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Advanced Nursing Practice I 20224 UPDATE
- You see a 75 - year old female in your clinic today complaining of urinary incontinence. She is otherwise healthy based upon her last visit. She states that her mother told her this would happen someday because it happens to every woman at some age. What would you tell this patient? This is not an expected condition related to aging. (Urinary incontinence is not an expected condition related to aging.)
- Spread of genital herpes only occurs during the time period with active lesions. Is this statement true or false? False (This is a false statement: spread of genital herpes only occurs during the time period with active lesions.)
- What is the treatment of choice for uncomplicated community- acquired cystitis? TMP-SMZ (TMP-SMZ is the treatment of choice for uncomplicated community-acquired cystitis.)
- What sexually transmitted disease is most widespread in the USA today? Chlamydia (The most widespread sexually transmitted disease in the USA today is chlamydia.)
NSG 6001 Week 4 Quiz Latest 2025
Update Verified With Rationale South
University Online
Advanced Nursing Practice I 20224 UPDATE
- Sexual partners of a patient with a diagnosed STI should always be examined and treated. Is this statement true or false? True
- Your 60-year old male patient arrives for his appointment. He complains of general malaise and fever over the past several days with low back pain. He also states that he is getting up at night more often to urinate and never feels his bladder is completely empty. What differential diagnosis should you consider in this patient? Acute bacterial prostatitis (Acute bacterial prostatitis is the correct answer.)
- Your patient has uncomplicated pyelonephritis. In deciding your recommended treatment, you consider the most common pathogenic reason for this diagnosis. What pathogen accounts for the majority of pyelonephritis? E. Coli (E. Coli is the pathogen that accounts for the majority of pyelonephritis
- The provider is evaluating a patient for potential causes of urinary incontinence and performs a postvoid residual (PVR) test which yields 30 mL of urine. What is the interpretation of this result? c. This is a normal result. PVR less than 50 mL is considered normal and this result does not indicate any abnormality.
- The provider is counseling a patient who has stress incontinence about ways to minimize accidents. What will the provider suggest initially? D. Voiding every 2 hours during the day Timed voiding is useful to help minimize stress incontinence and is used initially. Increasing fluid intake will increase symptoms. PT referral may be done if other measures fail to help with
Advanced Nursing Practice I 20224 UPDATE
- A male patient reports nocturia and daytime urinary frequency and urgency without changes in the force of the urine stream. What is the likely cause of this? B. Lower urinary tract Rationale: Lower urinary tract symptoms (LUTS) result from irritative changes in the lower tract. Bladder outlet obstruction causes hesitancy, decreased caliber and force of the urine stream, and post-void dribbling. Diagnosis of prostate cancer and UTI require further testing and are less likely causes.
- A 70-year-old male reports urinary hesitancy, post-void dribbling, and a diminished urine stream. A digital rectal exam reveals an enlarged prostate gland that feels rubbery and smooth. Which tests will the primary care provider order based on these findings? Urinalysis and serum Cr. Rationale: The DRE reveals a prostate gland consistent with BPH. The primary provider should order a urinalysis and creatinine to evaluate possible infection and renal function. A bladder scan is ordered at the discretion of the urologist. The prostate exam isn't consistent with prostate cancer, so PSA and bladder imaging are not necessary. Symptoms of prostatitis would indicate a need for evaluation of possible infection.REF: Diagnostics/Box 147 - 1: Diagnostics
- A patient has been taking terazosin daily at bedtime to treat BPH and reports persistent daytime dizziness. What will the provider do? A Rx Finasteride instead of terazosin Rationale: Patients who cannot tolerate the side effect of alpha-adrenergic antagonists, the provider may initiate therapy with a 5a-reductase inhibitor such as finasteride. Terazosin should be given at bedtime to minimize these adverse effects. Herbal preparations have not been proven to be safe or effective. Doxazosin is in the same drug class as terazosin.REF: Management
- An older male patient reports gross hematuria but denies flank pain and fever. What will the provider do to manage this patient?
Advanced Nursing Practice I 20224 UPDATE If hematuria resolves after treatment for UTI, no further testing is indicated, especially in women who are at increased risk for UTI.REF: Hematuria/ Diagnostics and Differential Diagnosis D. d. Refer for cystoscopy and imaging Rationale: Gross hematuria in older men denotes a significant risk of malignant disease, so cystoscopy and imaging are indicated. Proteinuria is concerning for hypertension. The patient does not have flank pain or fever, so the likelihood of infection is lower. A 24-hour urine collection is not indicated.REF: Hematuria/Clinical Presentation/Diagnostics and Differential Diagnosis
- A pregnant woman at 30 weeks gestation has proteinuria. What will the provider do next? Proteinuria after 24 weeks gestation is usually a sign of preeclampsia, so her blood pressure should be evaluated. Serum glucose evaluation for gestational diabetes is performed as part of routine screening, but is not related to the finding of proteinuria. A 24-hour urine collection is not indicated.REF: Proteinuria/Clinical Presentation
- A female patient reports hematuria and a urine dipstick and culture indicate a urinary tract infection. After treatment for the UTI, what testing is indicated for this patient? C. c. No testing if hematuria is resolved
- 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. ACR 325mg/g Rationale: An albumin/creatinine ratio greater than 300 mg/g warrants referral. A specialist is necessary for persistent hypertension refractory to treatment with four or more agents, a GFR of less than 30, and urine RBC greater than 20/hpf.REF: Specialist Referral
Advanced Nursing Practice I 20224 UPDATE
- Which tests should be monitored regularly in order to monitor for complications of chronic renal disease? Select all that apply. B Parathyroid hormone levels D. Serum lipids E .Vitamin D levels B, C, E Rationale: CKD can cause hyperparathyroidism, hyperlipidemia, and alterations in vitamin D, calcium, and phosphorus metabolism, so these should be monitored. Liver function and serum glucose are not affected by CKD.REF: Box 149-1: Major Complications of Stage 4- 5 CKD
- Which is a pre-renal cause of acute kidney injury? A. Anaphylactic shock interferes with perfusion of the kidney, which is a pre-renal cause of AKI. Hydronephrosis and renal calculi are post-renal causes leading to obstruction to renal pelvis, ureters, bladder, or urethra. Hypertension is an intrinsic cause.REF: Pathophysiology
- The provider orders the oral phosphodiesterase type 5 inhibitor sildenafil to treat erectile dysfunction in a 65 - year-old male patient. What will be included when teaching this patient about taking this medication? Select all that apply. A. The medication is best taken on an empty stomach. D. This medication has a rapid onset and short duration of action. Rationale: Sildenafil has a rapid onset and short duration of action and should be taken on an empty stomach. Fatty foods may delay or interfere with absorption. This medication is given when sexual activity is desired and not once daily.REF: Management A 50 - year-old man reports having erectile dysfunction. What is an important response by the provider when developing a plan of care for this patient?
Advanced Nursing Practice I 20224 UPDATE B Evaluating the patient for cardiovascular disease Rationale: Men under age 60 years with ED are at higher risk for cardiovascular disease, so this patient should be evaluated for this condition. Until the underlying cause is found, prescribing medications or hormones is not indicated. Psychotherapy and counseling are used when psychogenic ED is present.REF: Management Which is true about hypoactive sexual desire in older men? c. Men with hypoactive sexual desire may have normal excitement and orgasm. Rationale: Men with hypoactive sexual desire have diminished response in the desire phase of the sexual response cycle but may still experience normal excitement and orgasm. Sexual aversion and hypoactive desire are not related. Many people with normal sexual desires choose not to have sexual relations; hypoactive desire is a physiological condition. Only 16% of men have hypoactive desire.REF: Introduction A young adult male reports a dull pain in the right scrotum and the provider notes a bluish color showing through the skin on the affected side. Palpation reveals a bag of worms on the proximal spermatic cord. What is an important next step in managing this patient? b. Consideration of underlying causes of this finding Rationale: This patient has symptoms of varicocele. Because varicocele is rare on the right side, the provider should look for underlying causes of these findings. Anti-infective therapy is indicated for epididymitis. Varicocele requires surgical intervention or ablation to resolve. Testicular torsion is an emergency. An adolescent male reports severe pain in one testicle. The examiner notes edema and erythema of the scrotum on that side with a swollen, tender spermatic cord and absence of the cremasteric reflex. What is the most important intervention? B Immediate referral to the emergency department Rationale: This patient has symptoms of testicular torsion, which is a surgical emergency. An immediate referral is warranted. Doppler US and transillumination are useful in establishing a
Advanced Nursing Practice I 20224 UPDATE An asymptomatic female learns that her boyfriend has gonorrhea and asks about antibiotics. What will the provider recommend? c. Empiric ceftriaxone and azithromycin Rationale: Patients with gonorrhea usually have chlamydia as well, so treatment with both ceftriaxone and azithromycin are given. Amoxicillin- clavulanate and TMP-SMZ are used for UTIs. The patient should be treated empirically. Females are often asymptomatic.REF: Gonorrhea/Management What are some common goals of neuropsychiatric evaluation? Select all that apply. c. To evaluate cognition when neuro-diagnostic tests are normal d. To help identify rehabilitation goals in brain-injured patients e. To monitor changes in symptoms over time Rationale: ANSC, D, E Neuropsychological testing is performed to evaluate cognition when other diagnostic tests may be normal, to help identify rehabilitation goals for brain-injured patients, and to monitor changes in patients over time. Because they are one piece of the diagnostic workup, they do not definitively diagnose disorders or determine the need for surgical procedures.REF: Box 188 - 2: Neuropsychological Assessment Goals What is an important purpose of conducting an interview prior to beginning neuropsychological testing on an older adult suspected of having dementia? a. To assess the patient's ability to cooperate with the testing Rationale: The pre-testing interview may be conducted to determine whether a patient may need assistance or accommodations when being tested. The test itself will measure the degree of cognitive impairment. The interview may include the patient's feelings, but the ability to cooperate with testing is a more important part of the interview. The testing will identify the need for referral.REF: Overview of the Assessment Process
Advanced Nursing Practice I 20224 UPDATE A previously healthy 30 - year-old patient is brought to the emergency department with signs of stroke. Diagnostic testing determines an ongoing ischemic cause. The patient's spouse reports that symptoms began approximately 2 hours prior to transport. What is the recommended treatment? d. Tissue plasminogen activator (tPA) administration Rationale: This patient meets the criteria for tPA administration and it should be begun within 3 hours after onset of symptoms. This patient has had symptoms for over 2 hours, so tPA should begin immediately. LMW heparin is not indicated. Neurosurgical intervention is recommended for patients with hemorrhagic stroke.REF: Thrombolytic Therapy An elderly patient is brought to the emergency department after being found on the floor after a fall. The patient has unilateral sagging of the face, marked slurring of the speech, and paralysis on one side of the body. The patient's blood pressure is 220/190 mm Hg. What is the likely treatment for this patient? C. Neurosurgical consultation Rationale: This patient has signs consistent with hemorrhagic stroke and will need consultation with a neurosurgeon to determine whether surgical intervention will be beneficial. Carotid endarterectomy is performed in patients with carotid stenosis and is used in patients with hemispheric ACVS (TIA). Patients with TIA may be observed to monitor symptoms. Thrombolytic therapy is given to patients with ischemic stroke.REF: Management/Surgery
- A patient exhibits visual field defect, ataxia, and dysarthria and complains of a mild headache. A family member reports that the symptoms began several hours prior. An examination reveals normal range of motion of the neck. What type of cerebrovascular event is most likely? C Ischemic Stroke Rationale: Patients with ischemic stroke typically do not have headache; if they do, it is milder than with hemorrhagic stroke. A TIA resolves within minutes.REF: Clinical Presentation
Advanced Nursing Practice I 20224 UPDATE
- An 80-year-old patient becomes apathetic, with decreased alertness and a slowing of speech several days after hip replacement surgery alternating with long periods of lucidity. What is the most likely cause of these symptoms? a. Anesthesia effects b. Delirium c. Pain medications d. Stroke ANS: B An acute presentation of these symptoms is most likely delirium since they alternate with lucid periods. The other causes may contribute to delirium by intensifying it.REF: Clinical Presentation
- A patient with dementia experiences agitation and visual hallucinations and is given haloperidol with a subsequent worsening of symptoms. Based on this response, what is the likely cause of this patient's symptoms? a. Alzheimer's disease b. Lewy body dementia c. Pseudodementia d. Vascular neurocognitive disorder NS: B Patients with Lewy body dementia may present with these symptoms and will have an increased sensitivity to neuroleptics; when given haloperidol for agitation, will actually get worse. The other causes do not have these characteristic symptoms and are not sensitive to neuroleptics in this manner.REF: Clinical Presentation
Advanced Nursing Practice I 20224 UPDATE
- A patient with Alzheimer's disease (AD) is taking donepezil to treat cognitive symptoms. The patient's son reports noting increased social withdrawal and sleep impairment. What is the initial step to manage these symptoms? a. Encourage activity and exercise b. Prescribe a selective serotonin reuptake inhibitor c. Recommend risperidone d. Referral to a neurologist for evaluation ANS: A Patients with AD may have improvement in depression with nonpharmacologic management, including exercise and increased activity. If this is not effective, an SSRI may be prescribed. Risperidone, and other antipsychotics should not be prescribed.REF: Management
- An elderly patient has symptoms of depression and the patient's daughter asks about possible Alzheimer's disease since there is a family history of this disease. A screening evaluation shows no memory loss. What is the initial step in managing this patient? a. Order brain imaging studies such as CT or MRI b. Perform genetic testing to identify true risk c. Prescribe a trial of an antidepressant medication d. Recommend a trial of a cholinesterase inhibitor drug ANS: C Elderly patients with depression who do not have other signs of AD may be given a trial of antidepressant medications initially in order to evaluate these symptoms. Brain imaging studies are not indicated initially. Genetic testing is not indicated. Once the degree of depression is determined and if other symptoms appear, an anticholinesterase inhibitor may be ordered.REF: Clinical Presentation/Diagnostics
Advanced Nursing Practice I 20224 UPDATE
- Which medications may be useful in treating tension-type headache? Select all that apply. a. Antiemetics b. Lithium c. Muscle relaxants d. NSAIDs e. Oxygen ANS: A, C, D Antiemetics, muscle relaxants, and NSAIDs may all be used to treat tension-type headaches. Lithium and oxygen are not used.REF: Management
- A patient who has a seizure disorder and who takes levetiracetam is brought to an emergency department with a seizure which has persisted for15 minutes and which immediately followed another 15 minute seizure. What is the priority action for this patient? a. Administer a dose of levetiracetam now and repeat in 10 minutes b. Administer lorazepam and monitor cardiorespiratory status c. Administer phenytoin and phenobarbital along with oxygen d. Admit the patient to the hospital for a diagnostic work up ANS: B This patient has status epilepticus, which should be treated with benzodiazepines and close monitoring of airway, breathing, and circulation. The other interventions are not appropriate for acute seizure management.REF: Initial Stabilization and Management of Acute Seizures
Advanced Nursing Practice I 20224 UPDATE
- A patient with a seizure disorder has seizures which begin with eye twitching and occasionally visual hallucinations. Which site in the brain is the seizure focus? a. Frontal b. Occipital c. Parietal d. Temporal ANS: B Occipital sites causing complex partial seizures will have visual auras that may begin with eye twitching and visual hallucinations. Frontal sites cause dizziness or fear. Parietal sites cause sensory changes, such as numbness, tingling, or pain. Temporal sites cause epigastric and déjà vu sensations.REF: Table 201-1: Clinical Manifestations of Complex Partial Seizures
- Which drug is used to treat patients with focal epilepsy and complex partial seizures? a. Carbamazepine b. Ethosuximide c. Lamotrigine d. Topiramate ANS: A Carbamazepine is used for focal and complex partial seizures. Ethosuximide is useful for petit mal seizures in children. Lamotrigine has a wide range of effectiveness, but has an increased risk for Stevens-Johnson syndrome. Topiramate is not a first-line drug because of cognitive side effects.REF: Pharmacologic Management
- A patient who has a seizure disorder and who takes levetiracetam is brought to an emergency department with a seizure which has persisted for15 minutes and which immediately followed another 15 minute seizure. What is the priority action for this patient?
Advanced Nursing Practice I 20224 UPDATE d. Thionamide therapy ANS: A Beta blockers should be initiated for patients with Graves' disease to alleviate the alpha- adrenergic symptoms of the hyperthyroidism. Radioiodine therapy is used for patients with Graves' ophthalmopathy. Surgical resection is performed for pregnant women who cannot be managed with thioamides or for patients who refuse radioiodine therapy. Thioamide therapy is recommended for patients younger than 20 years old, pregnant women, those with a high likelihood of remission, and those with active Graves' Orbitopathy.REF: Management/Graves' Disease
- A postpartum woman develops fatigue, weight gain, and constipation. Laboratory values reveal elevated TSH and decreased T3 and T4 levels. What will the provider tell this patient? a. A thyroidectomy will be necessary. b. She should be referred to an endocrinologist. c. She will need lifelong medication. d. This condition may be transient. ANS: D Postpartum hypothyroidism may be a transient condition and does not require surgical intervention, referral to a specialist, or lifelong medication unless it proves to be long-standing or refractory to treatment.REF: Hypothyroidism/Management
- A patient has thyroid nodules and the provider suspects thyroid cancer. To evaluate thyroid nodules for potential malignancy, which test is performed? a. Radionucleotide imaging b. Serum calcitonin c. Serum TSH level
Advanced Nursing Practice I 20224 UPDATE d. Thyroid ultrasound ANS: D Thyroid ultrasound evaluation should be performed for all patients with known thyroid nodules; high-resolution sonography can clearly distinguish between solid and cystic components. Radionucleotide imaging is not specific; many cold nodules are benign. The routine measurement of serum calcitonin levels is not useful or cost-effective. TSH levels are not specific to malignancy.REF: Diagnostics and Differential Diagnosis
- Which thyroid stimulating hormone (TSH) level indicates hyperthyroidism? e. 0.2 uIU/L f. 0.4 uIU/L g. 2.4 uIU/L h. 4.2 uIU/L ANS: A A TSH less than 0.3 uIU/L indicates hyperthyroid; greater than 4.0 uIU/L indicates hypothyroid, and between 0.3 to 4.0 uIU/L indicates euthyroid.REF: Thyroid Function Tests
- A 20 - year-old female patient with tachycardia and weight loss but no optic symptoms has the following laboratory values: decreased TSH, increased T3, and increased T4 and free T4. A pregnancy test is negative. What is the initial treatment for this patient? e. Beta blocker medications f. Radioiodine therapy g. Surgical resection of the thyroid gland h. Thionamide therapy ANS: A
