A health care professional is caring for a patient admitted to the hospital with severe anorexia. What action by the health care professional would be most important?
A health care professional is caring for a patient admitted to the hospital with severe anorexia. What action by the health care professional would be most important?
Ensuring the patient is on a cardiac monitor
Facilitating laboratory testing of electrolytes
Arranging a psychiatry consultation
Assessing the patient’s favorite foods
Question 2
John, 64, reports that he has a severe curvature of his penis which occurred all at once. He is involved in vigorous athletic activities 4-5 days per week and does not recall an injury during his activities, only that he awoke with a painful curved erection and shortened erection. The nurse practitioner knows that:
Peyronie’s disease self-limiting and will go away on its own.
Peyronie’s disease is an inflammatory condition, resulting in noncompliant fibrous nodules in the tunica albuginea.
Peyronie’s disease only occurs as a result of microvascular trauma. All activities should be avoided for 4-6 weeks, to allow for healing.
Peyronie’s disease results from an abnormality in arterial inflow, resulting in venous leakage at the site of veno-occlusion.
Question 3
A severely malnourished patient is in the hospital to improve nutrition. On the second day, the patient reports palpitations and difficulty breathing. After placing the patient on a cardiac monitor, what action does the health care professional take next?
Take the patient’s temperature.
Have lab drawn for electrolyte levels.
Cancel the patient’s next meal.
Facilitate a chest x-ray.
Question 4
What is the primary pathologic alteration resulting from ankylosing spondylitis (AS)?
Inflammation of the bursa
Inflammation of the long bones
Inflammation of fibrocartilaginous joints of the vertebrae
Inflammation of the small hand and feet bones
Question 5
Which spinal tract carries the most nociceptive information?
Archeospinothalamic
Paleospinothalamic
Dorsal spinothalamic
Lateral spinothalamic
Question 6
A patient is 8 hours postoperative after a long orthopedic procedure. The student asks why this patient is at particular risk of developing a thromboembolism. What response by the healthcare professional is best?
Patients tend to have venous stasis from orthopedic operations.
Anesthetic agents often cause an immune response against clotting factors.
Endothelial damage occurs and repair is slowed by postoperative pain.
Atherosclerotic build up causes turbulent blood flow leading to clots.
Question 7
In which stage of syphilis would the following clinical manifestations be found: destructive skin, bone and soft tissue lesions, aneurysms, heart failure, and neurosyphilis?
Primary
Secondary
Latent
Tertiary
Question 8
A student studying osteomyelitis and asks for an explanation of the term sequestrum. What response by the professor is best?
An area of devascularized and devitalized bone
An enzyme that phagocytizes necrotic bone
A subperiosteal abscess
A layer of new bone surrounding the infected bone
Question 9
Which mother does the healthcare professional prepare to administer Rh immune globulin (Rho-GAM) to?
Is Rh-positive and the fetus is Rh-negative
Is Rh-negative and the fetus is Rh-positive
Has type A blood and the fetus has type O
Has type AB blood and the fetus has type B
Question 10
A child has iron deficiency anemia. In addition to iron supplements, what else does the healthcare professional educate the parents on giving the child?
Vitamin A
Magnesium
Vitamin C
Zinc
Question 11
A healthcare professional is planning a community event to reduce risk of cerebrovascular accident (CVA) in high risk groups. Which group would the professional target as the priority?
Insulin-resistant diabetes mellitus
Hypertension
Polycythemia
Smoking
Question 12
Which pain theory proposes that a balance of impulses conducted from the spinal cord to the higher centers in the central nervous system (CNS) modulates the transmission of pain?
Gate control theory (GCT)
Pattern theory
Specificity theory
Neuromatrix theory
Question 13
Bronchiolitis tends to occur during the first years of life and is most often caused by what type of infection?
Respiratory syncytial virus (RSV)
Influenza virus
Adenoviruses
Rhinovirus
Question 14
What is the most abundant class of plasma protein?
Globulin
Albumin
Clotting factors
Complement proteins
Question 15
The APRN is assessing a patient that has monotone speech and unchanged facial expressions even though he states he is happy and excited about his life. This is an example of:
Delusion
Hallucination
Anhedonia
Pressured speech
uestion 16
A patient in the hospital has been receiving heparin injections. The platelet count on admission was 222,000/mm 3 and four days later is 113,000/mm 3. What action by the healthcare professional is best?
Prepare to transfuse the patient with platelets.
Do nothing; this is an expected side effect.
Switch the heparin to lepirudin
Stop all the patient’s medications.
Question 17
A child has phenylketonuria (PKU). The healthcare professional educates the parents on the special diet needed, telling them that children with PKU are unable to synthesize what?
Essential amino acid, phenylalanine, to tyrosine
Renin, erythropoietin, and antidiuretic hormone
Aldosterone, cortisol, and androgens
Neurotransmitters gamma-aminobutyric acid (GABA) and acetylcholine
Question 18
A healthcare professional is trying to lower a patient’s body temperature by convection. What action by the professional will accomplish this?
Lower the temperature in the patient’s room.
Place the patient in a cooling blanket.
Obtain a fan and set it to blow over the patient.
Place cold moist towels over the patient.
Question 19
What are the clinical manifestations of testicular cancer?
Firm, nontender testicular mass
Painful, mobile, firm testicular mass
Painful fluid-filled testicular mass
Soft, nontender testicular mass
Question 20
Which condition is consistent with the cardiac defect of transposition of the great vessels?
The aorta arises from the right ventricle.
The pulmonary trunk arises from the right ventricle.
The right ventricle pumps blood to the lungs.
An intermittent murmur is present.
Question 21
What directly causes ovulation during the menstrual cycle?
Gradual decrease in estrogen levels
Sudden increase of LH
Sharp rise in progesterone levels
Gradual increase in estrogen levels
Question 22
A woman attempting to conceive tells the healthcare professional that she and her partner have intercourse when her basal body temperature (BBT) is around 37?C (98?F) without getting pregnant. What information does the professional give the woman?
Maybe you need a fertility workup.
That’s a normal temperature, but during ovulation BBT decreases.
Temperature alone is not the most accurate way to predict ovulation.
BBT rises consistently above 37.8″1eC (100″1eF) with ovulation.
Question 23
Cystic fibrosis is characterized by which symptom?
Excessive mucus production
Elevated blood glucose levels
Low sodium content in perspiration
Abnormally thin exocrine secretions
Question 24
A patient is in the intensive care unit and has intercranial pressure (ICP) monitoring. The patient’s ICP is 17 mmHg. The healthcare professional notes that the chart indicates the patient is now in stage 1 intracranial hypertension. What assessment finding does the professional associate with this condition?
Rapid spike in measured ICP
No significant change in ICP readings
Restlessness and subtle breathing and pupil changes
A widened pulse pressure and bradycardia
Question 25
What is the role of thromboxane A (TXA 2) in the secretion stage of hemostasis?
Stimulates the synthesis of serotonin.
Promotes vasodilation.
Stimulates platelet aggregation.
Promotes formation of cyclooxygenase.
Question 26
When examining a male age 50 and older, the Nurse Practitioner should know that:
It is not necessary to perform a DRE if the PSA is normal.
It is not necessary to perform a PSA if the DRE is normal.
The DRE and PSA should be performed.
The Nurse Practitioner can use her discretion until age 60.
Question 27
A patient has pernicious anemia and asks the healthcare professional to explain the disease. Which statement by the professional is most accurate?
The lack of certain foods in your diet
Your body cannot absorb vitamin B 12.
You are not getting enough vitamin C.
Your bone marrow has stopped working.
Question 28
Clinical manifestations that include irregular or heavy bleeding, the passage of large clots, and the depletion of iron stores support which diagnosis?
Premenstrual syndrome
Abnormal uterine bleeding
Polycystic ovary syndrome
Primary dysmenorrhea
Question 29
To quickly assess a patient’s nervous system for dysfunction, what assessment should the healthcare professional perform as the priority?
Size and reactivity of pupils
Pattern of breathing
Motor response
Level of consciousness
Question 30
A healthcare professional is seeing a patient with suspected schizophrenia. For which prenatal occurrence should the professional assess?
Viral infection
Maternal depression
Maternal smoking
Exposure to toxic waste
Question 31
Abnormalities in brain development related to schizophrenia are thought to develop when?
Prenatal
Infancy
Early Childhood
Adolescent
Question 32
A child has osteosarcoma and the healthcare team is assessing for metastases. What diagnostic study would be the priority?
Pancreatic enzyme analysis
Liver biopsy
Chest x-ray or CT scan
Brain MRI
Question 33
What is the effect of low plasma albumin?
Clotting factors decrease, thus increasing the chance of prolonged bleeding.
Fewer immunoglobulins are synthesized, thus impairing the immune function.
Less iron is stored, thus increasing the incidence of iron deficiency anemia.
Osmotic pressure decreases; thus water moves from the capillaries to the interstitium.
Question 34
A patient reports frequent nightmares. For which of these should the healthcare professional assess the patient?
A recent major loss
Family history of nightmares
History of traumatic event
Poor nutrition and weight loss
Question 35
A patient has been exposed to prolonged high environmental temperatures and now shows signs of dehydration, decreased plasma volumes, hypotension, decreased cardiac output, and tachycardia. What treatment does the healthcare professional prepare to administer to this patient?
Administer salty beverages to the patient.
Aggressive cooling methods to rapidly lower temperature
Encourage the patient to have genetic testing after recovery.
Give the patient plenty of cool fluids to drink.
Question 36
A patient has polycythemia vera and presents to the Emergency Department with plethora and neurological changes. The student asks the healthcare professional to explain the primary cause of these symptoms. What response by the professional is best?
Decreased erythrocyte count
Destruction of erythrocytes
Increased blood viscosity
Tissue destruction by macrophages
Question 37
Which of the following are negative clinical manifestations of schizophrenia?
Social withdraw, blunted affect, and failure to respond to simple questions
Hallucinations, delusions, and incoherent speech
Hallucinations, blunted affect, and social withdraw
Delusions, hallucinations, and failure to respond to simple questions
Question 38
In order to help prevent a preadolescent girl from developing later cervical cancer, which virus does the healthcare professional recommend vaccination against to the parent?
Human papillomavirus (HPV)
Epstein-Barr virus (EBV)
Herpes simplex II virus (HSV)
Cytomegalovirus (CMV)
Question 39
A healthcare professional wants to volunteer for a community education project to help prevent spinal cord injury. What activity would the professional most likely volunteer for?
Teaching school aged children bicycle safety
Teaching stretching to high school athletes
Teaching adults good body mechanics for lifting
Teaching older adults how to prevent trip-and-fall events
Question 40
A man has balanitis. What action by the healthcare professional is most appropriate?
Educate the man on the side effects of chemotherapy.
Perform a finger stick for a blood glucose reading.
Administer pain medication before retracting the foreskin.
Prepare the man for a needle aspiration of the corpus.
Question 41
Which nerve control might likely be affected in a patient that has incontinence of the bowel and bladder?
L2-L5, S1-S5 and the coccygeal nerves
T10-T11, T11 L1-L2, and the coccygeal nerves
L2-4 and L4-L5
T10-T11 and the cauda equina
Question 42
A preschool teacher notices a child who has burrows on the hands that are several millimeters to 1 cm long, papules, and vesicular lesions. What other assessment finding would help the teacher determine the type of infestation the child has?
Ask the child if he or she has been around puppies or kittens.
Check the child’s hair for the presence of small mites.
Ask the child if itching occurs especially at night.
Assess the child’s trunk and abdomen for petechiae.
Question 43
Which patient finding would lead the health care professional to assess the patient for inflammatory joint disease?
Unilateral joint involvement
Normal joint synovial fluid
Absence of synovial membrane inflammation
Systemic symptoms of inflammation
Question 44
The APRN is assessing a patient that is talking to his mother in the corner of the room even although you are the only other person in the room. This is an example of:
Delusion
Hallucination
Anhedonia
Pressured speech
Question 45
Parents report their 3-week-old infant who eats well and has gained weight began to have projectile vomiting for no apparent reason. What treatment option does the healthcare professional prepare to educate the parents on?
A gastric feeding tube
Wheat-free diet
Corrective surgery
Lactose-free diet
Question 46
52-year-old female presents to the clinic with dysuria, urgency and frequency. She reports symptoms have been present for the past week. She also has nausea, vomiting, flank pain and an elevated temperature of 100.7. Patient has a history of Diabetes Mellitus and Overactive Bladder. She reports intermittent gross hematuria for the past week. Further evaluation by urinalysis with micro, identifies microhematuria, with greater than 100 RBC/HPF present. What are the likely differential diagnoses to consider?
Urinary calculi
Atrophic Vaginitis
Pyelonephritis
Urinary Tract Infection
Question 47
A 9-year-old child has a blood pressure of 112/72 mmHg in the school nurse’s office. What action by the school nurse is most appropriate?
Inform the parents the child might be dehydrated.
Note the normal finding in the child’s records.
Calculate the child’s Body Mass Index.
Refer the child for medication.
Question 48
A child has Duchenne muscular dystrophy. What complication does the healthcare professional teach the parents is most important to control?
Respiratory infection
Joint contractures
Urinary tract infection
Fractures from falling
Question 49
In immunoglobulin G (IgG) nephropathies such as glomerulonephritis, IgG is deposited in which location?
Juxtamedullary nephrons
Glomerulus basement membranes
Mesangium of the glomerular capillaries
Parietal epithelium
Question 50
A healthcare professional is discussing breast feeding with a pregnant woman. Which beneficial substance does the professional tell the mother is found in breast milk?
IgA
IgE
IgG
IgM
Question 51
A patient has been hospitalized with Guillain-Barré syndrome (GBS). The patient asks how this could have occurred. What response by the healthcare professional is best?
It is often preceded by a viral illness.
It is due to a genetic defect in acetylcholine.
It could be caused by a brain tumor.
It is often transmitted by family pets.
Question 52
The disruption in cellular adhesion observed in bullous impetigo is caused by an exfoliative toxin related to which organism?
Staphylococcus aureus
Streptococcus pyogenes
Escherichia coli
Candida albicans
Question 53
Which bones are affected in Legg-Calvé-Perthes disease?
Heads of the femur
Distal femurs
Heads of the humerus
Distal tibias
Question 54
The myelin in the brain and spinal cords are formed by:
Neurons
Neurons and astrocytes
Astrocytes and microglia
Oligodendrocytes
Question 55
The healthcare professor states that a patient has reached pain tolerance. What further information from the professor is most accurate?
The patient cannot endure a higher level of pain intensity at this point.
The patient’s pain tolerance is much lower because of consuming too much alcohol.
The patient’s pain in one place is higher because pain in multiple other sites.
The patient now recognizes what is being felt is actually pain.
Question 56
A healthcare professional has taught a parent group about the causes of enuresis. What statement by a parent indicates the professional needs to give more information?
A maturational lag may cause enuresis.
Enuresis may be related to increased light sleep.
Obstructive sleep apnea may be a symptom of enuresis.
Elevated nocturnal levels of vasopressin may cause enuresis.
Question 57
In the majority of children experiencing delayed puberty, what is the problem caused by?
Disruption in the hypothalamus
Disruption of the pituitary
Deficit in estrogen or testosterone
Physiologic delays in maturation
Question 58
Obsessive compulsive disorder is characterized by what types of thoughts and behaviors?
disorganized irrational thoughts and disorganized behavior
constant irrational thoughts and constant behavior
repetitive irrational thoughts and ritualized behavior
repetitive irrational thoughts and disorganized behavior
Question 59
The APRN would expect to find elevated blood levels of which of the following markers for patients with a diagnosis of depression?
Proinflammatory cytokines and pH
Calcium and Cortisol
Calcium and pH
Proinflammatory cytokines and cortisol
Question 60
The musculoskeletal system is responsible for:
Movement and support
Movement and protection
Movement, support, and heat
Blood circulation, movement, support, heat, protection
Question 61
A person comes to the healthcare clinic and reports night sweats and fever. The healthcare professional obtains a chest x-ray which shows a mediastinal mass. What other assessment or diagnostic test does the professional provide as a priority?
Listen to heart sounds.
Assess the patient’s skin.
Arrange for familial DNA testing.
Test blood for anemia.
Question 62
A student asks the professor what the most common pathophysiologic process is that triggers aplastic anemia (AA). What response by the professor is most accurate?
Autoimmune disease against hematopoiesis by activated cytotoxic T (Tc) cells
Malignancy of the bone marrow in which unregulated proliferation of erythrocytes crowd out other blood cells
Autoimmune disease against hematopoiesis by activated immunoglobulins
Inherited genetic disorder with recessive X-linked transmission
Question 63
A patient had a seizure that consisted of impaired consciousness and the appearance of a dreamlike state. How does the healthcare professional chart this episode?
Focal seizure
Complex focal seizure
Tonic-clonic seizure
Atonic seizure
Question 64
A student asks the health care professional why obese people are at higher risk for hypertension than non-obese individuals. What response by the professional is best?
They produce more ghrelin in the stomach.
Their thyroid gland secretes less hormone.
They produce more angiotensinogen.
They secrete fewer endocannabinoids.
Question 65
Gait disturbances and instability are characteristic of which form of cerebral palsy?
Spastic
Dystonic
Ataxic
Biochemical
Question 66
A child has cystic fibrosis (CF). Which medication does the healthcare professional teach the parents about?
Salt tablets
Pancreatic enzymes
Antihypertensives
Antibiotics
Question 67
The healthcare professional directs a student to assess a teen who has Osgood-Schlatter disease. What assessment finding does the student anticipate for this disorder?
Lateral epicondylitis of the elbow
Inflammation of the anterior cruciate ligament
Bursitis of the subscapular bursa in the glenohumeral joint
Tendinitis of the anterior patellar tendon
zQuestion 68
A child has Duchenne muscular dystrophy and the parents want to know how this occurred. Which statement by the healthcare professional is most accurate?
X-linked recessive inheritance
Common SMN1 gene abnormality
Autosomal dominant inheritance
Inheritance is not well defined
Question 70
A healthcare professional is teaching a community group about inherited disorders. What pattern of inheritance does the professional describe for sickle cell disease?
Inherited X-linked recessive disorder
Inherited autosomal recessive disorder
Disorder initiated by hypoxemia and acidosis
Disorder that is diagnosed equally in men and women
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