NURS 6550 Final Exam 2, 100% Correct

A 21-year-old woman requests hormonal emergency contraception after a condom break during intercourse approximately 16 hours ago. Today is day 14 of her normally 27–29 day menstrual cycle. You advise her that: 2. A quali ...

A 21-year-old woman requests hormonal emergency contraception after a condom break during intercourse approximately 16 hours ago. Today is day 14 of her normally 27–29 day menstrual cycle. You advise her that: 2. A quality improvement plan characterized by limiting variability and removing defects in a process best describes: 3. A 38-year-old woman comes to the emergency department complaining of a rapid heartbeat, tremors, and chest tightness. She reports earlier in the day she was feeling a migraine starting so she took a pill given to her by her friend who also experiences migraines. Her medical history reveals that she is currently taking a monoamine oxidase inhibitor for depression. Which migraine medication did she most likely take? 4. You are seeing a 68-year-old woman for treatment of an uncomplicated urinary tract infection (UTI). She has well-controlled hypertension, type 2 diabetes mellitus, and dyslipidemia and takes an angiotensin-converting enzyme inhibitor (ACEI), statin, biguanide, and low-dose aspirin (ASA). She worked in a dry cleaning facility until approximately 8 years ago. During her evaluation, she mentions that she sometimes has difficulty understanding conversation, especially in noisy environments. This is likely a: 5. While evaluating a 33-year-old female with a 2-day history of dysuria, which of the following findings in urinalysis is most suggestive of urinary tract infection (UTI) caused by a Gram-negative organism? Nitrites 6. All of the following are examples of primary prevention strategies except: 7. A 23-year-old woman is being evaluated for an upper respiratory tract infection. As you prepare for auscultation, the patient states “I have a benign murmur that has been with me my whole life”. Anticipating a physiologic murmur, you would expect which of the following characteristics? Usually obliterates S2. 8. When evaluating the value of a test, the proportion of negative results that are truly negative best describes: 9. 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 mm Hg and his BMI=33 kg/m 2 . You notice velvet-like plaques at the nape of the neck. Laboratory assessment should include which of the following tests? 10. A 48-year-old woman is being evaluated with chief complaints of fatigue, weakness, lethargy, and decreased concentration. She also mentions a notable increase in facial hair over the past 6 months as well as unexplained weight gain (about 25 lbs [11.3 kg]) over the past 2 months. Her past medical history is notable for moderate persistent asthma with multiple exacerbations over the past 8 months requiring treatment with prednisone. The most likely diagnosis is: 11. You see a 73-year-old woman with a 40 pack-year smoking history, chronic obstructive pulmonary disease (COPD) and peripheral arterial disease (PAD) who presents with an ulcer on the sole of her left foot. The ulcer has an irregular edge and pale base and a 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: 12. In evaluating a 62-year-old male with ischemic heart disease and mitral incompetency, you expect to find the murmur that is: 13. You see a 76-year-old woman living at home who is accompanied by her home care provider. She has COPD and type 2 diabetes mellitus. An example of a secondary prevention strategy is: 14. 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: 15. You see a 54-year-old man living in subsidized housing with a history of hypertension. He states that he stopped taking his blood pressure medication about 4 months ago because of costs. 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 this patient, you would expect to detect an S 4 sound heard during: 16. 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: 17. When evaluating illness symptoms in older patients, the disease will often present differently from younger adults due to: 18. When prioritizing risk factors for bacterial endocarditis, the nurse practitioner knows who among the following patients has the highest risk. 19. The legal authority for NPs to perform healthcare services as defined by state law is called: 20. A patient who was seen for an upper respiratory tract infection has an abnormal blood test result and requires a follow-up visit. The patient repeatedly fails to show up for the follow-up visit. Which of the following is the best approach to inform the patient of the need and urgency for a repeat test? 21. 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? 22. 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 generalized 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? 23. 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” and is present when he is standing but disappears when he lies down. His past medical history is unremarkable and his BMI is 29 kg/m 2 . He has been in a monogamous relationship for the past 4months. The most likely diagnosis is: 24. A 67-year-old man is being evaluated for shortness of breath. His medical history reveals that he experienced a myocardial infarction about 2 years ago 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 (ECG)? 25. A 74-year-old male with asymptomatic atrial fibrillation underwent electrical cardioversion that successfully restored the heart’s rhythm. Which of the following medications can be considered for the purpose of maintaining the heart’s rhythm? 26. A 14-year-old male is brought in for evaluation after he reportedly collapsed during a tennis match, though he quickly regained consciousness. His medical history is otherwise unremarkable. You suspect hypertrophic cardiomyopathy. Which of the following heart murmur characteristics would support the diagnosis? 27. You see a 64-year-old man with an area of 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? 28. An NP’s duty of care can be established: 29. A 49-year-old woman presents with a 3-day history of burning during urination, a thin and grayish-white vaginal discharge, and vagina itching. On laboratory examination, you expect to find all of the following except: 30. The NP is called to evaluate a 34-year-old nonpregnant woman who complains of a 4-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? 31. In managing a 58-year-old woman who is admitted for deep vein thrombosis, caution should be used with which of the following medications due to a risk of drug-induced thrombocytopenia? 32. A 27-year-old woman with a known sulfa allergy presents with an uncomplicated UTI. She has not received any systemic antimicrobials in the past 6 months. She is currently not pregnant and is using norelgestromin/ethinyl estradiol patch (Ortho Evra ® ) for birth control. You recommend treatment with: 33. You are examining a 64-year-old woman with a history of rheumatic heart disease. In assessing the patient for mitral stenosis, you expect to find a heart murmur characterized as: 34. 21-year-old female student presents at the university clinic with a nosebleed. 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 for anterior epistaxis is: 35. Which of the following examples describes a potential malpractice scenario? 36. An 84-year-old female patient is admitted from a local long-term care facility (illnes). 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 4 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: 37. 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 acute cholecystitis. All of the following findings would be consistent with the diagnosis except: 38. A 23-year-old college student presents with a 2-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 would expect which of the following laboratory findings? 39. A 45-year-old male is being prepared for release after receiving analgesic treatment for low back pain due to an acute lumbosacral strain. He is in otherwise good health and typically exercises on a daily basis. He asks when he will be able to start exercising again. The most appropriate response is: 40.