• NR-601 Final.questions lashanna LATEST UPDATE

• NR-601 Fions lashanna • • Which of the following statements is NOT true about palliative care teams? • A: Provide weekly home visits • A 55-year-old women has type 2 DM she had three UTIs in the last 9 months and she is concerned about her kidneys. She has no report of dysuria, frequency or urgency at this time. Which of the following is the best action to follow? • A: Recheck UA dipstick today • According to the sexuality presentation, atrophic vaginitis (AV) • A: Is a contributing factor for frequent UTIs • Ms. L 55-year-old women with BMI of 28, has 20-year hx of primary HTN and has been on hydrochlorothiazide 25 mg daily for years with excellent response. During follow up visit Mrs L reports that for the last 6 months she has felt thirsty all of the time even though she drinks at least 10 glasses of water a day. Upon chart review the N notes that the last two fasting blood glucose levels have been 136 mg/dl and 165 mg/dl. The NP checks a random blood glucose, which is 210 mg/dl. What is the next appropriate test? • A: Prescribe Metformin 500 mg PO BID • A patient has been prescribed Metformin (Glucophage). One week later he returns with lowered blood sugars but complaints of some loose stools during the week. How should the NP respond? • A: Reassure the patient that this is an anticipated side effect • A 60-year-old obese male client has type 2 DM and a lipid panel of TC= 250, HDL = 32, LDL= 165. The NP teaches the patient about his modifiable cardiac risk factors which include: • A: Diabetes, obesity, and hyperlipidemia • Lifestyle approaches to postmenopausal symptom management include • A: avoiding sugar, coffee, chocolate and alcohol • When treating depression associated with dementia, which of the following would be a poor choice and should not be prescribed? • A: Amitriptyline • How does women’s anatomy make them more susceptible to UTIs? • A: the urethra is shorter • Don’t have • don’t have • A 48-year-old male patient screened for diabetes has a fasting plasma glucose level of 120 mg/dl. The NP plan includes • A: Educate the patient of lifestyle changes to lower blood glucose • Which of the following assessments are commonly noted in a client with Parkinson’s disease? • A: Micrographia and bradykinesia • A 76-year-old man is seen in the office for c/o urinary incontinence. The clinician should explore which of these causes of incontinence in men? • A: Urinary Tract Infection (UTI) • Which of the following maneuvers is contraindicated in acute prostatis? • A: Massaging the infected prostate • Mrs. N a 65-year-old women with BMI of 29 on Medicare , has a 20-year hx of primary HTN and has been on HCTZ 25 mg daily for years , reports that for the past 6 months she has felt thirsty all of the time even though she drinks at least 10 glasses of water a day. Upon charting NP notes that the last two fasting blood glucose levels have been 136 mg/dl and 165 mg/dl. What actions should the NP perform next? • A: order a fasting blood glucose??? PRESCRIBE METFORMIN XR 500MG PO • According to the WHO analgesic ladder, which drug combination would be most appropriate in an opiate-naïve patient who presents with moderate pain? • A: Indomethacin/ hydrocodone • The cornerstone of pharmacotherapy in treating Alzheimer’s disease is : • A: Cholinesterase inhibitors • The highest level of evidence to support interventions at the end of life is with: • A: opioids for dyspnea • The comorbid psychiatric problem with the highest frequency in dementia is: • A: Anxiety • All of the following are true statements regarding elder abuse EXCEPT: • A : common signs of abuse include decreased anxiety and depression • Which of the following is a role of the advanced nurse in ????? • A: All of the above • The proposed mechanism by which diphenhydramine causes delirium is: • A: Anticholinergic effect • A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea) is : • A : Morphine • According to the Palliative Care presentation, hospice care may be provided to: • A: those with a life expectancy 6 months • A 68-year-old women is being worked up for stress incontinence. UA reveals positive leukocyte esterase, positive nitrites, 15 WBCs, no RBS, no protein, no casts. She denies frequency, urgency, suprapubic pressure or urgency. What is the first treatment for her US results? • A: no treatment is necessary • The elderly are at higher risk for delirium because of: • A: All of the above • A 63-year-old man is seen in the clinic with a c/o nocturia. Which of the following should be included in the differential diagnosis? • A: Benign prostatic hypertrophy (BPH) • A 75-year-old man is being treated as an outpatient for metastatic prostate cancer. Which of the following statements is true regarding the management of pain with opioids in the elderly? • A: none of the above • The highest level of evidence with the use of adjuvant analgesics is with: • A: neuropathic pain patients are candidates for adjuvant analgesia • The 56-year-old man with chronic prostatis should initially be treated with antibiotics for how long? • A: 14 days • A 50-year-old female patient screened for diabetes has a fasting plasma glucose level of 124 mg/dl. The NP plan includes: • A: repeat fasting plasma glucose in one year • When assessing a patient who complains of a tremor, the NP must differentiate essential tremor from the tremor of Parkinson’s disease. Which of the following findings are consistent with essential tremor? • A: The tremor occurs with purposeful movement • Which characteristic of delirium helps to distinguish it from dementia? • A: abrupt or Acute onset • According to the sexuality presentation, the biggest barrier to appropriate sexual evaluation in the older patient: • A: Ageist attitudes • Mrs. Smith a 65-year-old women presents to the clinic for the first time and c/o UI and dyspareunia, she went through menopause 10 years ago without any hormone replacement therapy and had a hysterectomy for fibroid. Her mother had a hip fracture at 82, pt had mammogram 5 years ago and no known fam hx of breast cancer……you decide to begin topical hormone replacement therapy. Which of the following evaluations would be necessary prior initiating hormone replacement therapy? • A: Mammogram • Mr. A experienced a brief onset of right-sided weakness, slurred speech and confusion yesterday. The symptom has resolved. What should the NP do? • A: identify modifiable cardiovascular risk factors • Any women with a complicated cystitis or symptoms of upper tract disease needs a urine culture and • A: sensitivity test • All of the following patients have a risk of adverse reaction from Metformin except: • A: patients with BMI 30 • A middle-aged patient has been diagnosed with Parkinson’s disease. What influences the NP’s decision to begin pharmacological treatment for this patient? • A: symptom interfering with functional ability • Which of the following medications can blunt the signs of hypoglycemia in diabetes? • A: beta blockers • The Mini-cog is a short screening tool used to assess cognition. Which of the following statements pertaining to the test is a true statement? • A: A score of 0-2 is a positive screen for dementia • What is a sign of insulin resistance that can present in African American patients? • A: Acanthosis Nigricans • Age related changes in bladder, urethra and ureters include all of the following in older women except: • A: increased estrogen production’s influence on the bladder and ureter • The majority of patients enrolled in hospice care die: • A: at home • Diabetes is the leading cause of: • A: kidney failure • A male pt with a BMI of 30 presents to the office for an annual exam. You ordered a CMP as part of routine labs. The fasting glucose was 130. Your next action is: • A: repeat the fasting glucose • A pelvic mass in a postmenopausal woman: • A: highly suspicious of ovarian cancer • A 65-year-old Hispanic woman presents to the office for routine follow up for her DM2. Her routine UA results are as follows: few epithelial cells, negative leukocytes, negative nitrates, negative protein, no ketones. Which test would you order next? • A: 24-hour urine for albumin