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FULL REVISED EXAM
Which of the following antihypertensive medications should the nurse
practitioner avoid when treating patients with emphysema?
A) Calcium channel blockers
B) Angiotensin-converting enzyme (ACE) inhibitors
C) Beta-blockers
D) Diuretics
Answer- C) Beta-blockers
Rationale: Beta-blockers should be avoided in patients with a history of
emphysema. Studies have shown evidence of a reduction in forced
expiratory volume in 1 second (FEV1), increased airway hyper
responsiveness, and inhibition of bronchodilator response to beta
agonists in patients receiving non-selective beta- blockers and high
doses of cardio selective beta-blockers.
A 30-year-old chef complains of pruritic hives over her chest and arms
but denies difficulty swallowing or breathing. She reports a family
history of allergic rhinitis and asthma. Which of the following
interventions is most appropriate?
,A) Perform a complete and thorough history
B) Prescribe an oral antihistamine such as diphenhydramine 25 mg PO
QID
C) Give an injection of epinephrine 1:1000 intramuscularly stat
D) Call 911
Answer- A) Perform a complete and thorough history
Rationale: Prior to prescribing medications, a complete and thorough
history must be performed to determine possible causes of hives. The
patient denied difficulty with swallowing and breathing, so there was no
medical emergency to require calling 911.
Which of the following findings is most likely in young prim gravidas
with pregnancy-induced hypertension?
A) Abdominal cramping and constipation
B) Edema of the face and the upper extremities
C) Shortness of breath
D) Dysuria and frequency
Answer- B) Edema of the face and the upper extremities
Rationale: Common signs and symptoms of pregnancy-induced
hypertension include edema of the face and the upper extremities,
weight gain, blurred vision, elevated BP, proteinuria, and headaches.
,Which of the following symptoms is associated with B12 deficiency
anemia?
A) Spoon-shaped nails and pica
B) An abnormal neurological exam
C) A vegan diet
D) Tingling and numbness of both feet
Answer- D) Tingling and numbness of both feet
Rationale: Vitamin B12 deficiency anemia can cause nerve cell damage
if not treated. Symptoms of B12 deficiency anemia may include tingling
or numbness in fingers and toes, difficulty walking, mood changes or
depression, memory loss, disorientation, and dementia.
A second triple screen on a 35-year-old prim gravida reveals abnormally
low lev- ells of the alpha fetoprotein and stroll and high levels of human
chorionic gonad- atropine. Which of the following interventions is the
best choice for this patient?
A) Order an ultrasound
B) Order a computed tomography (CT) scan of the abdomen
C) Order a 24-hour urine for protein clearance
, D) Assess for a history of illicit drug or alcohol use
Answer- A) Order an ultrasound
Rationale: Abnormally low levels of alpha fetoprotein and stroll and
high levels of human chorionic gonadotropin are abnormal during
pregnancy. An ultrasound should be ordered to further evaluate the fetus
for characteristics of Down syndrome and/or fetal demise.
All of the following are true statements about diverticula except:
A) Diverticula are located in the colon
B) A low-fiber diet is associated with the condition
C) Most diverticula in the colon are infected with gram-negative bacteria
D) Supplementingwithfibersuchaspsyllium(Metamucil)is recommended
Answer- C) Most diverticula in the colon are infected with gram-
negative baste-
ria
Diverticula in the colon can be infected with both gram-negative and
gram- positive bacteria.
Patients who are diagnosed with gonorrhea should also be treated for
which of the following infections?