NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam Question 1 A patient expresses concern that she is at risk for breast cancer. To best assess the risk for this patient, what is the best initial action? a. Ask if there is a family history of breast cancer. b. Gather and record a three-generation pedigree. c. Order a genetic test for the breast cancer gene. d. Recommend direct-to-consumer genetic testing. ? ? ? Question 2 What is an important part of patient care that can minimize the risk of a formal patient complaint even when a mistake is made? Ensuring informed consent for all procedures Maintaining effective patient communication Monitoring patient compliance and adherence Providing complete documentation of visits ? ? ? Question 3 A patient asks about direct-to-consumer (DTC) genetic testing. What will the provider tell the patient? a. It is not useful for identifying genetic diseases. b. Much of the information does not predict disease risk. c. The results are shared with the patient?s insurance company. d. The results must be interpreted by a provider. ? ? Question 4 A previously healthy patient has an area of inflammation on one leg which has well-demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection? a. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam b.NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam c. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam d. Sulfamethoxazole-trimethoprim ? ? Question 5 A patient diagnosed with atopic dermatitis asks what can be done to minimize the recurrence of symptoms. What will the provider recommend? a. Calcineurin inhibitors b. Lubricants and emollients c. Oral diphenhydramine d. Prophylactic topical steroids ? ? ? Question 6 Which is the primary symptom causing discomfort in patients with atopic dermatitis (AD)? a. Dryness b. Erythema c. Lichenification d. Pruritis ? ? ? Question 7 A patient experiencing an inflamed pterygia lesion has been prescribed loteprednol topical steroid drops for 7 days. The patient shows no improvement in symptoms. What is the next course of action? NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam a. Consult with an ophthalmologist. b. Continue the medication for 7 more days. c. Prescribe a systemic corticosteroid. d. Refer the patient to the emergency department. ? ? Question 8 A patient experiences a penetrating injury to one eye caused by scissors. The provider notes a single laceration away from the iris that involves the anterior but not the posterior segment. What is the prognosis for this injury? a. Because the posterior segment is not involved, the prognosis is good. b. Blindness is likely with this type of eye injury. c. Massive hemorrhage and loss of intraocular contents is likely. d. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam ? Question 9 A primary care provider notes painless, hard lesions on a patient?s external ears that expel a white crystalline substance when pressed. What diagnostic test is indicated? a. Biopsy of the lesions b. Endocrine studies c. Rheumatoid factor d. Uric acid chemical profile ? ? ? Question 10 A patient experiencing heart failure with reduced ejection fraction will have which symptoms? a. Dyspnea and fatigue without volume overload b. Impairment of ventricular filling and relaxation c. Mild, exertionally related dyspnea d. Pump failure from left ventricular systolic dysfunction ? ? ? Question 11 A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies headaches, palpitations, snoring, muscle weakness, and nocturia and does not take any medications. What will the provider do next to evaluate this patient? a. Assess serum cortisol levels b. Continue to monitor blood pressure at each health maintenance visit c. Order urinalysis, CBC, BUN, and creatinine d. Refer to a specialist for a sleep study ? ? ? Question 12 A patient who has been diagnosed with heart failure for over a year reports being comfortable while at rest but experiences palpitations and dyspnea when walking to the bathroom. Which classification of heart failure is appropriate based on these symptoms? a. ClassI b. Class c. Class d. Class ? ? ? ? ? ? ? Question 13 A patient who has undergone surgical immobilization for a femur fracture reports dyspnea and chest pain associated with inspiration. The patient has a heart rate of 120 beats per minute. Which diagnostic test will confirm the presence of a pulmonary embolism (PE)? a. Arterial blood gases (ABGs) b. Computed tomography (CT) angiography c. D-dimer d. Electrocardiogram (ECG) ? Question 14 Which method of treatment is used to manage a traumatic pneumothorax? a. Needle aspiration of the pneumothorax b. Observation for spontaneous resolution c. Placement of a small-bore catheter d. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam ? ? ? ? ? ? Question 15 A patient with a central line develops respiratory compromise. What is the initial intervention for this patient? a. Lung ultrasonography (US) to determine the cause b. Obtaining cultures and starting antibiotics c. Prompt removal of the central line d. Rapid assessment and resuscitation ? ? ? ? ? ? ? ? Question 16 A patient reports lower abdominal cramping and occasional blood in stools. The provider suspects inflammatory bowel disease. Which test will the provider order to determine whether the patient has ulcerative colitis (UC) or Crohn?s disease (CD)? NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam a. b. c. d. ? ? ? Question 17 A patient who is asymptomatic tests positive for the hepatitis C virus (HVC). What will the provider tell the patient about managing this illness? a. A rapidly fulminant disease ending with cirrhosis is likely. b. Administering immunoglobulins helps shorten the course. c. Several medications are available based on the type of hepatitis C. d. Treatment is supportive since the infection is self-limiting. ? ? ? Question 18 A patient recovering from chronic alcohol abuse reports nausea, vomiting, diarrhea, and abdominal discomfort. A physical examination is negative for jaundice or ascites. What will the provider do initially? a. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam b. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam c. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam d. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam ? ? ? ? ? ? Question 19 Paula is a 68 y/o female who presents to the clinic with the following symptoms: bloating and abdominal discomfort, low back pain, pelvic pain, frequency and constipation. The most likely cause of these symptoms is: A. Ovarian Cancer B. Uterine Cancer C. Urethral Cancer D. None of the above ? ? ? ? ? Question 20 A 50-year-old man reports having erectile dysfunction (ED). What is an important response by the provider when developing a plan of care for this patient? A. Considering testosterone hormone replacement therapy B. Evaluating the patient for cardiovascular disease C. Prescribing an oral phosphodiesterase type 5 inhibitor D. Referring the patient for psychotherapy and counseling ? ? ? ? ? Question 21 A primary care provider sees a new patient who reports having a diagnosis of chronic kidney disease for several years. The patient is taking one medication for hypertension which has been prescribed since the diagnosis was made. The provider orders laboratory tests to evaluate the status of this patient. Which laboratory finding indicates a need to refer the patient to a nephrologist? A. Albumin/creatinine ratio (ACR) of 325 mg/g B. Blood pressure of 145/85 mm H C. Glomerular filtration rate (eGFR) of 35 D. Urine red blood cell (RBC) count of 15/hpf ? ? ? Question 22 Elijah is a 72 y/o African American male who presents to the clinic with the following symptoms: low back pain, perineal pain, weak urinary stream and multiple trips to the bathroom during the night. Labs taken one week ago show a PSA of 6.0 ng/ml. The most likely diagnosis is: A. Prostate Cancer B. Testicular Cancer C. Prostatitis D. Epididymis Question 88 A young male patient is reported to be more withdrawn from his peers than usual and has dropped out of college and quit his job within the last 5 months. The parent is concerned that the patient may have schizophrenia because a maternal uncle has the disease. What will the provider do next? A. Ask about the patient?s speech and thinking patterns B. Consider treatment with antipsychotic medications C. Reassure that classic symptoms of schizophrenia are not present D. Refer the patient for inpatient psychiatric treatment ? ? ? ? Question 89 Michael is an 18 y/o male who has recently been suffering from insomnia. During your evaluation you learn that Michael lost his best friend in a roadside bomb in Afghanistan. Michael?s insomnia could be treated with which of the following natural supplements: A. B. C. D. All the above D ? ? ? ? Question 90 A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The provider determines that these symptoms occur in relation to many events and concerns. What other things will the provider question this patient about? A. Ability to manage social situations B. Body image and eating habits C. Headaches and bowel habits D. Occupational performance C ? ? ? ? ? Question 91 A college student is brought to clinic by a parent who is concerned about increasingly bizarre behavior and poor school performance. The provider notes difficulty engaging the patient in an organized conversation. The patient denies any concerns about behavior. What will the provider do initially to manage this patient?s symptoms? a. b. c. Counsel the parent to report any symptoms of depression d. Schedule an appointment with a psychiatrist ? ? ? ? ? Question 92 A college student is brought to the emergency department by a roommate who is concerned about symptoms of extreme restlessness, nausea, and vomiting. The provider notes elevations of the pulse and blood pressure and pupillary dilation, along with hyperactive bowel sounds. The provider suspects withdrawal from which substance? A. Alcohol B. Cocaine C. LSD D. Opioids ? ? ? ? ? ? Question 93 Angela is a 28 y/o female who comes to the clinic with her partner. During the history taking her partner does not all Angela to answer any of the questions but instead answers all the questions for her. In doing the physical exam on Angela the NP should do all the following except: A. Have B. Collect C. Interview D. When appropriate develop a plan of safety ? ? ? ? Question 94 An 18-year-old male is brought to the clinic by a parent who is concerned that the patient has become more isolated and withdrawn. The patient has expressed suspicions that his teachers hate him and want him to fail. What will the provider tell this parent? A. The adolescent should be evaluated by a psychiatrist. B. The adolescent should be given a trial of antipsychotic medications. C. These are common adolescent behaviors and will eventually go away. D. These signs are diagnostic for schizophrenia. ? ? ? ? ? ? Question 95 Jason a 46 y/o male has a smoking addition and has smoke 2 packs /day for the past 26 years. Given this information his pack years for smoking would be: A. 26 pack years B. 38 pack years C. 52 pack years D. 62 Pack years ? ? ? question 96 Jason a 46 y/o male has a smoking addition and has smoke 2 packs /day for the past 26 years. Laboratory findings related to Jason?s smoking addiction would include all the following except: A. Decreased Hct B. Increased WBC C. Increased platelet count D. Decreased Vitamin C levels ? ? ? ? question 97 A patient is brought to the emergency department experiencing disorientation, confusion, and fever. The patient describes visual and auditory hallucinations. The patient?s spouse states that the patient had several drinks 12 hours prior to passing out. A blood alcohol level is 0.2%. What is the recommended treatment? A. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam B. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam C. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam D. NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam ? ? ? ? Question 98 In the elderly, depression often exists with dementia. True False ? Question 99 A patient is seen in clinic 2 weeks after the death of a parent. The patient reports feelings of sadness and hopelessness and a feeling that the parent is still present, even to the point of hearing the parent?s voice at times. What will the provider determine from these findings? A. There is a concern for hypermania. B. There is a possibility of manic episodes. C. These are concerning for depression. D. These are normal grief responses. ? Question 100 Michael is an 18 y/o male who has recently been suffering from insomnia. During your evaluation you learn that Michael lost his best friend in a roadside bomb in Afghanistan. Michaels insomnia can be classified as: A. Primary Insomnia B. Secondary Insomnia C. Short term Insomnia D. Chronic Insomnia NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

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