Walden NUR6531 Final Exam 2018 (limited questions)

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1. A patient reports “something flew in my eye” about an hour ago while he was splitting logs. If there were a foreign body in his eye, the nurse practitioner would expect to find all except:

Answer: Purulent drainage

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• 2. A false-positive result with the fecal occult blood test can result from:

ingestion of large amounts of vitamin C

a high dietary intake of rare cooked beef

a colonic neoplasm that is not bleeding

stool that has been stored before testing

Answer: a high dietary intake of rare cooked beef

3. What condition is associated with mucus production greater than 3 months per year for at least 2 consecutive years?

Answer: Chronic bronchitis

4. A patient presents with classic symptoms of gastroesophageal reflux disease (GERD). He is instructed on life style modifications and drug therapy for 8 weeks. Three months later he returns, reporting that he was “fine” as long as he took the medication. The most appropriate next step is:

Referral for surgical intervention such as a partial or complete fundoplication

Dependent upon how sever the practitioner believes the condition

To repeat the 8 week course of drug therapy while continuing lifestyle modifications

Investigation with endoscopy, manometry, and/or pH testing

Answer: Investigation with endoscopy, manometry, and/or pH testing

5. When teaching a patient with hypertension about restricting sodium, you would include which of the following instructions?

A. Sodium restriction can cause serious adverse effects
B. Diets with markedly reduced intake of sodium may be associated with other beneficial effects beyond blood pressure control
C. 75% of sodium intake is derived from processed food
D. A goal of 3g of Na or 1.2g of sodium per day is easily achievable

Answer: 75% of sodium intake is derived from processed food

6. A 70 year old patient presents with a slightly raised, scaly, erythematous patch on her forehead. She admits to having been a “sun worshiper.” The nurse practitioner suspects actinic keratosis. This lesion is a precursor to:

Squamous cell carcinoma

Basal cell carcinoma

Malignant melanoma

Acne vulgaris

Answer:Squamous cell carcinoma

7. An AST that is more than twice the level of ALT is suggestive of:

Answer: alcoholic liver disease

8. Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect?

A. Lymphocytoma cutis
B. Relapsing polychondritis
C. Systemic lupus erythematosus
D. An allergic reaction

Answer: Systemic lupus erythematosus

9. Which of the following is not a risk factor for coronary arterial insufficiency?

a. Hyperhomocysteinemia.

b. Smoking.

c. Genetic factors.

d. Alcohol ingestion.

Answer: Hyperhomocysteinemia.

10. The National Cholesterol Education Program’s Adult Treatment Panel III recommends that the goal for low density lipoproteins in high risk patients be less than:

Answer: The LDL-C treatment goal for patients in this high-risk category is <100 mg/dL.

11. A 70 year old patient presents with left lower quadrant (LLQ) abdominal pain, a markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition?





Answer: Diverticulitis

12. Your 31-year-old patient, whose varicella rash just erupted yesterday, asks you when she can go back to work. What do you tell her?

a.Once all the vesicles are crusted over

b.When the rash is entirely gone

c.Once you have been on medication for at least 48hours

d.Now, as long as you stay away from children andpregnant women

Answer: Once all the vesicles are crusted over

13. The most appropriate treatment for a child with mild croup is:

Answer: using mist from a humidifier or by sitting with the child in a bathroom filled with steam generated by running hot water from the shower

14. Which of the following is a secondary cause of hyperlipidemia?

Answer: unhealthy lifestyle factors

15. A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed?


16. Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by:

Answer: Candidiasis.

17. Group A ?-hemolytic streptococcal (GABHS) pharyngitis is most common in which age group?

Answer: 5 through 15 years of age

18. A patient presents to the office with a blood pressure 142/80. This patient is classified as having:

A. Normal bloodpressure

B. Prehypertension

C. Stage 1hypertension

D. Stage 2hypertension

Answer: Stage 1hypertension

19. Treatment of H.pylori includes which of the following

Answer: at least two different antibiotics at once. This helps prevent the bacteria from developing a resistance to one particular antibiotic. Treatment may also include medications to help your stomach heal, including: Proton pump inhibitors (PPIs).

20. A very active elderly patient has a documented diagnosis of arteriosclerosis obliterans. Common expected lower extremity physical exam findings include:


21. Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?





Answer: Antihistimines

22. Mort is hypertensive. Which of the following factors influenced your choice of using an alpha blocker as the antihypertensive medication?

A. Mort is African American
B. Mort also has congestive heart failure
C. Mort has benign prostatic hypertrophy
D. Mort has frequent migraine headaches.

Answer: Mort has benign prostatic hypertrophy

23. Which statement below is correct about pertussis?


24. A middle-aged male presents to urgent care complaining of fever, dysphagia, and shortness of breath. The nurse practitioner notes the patient leaning forward in a tripod position and drooling. The clinical presentation of this patient suggests:

Answer: Epiglottitis

25. A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is:

Answer: gallstones.

26. Which of the following is not a symptom of irritable bowel syndrome?


27. John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia?

Every 5 years

Every 2 years

Every year
Whenever blood work is done

Answer: Every 5 years

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

Answer: the physician must be on-site and engaged in client care.

29. A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe?

Answer: Ibuprofen

30. An employee picnic menu includes grilled hamburgers, potato salad, and homemade ice cream sundaes. Within an hour after the meal, several children and parents begin to have nausea, vomiting and stomach cramps. None of those affected have fever. What is the most likely etiologic agent?

Answer: Bacteria

31. A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with:

Mitral regurgitation

Systolic heart failure

Cardiac myxoma

Diastolic heart failure

Answer: Systolic heart failure

32. Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized?

A. Inability to take oral medications and multilobar involvement on chest x-ray
B. Alert and oriented status, slightly high but stable vital signs, and no one to take care of him at home
C. Sputum with gram-positive organisms
D. A complete blood count (CBC) showing leukocytosis

Answer: A. Inability to take oral medications and multilobar involvement on chest x-ray

33. A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory?’

Inferior wall

Anterior wall

Apical wall

Lateral wall

Answer: Inferior wall

34. Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in?

Mild intermittent

Mild persistent

Moderate persistent

Answer: Moderate persistent

35. Which of the following are classic features of ulcerative colitis?

Right lower quadrant pain. frequently accompagnied by a palpable mass, fever, and leukocytosis.

Painful hematemesis, occasionally accompagnied by melena.

Rapidly progressive dysphagia with ingestion of solid foods, anorexia, and weight loss out of proportion to the dysphasia.

Remissions and exacerbations of bloody diarrhea, tenesmus, fecal incontinence, abdominal pain and weight loss.

Answer: Remissions and exacerbations of bloody diarrhea, tenesmus, fecal incontinence, abdominal pain and weight loss.

Related answered questions on MODULE 1 Quiz Question 1 The ‘Woman of Willendorf’

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