Walden NURS6531 final exam

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Walden NURS6531 final exam

Question 1

A patient reports “something flew in my eye” about an hour
ago while he was splitting logs. If there were a foreign body in his eye, the
nurse practitioner would expect to find all except:

• Question
2

A
false-positive result with the fecal occult blood test can result from:

• Question
3

What
condition is associated with mucus production greater than 3 months per year
for at least 2 consecutive years?

• Question
4

A patient presents with classic symptoms of
gastroesophageal reflux disease (GERD). He is instructed on life style
modifications and drug therapy for 8 weeks. Three months later he returns,
reporting that he was “fine” as long as he took the medication. The most
appropriate next step is:

Perform test

• Question
5

When
teaching a patient with hypertension about restricting sodium, you would
include which of the following instructions?

• Question
6

A 70
year old patient presents with a slightly raised, scaly, erythematous patch on
her forehead. She admits to having been a “sun worshiper.” The nurse
practitioner suspects actinic keratosis. This lesion is a precursor to:

• Question
7

An AST
that is more than twice the level of ALT is suggestive of:

• Question
8

A
patient has experienced nausea and vomiting, headache, malaise, low grade
fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is
elevated with a shift to the left. He is requesting medication for diarrhea.
What is the most appropriate response?

• Question
9

After
thorough history, physical examination, and laboratory tests, a patient is
diagnosed with irritable bowel syndrome (IBS). Which of the following initial
treatment plans is currently considered most effective?

• Question
10

Margaret,
age 32, comes into the office with painful joints and a distinctive rash in a
butterfly distribution on her face. The rash has red papules and plaques with a
fine scale. What do you suspect?

• Question
11

Which
of the following is not a risk factor for coronary arterial insufficiency?

• Question
12

The
National Cholesterol Education Program’s Adult Treatment Panel III recommends
that the goal for low density lipoproteins in high risk patients be less than:

• Question
13

A 70
year old patient presents with left lower quadrant (LLQ) abdominal pain, a
markedly tender palpable abdominal wall, fever, and leukocytosis. Of the
following terms, which correctly describes the suspected condition?

• Question
14

Your
31-year-old patient, whose varicella rash just erupted yesterday, asks you when
she can go back to work. What do you tell her?

• Question
15

Harvey
has had Meniere’s disease for several years. He has some hearing loss but now
has persistent vertigo. What treatment might be instituted to relieve the
vertigo?

• Question
16

Which
of the following statements about malignant melanomas is true?

• Question
17

The
most appropriate treatment for a child with mild croup is:

• Question
18

A
patient reports to the nurse practitioner that he was diagnosed with hepatitis
B a year ago and has not seen a health care provider since then. What
information should this patient be given?

• Question
19

Which
of the following is a secondary cause of hyperlipidemia?

• Question
20

A patient
comes in complaining of 1 week of pain in the posterior neck with difficulty
turning the head to the right. What additional history is needed?

• Question
21

Stacy,
age 27, states that she has painless, white, slightly raised patches in her
mouth. They are probably caused by:

• Question
22

Group A
?-hemolytic streptococcal (GABHS) pharyngitis is most common in which age
group?

in children/ school-aged children,/ages 5 and 15 years

• Question
23

A patient presents to the office with a blood
pressure 142/80. This patient is classified as having:

• Question
24

Treatment
of H.pylori includes which of the following?

• Question
25

A very
active elderly patient has a documented diagnosis of arteriosclerosis
obliterans. Common expected lower extremity physical exam findings include:

weakness or sensory loss that mimics an acute aortic saddle
occlusion

• Question
26

Which
of the following medication classes should be avoided in patients with acute or
chronic bronchitis because it will contribute to ventilation-perfusion mismatch
in the patient?

• Question
27

Mort is
hypertensive. Which of the following factors influenced your choice of using an
alpha blocker as the antihypertensive medication?

• Question
28

The
Centor criteria for diagnosis of Group A B-hemolytic streptococcus includes
which of the following?

• Question
29

Which
statement below is correct about pertussis?

• Question
30

A
middle-aged male presents to urgent care complaining of fever, dysphagia, and
shortness of breath. The nurse practitioner notes the patient leaning forward
in a tripod position and drooling. The clinical presentation of this patient
suggests:

• Question
31

A
33-year-old female is admitted with acute pancreatitis. The nurse practitioner
knows that the most common cause of pancreatitis is:

• Question
32

Which
of the following is not a symptom of irritable bowel syndrome?

• Question
33

John,
age 33, has a total cholesterol level of 188 mg/dL. How often should he be
screened for hypercholesterolemia?

• Question
34

What
conditions must be met for you to bill “incident to” the physician, receiving 100%
reimbursement from Medicare?

• Question
35

A 16
year old male presents with mild sore throat, fever, fatigue, posterior
cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for
this patient, what drug would be least appropriate to prescribe?

• Question
36

A child
complains that his “throat hurts” with swallowing. His voice is very “throaty”
and he is hyperextending his neck to talk. Examination reveals asymmetrical
swelling of his tonsils. His uvula is deviated to the left. What is the most
likely diagnosis?

• Question
37

An
employee picnic menu includes grilled hamburgers, potato salad, and homemade
ice cream sundaes. Within an hour after the meal, several children and parents
begin to have nausea, vomiting and stomach cramps. None of those affected have
fever. What is the most likely etiologic agent?

• Question
38

A
patient presents to urgent care complaining of dyspnea, fatigue, and lower
extremity edema. The echocardiogram reveals and ejection fraction of 38%. The
nurse practitioner knows that these findings are consistent with:

• Question
39

Maxine,
Age 76, has just been given a diagnosis of pneumonia. Which of the following is
an indication that she should be hospitalized?

• Question
40

A
57-year-old male presents to urgent care complaining of substernal chest
discomfort for the past hour. The EKG reveals ST elevations in Leads II, III,
and AVF. The nurse practitioner is aware that these changes are consistent with
which myocardial infarction territory?’

• Question
41

A
46-year-old female with a past medical history of diabetes presents with a
swollen, erythematous right auricle and is diagnosed with malignant otitis
externa. The nurse practitioner knows that the most likely causative organism
for this patient’s problem is:

• Question
42

Lisa,
age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2
agonist daily. Her exacerbations affect her activities and they occur at least
twice weekly and may last for days. She is affected more than once weekly
during the night with an exacerbation. Which category of asthma severity is
Lisa in?

• Question
43

An
18-year-old female presents to the urgent care center complaining of severe
pruritus in both eyes that started 2 days ago. Associated symptoms include a
headache and fatigue. On examination, the nurse practitioner notes some clear
discharge from both eyes and some erythema of the eyelids and surrounding skin.
Which of the following is the most likely cause of this patient’s symptoms?

• Question
44

Sandra
has celiac disease. You place her on which diet?

• Question
45

A
patient complains of “an aggravating cough for the past 6 weeks.” There is no
physiological cause for the cough. Which medication is most likely causing the
cough?

• Question
46

A
cashier complains of dull ache and pressure sensation in her lower legs. It is
relieved by leg elevation. She occasionally has edema in her lower legs at the
end of the day. What is the most likely cause of these problems?

• Question
47

Acute
rheumatic fever is an inflammatory disease which can follow infection with:

• Question
48

An
elderly patient is being seen in the clinic for complaint of “weak spells”
relieved by sitting or lying down. How should the nurse practitioner proceed
with the physical examination?

• Question
49

A 60
year old male diabetic patient presents with redness, tenderness, and edema of
the left lateral aspect of his face. His left eyelid is grossly edematous. He
reports history of a toothache in the past week which “is better.” His
temperature is 100°F and pulse is 102 bpm. The most appropriate initial action
is to:

• Question
50

Which
of the following are classic features of ulcerative colitis?

• Question
51

A 55
year old man is diagnosed with basal cell carcinoma. The nurse practitioner
correctly tells him:

• Question
52

Martha
had a less than 7% value on her Schilling test. What medication do you
anticipate she might need?

• Question
53

Which
of the following dermatologic vehicles are the most effective in absorbing
moisture and decreasing friction?

• Question
54

John,
age 59, presents with recurrent, sharply circumscribed red papules and plaques
with a powdery white scale on the extensor aspect of his elbows and knees. What
do you suspect?

• Question
55

Treatment
of acute vertigo includes:

• Question
56

Diagnosis
of Crohn’s disease is made considering signs, symptoms and:

• Question
57

Amaurosisfugax
is described as a:

meaning darkening, dark, or obscure) is a painless temporary
loss of vision in one or both eyes

• Question
58

Expected
spirometry readings when the patient has chronic emphysema include:

• Question
59

Marvin
has sudden eye redness that occurred after a strenuous coughing episode. You
diagnose a subconjunctival hemorrhage. Your next step is to:

• Question
60

A 40
year old presents with a hordeolum. The nurse practitioner teaches the patient
to:

• Question
61

In
order to decrease deaths from lung cancer:

• Question
62

A 70
year old man who walks 2 miles every day complains of pain in his left calf
when he is walking. The problem has gotten gradually worse and now he is unable
to complete his 2 mile walk. What question asked during the history, if
answered affirmatively, would suggest a diagnosis of arteriosclerosis
obliterans?

• Question
63

An 8
year old presents to the health clinic with history of acute onset severe sore
throat and respiratory distress with stridor in the last 2 hours. The child’s
history is positive for fever and pharyngitis for 2 days. What is the most
likely diagnosis?’

• Question
64

Management
of a patient with hypertension and an abdominal aortic aneurysm would include:

• Question
65

An 80-year-old male admits to difficulty
swallowing during the review of systems. The nurse practitioner recognizes the
differential diagnosis for this patient’s dysphagia is:’

• Question
66

Which
type of lung cancer has the poorest prognosis?

• Question
67

What
prophylactic medication is commonly recommended for the patient under 35 years
of age with a positive PPD?

• Question
68

Risk
factors for acute otitis media (AOM) include all of the following except:

• Question
69

Larry,
age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months
post-MI. To prevent reinfarction, the most important behavior change that he
can make is to:

quit smoking

• Question
70

Shirley,
age 58, has been a diabetic for 7 years. Her blood pressure is normal. Other
than her diabetes medications, what would you prescribe today during her
routine office visit?

• Question
71

Antibiotic
administration has been demonstrated to be of little benefit to the treatment
of which of the following disease processes?

• Question
72

Impetigo
and folliculitis are usually successfully treated with:

• Question
73

A 65-year-old female with a past medical
history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to
urgent care with new onset left lower quadrant pain. Her current medications
include omeprazole 20 milligrams po daily, lisinopril 20 milligrams po daily,
simvastatin 20 milligrams po daily, and prednisone 12 milligrams po daily. The
nurse practitioner suspects acute diverticulitis and possibly an abscess. The
most appropriate diagnostic test for this patient at this time is:

• Question
74

Which
choice below is least effective for alleviating symptoms of the common cold?

• Question
75

Your
well-nourished 75-year-old patient has come into the office for a physical exam
and states that she recently had two nosebleeds. She does not take any
anticoagulants, and you have ruled out any coagulopathies. The most likely
cause of these nosebleeds is:

• Question
76

Which
of the following color changes in a pigmented lesion suggests malignant
transformation?

it should be brown, black, red, white, and blue

• Question
77

The
most common cancer found on the auricle is:

• Question
78

A 20
year old is diagnosed with mild persistent asthma. What drug combination would
be most effective in keeping him symptom-free?

• Question
79

A
58-year-old man is diagnosed with Barrett’s esophagus after an endoscopy. He
has no known allergies. Which of the following medications is MOST appropriate
to treat this patient’s disorder?

• Question
80

Harriet,
a 79-year-old woman, comes to your office every 3 months for follow up on her
hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg
daily, and Calcium 1500 mg daily. At today’s visit. Her blood pressure is
170/89. According to JNC VIII guidelines, what should you do next to control
Harriet’s blood pressure?

• Question
81

Sylvia,
age 83, presents with a 3 day history of pain and burning in the left forehead.
This morning she noticed a rash with erythematous papules in that site. What do
you suspect?

• Question
82

A 55
year old patient has a work-up for hypertension and is noted to have elevated
BUN and creatinine. Which of the following should the nurse practitioner
suspect?

• Question
83

An
active 65-year-old man under your care has known acquired valvular aortic
stenosis and mitral regurgitation. He also has a history of infectious endocarditis.
He has recently been told he needs elective replacement of his aortic valve.
When he comes into the office you discover that he has 10 remaining teeth in
poor repair. Your recommendation would be to:

• Question
84

Of the following signs and symptoms of
congestive heart failure (CHF), the earliest clinical manifestation is:

• Question
85

An 83-year-old female presents to the office
complaining of diarrhea for several days. She explains she has even had fecal
incontinence one time. She describes loose stools 3–4 times a day for several
weeks and denies fever, chills, pain, recent antibiotic use. The history
suggests that the patient has:

• Question
86

Appropriate
therapy for peptic ulcer disease (PUD) is:

• Question
87

Alan,
age 54, notices a bulge in his midline every time he rises from bed in the
morning. You tell him it is a ventral hernia, also known as:

• Question
88

Sheila,
age 78, presents with a chief complaint of waking up during the night coughing.
You examine her and find an S3 heart sound, pulmonary crackles that do not
clear with coughing, and peripheral edema. What do you suspect?

• Question
89

A 12
year old patient is afebrile and complains of severe left ear pain. On
examination, the TM is gray and intact and there is a green discharge in the
external canal. What action by the nurse practitioner is most appropriate?

• Question
90

Which
of the following is a predisposing condition for furunculosis?

• Question
91

A 58
year old complains of tightness in his chest while cutting firewood. It
disappears quickly if he stops chopping. He denies shortness of breath, his
total cholesterol level is less than 200 mg/dL, and he is a non-smoker. What is
the most appropriate action for the nurse practitioner to take with this
patient?

• Question
92

Salmeterol
(Servent) is prescribed for a patient with asthma. What is the most important
teaching point about this medication?

• Question
93

A 35 year old man presents with radicular pain
followed by the appearance of grouped vesicles consisting of about 15 lesions
across 3 different thoracic dermatomes. He complains of pain, burning, and
itching. The nurse practitioner should suspect:

• Question
94

The
differential diagnosis for a patient complaining of a sore throat includes
which of the following?

• Question
95

Which
of the following is the most appropriate therapeutic regimen for an adult
patient with no known allergies diagnosed with group A B-hemolytic strep?

• Question
96

A 76-year-old male complains of weight loss,
nausea, vomiting, abdominal cramping and pain. Physical findings include an
abdominal mass and stool positive for occult blood. The nurse practitioner pain
suspects a tumor in the small intestine. The best diagnostic test for this
patient is:

• Question
97

Dana
has ischemic arterial ulcers. What is your first priority when counseling her?

• Question
98

Risk
factors for acute arterial insufficiency include which of the following?

• Question
99

Which
of the following is the most important diagnosis to rule out in the adult
patient with acute bronchitis?

• Question
100

Which
of the following can result from chronic inflammation of a meibomian gland?

chalazion

• Question
101

When
completing this quiz, did you comply with Walden University’s Code of Conduct
including the expectations for academic integrity?

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