Tag: Clinical-Nursing

NURS – 6521N Advanced Pharmacology Midterm Exam

 

Question 1

A 77-year-old man’s chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? NURS – 6521N Advanced Pharmacology Midterm Exam

The man’s glomerular filtration rate and creatinine levels are within reference ranges.

The man’s heart rate is between 60 and 70 beats per minute with a regular rhythm.

The man’s potassium and sodium levels remain with reference ranges.

The man’s chest sounds are clear and his ankle edema is lessened.

D

 

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question 2

Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?

The resident has not eaten breakfast because of a recent loss of appetite

The resident’s apical heart rate is 112 beats/minute with a regular rhythm

The resident had a fall during the night while transferring from her bed to her bathroom

The resident received her annual influenza vaccination the previous day

B

 

 

 

 

Question 3

To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should

administer calcium supplements.

position the patient in the side-lying position.

administer carbohydrates.

monitor for nausea and vomiting.

NURS – 6521N Advanced Pharmacology Midterm Exam

C

 

 

 

 

Question 4

Which statement is 
FALSE
 regarding the treatment of hyperthyroidism?

Long-acting beta-blocking agents are given as adjunctive therapy until Propulthiouracil (PTU) or methimazole (Tapazole) restores the patient to euthyroid

Methimazole (Tapazole) is the drug of choice for pregnant or lactating females.

Propylthiouracil (PTU) reduces peripheral conversion of T4 to the more potent T3

Since methimazole (Tapazole) is stronger than Propylthiouracil (PTU), Methimazole should be initiated at 15 mg/day compared to 300 mg/day for Propylthiouracil for treatment of mild disease

D

Question 5

A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient’s medication regimen. Which of the patient’s medications should prompt the nurse to teach her to avoid drinking grapefruit juice?

Atorvastatin (Lipitor)

Rabeprazole (Aciphex)

Vitamin D

Citalopram (Celexa)

A

 

 

 

 

Question 6

A 65-year-old male presents with a history of worsening urinary urgency, frequency, and hesitancy. He also tells you that he has to “push really hard” to urinate and that his urine dribbles a little after he is done urinating. What medication should be avoided NURS – 6521N Advanced Pharmacology Midterm Exam

 

paroxetine

ipratropium inhaler

omeprazole

clonidine

A

 

 

 

uestion 7

A 39 y/o female is diagnosed with Graves disease.  She also has a small goiter =.  Her symptoms are not deemed to be severe and propylthiouracil is prescribed.  Whare is the most serious potential adverse effect of this medication?

Hypocalcemia

Renal Failure

Agranulocytosis

Hematouria

C

 

 

uestion 10

Which of the following patients is most likely to benefit from the administration of an adrenergic agonist?

A man who is in cardiogenic shock following a myocardial infarction

A man who has a diagnosis of primary hypertension

NURS – 6521N Advanced Pharmacology Midterm Exam

A woman who has been admitted with a suspected ischemic stroke

A woman who is in labor and may require a caesarean section

A

 

Question 11

A male patient who is hypertensive takes Hydrochlorothiazide for his blood pressure . He  presents with red, painful swelling of the great toe. In addition to treating gout, you recognize that you may need to:

Increase his HCTZ

Order laboratory studies for diabetes

Change his thiazide antihypertensive medication

Advise him to lose weight

C

 

 

 

 

Question 12

A patient has been prescribed a drug that can be self-administered at home. NURS – 6521N Advanced Pharmacology Midterm Exam. Which of the following would be the most important information for the nurse to relate to the patient concerning self-administration of a drug?

Where to purchase the medication

The cost of the drug

The therapeutic effects and possible adverse effects

The pharmacokinetics of the drug

C

 

 

 

 

 

Question 13

A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse’s advice?

Integrating the new drug into the patient’s existing schedule promotes adherence.

Combining a new drug with one or more existing drugs mitigates the risk of adverse effects.

Taking several drugs at one time maximizes recovery time for the liver and kidneys.

Rapid drug clearance fostered when a patient is able to minimize the number of drug administration times.

A

 

 

 

 

Question 14

A 
Nurse Practitioner
 is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. NURS – 6521N Advanced Pharmacology Midterm Exam. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to

the impact of the placebo effect on the patient’s response.

the accumulative effect of the drug if it has been taken for many years.

the impact of the warmer climate on the patient’s physical state.

problems with patient compliance with the drug regimen due to the move.

C

 

 

 

 

Question 15

A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be

liquid.

lozenge.

tablet.

suppository.

D

 

 

 

Question 16

A patient with unstable angina pectoris who is NOT controlled with a nitrate would likely benefit most from the addition of:

1.

Sodium channel blocker

2.

Beta blocker

3.

Cardiac glycoside

4.

Either 1 or 2

C

 

Question 17

When prescribing an antihypertensive medication for a type 2 diabetic patient, the drug classifications that would tend to reduce insulin sensitivity are:

 Diuretics and calcium channel blockers.

Diuretics and beta blockers.

Calcium channel blockers and ACE inhibitors.

Alpha blockers and ACE inhibitors. NURS – 6521N Advanced Pharmacology Midterm Exam

B

 

 

 

 

Question 18

A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to

crush the tablet before swallowing.

swallow the tablet whole. NURS – 6521N Advanced Pharmacology Midterm Exam

swallow the tablet with milk or food.

avoid drinking milk for 3 hours after swallowing the tablet.

C

 

 

 

Question 19

A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain?

Call the physician

Ask the patient to lie back and try to relax

Have the patient swallow a tablet every 5 minutes for 15 minutes

Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided

D

 

 

 

Question 20

After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient?

“Make sure that you take this at the scheduled times, regardless of whether you feel short of breath.”

“Most people find that ipratropium cures their lung disease within a few months.”

“You should think of this as an ’emergency drug’, and it should only be used when you experience symptoms.”

“It’s important that you perform deep breathing exercises before and after taking ipratropium.”

 

 

Question 77

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man’s most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man’s serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?

The man may be experiencing a paradoxical effect of aspirin

The man may be allergic to aspirin

The man may be experiencing liver toxicity from the aspirin

The man may be experiencing nephrotoxic effects of aspirin

D

 

 

Question 78

A patient receives 25 units of NPH insulin at 7.AM. NURS – 6521N Advanced Pharmacology Midterm Exam. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?

After breakfast

Before lunch

Late afternoon

Bedtime

C

 

 

estion 79

A patient is recovering from an acute episode of thrombophlebitis and is being treated with warfarin (Coumadin) 5 mg PO daily. In reviewing medication information, the Nurse Practitioner would include what information in their teaching?

Maintain close watch on Intake and Output

Do not take a multivitamin supplement

Limit dairy products

Aerobic exercises are the most effective

B

 

 

 

 

 

estion 80

A 47-year-old woman has been diagnosed with open-angle glaucoma. Pilocarpine drops are prescribed. The nurse’s assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to

apply the contact lenses and wait 5 minutes before applying the drops.

remove the contact lenses before applying the drops.

apply the drops directly on the contact lenses.

stop wearing the contact lenses during the pilocarpine therapy. NURS – 6521N Advanced Pharmacology Midterm Exam

B

 

 

 

ion 82

A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his “puffers”. In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to

permanent liver damage.

rebound bronchoconstriction.

community-acquired pneumonia.

severe anticholinergic effects.

B

 

stion 81

A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply.

Is there a need for the drug in treating the presenting problem?

Is this the best drug for the presenting problem?

Can the patient take the prescribed drug?

None of the above.

A

B

C

 

 

 

 

Question 83

A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient’s subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education NURS – 6521N Advanced Pharmacology Midterm Exam. What should the nurse teach the patient about her new medication?

“By reducing the amount of fluid that your body contains, digoxin will make it easier for your heart to pump.”

“This will lessen the workload of your heart by reducing your blood pressure.”

“Most patients see their heart failure resolve in 2 to 4 months after they begin taking digoxin.”

“This drug won’t cure your disease, but it will help you be able to exercise more and be more comfortable.”

D

 

 

 

 

 

 

Question 84

A Nurse Practitioner is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which of the following actions should the Nurse Practitioner take in order to minimize the potential for adverse drug effects and risks associated with prednisone treatment?

Avoid OTC antacids for the duration of treatment

Advocate for intravenous, rather than oral, administration

Teach the patient strategies for dealing with headaches

Carefully assess the patient for infections

D

 

 

Question 85

A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by

blocking adrenergic receptors and producing antisympathetic effects.

inhibiting the movement of calcium ions across the cardiac muscle cell membrane.

decreasing sodium and potassium conduction.

weakening diastolic depolarization and the action potential duration.

B

 

 

 

Question 86

The APRN would use what class of medication to manage COPD?

 

Mucolytic agents

Methylxanthine derivatives

Anticholinergic agents

Short-acting and long acting inhaled beta2 agonists

D

 

Question 87

A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of

an adrenergic antagonist.

an adrenergic agonist.

a cardiotonic.

a neurotransmitter.

A

 

 

 

 

Question 88

The Nurse Practitioner is treating a patient that takes frequent doses of antacids for his heartburn and is also taking an enteric coded aspirin.  What instructions should be provided to the patient?

The aspirin is less effective when taken with an antacid so you need to increase the dose.

The antacid destroys the aspirin so you should stop taking any antacids

The medications should be taken at least 2 hours apart. NURS – 6521N Advanced Pharmacology Midterm Exam

There is no effect of the antacid on the aspirin so they can be taken when it is convenient for you

C

 

 

 

Question 94

A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse?

“Sure, you may take an antacid with ranitidine.”

“No, the two drugs will work against each other.”

“Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine.”

“I wouldn’t advise it. You may experience severe constipation.”

B

 

 

 

 

Question 95

Mr. Contreras is a 64-year-old patient with Type 2 diabetes. He has recently been diagnosed with hypertension. Which antihypertensive drug is the recommended choice to treat hypertension in patients with diabetes?

Diuretics

Beta Blocker

Calcium Channel Blocker

ACE Inhibitor

D

 

 

 

 

 

Question 96

A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation?

Wash hands before and after taking the medicine

Keep track of any gastrointestinal tract infections

Monitor glucose levels closely

Note the time the medicine is taken each day

C

 

 

 

 

 

Question 97

A 42-year-old man is being treated for a peptic ulcer with ranitidine (Zantac) taken PO at bedtime. Even though few adverse effects are associated with this drug, one common adverse effect that can be severe is NURS – 6521N Advanced Pharmacology Midterm Exam

headache.

irritability.

dry mouth.

heart palpitations.

A

 

 

 

 

 

 

 

Question 98

A Nurse Practitioner is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?

The amount of the drug that must be given to produce a particular response

How well a drug produces its desired effect

A drug’s strength of attraction for a receptor site

A drug’s ability to stimulate its receptor

B

 

 

 

 

Question 99

The APRN is seeing Mrs. Smith, age 77, who is here for follow up of hypertension, dyslipidemia, and depression.  What should you consider during her follow-up?

 

Changes in lean body mass and fluids have little effect on drug serum concentrations

No alteration in dosing is required with low albumin levels and protein bound drugs

The effects of cardiovascular and CNS medications are predictable in older adults

Age-related changes in renal function are the main cause of adverse drug reactions

D

 

 

 

 

Question 100

The APRN should educate a diabetic patient that beta blockers may mask the signs and symptoms of

insulin resistance

insulin sensitivity

hypoglycemia

hyperglycemia

NURS – 6521N Advanced Pharmacology Midterm Exam

NURS 6512 Midterm Exam Review (Week 1-6)

Building A Complete Health History

Communication techniques used to obtain a patient’s health history

Recording and documenting patient information

SOAP note documentation

Subjective vs objective information when documenting

Ethical decision making and beneficence

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Diversity and Health Assessments

Cultural awareness and diversity

Socioeconomic, spiritual, and lifestyle factors affecting diverse populations

Functional assessments

NURS 6512 Midterm Exam Review (Week 1-6)

 

Assessment Tools and Diagnostic Tests in Adults and Children

Growth, Development, and Measurements in children and adults

Nutritional assessment to include recommended water intake and energy requirements

Macronutrients vs Micronutrients

Significance of a food diary

NURS 6512 Midterm Exam Review (Week 1-6)

BMI measurements for normal, overweight, obesity, morbid obesity

Pernicious Anemia

Examination techniques and equipment

Diagnostic Assessment tools and tests to include tuning forks, BP monitoring, use of stethoscope, otoscope, ophthalmoscope

 

Assessment of the Skin, Hair, and Nails

Skin lesion characteristics

Documenting skin lesions using “ABCD” rule

Anatomy and physiology of skin layers

Abnormal nail findings in older adults

Psoriatic skin lesions

NURS 6512 Midterm Exam Review (Week 1-6)

Vesicular skin characteristics

Normal vs abnormal hair distribution during aging

Characteristics of hair distribution

Assessment of Head, Neck, Eyes, Ears, Nose, and Throat

Cranial Nerves associated with the HEENT system

Normal assessment findings of an adolescent’s nose and throat

Normal examination findings of an infant’s fontanelles

Examination findings of a patient with hypothyroid and hyperthyroid

Techniques for examining the HEENT systems

NURS 6512 Midterm Exam Review (Week 1-6)

Examination findings for a patient with sinus symptoms

Appropriate tuning fork frequencies to approximate vocal frequencies

Examining the oral mucosa

Hearing loss findings when examining the elderly patient

Examination techniques used to examine the trachea and thyroid

 

Assessment of the Abdomen and Gastrointestinal System

Organs involved in the alimentary tract

Correct assessment order for examining the abdomen

Examination technique and findings of the liver

Examination findings associated with appendicitis

Examining McBurney’s sign

Assessment of abdominal pain in women

Landmarks for abdominal examination

Characteristics of bowel sounds heard during auscultation

NURS 6512 Midterm Exam Review (Week 1-6)

Chelsea Warren Focused Exam: Type 1 Diabetes Shadow health Documentation

Documentation / Electronic Health Record

 

Nursing Note

Student Documentation

Model Documentation

Patient Status

Chelsea is currently stable. She reports feeling better. No current nausea or vomiting She is alert and well oriented She expressed a desire to go home She said she has not administered insulin on her own or performed glucose monitoring on her own

Chelsea’s current condition is stable. She is feeling better than she has been lately. No current nausea or vomiting. Chelsea is alert and curious, and expressed an eagerness to go home. She said that she has not administered her own insulin yet, or done her own glucose monitoring.

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History of Present Illness

The patient had diabetic ketoacidosis two days ago, when she was hospitalized. When she was horseback riding, she started being nauseous and vomited in her father’s car. The father brought her to the ED and she was diagnosed with DKA and type 1 diabetes. Her blood glucose is now stable. Before the DKA, Chelsea was feeling sick for about 10 days. The father reported that she had lost about 5 pounds in 2 weeks. Chelsea Warren Focused Exam: Type 1 Diabetes Shadow health Documentation Chelsea has been having increased thirst and excessive urination before the DKA.

Chelsea had diabetic ketoacidosis two days prior. She was at a horseback riding lesson and started feeling nauseated; when her dad picked her up she threw up in his car. That evening, Ned said that his daughter seemed really out of it and was not acting like herself. He brought her to the ED, and she was diagnosed with DKA and type 1 diabetes. Chelsea’s blood glucose is more stable now. Prior to the DKA, Chelsea said she felt sick for about 10 days. Her dad, Ned, said that she lost five pounds in the two weeks since he’s seen her. She experienced increased thirst and increased urination / a higher volume of urine during the 10 days leading up to her DKA. Chelsea said her mother thought she was “going through a growth spurt” or coming down with a cold Chelsea Warren Focused Exam: Type 1 Diabetes Shadow health Documentation.

Assess Patient Knowledge

Chelsea is…Chelsea Warren Focused Exam: Type 1 Diabetes Shadow health Documentation

Chelsea Warren Type 1 Diabetes Shadow health Education & Empathy

Education & Empathy 
: 3 of 4 (75.0%)

During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A 
Model Statement
 is provided as an example of an appropriate response to each opportunity.

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Opportunities marked as 
Not Encountered
 are opportunities that were not elicited in the interview

Opportunities marked as 
Not Followed Up
 are missed opportunities that were present in the interview, but where no statements were made

Opportunities marked as 
Followed Up
 were followed up by students, and include the dialogue between student and patient

Chelsea Warren Type 1 Diabetes Shadow health Education & Empathy

 1 Type 1 Diabetes Management

Followed Up

 Description: 
Chelsea expresses that she doesn’t know much about diabetes or understand it, and that “other people” have been checking her blood sugar and administering insulin for her.

Do you take medications?

Question

06:15 PM PST

Um, I mean, I guess I take insulin every day, if that’s what you mean.

Do you monitor your blood glucose levels? (Clarified to: Do you check your blood sugar at home?)

Question

06:15 PM PST

Other people have been checking it for me. I haven’t done it myself yet. (Clarified to: if I check my blood sugar)

Okay. It is good to closely monitor your glucose levels

Educate

06:16 PM PST

Oh, ok. I think I get it.

thanks for answering the questions Chelsea.

Empathize

06:16 PM PST

Thank you.

Do you have a high heart beat?

Educate

06:17 PM PST

There’s so much to learn. I feel like my brain is full! But thanks for telling me.

 Model Statement: 
“I understand that type 1 diabetes can seem overwhelming, because you have a lot to learn about monitoring your blood sugar, giving yourself insulin injections, and changing the way that you eat. However, you’re going to have a lot of support along the way from your family members, friends, school nurses, and even your riding instructor. Chelsea Warren Type 1 Diabetes Shadow health Education & Empathy. While everyone is here to support you, you’re the most important part of this process, because you understand how you feel better than anyone else does.”

 2 Living With Chronic Illness

Not Encountered

 Description: 
Chelsea expresses mixed feelings about her new diagnosis of type 1 diabetes.

 Model Statement: 
“I understand that this diagnosis can make it seem like your life has been turned upside down. That’s a perfectly normal feeling to have. You should know that while type 1 diabetes is a lifelong and serious illness, it’s also manageable. You can still live a normal life, and do all of the things you love to do. With time, you’ll get used to all of these new experiences.” Chelsea Warren Type 1 Diabetes Shadow health Education & Empathy

 3 Hidden Carbohydrates

Followed Up

 Description: 
Mr. Warren expresses a belief that his daughter eats a low-carbohydrate and low-sugar diet, but he lists foods that are carb-heavy or high in sugar.

What is your daughter’s typical diet? (Clarified to: What is your daughter’s diet like?)

Question

06:06 PM PST

It’s actually pretty normal, I suppose. Pancakes and fruit for breakfast are my speciality. I’ll either fix a sandwich and chips for lunch or she’ll get lunch at school. Dinner varies between take-out or my world famous chili. (Clarified to: what my daughter’s diet is like)

It is recommended to avoid high intake of carbs and fatty foods. Please follow the appropriate debates diet. Chelsea Warren Type 1 Diabetes Shadow health Education & Empathy

Educate

06:07 PM PST

Okay.

 Model Statement: 
“Carbohydrates are a basic food group, and they can affect a diabetic person’s blood sugar. Even “healthy” foods, like whole-grain pancakes or fruit, can be high in carbohydrates. It’s important for you and Chelsea’s mother to monitor Chelsea’s carbohydrate intake, so that she can effectively control her blood sugar. Chelsea’s endocrinologist, and a pediatric nutritionist, can help you modify Chelsea’s diet.” Chelsea Warren Type 1 Diabetes Shadow health Education & Empathy

 4 Two Households and Chronic Illness

Followed Up

 Description: 
Mr. Warren says that he is divorced, and Chelsea splits her time evenly between two households. He expresses an amicable relationship with his ex-wife, but Chelsea’s diagnosis is going to require more cooperation and communication than ever before.

Are you married?

Question

06:10 PM PST

Chelsea’s mom, Nora, and I are divorced. We split custody 50/50, so Chelsea stays with me for two weeks at a time, and then stays with her mom for two weeks. We try to set a good example and, you know, do the civil co-parenting thing. Chelsea Warren Type 1 Diabetes Shadow health Education & Empathy

Okay, I know divorce is hard even for the kids. But it is good to see Chelsea has the love of both her parents even after the divorce

Empathize

06:11 PM PST

Mmmhmmm.

 Model Statement: 
“Communication between divorced or separated parents can often be difficult. It’s great that you and Chelsea’s mother have a good relationship, because Chelsea’s diagnosis will require a stable and supportive dual household that ensures she is getting everything she needs to live a healthy life. You and your ex-wife will have to coordinate diabetic supplies, diet, and routine blood glucose monitoring, so that there are no gaps in Chelsea’s care Chelsea Warren Type 1 Diabetes Shadow health Education & Empathy.”

Chelsea Warren Type 1 Diabetes Subjective Data

Subjective Data Collection: 25 of 25 (100.0%)

Hover To Reveal…

Hover over the 
Patient Data
 items below to reveal important information, including 
Pro Tips
 and 
Example Questions
.

Found:

 Indicates an item that you found. Chelsea Warren Type 1 Diabetes Subjective Data

Available:

 Indicates an item that is available to be found.

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Category

Scored Items

Experts selected these topics as essential components of a strong, thorough interview with this patient.

Patient Data

Not Scored

A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.

Patient Status

Finding:

Assessed patient status

Finding:

Reports feeling “way better”

(Found)

Pro Tip: Assessing a pediatric patient’s status involves asking about their current comfort, needs, and chief complaint. It’s important to check in with a patient’s status, because it may reveal insight into their current condition.

Example Question:

How do you feel?

Finding:

Reports eagerness to go home

(Found)

Pro Tip: Assessing a pediatric patient’s status involves asking about their current comfort, needs, and chief complaint. It’s important to check in with a patient’s status, because it may reveal insight into their current condition.

Example Question:

How do you feel?

Finding:

Asked about patient’s comfort

Finding:

Reports feeling comfortable

(Found)

Pro Tip: Assessing a pediatric patient’s status involves asking about their current comfort, needs, and chief complaint. It’s important to check in with a patient’s status, because it may reveal insight into their current condition.

Example Question:

Are you having pain right now?

Finding:

Asked about patient’s needs

Finding:

Denies needing anything

(Found)

Pro Tip: Assessing a pediatric patient’s status involves asking about their current comfort, needs, and chief complaint. It’s important to check in with a patient’s status, because it may reveal insight into their current condition.

Example Question:

Do you need anything?

History of Present Illness Patient

Finding:

Asked patient about symptoms of DKA

Finding:

Denies remembering incident very well

(Found)

Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Why were you admitted?

Finding:

Reports feeling nauseated at a horseback riding lesson

(Found)

Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Why were you admitted?

Finding:

Reports vomiting

(Found)

Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Why were you admitted?

Finding:

Asked about patient’s other symptoms prior to DKA

Finding:

Reports frequent urination prior to DKA

(Found)

Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Have you been urinating more often than usual?

Finding:

Reports excessive thirst prior to DKA

(Found)

Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Have you been feeling more thirsty lately?

Finding:

Reports fatigue prior to DKA

(Found)

Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Are you always fatigued?

Finding:

Reports lack of appetite prior to DKA

(Found)

Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

How is your appetite?

Finding:

Asked about onset of prior symptoms

Finding:

Reports other symptoms began around 10 days prior

(Found)

Pro Tip: Asking a pediatric patient about the duration and onset of their current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

When did you start feeling sick?

Assess Patient Knowledge

Finding:

Assessed patient’s knowledge of type 1 diabetes

Finding:

Reports knowledge of type 1 diabetes

(Found)

Pro Tip: Assessing a pediatric patient’s knowledge of their preexisting conditions helps you determine how to educate both guardian and patient.

Example Question:

What type of diabetes do you have?

Assess Patient Diet

Finding:

Asked about diet at mother’s house

Finding:

Reports mother is a “health nut”

(Found)

Pro Tip: Assessing a pediatric patient’s diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their chief complaint. Details of their current diet will help you to educate the patient on a diet that will help in the treatment and management of their condition.

Example Question:

What is your diet like?

Finding:

Reports typical breakfast at mother’s home is yogurt and fruit

(Found)

Pro Tip: Assessing a pediatric patient’s diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their chief complaint. Details of their current diet will help you to educate the patient on a diet that will help in the treatment and management of their condition.

Example Question:

What’s your usual breakfast?

Finding:

Reports typical lunch is a salad with chicken

(Found)

Pro Tip: Assessing a pediatric patient’s diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their chief complaint. Details of their current diet will help you to educate the patient on a diet that will help in the treatment and management of their condition.

Example Question:

What do you usually eat for lunch?

Finding:

Reports typical dinner is grilled meat and vegetables

(Found)

Pro Tip: Assessing a pediatric patient’s diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their chief complaint. Details of their current diet will help you to educate the patient on a diet that will help in the treatment and management of their condition.

Example Question:

What’s a typical dinner?

Social History Patient

Finding:

Asked about social activities

Finding:

Reports riding horses 2-3 times a week after school

(Found)

Pro Tip: A pediatric patient’s social history encompasses their family and support system, living situation, and daily behaviors such as diet and exercise. Even though you are working with pediatric patients, it is important to ask about sexual activity and substance use. These factors can influence their current health and wellness. Asking about a pediatric patient’s social history can also unveil the influence of their present illnesses in their social lives.

Example Question:

How often do you ride horses?

Finding:

Asked about substance use

Finding:

Denies tobacco use

(Found)

Pro Tip: A pediatric patient’s social history encompasses their family and support system, living situation, and daily behaviors such as diet and exercise. Even though you are working with pediatric patients, it is important to ask about sexual activity and substance use. These factors can influence their current health and wellness. Asking about a pediatric patient’s social history can also unveil the influence of their present illnesses in their social lives.

Example Question:

Have you ever experimented with smoking?

Finding:

Denies vaping

(Found)

Pro Tip: A pediatric patient’s social history encompasses their family and support system, living situation, and daily behaviors such as diet and exercise. Even though you are working with pediatric patients, it is important to ask about sexual activity and substance use. These factors can influence their current health and wellness. Asking about a pediatric patient’s social history can also unveil the influence of their present illnesses in their social lives.

Example Question:

Have you ever vaped or used an ecigarette?

Finding:

Denies alcohol use

(Found)

Pro Tip: A pediatric patient’s social history encompasses their family and support system, living situation, and daily behaviors such as diet and exercise. Even though you are working with pediatric patients, it is important to ask about sexual activity and substance use. These factors can influence their current health and wellness. Asking about a pediatric patient’s social history can also unveil the influence of their present illnesses in their social lives.

Example Question:

Do you drink alcohol?

Review of Relevant Systems Patient

Finding:

Asked about general symptoms

Finding:

Denies current excessive thirst

(Found)

Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

Have you been feeling more thirsty lately?

Finding:

Asked about gastrointestinal symptoms

Finding:

Denies current nausea

(Found)

Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require.

Example Question:

Did your nausea improve?

Finding:

Denies current vomiting

(Found)

Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

Are you going to be sick?

Finding:

Reports normal bowel movements

(Found)

Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require.

Example Question:

Are you feeling constipated?

Finding:

Asked about urinary symptoms

Finding:

Denies current frequent urination

(Found)

Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

How long have you been urinating more frequently?

Finding:

Denies high volume of urine

(Available)

Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

Do you urinate a lot?

Finding:

Asked about neurological system

Finding:

Denies neurological symptoms

(Found)

Pro Tip: Understanding a pediatric patient’s health involves a comprehensive overview of their physiological systems. This is necessary to understand what symptoms may indicate larger issues, and what treatments the patient may require. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

Do you feel tingling anywhere?

Confirmed Guardian’s Relationship

Finding:

Confirmed guardian’s relationship to patient

Finding:

Reports he is patient’s father

(Found)

Pro Tip: Determining the guardian’s relationship to a pediatric patient confirms the appropriate family members are present. Knowing who is with the pediatric patient will help you to develop the best approach to gathering information on the patient’s condition. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

what is your relationship to the patient

History of Present Illness Guardian

Finding:

Asked about patient’s diagnosis

Finding:

Reports patient is diagnosed with type 1 diabetes

(Found)

Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

What is your daughter’s diagnosis

Finding:

Followed up on history of present illness leading to diagnosis

Finding:

Reports patient was admitted to hospital two days prior

(Found)

Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

When was your daughter hospitalized

Finding:

Reports patient had diabetic ketoacidosis when admitted

(Found)

Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

Did your daughter have complications with her diabetes?

Finding:

Asked guardian about symptoms of DKA

Finding:

Reports thinking she had a “stomach bug” at first

(Found)

Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

How was your daughter feeling?

Finding:

Reports taking daughter to ED when he realized she was “out of it”

(Found)

Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

How was your daughter feeling?

Finding:

Asked about patient’s symptoms prior to DKA

Finding:

Reports weight loss

(Found)

Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

Has your daughter’s weight changed lately?

Finding:

Followed up on weight loss

Finding:

Reports patient lost 5 pounds

(Found)

Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

How much weight has your daughter lost?

Finding:

Reports weight loss happened in the two weeks since he last saw the patient

(Found)

Pro Tip: Asking a pediatric patient’s guardian about the duration and onset of the patient’s current health issues solicits information relevant to the history of their present illness. Details of their current complaint will help you follow-up on any present conditions or symptoms, such as the location of their pain or the amount of pain they may be experiencing.

Example Question:

How much weight has your daughter lost?

Assess Guardian Knowledge

Finding:

Assessed knowledge of type 1 diabetes

Finding:

Reports knowledge of type 1 diabetes

(Found)

Pro Tip: Assessing a pediatric guardian’s knowledge of the patient’s preexisting condition helps you determine how to educate both guardian and patient.

Example Question:

Do you know anything about type 1 diabetes?

Assess Patient Diet Guardian

Finding:

Asked about guardian’s knowledge of patient’s diet

Finding:

Reports patient’s favorite breakfast is pancakes and fruit

(Found)

Pro Tip: Asking a pediatric patient’s guardian about their diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their current chief complaint. Chelsea Warren Type 1 Diabetes Subjective Data Details of their current diet will help you to educated the guardian on a diet that will help in the treatment and management of their condition.

Example Question:

What does your daughter usually eat for breakfast?

Finding:

Reports typical lunch is a sandwich and chips

(Found)

Pro Tip: Asking a pediatric patient’s guardian about their diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their current chief complaint. Details of their current diet will help you to educated the guardian on a diet that will help in the treatment and management of their condition.

Example Question:

What does your daughter usually eat for lunch?

Finding:

Reports going out to dinner often

(Found)

Pro Tip: Asking a pediatric patient’s guardian about their diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their current chief complaint. Details of their current diet will help you to educated the guardian on a diet that will help in the treatment and management of their condition.

Example Question:

What does your daughter usually eat for dinner?

Finding:

Denies knowledge of high carb intake

(Found)

Pro Tip: Asking a pediatric patient’s guardian about their diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their current chief complaint. Chelsea Warren Type 1 Diabetes Subjective Data. Details of their current diet will help you to educated the guardian on a diet that will help in the treatment and management of their condition.

Example Question:

How many carbohydrates does your daughter eat a day

Finding:

Reports belief in a low sugar intake

(Found)

Pro Tip: Asking a pediatric patient’s guardian about their diet solicits information relevant to their current diagnosis that informs you of potential aggravating and relieving factors of their current chief complaint. Details of their current diet will help you to educated the guardian on a diet that will help in the treatment and management of their condition.

Example Question:

How many carbohydrates does your daughter eat a day

Social History Guardian

Finding:

Asked guardian about social history

Finding:

Reports being divorced from patient’s mom

(Found)

Pro Tip: A patient’s and their guardian’s social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Asking a guardian about a pediatric patient’s social history can also unveil the influence of their present illnesses on their social lives.

Example Question:

Are you married?

Finding:

Reports patient splits time evenly between homes

(Found)

Pro Tip: A patient’s and their guardian’s social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Asking a guardian about a pediatric patient’s social history can also unveil the influence of their present illnesses on their social lives. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

Are you married?

Finding:

Reports patient alternates between homes every 2 weeks

(Found)

Pro Tip: A patient’s and their guardian’s social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Asking a guardian about a pediatric patient’s social history can also unveil the influence of their present illnesses on their social lives. Chelsea Warren Type 1 Diabetes Subjective Data

Example Question:

Have you been divorced?

Finding:

Reports a stable home life

(Found)

Pro Tip: A patient’s and their guardian’s social history encompasses their family and support system, living situation, and daily behaviors such as diet, exercise, and substance use. These factors can influence their current health and wellness. Asking a guardian about a pediatric patient’s social history can also unveil the influence of their present illnesses on their social lives.

Example Question:

How is your daughter’s relationship with her mother?

Past Medical History Guardian

Finding:

Asked about past hospitalizations

Finding:

Denies past hospitalizations

(Found)

Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment.

Example Question:

Has your daughter been hospitalized before?

Finding:

Denies past surgeries

(Found)

Pro Tip: Asking a guardian about the pediatric patient’s relevant medical history can reveal past diagnoses and previous conditions or concerns. Information about the patient’s existing health conditions, a timeline of diagnosis, symptoms, and allergies can indicate where you should follow-up for further care and treatment Chelsea Warren Type 1 Diabetes Subjective Data.

Example Question:

Has your daughter been hospitalized before?

Family Medical History Guardian

Finding:

Asked about relevant family medical history

Finding:

Reports patient’s paternal grandmother has type 2 diabetes

Chelsea Warren Type 1 Diabetes Subjective Data

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

Question 1

There are many different types of dementia. Which dementia is NOT a direct result of disrupted neurotransmitters, but a result of degeneration of different regions in the brain? Onset of the disease is typically before the age of 60, and very rare after the age of 75.

A.

Alzheimer’s Disease

B.

Dementia with Lewy Bodies

C.

Creutzfeldt-Jakob Disease

D.

Frontotemporal Dementias

 

Question 2

J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which medication is recommended to help L. J. with his emotional outbursts?

A.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

B.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

C.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

D.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

 

Results Displayed

Feedback

·         Question 1

There are many different types of dementia. Which dementia is NOT a direct result of disrupted neurotransmitters, but a result of degeneration of different regions in the brain? Onset of the disease is typically before the age of 60, and very rare after the age of 75.

 

Response Feedback:

under subtitle “Epidemiology and genetic risk factors”

·         Question 2

L. J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which medication is recommended to help L. J. with his emotional outbursts?

 

Response Feedback:

under Treatment subtitle: “The behavioral features are sometimes helped by SSRIs, and these are the best-studied treatments for these disorders.”

·         Question 3

E. B., a 55-year-old female, is a patient at your clinic today who has a past medical history significant for breast cancer, hypertension, hepatic cirrhosis, type 2 diabetes, and a recent diagnosis of alcohol use disorder. She has no known drug allergies. She states she is ready to quit drinking but fears the cravings that it may bring. Which medication would you recommend for E. B. to begin?

 

Response Feedback:

“It is preferred for patients with liver damage since acamprosate is metabolized through the kidneys and not the liver” & Table 15-3 shows it reduces alcohol cravings; benzodiazepines are used in the acute setting if a patient is experiencing severe alcohol withdrawal that leads to seizures; thiamine is if a patient is admitted for alcohol intoxication.

 

 

 

Question 3

B., a 55-year-old female, is a patient at your clinic today who has a past medical history significant for breast cancer, hypertension, hepatic cirrhosis, type 2 diabetes, and a recent diagnosis of alcohol use disorder. She has no known drug allergies. She states she is ready to quit drinking but fears the cravings that it may bring. Which medication would you recommend for E. B. to begin?

A.

Naltrexone

B.

Acamprosate

C.

Any benzodiazepine

D.

Thiamine

 

Question 4

What should our treatment goal be with our patients when it comes to managing chronic pain?

A.

The goal is to make the pain go completely away.

B.

The goal is to make the patient feel numb so that the pain cannot be thought about.

C.

There are no specific treatment goals that we should discuss with our patients, just so they don’t get their expectations too high.

D.

The goal is to improve their function and to drop their pain scale to less than 5 out of 10.

 

 

Choose the correct statement regarding medications used for alcoholism

A.

Disulfiram: NMDA receptor antagonist & GABAA agonist

B.

Naltrexone: µ-opioid receptor antagonist that reduces the reinforcement/euphoria produced by alcohol

C.

Acamprosate: enhances the effect of the inhibitory neurotransmitter gamma-aminobutyric acid on the GABA receptors by binding to a site that is distinct from the GABA binding site in the central nervous system.

D.

Lorazepam: inhibits alcohol dehydrogenase, leading to a buildup of acetaldehyde

 

 

 

Question 6

Which medication below would you use in addition to benzodiazepine treatment if the patient is experiencing psychosis during alcohol withdrawal delirium?

A.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

B.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

C.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

D.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

 

Question 7

Of the following neurotransmitters, which ones play a critical role in modulating attention in ADHD?

Dopamine

Epinephrine

GABA

Norepinephrine

Glutamate

A.

II, III, and V

B.

II and IV

C.

I and IV

D.

III only

 

Question 8

Which of the following is the only Black Box Warning associated with the medication atomoxetine?

A.

Increased risk for cardiovascular events

B.

Suicidal ideation

C.

Substance abuse potential

D.

Slight growth inhibition

 

Question 9

Which of the following drugs is structurally similar to tramadol; thus, its opioid-mediated analgesia can be reversed by naloxone in mice?

A.

 

B.

 

C.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

D.

Gabapentin

 

Question 10

Which medication is a selective alpha-adrenergic agonist that works by mimicking norepinephrine binding in the pre-frontal cortex, which makes it particularly useful in the treatment of ADHD?

A.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

B.

 

C.

 

D.

 

 

 

Question 11

Daytrana is the MPH transdermal system of methylphenidate approved for the treatment of ADHD in children aged 6 years and older. What is the difference in terms of the metabolism compared to the other formulations in this class?

A.

It is mainly metabolized by the enzyme carboxylesterase once absorbed.

B.

It does not undergo first-pass metabolism by the enzyme carboxylesterase in the liver.

C.

It can be cut up and sprinkled onto food so it can bypass first-pass metabolism in the liver.

D.

It uses an osmotic releasing oral system technology to slowly deliver the drug to the enzyme carboxylesterase in order to make the drug last longer.

 

Question 12

A 59-year-old male has been admitted to the E. D. due to a methamphetamine overdose. The patient’s friend reported he ingested up to 2 grams because “he thought cops were coming to get him.” The patient’s vitals are all within normal limits, except his blood pressure is 180/110. What is the best recommendation to make at this time?

A.

Administer a beta-blocker like labetalol to help bring his blood pressure down

B.

Patient’s blood pressure is considered a hypertension urgency, but it is probably due to the drug overdose. No action is needed at this time until the drug has cleared his system.

C.

Blood pressure is not a concern right now, but supportive therapy should be provided in the incidence of respiratory depression.

D.

Administer an alpha-blocker like phentolamine to help bring his blood pressure down.

 

Question 40

SSRIs can be used in alcohol use disorder and offer modest drinking reduction through an anti-craving effect.

A.

True

B.

False

 

 

Question 41

K. is a 72-year-old female who has suffered many strokes in the past, likely due to uncontrolled hypertension and hyperlipidemia. She has now been diagnosed with vascular dementia due to memory loss and motor system slowing. What is the recommended treatment for T. K.?

A.

T. K. needs the drug donepezil to help with her memory loss only.

B.

T. K. needs the drug donepezil to help with her memory loss, but also needs her hypertension and hyperlipidemia controlled.

C.

T. K. needs the drug donepezil to help with her memory loss, but also needs her hypertension controlled.

D.

T. K. needs her hypertension controlled only.

 

 

 

Question 42

The patient is a 16-year-old girl with a past history of substance use disorder. She has been known to abuse prescription opioids and smokes one pack of cigarettes every day. She has been in and out of recovery for the past year. During her last admission into a recovery center, she was diagnosed with ADHD, which may have contributed to her addictive personality. She presents to your clinic today to initiate pharmacotherapy for her new diagnosis. What would you recommend in this patient? Her current weight is 55 kg.

A.

Ritalin 10 mg twice daily

B.

Focalin 10 mg twice daily

C.

Daytrana 30 mg patch worn for 12 hours daily

D.

Atomoxetine 60 mg once daily

 

Question 43

A new patient presents to your clinic today. The patient is a 13-year-old boy who complains that he has no interest in anything. The patient states, “I just want to sleep more than I normally do, and I don’t care much for playing my video games anymore.” His mother states he cannot focus on anything for more than a few minutes at a time, and that he often gets in trouble at school because he cannot sit still. What would you recommend at this time?

A.

Recommend doing a full evaluation to distinguish if this patient is presenting with ADHD symptoms or depressive symptoms

B.

Begin a stimulant at appropriate dose once patient’s weight is known

C.

Refer to a behavioral counselor

D.

Begin an SSRI at lowest initial dose and provide counseling on the increased risk of suicide during the first few months of therapy

 

 

 

Question 44

Disulfiram has been proven effective in the treatment of alcoholism, but recently it has been trialed in the management of cocaine addiction. What is the mechanism of action that likely helps produce these aversive effects?

A.

Inhibition on dopamine beta-hydroxylase

B.

Inhibition on aldehyde dehydrogenase

C.

Inhibition on alcohol dehydrogenase

D.

Inhibition on aldehyde reductase

 

Question 45

Which medication below should be routine for all suspected cases of alcohol intoxication and dependence?

A.

B vitamin thiamine 100 mg

B.

Haloperidol 5 mg

C.

Lorazepam 2 mg

D.

Acamprosate 666 mg

 

Question 46

FILL IN THE BLANK: ___________ is the main neurotransmitter behind reward systems in the brain, which usually leads to addiction when altered in any way.

A.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

B.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

C.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

D.

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

 

 

Question 47

If a patient suffers from a multitude of small strokes and later begins experiencing mood disturbances in an acute fashion that sometimes resolve, from what type of dementia would you think that patient may suffer?

A.

Vascular Dementia

B.

Frontotemporal Dementias

C.

Alzheimer’s Disease

D.

Dementia with Lewy Bodies

 

 

Question 48

Drug addiction includes many prescription medications and illegal substances. Of the drugs listed, which ones can be withdrawn abruptly WITHOUT medical intervention to prevent withdraw seizures?

A.

Alcohol

B.

Adderall

C.

Lorazepam

D.

Butalbital

 

Question 49

The experience of pain is ALWAYS subjective

A.

True

B.

False

 

Question 50

B. is a 55-year-old male who has diagnosed with type 2 diabetes 10+ years ago. He has since had complications from the disease and is suffering from severe neuropathy. On top of that, T. B. is struggling with his mental health and was recently told he could be depressed but he had refused treatment at that time. Besides getting his blood sugar under control, what medication(s) can we use that may be useful in helping T. B.?

Nortriptyline

Venlafaxine

Duloxetine

Fluoxetine

A.

I, II, and III

B.

I and II

C.

II and III

D.

IV only

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

Question 1

A patient expresses concern that she is at risk for breast cancer. To best assess the risk for this patient, what is the best initial action?

a.

Ask if there is a family history of breast cancer.

b.

Gather and record a three-generation pedigree.

c.

Order a genetic test for the breast cancer gene.

d.

Recommend direct-to-consumer genetic testing.

 

 

 

Question 2

What is an important part of patient care that can minimize the risk of a formal patient complaint even when a mistake is made?

Ensuring informed consent for all procedures

Maintaining effective patient communication

Monitoring patient compliance and adherence

Providing complete documentation of visits

 

 

 

Question 3

A patient asks about direct-to-consumer (DTC) genetic testing. What will the provider tell the patient?

a.

It is not useful for identifying genetic diseases.

b.

Much of the information does not predict disease risk.

c.

The results are shared with the patient’s insurance company.

d.

The results must be interpreted by a provider.

 

 

Question 4

A previously healthy patient has an area of inflammation on one leg which has well-demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection?

a.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

b.NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

c.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

d.

Sulfamethoxazole-trimethoprim

 

 

Question 5

A patient diagnosed with atopic dermatitis asks what can be done to minimize the recurrence of symptoms. What will the provider recommend?

a.

Calcineurin inhibitors

b.

Lubricants and emollients

c.

Oral diphenhydramine

d.

Prophylactic topical steroids

 

 

 

Question 6

Which is the primary symptom causing discomfort in patients with atopic dermatitis (AD)?

a.

Dryness

b.

Erythema

c.

Lichenification

d.

Pruritis

 

 

 

Question 7

A patient experiencing an inflamed pterygia lesion has been prescribed loteprednol topical steroid drops for 7 days. The patient shows no improvement in symptoms. What is the next course of action? NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

a.

Consult with an ophthalmologist.

b.

Continue the medication for 7 more days.

c.

Prescribe a systemic corticosteroid.

d.

Refer the patient to the emergency department.

 

 

Question 8

A patient experiences a penetrating injury to one eye caused by scissors. The provider notes a single laceration away from the iris that involves the anterior but not the posterior segment. What is the prognosis for this injury?

a.

Because the posterior segment is not involved, the prognosis is good.

b.

Blindness is likely with this type of eye injury.

c.

Massive hemorrhage and loss of intraocular contents is likely.

d.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

 

Question 9

A primary care provider notes painless, hard lesions on a patient’s external ears that expel a white crystalline substance when pressed. What diagnostic test is indicated?

a.

Biopsy of the lesions

b.

Endocrine studies

c.

Rheumatoid factor

d.

Uric acid chemical profile

 

 

 

Question 10

A patient experiencing heart failure with reduced ejection fraction will have which symptoms?

a.

Dyspnea and fatigue without volume overload

b.

Impairment of ventricular filling and relaxation

c.

Mild, exertionally related dyspnea

d.

Pump failure from left ventricular systolic dysfunction

 

 

 

Question 11

A 55-year-old patient has a blood pressure of 138/85 on three occasions. The patient denies headaches, palpitations, snoring, muscle weakness, and nocturia and does not take any medications. What will the provider do next to evaluate this patient?

a.

Assess serum cortisol levels

b.

Continue to monitor blood pressure at each health maintenance visit

c.

Order urinalysis, CBC, BUN, and creatinine

d.

Refer to a specialist for a sleep study

 

 

 

Question 12

A patient who has been diagnosed with heart failure for over a year reports being comfortable while at rest but experiences palpitations and dyspnea when walking to the bathroom. Which classification of heart failure is appropriate based on these symptoms?

a.

ClassI

b.

Class

c.

Class

d.

Class

 

 

 

 

 

 

 

Question 13

A patient who has undergone surgical immobilization for a femur fracture reports dyspnea and chest pain associated with inspiration. The patient has a heart rate of 120 beats per minute. Which diagnostic test will confirm the presence of a pulmonary embolism (PE)?

a.

Arterial blood gases (ABGs)

b.

Computed tomography (CT) angiography

c.

D-dimer

d.

Electrocardiogram (ECG)

 

Question 14

Which method of treatment is used to manage a traumatic pneumothorax?

a.

Needle aspiration of the pneumothorax

b.

Observation for spontaneous resolution

c.

Placement of a small-bore catheter

d.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

 

 

 

 

 

 

Question 15

A patient with a central line develops respiratory compromise. What is the initial intervention for this patient?

a.

Lung ultrasonography (US) to determine the cause

b.

Obtaining cultures and starting antibiotics

c.

Prompt removal of the central line

d.

Rapid assessment and resuscitation

 

 

 

 

 

 

 

 

Question 16

A patient reports lower abdominal cramping and occasional blood in stools. The provider suspects inflammatory bowel disease. Which test will the provider order to determine whether the patient has ulcerative colitis (UC) or Crohn’s disease (CD)? NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

a.

b.

c.

d.

 

 

 

Question 17

A patient who is asymptomatic tests positive for the hepatitis C virus (HVC). What will the provider tell the patient about managing this illness?

a.

A rapidly fulminant disease ending with cirrhosis is likely.

b.

Administering immunoglobulins helps shorten the course.

c.

Several medications are available based on the type of hepatitis C.

d.

Treatment is supportive since the infection is self-limiting.

 

 

 

Question 18

A patient recovering from chronic alcohol abuse reports nausea, vomiting, diarrhea, and abdominal discomfort. A physical examination is negative for jaundice or ascites. What will the provider do initially?

a.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

b.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

c.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

d.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

 

 

 

 

 

 

Question 19

Paula is a 68 y/o female who presents to the clinic with the following symptoms: bloating and abdominal discomfort, low back pain, pelvic pain, frequency and constipation. The most likely cause of these symptoms is:

A.

Ovarian Cancer

B.

Uterine Cancer

C.

Urethral Cancer

D.

None of the above

 

 

 

 

 

Question 20

A 50-year-old man reports having erectile dysfunction (ED). What is an important response by the provider when developing a plan of care for this patient?

A.

Considering testosterone hormone replacement therapy

B.

Evaluating the patient for cardiovascular disease

C.

Prescribing an oral phosphodiesterase type 5 inhibitor

D.

Referring the patient for psychotherapy and counseling

 

 

 

 

 

Question 21

A primary care provider sees a new patient who reports having a diagnosis of chronic kidney disease for several years. The patient is taking one medication for hypertension which has been prescribed since the diagnosis was made. The provider orders laboratory tests to evaluate the status of this patient. Which laboratory finding indicates a need to refer the patient to a nephrologist?

A.

Albumin/creatinine ratio (ACR) of 325 mg/g

B.

Blood pressure of 145/85 mm H

C.

Glomerular filtration rate (eGFR) of 35

D.

Urine red blood cell (RBC) count of 15/hpf

 

 

 

Question 22

Elijah is a 72 y/o African American male who presents to the clinic with the following symptoms: low back pain, perineal pain, weak urinary stream and multiple trips to the bathroom during the night. Labs taken one week ago show a PSA of 6.0 ng/ml. The most likely diagnosis is:

A.

Prostate Cancer

B.

Testicular Cancer

C.

Prostatitis

D.

Epididymis

Question 88

A young male patient is reported to be more withdrawn from his peers than usual and has dropped out of college and quit his job within the last 5 months. The parent is concerned that the patient may have schizophrenia because a maternal uncle has the disease. What will the provider do next?

A.

Ask about the patient’s speech and thinking patterns

B.

Consider treatment with antipsychotic medications

C.

Reassure that classic symptoms of schizophrenia are not present

D.

Refer the patient for inpatient psychiatric treatment

 

 

 

 

Question 89

Michael is an 18 y/o male who has recently been suffering from insomnia. During your evaluation you learn that Michael lost his best friend in a roadside bomb in Afghanistan.

Michael’s insomnia could be treated with which of the following natural supplements:

A.

B.

C.

D.

All the above

D

 

 

 

 

Question 90

A patient reports symptoms of restlessness, fatigue, and difficulty concentrating. The provider determines that these symptoms occur in relation to many events and concerns. What other things will the provider question this patient about?

A.

Ability to manage social situations

B.

Body image and eating habits

C.

Headaches and bowel habits

D.

Occupational performance

C

 

 

 

 

 

Question 91

A college student is brought to clinic by a parent who is concerned about increasingly bizarre behavior and poor school performance. The provider notes difficulty engaging the patient in an organized conversation. The patient denies any concerns about behavior. What will the provider do initially to manage this patient’s symptoms?

a.

b.

c.

Counsel the parent to report any symptoms of depression

d.

Schedule an appointment with a psychiatrist

 

 

 

 

 

Question 92

A college student is brought to the emergency department by a roommate who is concerned about symptoms of extreme restlessness, nausea, and vomiting. The provider notes elevations of the pulse and blood pressure and pupillary dilation, along with hyperactive bowel sounds. The provider suspects withdrawal from which substance?

A.

Alcohol

B.

Cocaine

C.

LSD

D.

Opioids

 

 

 

 

 

 

Question 93

Angela is a 28 y/o female who comes to the clinic with her partner. During the history taking her partner does not all Angela to answer any of the questions but instead answers all the questions for her.

In doing the physical exam on Angela the NP should do all the following except:

A.

Have

B.

Collect

C.

Interview

D.

When appropriate develop a plan of safety

 

 

 

 

Question 94

An 18-year-old male is brought to the clinic by a parent who is concerned that the patient has become more isolated and withdrawn. The patient has expressed suspicions that his teachers hate him and want him to fail. What will the provider tell this parent?

A.

The adolescent should be evaluated by a psychiatrist.

B.

The adolescent should be given a trial of antipsychotic medications.

C.

These are common adolescent behaviors and will eventually go away.

D.

These signs are diagnostic for schizophrenia.

 

 

 

 

 

 

Question 95

Jason a 46 y/o male has a smoking addition and has smoke 2 packs /day for the past 26 years. Given this information his pack years for smoking would be:

A.

26 pack years

B.

38 pack years

C.

52 pack years

D.

62 Pack years

 

 

 

question 96

Jason a 46 y/o male has a smoking addition and has smoke 2 packs /day for the past 26 years.

Laboratory findings related to Jason’s smoking addiction would include all the following except:

A.

Decreased Hct

B.

Increased WBC

C.

Increased platelet count

D.

Decreased Vitamin C levels

 

 

 

 

question 97

A patient is brought to the emergency department experiencing disorientation, confusion, and fever. The patient describes visual and auditory hallucinations. The patient’s spouse states that the patient had several drinks 12 hours prior to passing out. A blood alcohol level is 0.2%. What is the recommended treatment?

A.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

B.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

C.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

D.

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

 

 

 

 

Question 98

In the elderly, depression often exists with dementia.

True

False

 

Question 99

A patient is seen in clinic 2 weeks after the death of a parent. The patient reports feelings of sadness and hopelessness and a feeling that the parent is still present, even to the point of hearing the parent’s voice at times. What will the provider determine from these findings?

A.

There is a concern for hypermania.

B.

There is a possibility of manic episodes.

C.

These are concerning for depression.

D.

These are normal grief responses.

 

Question 100

Michael is an 18 y/o male who has recently been suffering from insomnia. During your evaluation you learn that Michael lost his best friend in a roadside bomb in Afghanistan. Michaels insomnia can be classified as:

A.

Primary Insomnia

B.

Secondary Insomnia

C.

Short term Insomnia

D.

Chronic Insomnia

NRNP 6531: Advanced Practice Care of Adults across the Lifespan Final Exam

NURS 6512: Advanced Health Assessment and Diagnostic Reasoning Final Exam

Question 1

Breath odors may clue the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify:

diabetic ketoacidosis.

hepatic dysfunction.

tuberculosis.

uremia.

 

D

 

Question 2

A parent is advised to restrict contact or collision sports participation for their child. An example of a sport in which this child could participate is: NURS 6512: Advanced Health Assessment and Diagnostic Reasoning Final Exam

hockey.

roller skating.

skateboarding.

riflery.

D

 

 

 

Question 3

To assess a cremasteric reflex, the examiner strokes the:

abdomen and observes whether the umbilicus moves away from the stimulus.

skin around the anus and observes for the anal wink.

inner thigh and observes whether the testicle and scrotum rise on the stroked side.

palm and observes whether the fingers attempt to grasp.

 

 

 

 

Question 4

Inspection of the scrotum should reveal:

two testes per sac.

smooth scrotal sacs.

left scrotal sac lower than the right.

lightly pigmented skin.

C

 

 

 

Question 5

One of the most important aspects to consider in the orthopedic screening examination is:

symmetry.

muscle contraction.

balance.

flexibility.

 

 

 

Question 6

Tarry black stool should make you suspect:

upper intestinal bleeding.

rectal fistula.

prostatic cancer.

internal hemorrhoids.

 

 

Question 7

Which one of the following is a proper technique for use of a speculum during a vaginal examination?

Insert one finger; insert opened speculum.

Press introitus downward; insert closed speculum obliquely.

Allow labia to spread; insert speculum slightly open.

Spread labia; insert closed speculum horizontally.

D

 

 

Question 8

The Mini-Mental State Examination should be administered for the patient who:

has repetitive ritualistic behaviors.

uses illegal hallucinogenic drugs.

sleeps an excessive amount of time.

gets lost in her neighborhood.

 

 

 

 

Question 9

If pitting edema is unilateral, you would suspect occlusion of a:

superficial artery.

major vein.

surface capillary.

lymphatic duct.

B

 

Question 10

You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should:

chart the finding as paraphimosis.

transilluminate the glans.

inquire about previous penile infections.

retract the foreskin firmly.

 

 

 

Question 11

Postural hypotension is defined as a _____ when the patient stands, compared with sitting or supine readings.

systolic pressure drop of more than 15 mm Hg with a pulse rate increase

pulse rate decrease with a systolic pressure increase of at least 15 mm Hg

pulse rate decrease and diastolic pressure decrease of more than 5 mm Hg

diastolic pressure increase of more than 5 mm Hg and no pulse rate changes

 

 

 

Question 12

Your older clinic patient is being seen today as a follow-up for a 2-day history of pneumonia. The patient continues to have a productive cough, shortness of breath, and lethargy and has been spending most of the day lying in bed. You should begin the chest examination by:

determining tactile fremitus.

percussing all lung fields.

estimating diaphragmatic excursion.

auscultating the lung bases.

 

 

Question 13

A red, hot swollen joint in a 40-year-old man should lead you to suspect:

cellulitis.

bursitis.

trauma.

gout.

D

Question 81

You are examining a patient in the emergency department who has recently sustained head trauma. In order to initially assess this patient’s neurologic status, you would:

test the six cardinal points of gaze.

observe for swallowing and test the gag reflex.

palpate the jaw muscles as the patient clenches teeth.

ask him to discriminate between the smell of orange and peppermint.

A

 

 

 

 

 

Question 14

While examining a 30-year-old woman, you note that one breast is slightly larger than the other. In response to this finding, you should:

tell the patient to get a mammary sonogram as soon as possible.

ask the patient if she has ever had breast cancer.

tell the patient to get a mammogram as soon as possible.

note the finding in the patient’s record.

 

 

 

Question 15

The Mini-Mental State Examination:

will determine the cause of memory loss.

scores do not vary with regard to age or education.

may be used to quantitatively estimate cognitive changes.

may be used to qualitatively estimate personality disorders.

C

 

 

 

Question 16

Breath sounds normally heard over the trachea are called:

bronchovesicular.

bronchial.

vesicular.

amphoric.

B

 

 

 

Question 17

Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of the stimulus through the atria is the:

QRS complex.

ST segment.

P wave.

PR interval.

c

 

Question 18

The best way to ease the apprehension of a 3-year-old child before a physical examination is to:

hand the child a picture book.

explain that you will be gentle.

let the child hold the stethoscope while you listen.

tell the child he or she will get a lollipop for good behavior.

C

 

 

 

Question 19

A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarction. During the health history interview of his family history, he relates that his father had died of “heart trouble.” The most important follow-up question you should pose is which of the following?

“What age was your father at the time of his death?”

“Did your father’s father have heart trouble also?”

“Did your father have coronary bypass surgery?”

“What were your father’s usual dietary habits?”

A

 

 

 

Question 20

An examiner has rotated a brush several times into the cervical os. The brush was withdrawn and stroked lightly on a glass slide. The slide was sprayed with fixative. Which type of specimen requires this technique for collection?

Trichomonas
smear

Cytology smear

Haemophilus
smear

Gonococcal culture

B

 

NURS 6512: Advanced Health Assessment and Diagnostic Reasoning Final Exam

 

Question 21

The goals of preparticipation sports evaluation include:

determining the best fit for positions in each sport.

identifying risk of injury or death during sports participation.

securing a legal contract before recommending limiting participation.

screening for steroid use or abuse.

B

Question 87

During a routine prenatal visit, Ms. T. was noted as having dependent edema, varicosities of the legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T. that her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would further explain that these findings:

suggest that she is having twins.

indicate a need for hospitalization.

are usual conditions during pregnancy.

indicate the need for amniocentesis.

C

 

 

 

Question 88

The difference in blood pressure readings between the right and the left arms is considered normal up to _____ mm Hg.

20

25

5

10

 

 

 

 

 

Question 89

The presence of cervical motion tenderness may indicate:

vulvovaginitis.

pelvic inflammatory disease.

pregnancy.

nulliparity.

B

 

 

Question 90

When palpating breast tissue, the examiner should use the _____ at each site.

finger pads, gliding

fingertips, lifting

palms of the hands, gliding

ulnar surface of the hands, gliding

A

 

 

 

 

Question 91

Which portion of the physical examination is best done with the patient standing?

Neurologic

Musculoskeletal

Rectal

Spinal

D

 

 

 

 

 

Question 92

Adrian Thompson is a 19-year-old girl who presents to the clinic with complaints of severe, acute chest pain. Her mother reports that Andrian, apart from occasional sinus infections, Andrian is not prone to respiratory problems. What potential risk factor is most important to assess with regards to Adrian’s current problem?

Anorexia symptoms

Cocaine use

Covid-19 contact

Last menses

 

 

 

 

 

Question 93

While collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding: NURS 6512: Advanced Health Assessment and Diagnostic Reasoning Final Exam

history of medication allergies.

alcohol, tobacco, and caffeine use.

level of personal education.

amount of personal income.

B

 

 

 

Question 94

A 25 yo AA female has come to the clinic because she has missed her menstrual period this month and 2 months before. She says her cycles are irregular and she wants to be on birth control to help regulate them.  She states that her breasts have enlarged and that her nipples have turned a darker color. Your further response to this finding is to:

schedule an appointment with a surgeon.

suggest a pregnancy test

instruct her that this is a side effect of birth control injection therapy.

refer her to a gynecologist for pap smear

 

 

 

 

 

 

Question 95

Part of the screening orthopedic component of the examination includes evaluating the person while he or she is:

performing push-ups.

twisting at the waist.

crossing the arms over the chest.

duck walking.

 

 

 

 

 

Question 96

Functional assessment is most important during the examination of a(n):

infant.

young adult.

adolescent.

older adult.

D

 

 

 

 

Question 97

You are conducting a preparticipation physical examination for a 10-year-old girl with Down syndrome who will be playing basketball. She has slight torticollis and mild ankle clonus. What additional diagnostic testing would be required for her?NURS 6512: Advanced Health Assessment and Diagnostic Reasoning Final Exam

Mini-Mental State Examination

Visual acuity

Nerve conduction studies

Cervical spine radiograph

D

 

 

 

 

 

Question 98

Which one of the following techniques is used to detect a torn meniscus?

Drawer test

McMurray test

Thomas test

Trendelenburg test

 

 

 

 

Question 99

Assessing orientation to person, place, and time helps determine:

ability to understand analogies.

abstract reasoning.

state of consciousness.

attention span.

 

 

 

 

Question 100

When assessing a 17-year-old for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test, you would also perform a test for the _____ sign.

Babinski

obturator

Brudzinski

Kernig

D

NURS 6512: Advanced Health Assessment and Diagnostic Reasoning Final Exam

Damien Brooks traumatic brain injury shadow health Transcript

Started:
Feb 11, 2021 |
Total Time:
123 min

All Lines (213)
Interview Questions (108)
Statements (21)
Exam Actions (84)

Hello, I am xxx. I will be interviewing you today and later perform a physical examination

Greet

02/05/21 10:42 PM PST

Hey.

What is your name?

Question

02/05/21 10:43 PM PST

Damien Brooks and my birthday is July 25th, if you want to get me anything. [AUDIO COMING SOON] Damien Brooks traumatic brain injury shadow health

Okay

Empathize

02/05/21 10:43 PM PST

Thanks, Nurse.

What brought you into the hospital?

Question

02/05/21 10:43 PM PST

I banged my head up pretty bad and got this big bump. Tim took me to the ER after I threw up. I know puking is a bad sign. Can confirm it’s also a bad time.

Sorry about the bump and the pain

ORDER A PLAGIARISM-FREE PAPER OR SHADOW HEALTH HELP HERE

Empathize

02/05/21 10:44 PM PST

Thanks.

How did you sustain the bump? (No matching questions found.) Damien Brooks traumatic brain injury shadow health

Question

02/05/21 10:44 PM PST

What happened?

Question

02/05/21 10:44 PM PST

I’m not really sure, to be honest.

I understand

Empathize

02/05/21 10:44 PM PST

Cool, I appreciate that.

Di you fall? (Clarified to Did you fall?.)

Question

02/05/21 10:45 PM PST

Yeah, I took a dive. I don’t remember it really at all though, but I can tell I hit my head. No idea how it happened, usually I shred. (Clarified to if I fell.)

Do you have a headache?

Question

02/05/21 10:45 PM PST

Yeah, I definitely have a headache. It hurts to look at light, even. [AUDIO COMING SOON]

Damien Brooks traumatic brain injury shadow health

ORDER A PLAGIARISM-FREE PAPER OR SHADOW HEALTH HELP HERE

Damien Brooks traumatic brain injury shadow health

Damien Brooks traumatic brain injury shadow health

Do you normally wear sport safety gear? (Clarified to Do you usually wear a helmet?.)

Question

02/05/21 11:03 PM PST

Not usually, but we’ll practice with them on sometimes. (Clarified to if I usually wear a helmet.)

why do you not wear helmet?

Question

02/05/21 11:03 PM PST

No one does, really. It looks goofy. Especially on film. I dunno . . . I just kind of got out of the habit.

It is always safe to wear sports safety gear such as helmet

Damien Brooks traumatic brain injury shadow health

Educate

02/05/21 11:04 PM PST

Ok, I’ll keep it in mind.

Do you take alcohol?

Question

02/05/21 11:04 PM PST

No, officer.

Do you take illegal drugs?

Question

02/05/21 11:04 PM PST

Nah. Not into it.

Do you smoke tobacco?

Question

02/05/21 11:05 PM PST

That doesn’t really fit with my brand.

That is good. Smoking, alcohol and drugs are bad for your health

Educate

02/05/21 11:05 PM PST

Sure, yeah.

Do you have changes in vision? (Clarified to Has your vision changed since the accident?.)

Question

02/05/21 11:08 PM PST

I can see just fine, my eyes just feel a little light sensitive. (Clarified to if my vision has changed since the accident.) Damien Brooks traumatic brain injury shadow health

Do you have difficulties moving your extremities? (Clarified to Are you having any issues moving your legs?.)

Question

02/05/21 11:08 PM PST

I’m not feeling awesome right now, but I can move around okay. (Clarified to if I have difficulty moving my legs.)

Do you have any tingling?

Question

02/05/21 11:09 PM PST

No, no tingling or anything.

Do you have ear problem? (Clarified to Do you have ringing in your ears?.)

Question

02/05/21 11:09 PM PST

No, I don’t have any ringing in my ears. [AUDIO COMING SOON] (Clarified to if I have ringing in my ears.)

Do you have memory problems?

Question

02/05/21 11:10 PM PST

Yeah, the whole wipe out is a blur. Kinda messed up not being able to remember stuff.

Do you have neck pain?

Question

02/05/21 11:10 PM PST

My neck is fine.

do you have muscle weakness? Damien Brooks traumatic brain injury shadow health

Question

02/05/21 11:10 PM PST

I’d say I’m pretty strong.

Do you have muscle spasms?

Question

02/05/21 11:11 PM PST

Haven’t had any muscle spasms.

Do you have gait or balance problem?

Question

02/05/21 11:11 PM PST

I can walk pretty OK, it’s my head that’s bothering me.

What is your relationship with the patient?

Question

02/05/21 11:12 PM PST

I’m his stepfather.

What happened to your step-son? (Clarified to Talk to me about what had happened to your son?.)

Question

02/05/21 11:14 PM PST

He was at the skatepark after school, like he usually is, and he fell off his board while doing a grind. He didn’t have a helmet on, which we’re going to have to chat about later . . . (Clarified to to tell you what happened to my son.)

Yeah, it is good to have a helmet

Educate

02/05/21 11:14 PM PST

Thanks, yeah, I’ll remember that.

Did you notice any headache for your son? (No matching questions found.)

Question

02/05/21 11:17 PM PST

Does he have a headache?

Question

02/05/21 11:17 PM PST

Yes, Damien’s had a headache since he got home.

Does he have dizziness? (No matching questions found.)

Question

02/05/21 11:17 PM PST

Did he have dizziness?

Question

02/05/21 11:17 PM PST

I didn’t give him anything at home, but they gave him some medication when we got here — acetaminophen, I think.

Did he have confusion? (No matching questions found.)

Question

02/05/21 11:18 PM PST

Did your son have scalp hematoma? (No matching questions found.)

Question

02/05/21 11:19 PM PST

Did he have scalp hematoma? (No matching questions found.)

Question

02/05/21 11:19 PM PST

Did you notice any blood

Question

02/05/21 11:19 PM PST

I didn’t notice any bleeding. [AUDIO COMING SOON]

Is your son son complaining of light sensitivity? (No matching questions found.)

Question

02/05/21 11:20 PM PST

Is your son complaining of light sensitivity? (Clarified to Has your son been sensitive to light?.)

Question

02/05/21 11:20 PM PST

Yes, definitely. (Clarified to if my son has been sensitive to light.)

Did he report vomiting? (No matching questions found.)

Question

02/05/21 11:21 PM PST

Did he have any vomiting? (Clarified to Has your son vomited?.) Damien Brooks traumatic brain injury shadow health

Question

02/05/21 11:21 PM PST

It was after Damien came home and told me he had fallen. He was feeling dizzy and had a headache. He threw up pretty soon after that, and that’s when I decided to drive him over here. (Clarified to if my son has vomited.)

Did you notice any other additional symptoms? (Clarified to Have you noticed any other injuries on your son?.)

Question

02/05/21 11:23 PM PST

I haven’t noticed any other injuries on Damien other than the welt on his head. (Clarified to if I have noticed any other injuries on my son.)

Describe the onset of the symptoms? (No matching questions found.)

Question

02/05/21 11:26 PM PST

Describe the onset of the head injury (No matching questions found.)

Question

02/05/21 11:26 PM PST

what is the duration of the pain? (No matching questions found.)

Question

02/05/21 11:27 PM PST

How frequent is the headache? (No matching questions found.)

Question

02/05/21 11:28 PM PST

Describe the frequency of the pain (No matching questions found.)

Question

02/05/21 11:28 PM PST

did you notice confusion? (Clarified to When did you notice your son’s symptoms?.)

Question

02/05/21 11:29 PM PST

He’s been dizzy and confused at least since he got home. Kyle said he was complaining about both on the walk back from the skatepark. (Clarified to when I noticed my sons symptoms.)

Did you notice dizziness? (Clarified to Did you see blood?.)

Question

02/05/21 11:29 PM PST

I didn’t notice any bleeding. [AUDIO COMING SOON] (Clarified to if I saw blood.)

When did the fall occur?

Question

02/05/21 11:30 PM PST

Damien fell about two hours ago.

Describe the mechanism of the injury? (No matching questions found.)

Question

02/05/21 11:30 PM PST

how did your son fall?

Question

02/05/21 11:30 PM PST

He was balancing on a rail and just lost his balance. His friend Kyle was recording it, so I watched the video. A hard thing to see.

did he lose consciousness?

Question

02/05/21 11:34 PM PST

Yeah, the fall knocked Damien unconscious.

What are relieving factors for the pain?

Question

02/05/21 11:52 PM PST

I gave him an ice pack and laid him down on the couch. I tried dimming the lights too. But once he threw up, I decided I was out of my depth and drove him here.

What makes the pain worse? Damien Brooks traumatic brain injury shadow health

Question

02/05/21 11:52 PM PST

I’m not sure what all can make his pain worse right now. I know he’s said that light hurts his eyes. [AUDIO COMING SOON]

Okay. i understand

Empathize

02/05/21 11:53 PM PST

Well, that’s kind of you to say.

Has your son received all vaccinations? (No matching questions found.)

Question

02/05/21 11:53 PM PST

Has he had all vaccinations? (Clarified to Does your son have all his vaccines?.)

Question

02/05/21 11:54 PM PST

Yes, he’s got all his shots. (Clarified to if my son is vaccinated.)

That is great. Vaccinations are very important for good health

Educate

02/05/21 11:54 PM PST

I gotcha, loud and clear. Damien Brooks traumatic brain injury shadow health

Has he ever been hospitalized?

Question

02/05/21 11:55 PM PST

Damien’s never been to the hospital before. We’re very lucky, especially if he hasn’t been wearing his helmet like this time. He’s definitely fallen in the past.

Has he ever had head injury? (Clarified to What previous head injuries has your son had?.)

Question

02/05/21 11:56 PM PST

Damien doesn’t have any previous head injuries. (Clarified to what my sons past head injuries are.)

Has your son had any surgery?

Question

02/05/21 11:56 PM PST

Damien’s never had surgery.

What home medication does your son use? (No matching questions found.)

Question

02/05/21 11:56 PM PST

Any home medications? (No matching questions found.)

Question

02/05/21 11:57 PM PST

what medications is your son using?

Question

02/05/21 11:57 PM PST

Really just acetaminophen when he has a fever and the like. He almost never takes any medication at all.

Is your son having dizziness? (No matching questions found.)

Question

02/05/21 11:58 PM PST

Any eye problem for your son? (No matching questions found.) Damien Brooks traumatic brain injury shadow health

Question

02/05/21 11:58 PM PST

Any eye problem? (No matching questions found.)

Question

02/05/21 11:59 PM PST

Does your son have eye problem? (No matching questions found.)

Question

02/05/21 11:59 PM PST

Does your son have headache?

Question

02/05/21 11:59 PM PST

Yes, Damien’s had a headache since he got home.

Does he have vision issues?

Question

02/06/21 12:00 AM PST

Damien’s only mentioned the light sensitivity. [AUDIO COMING SOON]

Any ear problem? (No matching questions found.)

Question

02/06/21 12:00 AM PST

Does Damien have ear issues? (No matching questions found.)

Question

02/06/21 12:00 AM PST

Any issues with the ears (No matching questions found.)

Question

02/06/21 12:00 AM PST

Has your son’s speech changed? (No matching questions found.)

Question

02/06/21 12:01 AM PST

Is he able to follow instructions?

Question

02/06/21 12:01 AM PST

He’s been walking fine. [AUDIO COMING SOON]

Does he have confusion? (No matching questions found.)

Question

02/06/21 12:02 AM PST

Has your son had confusion?

Question

02/06/21 12:02 AM PST

I didn’t give him anything at home, but they gave him some medication when we got here — acetaminophen, I think.

Does your son have movement problem? (No matching questions found.)

Question

02/06/21 12:02 AM PST

Does your son have issue with movement? (Clarified to Does your son have any balance or gait issues?.)

Question

02/06/21 12:03 AM PST

Nope, he’s been getting around just fine. (Clarified to if my son has any balance or gait issues.)

ORDER A PLAGIARISM-FREE PAPER OR SHADOW HEALTH HELP HERE

Damien Brooks traumatic brain injury shadow health

Exam Action

02/06/21 12:12 AM PST

 Inspected head front: No abnormal findings

Exam Action

02/06/21 12:12 AM PST

 Inspected left eye

Exam Action

02/06/21 12:12 AM PST

 Inspected right eye

Exam Action

02/06/21 12:12 AM PST

 Inspected left eye

Damien Brooks traumatic brain injury shadow health

Exam Action

02/06/21 12:13 AM PST

 Inspected right eye

Exam Action

02/06/21 12:13 AM PST

 Inspect e o m

Exam Action

02/06/21 12:13 AM PST

 Inspect shoulders

Exam Action

02/06/21 12:14 AM PST

 Inspected left shoulder

Exam Action

02/06/21 12:14 AM PST

 Inspected upper back

Exam Action

02/06/21 12:14 AM PST

 Inspected right shoulder

Exam Action

02/06/21 12:14 AM PST

 Inspected shoulders from the front

Exam Action

02/06/21 12:14 AM PST

 Inspected right shoulder

Exam Action

02/06/21 12:14 AM PST

 Inspected upper back

Exam Action

02/06/21 12:14 AM PST

 Inspected left shoulder

Exam Action

02/06/21 12:14 AM PST

 Inspected shoulders from the front

Exam Action

02/06/21 12:14 AM PST

 Inspect arms

Exam Action

02/06/21 12:15 AM PST

 Inspect elbows

Exam Action

02/06/21 12:15 AM PST

Damien Brooks traumatic brain injury shadow health
 Inspected left wrist

Exam Action

02/06/21 12:16 AM PST

 Inspected right wrist

Exam Action

02/06/21 12:16 AM PST

 Inspected both hands

Exam Action

02/06/21 12:17 AM PST

 Inspect hips

Exam Action

02/06/21 12:17 AM PST

 Inspect thighs

Exam Action

02/06/21 12:18 AM PST

 Inspect thighs

Exam Action

02/06/21 12:19 AM PST

 Inspect knees

Exam Action

02/06/21 12:43 AM PST

Damien Brooks traumatic brain injury shadow health
 Inspect lower legs

Exam Action

02/06/21 12:44 AM PST

 Inspect ankles

Exam Action

02/06/21 12:44 AM PST

 Inspect feet

Exam Action

02/06/21 12:44 AM PST

 Checked ID band

Exam Action

02/06/21 12:46 AM PST

 Auscultated breath sounds

Exam Action

02/06/21 12:46 AM PST

 Auscultated heart sounds

Exam Action

02/06/21 12:46 AM PST

 Auscultated breath sounds

Exam Action

02/06/21 12:47 AM PST

 Palp cardio pulses radial

Exam Action

02/06/21 12:47 AM PST

 Confirmed orientation

Exam Action

02/06/21 12:48 AM PST

What is your name and date of birth?

Question

02/06/21 12:48 AM PST

I’m Damien Brooks. It’s . . . [Mr. Brooks reports his correct date of birth.]

What building are you now?

Question

02/06/21 12:48 AM PST

We’re at Dr. Pulaski’s office, right?

what is the date and year

Question

02/06/21 12:49 AM PST

Today? It’s . . .[Mr. Brooks reports the correct date.]

Do you know what’s going on?

Question

02/06/21 12:50 AM PST

Wiped out on my board and knocked my head, which ended me up here. It’s pretty messed up.

 Assessed cognition

Exam Action

02/06/21 12:50 AM PST

repeat and remember burger, tulip, nose and tea

Question

02/06/21 12:51 AM PST

Burger, tulip, nose, tea. Damien Brooks traumatic brain injury shadow health

how did you celebrate your birthday?

Question

02/06/21 12:51 AM PST

My birthday? Oh, this year it was actually pretty sick. The squad threw a surprise party for me. They like ambushed me the morning of, had a cake and candles and everything for me right there in bed. The day just went from there. It was a good start to 15, yeah.

repeat the four words from before

Question

02/06/21 12:52 AM PST

Burger . . . nose? Tea?

 Vocabulary

Exam Action

02/06/21 12:52 AM PST

 Assessed speech

Exam Action

02/06/21 12:53 AM PST

 Assessed speech

Exam Action

02/06/21 12:53 AM PST

close your eyes and touch your fingers to your nose

Question

02/06/21 12:54 AM PST

I can do that.

 Observed left index finger to nose smooth and accurate Damien Brooks traumatic brain injury shadow health

Exam Action

02/06/21 12:54 AM PST

 Observed right index finger to nose smooth and accurate

Exam Action

02/06/21 12:54 AM PST

run your right foot down your shin

Question

02/06/21 12:54 AM PST

Sure.

 Observed right heel moving to shin smooth and accurate

Exam Action

02/06/21 12:54 AM PST

run your left foot down your right shin

Question

02/06/21 12:55 AM PST

Ok.

 Observed left heel moving to shin smooth and accurate

Exam Action

02/06/21 12:55 AM PST

place your hands on your knees and turn them over

Question

02/06/21 12:55 AM PST

Sounds good

 Observed rapid alternating hand movements

Exam Action

02/06/21 12:55 AM PST

 Eye Opening Response measured as “spontaneously “

Exam Action

02/06/21 12:56 AM PST

 Measured Damien’s best verbal response

Exam Action

02/06/21 12:56 AM PST

 Measured Damien’s best motor response

Exam Action

02/06/21 12:56 AM PST

 Determined Damien’s Glasgow Coma Score

Exam Action

02/06/21 12:57 AM PST

 Tested ROM of elbows – supination and pronation

Exam Action

02/06/21 12:57 AM PST

 Tested ROM of elbows – flexion and extension

Exam Action

02/06/21 12:57 AM PST

 Tested ROM of wrists – flexion

Exam Action

02/06/21 12:58 AM PST

 Tested ROM of wrists – extension

Exam Action

02/06/21 12:58 AM PST

 Tested ROM of wrists – ulnar and radial deviation

Exam Action

02/06/21 12:58 AM PST

 Tested ROM of hips – flexion

Exam Action

02/06/21 12:59 AM PST

 Tested ROM of hips – extension

Exam Action

02/06/21 12:59 AM PST

 Tested ROM of hips – abduction Damien Brooks traumatic brain injury shadow health

Exam Action

02/06/21 12:59 AM PST

 Tested ROM of hips – adduction

Exam Action

02/06/21 12:59 AM PST

 Tested ROM of knees – flexion

Exam Action

02/06/21 1:00 AM PST

 Tested ROM of knees – extension

Exam Action

02/06/21 1:00 AM PST

 Tested ROM of ankles – inversion and eversion

Exam Action

02/06/21 1:00 AM PST

 Tested ROM of ankles – dorsiflexion and plantar flexion

Exam Action

02/06/21 1:00 AM PST

 Tested right and left hand strength with grip test: 5/5

Exam Action

02/06/21 1:01 AM PST

 Strength test feet

Exam Action

02/06/21 1:02 AM PST

 Tested left arm distal sensation

Exam Action

02/06/21 1:03 AM PST

 Tested left arm proximal sensation

Exam Action

02/06/21 1:03 AM PST

Yeah.

Yeah.

 Tested right arm proximal sensation

Exam Action

02/06/21 1:03 AM PST

Yeah.

 Tested right arm distal sensation Damien Brooks traumatic brain injury shadow health

Exam Action

02/06/21 1:03 AM PST

Yeah.

Yeah.

 Tested left leg distal sensation

Exam Action

02/06/21 1:04 AM PST

Yeah.

 Tested left leg proximal sensation

Exam Action

02/06/21 1:04 AM PST

Yeah.

 Tested right leg proximal sensation

Exam Action

02/06/21 1:04 AM PST

Yeah.

 Tested right leg distal sensation

Exam Action

02/06/21 1:04 AM PST

Yeah.

 Tested sensation of left foot

Exam Action

02/06/21 1:05 AM PST

Yeah.

 Tested sensation of right foot

Exam Action

02/06/21 1:05 AM PST

 Palpated cap refill

Exam Action

02/06/21 1:06 AM PST

 Reflex hammer patellar mode

Exam Action

02/06/21 1:06 AM PST

 Reflex hammer brachioradialis mode

Damien Brooks traumatic brain injury shadow health

Exam Action

02/06/21 1:06 AM PST

NURS-6630 Approaches to Treatment quiz QUESTION 1

Richard is a 54-year-old male who suffers from schizophrenia. After exhausting various medication options, you have decided to start him on Clozapine. Which of the statements below is true regarding Clozapine?a.Regular blood monitoring must be performed to monitor for neutropenia.b.Clozapine can only be filled by a pharmacy that participates in the REMS program.c.Bradycardia is a common side effect of Clozapine.d.A & Be.All of the above

3.75 points  

QUESTION 2

Which of the following statements are true?a.First-generation (typical) antipsychotics are associated with a higher incidence of EPS.b.Second-generation (atypical) antipsychotics are associated with a higher risk of metabolic side effects.c.There is evidence that atypical antipsychotics are significantly more effective than typical antipsychotics in the treatment of cognitive symptoms associated with schizophrenia.d.A & Be.A, B, and C

3.75 points  

QUESTION 3

Cindy is a 55-year-old patient who presents with symptoms consistent with Generalized anxiety disorder. The patient has an unremarkable social history other than she consumes two or three glasses of wine per night. Which of the following would be an appropriate therapy to start this patient on?a.Xanax 0.25mg BID PRN Anxietyb.Escitalopram 10mg dailyc.Buspirone 10mg BIDd.Aripiprazole 10mg daily

3.75 points  

NURS-6630 Approaches to Treatment quiz QUESTION 4

Mirza is a 75-year-old patient with a long history of schizophrenia. During the past 5 years, she has shown significant cognitive decline consistent with dementia. The patient has been well controlled on a regimen of risperidone 1mg BID. As the PMHNP, the most appropriate course of action for this patient is:a.Increase the risperidone to 1mg QAM, 2mg QPMb.Discontinue risperidone and prescribe a long-acting injectable such as Invega Sustenna.c.Discontinue risperidone and initiate therapy with clozapine.d.Augment the patient’s risperidone with brexpiprazole.

3.75 points  

QUESTION 5

The patient in the previous question states, “I can’t even last 1 more day without feeling like my insides are going to explode with anxiety.” The most appropriate course of action would be:a.Inform the patient to try yoga or other natural remedies until the vortioxetine takes effect.b.Prescribe a short-term course of low dose benzodiazepine, such as alprazolam.c.Prescribe an SNRI, such as venlafaxine, in addition to the vortioxetine.d.Recommend in-patient mental health for the foreseeable future.

3.75 points  

QUESTION 6

Thomas is a 28-year-old male who presents to the clinic with signs and symptoms consistent with MDD. He is concerned about starting antidepressant therapy, however, because one of his friends recently experienced erectile dysfunction when he was put on an antidepressant. Which of the following would be the most appropriate antidepressant to start Thomas on?a.Vilazodoneb.Sertralinec.Paroxetined.Citalopram

3.75 points  

QUESTION 7

Stephanie is a 36-year-old female who presents to the clinic with a history of anxiety. Social history is unremarkable. For the last 4 years, she has been well controlled on paroxetine, however she feels “it just doesn’t work anymore.” You have decided to change her medication regimen to vortioxetine 5mg, titrating up to a max dose of 20mg per day based on tolerability. The patient asks, “When can I expect this to start kicking in?” The best response is:a.3 or 4 daysb.1 or 2 weeksc.3 or 4 weeksd.10 weeks

3.75 points  

QUESTION 8

Jane is a 17-year-old patient who presents to the office with signs consistent with schizophrenia. She states multiple times that she is concerned about gaining weight, as she has the perfect prom dress picked out and she finally got a date. Which of the following is the least appropriate choice to prescribe Jane?a.Aripiprazoleb.Olanzapinec.Haloperidold.Brexpiprazole

3.75 points  

NURS-6630 Approaches to Treatment quiz QUESTION 9

John is a 41-year old-patient who presents to the clinic with diarrhea, fatigue, and recently has been having tremors. He was diagnosed 19 years ago with bipolar disorder and is currently managed on Lithium 300mg BID. As the PMHNP, you decide to order a lithium level that comes back at 2.3mmol/l. What is the most appropriate course of action?a.Investigate other differential diagnoses for his symptoms.b.Tell John to skip his next four Lithium doses and resume therapy.c.Tell John he needs to go to the hospital and call an ambulance to bring him.d.Prescribe loperamide to treat the diarrhea and ropinirole to treat the tremors

3.75 points  

QUESTION 10

Jordyn is a 27-year-old patient who presents to the clinic with GAD. She is 30 weeks pregnant and has been well controlled on a regimen of sertraline 50mg daily. Jordyn says that “about once or twice a week my husband really gets on my nerves and I can’t take it.” She is opposed to having the sertraline dose increased due to the risk of further weight gain. You have decided to prescribe the patient a short-term course of benzodiazepines for breakthrough anxiety. Which of the following is the LEAST appropriate benzodiazepines to prescribe to this patient?a.diazepamb.alprazolamc.clonazepamd.lorazepam

3.75 points  

QUESTION 11

Rebecca is a 32-year-old female who was recently prescribed escitalopram for MDD. She presents to the clinic today complaining of diaphoresis, tachycardia, and confusion. The differential diagnosis for this patient, based on the symptoms presenting, is:a.Panic disorderb.Gastroenteritisc.Abnormal gaitd.Serotonin syndrome

3.75 points  

QUESTION 12

Mark is a 46-year-old male with treatment-resistant depression. He has tried various medications, including SSRIs, SNRI, and TCAs. You have decided to initiate therapy with phenelzine. Which of the following must the PMHNP take into consideration when initiating therapy with phenelzine?a.There is a minimum 7-day washout period when switching from another antidepressant to phenelzine.b.Patient must be counseled on dietary restrictions.c.MAOIs may be given as an adjunctive therapy with SSRIs.d.A & Be.All of the above

3.75 points  

QUESTION 13

Melvin is an 89-year-old male who presents to the clinic with signs/symptoms consistent with MDD. Which of the following would be the LEAST appropriate medication to prescribe to this elderly patient?a.nortriptylineb.amitriptylinec.desipramined.trazodone

3.75 points  

QUESTION 14

Earle is an 86-year-old patient who presents to the hospital with a Community Acquired Pneumonia. During stay, you notice that the patient often seems agitated. He suffers from cognitive decline and currently takes no mental health medications. Treatment for the CAP include ceftriaxone and azithromycin. The LEAST appropriate medication to treat Earle’s anxiety is:a.sertralineb.duloxetinec.citalopramd.venlafaxine

3.75 points  

NURS-6630 Approaches to Treatment quiz QUESTION 15

Martin is a 92-year-old male who presents to the clinic with signs/symptoms consistent with MDD. The patient suffers from glaucoma and just recently underwent surgery for a cataract. Which of the following is the LEAST appropriate course of therapy when treating the MDD?a.sertralineb.amitriptylinec.duloxetined.vilazodone

3.75 points  

QUESTION 16

Sam is a 48-year-old male who presents to the clinic with signs and symptoms consistent with GAD & MDD. Which of the following medications would be the LEAST appropriate choice when initiating pharmacotherapy?a.duloxetineb.sertralinec.mirtazapined.buproprion

3.75 points  

QUESTION 17

Steve is a 35-year-old male who presents to the primary care office complaining of anxiety secondary to quitting smoking cold turkey 2 weeks ago. The patient has a 14-year history of smoking two packs per day. The patient has an unremarkable social history other than a recent divorce from his wife, Brittany. Which of the following would be the LEAST effective medication to treat Steve’s anxiety?a.Buproprionb.Sertralinec.Vareniclined.Alprazolam

3.75 points  

QUESTION 18

Amber is a 26-year-old female who presents to the clinic 6 weeks postpartum. The patient states that she has been “feeling down” since the birth of her son. She is currently breastfeeding her infant. You diagnose the patient with Postpartum depression. Which of the following is the LEAST appropriate option in treating her PPD?a.paroxetineb.escitalopramc.citalopramd.sertraline

3.75 points  

QUESTION 19

Which of the following medications, when given intramuscularly, is most likely to cause severe postural hypotension?a.haloperidolb.lorazepamc.benztropined.chlorpromazine

3.75 points  

NURS-6630 Approaches to Treatment quiz QUESTION 20

Jason is a 6-year-old child whose mother presents to the clinic with him. The mother says that “he’s not himself lately.” After a thorough workup, you diagnose the patient as having GAD. Which of the following medications would be the LEAST appropriate to prescribe to this child?a.Sertralineb.Paroxetinec.Venlafaxined.Buspirone