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APEA Midterm with info
Advanced Clinical Diagnosis (NR-603)
Chamberlain University
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APEA Questions
- A patient report that she is taking kava kava regularly for anxiety with the results. What should the nurse practitioners evaluate? a. Liver function studies
- A person with 20/80 vision: HAS POORER VISION THAN SOMEONE WITH 20/ VISION
- One exception to the recommendation to limit dietary fat intake is CHILDREN UNDER 2 YEARS OF AGE
- The most effective treatment for anemia of chronic disease is: TREATMENT OF UNDERLYING DISEASE Rationale: The key phrase is “anemia of chronic disease” and with this, the pt’s chronic disease has caused the deficiency so once you correct and or treat the chronic disease, then the anemia will correct itself.
- Salicylates and other non-steroidal anti-inflammatory agents have all of the following actions EXCEPT- ANTI-EMETIC EFFECTS VIA SUPPRESSION OF GASTRIC ACID SECRETION
- Which of the following does NOT increase a woman’s risk of developing cervical cancer? NULLIPARITY
- All of the following principles apply to drug therapy for elders except ENCOURAGE THE ELDERLY TO CONTINUE SELF-MEDICATION ADMINISTRATION TO FACILITATE INDEPENDENCE AND SELF-SUFFIENCY
- A female patient believes that she was exposed to HIV through sexual intercourse several months ago. She asks for “the test for AIDS.” Which statement is NOT correct? THE ELISA IS USED FOR SCREENING, BUT MAY YIELD A FALSE NEGATIVE THIS SOON AFTER EXPOSURE
- The nurse practitioner teaches the parents of a 2-month-old infant with GERD that treatment typically includes all of the following interventions except MAINTAINING THE USUAL FEEDING REGIMEN AND BURPING THE INFANT WELL WHEN THE FEEDING IS COMPLETED 10 widowed 85-year-old was recently moved from her home of 65 years to a bedroom in her daughter’s home. According to reports by family members, she is now
“cantankerous” gets “mixed up” easily and cries for no apparent reason. Factors in the client history that are consistent with delirium may include all of the following except a. INSIDIOUS ONSET AND CHRONIC PROGRESSIVE COURSE 11. The two tests that can indicate current infection with hep B are: a. Presents of hep B antigen and IgM 12. A characteristic of elders which affects the pharmacotherapeutics of drug therapy in that population is an increase in PERCENT OF BODY FAT
An elder’s caretaker is planning the elder’s menu. The elder is on a bland diet. The nurse practitioner reviews the meal plans and notes that which of the following is NOT appropriate? a. Coffee, tea, carbonated sodas, Orange juice
The leading cause of death from injury in childhood is MOTOR VEHICE ACCIDENTS
Therapeutic International normalized ratio (INR) for a patient taking warfarin (coumadin) for a chronic atrial fibrillation is expected to be: a. Increased 16 most accepted recommendation regarding a skin cancer prevention is: a. Avoidance of excessive sun exposure
Antibiotic administration has been demonstrated to be of little benefit in the treatment of which of the following disease processes? a. Acute bronchitis
An anxious parent brings her three-day old female infant to see the nurse practitioner because of the serosanguineous vaginal discharge. The nurse practitioner tells the mother: a. This is a normal finding in female newborns
A common finding associated with temporal arteritis is: a. Severe headache
a. Post maturity delivery 31. According to Erikson, the developmental task of the early adult is: a. Ego integrity vs. despair 32 parents of a two-year-old Report that she is not saying any words, but make sounds, babbles, and understand simple commands from her parents. The parents are not concerned. The nurse practitioner responds: a. Your child should be saying a few words by this time. She should be referred for further assessment 33 group is considered to be at high risk for the development of testicular tumors? a. Late adolescence to early adulthood (you need to know the actual age groups) 34. An urgent call is received from a patient’s wife who states that her husband is having chest pain I’m relieved by three nitroglycerin tablets. The nearest hospital is 40 minutes away. Besides having the patient reach the hospital as soon as possible, what intervention can the nurse practitioners suggest might influence a positive outcome? A. Have the patient to an aspirin on the way to the hospital 35. Which of the following postpartum mothers should receive RhoGAM (BayRho-D) to prevent Rh iso-immunization? a. A G1 P1 mother who is Rh negative without Rh antibodies; cord blood is Coombs negative; newborn is Rh positive. 36 patient with a history of alcohol abuse presents with acute nausea, vomiting, and severe retrosternal pain that radiates to the back. Based on the most probable diagnosis, the nurse practitioner would appropriately order a CBC, chemistry profile, and: a. serum amylase and lipase, and liver function studies 37. A female patient asks, “how do I calculate my ideal body weight?” The nurse practitioner response: a. Start with 100 pounds, and add 5 pounds for every inch in height over 5 feet 38 35-year-old woman with prior history of extreme nervousness has been treated with diazepam (valium) for four weeks. She reports improvement. Today her pulse is 112bpm and blood pressure is 130/92 mmHg. She is 5’4” in weighs 105 pounds. What is the most likely diagnosis?
a. Hyperthyroidism 39. Which of the following is not a common early sign of benign prosthetic hyperplasia (BPH)? a. Increased force of urine flow 40 idiopathic thrombocytopenia purpura (ITP) is most commonly seen in childhood following: a. Acute infection 41. The nurse practitioner diagnosis epididymitis in a 24-year-old sexually active male patient. The drug of choice for treatment of this patient is: a. Oral doxycycline (Vibramycin) plus intramuscular ceftriaxone 42 55-year-old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him: a. It can be cured with surgical excision or radiation therapy. 43. A characteristic of delirium that is typically absent and dementia is: a. Acute onset of confusion in a previously alert and oriented patient 44. A 42-year-old male executive has been diagnosed with depression. He is otherwise healthy. And appropriate initial treatment choice is a: a. Selective serotonin reuptake inhibitor (SSRI) 45. the CAGE/ AUDIT questionnaire is useful to assess: a. alcohol use disorders (but you need to know a little more about 46. A 16-year-old athlete complains of pain underneath his heel every time he walks. There is verrucous surface level with the skin of the heel. What pharmacologic intervention should the nurse practitioner prescribed for this patient? a. Salicylic acid plasters 47. Previously immunized elderly patients should receive a tetanus and diphtheria (Td) booster every: a. 10 years 48 nurse practitioner is canceling a young woman who desires pregnancy. She discontinued her oral contraceptives for months ago. Her urine pregnancy test is negative. She expresses concern that she might have an infertility problem. The nurse
A two-year-old African-American child is being evaluated by the nurse practitioner. His clinical appearance and history are consistent with sickle cell anemia. What is the appropriate laboratory test to diagnose sickle cell anemia? a. Hemoglobin electrophoresis
Which activities are not characteristic of preschool children? a. Always follow rules during playground games
What type of question is most useful when opening an interview? a. Open ended
All of the following agents/ medication classes are generally contraindicated in pregnancy except: a. Cephalosporins, parenteral insulin, parenteral heparin.
A 35-year-old female with a history of mitral valve prolapse is scheduled for routine dental cleaning. According to the 2007 American Heart Association’s guidelines for endocarditis prophylaxis, what would you advise this patient? a. She does not need prophylaxis for any dental procedure
What diabetic complications result from hyperglycemia? a. (1) Retinopathy, (3) peripheral neuropathy, (4) accelerated atherogenesis
Which of the following diagnostic assessments must be considered before developing any plan of care for a 27-year-old female presenting to a family practice clinic? a. Pregnancy test
The process by which a professional association confers recognition that a licensed professional has demonstrated mastery of a specialized body of knowledge and skills is termed: a. Certification
A 15-year-old male has a history of cryptorchidism which was surgically repaired. Because of this information, it is essential for a nurse practitioner to teach him about: a. Testicular self-examination
A 30-year-old female comes into a clinic with classic signs and symptoms of appendicitis. The nurse practitioner fails to refer the patient tree surgeon. D appendix ruptured and the woman dies. This is an example of: a. Malpractice
And elderly patient is being seen in the clinic for a complaint of “weak spells” relieved by sitting or lying down. The nurse practitioner checks the patient’s blood pressure while he is lying, sitting, and standing. The nurse practitioner suspects: a. Orthostatic hypertension
The nurse practitioner knows that the frail elderly alright high risk for malnutrition. Indicators of malnutrition in this population included all of the following except: a. Hunger and increased appetite
The patient reports, “something flew in my eyes” about an hour ago while he was splitting logs. If there was a foreign body in his eye, the nurse practitioner would expect to find all except: a. A purulent discharge
Inappropriate initial treatment for external genital warts caused by human papilloma virus (HPV) in a non-pregnant patient is: a. Topical trichloroacetic acid (TCA)
A new patient presents to the nurse practitioner clinic stating she wants a second opinion. She started propylthioutacil (PTU, Propyl-Thyracil) 75 mg three times today a week ago as therapy for newly diagnosed Graves’ disease. She still feels irritable and jittery. How should the nurse practitioner respond? a. Inform the patient that improvement requires 2 to 3 weeks
What advice should be given to the parents of an infant at risk for SIDS? a. Place the baby in the supine position for sleeping
A six-month-old patient with type III metatarsus adductus (i., rigid and does not correct to neutral) should be treated with: a. Surgical intervention
Patient should be advised to purchase the same brand name for each of the following drugs except:
A patient requests information about foods to include in his diet while vacationing in Mexico to avoid “Montezuma’s revenge.” The nurse practitioner should advise him to ingest only: a. Cooked vegetables in soup, bottled water, and wine
An eight-month-old male presents with hemarthrosis of both knees and hematuria. The parents gave no history of trauma but say “he has always bruised easily.” The most likely diagnosis is: a. A type of hemophilia
Of the following for malpractice issues for which an APRN may incur liability, which is the most prevalent cause of action? a. Failure to refer when the APRN and skills are exceeded
86 of the following factors is (are) associated with increased incidence of cervical cancer? a. Smoking and sexual activity at an early age with multiple partners 87. Following the finding of prostate gland abnormalities on DRE, the nurse practitioner orders appropriate labs. When preparing to view lab reports with the patient, and Nurse practitioner knows all of the following are true except: a. Normal PSA it’s 10ng/ml or less 88. Which characteristic is not indicative of heart failure? a. Purulent sputum 89. A 32-year-old male patient complains of urinary frequency and burning on urination for three days. Urinalysis reveals bacteriuria and positive nitrates. He denies any past history of urinary tract infections. The initial treatment should be: a. Trimethoprim-sulfamethoxazole (Bactrim, sulfatrim) for 7 to 10 days 90. On trans illumination of the scrotum, the nurse practitioner identifies a hydrocele in a three-month-old infant. What course of action should be taken? a. Monitor the infants until 12 months of age 91. Which of the following is an appropriate drug for initial treatment of gastroesophageal reflux disease (GERD) in adults? a. Famotidine (Pepcid)/ You need to know the drug class
- The major health risk associated with oral contraceptive therapy is? a. Cardiovascular events
- The most effective treatment of primary and secondary encopresis focuses on: a. Establishment of a regular bowel routine
- A 55-year-old male patient complains of blood in his urine for the past two weeks. He denies dysuria. Urinalysis is positive for red blood cells and negative for leukocytes and nitrates. The initial evaluation of this patient should include: a. Renal ultrasonography
- A 50-year-old non-smoker with no comorbidities presents to the clinic an is diagnosed with community acquired pneumonia. His vital signs are normal except for temperature 101°F. a sputum specimen is collected and sent for culture and sensitivity. What action should the nurse practitioner take today? a. Start Clarithromycin (Biaxin) 500 mg BID for five days
- ??????? a. Influenza vaccine should be given annually to all persons 65 years or older, anti- persons six months or older who are And chronic care facilities, or who suffer chronic cardiopulmonary disorders, metabolic disorders, hemoglobinopathies, or immunosuppression.
- Simple cases of impetigo and folliculitis are usually successfully treated with: a. Topical antibiotics
- A patient on oral contraceptives reports that she has forgotten to take her pill the last two days in A row. What should you advise her? 1-take two tablets daily for the next two days, then resumed a regular schedule. 2-begin a new compact of tablets starting the first day of the next cycle. 3-use an additional method of contraception for the rest of the pill pack-take one tablet, discard the second, and continue as scheduled. a. 1 and 3
- A three-year-old has enlarged, warm, tender cervical lymph nodes, indicating: a. Infection proximal to the nodes
a. Explain why an infant with hypospadias should not be circumcised 109. A patient complains of “stomach pains” on and off for the past month. In distinguishing between a gastric and duodenal ulcer, what question is least important to ask? a. Have you been out of the country in the past several months 110. Enlargement of the scrotum and testes with little change in size of the penis characterizes which tanner stage of sexual development? a. Tanner 2 111. Which of the following ecchymotic lesions in a four-year-old patient most likely represents a possible bleeding disorder: a. 7 cm on the abdomen 112. The mother of a six-month-old infant asked about the use of an infant walker. The most appropriate response is to: a. Discourage the use of walkers and encourage parental holding and floor play 113. The developmental task for the family of an adolescent is to: a. Allow the adolescent increasing freedom and responsibility 114. Which of the following diseases is not acquired trans placentally? a. Tuberculosis 115. A two-year-old has iron deficiency anemia and has not had an increase in hemoglobin for the past three months despite Iron supplementation. The nurse practitioner should: a. Consider referral to a hematologist for further assessment 116. A 38-year-old penicillin allergy patient has folliculitis on A bearded part of his face. The nurse practitioner prescribes erythromycin and tells the patient: a. Erythromycin may upset his stomach, so it should be taken with food. 117. A 45-year-old male is diagnosed with hypertension. His blood pressures have been gradually increasing overtime, with a reading today of 152/98. Diagnostic studies are normal. The most likely diagnosis for this patient is: a. Essential hypertension 118. Which of the following signs and symptoms are typical of hypothyroidism? a. Constipation
- The most commonly recommended method for prostate cancer screening in a 55-year-old man is: a. prostate specific antigen (PSA) testing alone
- An obese 43-year-old has recurrent superficial fungal skin infections over the past two years. Today, she presents with intertriginous candida. Her skin is macerated from frequent rubbing and scratching. The plan of care should include: a. Recommended screening for diabetes myelitis and HIV infection
- If 37-year-old female patient with A history of a single episode of depression and frequent complaints of PMS is being treated for hypothyroidism. Today she complains of poor concentration and fatigue. The nurse practitioner should: a. Question her further
- Which of the following drugs has a beneficial effect on benign prosthetic hyperplasia? a. Doxazosin (Cardura)
- A patient that has 20/80 Visual acuity can see: a. At 20 feet what a person with normal vision can see it 80 feet
- The goals of treatment for patients with alcohol abuse disorder are: a. Abstinence or reduction in use, relapse prevention, and rehabilitation
- The nurse practitioner correctly teaches the patient with diabetes mellitus that if blood glucose is less than 100mg/dl (5 mmol/L) prior to exercise, the patient should first consume 15 g of carbohydrates, such as: a. Once slice of bread
- Characteristics of prescription and OTC drug use in the elder population include all of the following except: a. Increased tolerance to drug effects
- Acute lymphocytic leukemia (ALL) is usually diagnosed by: a. A bone marrow examination
- Subsequent to successful completion of the nurse practitioner certification exam, the candidate is considered to be: a. CERTIFIED
demonstrate positive HBsAg/ surface antigen. The nurse practitioner would most likely diagnose: a. A chronic hepatitis B infection 139. Phalen’s test, 90° wrist flexion for 60 seconds, reproduces symptoms of: a. Carpal tunnel syndrome/ I think the question states what will show in a person who has Carpal tunnel syndrome, and the answer is a positive phalens and tinnels sign 140. According to the American nurses Association (ANA), the role of the nurse practitioner who provides primary healthcare is: a. Direct nursing care role 141. Health maintenance organization (HMOs) and preferred provider organizations (PPOs) are: a. Managed care systems 142. A nurse practitioner has been sued by a patient for malpractice. The nurse practitioner is considered to be a: a. Defendant 143. A young couple is being seen by the nurse practitioner for preconception counseling. They Express the wish for pregnancy within the next three months and are very eager to know what they can do now to “make the baby as healthy as possible”. Which of the following should the nurse practitioner in courage to decrease the chance of neural tube defect in the fetus? a. Folic acid 0 mg daily 144. An active 82-year-old male in good health complains “I don’t see as well as I used to and my eyes are very sensitive to glare.” His near and distant visual acuity is diminished, and he has a bilateral white pupillary reflex. The most likely diagnosis is: a. Cataracts 145. The Papanicolaou (PAP) smear report on a 36-year-old female patient indicate atypical squamous cells of undetermined significance (ASCUS). Which of the following constitutes appropriate care for this patient? a. Repeat the Pap smear in four months
A 23-year-old female college student is being evaluated by the nurse practitioner for immunization status. She has documentation of completion of IPV, DTaP, and MMR series. She states, “I got a shot when I was 12 years old, but none since then.” Which vaccines should she received today? a. Td and HBV
A 20-month-old Child has been brought to the clinic after having a simple febrile seizure. The most appropriate intervention is to: a. Educate the patient about febrile seizures and first aid
A 75-year-old female complains that she awakens 3 to 4 times each night sensing bladder fullness, but is unable to “hold it” until she can get seated on the bathroom toilet. This type of urinary incontinence is termed: a. Urge incontinence
A one-month old presents with reported recurrent diarrhea, screaming, and drawing up of the legs followed by periods of lethargy. On physical examination, A” sausage-like” mass is palpated in the upper right quadrant of the distended abdomen. Which of the following is the most likely diagnosis? a. Intussusception
A critically ill patients states, “my family is well provided for”. The nurse practitioner must interpret this meaning as the patient: a. Wishes to discuss the topic of death
A 46-year-old female has hypertension and is well managed on propranolol (Inderal). Which of the following is a beneficial secondary effect of this drug? a. Migraine prophylaxis
During pregnancy, it is important to be physically active. The nurse practitioner should encourage her pregnant patient who has a very sedentary lifestyle to: a. Start walking daily and slowly build up distance
A 19-year-old pregnant patient, at 20 weeks gestation, complains of pain in the right lower quadrant. She is afebrile and denies nausea and vomiting. The most likely diagnosis is: a. Round ligament pain
Which of the following is not covered by Medicare part B?
The most common symptoms of transient ischemic attack (TIA) include: a. Weakness and extremity, abruptly slurred speech or partial loss of vision, and sudden gate changes
A 15-year-old patient has a complaint of vaginal discharge. She is sexually active with multiple partners. Which of the following symptoms should leave the nurse practitioner to suspect pelvic inflammatory disease (PID)? a. Cervical motion tenderness (CMT)
The nurse practitioner wants to assess intactness of a patient’s cerebellar function. Which of the following clinical test will provide information relative to cerebellar function? a. Romberg
A patient presents with distorted area and a blind spot in the visual field. The painless condition was first noticed on awakening this morning. The nurse practitioner would most appropriately include all of the following in the plan of care except: a. Refer the patient to an ophthalmologist if the condition does not get better within 24hrs.
Which murmur is associated with radiation to the neck? a. Aortic stenosis
The correct order of physical examination of the abdomen is: a. Inspection, auscultation, percussion, palpation
What disease process is Bouchard’s nodes most commonly associated with? a. Osteoarthritis (OA)
A patient has Kawasaki syndrome. Which characteristic would be unusual? a. Age >15years
The nurse practitioner should instruct the mother of an infant with thrush to: a. Sterilize pacifiers and bottle nipples
A 24-year-old female taking oral contraceptives has missed her last 2 pills. What should the nurse practitioner advise her to do? a. Double today’s dose and tomorrow’s dose and use a barrier method the rest of this month
A 65-year-old diabetic patient has newly diagnosed peripheral artery disease in her lower extremities. She is exhibiting symptoms of this disease. In assessing this patient, the nurse practitioner would expect to find: a. Dependent rubor
A patient recovering from a recent stroke is starting anticoagulant therapy. The nurse practitioner should teach the patient to avoid all of the following except: a. Milk and milk products
The anatomical site currently believed to be the best location for subcutaneous insulin administration is: a. Abdomen
A patient presents with periorbital erythema and edema, fever, and nasal drainage. The nurse practitioner should: a. Start aggressive antibiotic therapy
A nurse practitioner is examining a 2-month-old infant. What question is most important to ask about the baby? a. Was the infant full-term at birth
Which of the following patients is least likely to develop osteoporosis secondary to a comorbid condition? a. A 28-year-old female with type II diabetes
A 72-year-old man has chronic prostatitis. What is the initial drug treatment of choice for this patient? a. Ciprofloxacin
Practitioners working with physically active girls need to be aware of the “female athlete triad” in order to develop an effective plan for prevention, recognition, and treatment. The component of the female athlete triad are: a. Eating disorder, amenorrhea, and osteoporosis
Which of the following drug classes may potentiate hyperkalemia in a patient taking potassium-sparing diuretic or potassium supplement? a. Angiotensin converting enzyme inhibitor
Salicylates and other nonsteroidal anti-inflammatory agents have all of the following actions except:
APEA Midterm with info
Course: Advanced Clinical Diagnosis (NR-603)
University: Chamberlain University
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