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Maryville
NURS 620 Adult 1 EXAM 1
Common causative organisms of acute bacterial conjunctivitis include all of the following except what? A. Haemophilus influenzae B. Pseudomonas aeruginosa C. Staphylococcus aureus D. Streptococcus pneumoniae - ANSWER B. Pseudomonas aeruginosa What is the easiest way to differentiate between otitis externa and otitis media? A. With otitis media, there is usually tenderness on palpation over the mastoid process. B. With otitis externa, movement or pressure on the pinna is extremely painful. C. With otitis media, tender swelling is usually visible. D. With otitis media, there is usually bilateral pain in the ears. - ANSWER B. With otitis externa, movement or pressure on the pinna is extremely painful.
Acute otitis media is diagnosed when there is: A. Fluid in the middle ear without signs or symptoms of ear infection. B. Fluid in the middle ear accompanied by otalgia and fever. C. Fluid in the middle ear for at least 3 months. D. A diagnosis of three or more episodes of otitis media within 1 year. - ANSWER B. Fluid in the middle ear accompanied by otalgia and fever. In assessing a client with bacterial conjunctivitis, the nurse practitioner finds: A. Minimal itching, moderate tearing, and mucoid exudate B. Minimal tearing, moderate itching, and profuse exudate. C. Severe itching, moderate tearing, and minimal discharge. D. Minimal itching, moderate tearing, and profuse exudate. - ANSWER D. Minimal itching, moderate tearing, and profuse exudate. The antibiotic of choice for beta-lactamase coverage of otitis media is: A. Azithromycin B. Amoxicillin C. Prednisone D. Amoxicillin and potassium clavulanate - ANSWER D. Amoxicillin and potassium clavulanate
The clinician is assessing a patient complaining of hearing loss. The clinician places a tuning fork over the patient's mastoid process, and when the sound fades away, the fork is placed without restriking it over the external auditory meatus. The patient is asked to let the clinician know when the sound fades away. This is an example of which type of test? A. Rinne test B. Weber test C. Auditory Brainstem Response (ABR) test D. Schwabach test - ANSWER A. Rinne test As diabetic retinopathy progresses, the presence of "cotton wool" spots can be detected. Cotton wool spots refer to: A. Blood vessel proliferation B. Nerve fiber layer infarctions C. Venous beading D. Retinal hemorrhage - ANSWER B. Nerve fiber layer infarctions Acute otitis media is diagnosed when there is: A. Fluid in the middle ear without signs or symptoms of an ear infection. B. A diagnosis of three or more episodes of otitis media within 1 year. C. Fluid in the middle ear accompanied by otalgia and fever. D. Fluid within the middle ear for at least 3 months - ANSWER C. Fluid in the middle ear accompanied by otalgia and fever.
Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect? A. Acute otitis media B. Chronic otitis media C. External otitis D. Temporomandibular joint syndrome - ANSWER C. External otitis When Judith, age 15, asks you to explain the 20/50 vision in her right eye, you respond: A. "You can see at 20 ft with your left eye what most people can see at 50 ft." B. "You can see at 20 ft with your right eye what most people can see at 50 ft." C. "You can see at 50 ft with your right eye what most people can see at 20 ft." D. "You can see at 50 ft with the left eye what most people can see at 20 ft." - ANSWER B. "You can see at 20 ft with your right eye what most people can see at 50 ft." You have made a diagnosis of acute sinusitis based on Martha's history and the fact that she complains of pain behind her eye. Which sinuses are affected? A. Maxillary B. Ethmoid C. Frontal D. Sphenoid - ANSWER C. Frontal
A. Temporal mandibular joint malocclusion. B. Bruxism. C. A psychosis. D. An oropharyngeal lesion. - ANSWER B. Bruxism. Jill presents with symptoms of hay fever, and you assess the nasal mucosa of her turbinates to be pale. What diagnosis do you suspect? A. Allergic rhinitis B. Viral rhinitis C. Nasal polyps D. Nasal vestibulitis from folliculitis - ANSWER A. Allergic rhinitis While doing a face, head, and neck examination, you note that the palpebral fissures are abnormally narrow. What are you examining? A. Nasolabial folds B. The openings between the margins of the upper and lower eyelids C. The thyroid gland in relation to the trachea D. The distance between the trigeminal nerve branches Feedback - ANSWER B. The openings between the margins of the upper and lower eyelids
Nathan, age 19, is a college swimmer. He frequently gets swimmer's ear and asks if there is anything he can do to help prevent it other than wearing earplugs, which don't really work for him. What do you suggest? A. Use a cotton-tipped applicator to dry the ears after swimming. B. Use eardrops made of a solution of equal parts alcohol and vinegar in each ear after swimming. C. Use a hair dryer on the highest setting to dry the ears. D. Tell Nathan he must change his sport. - ANSWER B. Use eardrops made of a solution of equal parts alcohol and vinegar in each ear after swimming. The most common cause of loss of vision in the adult over 45 is: A. Photopsia. B. Presbyopia. C. Age-related macular degeneration. D. Myopia. - ANSWER B. Presbyopia. Mark, age 18, has a persistent sore throat, fever, and malaise not relieved with penicillin therapy. What would you order next? A. A throat culture B. A monospot test C. A rapid antigen test D. A Thayer-Martin plate test - ANSWER B. A monospot test
palpable, tender cervical lymph nodes. Based on these findings, what is the most likely diagnosis? A. Mono B. Sinusitis C. Strep pharyngitis D. Viral pharyngitis - ANSWER D. Viral pharyngitis Matthew, age 52, has allergic rhinitis and would like some medicine to relieve his symptoms. He is taking cimetidine (Tagamet) for gastroesophageal reflux disease. Which medication would you not order? A. A first-generation antihistamine B. A second-generation antihistamine C. A decongestant D. A topical nasal corticosteroid Feedback - ANSWER B. A second-generation antihistamine What therapy has proved beneficial for long-term symptom relief of tinnitus? A. Aspirin B. Lidocaine C. Cognitive behavioral therapy D. Corticosporin otic 2 drops per ear prn - ANSWER C. Cognitive behavioral therapy
Maury, age 52, has throbbing pain in the left eye, an irregular pupil shape, marked photophobia, and redness around the iris. What is your initial diagnosis? A. Conjunctivitis B. Iritis C. Subconjunctival hemorrhage D. Acute glaucoma Feedback - ANSWER B. Iritis Which of the following symptoms is most indicative of mononucleosis (Epstein- Barr virus)? A. Rapid onset of anterior cervical adenopathy, fatigue, malaise, and headache B. Gradual onset of fatigue, posterior cervical adenopathy, fever, and sore throat C. Gradual and seasonal onset of pharyngeal erythema D. Rapid onset of cough, congestion, and headache - ANSWER B. Gradual onset of fatigue, posterior cervical adenopathy, fever, and sore throat Which of the following signs of thyroid dysfunction is a sign of hyperthyroidism? A. Slow pulse B. Decreased systolic blood pressure C. Exophthalmos D. Dry, coarse, cool skin - ANSWER C. Exophthalmos
examination, you note a palpable, pulsatile abdominal mass in the umbilical region; a bruit above the umbilical region; and diminished femoral pulses. You suspect: A. Renal artery stenosis. B. An abdominal aortic aneurysm. C. A cardiac tumor. D. A thoracic aortic aneurysm. - ANSWER B. An abdominal aortic aneurysm. According to the Eighth Joint National Committee JNC 8 guidelines, what is the goal BP level in healthy patients age 60 and older? A. Less than 120/ B. Less than 130/ C. Less than 140/ D. Less than 150/90 - ANSWER D. Less than 150/ Selma has acute peripheral arterial occlusion of a lower extremity. Before you begin your examination, you know that it: A. May present with only complaints of coldness or paresthesia of the extremity. B. May present as the only disease. C. Always occurs in the lower extremities. D. Will result in an extremity that appears "blue." - ANSWER A. May present with only complaints of coldness or
Which of the following is usually indicative of an abdominal aortic aneurysm? A. Right upper quadrant tenderness B. Venous hum in abdomen C. Ascites D. Positive bruit or wide, diffuse pulsation in epigastric area - ANSWER D. Positive bruit or wide, diffuse pulsation in epigastric area During a cardiovascular assessment, why is it important to note funduscopic changes? A. You may pick up beginning cataracts in this age group. B. You should note any glaucoma because some medications will be contraindicated. C. Changes may suggest target organ involvement. D. You may be able to pick up arcus senilis. - ANSWER C. Changes may suggest target organ involvement. Ted, age 18, is to have a cardiac screening examination to determine if he can play college basketball. The diagnostic test of choice for detecting hypertrophic cardiomyopathy or idiopathic left ventricular hypertrophy is a(n): A. Echocardiogram. B. Electrocardiogram. C. Arteriogram. D. Stress test. - ANSWER A. Echocardiogram.
Before counseling partners about sexual activity following a myocardial infarction, the provider should consider what factor(s)? A. Most clients do not want to know how their condition affects their sex life. B. Spouses are knowledgeable about their partner's condition; therefore, they do not need counseling. C. Most clients return to the same frequency of sexual intercourse after they have regained their physical strength. D. Depression, loss of interest, spousal reluctance, and anxiety may interfere with a client's resumption of sexual activities. - ANSWER D. Depression, loss of interest, spousal reluctance, and anxiety may interfere with a client's resumption of sexual activities. What is the most important question to ask when a client presents with chest pain? A. "What were you doing at the time of onset?" B. "What was the time of the onset?" C. "Are you a smoker?" D. "When was the last time you had blood work done?" - ANSWER B. "What was the time of the onset?" Which of the following usually indicates hyperlipidemia? A. Lipoma B. Xanthelasma C. Jaundiced skin
D. Multiple actinic keratosis - ANSWER B. Xanthelasma Pathological U waves on the electrocardiogram are most commonly associated with which disorder? A. Hypercalcemia B. Hypocalcemia C. Hyperkalemia D. Hypokalemia - ANSWER D. Hypokalemia Signs of right-sided heart failure include: A. A low cardiac output. B. Symptoms of fluid retention. C. Dyspnea. D. Elevated pulmonary venous pressure. - ANSWER B. Symptoms of fluid retention. Mr. Michaels has a long-standing cardiac problem. His electrocardiogram rhythm strip is shown below. Which medication should he be taking to prevent a pulmonary or cerebral problem? A. An ACE inhibitor such as enalapril (Vasotec) B. An antiarrhythmic agent such as procainamide (Procan-SR) C. An anticoagulant such as warfarin, dabigatran, apixaban, or rivaroxaban
D. Starting statin drug therapy - ANSWER D. Starting statin drug therapy Jeremiah has been on lipid-lowering therapy (statins) for 2 years. He is new to your practice. He says, "I haven't had my liver function tests (LFTs) in a while to check if my cholesterol medication is causing a problem." What do you tell him? A. "You've been tolerating the medication well. We no longer need to monitor this." B. "Oh yes, we check liver function tests every 6 months when you're on statins." C. "We'll order LFTs prior to your next visit." D. "We better stop your medication until we get the results." - ANSWER A. "You've been tolerating the medication well. We no longer need to monitor this." Which of the following statements is true about hypertension (HTN) during pregnancy? A. Methyldopa (Aldomet) is the drug of first choice for control of mild-to- moderate HTN during pregnancy. B. Beta blockers are safe during pregnancy. C. ACE inhibitors (I and II) are safe during all trimesters. D. Beta blockers are safe only in the first trimester of pregnancy. - ANSWER A. Methyldopa (Aldomet) is the drug of first choice for control of mild-to- moderate HTN during pregnancy.
Marvin, age 56, is a smoker with diabetes mellitus. He has just been diagnosed as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis? A. Angiotensin-converting enzyme (ACE) inhibitors B. Beta blockers C. Calcium channel blockers D. Diuretics - ANSWER B. Beta blockers Tee, age 64, presents with a sore throat. Your assessment reveals tonsillar exudate, anterior cervical adenopathy, presence of a fever, and absence of a cough. There is a high probability of which causative agent? A. Rhinovirus B. Group A beta-hemolytic streptococcus C. Haemophilus influenzae D. Epstein-Barr virus - ANSWER B. Group A beta-hemolytic streptococcus Mark, age 18, has a persistent sore throat, fever, and malaise not relieved with penicillin therapy. What would you order next? A. A monospot test B. A throat culture C. A rapid antigen test D. A Thayer-Martin plate test - ANSWER A. A monospot test
