat sexual partners
◉ HPV (Genital Warts). Answer: Findings -Genital warts visually
noted•Testing -Biopsy rarely needed -Biopsy for lesions > 1 cm;
indurated, ulcerated, fixed to underlying structures, atypical in
appearance, pigmented, treatment resistant •Treatment-External
wart elimination with topical agents to eliminate symptoms -
Treatment considered for precancerous lesions-Subclinical infection
is not treated, may resolve spontaneously
,◉ Delirium. Answer: mental disorder marked by confusion;
uncontrolled excitement; ADJ. delirious
additional features: psychomotor disturbances (hyper/hypo active )
lucid during morning rounds, less lucid as day progress.
◉ Delirium risk factors. Answer: existing cognitive impairment, low
functional autonomy, polypharmacy (especially benzos, narcotics,
and anticholinergics), and clinical severity of primary illness
severe illness
depression
alcohol dependence
medications
post op
Management: Reduce precipitating factors
suportive: improve congition with family members, sleep, vision,
hearing, Avoid restraints if possible.
◉ CAM Test. Answer: for delerium
1.Acute onset & fluctuating course
2.Inattention
, 3.Disorganized thinking
4.Altered LOC (bold = altered)-Alert, Vigilant, Lethargic, Stupor,
Coma
•Delirium suspected if -+ inattention and-+ acute onset or
fluctuating course and-Either disorganized thinking or altered LOC
◉ Procedural anxiety. Answer: First line: Benzos
IV: midazolam IV
Po: Diazepam 30-9- min in advance.
50% dose reduction for adults older than 60, concomittent opiods,
hepatic insufficiency.
melatonin 3 mg may be repeat x1
◉ Chronic pain disorder. Answer: managed by single clinician
psycholocial/ behavioral
nonopiod therapies
◉ Depression in older adults assessment questions. Answer:
Screening -"In past 2 weeks, have you"1.Felt down, depression or
hopeless 2.Felt little interest / pleasure in doing things
◉ Testing needed for Tricyclics. Answer: EKG
FULL QUESTIONS AND CORRECT ANSWERS
ALREADY PASSED
◉ Trichomoniasis. Answer: an STD caused by a microscopic
protozoan that results in infections of the vagina, urethra, and
•Findings -Thin, yellow or yellow-green frothy-Malodorous -Vulvar
irritation worsens following menstruation -May have minimal / no
symptoms-pH>4.5, wet prep: motile T.vaginalis, culture: T.vaginalis
•Testing-Fresh wet mount shows motile trichomonads-Point of care
testing or culture may be available •Treatment-Metronidazole po-
Treat sexual partners
◉ HPV (Genital Warts). Answer: Findings -Genital warts visually
noted•Testing -Biopsy rarely needed -Biopsy for lesions > 1 cm;
indurated, ulcerated, fixed to underlying structures, atypical in
appearance, pigmented, treatment resistant •Treatment-External
wart elimination with topical agents to eliminate symptoms -
Treatment considered for precancerous lesions-Subclinical infection
is not treated, may resolve spontaneously
,◉ Delirium. Answer: mental disorder marked by confusion;
uncontrolled excitement; ADJ. delirious
additional features: psychomotor disturbances (hyper/hypo active )
lucid during morning rounds, less lucid as day progress.
◉ Delirium risk factors. Answer: existing cognitive impairment, low
functional autonomy, polypharmacy (especially benzos, narcotics,
and anticholinergics), and clinical severity of primary illness
severe illness
depression
alcohol dependence
medications
post op
Management: Reduce precipitating factors
suportive: improve congition with family members, sleep, vision,
hearing, Avoid restraints if possible.
◉ CAM Test. Answer: for delerium
1.Acute onset & fluctuating course
2.Inattention
, 3.Disorganized thinking
4.Altered LOC (bold = altered)-Alert, Vigilant, Lethargic, Stupor,
Coma
•Delirium suspected if -+ inattention and-+ acute onset or
fluctuating course and-Either disorganized thinking or altered LOC
◉ Procedural anxiety. Answer: First line: Benzos
IV: midazolam IV
Po: Diazepam 30-9- min in advance.
50% dose reduction for adults older than 60, concomittent opiods,
hepatic insufficiency.
melatonin 3 mg may be repeat x1
◉ Chronic pain disorder. Answer: managed by single clinician
psycholocial/ behavioral
nonopiod therapies
◉ Depression in older adults assessment questions. Answer:
Screening -"In past 2 weeks, have you"1.Felt down, depression or
hopeless 2.Felt little interest / pleasure in doing things
◉ Testing needed for Tricyclics. Answer: EKG
