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NURS 6550 Board Vitals Quiz Week 8.
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NURS 6550 Board Vitals Quiz Week 8.
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Week I8 IBoard IVitals IQuiz1. A I35-year-old Iman Iis Ifor Ia Iphysical Iexamination. ILabs Ireveal Ian IHIV Itest Ithat Iis
Ipositive. IHe Iundergoes Icounseling Iregarding Ihis Idiagnosis. IHis ICD4 Icount Iis I125, Iand
Iviral Iload Iis I36,000; Ihe Iis IToxoplasma Igondii IIgG Ipositive. IHis Ihepatitis Ipanel Ishows
Ihepatitis IB Isurface Iantibody Ipositive Iand Ihepatitis IC Iantibody Inegative. IHe Ihad Ia
Ituberculin Iskin Itest I(TST) Ireaction Imeasuring I4 Imm. IWhich Iof Ithe Ifollowing
Iprophylaxis Itreatments Ifor Iopportunistic Iinfections Ishould Iyou Ioffer?
Correct Ianswer: I(A) ITMP-SMX Ifor IPneumocystis Ijiroveci Iprophylaxis.
2. Which Iof Ithe Ifollowing Iis Ia Irisk Ifactor Ifor Iurinary Itract Iinfection Iin Isexually Iactive
Iwomen?
Correct Ianswer: I(A) IRecent Ispermicide Iuse.
3. A I39-year-old Ifemale Ipresents Iwith Ianxiety Iand Ifrequent I“panic Iattacks.” IShe Iwas
Iseen I2 Iweeks Iago, Iand I her Iexamination Iwas Iunremarkable. IThe Ipatient Iis Ireferred Ito
Ia Itherapist Ifor Ia Ipsychological Ievaluation. IShe Ireturns Itoday Iwhile Iexperiencing Ia
Ipanic Iattack. IShe Iis Idiaphoretic Iwith Ia Iheart Irate Iof I101, Iblood Ipressure Iof I150/90, Iand
Ipapilledema. IThe Ipatient Idenies Ichest Ipain Ior Idyspnea. IShe Istates Ithis Iis Ia Itypical
Iepisode. IWhich Iof Ithe Ifollowing Itests Iis Ithe Inext Ibest Istep Iin Iestablishing Ia Idiagnosis?
Correct Ianswer: I(B) I24-hour Iurinary Ifractionated Imetanephrines.
4. Which Iof Ithe Ifollowing Iis Itrue Iof Imanagement Igoals Iin Isepsis?
Correct Ianswer: I(D) IUrine Ioutput Iof I0.5 ImL/kg/hour Ior Imore Ishould Ibe Itargeted Iin Ifluid
Iresuscitation Iin Iearly Isepsis. I
5. A Ipatient Ipresents Iwith Ithe Ilesion Ishown Ibelow. IWhich Iof Ithe Ifollowing Idrugs Ishould Ibe
Igiven Ias Ipost-exposure Iprophylaxis I(PEP) Ifor Ithis Idisease? I
Correct IAnswer: IB. IDoxycycline
6. A I45-year-old Iwhite Iwoman Iwith Iclinical Ifindings Isuggestive Iof ICushing Isyndrome Ihas
I2 Ielevated Ilate Inight Isalivary Icortisol Ilevels Iand I2 Ielevated Iurinary Ifree-cortisol Itests Iof
I220 Iand I300 I(normal I2-50mg/24 Ihour); Iher IACTH Ilevel Iis I55 I(normal I5-50pg/mL), Iand
Iher Ipituitary IMRI Ishows Ia I3mm Iadenoma. IWhich Iof Ithe Ifollowings Iis Ithe Ibest Inext
Icourse Iof Iaction?
Correct Ianswer: I(D) IHigh-dose Idexamethasone Isuppression Itest I(HDDST) Iand/or
Icorticotropin-releasing Ihormone I(CRH) Istimulation Itest.
7. A Ifemale Ipatient Iwith Iprimary Ihypothyroidism Ihas Ibeen Istable I(normal ITSH) Ion
Ireplacement ILT4 I(dose I1.6μg/kg Iof Ibody Iweight) Ifor Iseveral Iyears. IOn Iannual Ifollow-up,
Ithe Ifollowing Ilaboratory Itests Iare Iobtained: IT4 I= I14.1μg/dL I(normal I5.0-10.5) Iand ITSH I=
I23.4μU/mL I(normal I0.4-5.5). IWhich Iis Ithe Imost Ilikely Idiagnosis?
Correct Ianswer: I(D) IPoor Icompliance Ithis Ipast Iyear, Iwith Irecent Iattempt Ito I“catch Iup” Iwith
Iexcessive ILT4 Iintake.
8. Which Iof Ithe Ifollowing Iis Ithe Iorganism Imost Ifrequently Iimplicated Iin Itoxic Ishock
Isyndrome Iin Iwomen Iwho Iare Iusing Itampons?
,Correct Ianswer: I(B) IStaphylococcus Iaureus. I
9. Rocky IMountain Ispotted Ifever Iis Icaused Iby Iwhich Iof Ithe Ifollowing?
Correct Ianswer: I(C) ITick Ibite. I
10. A I36-year-old Ifemale Ipresents Ito Ia Iprimary Ihealthcare Iprovider Iwith Ia Ihistory Iof Iirregular
Imenstrual Icycles Iand Isecondary Iamenorrhea. IShe Ihad Ino Iproblem Iconceiving Iher Ifirst
Ichild Iat Iage I24, Ibut Ishe Ihas Ibeen Itrying Iunsuccessfully Ito Ibecome Ipregnant Ifor Ithe Ipast I2
Iyears. IShe Ialso Ireports Ia Iweight Igain Iof Iabout I5kg, Iincreasing Ifatigue, Ia Ipuffy Iface, Iand
Imarked Icold Iintolerance. ICBC Ireveals Ian IHb Iof I11.1 Iand Ian IMCV Iof I90. IPhysical Iexam
Ireveals Ia Imoderate-sized Idiffuse Ienlargement Iof Ithe Ithyroid Igland. IWhich Iof Ithe Ifollowing
Ithyroid Iprofiles Iis Imost Ilikely Ipresent Iin Ithis Iwoman?
Correct Ianswer: I(A) ILow IT3, Ilow IT4, Ihigh ITSH.
11. A I40-year-old Iwhite Iwoman Iwith Ia Ihistory Iof Isevere Iasthma Iand IHashimoto Ithyroiditis
Ireports I2 Imonths Iof Ifatigue, Ianorexia, Inausea, Iweight Iloss, Iand Imyalgia. IExamination Iis
Iremarkable Ionly Ifor Ia IBP Iof I98/60 ImmHg Iand Ia Ipulse Iof I98 Ibeats/minute Iwithout
Iorthostasis. IShe Ishows Ino Ihyperpigmentation. ILab Ivalues Iare Ias Ifollows: Isodium I130
ImEq/L, Ipotassium I4.5 ImEq/L, Ichloride I105 ImEq/L, Iand Ibicarbonate I24 ImEq/L. IACTH
Istimulation Itesting Ishows Ian IAM Icortisol Ilevel Iof I5.8 Iμg/dL Iat IT0 I(normal Iis I10-20 Iμg/dL)
Iand I13.2 Iμg/dL I(normal I>18 Iμg/dL) Iat IT60 I(60 Iminutes Iafter Iadministration Iof IACTH).
IWhich Iof Ithe Ifollowing Iis Icorrect?
ANSWER: IB. IThe Imost Ilikely Icause Iof Iher Iadrenal Iinsufficiency Iis Iprior Iexogenous
Icorticosteroid Iuse.
12. Which Iof Ithe Ifollowing Iis Ithe Ifirst Iline Itreatment Ifor Igonorrheal Iinfections?
Correct Ianswer: I(C) IAzithromycin Iplus Iceftriaxone.
13. A I59-year-old Iwoman Ipresents Ito Ithe IED Ifeeling Igenerally Iunwell Iwith I2 Imonths Iof
Iworsening Ilethargy, Inausea, Igeneralized Iabdominal Ipain, Iand Iconstipation. IShe Iis Ia Iheavy
Ismoker Iand Ihas Ihypertension, Ihigh Icholesterol, Iand Ichronic Ibronchitis. IShe Itakes
Iamlodipine I5mg Idaily Iand Iatorvastatin I40mg Idaily Iwith Ino Irecent Ichanges Iin Idoses Ior
Ifrequency. IThe Ipatient Ihas Ilost I15lbs Idespite Ia Inormal Iappetite Iover Ithis Iperiod. IThere Ihas
Ibeen Ino Irecent Iexacerbation Iof Iher Ichronic Icough. IShe Ihad Ia Ifew Iepisodes Iof Iminimal
Ihemoptysis Ia Ifew Imonths Iago Ibut Inone Isince. IVital Isigns Iare Iwithin Inormal Ilimits.
IAuscultation Iof Ithe Ilungs Ireveals Imild Idecreased Iair Ientry Ithroughout Iand Ino Iadventitious
Isounds. IMild Igeneralized Iabdominal Itenderness Ito Ipalpation Iis Inoted. IPhysical
Iexamination Iis Iotherwise Iunremarkable. ILaboratory Iinvestigations Iare Inotable Ifor Ia ICr Iof
I0.8 Iand ICa Iof I12.1. IAlbumin Iis I3.8. IChest Iradiograph Ishows Ia Idiscrete Imass Iin Ithe Iright
Ihilum Ithat Iis Iapproximately I10mm Iin Idiameter; Iotherwise, Ilung Ifields Iare Iclear Iwithout
Icollapse Ior Iconsolidation. IWhat Iis Ithe Ibest Iinitial Imanagement Iof Ithis Ipatient?
Correct Ianswer: I(B) IIV Ihydration Iwith Inormal Isaline.
14. A I26-year-old Iman Ihas Ihad Ia Ipainless Ipenile Ilesion Ifor Iseveral Iweeks Iand Inew Iswelling Iin
Ithe Igroin. IOn Iexamination, Ia Isingle Inontender Ipenile Iulcer Iand Ibilateral Ipalpable
, Inontender Iinguinal Ilymph Inodes Iare Ipresent. IRapid Iplasma Ireagin Itest Iresults Iare Inegative.
IWhat Iis Ithe Imost Ilikely Idiagnosis?
Correct Ianswer: I(C) IPrimary Isyphilis.
15. IA I60-year-old Imale Ipatient Iis Ievaluated Iin Ithe Iemergency Idepartment Ifor Imental
Istatus Ichanges. IHe Ihas Ia Ihistory Iof ICOPD Iand Ia I40 Ipack Iyear Ihistory Iof Itobacco Iuse.
ILaboratory Iresults Ireveal:
Na: I123 ImEq/L
K: I4.0/L
HCO3: I25 ImEq/L
BUN: I20 Img/dL
Cr: I1.0 Img/dL
Glucose: I110 Img/dL
Urinalysis:
Osmolality I340 ImOsm/kg I(280-295)
Na I50 ImEq/L
Which Iof Ithe Ifollowing Iis Ithe Ilikely Ietiology Iof Ithe Ipatient’s Imental Istatus Ichanges?
Correct Ianswer: I(C) ISyndrome Iof Iinappropriate Iantidiuretic Ihormone.
16. Which Iof Ithe Ifollowing Iis Ia Icharacteristic Iof Iacromegaly
Correct Ianswer: I(D) ICoarse Ifacial Ifeatures.
17. Which Iof Ithe Ifollowing Ioral Iantimicrobials Ishould Ia Inurse Ipractitioner Iprescribe Ifor
Ioutpatient Itreatment Iof Icommunity Iacquired Imethicillin Iresistant IStaphylococcus Iaureus
Iinfection?
Correct Ianswer: I(C) IClindamycin. I
18. IAn I85-year-old Imale Inursing Icare Iresident Iwith IAlzheimer Idisease Iis Ibrought Ito Ithe
Iemergency Idepartment Iwith Idiarrhea Iand Ivomiting Ifor I3 Idays. IHis Inurse-aid Ireports
Ithat Ithe Ipatient Ihas Ibeen Iunable Ito Ieat Ior Idrink Ifor Ithe Ipast I24 Ihours Iand Iappears Imore
Ilethargic Ithan Iusual. IHis Ivitals Iat Ithe Itime Iof Iadmission Iare Itemperature I37.0 Idegrees
IC I(98.6 Idegrees IF), Iblood Ipressure I90/60 ImmHg, Iheart Irate I138/min, Iand Irespiratory
Irate I19/min. IThe Ipatient's Imucous Imembranes Iare Idry.
Laboratory Istudies Ishow Ithe Ifollowing:
• Sodium I147 ImEq/L
• Potassium I5.4 ImEq/L
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