Final Exam NUR6111 PDF

Final Exam NUR6111 Question 1 "Hot flashes" that occur during (peri-)menopause are thought to be related to: a. Low estrogen levels. b. Low progesterone levels. c. Fluctuating progesterone levels. d. Fluctuating estrogen levels Question 2 Which of the following physical examination findings in a 65...

Final Exam NUR6111 Question 1 "Hot flashes" that occur during (peri-)menopause are thought to be related to: a. Low estrogen levels. b. Low progesterone levels. c. Fluctuating progesterone levels. d. Fluctuating estrogen levels Question 2 Which of the following physical examination findings in a 65-year-old woman warrants further evaluation? a. decrease in axillary hair b. atrophy of glandular breast tissue c. A new retraction of the nipple d. atrophic vaginitis Question 3 Which of the following is not representative of the presentation of primary syphilis? a. a painless ulcer b. a flu-like symptoms c. chance d. spontaneously healing lesion Question 4 A patient diagnosed with trichomoniasis is being treated with metronidazole (Flagyl). When teaching the patient following will the nurse practitioner include? a. "Call our office if you experience any tendon pain or tenderness" b. "Report the occurrence of pain in your upper abdomen immediately c. "You should avoid milk or dairy products during they" d."Do not drink alcohol while you are taking this mediator" Question 5 The recommended time to initiate screening for cervical cancer in women is: a. a prior to becoming sexually active b.at age 21 years c. at age 18 years. d.3 years after sexual intercourse. Question 6 The nurse practitioner recognizes the following assessment findings as being consistent with Chlamydia (select 2 that apply) a mucopurulent cervicitis b. edematous, congested friable cervix c. thick white curdy discharge d. fever Question 7 The nurse practitioner is treating a 35-year-old patient for a primary herpes infection. The first- line treatment option for primary herpes infection include: a. acyclovir b. penicillin c. ciprofloxacin d. ceftriaxone Question 8 The nurse practitioner examines a patient with complaints of foul-smelling frothy, copious, and pale yellow to gray-green vaginal discharge. On exam, vulvar irritation and cervical petechia is noted. Based on this, the most likely treatment include: (Trichomonas) a. Cipro 500 mg Q12 PO x 5 days b.Metronidazole 2 G PO x I dose c. Doxycycline 100 mg PO x daily x7 days d. Fluconazole 150 mg PO x I dose Question 9 Mary is a 36-year-old woman who complains of vaginal burning. The nurse practitioner assesses greyish-white adherent vaginal discharge that has a fishy odor. The discharge pH level is 5.1 and there is (+) whiff test. The treatment of choice for this is: (Bacterial Vaginosis) a. Fluconazole 150 mg PO x I dose b.Doxycycline 100 mg PO daily x7 days c. Cipro 500 mg Q12 PO x 5 days d.Metronidazole 500 mg PO BID x 7 days. Question 10 Jane is a 38-year-old female who presents with non-odorous thick, white, curd-like vaginal discharge and vulvar itching. She is in a monogamous relationship. She was recently treated for a sinus infection. The most likely treatment include which of the following? a. Doxycycline 100 mg by mouth twice daily fix 7 days b.Metrogel 0.75% - one vaginal applicatorful at bed time X 5 c. Augmentin 875 mg by mouth twice daily for7? days d.Fluconazole (Diflucan) 150 mg by mouth single dose Question 11 A female patient is diagnosed with chlamydia. She has complaints of vaginal discharge and dysuria. Her male partner is asymptomatic. How should they be treated? a. She should be treated with ceftriaxone be should be treated. b.They both should receive metronidazole and ceftriaxone c. They both should be treated with ceftriaxone and doxycycline d. Doxycycline x 7 days or azithromycin 1g IM Question 12 A female patient is 31 years old. She has never had an abnormal PAP smear and has had regular screening since age 22. According to the ACS and ACOG guideline has a normal PAP smear with HPV testing today, when should she have the next cervical cancer screening? a. yearly with cervical cytology b. every 5 years with cervical cytology plus HPV co-testing c. continue cervical cytology every 3 years d.yearly cervical cytology and HIV co-testing Question 13 A 53-year-old woman who is taking HRT with conjugated estrogen, 0.45 mg/day with medroxyprogesterone acetate (MPA), 1.5 mg, has bothersome atrophic vaginitis symptoms. You would consider: A. her oral estrogen dose should be increased. B. the addition of a topical estrogen can be helpful. C. the MPA component should be discontinued. D. baking soda douche should be tried. Question 14 Samantha is a 23-year-old female presents with urinary burning, frequency, and urgency. Urine dipsticks is positive for leukocytes and nitrites. Given that she has no medical history a no other pertinent clinical findings, the recommended treatment of choice is: a)Bactrim DS 160/800 mg BID x7 days b) Nitrofurantoin 100 mg BID x 5 days c)Levaquin 250 mg OD x7 days d) Cipro 250 mg BID x 5 days Question 15 A 29-Year-old female patient with no medical history presented to the NP office with fever chills and +WBC casts has been diagnosed with pyelonephritis: Which clinical findings would be consistent in this patient? a)positive Murphy's sign b) vaginal discharge c) costovertebral angle tenderness d) a positive Prehn's sign Question 16 A 29-year-old female patient who presented to the NP office with fever chills and +WBC casts has been diagnosed with pyelonephritis. What is the recommended pharmacological management for above patient? a) Levaquin 750 mg PO daily x 5 days b) Doxycycline 100 mg PO x 10 days c) Ceftriaxone 1gram intramuscular X 1 dose.  d) Bactrim 800 mg x 3 days Question 17 Mrs. Lowell is a 45-year-old active woman with diabetes who presents with urinary frequency, dysuria and fatigue. She has no fever or chills: Urine dipstick shows the presence of leukocytes and nitrites. As a nurse practitioner, which pharmacologic treatment is appropriate for this patient? a)Bactrim DS 800/160 mg BID x7 days. b) Cipro 250 mg BID x 3 days c)Levaquin 250 mg OD x 3 days d) Macrobid 100 mg PO BID x 3 dais Question 18 Mrs. Jones is a physically independent 65 y/o who walks one mile daily on most days. She is beginning to have some joint pain but is otherwise health and takes only her hormones" She is found on a routine well visit to have WBCs in her urine. She has no signs or symptoms of UTI infection. How should she be managed? a) treat her as having uncomplicated cystitis b) Treat her today with a one-day dose of an antibiotic. c)Monitor her for symptoms of UTIL d) Start Bactrim DS 1601800 mg BID X7 days Question 19 Mr. Smith has HTN. His GFR of 65. The nurse practitioner should consider all of the following interventions EXCEPT: a)check for urine albumin b) review medications c)start AGE Inhibitor d) refer to nephrologist for hemodialysis Question 20 A 42-year-old male patient presents to the NP office with a sudden unset of lower back pain, hematuria, and diaphoresis. He has no scrotal pain, fever or penile discharge. He is currently on thiazides diuretic for high blood pressure What should be on the NP' highest differential diagnosis consideration? a. Epididymitis b.UTI c. Prostatitis d.renal lithiasis Question 21 A 22-year-old male patient who is otherwise healthy presents to the NP office with a sudden onset of scrotal pain. He complains of nausea and is found to have an asymmetric, high-riding testes on the right side. What should the NP suspect? a. testicular cancer b. inguinal hernia c. prostatitis d. Testicular Torsion Question 22 A classic physical finding in a patient with testicular torsion include: a. absences of cremasteric reflex on affected side. b. positive Prehn’s sing c. the affected testis is lower d. absence of cremasteric reflex on the unaffected side Question 23 Ben is 28-year-old sexually active male who the APN suspects as having epididymitis. Which P exam findings are most consistent with the diagnosis? a. urethral discharge, scrotal edema, cremasteric reflex absent, pain increased in with b.scrotal edema, scrotal erythema, fever, absence of one or both testes upon. c. scrotal edema, low back pain, pain relieved with scrotal elevation level d.cremasteric reflex present, urethral discharge, scrotal edema, pain leveled o with scrotal tenderness Question 24 A client has stress incontinence. When obtaining the health history, the nurse should ask if the client has: a. Inability to empty the bladder. b. Loss of urine when coughing. c. Involuntary urination with minimal warning. d. Frequent dribbling of urine. Question 25 Cheryl, 72-year-old female, is complaining of difficulty holding her urine when she has the urge to void This results in leaking. She is asking for medications to help her problem as a NP. you would consider which medication for this patient. a. Tamsulosin 0.4 mg OD b.Pseudoephedrine 30 mg g 6H c. Oxybutynin 2.5 mg TID d.Imipramine 10 mg TID Question 26 A 40-year-old healthy Caucasian male with no risk factors and no significant medical or family history presents for his annual physical Patient requested a baseline screening for prostate cancer how should the nurse practitioner proceed? a. Perform a digital rectal exam and order a base line PSA b. Order a baseline PSA only. c. Inform patient that guideline does not recommend screening at this time. d.Refer patient to urologist oncologist Question 27 What Is the recommendation of American Cancer Society for initial screening of African- American male for prostate cancer? a. Digital rectal exam only stating ata93 40 jess b.Discussion for PSA screening starting at age 45 years c. Discussions starting at age 40 years d.He should be screened starting at aga 50 years Question 28 Mr. Cruz was started on Proscar 5 mg daily 4 weeks ago If a repeat PSA was done today the NPs initial expectation: a.it may take 6 months to assess efficacy b.if the PSA did not decrease, the dose should be increased to10 mg daily c. an elevation of the PSA would occur d.his PSA and symptoms should decrease Question 29 Mr. Adams is a 52-year-old male truck driver who informs the NP that his sexual performance has not been adequate lately. Recently he was speaking to one of his. "buddies” who had been prescribed medication for the same problem and was wondering if he could be prescribed the same medication. the NP knows that the risk factors for ED include all of the following EXCEPT: a. smoking b.obesity c. sleep apnea d.family history Question 30 Which test below may be used to exclude a common secondary cause of hyperlipidemia? a. CBC b. GFR c. AST/ALT d. TSH Question 31 A 65-year-old male patient with NO history of ACVD or DM Lipid profile Total cholesterol = 210, LDL = 130, HDL= 35, Triglycerides= 129. Based on the guidelines, what is the next step To manage this patient? a. Calculate the patients 10-year CV risk. b. start a low dose statin. c. Repeat lipid profile in 1 year d. Start Rosuvastatin 40 mg daily Question 32 A 52-Year-old male patient with known diabetes has the following lipid profile total cholesterol 198. LDL 115, HDL 35triglicerides 124 ASCVD. Risk score 6.7/%: How would you manage this patient? e. Start Atorvastatin 10 mg PO dan. f.Start Atorvastatin 40 mg PO daily. g. Start Rosuvastatin 40 mg PO daily. h. no statin necessary due to low ASCVD sore. Question 33 A patient on Simvastatin for newly diagnosed hyperlipidemia complains of generalized muscle aches for about 2 weeks How should this be evaluated? a. Check rheumatoid factor b.Order a CPK. c. Recheck fasting lipid profile. d. Send for lower extremity arterial dopplers. Question 34 A 45-year-old diabetic patient with elevated BP Which medication would you consider first in treating his HTN? a. Metoprolol succinate 25 mg PO BID dan b.HCTZ 25 mg PO daily c. Enalapril 10 mg dally d.Amlodipine 10 mg Question 35 A 40-year-old African American patient with no medical history has had BP readings between 136/90 and 144/80 despite lifestyle modifications for 3 months what is the most appropriated the plan of care for this patient? a. start amlodipine 5 mg daily. b. start ramipril 10 mg daily c. start. Metoprolol tartrate 25 mg BID d. Recommend a low Na diet and recheck in 3 months Question 36 When starting patient on ACE inhibitor, which laboratory test would you monitor? a. PT/INR for decreased INR b.LFT for increased AST c. BMP for elevated potassium level d.BMP for elevated Calcium level Question 37 A 54-year-Old patient was recently diagnosed with HTN She was started on Lisinopril 20 mg OD 3 months ago: Her current BP Is 156/94. Using the guidelines, what is the appropriated next step? a. Stop Lisinopril and start another medication tom a different class. b.Add HCTZ 25 mg PO daily c. Add Olmesartan 20 mg. d. BP is acceptable, recheck in 3 months. Question 38 Which would represent the best choice of anti-hypertensive agent for the indicated patient’s condition? a. Beta-blocker for a diabetic patient. b.ARB for a patient on ACE inhibitor c. Beta-blocker for a patient with a history of MI d.Diuretic for a patient with history di gout. Question 39 Which anti-hypertensive medication would you avoid using in a patient with severe asthma? a. Ca channel blocker b.ACE inhibitor c. Beta blockers d.Diuretics Question 40 Which class of anti-hypertensive medication Is used to improve long-term outcomes of patient with systolic dysfunction? a. ACE inhibitors b. Calcium channel blockers c. Loop diuretics d. Thiazide diuretics Question 41 You are trying to determine the thromboembolic risk in a patient with Afib Using the CHADSVASc score, you would consider the following as risk factors EXCEPT: a. HTN b. CHF c. DM d. age of 55 Question 42 A patient with new onset Afib has a CHADSVASc score of 4 with no bleeding risks. The best approach for this patient is to: a.start Rivaroxaban 20 mg daily b.start Plavix 75 mg daily c. start ASA 81 mg Daily d. tell the patient his risk for stroke is low and he does need anticoagulation Question 43 A serious complication of deep venous thrombosis is: a.pulmonary embolus b. venous stasis ulceration c. peripheral arterial disease d. atrial fibrillation Question 44 A patient presents to the office with left lower leg swelling and discomfort Based on his history and PE findings, he has a Well’s score of 4. what is the most appropriated next step? a. order a D-dimer b.order a venous ultrasound c. start Coumadin d.refer to vascular surgeon Question 45 A patient, with no significant co-morbidities, is diagnosed with proximal DV A decision has been made to start him on pharmacologic management the appropriated initial medication start the patient on is: a.Rivaroxaban 15 mg bid b.Pletal 100 mg bid c. Trental 400 mg tid d. Rivaroxaban 20 mg daily Question 46 An indicator of severe peripheral artery disease would be: a.claudication unrelieved with rest b. intermittent claudication c. ankle brachial index > 1.0. d.decreased hair distribution on the lower extremities. Question 47 Management of peripheral arterial disease include all of the following EXCEPT: a. antiplatelet therapy b. an exercise program c. vasodilator therapy d. elevation and compression therapy. Question 48 In a patient with an ABI of 0.9 you would recommend: a. smoking cessation b. arterial ultrasound c. guided exercise d. all of the above Question 49 In a patient suspected of having PAD, the following statement is true a. venous doppler is necessary for diagnoses b.ABl can be used lo diagnoses PAD. c. Palpable pulses eliminates PAD as a differentia’s diagnoses d.peripheral angiography is necessary for diagnoses Question 50 Factors included in the Wells criteria used to evaluate the patient's risk for DVT include: a. gender b.dyspnea c. patient immobilization d. age Question 36 In order to reduce lipid levels, statins are most beneficial when taken: a. once daily in the AM b. always with food c. with an aspirin in the evening d. in conjunction with diet and exercise Question 20 The gold standard diagnostic test for kidney stones is: Helical computed tomography (CT) non-contrast of the abdomen and pelvis - considered the best initial and gold standard test for detection of stones because of its high sensitivity (95%) and specificity (98%)