NURS 6550N FINAL EXAM Discussion

NURS 6550N FINAL EXAM Discussion

A 21-year-old woman requests hormonal emergency contraception after a condom break during intercourse approximately 16 hours ago. Today is day 14 of her normally 27–29 day menstrual cycle. You advise her that:

Likelihood of conception is minimal and emergency contraception use is not advised

Hormonal emergency contraception can be effective up to 5 days after intercourse

When taken as advised, hormonal emergency contraception use reduces the risk of pregnancy by up to 65%

The most likely mechanism of action of hormonal emergency contraceptive is as an abortifacient

Question

A 36-year-old man is hospitalized for alcohol poisoning. During follow-up evaluation the next day, he denies that he has a drinking problem. The best approach to assess for possible alcoholism is conducting which of the following questionnaires?

BDI.

HEADDS.

CAGE.

PHQ-9.

Question

A quality improvement plan characterized by limiting variability and removing defects in a process best describes:

Six Sigma.

Continuous Quality Improvement.

Total Quality Management.

Healthcare Stewardship.

Question

A 38-year-old woman comes to the emergency department complaining of a rapid heartbeat, tremors, and chest tightness. She reports earlier in the day she was feeling a migraine starting so she took a pill given to her by her friend who also experiences migraines. Her medical history reveals that she is currently taking a monoamine oxidase inhibitor for depression. Which migraine medication did she most likely take? NURS 6550N FINAL EXAM Discussion

Acetaminophen and caffeine (Excedrin ® Migraine)

Naproxen sodium (Aleve ® )

Almotriptan (Axert ® )

Butalbital, acetaminophen and caffeine (Fioricet ® )

Question

All of the following are elements of malpractice except:

A duty of care to the patient.

A fee is charged for the healthcare services related to the malpractice claim.

Breach of the standard of care.

Injury.

Question

You are seeing a 68-year-old woman for treatment of an uncomplicated urinary tract infection (UTI). She has well-controlled hypertension, type 2 diabetes mellitus, and dyslipidemia and takes an angiotensin-converting enzyme inhibitor (ACEI), statin, biguanide, and low-dose aspirin (ASA). She worked in a dry cleaning facility until approximately 8 years ago. During her evaluation, she mentions that she sometimes has difficulty understanding conversation, especially in noisy environments. This is likely a:

Drug-related reaction.

Consequence of occupational chemical exposure.

Early sign of dementia.

Normal age-related change in hearing

Question

While evaluating a 33-year-old female with a 2-day history of dysuria, which of the following findings in urinalysis is most suggestive of urinary tract infection (UTI) caused by a Gram-negative organism?

Nitrites

30 mg/dL protein

Epithelial cells

pH>8

Question

All of the following are examples of primary prevention strategies except: NURS 6550N FINAL EXAM Discussion

Counseling an elderly patient prior to discharge about fall risk at home and how to prevent falls through adequate illumination.

Performing a hemoglobin A1C for all patients admitted to the hospital.

Conducting a study to identify the leading cause of mortality in teenagers and how to reduce risk.

Immunizing all adults ≥60 years with zoster vaccine.

Question

A 23-year-old woman is being evaluated for an upper respiratory tract infection. As you prepare for auscultation, the patient states “I have a benign murmur that has been with me my whole life”. Anticipating a physiologic murmur, you would expect which of the following characteristics?

Usually obliterates S2.

Becomes softer when going from a supine to standing position.

Occurs late in systole.

Has localized area of auscultation

Question

When evaluating the value of a test, the proportion of negative results that are truly negative best describes:

Positive predictive value.

Negative predictive value.

Sensitivity.

Specificity.

Question

A 16-year-old male presents for evaluation after a syncopal episode at school. He reports that he has recently been experiencing bouts of lightheadedness. His blood pressure is 126/76 mm Hg and his BMI=33 kg/m 2 . You notice velvet-like plaques at the nape of the neck. Laboratory assessment should include which of the following tests?

Hemoglobin A1c

Serum electrolytes

ALT/AST

Hemogram

Question

The NP is called to treat a 43-year-old woman for multiple contusions following a domestic violence attack. The NP realizes that one of the best predictors of a subsequent homicide of victims of domestic violence is:

History of alcohol/drug abuse by perpetrator.

Access to kitchen knives by the perpetrator.

History of perpetrator attempting to strangle the victim.

Issuance of a restraining order by the victim.

Question

A 48-year-old woman is being evaluated with chief complaints of fatigue, weakness, lethargy, and decreased concentration. She also mentions a notable increase in facial hair over the past 6 months as well as unexplained weight gain (about 25 lbs [11.3 kg]) over the past 2 months. Her past medical history is notable for moderate persistent asthma with multiple exacerbations over the past 8 months requiring treatment with prednisone. The most likely diagnosis is:

Type 2 diabetes mellitus.

Hashimoto thyroiditis.

Cushing’s syndrome.

Addison’s disease.

Question

You see a 73-year-old woman with a 40 pack-year smoking history, chronic obstructive pulmonary disease (COPD) and peripheral arterial disease (PAD) who presents with an ulcer on the sole of her left foot. The ulcer has an irregular edge and pale base and a punched out appearance, with the surrounding skin white and shiny. The patient states that the pain is worse at night in bed and when the legs are elevated. The most likely diagnosis is:

Pressure ulcer

Pyoderma gangrenosum

Venous ulcer

Arterial ulcer

Question

In evaluating a 62-year-old male with ischemic heart disease and mitral incompetency, you expect to find the murmur that is: NURS 6550N FINAL EXAM Discussion

Localized systolic.

Diastolic with radiation to the neck.

Diastolic with little radiation.

Systolic with radiation to the axillae.

Question

21-year-old camp counselor presents for evaluation with a chief complaint of generalized itchiness. He has just returned after a week of summer camp. Physical examination reveals excoriated papules along his axillary folds and at the belt line. The NP suspects scabies and prescribes permethrin (Elimite ® ) lotion. In counseling the patient on the use of permethrin, the NP mentions that:

Its use is associated with neurotoxicity risk.

Itch often persists for a few weeks after successful treatment.

A marked reduction in lesions is noted within 48 hours.

The medication should be rinsed off within 2 hours of application.

Question

You see a 76-year-old woman living at home who is accompanied by her home care provider. She has COPD and type 2 diabetes mellitus. An example of a secondary prevention strategy is:

Administering the seasonal influenza vaccine.

Screening for physical or financial abuse/Checking her blood glucose level.

Checking her blood pressure.

Adjusting her insulin dosing regimen.

Question

A 43-year-old woman is being evaluated in the emergency department with a complaint of a severe headache. She describes a unilateral, pulsing headache that was preceded by a gradual onset of paresthesia affecting the ipsilateral face and arm. The patient stated she noticed a “funny smell” prior to the symptoms starting. This description is most typical of:

Migraine with aura.

Cluster headache.

Transient ischemic attack.

Tension-type headache.

Question

A 20-year-old college student living in a campus dormitory has been diagnosed with meningococcal meningitis. The NP decides to speak with the university health officials and inform them that:

There is little to no risk of spread of the disease to other individuals.

Only intimate partners are at risk for infection.

Individuals with household-type or more intimate contact are at risk for infection.

All individuals on campus can be considered to be at risk for infection.

Question

You see a 54-year-old man living in subsidized housing with a history of hypertension. He states that he stopped taking his blood pressure medication about 4 months ago because of costs. He is concerned because his blood pressure is high whenever he checks it, though he does not report any symptoms. His BP at this visit is 196/104 mm Hg. Upon examination of this patient, you would expect to detect an S 4 sound heard during:

Early systole.

Late systole.

Early diastole.

Late diastole.

Question

32-year-old man requires evaluation for hepatitis infection prior to taking a job as a restaurant cook. He presents with the following laboratory results:

Hepatitis A Panel Hepatitis B Panel Hepatitis C Panel Anti-HAV Negative HBsAg Negative Anti-HCV Positive IgM Negative Anti-HBc Negative HCV RNA Negative IgM Negative Anti-HBs Positive You recognize the patient is susceptible to:NURS 6550N FINAL EXAM Discussion

Hepatitis A and B

Hepatitis B and C

Hepatitis B only

Hepatitis A only