Midterm NRSG Care of the older adult

Question 1

Determine the best description of tachycardia.

Regular heart rate is below 50.

Regular heart rate is over 100.

It is common in athletes.

It is an abnormal response to stress.

Answer 1

Regular heart rate is over 100.

Question 2

A 40-year-old- patient presents to the clinic with complaints of cough, difficulty breathing, chest discomfort and cyanosis. The patient has a 10-year history of working at an asbestos plant. Diagnostic testing reveals inflammation of the lining of the lungs. Determine with which this is consistent.

Tuberculosis

Asthma

Plueresy

Pneumonia

Answer 2

Plueresy

Question 3

The nurse practitioner is assessing a rash in a 25-year-old patient. Identify an example of a primary skin infection.

Fissure

Lichenification

Excoriation

Wheal

Answer 3

Wheal

Question 4

Determine what is included in treatment for a patient presenting with a diagnosis of pleurisy.

Antibiotics for viral infection

Chemotherapy for tuberculosis

Bacterial infections resolve spontaneously

Treatment based on the cause of the inflammation

Answer 4

Treatment based on the cause of the inflammation

Question 5

The nurse practitioner educated the community on the risk of skin cancer. Identify the type of skin cancer on which sunscreen has minimal effect of reducing the risk.

All forms of cancer.

Malignant melanoma

Squamous cell carcinoma.

Basal cell carcinoma.

Correct answer

Answer 5

Malignant melanoma

Question 6

A patient presents to the emergency room with clinical symptoms of a stroke. Identify the clinical exam finding that should not be included for this patient.

Bilateral weakness

Difficulty with ambulation

Unilateral motor dysfunction

Slurred speech

Answer 6

Bilateral weakness

Question 7

A 45-year-old female presented to the clinic 3 days after noticing a bug bite on her right lower leg. Patient examination reflected a warn, red, edematous area, with sharply demarcated borders. The patient denies a history of fever or any other complaints. Predict the likely cause.

An allergic reaction

Contact dermatitis

Herpes zoster

Cellulitis

Answer 7

Cellulitis

Question 8

An 18-year-old patient was recently diagnosed with epilepsy. Patient education is essential. Determine the accurate statements.

“I was told that I am safe to take baths.”

“I will not be able to go to college.”

“I am still able to drive.”

”I should avoid swimming alone.”

Answer 8

”I should avoid swimming alone.”

Question 9

A 25-year-old-patient presents to the clinic with a bump on her left eyelid. Examination revealed a 2 mm, hard, nontender inflammation of the glandular tissue of the upper eyelid. Recommend a diagnosis for this patient.

Chalazion

Hordeolum

Blepharitis

Cellulitis

Answer 9

Chalazion

Question 10

The nurse practitioner is educating a group of students regarding chronic obstructive lung disease (COPD). Identify the leading cause of COPD.

Smoking

Environmental pollution

Work environment

Genetics

Answer 10

Smoking

Question 11

You are evaluating a patient who has rheumatic heart disease. When assessing for mitral stenosis, predict the finding.

Patient presents with the classic triad of angina, syncope and dyspnea.

A leakage of the aortic valve.

Increased left atrial pressure resulting pulmonary hypertension.

Patient presents with a harsh systolic murmur.

Answer 11

Increased left atrial pressure resulting pulmonary hypertension.

Question 12

An 80-year-old man presents to the clinic with a history of difficulty swallowing and choking. Determine what is not a common reason for oropharyngeal dysphagia.

Scleroderma

Neurological disorders

Spinal cord injury

Zenker’s diverticulum

Answer 12

Scleroderma

Question 13

A 22 year old female presents to the office complaining of intermittent chest palpitations with concurrent dizziness. The NP diagnoses her with mitral valve prolapse (MVP). Her echocardiogram reveals thickened redundant leaflets. The NP is able to identify a grade III/VI systolic murmur with ejection click. Which of the following is true in relation to this conditions:

Endocarditis prophylaxis is warranted for some dental, urologic and gastrointestinal invasive procedures.

Warfarin sodium (Coumadin) therapy is always indicated.

Endocarditis prophylaxis is only warranted for dental procedures

No endocarditis prophylaxis is warranted for any procedures

Answer 13

No endocarditis prophylaxis is warranted for any procedures

Question 14

A patient presents to the clinic with a burn on their right leg. Determine the accurate statement about minor burns.

Clean area with soap and water.

Minor burns are painless, and do not require tetanus prophylaxis.

Infection is uncommon in minor burns.

Minor burns involving less than 15% of total body surface must be referred to specialist.

Answer 14

Clean area with soap and water.

Question 15

Identify the patient who should not be treated with enoxaparin.

A patient with chest pain and ST elevation.

A patient presenting with left leg pain, warmth and swelling.

A patient with a myocardial infarction.

A patient with hemophilia.

Answer 15

A patient with hemophilia.

Question 16

A 60-year-old patient presents to the clinic with complaints of chest pain. Recommend a test that would be completed on initial examination of this patient.

Electrocardiogram

Chest X-Ray

Laboratory values for Cardiac T

CT scan

Answer 16

Electrocardiogram

Question 17

A 45-year-old patient presents to the clinic with a 2-week history of headaches that last minutes to hours. Other symptoms include pain in or around the eye. Determine the disorder with which these symptoms are consistent.

Cluster headache

Sinus headache

Migraine headache

Tension headache

Answer 17

Cluster headache

Question 18

Identify the disorder that is considered the leading cause of mortality worldwide.

Diabetes

Heart disease

Breast cancer

Unintentional injuries

Answer 18

Heart disease

Question 19

A 20-year-old presents to the clinic with complaints of bilateral, itchy, red eyes with rope-like eye discharge and clear nasal drainage. The problem has been intermittent for approximately 1 year. Determine with what these symptoms are most consistent.

Allergic conjunctivitis

Mechanical injury

Viral conjunctivitis

Bacterial conjunctivitis

Answer 19

Allergic conjunctivitis

Question 20

Identify the disorder that is an acute viral illness caused by the Epstein-Barr virus.

Infectious mononucleosis

Bacterial pharyngitis

Peritonsillar abscess

Epiglottitis

Answer 20

Infectious mononucleosis

Question 21

A 45-year-old patient has been diagnosed with acute bronchitis. Determine the statement that indicates a need for more education.

“There are no antivirals to treat bronchitis.”

“Which antibiotics will you be prescribing me.”

“Acute bronchitis is common in patients my age.”

“The majority of cases heal without medical treatment.”

Answer 21

“Which antibiotics will you be prescribing me.”

Question 22

dentify what is not considered a risk factor for the development of infection reactivation in patients with latent tuberculosis.

Immunocompromised

Diabetes mellitus

Male gender

Long-term corticosteroid use

Answer 22

Male gender

Question 23

Myocarditis is a difficult condition to diagnose. Determine what the gold standard for diagnosing suspected myocarditis includes.

Endomyocardial biopsy

Echocardiogram

Laboratory evaluation

CT scan

Answer 23

Endomyocardial biopsy

Question 24

A patient is discussing strokes and risk factors with her nurse practitioner. Identify the statement that reflects a need for further education.

Stroke is the leading cause of long-term disability.

Caucasian women carry the highest risk and prevalence of stroke.

Strokes are more common in men than women.

Stroke is the fifth leading cause of death in men.

Answer 24

Caucasian women carry the highest risk and prevalence of stroke.

Question 25

The provider examines a 72-year-old woman with a history of heart failure. Determine the accurate statement when evaluating a patient presenting with heart failure.

Manifestations of heart failure include thrombosis, pain, and arterial ulcers.

Heart failure is the primary cause of occlusion of the coronary arteries.

Heart failure occurs because of altered cardiac function that leads to inadequate cardiac output.

Diagnostic testing for heart failure includes obtaining and ECG, laboratory data and the ankle-brachial index.

Answer 25

Heart failure occurs because of altered cardiac function that leads to inadequate cardiac output.

Question 26

Which of the following heart sounds are associated with heart failure?

S3

Still’s murmur and S4

S1, S2, and S4

S1,S2, and S3

Answer 26

S3

Question 27

A 30-year-old patient is diagnosed with viral pharyngitis. Determine the false statement regarding this patient.

Symptoms include sore throat, fever and malaise.

Antimicrobial therapy is recommended.

The treatment strategy includes symptom management.

A throat culture is commonly used to diagnose pharyngitis.

Answer 27

Antimicrobial therapy is recommended.

Question 28

A 55-year-old patient was recently diagnosed with generalized anxiety disorder (GAD). Identify the statement that reflects the patient has an understanding of this disorder.

“Patient presenting with GAD must be diagnosed by aged 25.”

“Most patients with GAD do not have an increased risk for addiction.”

“This explains why I constantly worry almost every day of the week.”

“Patients with GAD present to the clinic with specific symptoms, diagnosis is clear.”

Answer 28

“This explains why I constantly worry almost every day of the week.”

Question 29

A 65-year-old patient is being evaluated for pneumonia. Propose what confirms the diagnosis.

Chest X-Ray

Sputum gram stain

Bronchoalveolar lavage

Sputum culture

Answer 29

Chest X-Ray

Question 30

Which of the following described how to elicit Murphy’s sign?

on deep inspiration by the patient, firmly palpate the right upper quadrant of the abdomen below the costovertebral angle

Press deeply into the abdomen and then release

Bend patient’s hip and knee to a 90 degree angle then rotate hip externally and then internally

With the stethoscope on the apical area, auscultate while the patient squats

Answer 30

on deep inspiration by the patient, firmly palpate the right upper quadrant of the abdomen below the costovertebral angle

Question 31

Identify the elderly patient who is at risk for being diagnosed with depression.

A 90-year-old patient without insomnia.

An 82-year-old couple who have been married for 5 years.

An 80-year-old patient living with family members.

A 75-year-old female.

Answer 31

A 75-year-old female.

Question 32

All of the following are false statements regarding acute gastritis except:

the screen test for the disorder is the barium swallow test

chronic intake of nonsteroidal analgesics (NSAIDs) can cause the disorder

chronic lack of dietary fiber is the main cause of the disorder

the gold standard test to evaluate is the colonoscopy

Answer 32

chronic intake of nonsteroidal analgesics (NSAIDs) can cause the disorder

Question 33

Determine the finding that is most consistent with a diagnosis of microcephaly.

The head circumference is less than two standard deviations for the age.

The head circumference is greater than two standard deviations.

Many patients with microcephaly have average intellectual capabilities.

Craniosynostosis is an associated condition that is typically treated with physical therapy.

Answer 33

The head circumference is less than two standard deviations for the age.

Question 34

The nurse practitioner is discussing seizure disorders with a 16-year-old who had been recently diagnosed. Determine the accurate statement regarding seizures.

Status epilepticus is a seizure lasting longer than 10 minutes.

Absence seizures often occur in adults and are characterized by stiffening of muscles.

General seizures originate from activity within 1 region of the brain.

The most common cause of seizures is epilepsy.

Answer 34

The most common cause of seizures is epilepsy.

Question 35

The nurse practitioner is speaking with a patient regarding acute and chronic wounds. Determine the inaccurate example of acute injuries.

Diabetic foot ulcers.

Crush injuries.

Surgical wounds.

Skin tears.

Answer 35

Diabetic foot ulcers.

Question 36

The health care provider is completing an abdominal assessment on a 75-year-old-patient. Determine what is not included in clinical presentation of a patient presenting with jaundice.

Ascending cholangitis

Rebound tenderness

Pale stool and dark urine

Altered cognition

Answer 36

Rebound tenderness

Question 37

A patient with an asymptomatic abdominal aortic aneurysm measuring 3.5cm is being evaluated for treatment. Determine what is not included in management.

Surgical intervention.

Smoking cessation.

Exercise program to manage obesity.

Monitor with ultrasound surveillance.

Answer 37

Surgical intervention.

Question 38

Determine what the management for a patient presenting with mild aortic stenosis includes.

Use of Warfarin.

Use of balloon catheter to separate fused valve leaflet.

Ongoing monitoring with echocardiogram.

Aortic valve replacement.

Answer 38

Ongoing monitoring with echocardiogram.

Question 39

The nurse is discussing pneumonia with a patient who was recently diagnosed with this disorder. Identify what is considered the most frequent symptom of respiratory disease.

Cough

Fever

Postnasal drip

Dyspnea

Answer 39

Cough

Question 40

The nurse practitioner is evaluating a 68-year-old patient on alcohol consumption. Identify the patient who should receive further evaluation.

A 60-year-old patient who consumes more than 1-2 drinks per day.

A 65-year-old woman who consumes more than 7 standard drinks per week on average.

A 45-year-old male who consumes more than 8 drinks per week on average.

Anyone who drinks more than 1-2 drinks per day.

Answer 40

A 65-year-old woman who consumes more than 7 standard drinks per week on average.

Question 41

A 32-year-old woman has a 6-week history of throat pain and difficulty swallowing. The provider also notes unilateral facial and neck swelling. Identify the disorder for which these symptoms are considered red flags.

Gastroesophageal reflux disease

Tonsillar lymphoepithelioma

Pharyngitis

Throat cancer

Answer 41

Pharyngitis

Question 42

Determine the true statement regarding Meniere’s disease.

High frequency hearing loss is common.

Tragal tenderness is noted on examination.

Tinnitus is rarely reported.

It is characterized by vertigo and hearing loss.

Answer 42

It is characterized by vertigo and hearing loss.

Question 43

The nurse practitioner is educating a group of students on the risk factors associated with colon cancer. Determine what does not increase the risk of developing colorectal cancer.

Long-term aspirin therapy

History of polyps

History of diabetes

Family history of colorectal cancer

Answer 43

Long-term aspirin therapy

Question 44

The nurse practitioner is discussing nicotine replacement therapy with a patient. Determine what is not included in nicotine therapy.

Nicotine gum

Nicotine nasal spray

Transdermal nicotine patch

Nicotine sublingual pill

Answer 44

Nicotine sublingual pill

Question 45

The nurse practitioner is educating a group of nursing students on primary and secondary skin lesions. Determine the true statement regarding skin lesions.

Pustules are collection of fluid within the dermal layer of the skin that forms an edematous plaque.

Plaques are localized changes in the skin color that is flat and non-palpable.

A common example of a macule includes tinea versicolor.

A bullae is a vesicle that is more than 5mm in diameter.

Answer 45

A bullae is a vesicle that is more than 5mm in diameter.

Question 46

A 67-year-old patient with a history of chronic obstructive pulmonary disorder presents to the clinic for a well examination. Advise this patient about immunizations.

Receive the inactivated influenza virus vaccine.

Avoid immunization against the flu due to associated risk.

Take an antiviral for the influenza season.

Receive live attenuated influenza virus vaccine.

Answer 46

Receive live attenuated influenza virus vaccine.

Question 47

Determine the identify of a gallstone that is not visualized on a standard x-ray.

Hepatitis C

Barium swallow

Intraanal corticosteroids

Chronic alcohol use

Answer 47

Intraanal corticosteroids

Question 48

Which of the following pharmacologic agents is used to treat nicotine dependence:

bupropion (Zyban)

Sertraline (Zoloft)

Multivitamins

Diazepam (Valium)

Answer 48

bupropion (Zyban)

Question 49

A 25-year-old patient presents to the clinic with complaints of right sided ear pain that has been ongoing for 3 days. Identify a common bacterium causing otitis media.

Streptococcus pneumoniae

E. coli

Pseudomonas aeruginosa

Moxerella catarrhalis

Answer 49

Streptococcus pneumoniae