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A nurse practitioner diagnoses

FINAL EXAM

Question 1

When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

Question 2

Your patient has an elevated mean cell volume (MCV). What should you be considering in terms of diagnosis?

Question 3

A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as:

Question 4

The most effective intervention(s) to prevent stroke is (are):

Question 5

Which of the following physical modalities recommended for treatment of rheumatoid arthritis provides the most effective long term pain relief?

Question 6

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?

Question 7

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:

Question 8

Prolonged PT suggests:

Question 9

Diagnostic radiological studies are indicated for low back pain:

Question 10

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:

Question 11

Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus?

Question 12

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?

Question 13

A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the following symptoms would lead you to look for another diagnosis?

Question 14

Which of the following statements about multiple sclerosis (MS) is correct?

Question 15

Which patient would benefit most from screening for type 2 diabetes?

Question 16

Differential diagnosis of proteinuria includes which of the following?

Question 17

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:

Question 18

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:

Question 19

What intervention does the American College of Rheumatology recommend as first line therapy for osteoarthritis?

Question 20

The cardinal sign of infectious arthritis is:

Question 21

Legal authority for advanced practice nursing rests with:

Question 22

The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is:

Question 23

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?

Question 24

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?

Question 25

Risk factors for prostate cancer include all of the following except:

Question 26

An obese hyperlipidemic patient, newly diagnosed with type 2 diabetes mellitus, has fasting glucose values 180 to 250 mg/Dl. What is the most appropriate initial treatment to consider?

Question 27

The primary goals of treatment for patients with alcohol abuse disorder are:

Question 28

What is the most commonly abused substance?

Question 29

Central obesity, “moon” face, and dorsocervical fat pad are associated with:

Question 30

Reed-Sternberg B lymphocytes are associated with which of the following disorders:

Question 31

Deficiency of which nutritional source usually presents with an insidious onset of paresthesias of the hands and feet that are usually painful?

Question 32

The most commonly recommended method for prostate cancer screening in a 55 year old male is:

Question 33

What is the most common cause of Cushing’s syndrome?

Question 34

Urine cultures should be obtained for which of the following patients?

Question 35

The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is:

Question 36

The 4 classic features of Parkinson’s disease are:

Question 37

The correct treatment for ankle sprain during the first 48 hours after injury includes:

Question 38

Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect?

Question 39

The nurse practitioner is following a child with juvenile rheumatoid arthritis (JRA) who has been previously diagnosed and is being managed for the disease by a pediatric rheumatologist. The mother asks for information about the child’s long term prognosis. What is the most appropriate reply?

Question 40

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?

Question 41

The initial clinical sign of Dupuytren’s contracture is:

Question 42

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?

Question 43

In which of the following presentations is further diagnostic testing not warranted?

Question 44

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:

Question 45

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?

Question 46

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?

Question 47

The intervention known to be most effective in the treatment of severe depression, with or without psychosis, is:

Question 48

Establishment of a definitive diagnosis of osteomyelitis requires:

Question 49

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?

Question 50

Successful management of a patient with attention deficit hyperactivity disorder (ADHD) may be achieved with:

Question 51

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:

Question 52

Diagnostic confirmation of acute leukemia is based on:

Question 53

What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?

Question 54

Potential causes of septic arthritis include which of the following?

Question 55

What diabetic complications result from hyperglycemia?

Retinopathy

Hypertension resistant to treatment

Peripheral neuropathy

Accelerated atherogenesis

Question 56

A patient taking levothyroxine is being over-replaced. What condition is he at risk for?

Question 57

Which of the following patients most warrants screening for hypothyroidism?

Question 58

You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of:

Question 59

A typical description of a tension headache is:

Question 60

What is the first symptom seen in the majority of patients with Parkinson’s disease?

Question 61

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:

Question 62

The most effective treatment of non-infectious bursitis includes:

Question 63

Which of the following medications increase the risk for metabolic syndrome?

Question 64

Which history is commonly found in a patient with glomerulonephritis?

Question 65

Warfarin (Coumadin) is prescribed for a frail, elderly male with new onset atrial fibrillation. The goal INR for this patient should be:

Question 66

Other than smoking cessation, which of the following slows the progression of COPD in smokers?

Question 67

The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in almost 100% of patients is:

Question 68

The organism most often associated with prostatitis is:

Question 69

Potential causes of hypocalcemia include which of the following?

Question 70

A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder?

Question 71

The most common cause of elevated liver function tests is:

Question 72

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:

Question 73

Which is the most common cause of end-stage renal disease in the United States?

Question 74

A diabetic patient is taking low-dose enalapril for hypertension. A record of the patient’s blood pressure over 4 weeks ranges from 130 to 142 mmHg systolic and 75 to 85 mmHg diastolic. How should the nurse practitioner respond?

Question 75

A patient has just been diagnosed with Bell’s palsy. He is understandably upset and has questions about the prognosis. You response should be:

Question 76

Major depression occurs most often in which of the following conditions?

Question 77

At what age is screening most likely to detect scoliosis?

Question 78

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?

Question 79

Sam, age 67, is a diabetic with worsening renal function. He has frequent hypoglycemic episodes, which he believes means that his diabetes is getting “better.” How do you respond?

Question 80

Which of the following set of symptoms should raise suspicion of a brain tumor?

Question 81

What is the first step in the treatment of uric acid kidney stones?

Question 82

A 35 year old male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency, and reduced force of stream. The nurse practitioner suspects acute bacterial prostatitis. Which of the following specimens would be least helpful for diagnosis?

Question 83

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?

Question 84

How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout?

Question 85

The most reliable diagnostic indicator of gout is:

Question 86

What information should patients with diabetes and their families receive about hypoglycemia?

Question 87

Martin, a 58 year old male with diabetes, is at your office for his diabetes follow up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Martin receive today regarding the care if his feet?

Question 88

Microalbuminuria is a measure of:

Question 89

Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to:

Question 90

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?

Question 91

The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy:

Question 92

Which factors are associated with high risk for foot complications in a patient with diabetes mellitus?

Obesity

Abnormal nails

Abnormal gait

Poorly controlled lipids

Question 93

After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been cured?

Question 94

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?

Question 95

A patient has been diagnosed with hypothyroidism and thyroid hormone replacement therapy is prescribed. How long should the nurse practitioner wait before checking the patient’s TSH?

Question 96

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:

Question 97

A 25 year old overweight patient presents with a complaint of dull achiness in his groin 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?

Question 98

Which of the following is the most common cause of low back pain?

Question 99

A nurse practitioner diagnoses a 60 year old male with balanitis. Which disease is commonly associated with balanitis?

Question 100

Which of the following characteristics are associated with prepatellar bursitis?

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