NRNP6540 Final Exam Latest 2021

A 77 year old female  presents with twitching and burning sensations in her right leg that cause difficulty in walking.  She has a 10 year history of diabetes and osteoporosis.  What initial treatment should the NP consider?

                                Physical therapy

                                Occupational therapy

                                Nerve block

                                Gabapentin

Max is a 55-year-old male who is being treated for cirrhosis of the liver. Which of the following does the nurse practitioner include in his discharge teaching?

Avoid alcohol and over the counter medications

Eat 3 large meals with  4 to 5 mg protein/kg body weight per day              

Increase your intake of vitamin A to 1.5 the normal daily recommended intake

Herbal preparations are safe since they don't affect the liver.

A 66 year old patient with rheumatoid arthritis is seeking medication for pain control and that will alter the course of the disease.  What medication should the NP order?

                                Corticosteroids

                                NSAIDS

                                Acetaminophen

                                Biological disease-modifying antirheumatic drugs (DMARDs)

Mr. Epstein developed a sudden onset of severe headache, weakness on one side of his body, difficulty speaking, and loss of balance. He was immediately admitted to the hospital with the diagnosis of hemorrhagic stroke. Which of the following is the manifestation of a hemorrhagic stroke?

                1.            Leak or rupture in an artery wall.

                2.            Leak or rupture in a venous wall.

                3.            Blockage in the heart.

                4.            Blockage of an artery.

Steve came in for an office visit presenting complaints of difficulty speaking, gait problems, and dizziness. Which of the following should be noted as additional signs and symptoms in the focused interview?

                                Paresthesias, weight gain, tobacco use

                                Weight gain, tobacco use, loss of conciousness

                                Tobacco use, loss of consciousness, paresthesias

                                Loss of consciousness, parasthesias, pertinent family history

A 67 year old male presents to the clinic with complaints of painful urination.   He states that his brother was just diagnosed with kidney cancer and is worried that he has cancer too.  Which of the following diagnostic tests should the NP order?

                1.            CT scan of the abdomen and pelvis

                2.            IV pyelogram

                3.            Urinalysis and cytology

                4.            Ultrasound

Which of the following statements is true for untreated symptomatic cystitis?

                1.            Untreated symptomatic cystitis can lead to pneumonia.

                2.            Untreated symptomatic cystitis can resolve on its own.

                3.            Untreated symptomatic cystitis can lead to pyelonephritis, sepsis, shock, and death.

                4.            Untreated symptomatic cystitis can lead to prostatitis, vaginitis, and sepsis.

A 77 year old female is seen in the emergency department with complaints of a low grade fever and left lower quadrant pain aggravated by movement.   The pain occurs right after eating and is described as a colicky pain.   What initial diagnostic tests should the NP order?

                                CBC. Liver function tests,, CT Scan of the abdomen

                                CBC, Chem-12, Abdominal Xray

                                CBC, AST, ALT, Colonoscopy

                                CBC, urinalysis, barium enema

Which of the following medical providers is responsible for the early components of diagnostic work-up?

                1.            Primary care provider (PCP)

                2.            Anesthesiologist

                3.            Surgeon

                4.            Pulmonologist

Mr. King a 57-year-old male, is being seen in the clinic for complaints of pain in his thigh. There is swelling in the soft tissue, dislocation, altered ROM, bruising, local tenderness, and pain with any motion. The nurse practitioner suspects which of the following?

                                ACL tear

                                achilles rupture

                                femoral neck fracture

                                pelvic fracture

Factors that contribute to the development of iron deficiency anemia include inadequate iron intake, peptic ulcer disease, and malabsorption syndrome.

  True

  False

Maria is a 58-year-old woman experiencing itching, discomfort, and bleeding after intercourse. Which of the following conditions may be developing in the patient?

                1.            Atrophic vaginitis

                2.            Vaginal cancer

                3.            Fibroadenoma

                4.            Cystitis

According to studies, Restless Leg Syndrome (RLS) is a condition for which there is no cure. Which of the following are recommended for the management of RLS symptoms?

                                Melatonin before bed

                                Massage and exercise

                                Physical therapy

                                Vasodilators

Physiological changes of aging and multiple comorbidities influence the dying process. The growing acceptance of hospice and palliative care is creating a more natural dying experience. Which of the following is true regarding the process of death?

                1.            Urinalysis is usually performed as a diagnostic test for further infection.

                2.            Age has no bearing on the risk of death.

                3.            The meaning and experience of death are often influenced by society.

                4.            The meaning and experience of death are often influenced by one’s culture and ethnicity.

Some common medications, including Metformin, can interfere with the absorption of vitamin B12

  True

  False

Question 16

Chronic inflammation and smoking are are contributing factors to the development of Acute Lymphocytic Leukemia

  True

  False

Mr.Zieglar is irritated with his daughter for insisting that he eat more food. He says that he is not hungry and wants to be left alone. The nurse practitioner recommends which of the following?

                                Placing a percutaneous endoscopic gastrostomy (PEG) tube until he eats orally

                                Providing appropriate food that he prefers

                                Providing nutritional supplements until he begins to eat again

                                All of the above

 

Mrs. Smith is 90 years old and a frail, older woman with functional limitations, cognitive impairment, and lack of family or social support. Which type of care is best for the patient?

                1.            Hospice care

                2.            Palliative care

                3.            Skilled nursing care

                4.            Physical therapy care

The treatment of acute lymphoblastic leukemia (ALL) consists of the control of bone marrow and systemic disease. Which of the following therapies eliminates any leukemic cells that may remain?

                1.            Consolidation therapy

                2.            Maintenance therapy

                3.            Induction remission

                4.            Central nervous system (CNS) prophylaxis

Question 20

The nurse practitioner discusses vitamin and mineral supplementation with Ed, who is 75 years old. Ed wants to know why he should take calcium because he understands that calcium is for women. The nurse practitioner responds:

                1.            As one gets older, albumin can decrease, and calcium is bound to albumin.

                2.            Dietary patterns may result in low nutrient intake.

                3.            An increase in lactose intolerance that comes with aging decreases the amount of calcium absorbed by the body.

                4.            Aging aids the absorption of nutrients from the intestine.

G

 

A 54 year old women with atrophic vaginitis should be encouraged to use over the counter medications for pain and petroleum based lubricants to facilitate sexual activity.

  True

  False

Pain is a common end-of-life symptom in the older adult.

  True

  False

Question 23

Which of the following is a neurological disorder characterized by leg cramping, pulling, and tugging sensations, and may have a genetic component?

                1.            Radiculopathy

                2.            Nerve compression

                3.            Restless legs syndrome (RLS)

                4.            Sleep impairment

Mrs. Morgan is an 70-year-old female who comes to the emergency department with complaints of  pain in her lower leg that is aggravated by movement. Which early treatment does the nurse practitioner implement?

                                Rest, ice application to affected area,  elevation of the leg

                                Heat application to the affected area, opioid medication, compression dressing

                                Opioid medication, compression dressing, ice application to the affected area

                                Physical therapy, compression dressing, heat to the affected area

The nurse practitioner is working in a clinic dedicated to patients over age 65 years. The nurse practitioner observes several common characteristics in the posture of elderly patients. Which of the following is common?

                1.            Increase in the length of the trunk in relationship to the upper extremities.

                2.            Head tips backward.

                3.            Disappearance of bony prominences.

                4.            Increase in the range of motion (ROM).

Mrs. Foster reports the presence of pain in her lower and upper back. The nurse practitioner responds by doing which of the following?

                1.            Determining where the pain is coming from.

                2.            Ignoring any history of injury.

                3.            Ruling out the presence of anything inflammatory.

                4.            Determining that this pain does not affect activities of daily living (ADLs), as the patient came in independently.

Mrs. Cassidy is a 76-year-old woman who comes to see her nurse practitioner for pain in her right thigh. The nurse practitioner assesses that Mrs. Smith has bruises on her thigh and muscle weakness distally, near the knee. The nurse practitioner suspects which of the following?

                1.            Musculoskeletal lesions

                2.            Tendon rupture

                3.            Gout

                4.            Arthritis

Lucy is 65 years old and has  irritable bowel syndrome-diarrhea (IBS-D) for over 10 years. She has tried various treatments with minimal effectiveness. What interventions could the nurse practitioner suggest to help control the diarrhea?

                                Antispasmodics and antidiarrheal medications

                                Caffeinated beverages and antispasmodics

                                Antidiarrheals and eluxadoline

                                Eluxadoline  and  Rifaximin

Tanya came in for an office visit due to recurrent epistaxis. She also has a diagnosis of systemic lupus erythematosus. CBC with peripheral blood smear was performed and confirmed that she has idiopathic thrombocytopenic purpura (ITP). Which of the following is true relating to the condition of ITP?

                                Patients 65 years or older have a higher risk of bleeding and mortality.

                                ITP etiology is known.

                                ITP affects men more than women

                                ITP is more common in children.

Neurological assessment of the older adult requires specific tools and considerations to assess patient mental status. Which of the following should be used to assess patient cognition?

                1.            Administer SLUMS, a short dementia assessment.

                2.            Administer MoCA v 7.1, a 12-item assessment to detect mild neurocognitive disorders.

                3.            Administer testing of cranial nerve III.

                4.            Administer Mini-Cog, a three-word recall with clock drawing capability.

According to studies, which of the following is true regarding cerebrovascular disease?

                1.            The earliest symptom of cerebrovascular disease is seizures

                2.            Cerebrovascular disease is not a risk factor for seizures

                3.            Twenty to fifty percent of patients with a history of stroke with develop seizures

                4.            Transient ischemic attacks have a relatively high incidence of seizures.

Symptoms of Acute Lymphocytic Leukemia can include joint pain, enlarged lymph nodes, and abdominal swelling

  True

  False