13 Jan Insufficient supplemental oxygen thera

MN551 week quizzzes

MN551 Quiz # 2

Which of the following patients is most likely to benefit from transportation of thymic tissue or major histocompatibility complex ( MHC) – compatible bone marrow?

As part of his diagnostic workup, a 77 yo man nurse practitioner has ordered blood work that includes ferritin levels. The man is very interested in the details of his health care is unfamiliar with ferritin and it’s role. Which of the following explanations by the nurse practitioner is most accurate?

The blood work of a 44 yo male with a diagnosis of liver disease secondary to alcohol abuse indicates low levels of albumin. Which of the following phenomena would a clinician be most justified in anticipating?

A 14 yo boy has been diagnosed with infectious Mono. Which of the following pathophysiological phenomena is most responsible for his symptoms?

Which of the following phenome would be least likely to result in activation of the complement system?

Following a course of the measles a 5yo girl developed scattered bruising over numerous body surfaces and was diagnosed with immune thrombocytopenia purpura (ITP). Diagnostic workup, blood work was performed. Which results is most likely to be considered unexpected by the health care team

A patient presented to the ED with a swollen, reddened, painful leg wound , diagnosed with MRSA cellulitis. The nurse practitioner ordered a CBC and white cell diff. Which of the following blood components would the nurse anticipate to be elevated?

A nurse practitioner is explaining to a 40 yo male pt the damage that Mycobacterium tuberculosis could do to lung tissue. Which of the following phenomena would underlie the NP explanation?

A 29 yo construction worker got silver under his fingernail 4 days ago. The affected finger is reddened, painful, swollen, and warm. Which of the following hematological processes is most likely occurring in response to the infection?

Which of the following patients would the student recognize as being least likely to have a diagnosis of antiphospholipid syndrome in his or her medical historory?

A couple who are expecting their first child have been advised by friends to consider harvesting umbilical cord blood in order to have a future source of stem cells. The couple have approached their NP with this request and are seeking clarification of exactly why stem cells are valuable. How can the nurse practitioner best respond to the couple’s inquiry?

A 16 yo female has been brought to her primary NP by her mother due to perisistent sore throat and malaise. Which of the following facts revealed in the girl history and exam would lead the NP to r/o infectious mono

A 60 yo woman is suspected of having non-Hodgkin lymphoma (NHL). Which of the following aspects of her condition would help to r/o Hodgkin lymphoma?

A NP is providing prenatal care and eduction for a first-time expectant mother, 22 wks gest, who has a diagnosis of a STD. Which of the following statements by the expectant mother demonstrates an adequate understanding of vertical disease transmission and congenital infections?

A 71 yo male pt w/ a hx of MI and peripheral vascular disease has been advised by his NP to begin taking 81 mg of ASP once daily. Which of the underlying rationale for the NP suggestion?

Which of the following statements most accurately conveys an aspect of lymphatic system activity?

A 23 yo man has received a recent dx of appendicitis following 24 hrs of acute abd pain. The NP providing care for the man is explaining that while it is unpleasant, the inflammation of his appendix is playing a role in his body’s fight against the underlying infectious process. Which of the following teaching points should the NP eliminate from his teaching for the patient?

A 66yo female pt has presented to the ED w/ several months of intermittently bloody stools that has recently become worse. The woman has since been diagnosed w/ a GI bleed secondary to overuse of NSAIDs that she takes for her arthritis. The health care team would realize that which of the following situations is most likely?

A 40 yo woman experiences severe seasonal allergies has been referred by her family physician to an allergist for weekly allergy injections. The woman is confused as to why repeated exposure to substances that set off her allergies would ultimately benefit her. Which of the following phenomena best captures the rationale for allergy desensitization therapy?

A 44 yo female patient presents to the ED with abnormal bleeding and abd pain that is later attributed to gallbladder disease. Which of the following diagnoses would the medical team be most justified in suspecting as a caus of the patient’s bleeding?

A NP is teaching her colleagues about the role of cytokines in a variety of pathologies. Which of the following teaching points best captures an aspect of the functions and nature of cytokines?

A 24 yo woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates neutrophilia with a shift to the left. She most likely has:

A tourist presented to a primary care health clinic complaining of malaise, fever, and headache. She has been diagnosed with Rocky Mountain Spotted fever, a pathology caused by Rickettsiaceae. Which of the following statements best captures a characteristic trait of Rickettsiaceae?

A 22 yo female who adheres to a vegen diet has been diagnosed with iron-deficiency anemia. Which of the following componets of her diagnostic blood work would be most likely to necessitate further investigation?

Sputum samples from a pt with pneumonia contain an infective agent that has a peptidoglycan cell wall, expresses endotoxins, replicates readily in broth and on agar, grows in clusters, has pili, and does not stain when exposed to crystal violet. This pneumonia is most likely:

MN551 Quiz # 3 & 4

MN551 Quiz 3 and 4 Cardiovascular.

3 – structure and function of the cardiovascular system

4 – structure and function of the respiratory system

Question 1. The nurse practitioner for a cardiology practice is responsible for providing presurgical teaching for patients who are about to undergo a coronary artery bypass graft. Which of the following teaching points best conveys an aspect of the human circulatory system?

Question 2. Which of the short term and long term compensatory mechanisms is least likely to decrease the symptoms of his heart failure?

Question 3. A physical assessment of a 28-year-old female patientindicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which of the following possibilities would her care provider be most likely to suspect? (Points : 3)

Question 4. As part of the diagnostic workup for a male patient with a complex history of cardiovascular disease, the care team has identified the need for a record of the electrical activity of his heart, insight into the metabolism of his myocardium, and physical measurements, and imaging of his heart. Which of the following series of tests is most likely to provide the needed data for his diagnosis and care? (Points : 3)

Question 5. An older adult female patient has presented with a new onset of shortness of breath, and the patient’s nurse practitioner has ordered measurement of her BNP levels along with other diagnostic tests. What is the most accurate rationale for the nurse practitioner’s choice of blood work? (Points : 3)

Question 6. A patient in the intensive care unit has a blood pressure of 87/39and has warm, flushed skin accompanying his sudden decline in level of consciousness. The patient also has arterial and venous dilation and a decrease in systemic vascular resistance. What is this patient’s most likely diagnosis? (Points : 3)

Question 7. A number of patients have presented to the emergency department in the last 24 hourswith complaints that are preliminarily indicative of myocardial infarction. Which of the following patients is least likely to have an ST-segment myocardial infarction (STEMI)? (Points : 3)

Question 8. A 54-year-old man with a long-standing diagnosis of essential hypertension ismeeting with his nurse practitioner. The patient’s nurse practitioner would anticipate that which of the following phenomena is most likely occurring? (Points : 3)

Question 9. A 66-year-old obese manwith a diagnosis of ischemic heart disease has been diagnosed with heart failure that his care team has characterized as attributable to systolic dysfunction. Which of the following assessment findings is inconsistent with his diagnosis? (Points : 3)

Question 10.Which of the following assessment findings in a newly admitted 30-year-old male patient would be most likely to cause his nurse practitioner to suspect polyarteritis nodosa? (Points : 3)

Question 11. A 6-year-old boyhas been brought to the emergency department by ambulance after his mother discovered that his heart rate was “so fast I couldn’t even count it.” The child was determined to be in atrial flutter and his mother is seeking an explanation from the health care team. Which of the following points should underlie an explanation to the mother? (Points : 3)

Question 12. A patient has suffered damage to his pericardium following a motor vehicleaccident. Which of the following consequences should the nurse practitioner be most likely to rule out? (Points : 3)

Question 13. Which of the following situations related to the transition from fetal to perinatal circulationwould be most likely to necessitate medical intervention? (Points : 3)

Question 14. A 70-year-old malepatient presents to the emergency department complaining of pain in his calf that is exacerbated when he walks. His pedal and popliteal pulses are faintly palpable and his leg distal to the pain is noticeably reddened. What would his care provider’s preliminary diagnosis and anticipated treatment most likely be? (Points : 3)

Question 15. A patient is experiencing impaired circulation secondary to increased systemic arterial pressure.Which of the following statements is the most relevant phenomenon? (Points : 3)

Question 16. A nurse practitioner is providing care for several patients on a medical unit of a hospital. In which of the following patient situations would the nurse practitioner be most likely to rule out hypertension as a contributing factor? (Points : 3)

Question 17. A formerly normotensive woman, pregnant for the first time, develops hypertension and headaches at 26 weeks’ gestation. Her blood pressure is 154/110 mm Hgand she has proteinuria. What other labs should be ordered for her? (Points : 3)

Question 18. A nurse practitioner is instructing a group of older adults about the risks associated with high cholesterol.Which of the following teaching points should the participants try to integrate into their lifestyle after the teaching session?

Question 19. An autopsy is being performed on a 44-year-old femalewho died unexpectedly of heart failure. Which of the following components of the pathologist’s report is most suggestive of a possible history of poorly controlled blood pressure?

Question 20.A nurse practitioner has ordered the measurement of a cardiac patient’s electrolyte levels as part of the patient’s morning blood work. Which of the following statements best captures the importance of potassium in the normal electrical function of the patient’s heart? (Points : 3)

Question 21.In which of the following patient situations would a nurse practitioner be most justified in preliminarily ruling out pericarditis as a contributing pathology to the patient’s health problems?

Question 22. During a routine physical examination of a 66-year-old woman, her nurse practitioner notes a pulsating abdominal mass and refersthe woman for further treatment. The nurse practitioner is explaining the diagnosis to the patient, who is unfamiliar with aneurysms. Which of the following aspects of the pathophysiology of aneurysms would underlie the explanation the nurse provides?

Question 23. A 66-year-old patient’s echocardiogramreveals a hypertrophied left ventricle, normal chamber volume, and a normal ejection fraction from the heart. What is this patient’s most likely diagnosis?

Question 24.A nurse practitioner is teaching a student NP about the physiologic basis for damage to the circulatory and neurological systems that can accompany hypotension. Which of the following responses by the student would warrant correction by the nurse practitioner?

Question 25. An 81-year-old femalepatient of a long-term care facility has a history of congestive heart failure. The nurse practitioner caring for the patient has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the patient’s condition?

Question 26. A 22-year-old male is experiencing hypovolemicshock following a fight in which his carotid artery was cut with a broken bottle. What immediate treatments are likely to most benefit the man?

Question 27. A 68-year-old malecomplains to his NP when he tests his blood pressure using a machine at his pharmacy, his HR is always low. He feels his heart racing and it seems to pause at times. He is lightheadedness and a recent syncopal episode. What is the patient’s diagnosis and the phenomenon underlying it?

Question 28. A 77-year-old woman with a recent onset of syncopal episodeshas been referred to a cardiologist by her family physician. As a part of the patient’s diagnostic work-up, the nurse practitioner conducting the intake assessment has ordered a Holter monitor for 24 hours. Which of the following statements best captures an aspect of Holter monitor?

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MN551 Quiz 4

1. Which of the following patients who presented to a walk-in medical clinic is most likely to be diagnosed with a rhinosinusitis rather than a common cold? Fever and facial pain are more commonly associated with rhinosinusitis rather than the common cold. The other noted symptoms are indicative of the common cold rather than rhinosinusitis.

A man complaining of general fatigue, a headache, and facial pain with a temperature of 100.9° pg 929-930

A woman presenting with malaise, lethargy, and copious nasal secretions

A man with a dry, stuffy nasopharynx, a sore throat, and temperature of 98.9°F

A woman complaining of generalized aches who has a hoarse voice and reddened, painful upper airways

Question 2.2. A 44-year-old woman developed calf pain during a transatlantic flight followed by acute shortness of breath upon arrival at her destination. She was subsequently diagnosed with a pulmonary embolism (PE), which resolved with anticoagulant therapy. Which of these statements best characterizes the underlying problem of her PE? Ventilation was occurring, but perfusion was inadequate causing shortness of breath. Impaired blood flow to a portion of the lung, such as with a PE, is associated with ventilation without perfusion, rather than perfusion without ventilation. The situation is not related to an anatomic shunt or impaired diffusion across alveolar membranes.

She was short of breath because ventilation was occurring but perfusion was inadequate. Pg 984-985

The combination of normal perfusion but compromised ventilation caused hypoxia.

She developed a transient anatomic shunt resulting in impaired oxygenation.

Impaired gas diffusion across alveolar membranes resulted in dyspnea and hypoxia.

Question 3.3. A premature infant on mechanical ventilation has developed bronchopulmonary dysplasia (BPD) and is showing signs and symptoms of hypoxemia, low lung compliance, and respiratory distress syndrome (RDS). Which of the following is the most likely contributor to the infant’s present health problem? (Despite the administration of corticosteroids in utero to hasten alveolar maturation, premature infants suffering respiratory distress syndrome often must be treated with supplemental oxygen and mechanical ventilation. However, overly forceful positive-pressure ventilation (barotrauma) can lead to the chronic lung impairment of BPD. Surfactant therapy is a first-line defense against the development of RDS and is also used to treat cases of BPD; additional time on a ventilator is often required as well.

High inspired oxygen concentration and injury from positive-pressure ventilation. Pg 952

Failure to administer corticosteroids to the infant in utero

Insufficient surfactant production and insufficient surfactant therapy

Insufficient supplemental oxygen therapy

Question 4.4. Which of the following residents of a long-term care facility is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)? Productive cough and recurrent respiratory infections are associated with COPD, while pain, fever, and increased white cells are not common signs and symptoms of COPD. Acute shortness of breath and bronchoconstriction are associated with asthma.

A 79-year-old lifetime smoker who is complaining of shortness of breath and pain on deep inspiration

An 81-year-old smoker who has increased exercise intolerance, a fever, and increased white blood cells

An 81-year-old male who has a productive cough and recurrent respiratory infections. pg 975

An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke/

5.5. A 66-year-old male presents to the emergency department accompanied by his wife who claims that he has been acting confused. The man is complaining of a sudden onset of severe weakness and malaise and has a dry cough and diarrhea. His temperature is 102.8°F and his blood work indicates his sodium level is 126 mEq/L (normal is 135 to 145 mEq/L). What will be the assessing nurse practitioner’s most likely suspicion? Confusion, dry cough, diarrhea, and hyponatremia are associated with Legionnaire disease and less so with bronchopneumonia, Mycoplasma pneumonia, or pneumococcal pneumonia.

Bronchopneumonia

Mycoplasma pneumonia

Legionnaire disease Pg. 938

Pneumococcal pneumonia

Question 6.6. A 51-year-old female patient who is 2 days postoperative on a surgical unit of a hospital is at risk for developing atelectasis as a result of being largely immobile. Which of the following teaching points by her nurse practitioner is most appropriate? (Atelectasis is characterized by incomplete lung expansion and can often be prevented by deep breathing and coughing. Pleural effusion, not atelectasis, is associated with fluid accumulation between the lungs and their lining, and neither chest tube insertion nor bronchodilators are common treatments for atelectasis.

“Being in bed increases the risk of fluid accumulating between your lungs and their lining, so it’s important for you to change positions often.”

“You should breathe deeply and cough to help your lungs expand as much as possible while you’re in bed.”

“Make sure that you stay hydrated and walk as soon as possible to avoid our having to insert a chest tube.”

“I’ll prescribe bronchodilator medications that will help open up your airways and allow more oxygen in.”

Question 7.7. Due to complications, a male postoperative patient has been unable to mobilize for several days following surgery and has developed atelectasis. Which of the following processes would his care team anticipate with relation to his health problem? Regional hypoxia, such as with a diagnosis of atelectasis, is associated with vasoconstriction and redirection of blood away from, not toward, the affected area of the lung. This also contributes to an increased workload for the right side of the heart.

Vasodilation in the alveolar vessels in the affected region of his lung