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NRNP 6531 Final Exam / NRNP6531 Final Exam/ NRNP 6531 Week 11 Final Exam / NRNP6531 Week 11 Final Exam(2 Versions)(Total 200+ Questions and Answers)(2024-2025):Walden university
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1.) What is the most commonly abused substance? alcohol is the #1 abused substance in America.
An estimated 135.5 million people drink alcohol, but of those people, 86 million are
considered to be abusers,
2.) Diagnostic confirmation of acute leukemia is based on: Bone marrow aspiration and biopsy
3.) Risk factors for Addison’s disease include which of the following? Tuberculosis, Autoimmune
disease, AIDS (all of the above)
4.) Successful management of a patient with attention deficit hyperactivity disorder (ADHD) may be
achieved with: Ritalin and diet
5.) The correct treatment for ankle sprain during the first 48 hours after injury includes: a cold
compress to help reduce swelling (Rest, ice, compression, elevation)
6.) A 15 year-old female patient is 5 feet tall and weighs 85 pounds. You suspect anorexia and know
that the best initial approach is to: Having the client in view of staff for 90 minutes after each
meal Provide the client with a feeling of responsibility and control over her behavior
7.) A 32 year old male patient complains of urinary frequency and burning on urination for 3 days.
Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial
treatment should be: include nitrofurantoin monohydrate/macrocrystals, trimethoprim-
sulfamethoxazole (TMP-SMX), or fosfomycin. trimethoprim and sulfamethoxazole
8.) Dave, age 38, states that he thinks he has an ear infection because he just flew back from a
business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next
action? Prescribe nasal steroids and oral decongestants
9.) A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be
classified as: Overweight
10.)Which of the following is not a common early sign of benign prostatic hyperplasia (BPH )? Strong
urinary stream flow.
11.)Which of the following accounts for half of the bladder tumors among men and one third in
women? Cigarette smoke, both active and passive inhalation
12.)Which of the following set of symptoms should raise suspicion of a brain tumor? Holocranial
headaches present in the morning and accompanied by projectile vomiting without nausea
13.)Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome.
Your next step is to: try neutral position wrist splinting and order an oral NSAID
14.)Which drug category contains the drugs that are the first line Gold standard therapy for COPD?
Beta antagonist
15.)Other than smoking cessation, which of the following slows the progression of COPD in
smokers? oxygen
16.)Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis?
Erythromycin
17.)Central obesity, “moon” face, and dorsocervical fat pad are associated with: Cushings syndrome
18.)What is the most common cause of Cushing’s syndrome? the long-term, high-dose use of
the cortisol-like glucocorticoids
29.)The intervention known to be most effective in the treatment of severe depression , with or
without psychosis, is: electroconvulsive therapy (ECT).
30.)A 72 year old female patient reports a 6 month history of gradually progressive swollen and
painful distal interphalangeal (DIP) joints of one hand. She has no systemic symptoms but the
erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), and rheumatoid factor (RF)
are all minimally elevated. What is the most likely diagnosis? Osteoarthritis
31.)You are assessing a patient after a sports injury to his right knee. You elicit a positive
anterior/posterior drawer sign. This test indicates an injury to the: cruciate ligament
32.)A positive drawer sign supports a diagnosis of: Posterior cruciate ligament injury
33.)The initial clinical sign of Dupuytren’s contracture is: Painless nodule on palmer fascia
34.)A 26 year old female presents with elbow pain that is described as aching and burning. There is
point tenderness along the lateral aspect of the elbow and painful passive flexion and
extension. She reports she has been playing tennis almost daily for the past month. The most
likely diagnosis is: lateral epicondylitis (tennis elbow)
35.)Which is the most common cause of end-stage renal disease in the United States? Diabetes
36.)The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The
drug of choice for treatment of this patient is: Ceftriaxone 250 mg IM in a single dose plus.
Doxycycline 100 mg orally twice a day for 10 days
37.)A 27 year old female patient with epilepsy is well controlled with phenytoin (Dilantin). She
requests information about contraception. The nurse practitioner should instruct her that while
taking phenytoin: the effective of an oral contraceptive may be reduced
38.)Martin is complaining of erectile dysfunction. He also has a condition that has reduced arterial
blood flow to his penis. The most common cause of this condition is: diabetes mellitus
39.)A 60 year old male patient with multiple health problems presents with a complaint of
erectile dysfunction (ED). Of the following, which medication is most likely to be causing the
problem? Hypertensive medication such as hydrochlorothiazides, and other DM2 medications
40.)A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the
following symptoms would lead you to look for another diagnosis? high fever (102 to 104
degrees F), irregular pulse, accelerated heartbeat (tachycardia), increased rate of
respiration (tachypnea), muscle rigidity, altered mental status, autonomic nervous system
dysfunction resulting in high or low blood pressure, profuse perspiration, and excessive
sweating. called Malignant Hyperthermia” OR Neuroleptic malignant syndrome
41.)Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome,
which have many similarities. Which of the following is more characteristic of fibromyalgia?
Musculosckeletal pain
42.)A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following
medications may be used to treat generalized anxiety disorder? benzodiazepines include
Xanax, Librium, Valium, and Ativan
43.)Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to
reduce his lower esophageal sphincter pressure, which substances do you recommend that
he avoid? Food that is very hot or very cold. Fatty or fried foods. Peppermint or spearmint,
including flavoring Coffee, tea, and soft drinks that contain caffeine. Spicy, highly seasoned
foods. Fried food DT caffeine, chocolate and anticholinergics
44.)A 65 year old patient complains of recurrent bilateral temporal headaches, malaise, muscle
aches, and low grade fever. The headache is described as superficial tenderness rather than
deep pain. Giant cell arteritis is suspected. Appropriate treatment is: refer for temporal artery
biopsy and initiation of oral prednisone
45.)Which history is commonly found in a patient with glomerulonephritis? upper respiratory tract
infection or a skin infection that was caused by those bacteria
46.)The most reliable diagnostic indicator of gout is: Elevated serum uric acid levels
47.)After treating a patient for Helicobacter pylori infection , what test do you order to see if it has
been cured? A urea breath test
48.)A 28-year-old female presents to the office requesting testing for diagnosis of hereditary
thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her
risk factors. The nurse practitioner explains that: B and D (does not always require
anticoagulation therapy and genetic and risk management counseling are recommended
49.)A patient has HIV infection and is having a problem with massive diarrhea. You suspect the
cause is: Cryptosporidiosis
50.)A patient with HIV infection has a fever of unknown origin (FUO). Which of the following is a
possible cause of FUO in a patient with HIV? drug fever
51.)The diagnosis of human papilloma virus (HPV) infection in males is usually made by: The
diagnosis of HPV in men is made when external genital warts are seen. The diagnosis of genital
warts is made by examination of the lesions
52.)A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse
practitioner what the treatment for this disorder is. The nurse practitioner explains: Primary
hyperparathyroidism is treated with parathyroidectomy
53.)A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals
hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the
patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness,
anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take? Obtain a
thorough history and physical, and check serum cortisol and ACTH levels.
54.)What diabetic complications result from hyperglycemia? Retinopathy 2. Hypertension resistant
to treatment 3. Peripheral neuropathy
55.)Potential causes of hypocalcemia include which of the following? Hypoalbuminemia is the
most common cause of hypocalcemia. Causes include cirrhosis, nephrosis.
hypoparathyroidism, vitamin D deficiency, and renal disease.
56.)Which of the following patients most warrants screening for hypothyroidism? An elderly female
with recent onset of mental dysfunction
71.)Diagnostic radiological studies are indicated for low back pain : Pain lasting more than 1 month -
Objective radiculopathy - Cauda equina syndrome - Considering "red flag": systemic arthritis,
infection, malignancy, trauma, congenital/developmental abnormalities
72.)Josh, age 22, is a stock boy and has an acute episode of low back pain. You order and NSAID and
tell him which of the following? Begin lower back strengthening exercises depending on pain
tolerance.
73.) Major depression occurs most often in which of the following conditions? Stroke
74.)Which of the following is characteristic of a manic episode? Grandiosity or grandiose delusions
75.)Your patient has an elevated mean cell volume (MCV). What should you be considering in terms
of diagnosis? Anemia (pernicious or folic acid anemia) macrocytic Liver disease
76.)A middle-aged man presents to urgent care complaining of pain of the medial condyle of the
lower humerus. The man works as a carpenter and describes a gradual onset of pain. On exam,
the medial epicondyle is tender and pain is increased with flexion and pronation. Range of
motion is full The most likely cause of this patient’s pain is: epicondylitis
77.)Which of the following medications increase the risk for metabolic syndrome? Answer:
antihistamines and proton pump inhibitors, diuretics, beta-blockers
78.)Which of the following is a contraindication for metformin therapy? hypersensitity metabolic
acidiosis, dehydration, sepsis, hypoxemia, hepatic impairment, renal dysfunction
79.)The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy: to
measure albumin in a spot urine sample, collected either as the first urine in the morning or at
random, for example, at the medical visit. This method is accurate,:Early morning
80.) Microalbuminuria is a measure of: Urinary excretion of 30-299mg/24 hours of albumin,
Expressing albumin and creatinine ratio (ACR) takes the variability into account and normalizes
the albumin in a spot specimen
81.)The obligatory criteria for diagnosis of muscular dystrophy (MD) are: Genetic testing to
evaluate missing or repeated mutations in the dystrophin gene. A lack of the dystrophin gene
can lead to a diagnosis of Duchenne or Becker MD. The test is important not only to confirm the
MD diagnosis in males but also to determine whether women with a family history of Duchenne
or Becker MD may be carriers
82.)Which of the following is the most common complication of the myelodysplastic syndromes?
Bleeding
83.)Who is at a higher risk for developing nephrolithiasis? Bill, who runs every day and takes
excessive amounts of vitamin C
84.)The most effective treatment of non-infectious bursitis includes: Conservative treatment
includes rest, cold and heat treatments, elevation, administration of nonsteroidal anti-
inflammatory drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections.
85.)Which of the following is the most common causative organism of nongonococcal urethritis?
Chlamydia trachomatis
86.)A 77-year-old female presents to the office complaining a sudden swelling on her right elbow.
She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling
over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse
practitioner suspects: Olecranon bursitis
87.)What intervention does the American College of Rheumatology recommend as first line
therapy for osteoarthritis? Acetaminophen should be used as first-line therapy for mild
osteoarthritis. Nonsteroidal anti-inflammatory drugs are superior to acetaminophen for
treating moderate to severe osteoarthritis
88.)Establishment of a definitive diagnosis of osteomyelitis requires: Bone biopsy leads to a
definitive diagnosis
89.)Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How
do you respond? "A high caffeine intake has a diuretic effect that may cause calcium to be
excreted more rapidly."
90.)Martin, age 24, presents with an erythematous ear canal, pain, and a recent history
of swimming. What do you suspect? Otitis externa/ swimmer’s ear
91.)What is the first symptom seen in the majority of patients with Parkinson’s disease? Tremor at
rest
92.)Which of the following antibiotics should not be prescribed for a pregnant woman in the 3rd
trimester? Trimethoprim-sulfamethoxazole
93.) Phalen’s test , 90°wrist flexion for 60 seconds, reproduces symptoms of: carpal tunnel syndrome
94.)Which of the following characteristics are associated with prepatellar bursitis? Repetitive knee
trauma
95.)A patient has been taking fluoxetine (Prozac) since being diagnosed with major depression, first
episode, 2 months ago. She reports considerable improvement in her symptoms and her
intention to discontinue the medication. What should be the nurse practitioner’s
recommendation? Answer: Recommend that the patient continue the antidepressant
medication for at least 4 more months
96.)Maria, age 17, was raped when she was 13 year old. She is now experiencing sleeping problems,
flashbacks, and depression. What is your initial diagnosis? Post-traumatic stress disorder
97.)The most commonly recommended method for prostate cancer screening in a 55 year old male
is: digital rectal exams
98.)Risk factors for prostate cancer include all of the following except: BPH
99.)A 63-year-old man presents to the office with hematuria, hesitancy, and dribbling. Digital rectal
exam (DRE) reveals a moderately enlarged prostate that is smooth. The PSA is 1.2. What is the
most appropriate management strategy for you to follow at this time? Prescribe an alpha
adrenergic blocker.
100.) The organism most often associated with prostatitis is: Escherichia coli
101.) Prolonged PT suggests: Abnormality in extrinsic coagulation pathway, Deficiency of
FII, FV, FX, or fibrinogen abnormalities
102.) A 32 year old female patient presents with fever, chills, right flank pain, right
costovertebral angle tenderness, and hematuria. Her urinalysis is positive for leukocytes and red
blood cells. The nurse practitioner diagnoses pyelonephritis. The most appropriate
management is: Include 500 mg of oral ciprofloxacin (Cipro) twice per day for seven days; 1,
mg of
117.) Which of the following is a potential acquired cause of thrombophilia?
Antiphospholipid antibodies
118.) A 28-year-old female presents to the office requesting testing for diagnosis of
hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned
about her risk factors. The nurse practitioner explains that: B and D (does not always require
anticoagulation therapy and genetic and risk management counseling are recommended
119.) The most common symptoms of transient ischemic attack (TIA) include: Common
symptoms are sudden and transient, and include unilateral paresis, speech disturbance,
and monocular blindness. clinical symptoms typically lasting less than one hour, and
without evidence of infarction on imaging
121.) The most common presentation of thyroid cancer is: is an asymptomatic thyroid mass
or a nodule that can be felt in the neck.
122.) A 14 year old female cheerleader reports gradual and progressive dull anterior knee
pain, exacerbated by kneeling. The nurse practitioner notes swelling and point tenderness at
the tibial tuberosity. X-ray is negative. What is the most likely diagnosis? prepatellar bursitis?
123.) Diagnostic evaluation for urinary calculi includes: Diagnosis is based on urinalysis
and radiologic imaging, usually noncontrast helical CT.
124.) A 21-year-old female presents to the office complaining of urinary frequency and
urinary burning. The nurse practitioner suspects a urinary tract infection when the
urinalysis reveals 10WBC/HPF.
125.) The diagnosis which must be considered in a patient who presents with a
severe headache of sudden onset, with neck stiffness and fever, is: viral meningitis
126.) A middle-aged female presents complaining of recent weight loss. The physical
exam reveals an enlarged painless cervical lymph node. The differential diagnosis for this
patient’s problem includes: Answer: infection
127.) The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in
almost 100% of patients is: cafe au lait spots.
Misc
128.) What conditions must be met for you to bill “incident to” the physician, receiving
100% reimbursement from Medicare? The physician must be on-site and engaged in patient
care.
129.) A 30 year old female patient presents to the clinic with heat intolerance, tremors,
nervousness, and weight loss inconsistent with increased appetite. Which test would be most
likely to confirm the suspected diagnosis? TSH. We also assess free thyroid hormone (FT4) and
at times T
A Trauma
B Tight shoes
C Arthritis flare
- Question 2
A Metabolic syndrome
B Unilateral
pheochromocytoma
C Cushing’s syndrome
D None of the above
- Question 3
130.) A 72 year old patient exhibits sudden onset of fluctuating restlessness, agitation,
confusion, and impaired attention. This is accompanied by visual hallucinations and sleep
disturbance. What is the most likely cause of this behavior? Delirium
131.) Jack, age 55, comes to the office with a blood pressure of 144/98 mm Hg. He states that he did
not know if it was ever elevated before. When you retake his blood pressure at the end of the exam, it
remains at 144/98. What should your next action be? stage 2 hypertension (lifestyle change, and
medication
132.) How do you respond when Jessica, age 42, asks you what constitutes a good minimum
cardiovascular workout? 20 3x per week
Central obesity, “moon” face, and dorsocervical fat pad are associated with:
An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days
later, he returns to the office complaining of left great toe pain. On exam, the nurse
practitioner notes an edematous, erythematous tender left great toe. The likely precipitant
of this patient’s pain is:
The most effective treatment of non-infectious bursitis includes: Conservative treatment
- Question 9
- Question 10
- Question 11
- Question 12
reduce his lower esophageal sphincter pressure, which substances do you recommend that
he avoid?
Food that is very hot or very
cold Fatty or fried foods
Peppermint or spearmint, including flavoring
Coffee, tea, and soft drinks that contain
caffeine Spicy, highly seasoned foods
Which drug category contains the drugs that are the first line Gold standard therapy for
Beta antagonist
The most commonly recommended pharmacological treatment regimen for low back pain
(LBP) is:
Nsaid
Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis?
Erythromycin
A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals
hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the
patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness,
anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take?
.A Obtain a thorough history and physical, and check serum cortisol
and ACTH levels.
B. Perform a diet history and check CBC and FBS.
- Question 16
- Question 17
- Question 19
- Question 21
C. Provide nutritional guidance and have the patient return in one month.
D. Consult home health for intravenous administration
You are assessing a patient after a sports injury to his right knee. You elicit a positive
anterior/posterior drawer sign. This test indicates an injury to the: he
A. lateral
meniscus B.
cruciate ligament
C. medial meniscus
D. collateral ligament.
A 32 year old female patient presents with fever, chills, right flank pain, right costovertebral
angle tenderness, and hematuria. Her urinalysis is positive for leukocytes and red blood
cells. The nurse practitioner diagnoses pyelonephritis. The most appropriate management
is:
Include 500 mg of oral ciprofloxacin ( Cipro ) twice per day for seven days; 1,
mg of extended-release ciprofloxacin once per day for seven days; or 750 mg
of levofloxacin ( Levaquin ) once per day for five days.
A middle-aged man presents to urgent care complaining of pain of the medial condyle of the
lower humerus. The man works as a carpenter and describes a gradual onset of pain. On
exam, the medial epicondyle is tender and pain is increased with flexion and pronation.
Range of motion is full The most likely cause of this patient’s pain is: epicondylitis
A Lumbar disc
disease
B Spinal stenosis
C Traumatic
fracture
D Osteoporosis A Arthritis
B Ulnar neuritis
C Septic
arthritis
D Olecranon
bursitis
- Question 30
- Question 31
Which of the following is the most common cause of low back pain?
Which is the most common cause of end-stage renal disease in the United States?
Diabetes
A 77-year-old female presents to the office complaining a sudden swelling on her right
elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender
area of swelling over the extensor surface over the right elbow with evidence of trauma
or irritation. The nurse practitioner suspects:
Question 32**
- Question 33
- Question 35
- Question 37
A 60 year old female patient complains of sudden onset unilateral, stabbing, surface pain in
the lower part of her face lasting a few minutes, subsiding, and then returning. The pain is
triggered by touch or temperature extremes. Physical examination is normal.
Which of the following is the most likely diagnosis? A.
fibromyligia or neuro something
Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within normal
limits. Which of the following diagnoses do you explore further?
Arthritis, C
**- Question 34
A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the
following symptoms would lead you to look for another diagnosis?
syndrome hallucinations.
Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of:
carpal tunnel syndrome
The most common cause of elevated liver function tests is: alcohol
- Question 44
- Question 46
- Question 47
and history of a palpable lump in his scrotum that “comes and goes”. On physical
examination, the nurse practitioner does not detect a scrotal mass. There is no
tenderness, edema, or erythema of the scrotum, the scrotum does not transilluminate.
What is the most likely diagnosis?
A. Testicular torsion
B. Epididymitis
C. Inguinal hernia
D. Varicocele
Dave, age 38, states that he thinks he has an ear infection because he just flew back from a
business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is
your next action?
The physiological explanation of syncope is:
Syncope is a transient loss of consciousness (TLOC) due to global cerebral
hypoperfusion characterized by rapid onset, short duration and spontaneous
complete recovery.
- Question 48
- Question^49
- Question 51
A Weight gain
B Fracture risk
C Hypoglycem
ia
D Weight loss
A 20 year old male patient complains of “scrotal swelling.” He states his scrotum feels heavy,
but denies pain. On examination, the nurse practitioner notes transillumination of the
A 32 year old male patient complains of urinary frequency and burning on urination for 3 days.
Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial
treatment should be: nclude nitrofurantoin monohydrate/macrocrystals,
Diagnostic radiological studies are indicated for low back pain:
An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for
this patient, the nurse practitioner is most concerned with which of the following side
effects?