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NUR 662 Test questions to practice with
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What are management options for PMS and PMDD? - CORRECT ANSWERS ✔✔Exercise - Exercise can help to reduce stress, tension, anxiety, and depression. ●Relaxation therapy - PMS and PMDD can be worsened by stress, anxiety, depression, and other psychological conditions. Relaxation therapy can help to ease the stress and anxiety of daily life and may include techniques such as meditation, progressive muscle relaxation, self-hypnosis, or biofeedback. ●Vitamin and mineral supplements - Vitamin B6 (up to 100 mg/day) might have a small benefit for women with mild PMS. Selective serotonin reuptake inhibitors (SSRIs): Antidepressants Birth control pills When evaluating renal function in the elderly adult, the clinician understands A There will be an increase in the level of serum creatine B Medication dosages may need to be adjusted upward in the elderly C an increase in the GFR is an expected age related change D The kidney demonstrates decreased sodium excretion - CORRECT ANSWERS ✔✔the kidney demonstrates decreased sodium excretion Oral contraceptive pills can cause endometrial cancer?
T/F - CORRECT ANSWERS ✔✔False Most breast cancer cases are in women with a history of breast cancer? T/F - CORRECT ANSWERS ✔✔False The clinician is counseling a 30 year old who is considering pregnancy. Which statement regarding folic acid supplementation is correct? A: 0.4mg folic acid is recommended for all women of child bearing age B: She should begin taking 4mg of folic acid/day now C: Folic acid supplementation is the most important during the 2nd trimester of pregnancy D: Red meat is a good source of folic acid - CORRECT ANSWERS ✔✔A: 0.4mg folic acid is recommended for all women of child bearing age When assessing a woman for infertility, which diagnostic test should be done initially? A: Estrogen level B: Sperm analysis of partner C: hystersalpinogram D: MRI of the ovaries - CORRECT ANSWERS ✔✔B: Sperm analysis of partner
A 23 year old male presents with low back pain. he lifted a heavy box yesterday at work but had no symptoms yesterday. Today however, he began to feel pain and stiffness in his lower back that hurts worse when he bends forward. On exam he has pain with flexion and extension and a negative straight leg raise test. What management plan would be appropriate for him at this time? A: order lumbar spine radiographies B: refer for epidural steroid injections C: Over the counter NSAID's, ice/heat, and return to work in 2 days D: Order MRI lumbar spine - CORRECT ANSWERS ✔✔C: Over the counter NSAID's, ICE/HEAT, and return to work in 2 days Which of the following diagnostic tools is the best measure of renal function in a patient suspected of CKD? A: Electrolytes B: Creatinine clearance C: BUN and Creatinine D: Urinalysis - CORRECT ANSWERS ✔✔B: Creatinine clearance A 32 year old woman comes to the clinic for evaluation of hand pain for the past 6 months. She also experiences numbness in the first through third fingers, and half of the fourth finger. Additionally she states she has been dropping things much more than usual. Physical examination is significant for tingling sensation triggered by palmar surface wrist percussion. Which of the following is a known risk factor for this condition?
A: Hypertention B: Pregnancy C: Osteoarthtitis D: Anemia - CORRECT ANSWERS ✔✔B: Pregnancy A 38 year-old-man comes to the clinic for evaluation of low back pain which radiates into the entire right lower extremity.physical examination reveals decreased sensation to the top of the right foot and decreased strength with resisted flexion of the right great toe. Lower extremity deep tendon reflexes are 2/4 and symmetrical. Compression of which of the following nerve roots is most likely? A: L B: L C: L D: S1 - CORRECT ANSWERS ✔✔A: L A 78 year old woman tripped and fell in the hallfway of your office and is complaining of right hip pain and severe pain with movement of that extremity which of the following finding is expected on physical examination if you suspect a hip fracture? A: Right hip and leg in flexion, internally rotated and shortened B: Right hip and leg in flexion and internally rotated C: Right hip and leg in flexion, externally roatatd and shortened
When prescribing oxybutynin (ditropan) for the patient with overactive bladder symptoms, which disorder in the patient's medical history must the family nurse practitioner consider before prescribing? A: Cough B: Narrow angle Glaucoma C: Diabetes D: Gallstones - CORRECT ANSWERS ✔✔B: Narrow angle Glaucoma A 30 year old woman comes into the clinic for evaluation of right wrist pain for the past 2 months. She denies any known trauma to the wrist, and has not started any new hobbies or activities. She stays home with her 4 month old infant, and has had increasing difficulty holding her baby due to pain. Physical examination is significant for tenderness with palpation of the radial aspect of the wrist, and pain is aggravated when the patient grasps her thumb while performing ulnar deviation of the wrist. Which of the following is the most appropriate initial management? A: Intra Articular steroid injection B: Thumb spica splint C: Surgical release D: Prescribe acetominophen - CORRECT ANSWERS ✔✔B: Thumb Spica Splint
A patient with a known lumbar disc herniation presents with increased pain, difficulty urinating, and saddle anesthesia. What is the most appropriate management option? A: Order transcutaneous electrical stimulation (TENS) B: Provide patient with a narcotic analgesic for pain relief and re-evaluate in 24 hours C: Refer for emergent surgical decompression D: refer epidural steroid injection E: administer a trigger point injection - CORRECT ANSWERS ✔✔C: Refer for mergent surgical decompression Which of the following findings, when persistent, would cause the clinician to suspect the development or early kidney disease? A: decreased uric acid B: Persistent albuminuria C: Increased glomerular filtration rate (GFR) D: Hypocalcemia - CORRECT ANSWERS ✔✔B: Persistent Albuminuria The family nurse practitioner is taking a history of a patient who has been diagnosed with renal calculi. What information in the history would the family nurse practitioner identify as a precipitating factor in the development of renal calculi? A: Drinking 6-8 oz of milk daily
abdominal ultrasound for right upper quadrant pain, on review, both kidneys were normal. Which of the following would be the most appropriate next step in your evaluation of this patient? A: Voiding Cystourethrogram B: Cystoscopy C: Renal biopsy D: MRI E: PSA - CORRECT ANSWERS ✔✔B: Cystoscopy What is the most common location of an osteoporotic fracture related to old age? A: tibia/fibula B: hip C: humerus D: Distal radius E: vertebral column - CORRECT ANSWERS ✔✔B: hip A 52 year old man comes to the clinic for evaluation of left toe pain that began 16 hours prior. He reports the pain began acutely, but denies trauma, wounds, bites, or fever. Medical history is significant for hypertension for which he takes hydrochlorothiazide. Physical examination reveals swelling and erythema over the left first metalarsophalaneal joint. Which of the following dietary recommendations will help prevent a recurrence of symptoms?
A: Avoidance of seafood B: Niacin supplementation C: Vitamin D supplementation D: Increase spinach consumption - CORRECT ANSWERS ✔✔A: avoidance of seafood Which sign or symptom indicates an inflammatory etiology to musculoskeletal pain? A: hyperalbuminemia B: Morning stiffness C: decreased C reactive protein D: weight gain - CORRECT ANSWERS ✔✔B: morning stiffness Which if the following information is essential before prescribing Bactrim DS to a 24 year old woman with a uti? A: last unprotected sexual contact B: Last menstrual period C: Method of birth control D: All of the above - CORRECT ANSWERS ✔✔D: all of the above A 60 year old man presents with recurrent urinary tract infection (UTI's). What is the most likely cause?
C: Apprehension sign D: None of the above - CORRECT ANSWERS ✔✔C: Apprehension sign A 66 year old woman comes to the clinic for a routine wellness examination. Medical history is significant for hypothyroidism, coronary artery disease, and rheumatoid arthritis. Physical examination reveals one inch loss of height. Which of the following diagnostic studies is indicated for osteoporosis evaluation in this patient? A: Anti GGP antibodies B: thoracolumbar spine radiograph C: Dexa Scan D: 26 hydroxyvitamin D level E: thyroid stimulating hormone level - CORRECT ANSWERS ✔✔C: Dexa Scan A 64 year old woman comes to the clinic for evaluation of chronic bilateral knee pain over the past several years. She states she is stiff for approximately 10-15 minutes every morning. She watches her toddler grandchildren daily and her pain is significantly worse at the end of the day. radiographs of the affected joints reveal joint space narrowing and osteophyte formation. Given the most likely diagnosis, which of the following risk factors may have contributed to the development of this condition? A: excess alcohol B: obesity
C: smoking D: competitive swimming - CORRECT ANSWERS ✔✔B: obesity Compared to younger women, uncomplicated UTI in an elderly woman is more likely to be associated with each of the following signs and symptoms except A: Weakness B: delirium C: hematuria D: new onset urinary incontinence - CORRECT ANSWERS ✔✔C: hematuria Which of the following 24 hour urine volumes is termed "oliguria"? A: >1000cc/24hr B: <500cc/24hr C: <100cc/24hr D: >500cc/24hr - CORRECT ANSWERS ✔✔B: < 500cc/24hr Which of the following urinary findings helps discriminate between simple cystitis and pyelonephritis? A:Presence of RBC's B: Presence of WBC Casts C: Presence of RBC Casts
An 82 year old woman with chronic kidney disease is in the clinic complaining of right knee pain. The provider should question the patient about the intake of which of these? A: Ibuprofen 200mg 2-3 time/day B: Losartan 50mg daily C: All of the above D: lisinopril 30 mg daily - CORRECT ANSWERS ✔✔A: Ibuprofen 200mg 2-3 times/day A 58 year old woman comes to the clinic for a routine wellness examination. She reports in the past year she fractured her wrist. She doesn't recall any significant injury, her wrist just started hurting, and when she had radiographs completed at urgent care they identified a fracture. She has a past medical history of diabetes type 2, and osteoarthritis. She is a current smoker with a 35 pack year smoking history, and she drinks one alcoholic drink per day. Physical examination reveals her weight is 115lbs. Given the most likely etiology for her wrist fracture, which of the following is the most appropriate patient education? A: her past medical history of osteoarthritis is a contributing factor B: tobacco cessation will improve her condition C: weight loss will improve her condition D: she should decrease her amount of daily alcohol consumption - CORRECT ANSWERS ✔✔B: tobacco cessation will improve her condition
