south university Advanced Nursing Practice I quiz 4

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south university Advanced Nursing Practice I quiz 4

south university Advanced Nursing Practice I quiz 4

Question 1 (1 point)

An older male patient
reports urinary frequency, back pain, and nocturia. A dipstick urinalysis
reveals hematuria. What will the provider do next to evaluate this condition?

Question 1 options:

a) Order a PSA and perform a digital rectal exam

b) Refer for a biopsy

c) Refer the patient to a urologist

d) Schedule a transurethral ultrasound

Question 2 (1 point)

An older male patient has a
screening PSA which is 12 ng/mL. What does this value indicate?

a) A normal result

b) Benign prostatic hypertrophy

c) Early prostate cancer

d) Prostate cancer

Question 3 (1 point)

A male patient reports
nocturia and daytime urinary frequency and urgency without changes in the force
of the urine stream. What is the likely cause of this?

a) Bladder outlet obstruction

b) Lower urinary tract symptoms

c) Prostate cancer

d) Urinary tract infection

Question 4 (1 point)

A 70-year-old male reports
urinary hesitancy, post-void dribbling, and a diminished urine stream. A
digital rectal exam reveals an enlarged prostate gland that feels rubbery and
smooth. Which tests will the primary care provider order based on these
findings?

a) Bladder scan for post-void residual

b) PSA and bladder imaging

c) Urinalysis and serum creatinine

d) Urine culture and CBC with differential

Question 5 (1 point)

The provider orders the oral
phosphodiesterase type 5 inhibitor sildenafil to treat erectile dysfunction in
a 65-year-old male patient. What will be included when teaching this patient
about taking this medication?

a) The medication is best taken on an empty stomach.

b) The medication should be taken with a fatty food or meal.

c) The medication’s effects may last for 24 to 36 hours.

d) This medication has a rapid onset and short duration of
action.

e) This medication may be taken once daily.

Question 6 (1 point)

Which is true about
hypoactive sexual desire in older men?

Question 6 options:

a) Hypoactive sexual desire in older men is related to sexual
aversion.

b) Hypoactive sexual desire is a conscious choice to avoid
sexual relations.

c) Men with hypoactive sexual desire may have normal excitement
and orgasm.

d) The most common type of sexual dysfunction is hypoactive
sexual desire.

Question 7 (1 point)

A young adult male reports a
dull pain in the right scrotum and the provider notes a bluish color showing
through the skin on the affected side. Palpation reveals a “bag of worms” on
the proximal spermatic cord. What is an important next step in managing this
patient?

Question 7 options:

a) Anti-infective therapy with ceftriaxone or doxycycline

b) Consideration of underlying causes of this finding

c) Reassurance that this is benign and may resolve spontaneously

d) Referral to an emergency department for surgical consultation

Question 8 (1 point)

An adolescent male reports
severe pain in one testicle. The examiner notes edema and erythema of the
scrotum on that side with a swollen, tender spermatic cord and absence of the
cremasteric reflex. What is the most important intervention?

Question 8 options:

a) Doppler ultrasound to assess testicular blood flow

b) Immediate referral to the emergency department

c) Prescribing anti-infective agents to treat the infection

d) Transillumination to assess for a “blue dot” sign

Question 9 (1 point)

A high school athlete is
brought to the emergency department after collapsing during outdoor practice on
a hot day. The patient is weak, irritable, and confused. Serum sodium is 152
mEq/L and has dry mucous membranes and tachycardia. What is the initial approach
to rehydration in this patient?

Question 9 options:

a) Hypotonic intravenous fluid replacement

b) Intravenous fluid resuscitation with an isotonic solution

c) Loop diuretics and hypotonic intravenous fluids

d) Oral water replacement

Question 10 (1 point)

An elderly patient who is
taking a thiazide diuretic has been ill with nausea and vomiting and is brought
to the emergency department for evaluation. An assessment reveals oliguria,
hypotension, and tachycardia and serum sodium is 118 mEq/L. What is the
treatment?

Question 10 options:

a) A single infusion of hypertonic saline

b) Addition of spironolactone

c) Emergency volume repletion with 3% NaCl.

d) Fluid and dietary sodium restriction

Question 11 (1 point)

Which thyroid stimulating
hormone (TSH) level indicates hyperthyroidism?

Question 11 options:

a) 0.2 uIU/L

b) 0.4 uIU/L

c) 2.4 uIU/L

d) 4.2 uIU/L

Question 12 (1 point)

A patient has thyroid
nodules and the provider suspects thyroid cancer. To evaluate thyroid nodules
for potential malignancy, which test is performed?

Question 12 options:

a) Radionucleotide imaging

b) Serum calcitonin

c) Serum TSH level

d) Thyroid ultrasound

Question 13 (1 point)

What are some common goals
of neuropsychiatric evaluation?

Question 13 options:

a) To definitively diagnose neurobehavioral disorders

b) To determine the need for neurosurgical procedures

c) To evaluate cognition when neuro-diagnostic tests are normal

d) To help identify rehabilitation goals in brain-injured
patients

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e) To monitor changes in symptoms over time

Question 14 (1 point)

A patient exhibits visual
field defect, ataxia, and dysarthria and complains of a mild headache. A family
member reports that the symptoms began several hours prior. An examination
reveals normal range of motion of the neck. What type of cerebrovascular event
is most likely?

south university Advanced Nursing Practice I quiz 4

south university Advanced Nursing Practice I quiz 4

Question 14 options:

a) Hemorrhagic stroke

b) Hypertensive intracerebral hemorrhage

c) Ischemic stroke

d) Transient ischemic attack

Question 15 (1 point)

An elderly patient is
brought to the emergency department after being found on the floor after a
fall. The patient has unilateral sagging of the face, marked slurring of the
speech, and paralysis on one side of the body. The patient’s blood pressure is
220/190 mm Hg. What is the likely treatment for this patient?

Question 15 options:

a) Carotid endarterectomy

b) Close observation until symptoms resolve

c) Neurosurgical consultation

d) Thrombolytic therapy

Question 16 (1 point)

What are initial approaches
when managing delirium in a hospitalized patient who is agitated and confused?

Question 16 options:

a) Administer medications for sleep

b) Apply physical restraints

c) Attend to hydration and toileting needs

d) Decrease stimulation

e) Discontinue any non-essential medications

Question 17 (1 point)

A previously lucid patient
with early-stage Alzheimer’s disease is hospitalized after a surgical procedure
and exhibits distractibility and perceptual disturbances that occur only in the
late afternoon. The patient has difficulty sleeping at night and instead sleeps
much of the morning. What is the likely cause of these symptoms?

Question 17 options:

a) Hyperactive delirium

b) Hypoactive delirium

c) Sundowner syndrome

d) Worsening dementia

Question 18 (1 point)

An elderly patient has
symptoms of depression and the patient’s daughter asks about possible
Alzheimer’s disease since there is a family history of this disease. A
screening evaluation shows no memory loss. What is the initial step in managing
this patient?

Question 18 options:

a) Order brain imaging studies such as CT or MRI

b) Perform genetic testing to identify true risk

c) Prescribe a trial of an antidepressant medication

d) Recommend a trial of a cholinesterase inhibitor drug

Question 19 (1 point)

A patient with dementia
experiences agitation and visual hallucinations and is given haloperidol with a
subsequent worsening of symptoms. Based on this response, what is the likely
cause of this patient’s symptoms?

Question 19 options:

a) Alzheimer’s disease

b) Lewy body dementia

c) Pseudodementia

d) Vascular neurocognitive disorder

Question 20 (1 point)

Which medications may be
useful in treating tension-type headache?

Question 20 options:

a) Antiemetics

b) Lithium

c) Muscle relaxants

d) NSAIDs

e) Oxygen

Question 21 (1 point)

A patient has recurrent
cluster headaches and asks about abortive therapy. Which therapy is effective
for a majority of patients with cluster headaches?

Question 21 options:

a) Lithium

b) NSAIDs

c) Oxygen

d) Verapamil

Question 22 (1 point)

A patient with a seizure
disorder has seizures which begin with eye twitching and occasionally visual
hallucinations. Which site in the brain is the seizure focus?

Question 22 options:

a) Frontal

b) Occipital

c) Parietal

d) Temporal

Question 23 (1 point)

A patient who has a seizure
disorder and who takes levetiracetam is brought to an emergency department with
a seizure which has persisted for15 minutes and which immediately followed
another 15 minute seizure. What is the priority action for this patient?

Question 23 options:

a) Administer a dose of levetiracetam now and repeat in 10
minutes

b) Administer lorazepam and monitor cardiorespiratory status

c) Administer phenytoin and phenobarbital along with oxygen

d) Admit the patient to the hospital for a diagnostic work up

Question 24 (1 point)

Which drug is used to treat
patients with focal epilepsy and complex partial seizures?

Question 24 options:

a) Carbamazepine

b) Ethosuximide

c) Lamotrigine

d) Topiramate

Question 25 (1 point)

Benign prostatic hypertrophy
is a common finding as men age. Classically, this condition has many
symptoms. Please select all that apply:

Question 25 options:

a) Difficulty initiating urinary stream

b) Urinary hesitancy and urgency

c) Sensations of a full bladder and bladder spasms

d) Incontinence and post void dribbling

Question 26 (1 point)

A 63 year old client
presents to you with hematuria, hesitancy and dribbling. Digital rectal examination (DRE) reveals a moderately
enlarged prostate that is smooth. The
client’s prostate specific antigen (PSA) is 1.2. What is the most appropriate management
strategy for the provider to follow at this time?

Question 26 options:

a) Prescribe an alph adrenergic blocker

b) Recommend saw palmetto extract

c) Prescribe antibiotic

d) Refer the client to urology

Question 27 (1 point)

A 15 year old client comes
in with acute abdominal pain. When
taking his history the nurse practitioner (NP) finds that he fell off his bike
this morning and has vomited. Upon closer examination the NP determines his
pain is localized to the Left groin and testicle. He is afebrile and reports no dysuria. The most likely differential diagnosis is:

Question 27 options:

a) Testicular torsion

b) Epididymitis

c) Hydrocele

d) Varicocele

Question 28 (1 point)

A client is pregnant and has
been taking the same levothyroxine medication for years. What might the provider expect to do with the
levothyroxine medication?

Question 28 options:

a) Increase the dosage while pregnant

b) Maintain her established dose

c) Decrease her dosage during the pregnancy

d) Decrease her dosage during the pregnancy

Question 29 (1 point)

A TSH of 0.2 can lead to the
following symptoms.

Question 29 options:

a) Osteoporosis

b) Weight loss

c) Bradycardia

d) Diarrhea

Question 30 (1 point)

Which of the following are
causes of dementia in older adults that can be removed or reversed?

Question 30 options:

a) Polypharmacy and nutritional disorders

b) Alzheimer’s diease and vascular disorders

c) Metabolic disorders and space-occupying lesions

d) Infections affecting the brain and polypharmacy

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