NURS 6531 Final Exam ( Version 1, 100 Q/A) / NURS6531 Final Exam (Latest 2020): Walden University

NURS 6531 Final Exam ( Version 1, 100 Q/A) / NURS6531 Final Exam (Latest 2020): Walden University

Walden NURS 6531 Final Exam / Walden NURS6531 Final Exam (Latest)

·         Question 1

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

·         Question 2

A patient complains of generalized joint pain and stiffness associated with activity and relieved with rest. This patient history is consistent with which of the following disorders?

·         Question 3

What diabetic complications result from hyperglycemia?

1.       

1.       

1.       Retinopathy

2.       Hypertension resistant to treatment

3.      Peripheral neuropathy

4.       Accelerated atherogenesis

·         Question 4

Which factors are associated with high risk for foot complications in a patient with diabetes mellitus?

1.      Obesity

2.      Abnormal nails

3.      Abnormal gait

4.      Poorly controlled lipids

·         Question 5

Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)?

A. Nocturia
B. Urgency incontinence
C. Strong urinary stream flow
D. Straining to void

·         Question 6

A 63-year-old man presents to the office with hematuria, hesitancy, and dribbling. Digital rectal exam (DRE) reveals a moderately enlarged prostate that is smooth. The PSA is 1.2. What is the most appropriate management strategy for you to follow at this time?

A. Prescribe an alpha adrenergic blocker.
B. Recommend saw palmetto.
C. Prescribe an antibiotic
D. Refer the client to urology.

·         Question 7

A 30 year old female patient presents to the clinic with heat intolerance, tremors, nervousness, and weight loss inconsistent with increased appetite. Which test would be most likely to confirm the suspected diagnosis?

·         Question 8

Which history is commonly found in a patient with glomerulonephritis?

Ask about recent infections (skin or upper respiratory);

recent travel (possible exposure to viruses, bacteria, fungi, or parasites);

recent illnesses, surgery, or invasive procedures (possible infection);

any systemic diseases (Systemic Lupus Erythematosus -SLE)

·         Question 9

 A 60 year old male patient with multiple health problems presents with a complaint of erectile dysfunction (ED). Of the following, which medication is most likely to be causing the problem?

·         Question 10

 Which of the following is not a characteristic of type 2 diabetes mellitus?

·         Question 11

A patient has been diagnosed with hypothyroidism and thyroid hormone replacement therapy is prescribed. How long should the nurse practitioner wait before checking the patient’s TSH?

·         Question 12

A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder?

·         Question 13

 What is the most common cause of Cushing’s syndrome?

·         Question 14

Which of the following is the most  cause of low back pain?

·         Question 15

Warfarin (Coumadin) is prescribed for a frail, elderly male with new onset atrial fibrillation. The goal INR for this patient should be:

·         Question 16

A 72 year old patient exhibits sudden onset of fluctuating restlessness, agitation, confusion, and impaired attention. This is accompanied by visual hallucinations and sleep disturbance. What is the most likely cause of this behavior?

·         Question 17

Which of the following is the most common causative organism of nongonococcal urethritis?

which of the following does not cause nongonococcal urethritis

a chlamydia – most common
b. mycoplasma
c. neisseria
d. ureaplasma

·         Question 18

Which appropriate test for the initial assessment of Alzheimer’s disease provides the performance ratings on 10 complex, higher order activities?

·         Question 19

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

·         Question 20

Diagnostic evaluation for urinary calculi includes:

A.

Urinalysis and culture

B.

Non contrast CT

C.

Serum calcium

D.

All of the above

·         Question 21

Reed-Sternberg B lymphocytes are associated with which of the following disorders:

·         Question 22

Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia?

A. Musculosckeletal pain
B. Difficulty sleeping
C. Depression
D. Fatigue

·         Question 23

Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within normal limits. Which of the following diagnoses do you explore further?

·         Question 24

Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid?

·         Question 25

The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is:

Rest the affected part of the body
- Once pain free, the person can gradually begin the sporting activity again
- Air splinting can reduce pain and decrease the time until return to full participation or intensity of exercise.
- NSAIDs to reduce pain and inflammation

·         Question 26

Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus?

·         Question 27

A thymectomy is usually recommended in the early treatment of which disease?

·         Question 28

The most common cause of elevated liver function tests is:

·         Question 29

A 14 year old female cheerleader reports gradual and progressive dull anterior knee pain, exacerbated by kneeling. The nurse practitioner notes swelling and point tenderness at the tibial tuberosity. X-ray is negative. What is the most likely diagnosis?

·         Question 30

Which of the following is a contraindication for metformin therapy?

Creatinine > 1.5

·         Renal dysfunction.

·         Congestive cardiac failure needing drug treatment.

·         Hypersensitivity to metformin.

·         Acute or chronic metabolic acidosis.

·         Impaired hepatic function.

·         Question 31

The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy:

·         Question 32

Which is the most common cause of end-stage renal disease in the United States?

·         Question 33

A middle-aged female presents complaining of recent weight loss. The physical exam reveals an enlarged painless cervical lymph node. The differential diagnosis for this patient’s problem includes:

·         Question 34

Risk factors for prostate cancer include all of the following except:

·         Question 35

Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of:

·         Question 36

The most effective intervention(s) to prevent stroke is (are):

·         Question 37

A diabetic patient is taking low-dose enalapril for hypertension. A record of the patient’s blood pressure over 4 weeks ranges from 130 to 142 mmHg systolic and 75 to 85 mmHg diastolic. How should the nurse practitioner respond?

·         Question 38

Microalbuminuria is a measure of:

·         Question 39

Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect?

·         Question 40

 A 32 year old male patient complains of urinary frequency and burning on urination for 3 days. Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial treatment should be:

·         Question 41

 A 21-year-old female presents to the office complaining of urinary frequency and urinary burning. The nurse practitioner suspects a urinary tract infection when the urinalysis reveals

·         Question 42

Which of the following medications increase the risk for metabolic syndrome?

·         Question 43

The most accurate measure of diabetes control is:

·         Question 44

The 4 classic features of Parkinson’s disease are:

·         Question 45

A child with type 1 diabetes mellitus has experienced excessive hunger, weight gain and increasing hyperglycemia. The Somogyi effect is suspected. What steps should be taken to diagnose and treat this condition?

·         Question 46

A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness, anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take?

·         Question 47

Other than smoking cessation, which of the following slows the progression of COPD in smokers?

·         Question 48

A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains:

·         Question 49

The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in almost 100% of patients is:

·         Question 50

A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is:.

·         Question 51

How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout?

·         Question 52

The treatment of choice for chronic bacterial prostatitis (CBP) is:

·         Question 53

Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to:

·         Question 54

Urine cultures should be obtained for which of the following patients?

·         Question 55

Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse?

·         Question 56

The diagnosis which must be considered in a patient who presents with a severe headache of sudden onset, with neck stiffness and fever, is:

·         Question 57

An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects?

·         Question 58

Which patient would benefit most from screening for type 2 diabetes?

·         Question 59

The intervention known to be most effective in the treatment of severe depression, with or without psychosis, is:

·         Question 60

Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond?

·         Question 61

Which of the following patients most warrants screening for hypothyroidism?

·         Question 62

Successful management of a patient with attention deficit hyperactivity disorder (ADHD) may be achieved with:

·         Question 63

Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following:

A.

HbA1C

B.

2-hour 75 gram oral glucose tolerance test

C.

C-peptide level

D.

A and B

E.

All of the above

·         Question 64

Prolonged PT suggests:

·         Question 65

Diagnostic confirmation of acute leukemia is based on:

·         Question 66

Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis?

·         Question 67

The most effective treatment of non-infectious bursitis includes:

·         Question 68

Differential diagnosis of proteinuria includes which of the following?

A.

Orthostatic proteinuria

B.

Nephrotic syndrome

C.

Infection

D.

Trauma

E.

A and B

·         Question 69

You are assessing a patient after a sports injury to his right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to the:

·         Question 70

A positive drawer sign supports a diagnosis of:

·         Question 71

A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as:

·         Question 72

A patient has been taking fluoxetine (Prozac) since being diagnosed with major depression, first episode, 2 months ago. She reports considerable improvement in her symptoms and her intention to discontinue the medication. What should be the nurse practitioner’s recommendation?

·         Question 73

Diagnostic radiological studies are indicated for low back pain: 

·         Question 74

A 32 year old female patient presents with fever, chills, right flank pain, right costovertebral angle tenderness, and hematuria. Her urinalysis is positive for leukocytes and red blood cells. The nurse practitioner diagnoses pyelonephritis. The most appropriate management is:

·         Question 75

Which of the following symptoms suggests a more serious cause of back pain? 

·         Question 76

What is the first step in the treatment of uric acid kidney stones?

·         Question 77

A 20 year old male patient complains of “scrotal swelling.” He states his scrotum feels heavy, but denies pain. On examination, the nurse practitioner notes transillumination of the scrotum. What is the most likely diagnosis?

·         Question 78

What is the first symptom seen in the majority of patients with Parkinson’s disease?

·         Question 79

A 60 year old female patient complains of sudden onset unilateral, stabbing, surface pain in the lower part of her face lasting a few minutes, subsiding, and then returning. The pain is triggered by touch or temperature extremes. Physical examination is normal. Which of the following is the most likely diagnosis?

·         Question 80

Which of the following set of symptoms should raise suspicion of a brain tumor?    

·         Question 81

The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are):

·         Question 82

 A 25 year old overweight patient presents with a complaint of dull achiness in his groin and history of a palpable lump in his scrotum that “comes and goes”. On physical examination, the nurse practitioner does not detect a scrotal mass. There is no tenderness, edema, or erythema of the scrotum, the scrotum does not transilluminate. What is the most likely diagnosis?

·         Question 83

Which of the following characteristics are associated with prepatellar bursitis?

·         Question 84

Which drug category contains the drugs that are the first line Gold standard therapy for COPD?

·         Question 85

Which of the following physical modalities recommended for treatment of rheumatoid arthritis provides the most effective long term pain relief?

·         Question 86

Which of the following accounts for half of the bladder tumors among men and one-third in women?

·         Question 87

 A 35 year old male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency, and reduced force of stream. The nurse practitioner suspects acute bacterial prostatitis. Which of the following specimens would be least helpful for diagnosis?

·         Question 88

In which of the following presentations is further diagnostic testing not warranted?

·         Question 89

Martin is complaining of erectile dysfunction. He also has a condition that has reduced arterial blood flow to his penis. The most common cause of this condition is:

·         Question 90

Which of the following is the most common complication of the myelodysplastic syndromes?

·         Question 91

. You know that this is indicative of:

A.    Infection 
B. Malignancy 
C. Inflammation
D. Drug 
E. Endocrine

B.     A. Infection 
- Viral: infectious mononucleosis (CMV, EBP), HIV 
- Bacterial: skin infection, TB
- Fungal: cryptococcal 

B. Malignancy
- Hematological: lymphoma, leukemia 
- Solid tumour LN met 

C. Inflammatory 
- Castleman ds
- Kimura ds
- Kikuchi ds 
- SLE, RA 
- Amyloidosis, sarcoidosis 

D. Drug 
- Phenytoin (anti-seizure) 
- Hydralazine (HF)

E. Endocrine [rare]
- Addison's disease 
- Hypothyroidism

·         Question 92

A 15 year-old female patient is 5 feet tall and weighs 85 pounds. You suspect anorexia and know that the best initial approach is to:

·         Question 93

 A patient taking levothyroxine is being over-replaced. What condition is he at risk for?

·         Question 94

A nurse practitioner diagnoses a 60 year old male with balanitis. Which disease is commonly associated with balanitis?

·         Question 95

The diagnosis of human papilloma virus (HPV) infection in males is usually made by:

·         Question 96

Martin, a 58 year old male with diabetes, is at your office for his PRO follow up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Martin receive today regarding the care if his feet?

·         Question 97

Which of the following is a potential acquired cause of thrombophilia?

·         Question 98

Deficiency of which nutritional source usually presents with an insidious onset of paresthesias of the hands and feet that are usually painful?

·         Question 99

What information should patients with diabetes and their families receive about hypoglycemia?

·         Question 100

Josh, age 22, is a stock boy and has an acute episode of low back pain. You order and NSAID and tell him which of the following?

·         Question 101

A 28-year-old female presents to the office requesting testing for diagnosis of hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her risk factors. The nurse practitioner explains that:

A.

The patient should start anticoagulant therapy immediately.

B.

Hereditary thrombophilia does not always require anticoagulation therapy.

C.

Women of childbearing age cannot take anticoagulant therapy.

D.

Genetic and risk management counseling are recommended.

E.

B and D