NR 511 Midterm Exam

04 August 2024

Question #1: Which of the following is associated with severe tinnitus?

  • Depressive disorder.
  • Hypertension.
  • Stroke. (Correct Answer)
  • Diabetic retinopathy.

Explanation: Severe tinnitus can be associated with a stroke, especially if it occurs suddenly and is accompanied by other neurological symptoms.

Question #2: How do most clients on traditional Medicare cover their out-of-pocket expenses?

  • Acquiring Medicare Part B.
  • Acquiring a secondary insurance plan. (Correct Answer)
  • Setting up a monthly payment plan.
  • Paying after the service has been rendered.

Explanation: Most clients on traditional Medicare obtain a secondary insurance plan, such as a Medigap policy, to cover out-of-pocket expenses not covered by Medicare.

Question #3: Which of the following is true regarding atopic dermatitis?

  • The client complains of itching after the rash appears.
  • The cardinal sign is severe pruritus. (Correct Answer)
  • Pruritus occurs during the acute phase of the rash.

Explanation: The cardinal sign of atopic dermatitis is severe itching (pruritus), which often occurs before and during the rash.

Question #4: A 16-year-old client presents to the clinic with right ear pain for two days following participation in a high school swim meet. The eardrum demonstrates tenderness with traction of the pinna and tragus pain when pressure is applied. The ear canal is red and swollen to the point that the tympanic membrane cannot be visualized. Which of the following is the most likely diagnosis?

  • Foreign body in the ear.
  • Otitis media.
  • Otitis externa. (Correct Answer)
  • Ruptured tympanic membrane.

Explanation: The symptoms described, including pain on manipulation of the pinna and tragus, redness, and swelling of the ear canal, are characteristic of otitis externa.

Question #5: A 10-year-old client was prescribed amoxicillin for otitis media. The FNP receives a call from the parents that the client has developed a rash on the trunk. What is the most appropriate next activity by the FNP?

  • Stop the medication. (Correct Answer)
  • Prescribe systemic antihistamines.
  • Prescribe a short course of systemic steroids.
  • Continue the drug since it is an expected early reaction.

Explanation: The development of a rash after starting a new medication, such as amoxicillin, could indicate an allergic reaction. Stopping the medication is the appropriate first step.

Question #6: Which of the following statements regarding the client history is true?

  • History of present illness (HPI) is a detailed breakdown of the client’s chief complaint. (Correct Answer)
  • Objective findings are reported in the review of systems (ROS).
  • The OLDCART acronym represents the client’s previous medical history.
  • Objective findings are reported in the history of present illness (HPI).

Explanation: The History of Present Illness (HPI) provides a detailed account of the client’s current health issue and its progression, not the ROS or previous medical history.

Question #7: Which of the following individuals is at most risk for developing epiphora (excessive tearing)?

  • A 15-year-old soccer player.
  • A 76-year-old with Type 2 diabetes. (Correct Answer)
  • A 40-year-old with hypertension.
  • A 30-year-old computer programmer.

Explanation: The elderly with chronic conditions like diabetes are at a higher risk for developing epiphora due to age-related changes and the effects of chronic diseases.

Question #8: A client presents to the office with a complaint of skin irritation, redness, and tenderness on the back of his neck. Examination reveals a rubbery, smooth, and round mass of tissue. The mass is compressible and has a soft texture. What is the most likely diagnosis?

  • Acrochordons
  • Skin tags
  • Nevi
  • Lipoma. (Correct Answer)

Explanation: A lipoma is a benign, soft, and compressible subcutaneous mass of fatty tissue, which matches the description provided.

Question #9: A complete blood count (CBC) may identify which of the following as a cause of tinnitus?

  • Thyroid disease.
  • Zinc deficiency.
  • Anemia. (Correct Answer)
  • Hyperlipidemia.

Explanation: Anemia can lead to tinnitus due to decreased oxygen delivery to the inner ear, which can be detected through a CBC.

Question #10: A 45-year-old client with a history of a total thyroidectomy comes to the office concerned with a rash that has developed around a new tracheostomy site. Upon examination, the NP notes a papular rash with satellite lesions surrounding the stoma. What does this indicate?

  • Candidiasis. (Correct Answer)

Explanation: The papular rash with satellite lesions around a tracheostomy site suggests candidiasis, a fungal infection commonly occurring in moist areas and around medical devices.