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"When disseminating research findings in a peer-reviewed journal, the adult-gerontology primary care nurse practitioner: (a) concludes that the study proves the hypothesis. (b) excludes the discussion section, because the conclusion contains this information. (c) recommends incorporating the results directly into clinical practice. (d) uses the methodology section to support the validity of the study. - CORRECT ANSWER✅ (d) uses the methodology section to support the validity of the study."
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"When disseminating research findings in a peer-reviewed journal, the adult-gerontology primary care nurse practitioner: (a) concludes that the study proves the hypothesis. (b) excludes the discussion section, because the conclusion contains this information. (c) recommends incorporating the results directly into clinical practice. (d) uses the methodology section to support the validity of the study. - CORRECT ANSWER ✅ (d) uses the methodology section to support the validity of the study." "A patient's adult child telephones the adult-gerontology primary care nurse practitioner to inquire about the patient's illness. The patient's child reports that the parent relies upon the child to explain everything to him or her. The nurse practitioner: (a) asks the child to provide a copy of the patient's advance directive document. (b) assures the child that the nurse practitioner can disclose requested information. (c) informs the child that he or she must come to the clinic to discuss the parent's case. (d) tells the child that the nurse practitioner can discuss the information only with the patient. - CORRECT ANSWER ✅ (d) tells the child that the nurse practitioner can discuss the information only with the patient."
"The adult-gerontology primary care nurse practitioner is appointed to a hospital's multidisciplinary medical ethics review committee. The nurse practitioner's role is to: (a) evaluate standards, risks, benefits, and outcomes. (b) identify how to anticipate and resolve similar future situations. (c) investigate the need for disciplinary action. (d) obtain agreement of all parties with a chosen solution. - CORRECT ANSWER ✅ (a) evaluate standards, risks, benefits, and outcomes." "To improve the quality of clinical practice, the adult-gerontology primary care nurse practitioner: (a) charges a fee for patients who arrive late to clinic appointments. (b) disseminates research study results to colleagues. (c) expresses opinions about alternative therapies with patients who consider such treatments. (d) schedules time during clinic hours to meet with pharmaceutical representatives. - CORRECT ANSWER ✅ (b) disseminates research study results to colleagues." "One effect of using electronic health record applications, such as telemedicine and portable monitoring systems, has been to: (a) create stand-alone clinics. (b) decrease billable visits. (c) increase risks to patients. (d) open access to care. - CORRECT ANSWER ✅ (d) open access to care." "The adult-gerontology primary care nurse practitioner evaluates an 80-year-old patient with cognitive deficits, who is unaccompanied by the adult child who typically is present. The patient has urinary symptoms, for which the nurse practitioner considers ordering sulfamethoxazole- trimethoprim (Bactrim). The patient's previous medical record is unavailable. Before prescribing the medication, the nurse practitioner:
"The adult-gerontology primary care nurse practitioner plans to provide smoking cessation education at a community center to older adults and their families. The nurse practitioner designs the program based on knowledge that older adult smokers: (a) are likely to be optimistic about their ability to quit. (b) are more likely to be successful at quitting than younger smokers. (c) have a decreased risk of morbidity and mortality than do younger smokers. (d) receive more instruction to quit from health care providers than younger smokers. - CORRECT ANSWER ✅ (b) are more likely to be successful at quitting than younger smokers." "An 84-year-old patient arrives at the office for an initial visit. The patient questions the need for colorectal screening, since 10 years have passed since the last colonoscopy. The adult- gerontology primary care nurse practitioner recommends: (a) a colonoscopy. (b) a fecal DNA test. (c) flexible sigmoidoscopy. (d) watchful waiting. - CORRECT ANSWER ✅ (d) watchful waiting." "To evaluate for heart failure, which diagnostic test does the adult-gerontology primary care nurse practitioner order for a patient with swelling in the lower extremities? (a) Ankle-brachial index. (b) Brain natriuretic peptide test. (c) D-dimer assay. (d) Spirometry study. - CORRECT ANSWER ✅ (b) Brain natriuretic peptide test." "Before placing a patient with onychomycosis on a pulsed dose of itraconazole (Sporanox), which laboratory values does the adult-gerontology primary care nurse practitioner obtain? (a) Liver function studies. (b) Platelet count. (c) Renal function studies. (d) White blood cell count. - CORRECT ANSWER ✅ (a) Liver function studies."
"A 30-year-old, female patient has a two-week history of nausea, vomiting, decreased weight, abdominal pain, and a long-term history of multiple sexual partners. The patient's physical examination reveals abdominal tenderness with icteric sclerae and skin. Which laboratory test confirms active hepatitis B? (a) Antibody. (b) Enzyme-linked immunosorbent assay. (c) Immune globulin G. (d) Surface antigen. - CORRECT ANSWER ✅ (d) Surface antigen." "For two to three months, a 78-year-old patient has not been taking levothyroxine (Synthroid) as prescribed. The patient now has symptoms of increasing constipation, lethargy, and weakness. The adult-gerontology primary care nurse practitioner anticipates that laboratory tests will show that the patient's: (a) T4 level decreased, and TSH level increased. (b) T4 level increased, and TSH level decreased. (c) T4 level increased, and TSH level is unchanged. (d) T4 level is unchanged, and TSH level decreased. - CORRECT ANSWER ✅ (a) T4 level decreased, and TSH level increased." "A 68-year-old patient has sustained an unintended weight loss of 15 lb (6.8 kg) over the last two months but reports feeling well. The patient's problems include depression, tobacco abuse, obesity, and dyslipidemia. His or her medications are sertralizine (Zoloft), simvastatin (Zocor), and famotidine (Pepcid). The adult-gerontology primary care nurse practitioner performs which THREE actions? (a) Adds a probiotic. (b) Conducts a depression screening. (c) Decreases the dosage of the statin medication.
"The adult-gerontology primary care nurse practitioner working in an urban community health center recognizes that asthma-related health issues commonly result in higher morbidity and mortality for persons with: (a) alcohol dependency. (b) lower socioeconomic status. (c) persistent social isolation. (d) recent immigrant status. - CORRECT ANSWER ✅ (b) lower socioeconomic status." "During an annual health visit, a 15-year-old female patient is found to have grown 5 in (12. cm) over the past year. She has not reached menarche. Her mother is concerned because the patient's sister reached menarche at age 11 and the mother reached menarche at age 12. Examination reveals that the patient's breasts are enlarged, with the areolae forming a mound above the general contour of each breast, and that the left breast is larger than the right. Axillary hair is absent and the pubic hair is dark, coarse, curly, dense, and similar in pattern to that of an adult female. These findings are consistent with a diagnosis of: (a) hypothyroidism. (b) normal development. (c) polycystic ovary syndrome. (d) Turner syndrome. - CORRECT ANSWER ✅ (b) normal development." "A pale, thin 54-year-old male patient reports a two-month history of numbness in his feet. Past medical history includes hypertension and a subtotal gastrectomy. An examination reveals a decreased vibratory sensation and position sense. Blood tests indicate a hematocrit of 27%, mean corpuscular volume of 105 fL, mean corpuscular hemoglobin of 45 pg, and reticulocytes of 1.5%. The diagnosis is: (a) chronic simple anemia. (b) folate deficiency anemia. (c) iron deficiency anemia. (d) vitamin B12 deficiency anemia. - CORRECT ANSWER ✅ (d) vitamin B12 deficiency anemia."
"Upon referral from a gynecologist, an adult nurse practitioner evaluates an 89-year-old female nursing home resident for vaginal bleeding. The patient has a history of occasional periods of confusion and memory loss. The gynecologist recommended dilation and curettage and the patient consented to the procedure after the gynecologist answered her questions, but the patient's daughter protests. The nurse practitioner's ethical duty is to support the: (a) daughter, because she might file a lawsuit over unsatisfactory care. (b) daughter, because the patient is occasionally confused and incapable of granting informed consent. (c) nursing home administration, which may choose to support either the patient or the daughter. (d) patient, who has given informed consent. - CORRECT ANSWER ✅ (d) patient, who has given informed consent." "A 16-year-old patient has been diagnosed with mononucleosis and has a positive throat culture for group Alpha-hemolytic streptococcal infection. The medication of choice for this patient is: (a) amoxicillin (Amoxil). (b) doxycycline (Vibramycin). (c) erythromycin (E-Mycin). (d) trimethoprim-sulfamethoxazole (Bactrim). - CORRECT ANSWER ✅ (c) erythromycin (E-Mycin)." "A 70-year-old patient reports fatigue and a nonproductive cough with pain on inspiration and expiration. The patient denies a sore throat, fever, nasal congestion, or postnasal drip. Examination reveals a well-developed patient in no acute distress who is afebrile and has respirations of 32 breaths/min. The patient's lungs have diminished breath sounds. The heart rate is 70 beats/min, regular with no murmur. There is no edema of the extremities. An adult nurse practitioner orders: (a) a chest x-ray. (b) a lung perfusion scan.
(d) treatment with several ophthalmologic agents. - CORRECT ANSWER ✅ (c) immediate referral to an ophthalmologist." "A 45-year-old patient with diabetes comes to the clinic for an annual appointment. The patient declines a parenteral influenza vaccination because a friend "came down with the flu after receiving the vaccination." The adult nurse practitioner explains that the vaccination is: (a) a polysaccharide, so it may cause a mild case of influenza. (b) activated, so it may cause a mild case of influenza. (c) inactivated, and this is unable to cause influenza. (d) live attenuated, so it may cause a mild case of influenza. - CORRECT ANSWER ✅ (c) inactivated, and this is unable to cause influenza." "An institutional review board rejects an adult nurse practitioner's research proposal on the grounds that the: (a) chosen statistics were not optimal to meet research objectives. (b) literature review was insufficient to develop the research question. (c) proposed budget did not cover the cost of the study. (d) subject's rights were not clearly protected. - CORRECT ANSWER ✅ (d) subject's rights were not clearly protected." "A patient informs an adult nurse practitioner, "I want to stop smoking." The nurse practitioner responds: (a) "Do you have any ideas about how you would like to quit smoking?" (b) "Does your health insurance cover smoking cessation?" (c) "I will develop a plan for you to stop smoking."
(d) "Quitting smoking is the most important thing you can do for your health." - CORRECT ANSWER ✅ (a) "Do you have any ideas about how you would like to quit smoking?"" "An adult nurse practitioner is responsible for billing codes that are selected and submitted to third party payors when: (a) a certified coder has selected the code. (b) a change has occurred in the insurance carrier. (c) a misprint has appeared in the coding book. (d) the evaluation and management criteria have changed. - CORRECT ANSWER ✅ (a) a certified coder has selected the code." "Many patients view illness as a distortion in the balance of some aspect of their lives, and believe that folk medicine can remedy this. When encountering such beliefs, an adult nurse practitioner's appropriate action is to: (a) discuss these remedies and include them in the management plan. (b) educate these patients about evidence-based practice that is specific to their present condition. (c) promote scientifically proven treatment measures. (d) refer the patient to a homeopathic specialist. - CORRECT ANSWER ✅ (a) discuss these remedies and include them in the management plan." "An adult nurse practitioner is designing a research study to investigate the efficacy of a patient education tool for adults with low literacy levels. Which action reflects the nurse's inclusion of ethical principles in the research plan? (a) Ensuring that the participants understand their right to withdraw from the study at any time, without incurring penalties (b) Explaining the study in scientific, medical, and nursing terms so as not to patronize the participants
(b) conduct the history as part of the physical examination. (c) maintain an open attitude about the information that is divulged. (d) suggest that the patient reschedule the appointment and bring a friend. - CORRECT ANSWER ✅ (c) maintain an open attitude about the information that is divulged." "The practical application of findings from a set of studies is known as: (a) critical analysis. (b) data implementation. (c) guideline development. (d) research utilization. - CORRECT ANSWER ✅ (d) research utilization." "An adult nurse practitioner is encouraging an older adult patient to reminisce about successful life accomplishments. Which theoretical framework is the nurse practitioner using? (a) Erikson's model of psychosocial development (b) Maslow's hierarchy of needs theory (c) Rogers' science of unitary human beings (d) Roy's adaptation model - CORRECT ANSWER ✅ (a) Erikson's model of psychosocial development [Note: Stage, Ego Integrity vs. Despair]" "An adult nurse practitioner evaluates a new patient, an African American with hypertension who has been taking lisinopril (Prinivil). To optimize the patient's response, a more effective pharmacological treatment is: (a) a beta-blocker. (b) a direct-acting vasodilator. (c) a thiazide diuretic.
(d) an angiotensin-converting enzyme inhibitor. - CORRECT ANSWER ✅ (c) a thiazide diuretic." "Initial measures to prevent deformity and maintain function for the knee during an acute inflammatory reaction secondary to injury include: (a) a hot daily shower followed by a short period of exercise. (b) application of a splint to the joint followed by application of heat. (c) cautious performance of active range-of-motion exercises. (d) total immobilization of the joint and performance of isometric exercises. - CORRECT ANSWER ✅ (d) total immobilization of the joint and performance of isometric exercises." "A 34-year-old truck driver reports a sharp pain in the lower back that worsens with ambulation. The symptoms began after a strenuous three-day driving trip. During an examination, the patient has difficulty walking on the heels and shows weakness in the extensors of the big toes. The initial differential diagnosis is: (a) compression fracture. (b) L-1 root irritation. (c) L-5 root irritation. (d) ruptured disc. - CORRECT ANSWER ✅ (c) L-5 root irritation." "The gerontological nurse practitioner performs a speculum examination for a 71-year-old female patient without symptoms, and finds a thin, whitish, nonodorous mucoid discharge high in the patient's vagina. The nurse practitioner's most appropriate intervention is to: (a) explain to the woman that the discharge is normal. (b) prescribe estrogen cream, twice a week. (c) prescribe a topical antifungal medication, applied vaginally each night for one week. (d) recommend the daily use of a vaginal lubricant, for three days. - CORRECT ANSWER ✅ (a) explain to the woman that the discharge is normal."
(b) will disappear in four to six weeks. (c) will disappear in six months to one year. (d) will disappear once the lesions are gone. - CORRECT ANSWER ✅ (a) might never completely disappear." "A 69-year-old female patient reports dyspareunia. Physical examination reveals sparse hair, an introitus that admits two fingers, and a pale, dry vagina. The gerontological nurse practitioner's initial management of this problem is to prescribe: (a) a local, topical antifungal cream. (b) a topical hormonal cream. (c) a water-soluble lubricating jelly. (d) daily douching. - CORRECT ANSWER ✅ (b) a topical hormonal cream." "An older patient, who has chronic obstructive pulmonary disease, develops a fever and changes in sputum production. The gerontological nurse practitioner prescribes: (a) a corticosteroid. (b) an antibiotic. (c) an inhaled bronchodilator. (d) nebulizer treatments. - CORRECT ANSWER ✅ (b) an antibiotic." "The charge nurse at a nursing home consults a gerontological nurse practitioner about a resident with dementia who fell two weeks ago. The patient's x-ray on the day of the fall was negative, but the resident continues to limp and exhibits increasing agitation. The nurse practitioner advises the charge nurse to: (a) administer the prescribed pain medication to the resident. (b) apply heat to the affected hip and monitor the resident's ambulation. (c) initiate physical therapy for the resident.
(d) obtain another x-ray of the affected hip and pelvis. - CORRECT ANSWER ✅ (d) obtain another x- ray of the affected hip and pelvis." "Which patient has the greatest nutritional risk? (a) A patient who has dementia and is living with family (b) A patient who has hypothyroidism and is 30% overweight (c) A patient who has multiple dental caries and lives alone (d) A patient who is wheelchair-bound from a stroke and receives live-in care - CORRECT ANSWER ✅ (c) A patient who has multiple dental caries and lives alone" "The primary reason for reassessing patients' alcohol use is to: (a) advise about safe levels of consumption. (b) evaluate the risk for peripheral neuropathy. (c) prevent or reduce associated health risks. (d) screen for liver dysfunction. - CORRECT ANSWER ✅ (c) prevent or reduce associated health risks." "The medical history of a robust, 64-year-old patient is negative for hypertension, heart disease, and diabetes. Upon examination, the gerontological nurse practitioner detects a new grade 3 crescendo-decrescendo systolic murmur that is heard loudest at the base of the heart, with radiation to the carotid arteries. The gerontological nurse practitioner's next action is to order: (a) a C-reactive protein test. (b) a troponin level. (c) an echocardiogram. (d) an electrocardiogram. - CORRECT ANSWER ✅ (c) an echocardiogram." "Which drug puts an older adult at the highest risk for injury after a fall?
"The purpose of a Long-Term Care Ombudsman Program is: (a) implementing quality assurance activities. (b) performing comprehensive resident assessments. (c) preserving the rights of nursing home residents. (d) providing training requirements for nursing assistants. - CORRECT ANSWER ✅ (c) preserving the rights of nursing home residents." "Which factor is associated with the highest risk of falls in older persons living in the community? (a) A history of previous falls (b) Living alone (c) Osteoporosis (d) Use of an assistive device - CORRECT ANSWER ✅ (a) A history of previous falls" "An older adult patient complains of recent lapses in memory and decreased alertness. The patient's laboratory test results indicate a mild, macrocytic anemia. Which additional test does the adult-gerontology acute care nurse practitioner order to confirm a diagnosis? (a) A reticulocyte count (b) A serum folate level (c) An erythrocyte sedimentation rate (d) Iron studies - CORRECT ANSWER ✅ (b) A serum folate level" "An 80-year-old male patient with dementia requires long-term care placement. To which funding agency does the patient apply, after "spending down" to qualify? (a) Medicaid (b) Medicare
(c) The American Association of Retired Persons (d) The United States Social Security Administration - CORRECT ANSWER ✅ (a) Medicaid" "A 70-year-old patient with acute systolic heart failure denies any functional limitations, is able to walk five blocks before tiring, and is euvolemic. Which medication is the first-line therapy for this patient? (a) Amlodipine (Norvasc) (b) Digoxin (Lanoxin) (c) Furosemide (Lasix) (d) Lisinopril (Zestril) - CORRECT ANSWER ✅ (d) Lisinopril (Zestril) [Note: ACE-I's are first line therapy for asymptomatic and symptomatic heart failure, unless presenting with dyspnea at rest, in which case a diuretic would be first line.]" "A 15-year-old patient with type 1 diabetes mellitus reports elevated blood glucose levels in the morning. An adult-gerontology acute care nurse practitioner determines that the patient's hyperglycemia is due to the dawn phenomenon and: (a) increases the insulin dosage at bed time. (b) reduces the insulin dosage at bed time. (c) tests the blood glucose level at 3:00 AM every morning. (d) tests the blood glucose level in the evening. - CORRECT ANSWER ✅ (a) increases the insulin dosage at bed time." "Which research design has the greatest strength in determining if an intervention is effective? (a) Case control (b) Clinical trial (c) Cohort (d) Cross-sectional - CORRECT ANSWER ✅ (b) Clinical trial"