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A study guide for the nur 6531 final exam in 2024, focusing on the diagnosis and treatment of various conditions. It includes questions and answers on topics such as bursitis, arthritis, diabetes, thyroid disorders, and urinary calculi. The guide also covers the symptoms, diagnostic tests, and treatments for each condition.
Typology: Exams
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A (^) Metabolic syndrome
.
B (^) Unilateral
. (^) pheochromocytoma
C (^) Cushing’s syndrome
.
D (^) None of the above
.
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A Trauma
.
B Tight shoes
.
C Arthritis flare
.
D Hydrochlorothiazide
.
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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
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drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections
What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?
Selected Answer: The physician must be on-site and engaged in patient care Answers: You must initiate the plan of care for the patient
The physician must be on-site and engaged in patient care You must be employed as an independent contractor You must be the main health care provider who sees the patient
Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus?
The metabolic syndrome refers to the co-occurrence of several known cardiovascular risk factors, including insulin resistance, obesity, atherogenic dyslipidemia and hypertension.
Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)?
A. Nocturia B. Urgency incontinence C. Strong urinary stream flow D. Straining to void
Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to
includes rest, cold and heat treatments, elevation, administration of nonsteroidal anti-inflammatory
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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; 1,000 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
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The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy
s 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
What is the first symptom seen in the majority of patients with Parkinson’s disease?
Tremor at rest
The most commonly recommended method for prostate cancer screening in a 55 year old male is:
digital rectal exams,
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
Which of the following symptoms suggests a more serious cause of back pain?
Pain associated with lying down at night
A patient taking levothyroxine is being over-replaced. What condition is he at risk for?
osteoporosis
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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
1 out of 1 points 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 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
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Primary hyperparathyroidism is treated with Vitamin D restriction
Primary hyperparathyroidism is treated with parathyroidectomy
Primary hyperparathyroidism is treated with daily magnesium
Primary hyperparathyroidism is treated with parenteral parathyroid
hormone (PTH)
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Reed-Sternberg B lymphocytes are associated with which of the following disorders:
A (^) Aplastic anemia . B (^) Hodgkin’s lymphoma . C (^) Non Hodgkin’s
. (^) lymphoma D (^) Myelodysplastic . (^) syndromes
Which of the following is a potential acquired cause of thrombophilia?
A (^) Homocysteinuria . B (^) Protein C deficiency . C (^) Factor V Leiden . D (^) Antiphospholipid
. (^) antibodies
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:
A 25 year old overweight patient presents with a complaint of dull achiness in his groin
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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 scrotum. What is the most likely diagnosis? hydrocele
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, trimethoprim-sulfamethoxazole (TMP-SMX), or fosfomycin. trimethoprim and sulfamethoxazole
Diagnostic radiological studies are indicated for low back pain:
Diagnostic imaging is indicated for patients with low back pain only if they have severe progressive neurologic deficits or signs or symptoms that suggest a serious or specific underlying condition. In other patients, evidence indicates that routine imaging is not associated with clinically meaningful benefits but can lead to harms.
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?
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is an asymptomatic thyroid mass or a nodule that can be felt in the neck.
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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
Which history is commonly found in a patient with glomerulonephritis?
A patient complains of generalized joint pain and stiffness associated with activity and
relieved with rest. This patient history is consistent with which of the following disorders?
Osteoarthritis
The most common presentation of thyroid cancer is:
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 The case for genetic diagnosis.
Accurate diagnosis of the muscular dystrophies is important for patients, their families, and efficient and cost-effective use of medical resources.
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women with a family history of Duchenne or Becker MD may be carriers.^4
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The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is: relative rest-that being the cessation of the offending activity for a period of time until the irritation is eliminated, pain is gone and the bone is given a chance to heal.
Rest the affected part of the body
Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to:
a. refer her to a hand surgeon b. take a more complete hx c. try neutral position wrist splinting and order an oral NSAID d. order a nerve conduction study such as an electromyography (EMG)
Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia?
A. Musculosckeletal pain B. Difficulty sleeping C. Depression D. Fatigue
The cardinal sign of infectious arthritis is:
Affected joint is painful at rest, with movement and weight bearing
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Diagnostic evaluation for urinary calculi includes:
Diagnosis is based on urinalysis and radiologic imaging, usually noncontrast helical CT.
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
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?
A. Prescribe an alpha adrenergic blocker. B. Recommend saw palmetto. C. Prescribe an antibiotic D. Refer the client to urology.
A positive drawer sign supports a diagnosis of:
Posterior cruciate ligament injury
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?
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A (^) Chlamydia
. (^) trachomatis
B (^) Ureaplasma
. urealyticum
C (^) Mycoplasma
. (^) hominis
D (^) Trichonomas
. vaginalis
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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
Establishment of a definitive diagnosis of osteomyelitis requires:
Bone biopsy leads to a definitive diagnosis.
Which of the following is the most common causative organism of nongonococcal urethritis?
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
imaging
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A (^) Klebsiella
.
B (^) Neiserria
. (^) gonorrhoaes
C (^) Chlamydia
. trachomatis
D (^) Escherichia coli
.
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most likely to confirm the suspected diagnosis?
TSH. We also assess free thyroid hormone (FT4) and at times T
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.
Which of the following is a contraindication for metformin therapy?
hypersensitity metabolic acidiosis, dehydration, sepsis, hypoxemia, hepatic impairment, renal dysfunction
The organism most often associated with prostatitis is:
The most effective intervention(s) to prevent stroke is (are):
A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as:
Overweight
- Question 2
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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?
Answer: Obtain a thorough history and physical, and check serum cortisol and ACTH levels.
Question 5
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Which of the following is a potential acquired cause of thrombophilia?
Antiphospholipid antibodies
Question 8
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Differential diagnosis of proteinuria includes which of the following?
- Question 10
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Question 35 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
- Question 11
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How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout?
20 3x per week
- Question 12