NR509 Advanced Physical Assessment Midterm Exam Review

15 July 2024

NR509 Advanced Physical Assessment Midterm Exam Review.

Here is the reproduced information with the word “correct” inserted for every correct answer:

  1. When performing a visual acuity test the nurse practitioner notes 20/30 in the left eye and 20/40 in the right eye using the Snellen eye chart. This means:
    • c) correct refer the patient to an ophthalmologist
  2. The American psychiatric association’s diagnostic and statistical manual of mental disorder defines Munchausen Syndrome By Proxy
    • b) correct a caregiver making up or causing an illness or injury in a person under his or her care
  3. Symptoms of depression are a side effect of which neurotransmitter medication?
    • a) correct dopamine serotonin, norepinephrine
  4. Which lesion is dark raised and asymmetric with an irregular border? Quizlet Bates Chapter 20
    • d) correct Melanoma
  5. A 32 years old woman presents with dull puffiness of the eyes pronounced not pitting periorbital edema. This finding is suggestive of this condition? APEA
    • b) correct Myxedema
  6. A 42 years old woman with a past medical history of migraine headaches is requesting prophylactic medication treatment. Which medication should the Nurse practitioner prescribe?
    • b) correct Amitriptyline (Elavil)
  7. A pediatric patient has areas of scaling on the scalp with round patches of alopecia. This clinical finding is consistent with:
    • a) correct Tinea capitis
  8. Why would a combined hormonal contraceptive be contraindicated in a 36 year old patient with a past medical history of type 2 diabetes, obesity, chronic smoking and sedentary life
    • c) correct Her age and tobacco use
  9. During the breast examination of a perimenopausal woman the NP detects a bloody spontaneous discharge from the right nipple. This indicates further evaluation.
    • c) correct An intraductal papilloma
  10. Rh negative women should receive Rho (D) immunoglobulin at what gestational time?
    • c) correct 28 weeks
  11. When interpreting a complete blood count (CBC) lab report which of the following results describes the size of the RBCs?
    • b) correct Mean corpuscular volume (MCV)
  12. What medication should be avoided when prescribing prophylactic therapy for a headache
    • c) correct Venlataxin (Effexor)
  13. What is the mechanism of action of prostaglandin E1 (PG1) in a patient with the transposition of the great arteries
    • c) correct To produce vasodilation on …………….
  14. Which of the following complaints best describes lower extremity calf pain associated with peripheral artery disease
    • b) correct A dull pain or cramp
  15. Which of the following conditions is NOT a typical finding of hyperprolactinemia in a 47-year-old premenopausal woman?
    • b) correct Gynecomastia
  16. When treating a patient with asthma who is experiencing acute wheezing which medication should be given to relieve the symptom?
    • a) correct Short acting bronchodilator
  17. Which immunization reduces a patient’s risk for infection with the virus that causes a painful localized blistering rash?
    • c) correct Shingles (herpes zoster) vaccine
  18. Headache warning signs that need prompt investigation include all of the following EXCEPT:
    • d) correct Headache relieved with mild infrequent use of analgesics
  19. The client with iron deficiency anemia should be advised to take the iron supplement
    • c) correct On an empty stomach between meals
  20. Which one of the following statements is true of Munchausen syndrome by proxy?
    • b) correct Under the supervision of adults other than the abuser, the patient does not exhibit symptoms
  21. Which of the following is the most common presenting sign of substance abuse in adolescents?
    • d) correct changes in behavior
  22. A woman is 11 weeks pregnant and has a maternity history of one full term vaginal delivery, a set of premature triplets delivered vaginally, and a first-trimester abortion. Using her TPAL system to document her maternal status
    • a) correct Gravida 4 para 1114
  23. The nurse practitioner palpates an enlarged right epitrochlear lymph node in a 30 years old patient. The Nurse Practitioner should assess the patents
    • c) correct Right forearm and hand
  24. Anticholinergics are indicated for the treatment of
    • c) correct Urge incontinence
  25. A patient presents with signs of chest pain, the nurse practitioner observes jugular venous distention. Their finding is consistent with
    • b) correct Heart failure
  26. On examination of the neck, a dome-shaped lesion in the dermis forming a benign closed firm sac attached to the epidermis is noted on the right lateral side of the neck. The type of lesion is known as
    • c) correct A cutaneous cyst
  27. Symptoms of heartburn and regurgitation are associated with:
    • b) correct Gastroesophageal reflux
  28. A 70 years old man walks 20 minutes most days of the week. He has begun to complain of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 20 minutes walks without stopping to rest. What choice best describes the pain associated with peripheral artery disease?
    • b) correct A dull pain and cramp
  29. Papilledema is a cause for concern because it is suggestive of
    • c) correct Increased intracranial pressure
  30. A 38-year-old patient with a history of abdominal pain presents to the nurse practitioner. Findings reveal superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. Hemorrhagic pancreatic is suspected because of which finding?
    • b) correct A positive Cullen’s sign
  31. A 57 years old post-menopausal female presents with a complaint of vaginal burning, pruritus, and painful intercourse. On examination, the nurse practitioner would be most concerned with the findings
    • c) correct A friable cervix
  32. What intervention does the American College of Rheumatology recommend as first-line therapy for Osteoarthritis, rheumatoid arthritis, or something else
    • d) correct Exercise and weight loss
  33. Which of the following drugs is not contraindicated for concurrent use with warfarin (Coumadin)?
    • a) correct Amoxicillin (Amoxil)
  34. The lymphatic ducts drain into the (APEA)
    • b) correct venous system
  35. Which of the following is the most appropriate treatment for trichomoniasis in a non-pregnant woman?
    • a) correct Metronidazole (flagyl)
  36. Osteosarcoma in a pediatric patient is most often diagnosed when there is:
    • a) correct Pain in the affected bone
  37. In a patient who has a history of migraine headaches, which characteristic is most common?
    • b) correct Family history
  38. Symptoms associated with small bowel obstruction usually include:
    • b) correct Vomiting and pain
  39. Unilateral rhinitis could be caused by all of the following except
    • c) correct Drug induced rhinitis
  40. A 7 years old child has been diagnosed with acute sinusitis. The drug class that should be avoided is:
    • a) correct Antihistamines
  41. A patient presents with an elongated head with bony prominence of the forehead, nose, and lower jaw. These facial features could be suggestive of:
    • b) correct Acromegaly
  42. Why would a child diagnosed with beta thalassemia and hemosiderosis receive deferoxamine (desferal)?
    • d) correct To eliminate excessive iron and prevent organ damage
  43. A patient has newly diagnosed hypothyroidism. What are the patients TSH levels expected to be?
    • a) correct Higher than normal
  44. Which of the following symptoms would be a clinical manifestation noted during the secondary stage of syphilis?
    • c) correct Rash marked by red or reddish-brown, penny-sized lesions over the palms and soles
  45. An 84-year-old male with prostatic hypertrophy is at increased risk of:
    • c) correct Urinary tract infections
  46. A characteristic lesion observed in a male with primary syphilis is a:
    • b) correct Chancre
  47. During an acute attack of gout, the nurse practitioner knows NOT to prescribe
    • b) correct Allopurinol (zyloprim)
  48. What two vitamins and minerals should be included in oral multivitamins in women
    • d) correct Folic Acid and Iron
  49. In a patient with bacterial meningitis, the most common reason for finding headaches:
    • b) correct Increased intracranial pressure
  50. Janeway lesions, petechiae, and Osler nodes are associated with:
    • b) correct Infective endocarditis
  51. A patient presents with decreased hearing related to antibiotic use. Which class of antibiotics is this?
    • a) correct Aminoglycosides
  52. Which antihypertensive would be appropriate to prescribe for a hypertensive patient (B/P 150/95) that is in her third trimester?
    • c) correct Methyldopa
  53. A 40-year-old admits to multiple sex partners presents with several lesions over his body. Finding reveals hemorrhagic vesiculopustular lesions over the hands and feet. These lesions are most likely associated with:
    • a) correct Gonococcemia
  54. Which agent is NOT useful in prophylactic treatment of migraine headaches?
    • a) correct Sumatriptan (Imitrex)
  55. The right lymph duct drains lymphatic fluid from all the following except the (APEA)
    • d) correct Right leg
  56. Acute lymphocytic leukemia is usually diagnosed by:
    • d) correct A bone marrow examination
  57. The medication that blocks the transportation of glucose across the intestines into the bloodstream to target prandial blood glucose is:
    • b) correct Acarbose (Precose)
  58. Prostate pain is usually located in the:
    • c) correct Perineum
  59. A nurse practitioner examines the skin of an elderly patient. Which finding below is NOT a benign lesion associated with the aging process?
    • d) correct Dermatophytosis
  60. A 65-year-old male presents with findings of a symmetric thorax with moderate kyphosis and an anterior diameter. Chest expansion is decreased and the diaphragm descends 2 cm bilaterally. These findings relate to:
    • d) correct Chronic obstructive pulmonary disease
  61. Phenazopyridine (Pyridium) is recommended for very short-term use in patients with urinary tract infections (UTIs) because:
    • b) correct Occurrence of hemolytic anemia
  62. Estrogen-progestin contraceptives should be avoided in women with:
    • b) correct Migraines with aura
  63. The addition of benzoyl peroxide to erythromycin for the topical treatment of acne:
    • a) correct Improve the efficacy of erythromycin
  64. An elderly male with benign prostate hyperplasia (BPH) should be advised to avoid antihistamines. What is the reason for this?
    • d) correct Urinary retention
  65. Examination of the hair reveals a fine silky appearance. This finding may be seen in patients that have:
    • b) correct Hyperthyroidism
  66. A patient develops a cough secondary to an angiotensin-converting enzyme (ACE). The most appropriate statement related to ACE-I cough is that the cough typically:
    • a) correct Resolves within a week after stopping the ACE inhibitor
  67. A patient with a diagnosis of giardiasis is being treated with metronidazole (flagyl). What information would be important to obtain before prescribing this medication?
    • d) correct If the patient drinks alcohol
  68. A 20 years old male living in the college dorm, complains of a dry cough for the past month. Assessment finding associated with atypical, community-acquired pneumonia would include:
    • a) correct A low-grade fever, malaise, and clear lung fields on auscultation
  69. The most appropriate medication indicated for reversing the anticoagulated effects of dabigatran etexilate (Pradaxa)
    • a) correct Idarucizumab (Praxbind)
  70. A common pathological finding in patients with asthma
    • d) correct Hypertrophy of smooth muscle
  71. Which cranial nerves are responsible for eye movement?
    • b) correct CN III, IV, VI
  72. The typical presentation of severe acute aortic regurgitation (AR) includes sudden severe shortness of breath, rapidly developing heart failure, and:
    • c) correct Decreased blood pressure
  73. Disorders in the kidneys and the ureters may cause pain in all of the following areas except the:
    • d) correct Suprapubic
  74. When palpating the prostate gland during the rectal exam, the prostate feels tender, swollen, boggy, and warm. This finding is consistent with:
    • b) correct Acute bacterial prostatitis
  75. This contagious disease causes fever, headache, stiff neck, photophobia, nausea, vomiting, and altered mental status. What immunization prevents this?
    • a) correct Meningococcal vaccine
  76. Headache warning signs that need prompt investigation include all of the following
    • a) correct New onset after 50
  77. Serotonin Syndrome is a potentially life-threatening condition associated with:
    • c) correct Increased levels of serotonin
  78. Which one of the following statements about treating scabies with lindane (Kewell) is correct? Know that Nix is the treatment.
    • b) correct Lindane lotion and/or shampoo is not considered first-line therapy
  79. Symptoms consistent with later-stage human deficiency disease (HIV) typically include all of the following except,
    • c) correct Persistent vomiting
  80. The earliest clinical manifestation of diabetic nephropathy is:
    • d) correct Microalbuminuria
  81. When fluid accumulates between the visceral and parietal pleural spaces, the term used is:
    • b) correct Pleural effusion
  82. Children born with Down syndrome often have other anomalies. They especially require evaluation of what body system?
    • c) correct Cardiac
  83. What finding is typical in a patient with a meniscal tear? (APEA)
    • a) correct Positive McMurray’s test
  84. The nurse practitioner diagnoses a female patient with trichomoniasis. A common chief complaint of a patient with trichomoniasis is:
    • c) correct Vaginal discharge
  85. When deciding on an initial treatment option for an acute flare of atopic dermatitis, unresponsive to emollient therapy, the next best choice for treatment is:
    • c) correct Desonide 0.5%
  86. When examining the breast, the “tail of Spence” would be located
    • d) correct Laterally across the anterior axillary fold
  87. Headaches with symptoms of nausea and vomiting may be associated with all of the following, EXCEPT:
    • d) correct Tension headache
  88. Which of the following findings could indicate a need for further evaluation of the cardiac patient?
    • d) correct Low-density lipoprotein of 190 mg/dl
  89. Alpha-adrenergic blockers increase urine outflow in males by:
    • c) correct Relaxing prostate smooth muscle
  90. The scoliosis patient who would cause the greatest concern for the nurse practitioner is a:
    • a) correct 13 y/o female with a 100 curve
  91. Which finding below would be unusual in a patient with diabetic retinopathy?
    • a) correct Papilledema
  92. Where should the uterine fundus be palpable at 12 weeks?
    • b) correct At the level of the symphysis pubis
  93. Ophthalmoscopic examination of a 40-year-old carpenter reveals a triangular thickening of the bulbar conjunctiva across the outer surface of the cornea. This condition is termed:
    • c) correct Pterygium
  94. A patient calls the nurse practitioner, and states that he missed his morning daily dose of warfarin, 5 mg yesterday and today. The nurse practitioner instructs the patient to:
    • d) correct take warfarin 5 mg now and resume the warfarin 5 mg daily dose in the morning as scheduled.
  95. What common clinical finding is present in a patient who has croup?
    • a) correct Barking cough
  96. A type of breast cancer that begins with erythema and swelling of the breast and progresses rapidly is termed:
    • c) correct Inflammatory breast cancer
  97. Salmeterol (sereventR) in combination with an inhaled steroid is prescribed for a patient with moderate persistent asthma. What is the most important teaching point about salmeterol?
    • a) correct It is not effective during an acute asthma attack
  98. A 50-year-old male has a non-tender, enlarged scrotum. The nurse practitioner suspects which of the following conditions:
    • c) correct Hydrocele
  99. Risk factors associated with breast cancer include all of the following except:
    • d) correct Low socioeconomic status.
  100. Which group of lymph nodes are located on the medial surface of the arm approximately 3 cm above the elbow? - c) correct Epitrochlear nodes
  101. An elderly patient has been diagnosed with a cataract. What structure in the eye has become diseased? - c) correct Lens
  102. A patient presents with pain in the shoulder. The nurse practitioner knows that there are four rotator cuff muscles. The muscle that initiates abduction movement at the shoulder is known as the: - a) correct Supraspinatus
  103. A patient with bulimia is likely to be: - c) correct Of average weight
  104. Chronic bloody diarrhea could be suggestive of: - b) correct Crohn’s disease
  105. On examination a patient is noted to have a “mask-like” face with decreased blinking and a characteristic stare. These features may be characteristic of: - d) correct Parkinson disease
  106. An appropriate initial treatment for benign positional vertigo is: (APEA) - b) correct Meclizine (Antivert)
  107. Conductive and sensorineural phases are necessary for hearing to take place. The sensorineural phase of hearing pathways involves the: - a) correct cochlea and the cochlear nerve
  108. A 65-year-old has a history of one kidney with early renal insufficiency. He is diagnosed with pneumonia and will require: - c) correct Lower dose of antibiotics
  109. A 44-year-old male presents to the nurse practitioner for an employment physical and is concerned about testing positive for amphetamines on a drug screen, even though he is not taking amphetamines. His current medication list includes metformin, lisinopril, glyburide, and bupropion. The most likely medication cause for a false positive result for amphetamines would be: - d) correct Bupropion
  110. Desmopressin acetate (DDAVP) nasal spray has been found to be useful in the management of enuresis in children. In which of the following situations is the drug especially beneficial? - d) correct Sleepovers
  111. Rapid Human Immunodeficiency virus (HIV) testing would be appropriate for a patient with complaints of - b) correct Painful urination, dyspareunia, and vaginal or penile discharge
  112. Which of the following conditions is NOT associated with the symptoms of hemoptysis? - c) correct Viral pneumonia
  113. Which condition is associated with end-stage renal disease in pediatric patients and requires recombinant erythropoietin treatment? - d) correct Anemia
  114. When evaluating a 17 y/o girl with infrequent menstrual periods, which findings suggest probable hyperandrogenism? - b) correct Hirsutism
  115. Which form of urinary incontinence is present in a patient with Alzheimer’s disease who is unable to reach the toilet in time? (APEA) - a) correct Functional incontinence
  116. A 27 y/o male patient presents with a painless chancre on the shaft of his penis and regional lymphadenopathy. He is diagnosed with primary syphilis. The best initial treatment is: - d) correct Benzathine penicillin G (Bicillin L.A)
  117. An 80 y/o man is being evaluated for recent episodes of incontinence and confusion. His family states that he is usually independent with no altered mental issues, but has become forgetful within the last 2 weeks. Which medication is most likely associated with these symptoms? - a) correct Cimetidine (tagamet)
  118. When ordering an oral diabetes medication for a 72 y/o patient with a recent hx of decreased appetite and ongoing risk of hypoglycemia. The NP should Rx. - c) correct Metformin (Gucophage)
  119. To increase urine outflow in men with BPH, the NP should prescribe - a) correct An alpha blocker
  120. A 64 y/o man c/o leg pain and occasional numbness that worsens with ambulation and improves with lumbar flexion. The symptoms are consistent with: - b) correct Spinal stenosis
  121. Which is a true statement about varicose veins? - d) correct They are more symptomatic during ovulation
  122. A 17 y/o is dx. With mild bronchospasm. Which of the following would provide relief? - b) correct Inhaled levalbuterol (Xopenex)
  123. A common cause of decreased libido in men is due to? - b) correct Endocrine dysfunction
  124. What should be included in the initial tx of bacterial epididymitis in a sexually active 22 y/0 male? - a) correct Doxycycline and ceftriaxone
  125. Which assessment findings are NOT associated with pyloric stenosis in a 2-month-old infant? - c) correct A bloated and tense tympanic abdomen
  126. Hyperkalemia is associated with - c) correct Diminished renal function
  127. The assessment of a 72 y/o male causes the NP to have concerns that the pt. is a suicide risk. Risk factors for suicide in the elderly do NOT include - d) correct Retirement
  128. A pregnant pt presents for a routine 16-week prenatal visit. Her BP has decreased from 119/78 mm/Hg at her 12-week visit to 110/69 mmHg. What hemodynamic for the decreased BP? - d) correct Decrease in systemic vascular resistance
  129. The most common treatment for Helicobacter pylori is a triple therapy, interpreted as: - a) correct 2 antibiotics and proton pump inhibitor for 7-14 days
  130. Patients with psoriasis frequently have - c) correct Pitted nails and plaques
  131. Which condition is best treated using alpha adrenergic antagonist? - d) correct Overflow incontinence
  132. A patient who is taking an oral glucocorticosteroid should be advised to - d) correct Take it with food
  133. Which of the following drug classes is not indicated for the treatment of depression? - a) correct Buspirone (Buspar)
  134. A Hispanic woman who is 26 weeks pregnant states that she recently began eating ice chips between meals. - b) correct Assess the patient for iron deficiency anemia
  135. Snellen chart evaluation indicated that the patient vision is 20/30. What is the proper description of this result? - a) correct At 20 feet, this patient can see what a person with normal vision can see at 30 feet
  136. Which of the following is NOT a common symptom of Vit b12 deficiency - d) correct Vomiting
  137. During a migraine, the cerebral arteries - b) correct Dilate
  138. Which is the appropriate medication for a 31 y/o pregnant diagnosed with UTI - a) correct Cefuroxime (Zinafed) or nitrofurantoin (Macrobid)
  139. Which of the following medications is not indicated for the treatment of muscle spasms? - a) correct Baclofen (lioresal)
  140. During an abdominal examination, the NP percusses the bulging area of the abdomen. Which sound suggests the presence - b) correct Dullness
  141. Which pathogen is associated with common urinary tract infections? - a) correct e.coli
  142. Which condition is caused by an insufficient production of intrinsic factor by gastric mucosa and vitamin B insufficiency? - b) correct Pernicious anemia
  143. A multiparous pregnant patient presents at 24 weeks gestation with a complaint of painless vaginal bleeding. This presentation is consistent with: - b) correct Placenta previa
  144. When measuring the fundal height of a pregnant female at 32 weeks gestation, which measurement would the NP suspect fetal growth - d) correct 32 cm
  145. A 40 y/o female, the overall texture of the breast is soft, with an uneven contour bilaterally. The NP informs the patient that: - a) correct Warrants a mammogram
  146. A 74 y/o man who recently lost his spouse of 50 years in an auto accident tells the NP that “he has no purpose in this life” - b. correct Have you thought about hurting yourself?
  147. A 67 y/o woman with Hx of A-fib and an ejection fraction of 48% has had normal digoxin levels. Which can cause a decrease in the digoxin level? - d. correct Regular use of antacid
  148. 5-alpha reductase inhibitor work to improve symptoms of benign prostatic hyperplasia by? - a. correct Decreasing the size of the prostate
  149. Which medication is indicated for patients with generalized anxiety disorder? - a. correct Buspirone (Buspar)
  150. Pregnant women are evaluated for syphilis with serology testing because: - a. correct Syphilis during pregnancy predisposes the fetus to spontaneously abort or the newborn to have congenital syphilis
  151. When treating a patient with asthma who is experiencing acute wheezing, which medication should be given to relieve the symptoms? - a. correct Short acting bronchodilator
  152. Recommended combination therapy for uncomplicated anorectal and pharyngeal gonorrhea is? - d) correct Ceftriaxone and azithromycin
  153. An example of synovial joints would be - c) correct Shoulder