NR 601 Final Exam

A 56-year old male patient screened for diabetes has a fasting plasma glucose level of 96mg/dl. The nurse practitioner management plan includes: a. repeat fasting plasma glucose in three years b. prescribe Metformin 500mg po BID c. repeat fasting plasma glucose in one year d. refer to ophthalmology for eye exam - correct answer a. repeat fasting plasma glucose in three years According to the Sexually presentation, atrophic vaginitis a. the symptoms are the same for each woman b. creates a more acidic vaginal environment c. is a contributing factor for frequent urinary tract infections d. is not treated with vaginal lubricants - correct answer c. is a contributing factor for frequent urinary tract infections Which of the following would you recommend annually for the elderly type 2 diabetic? a. periodic visits to a gastroenterologist b. colonoscopy c. follow up with a urologist d. eye exam with an ophthalmologist - correct answer d. eye exam with an ophthalmologist The majority of patients enrolled in hospice care die: a. in the hospital b. in an inpatient hospice facility c. in a nursing home d. at home - correct answer d. at home Which of the following is a role of the advanced practice nurse in palliative cancer care? a. detecting cancer in asymptomatic patients or those with specific symptoms b. arranging for follow up including patients c. identifying and managing complications of care d. all of the above - correct answer d. all of the above A 58 year old Caucasian mane with type 2 diabetes mellitus presents to the clinic as a new patient. He takes metformin 500mg twice a day. His last Hgb A1c was 7%. He is up to date on eye and foot examinations. His BP is 142/96. According to ACC 2017 guidelines for high blood pressure in adults, what is the most appropriate first line medication? a. lisinopril b. furosemide c. amlodipine d. clonidine - correct answer a. lisinopril A 68 year old woman presents with a complaint of urine leakage whenever she sneezes, laughs or strains for the past 4 months. She denies dysuria, frequency and nocturia. US dipstick is negative for RBC's leukocyte esterase, nitrates, ketones and urobilinogen. What is the diagnosis? a. stress incontinence b. urinary incontinence c. urge incontinence d. overflow incontinence - correct answer a. stress incontinence A 52 year old female patient screened for diabetes has a fasting plasma glucose level of 123 mg/dl. The nurse practitioners plan includes: a. repeat fasting glucose in 1 month b. prescribe metformin 500mg BID po c. repeat fasting plasma glucose in one year d. repeat fasting glucose in three years - correct answer c. repeat fasting plasma glucose in one year According to the palliative care presentation, most elderly patients die: a. alone b. at home c. in institutions d. in pain - correct answer c. in institutions Male patient presents with a BMI of 30 presents to the office for an annual exam. You are reviewing the lab results. You ordered a CMP as part of routine labs. The fasting glucose was 130. Your next action is: a. repeat the fasting glucose b. start metformin 500mg BID c. repeat fasting glucose in 1 year d. call the patient and report lab results as normal - correct answer a. repeat the fasting glucose The task of grieving include all of the following except a. begin to disengage b. acknowledge the reality of death c. work through the pain of grief d. restructure relationships - correct answer a. begin to disengage All of the following are true statements regarding elder abuse except: a. a new STI in an elderly patient can be a sign of abuse b. persons over 80 years of age are at highest risk for abuse c. missing scheduled appointments and delays in medical care are common d. common signs of abuse include decreased anxiety and depression - correct answer d. common signs of abuse include decreased anxiety and depression Hospice care differs from palliative care in that: a. it cannot be provided in the nursing home b. the majority of those admitted to hospice die within 7 days c. it is not covered by insurance d. it is designed for the last six months of life - correct answer d. it is designed for the last six months of life How does woman's anatomy make them more susceptible to UTI's a. the female urethra is shorter b. asymptomatic UTI's do not resolve themselves without treatment c. women tend to get UTI's when they are pregnant d. there is a longer distance between the urethra and anus - correct answer a. the female urethra is shorter Mrs. Smith, a 64 year old woman presents to the clinic for the first time and complains of urinary incontinence and dyspareunia. She went through menopaused 10 years ago without any hormone replacement therapy and had a hysterectomy for a fibroid. Her mother had a hip fracture at 87 years of age. The patient's most recent mammogram was 7 years ago and no known family history of breast cancer. She is not taking any medications. Her physical exam is unremarkable except for findings consistent with atrophic vaginitis. You prescribed topical hormone replacement therapy today. Which of the following evaluations should also be ordered today a. bone mineral density measurement b. mammogram - correct answer b. mammogram All of the following patients should be screened for diabetes except: a. a 44 year old Caucasian male with hypertension. b. a 42 year old female on disability from back injury from back injury who is unable to exercise c. an overweight middle aged African American woman with a family history of type 2 diabetes mellitus d. an obese Hispanic man - correct answer a. a 44 year old Caucasian male with hypertension. A 60 year old obese male client has type 2 diabetes mellitus and a lipid panel of TC=250 HDL=32 LDL=165. The nurse practitioner teaches the patient about his modifiable cardiac risk factors, which include: a. diabetes, obesity and hyperlipidemia b. advancing age, diabetes, hyperlipidemia, and male gender c. hyperlipidemia, smoking and family history of heart disease d. male with age 45, diabetes mellites and hyperlipidemia - correct answer a. diabetes, obesity and hyperlipidemia Which of the following is the most appropriate screening tool for delirium? a. St Louis University Mental Status Exam (SLUMS) b. Montreal Cognitive Assessment c. Lawton Scale of instrumental Activities of Daily Living d. Confusion Assessment Model - correct answer d. Confusion Assessment Model A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea) is: a. lorazepam b. Gabapentin c. Methadone d. Morphine - correct answer d. Morphine Which characteristic of delirium helps to distinguish it from dementia? A. short term memory impairment b. personality changes c. acute onset d. impaired attention - correct answer c. acute onset