answers
An older adult patient complains of recent lapses in memory and decreased
alertness. The patient's laboratory test results indicate a mild, macrocytic anemia.
Which additional test does the adult-gerontology acute care nurse practitioner order
to confirm a diagnosis?
A reticulocyte count
A serum folate level
An erythrocyte sedimentation rate
Iron studies - answerA serum folate level
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An 80-year-old male patient with dementia requires long-term care placement. To
which funding agency does the patient apply, after "spending down" to qualify?
Medicaid
Medicare
The American Association of Retired Persons
The United States Social Security Administration - answerMedicaid
A 70-year-old patient with acute systolic heart failure denies any functional
limitations, is able to walk five blocks before tiring, and is euvolemic. Which
medication is the first-line therapy for this patient?
Amlodipine (Norvasc)
Digoxin (Lanoxin)
Furosemide (Lasix)
Lisinopril (Zestril) - answerLisinopril (Zestril)
A patient has hyperactive reflexes of the lower extremities. The adult-gerontology
acute care nurse practitioner assesses for ankle clonus by:
C) applying a low-pitched tuning fork firmly to the lateral malleolus.
B) sharply dorsiflexing and maintaining the foot in this position, while supporting the
knee.
striking the Achilles tendon with the percussion hammer C) after flexing the leg at
the knee and rotating it externally.
D) stroking the lateral aspect of the sole with the sharp end of the percussion
hammer from the heel to the ball of the foot. - answerB) sharply dorsiflexing and
maintaining the foot in this position, while supporting the knee.
, A 15-year-old patient with type 1 diabetes mellitus reports elevated blood glucose
levels in the morning. An adult-gerontology acute care nurse practitioner determines
that the patient's hyperglycemia is due to the dawn phenomenon and:
A) increases the insulin dosage at bed time.
B) reduces the insulin dosage at bed time.
C) tests the blood glucose level at 3:00 AM every morning.
D) tests the blood glucose level in the evening. - answerA) increases the insulin
dosage at bed time.
A patient with profound hypotension is transferred from the medical-surgical unit to
the intensive care unit. The patient is started on fluids and norepinephrine
(Levophed) IV. The blood cultures that were drawn 48 hours ago from the tunneled
catheter, show preliminary results of gram-negative bacilli. The patient's most recent
echocardiogram report reveals an ejection fraction of 40%. The adult-gerontology
acute care nurse practitioner determines that:
A) a pulmonary artery catheter insertion is indicated, to manage septic shock.
B) fluid resuscitation will be limited to no more than 4 L
C) indwelling vancomycin (Vancocin) should be placed in the ports of the tunneled
catheter.
D) piperacillin-tazobactam (Zosyn) is indicated for the line-related infection. -
answerD) piperacillin-tazobactam (Zosyn) is indicated for the line-related infection.
Which research design has the greatest strength in determining if an intervention is
effective?
Case control
Clinical trial
Cohort
Cross-sectional - answerClinical trial
A 55-year-old man who has no history of diabetes mellitus, heart disease,
hypertension, or thrombotic events is diagnosed with paroxysmal atrial fibrillation.
Based on national stroke prevention guidelines, the recommended antithrombotic
management for this patient is:
aspirin (Bayer).
aspirin with dipyridamole (Aggrenox).
clopidogrel (Plavix).
warfarin (Coumadin). - answeraspirin (Bayer)
An adult-gerontology acute care nurse practitioner who specializes in cardiology is
asked to give a presentation on lipid-lowering drugs. A major drug company that
markets a lipid-lowering medication plans to pay the presenter an honorarium, but
asks the nurse practitioner to limit his or her remarks to its drug. This situation
presents a:
breach of contract.
conflict of interest.
personal choice.