NURS 6560 Exit Exam (Test Bank solution) | NURS6560 exit exam (Fall2020)

NURS 6560 Exit Exam 1. You see a 73-year-old woman with a 40 pack year smoking history, chronic obstruction pulmonary disease and peripheral artery disease who presents with an ulcer on the soul of her left foot. The al ...

NURS 6560 Exit Exam 1. You see a 73-year-old woman with a 40 pack year smoking history, chronic obstruction pulmonary disease and peripheral artery disease who presents with an ulcer on the soul of her left foot. The also has an irregular edge and pale face and punched out appearance, with the surrounding skin white and shiny. The patient states that the pain is worse at night in bed and when the legs are elevated. The most likely diagnosis is: 2. Hey 75-year-old man presents with chief complaints of headache, Nausea, and muscle weakness. His creatinine level is 2.1 MG/DLNGFR is 30 ML/MIN/1.73 m2. He currently takes a thiazides diuretic for the management of hypertension. Which of the following statements is false regarding the use of diuretics in the elderly? 3. All of the following practices are recommended when prescribing medication with confusing or similar-sounding names except: 4. A 19-year-old is diagnosed with meningococcal meningitis. In order to prevent secondary infections among adults who had close contact with the patient, all of the following are recommended except: 5. A 38-year-old woman comes to the emergency department complaining of a rapid heartbeat, tremors, and chest tightness. She reports early in the day she was feeling a migraine starting so she took a pill giving to her by her friend who also experience migraines. Her medical history reveals that she is currently taking a monoamine oxidase inhibitor for depression. Which migraine medication did see most likely take? 6. 826-year-old woman presents with uncomplicated UTI. She is otherwise healthy, has not received any systematic anti microbials in the past year and it’s not taking any medications. She is currently not pregnant and is using etonogestrel/ estradiol vaginal ring for contraception. The local E. Coli resistance rate to TMP/SMX is about 12%. The preferred therapy for this patient is: 7. As part of the Deficit reduction act of 2005, Medicare will incorporate quality payment adjustments for certain hospitals-acquired conditions, including all of the following except: 8. Which of the following example describes a potential malpractice scenario? 9. A 57-year-old woman presents for a flu shot as she has heard reports that it will be “a bad flu season’. She has had no primary care for more than 10 years she like health insurance. She admits to a 30 pack here cigarette smoking history, currently smoking one pack for a day. Her history and examination are unremarkable. Which screening test would you recommend? 10. A 28-year-old woman presents who complains of tugging chest pain unrelated to physical activity. She is generally in good health and non-smoker has a BMI of 23 KG/M2, and denies dyspnea of dizziness. Physical examination reveals a grade 2/6 late systolic murmur that follows a midsystoloc click at the 5th intercostal space, mid-clavicular line. An echocardiogram Fails to reveal mitral valve tissue redundancy. This can you go presentation is most consistent with: 11. A quality improvement plan characterized by Limiting variability and removing defects in a process best describes: 12. Laboratory findings of a 28-year-old male suspected of a heart stroke can include all of the following except: 13. A 42-year-old male presents with a sudden onset of inability to tightly close the eye lid, frown, or smile on the right side. His examination is otherwise unremarkable and past medical history is unremarkable. This likely represent paralysis of cranial nerve: 14. You see a 71-year-old man with atrial fibrillation and chronic obstructive pulmonary Disease who is diagnosed with community-acquired Pneumonia. His medical history does not show any drug allergies and he completed a course of respiratory fluoroquindore for the treatment of acute bacterial sinuses within the past month. Which of the following would you consider The most appropriate choice of anti-microbial? 15. According to the Consolidated Omnibus Reconciliation Act ( CORBA), The spouse of an eligible employee will be eligible for COBRA coverage in all of the following circumstances except when the eligible employee: 16. A 43-year-old woman presents in the emergency department with a chief complaint of swelling of the ankles, hands, and face. She also reports urine dad is darkly colored and foamy. Her blood pressure is 184/118 mm hg. All of the following urinalysis findings will support a diagnosis of glomerulonephritis except: 17. A 78-year-old male is being treated for hypoglycemia episode. He has a long history of type 2 diabetes mellitus as well as congestive heart failure and COPD. He is currently taking basal insulin with a sulfonylurea. What is the acceptable a A1C goal for this patient? 18. Tertiary Prevention activities for a 69-year-old woman with congestive heart failure and type 2 diabetes mellitus include: 19. A physicians employs an NP to provide service at a satellite acute care clinic. If the physician is never present at the clinic, which of the following statements is true? 20. You see a 48-year-old man with a chief complaint of pain during urination. Imaging reveals the presence of a kidney stone in the ureter. Do you consider all of the following management option except: 21. In managing a 58-year-old woman who is admitted for deep vein thrombosis, caution should be used with which of the following medication due to risk of heparin induced thrombocytopenia? 22. You see a 76-year-old woman living at home who is accompanied by her home care provider. She has COPD and type two diabetes mellitus. An example of a secondary prevention strategy is: 23. All of the following persons are eligible for Medicare service except: 24. The NP is called to treat a 43-year-old woman for multiple contusions following a domestic violence attack. The NP realizes that one of the best predictors of a subsequent homicide of victims are domestic violence is: 25. When initiating therapy for a spironolactone for a patient who Is also and ace inhibitor, you advise the patient to return in 5 days to check which of the following laboratory parameters? 26. All of the following are examples of primary prevention strategies except: 27. When considering HIPAA regulations, all the following are examples of” individual identifiable health information” except: 28. Which of the following statements is false regarding end-of-life decisions making for a patient that is hopelessly and terminally ill? 29. While evaluating 833 or female with a two day history of dysuria, which of the following findings in urinalysis is most suggestive of urinary tract infection caused by a gram-negative organism? 30. You are examining a 65-year-old woman with a history of rheumatic heart disease. In assessing the patient for mitral stenosis, you expect to find a heart heart murmur characterized as: 31. The privacy rule established by the US health department and human services in 1996 Implemented the requirements for: 32. When managing elderly patients with diminish cognitive function, which of the following statements is true regarding patient’s competence for making in form healthcare decisions? 33. A 17-year-old male is admitted after experiencing sudden, severe pain in the scrotum during the night. Physical examination reveals swelling of the scrotum and the loss of cremasteric reflex. His heart rate is 110 bpm, Blood pressure 150/80 mm hg, and temperature 99.8 F. There’s most likely represents: 34. In considering treatment for Jane in the previous question, which of the following would be most appropriate if she has a history of penicillin allergy? 35. All of the following are required Medicare terms and conditions for paying NP service except: 36. The NP is called to evaluate a 57-year-old man who reports episodes of acute angina with physical exertion. He is currently taking an ace inhibitor and low-dose aspirin. The NP considers which of the following approaches at the start of anginal symptoms? 37. A 41-year-old woman is diagnosed with hypertension that requires medication. She is otherwise healthy but currently takes drospirenone/ethinyl estradiol for birth control. Which of the following antihypertensive medication would be least preferred for this patient? 38. The NP is called to evaluate Jane, a 43-year-old woman, who presents with a diffuse maculopapular rash that began on The trunk but now covers the entire body, including the palms and soles. The rash is not itchy but wart-like sores are present in the mouth and genital area as well as skin folds. Initial evaluation reveals generalize lymphadenopathy And a low-grade fever, and she complains of lethargy and headache. The patient reports that she had a painless genital ulcer that healed on its own about 3 weeks earlier. Which of the following is the most likely diagnosis? 39. Gary is a 63-year-old African-American male who has been treated for hypertension with ace inhibitors her monotherapy for the past six weeks. Despite carries insistence that he is taking his medication as directed, his blood pressure continues to elevated. Gary mentions that he prefers not having to take multiple medications is day due to the cost and convenience. Which of the following is the most appropriate course of action? 40. A 15-year-old male is brought into the emergency department by his parents following a 12 hour history of nausea, family, and abdominal pain. Physical examination reveals obturator and psoas signs and a temperature of 102.6 F. Anticipated white blood cell with differential results are as follows: 41. A 27-year-old man presents with a chief concern of an abnormal mass within his left scrotum. He describes it as feeling like a bag of worms in his present when he is standing but disappears when he lies down. His past medical history is unremarkable and his BMI is 29 KG/M2. He has been in a monogamous relationship for the past four months. The most likely diagnosis is: 42. In a patient diagnosed with infections mononucleosis, the use of amoxicillin should be avoided due to the risk: 43. Mrs. Gonzalez is a 53 old female who is being evaluated for routine follow-up care. Her medical history includes dyslipidemia; hypertension, and rheumatoid arthritis. Laboratory animal is reveals elevated serum alanine transaminase and aspartate transaminase. The long-term use of which of the following medications is the most likely cause of this finding? 44. A 77 year old woman is accompanied by her husband for evaluation. She is currently being treated for metoprolol for hypertension and digoxin for atrial fibrillation. He reports that his wife is becoming increasingly forgetful over the past year, fell into note in Porten family events such as birthdays sometime to come and confused with driving directions to familiar locations. She has no previous psychiatric history. The most likely diagnosis is: 45. A 22-year-old college student presents with a two day history of severe sore throat and difficulty eating or drinking due to trouble swallowing. A physical examination reveals exudative pharyngitis and minimally tender anterior and posterior cervical lymphadenopathy. The NP suspects infectious mononucleosis and expects which are the following laboratory findings? 46. Phyllis is a 34-year-old woman who presents with a chief complaint of a migraine resulting in nausea and vomiting. She reports that she experiences multiple migraines each month. She has given a prescription for sumatriptan 100-mg tablets orally to treat acute migraine pain. When counseling Phyllis about the medication, the nurse practitioner advises about all of the following adverse effects except: 47. A 27-year-old woman is being evaluated for a seven day history of acute bacterial rhino-sinusitis. She is otherwise healthy and has not received any antimicrobial therapy in the past six months. She also has no history of drug allergy. In considering a first-line antimicrobial treatment, which of the following would be most appropriate? 48. A 21-year-old female student presents at the university clinic with a nose bleed. This is her third bleeding episode in the past week she is otherwise healthy with no history of bleeding disorders. The NP advises that the appropriate first line intervention of anterior epistaxis is: 49. A 49-year-old woman presents with a three day history of Burning during urination, a thin and grayish white vaginal discharge in vagina itching. Laboratory examinations common you expect to find all-of the following except: 50. You see a 77-year-old male for treatment in lacerations on his forearm. Upon examination, you notice poor skin turgor what it says on the arms and back of the hands. This is likely a sign of: 51. A 26-year-old male presents with a chief complaint of bilateral, intermittent itchy eyes accompanied by a rope like discharge. This is most consistent with conjunctivitis caused by: 52. A 32 -year-old woman in her second trimester pregnancy presents with fever, flank pain, and hematuria. The NP suspects pyelonephritis. Which of The following urinalysis results would be most indicative of pyelonephritis? 53. A 21 year old camp counselor presents for evaluation with a chief complaint of generalized itchiness. He has just returned after a week of summer camp. Physical examination reveals excoriated papules along his axillary folds and at the belt line. The NP suspects scabies and prescribes permethrin lotion. In counseling the patient on the use of permethrin, the NP mention that: 54. Bill is a 46-year-old man who rushed to the emergency department at the experiencing Senate onset of edema of the lips and face and a sensation of the tightness and difficulty breathing following a wasp sting. His blood pressure is 78/52 mm hg, heart rate 120 BPM, and respiratory rate is 32/min. The course of action in caring for Bill is to administer: 55. A 32-year-old man requires evaluation for hepatitis infection prior to taking a job as a restaurant cook. He Presents with the following Laboratory results: 56. A 57-year-old woman presents with a six month old numbness of the finger tips and oral irritation. Physical examination reveals pale conjunctiva and the heart murmur. She is otherwise healthy, exercise regularly, has a BMI of 22 kg/m2, and she states she is a vegan. Hemogram results are as follows: Hg= 8.2 g/dL (12-16 g/dL) Hct =23% (36% - 42%) MCV = 135 fl ( 80 - 96 fL) - Red Blood Cell distribution width =17%, These findings are most consistent with: 57. A 23-year-old man is admitted after experiencing seizures. A witness to the seizure described how the patient fell to the ground with rigid extension of the arms and legs which was followed by A period of jerking movement and loss of consciousness. This best describes which type seizures? 58. A 23-year-old male patient is evaluated in the early morning hours for nausea with vomiting. He had eaten some food from the fridge from the night before that “was probably to old”. The NP expects acute gastroenteritis and would expect The course of the disease over the next 48 to 72 hours to involve: 59. A 64-year-old woman with chronic kidney disease presents with a chief complaint lethargy. His hemogram is as follows: Hemoglobin (Hg)=9.9 g/dL, Hematocrit (Hct)=30% 60. There is no number 60 61. A 16-year-old male presents for evaluation after a syncopal Episode at school. He reports that he has recently been experiencing bouts of lightheadedness. His blood pressure is 126/76 episode at school. He reports that he has recently been experiencing bouts of lightheadedness. His blood pressure is 126/76 mm Hg and his BMI=33 kg/m2. You notice velvet-like plaques at the naps of the neck. Laboratory assessment should include which of the following tests? 62. 846-year-old man is rushed to the emergency department while experiencing an acute adrenaline crisis that presents with abdominal pain, severe vomiting, and low blood pressure. He appears cyanotic and confused. The most appropriate treatment for this patient is an injection of: 63. A 17-year-old male with intermittent asthma presents for routine follow-up. He explains that he experienced asthma symptoms once or twice is weak, usually during physical activity. Symptoms are promptly will leave each time with albuterol per MDI with spacer. He does not report any nighttime awakenings due to his asthma. His act score is 24 and vital signs are all within normal limits. According to the NAEPP EPR-3, what is the next step in the management of his asthma? 64. Which of the following electrocardiogram changes do you expect to find in a person with myocardial ischemia? 65. Clinical features of Hashimoto’s thyroiditis typically include: 66. Which of the following is the most appropriate antibiotic for a 57-year-old man with acute bacterial rhinosinusitis and who has type 2 Diabetes mellitus, COPD and a beta lactam allergy? 67.The NP is called to evaluate a 56-year-old man complaining of severe pain in the upper right abdomen that radiates to the right shoulder, nausea and vomiting, which started soon after dinner. The NP suspects a cute cholecystitis. All of the following findings would be consistent with the diagnosis except: 68. The NP is called to evaluate a 34 year old non-pregnant woman who complains of a four week history of anxiety, palpitations, diarrhea, unexplained weight loss, and sensitivity to heat. Her medical history is unremarkable and she is not taking any medications. Physical examination reveals warm moist skin and exaggerated deep tendon reflexes. The NP suspects Graves’ disease. Which of the following laboratory results would best support this diagnosis? 69. A 27-year-old male is rushed to the emergency department after experiencing a series of seizures. He has no history of neurologic disorder. His girlfriend states that he was taking multiple medications for mood disorder but recently stopped taking one of them. The most likely medication the patient discontinue is a: 70. A 68-year-old woman who resides in a long-term care facility is being treated for a urinary tract infection. Her medical history includes hypertension, peripheral artery disease, and a 35 pack year smoking history. During the evaluation, she brings to your attention a painless, pearly nodule on the upper lip. This clinical presentation most likely represents: 71. A 24 year old with a history of major depressive disorder is rushed to the emergency department by his friends after taking an overdose of antidepressant medication. The ingestion of which of the following medications poses the greatest risk of death for this patient? 72. You see a 24-year-old woman of Asian and Sestri who is being evaluated for a neurologic disorder. A thorough laboratory analysis is conducted in the hemogram results are as follows: hemoglobin 10.4, hematocrit 32%, Mean cell volume (MCV) 71, Red blood cell distribution with (RDW) 13%, Red blood cells 5.5, the most likely condition associated with these hemogram results are: 73. And 18-year-old man is being evaluated for a severe exacerbation of asthma. He is currently taking an inhaled corticosteroid, a long acting beta agonist, and a short acting beta agonist one and as needed basis. The most important component of the initial assessment includes an: 74. A 19 year old college freshman has been urged by her friends to be evaluated for lethargy, loss of appetite, and hypersomnia over the past two weeks. You administer the Beck Depression inventory assessment and she scores at 22. This would indicate: 75. 35-year-old woman presents with a chief complaint of being unable to close her right eyelid tightly, frown, or Smile on the right side. She is otherwise healthy with no significant prior medical history. Inappropriate diagnostic test for this patient would be: 76. The NP is called to evaluate a 72 year old woman with community acquired pneumonia. Her vital signs include temperature 101.6°F, blood pressure 106/68 mmHg, and heart rate 78 BPM, physical examination reveals increased tactile fremitus and donis to percussion at the left lung base. These findings are consistent with: 77. The nurse practitioner is evaluating a 19-year-old male suffering from a severe headache. He has a history of headaches that lead to occur in clusters over a few days. He has unsuccessfully tried several therapeutic modalities. A positive response to which of the following interventions supports the diagnosis of cluster headache? 78. When developing a management plan for patients with genitourinary infections, which of the following would you most likely recommend for follow-up imaging following resolution of their infection? 79. The NP is called to evaluate a 48-year-old man who was brought to the emergency department after experiencing severe low back pain following an attempt to lift heavy furniture. He also reports a coincident loss of bowel and bladder control. This most likely indicates: 80. A 43-year-old woman is being evaluated in the emergency department with a complaint of a severe headache. She describes a unilateral, pulsing headache that was preceded by a gradual onset of paresthesia affecting the ipsilateral face and arm. The patient stated she noticed a funny smell prior to the symptoms starting. This description is most typical of: 81. A 20-year-old college student living in a campus dormitory has been diagnosed with Meningococcal meningitis. The NP decides to speak with the University health officials and inform them that: 91. Mr. Waugh is a 62-year-old man who has been previously diagnosed with Dilated cardiomyopathy and is being evaluated for fatigue, Edina, and shortness of breath. On examination, you expect to find: 92. A A 54-year-old man is being evaluated for pain related to acute bacterial prostatitis. In considering the diagnosis and management, the NP realizes that: 93. You see a 64-year-old man with an area erythema concentrated on the left side of his neck with clusters of vesicles forming a line. He reported pain in the area a couple of days before the eruption of the lesions. He states that he recently initiated biologic therapy for rheumatoid arthritis. Which of the following is the most likely diagnosis? 94. While taking the history on a 60-year-old female patient the nurse practitioner learns that she has a 15-year-old history of poorly controlled hypertension. The patient admits that another provider had told her that the high blood pressure had affected her eyes. As a result, the nurse practitioner expects that funduscopic examination will likely reveal: 95. A 71-year-old male presents to the emergency department. He is complaining of severe abdominal pain in the right lower quadrant. Diagnostic findings to support a ruptured appendix would include all of the following except: 96. You are evaluating a 43-year-old woman with community-acquired pneumonia. She has no comorbidities, no reported history of drug allergies, and has not received antimicrobial therapy in the past six months. Which of the following is the most appropriate treatment choice? 97. You see a 58-year-old man who complains of a persistent dry, hacking cough. He reports that he recently started taking a medication to treat high blood pressure. He is most likely taking a(n): 98. Ms. Wang is a 57-year-old female who was seen 2 weeks ago for evaluation of ongoing abdominal discomfort and nausea. Laboratory assessment reveal H. pylori and she was treated for peptic ucler disease with an appropriate antibiotic/proton-pump inhibitor combination. She returns today and admits to no real change in her symptoms. This suggestion that: 99. You see a 26-year-old man with moderate persistent asthma who is experiencing a severe exacerbation. Which of the following would you most likely expect when evaluating this patient? 100. A 70-year-old man who lives in a long-term care facility is being evaluated following a fall. He is fairly healthy with no mobility limitations or other obvious risk factors. He is taking simvastatin for dysilpidemia as well aspirin. A caregiver who witnessed the fall reports that the patient did not try to brace himself for the fall but just”fell flat on the ground.” This likely suggests: 101. Which of the following is most consistent with the hepatic enzyme profile of a person with non-alcoholic fatty liver disease? 102. A 40 sexual woman presents with a 12 hour history of fever, severe pain in the upper right abdomen, and positive Murphy’s sign. Her medical history is unremarkable and she is an otherwise good health. The most likely diagnosis is: 103. You see a 54-year-old man living in subsidize housing with a history of hypertension. He states that he stopped taking his high blood pressure medication about four months ago because of calls. He is concerned because his blood pressure is high whenever he checks it, though he does not report any symptoms. His BP at this visit is 196/104 mm Hg. Upon examination of his patient, you would expect to detect an S4 sound heard during: 104. A 47-year-old woman reports that her long-time boyfriend was recently diagnosed with liver cancer possibly caused by a chronic hepatitis B infection. Though she does not have symptoms, she wants to be checked for hepatitis B. She can’t recall if she has ever been vaccinated for hepatitis B. The laboratory results are as follows: Hepatitis B surface antigen positive, hepatitis B surface antibody negative, total hepatitis B core antibody positive, IgM antibody to hepatitis B core antigen negative. These findings are most consistent with: 105. An 84-year-old female patient is admitted from a local long-term care facility(LTCF). The patient is normally awake, alert and oriented. She resides in the LTCF because she has not fully recovered from a broken hip resulting from a fall four months ago, otherwise she is in relatively good health. She can walk short distances with a walker, though she primarily stays in a wheelchair. Today, however, the nursing staff found her to be acutely confused and unable to ambulate without falling. She was transferred to the emergency department for evaluation. Initial laboratory testing must include: 106. You see a 75-year-old female who complains of dizziness and lightheadedness and nearly fallen a few times over the past couple of days. Hospital evaluation reveals no apparent cardiac or neurological reasons for the symptoms. Her medical history shows that she is taking several medications for various conditions, including hypertension depression; type two diabetes mellitus, and urinary incontinence. In reviewing the medications for fall risk, which of the following changes will likely decrease her fall risk? 107. A 74-year-old male with asymptomatic atrial electrical cardioversion that successfully restored the heart rhythm. Which of the following medications can be considered for the purpose of maintaining the heart rhythm? 108. Communication skills are critical when interviewing patients to gather information that can be used to diagnose conditions and develop a management plan. IContact and nonverbal cues are examples of ways of the following communication skills? 109. A 78-year-old man is brought in by his neighbor who reports that he found him sitting in the front yard. She reports that he mumbled something about waiting for his wife, though she passed away more than 10 years ago. The neighbor says that the patient lives by himself and that this is the first time he has acted in this manner. The patient is calm but has trouble understanding simple directions and is unable to respond properly to simple questions. Suspecting delirium, The most appropriate first course of action is to: 110. A 67-year-old man is being evaluated for shortness of breath. His medical history reveals that he experience a myocardial infarction about 2 years A girl and a history of hypertension, which is well controlled by diet. Otherwise, his medical history is unremarkable. Which of the following would you expect to find on electrocardiogram? 111. Mrs. Yamamoto presents for evaluation of a domino pain. She does not speak English well and wants to use her 16-year-old son to interpret. The NP knows that when evaluating a patient who requires an interpreter, it is best to: 112. Do you see a 74-year-old male who is accompanied by his granddaughter who lives with him. He has hypertension, a prior why myocardial infarction, long-standing type two diabetes, and recently underwent a lower limb Amputation secondary to diabetes. He is currently taking a ace inhibitor, statin, lower dose of aspirin, biguanide and insulin. The granddaughter reports that since the amputation, her grandfather sometimes becomes withdrawn, irritable and moody for no apparent reason, does not want to participate in the typical activity he enjoys, and often does not appear to eat much during the day. She also states that he often complains of being tired but normally wakes up in the early morning hours. The most appropriate action is to evaluate the patient for: 113. In evaluating a 62-year-old male with ischemic heart disease in mitral incompetency, you expect to find the murmur that is: 114. A 77-year-old woman with urinary incontinence is brought in by her caregiver for evaluation are they potential urinary track infection. She is mentally alert and responds clearly to questions. The caregiver waits in the waiting area. While performing a routine comprehensive physical exam, you notice bruises on her right and left upper arms. The most appropriate approach would be to say: 115. When prioritizing risk factors for bacterial endocarditis, The nurse practitioner knows who among the following patients has the highest risk. 116. A 22-year-old woman is being evaluated for an upper respiratory tract infection. As you prepare for auscultation, the patient states quote quotesI have a benign murmur that has been with me my whole life. “ anticipating a physiologic murmur, you would expect which of the following characteristics? 117. A 36-year-old man is hospitalized for alcohol poisoning. Do I follow up evaluation the next day, he denies that he has a drinking problem. The best approach to assess for possible alcoholism is conducting with other following questionnaires? 118. A 79-year-old man is brought into the emergency department by his daughter. She reports that her father lives by herself independently and she checks on him several times each week. This morning when she arrived at his home, he was acting confused, did not immediately respond to simple commands, and insisted that he saw his the season wife. He was “perfectly fine“ just a couple of days ago. She is concerned that this may be an early indication of dementia. When differentiating between delirium and dementia, the nurse practitioner knows that: 119. In considering the use of an inhaled anticholinergic, such as tiotropium bromide, for the treatment of chronic obstructed pulmonary disease the NP recognizes which of the following is the desired therapeutic action? 120. You see a 14-year-old soccer player with an ankle sprain. Physical examination reveals complete ankle instability, significant swelling, and moderate to severe ecchymosis. You would grade this sprain as: 121. A 25-year-old male presents who complain of excessive shortness of breath with mild exercise ( walking up a couple of flights of stairs). He denies chest pain shut up to my little friend body mass index (BMI) = 24 kg/m2, denies smoking, and his blood pressure is 128/68 mm Hg. Physical examination reveals a grade 3/6 crescendo-decrescendo systolic murmur at the second intercostal space, right sternal border that radiates to the neck. These findings are most consistent with: 122. A 43-year-old man who smokes one pack per day and has an 18 pack year smoking history presents with a chief complaint of increasing shortness of breath, chronic cough and sputum production. In considering chronic obstruction pulmonary disease, which of the following is required for the diagnosis of COPD? 123. In which of the following situations is parental consent usually needed prior to treatment? 124. When a valuate illness symptoms in older patients, the disease will often present differentially from younger adults to: 125. An 18-year-old female is being evaluated for wheezing that occurs on a intermittent basis. Symptoms occur about 3 to 4 times weekly, but not daily. Nighttime awakening due to wheezing and coughing occurs about once per week. Her FEV1 is 85% predicted and asthma control test score is 22. The patient is diagnosed with mild persistent asthma and initiated on Step 2 treatment, which will include: 126. When considering and end of life decisions for a terminally ill person with Alzheimer-type dementia who can no longer communicate, all of the following can be used as an advance directive except: 127. You are seeing a 68-year-old woman for treatment of an uncomplicated urinary track infection. She has well-controlled hypertension, type two diabetes mellitus, and dyslipidemia and takes an angiotensin-converting enzyme inhibitor, statin, biguanide, and low-dose aspirin. She understanding conversation, especially in noisy environments. This is likely a: 128. A 28-year-old male with asthma presents with a chief complaint that he has to use his rescue inhaler multiple times his day. Evaluation reveals that he has moderate to severe persistent asthma and Step 4 treatment. And appropriate regimen would included: 129. The healthcare principle that promotes action that lead to achieving the greatest good for the greatest number is known as: 130. A Forteo male is brought in for an evaluation after he reportedly collapsed doing a tennis match, though he quickly regain consciousness. His medical history is otherwise unremarkable. You suspect hypertrophic cardiomyopathy. Which of the following a heart murmur characteristics would support the diagnosis? 131. A 47-year-old man is being evaluated for severe eye pain and sign on set a reduced acuity. The NP suspects acute angle closure glaucoma. Which of the following is most likely to be found on funduscopic examination to support this diagnosis? 132. When evaluating the value of a test, the portion of negative results that are truly negative best describes: 133. The NP is called to evaluate a 53-year-old man who acute bacterial rhinosinusitis. He currently smokes in one PPD and has a 30 pack year cigarette smoking history. His medical history shows that he is allergic to penicillin. Two weeks ago, he was treated with a macrolide for “bronchitis. “ You now prescribe: 134. The ability of a test to identify individuals who truly have a disease with a positive test result best describes: 135. Which of the following types of clinical studies represent the lowest level of evidence used to guide medical decisions? 136. Which of the following represents the highest level of scientific evidence when evaluating clinical research? 138. While conducting an examination of a 15-year-old female accompanied by her mother regarding a potential sexually transmitted disease, The NP knows that the best approach to the visit would be to: 137. Which of the following activities best demonstrates fulfillment of the nursing leadership role? 139. You see a 68-year-old woman who is being treated for moderate depression. She complains that her medication is causing symptoms of dry mouth and constipation. She most likely taking which of the following medication? 140. A 25-year-old landscaper with a six CM abscess on the left upper arm presents one week post incision and drainage for the follow up appointment. The area is most improved, but has some residual erythema and discomfort. The nurse practitioner correctly interpret that: 141. Hey 67-year-old female has a long history of chronic venous insufficiency(CVI) and was seen by the nurse practitioner from brown discoloration on her calves. The nurse practitioner diagnose Hyperpigmentation is due to CVI and present the appropriate treatment plan. When evaluating the patients understanding, the nurse practitioner expects that she will say: 142. Betty is a 33-year-old mother of two children who presents for treatment of a lower urinary track infection. This is her third episode in the past six months. She is prescribed appropriate antibiotic therapy and is taught strategies to decrease urinary tract infection. Which of the following is recommended for the prevention of recurrent UTI in at risk patients? 143. A patient who was seen for upper respiratory tract infection has an abnormal blood test results and requires a follow up visit. The patient repeatedly fails to show up for the following visit. Which of the following is the best approach is to inform the patient of the need an urgency for a repeat test? 144. And NP’s duty of care can be established: - when the NP gives professional advice or treatment is any setting 145. All of the following are elements of malpractice except: - charging a patient for a procedure that was not performed 146. Which of the following describes the ethical principle of beneficence? 147. Which of the following describes the ethical principle of veracity - The healthcare provider must be truthful and avoid deception 148. The legal authority of an NP’s to perform healthcare service as defined by state law is called: 149. “Incident-to” Service are defined as those which are “an Integral, although incidental, part of the physicians personal professional service in the course of diagnosis or treatment of an injury or illness.“ as long as certain criteria are met, “incident to“ billing is an option in all of the following settings except: 150. A 50-year-old woman presents with a chief complaint of a four day history of unilateral headache with occasional blurred vision. Her medical history is unremarkable. Blood pressure is 146/94 mm Hg, heart rate is 86 bpm, and respiratory rate is 26/minute. Physical examination reveals a tender, pulseless temporal artery. All of the following are true except: