NR 511 Week 4 Midterm Exam Version 4 (Already graded A+)

NR 511 Week 4 Midterm Exam Version 4

 Question 1. Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

Posterior dislocations are more common than anterior dislocations.

There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.

Recurrent dislocations are uncommon and would require a greater force to result in injury.

Surgery is most commonly the treatment of choice.

Question.2 In the United States, what is the second most common connective tissue disease and the most destructive to the joints?  

Osteoarthritis

Systemic lupus erythematosus (SLE)

Rheumatoid arthritis

Sjögren's syndrome

Question.3 Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease?

a.Elevated thyroid-stimulating hormone (TSH)

b.Elevated T4

c.Elevated TRH

d.All of the above

Question.4 Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?  

Benzodiazepinesb.

Antipsychoticsc.

Anticonvulsantsd.

Antidepressants

Question.5 When may confidentiality be overridden?

When personal information is available on the computer

When a clinician needs to share information with a billing company

When an insurance company wants to know the results of a breast cancer gene testX

When a patient has a communicable disease

Question.6 What percentage of burns is involved using the rule of nines if both front legs are burned?

9%

18%

24%

36%

Question.7 The clinician should question the patient with suspected gout about use of which of these medications that may be a risk factor?

Low-dose aspirin

Thiazide diuretics

Ethambutol

All of the above

Question.8 Women are at the highest risk for developing postpartum depression for up to how long after childbirth?

2 weeks

1 month

3 months

6 months

Question.9 Which ethical principle reflects respect for all persons and their self-determination?

Autonomy

Beneficence

Justice

Veracity

Question.10 George, aged 59, complains of a flulike illness, including fever, chills, and myalgia after returning from visiting his grandchildren in New England. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?

a. A viral syndromes
b. Lyme disease
c. Rocky Mountain spotted fever
d. Relapsing fever

Question.11 A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?  

Pregnancy test.

Endometrial biopsy

Pelvic ultrasound

Platelet count

Question.12 Which of the following statements is true regarding the treatment of carpal tunnel syndrome?  

a. The goal of treatment is to prevent flexion and extension movements of the wrist.
b. Splints are used in carpal tunnel syndrome because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position.
c. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.
d. All of the above

Question.13 During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

a. An enlarged rubbery gland

b. A hard irregular gland

c. A tender gland
 d. A boggy gland

Question.14 Which drug commonly prescribed …. partial- and full-thickness thermal injuries?  

Clotrimazole cream (Lotrimen)

Mafenide acetate (Sulfamylon)

Silver nitratex

Silver sulfadiazine (Silvadene)

Question.15 A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

"It is probably just a cyst, because that is the most common breast mass.

"We will order a mammogram and ultrasound to help establish a diagnosis."

"We will go ahead and schedule you for a biopsy because that is the only way to know for sure."

"Because your lump is painful, it is most likely not cancer."

Question.16 After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

Suggest she use a heating pad to improve circulation

Refer to a podiatrist for a foot care treatment plan

Send her for acupuncture treatments

All of the above

Question.17 Which of the following medications is the treatment of choice for trichomonas?  

Metranidazole

Ceftriaxone

Diflucan

Doxycycline

Question.18 Most adult poisonings are:

intentional and self-inflicted.

accidental.

caused by someone wishing to do harm to the person.

not attributed to any reason.

Question.19 Which solution should be used when irrigating lacerated tissue over a wound on the arm?  

Dilute povidone-iodine solutionx

Hydrogen peroxide (H2O2)

Saline solution infused with an antibiotic

Saline irrigation or soapy water

Question.20 A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?  

Sinus bradycardia

Atrial fibrillation

Supraventricular tachycardia

U waves

Question.21 What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?  

A stabbing pain on one small area of the body

A vesicular skin lesion on one side of the body

A pain that is worse upon awakening

A lesion on the exterior ear canal

Question.22 Which patient is more likely to have a cluster headache?

A female in her reproductive years

A 40-year-old African American male

A 55-year-old female who drinks 10 cups of coffee daily

A 45-year-old male awakened at night

Question.23 If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?  

Permanent tissue damage may occur, resulting in necrosis to that body part.

The area will be super sensitive.

The area is prone to a repeat frostbite.

The area is as susceptible as any other area.

Question.24 The current goal of treatment for a patient with HIV infection is which of the following?

Viral suppression of HIV to undetectable levels in the peripheral blood

Compete eradication of the virus

Encouraging the person to have no contact with uninfected individuals

Complete abstinence

Question.25 The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?  

Overweight

Mild obesity

Moderate obesity

Morbid obesity

Question.26 The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs to manage his pain?

You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.

You should start with the lowest dose that is effective in managing your pain in order to avoid developing tolerance to the medication.

You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.

It is important to take NSAIDs on an empty stomach in order to increase absorption.

Question.27 In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the “C” of LACE represents?  

Commitment

Consensusx

Certification

Collaboration

Question.28 Which of the following statements is true concerning the management of the client with a herniated disc?  

Muscle relaxants and narcotics can be used to control moderate painbut should be discontinued after 3 weeks of use.

An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred.

Intolerable pain for more than a 3-month period is an indication for surgical intervention.

All of the above

Question.29 Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?  

Superficial burns

Superficial partial-thickness burns

Deep partial-thickness burns

Full-thickness burns

Question.30 CPT coding offers the uniformed language used for reporting medical services and procedures performed by physician and non physician practitioners. Clinicians are paid based on calculated resource costs that are calculated based on practice components. Which of the following are part of the components used to calculate the per CPT code payment rate?

a. Clinician education loans

b. Clinician practice liability and malpractice expense

c. Clinician reported cost reduction efforts

d. Clinician volume of patients treated

Question.31 Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point?  

10%

x 20%

30%

50%

Question.32 A bulla is:  

A vesicle larger than 1 cm in diameter.

An elevated solid mass with a hard texture, and the shape and borders can be regular or irregular.

A superficial elevated lesion filled with purulent fluid.

Thinning of the skin (epidermis and dermis) that appears white or translucent.

Question.33 Clinicians who learn how to code and document Evaluation and Management (E&M) and clinician services will be more successful in gaining timely payment for care delivery. Which or the following Centers for Medicare and Medicaid Services (CMS) practices are designed to financially penalize clinicians who do not bill according to CMS guidelines?  

Audits and probes

Add-on codes

Modifier codes

HAC guidelines

Question 34. Which characteristic of delirium helps to distinguish delirium from dementia?

Abrupt onset

Impaired attention

Affective changes

Delusions

Question.35 Which of the following statements is true concerning the musculoskeletal exam?  

The uninvolved side should be examined initially and compared to the involved side.

The part of the body that is causing the patient pain should be examined first.

The patient should not be asked to perform active range-of-motion (ROM) exercises whenever possible to avoid causing pain.

Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

Question.36 A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnoses?

Testicular cancer

Inguinal hernia

Varicocele

All of the above

Question.37 When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are? 

Spores

 Leukocytes

Pseudohyphae

Epithelial cells

Question.38 Which of the following is a role of the advanced practice nurse in palliative cancer care?  

 Detecting cancer in asymptomatic patients or those with specific symptoms

Arranging for follow-up care, including psychosocial and spiritual support

Identifying and managing complications of care

All of the above

Question.39 Immunizations are an example of which type of prevention?  

 Primary

Secondary

Tertiary

Question.40 Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines? 

Propranolol

Timolol

Ergotamine

Topiramate

Question.41 A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?  

Human papillomavirus (HPV)

Endometrial hyperplasia

Vagismus

Polycystic ovarian syndrome

Question. 42 How often should the clinician examine the feet of a person with diabetes?

Once a year

Every 6 months

Every 3 months

Every visit

Question.43 A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding?

Trichomonas

 Bacterial vaginosis

Human papillomavirus (HPV)

Herpes simplex virus (HSV)

Question.44 After 6 months of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? 

 Elevated thyroid-stimulating hormone (TSH)

Normal TSH

Low TSH

Undetectable TSH

Question.45 The main mechanism for avoiding a lawsuit involves:

Good liability insurance

A collaborating physician

Good documentation

Open communication skills

Question.46 The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least: 

1 month.

3 months.

6 months.

12 months.

Question. 47 What is the treatment of choice for a patient diagnosed with testicular cancer?

Radical orchidectomy

Lumpectomy

Radiation implants

All of the above

Question. 48 Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? Gastrocnemius weakness

A reduced or absent ankle reflex

Numbness in the lateral foot

 Paresthesia of the perineum and buttocks

Question.49 Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

Cholinesterase inhibitors

Anxiolytics

Antidepressants

Atypical antipsychotics

Question.50 Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Decreased C-reactive protein

Hyperalbuminemia

Morning stiffness

Weight gain