NR 601 / NR601 FINAL EXAM STUDY GUIDE QUESTIONS AND ANSWERS. LATEST 2020/2021.

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Question 1. Mr. A, experienced a brief onset of right sided weakness, slurred speech and confusion yesterday. The symptoms have resolved and the CT is normal. What is the next step of the plan for Mr... . A? a. Assure the patient that he will not experience the symptoms again b. Identify modifiable cardiovascular risk factors c. order ASA 81mg stat d. Order a stat EEG and administer O2 by mask Question 2. A 56-year old male patient screened for diabetes has a fasting plasma glucose level of 96mg/dl. The nurse practitioner management plan includes: a. repeat fasting plasma glucose in three years b. Prescribe Metformin 500mg po BID c. repeat fasting plasma glucose in one year d. Refer to ophthalmology for eye exam Question 3. RW, a 57 year old native American female, presents to the office. RW states she feels irritable and has difficulty concentrating as well as fallingn asleep and staying aleep. She states she is worried about her finances, her husband has just lost his job. The NP diagnoses anxiety. The NP prescribes a first line treatment which is a. Diazepam b. Clonazepam c. Ariprprazole d. Paroxetine Question 4. The most common sustained rhythmic disorder, which consists of fibrillatory p waves is: a. AV block b. atrial tachycardia c. atrial fibrillation d. atrial flutter Question 5. According to the Sexually presentation, atrophic vaginitis a. the symptomsm are the same for each woman b. creates a more acidic vaginal environment c. is a contributing factor for frequent urinary tract infections d. is not treated with vaginal lubricants Question 6. Which of the following is the most appropriate screening tool for delirium? a. St Louis University Mental Status Exam (SLUMS) b. Montreal Cognitive Assessment c. Lawton Scale of instrumental Activities of Daily Living d. Confusion Assessment Model Question 7. A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea_ is: a. lorazepam b. Gabapentin c. Methadone d. Morphine Question 8. Which of the following would you recommend annually for the elderly type 2 diabetic? a. periodic visits to a gastroenterologist b. colonoscopy c. follow up with a urologist d. eye exam with an opthlamologist Question 9. Which characteristic of delerium helps to distinguish it from dementia? a, short term memory impairment b. personality changes c. acute onset d. impaired attention Question 10. The majority of patients enrolled in hospice care die: a. in the hospital b. in an inpatient hospice facility c. in a nursing home d. at home Question 11. A middle aged patient has been diagnosed with Parkinson's disease. What influences the nurse practitioners descision to begin pharmacological treatment for this patient? a. medications initiated at first sign of unilateral involvement b. gait instability requiring the use of a cane c. intentional tremors d. symptoms interfering with functional ability Question 12. Which of the following is a role of the advanced practice nurse in palliative cancer care? a. detecting cancer in asymptomatic paitents or those with specific symptoms b. arranging for follow up including patiennts c. identifying and managing complications of care d. all of the above Question 13. A 58 year old Caucasian mane with type 2 diabetes mellitus presents to the clinic as a new patient. He takes metformin 500mg twice a day. His last Hgb A1c was 7%. He is up to date on eye and foot examinations. His BP is 142/96. According to ACC 2017 guidelines for high blood pressure in adults, what is the most appropriate first line medication? a. lisinopril b. furosemide c. amlodipine d. clonidine Question 14. An older male patient is experiencing acute onset of right sided weakness, slurred speech and confusion. What should the nurse practitioner do promptly? a. order an EKG and administer O2 by cannula immediately b. Do a through medication review and stat blood sugar c. evaluate for a stroke and arrange transport to the hospital right away d. administer an aspirin by mouth Question 15. The NP knows that medications can trigger or worsen heart failure. With this knowledge in mind, the NP will avoiding prescribing the following classes of medications a. benzodiazepines b. macrolides c. muscle relaxants d. NSAIDS Question 16. MG, a 60 year old female presents with complaints of her "heart flipping in her chest" The NP wants to evaluate for arrhythmia. The nP knows that the cornerstone for arrhythmia evaluation includes: a. electrocardiogram b. physical examination c. all options are appropriate d. history Question 17. The elderly are at high risk for delerium because of: a. multiple medical problems b. multisensory deficits c. polypharmacy d. all of the above Question 18. A 68 year old woman presents with a complaint of urine leakage whenever she sneezes, laughs or strains for the past 4 months. She denies dysuria, frequency and nocturia. US dipstick is negative for RBC's leukocyte esterase, nitrates, ketones and urobilinogen. What is the diagnosis? a. stress incontinence b. urinary incontinence c. urge incontinence d. overflow incontninence Question 19. Which of the following signs or symptoms are not characteristics of delirium a. patient is coherent b. short duration c. sudden onset d. symptoms are worse in the evenings Question 20. A 52 year old female patient screened for diabetes has a fasting plasma glucose level of 123 mg/dl. The nurse practitioners plan includes: a. repeat fasting glucose in 1 month b. prescribe memformin 500mg BID po c. repeat fasting plasma glucose in one year d. repeat fasting glucose in three years Question 21. According to the palliative care presentation, most elderly patients die: a. alone b. at home c. in institutions d. in pain Question 22. Older adults with dementia sometimes suffer from agnosia, which is defined as the inability to a. Remember events and places b. understand language c. use language d. Recognize objects Question 23. When treating depression associated with dementia, which of the following would be a poor choice and not be prescribed a. desimpramine b. amitryptyline c. fluoxitine d. mirtazapine Question 24. Male patient presents with a BMI of 30 presents to the office for an annual exam. You are reviewing the lab results. You ordered a CMP as part of routine labs. The fasting glucose was 130. Your next action is: a. repeat the fasting glucose b. start metformin 500mg BID c. repeat fasting glucose in 1 year d. call the patient and report lab results as normal Question 25. The task of grieving include all of the following except a. begin to disengage b. acknowledge the reality of death c. work through the pain of grief d. restructure relationships Question 26. All of the following are true statements regarding elder abuse except: a. a new STI in an elderly patient can be a sign of abuse b. persons over 80 years of age are at highest risk for abuse c. missing scheduled appointments and delays in medical care are common d. common signs of abuse include decreased anxiety and depression Question 27. Hospice care differs from palliative care in that: a. it cannot be provided in the nursing home b. the majority of those admitted to hospice die within 7 days c. it is not covered by insurance d. it is designed for the last six months of life Question 28. When assessing an elderly client who reports a tremor, which assessment findings would be most reliable in identifying Parkinsons disease? a. congwheel rigidity, bradykinesia, and macrorgraphia b. any presence of fever c. symptoms of slowed movement, unstable angina and tremor d. resting tremor, slow unsteady gait and cogwheel rigidity Question 29. How dies womans anatomy make them more susceptible to UTI's a. the female urethra is shorter b. aymptomatic UTI's do not resolve themselves without treatment c. women tend to get UTI's when they are pregnant d. there is a longer distance between the urethra and anus Question 30. Mrs. Smith, a 64 year old woman presents to the clinic for the first time and complains of uruinary incontinece and dyspareunia. She went through menipause 10 years ago without any hormone replacement therapy and had a hysterectomy for a fibroid. Her mother had a hip fracture at 87 years of age. The patiennt's most recent mammogram was 7 years ago and no known family history of breast cancer. She is not taking any medications. Her physical exam is unremarkable except for findings consistant with atrophic vaginitis. You prescribed topical hormone replacement therapy today. Which of the following evaluations should also be ordered today a. bone mineral density measurement b. mammogram Question 31. All of the following patients should be screened for diabetes except: a. a 44 year old caucasian male with hypertension b. a 42 year old femal on disability from back injury from back injury who is unable to exercise c. an overweight middle aged african american woman with a family history of type 2 diabetes mellitus d. an obese hispanic man [Show More]

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