A 14-year-old, male patient has some general concerns about eczema, as his twin
brother was recently diagnosed with this condition. The patient reports urticaria and a
rash on his posterior knees bilaterally. The three factors that put the patient at risk for
eczema are a family history of eczema, a personal history of allergic rhinitis, and a
history of:
A patient has hyperactive reflexes of the lower extremities. The adult-gerontology
primary care nurse practitioner assesses for ankle clonus by:
(a) firmly applying a low-pitched tuning fork to the lateral malleolus.
(b) flexing the leg at the knee, rotating it externally, and striking the Achilles tendon with
the percussion hammer.
(c) sharply dorsiflexing the foot and maintaining this position while supporting the knee.
(d) stroking the lateral aspect of the sole from the heel to the ball of the foot with the
sharp end of the percussion hammer. -
\(c) sharply dorsiflexing the foot and maintaining this position while supporting the knee.
A 70-year-old, female patient is having her yearly evaluation. The adult-gerontology
primary care nurse practitioner gives which physical examination finding the highest
priority for immediate treatment?
The adult-gerontology primary care nurse practitioner reminds a 16-year-old, male
patient who just received his driver's license to wear a seat belt at all times when in a
car. The patient replies that he does not need to wear a seat belt, because nothing will
happen to him if he is involved in an automobile collision. According to the health belief
model, what chief component does the patient lack?
The adult-gerontology primary care nurse practitioner treats several patients for
biological exposure. In the patients' records, the nurse practitioner documents which
epidemiological factors for each exposure?
(a) Comorbidities and length of exposure.
(b) Location and event intensity.
(c) Mode of transmission and incubation.
(d) Premorbid conditions and surveillance rates. -
\(c) Mode of transmission and incubation.
When disseminating research findings in a peer-reviewed journal, the adult-gerontology
primary care nurse practitioner:
(a) concludes that the study proves the hypothesis.
(b) excludes the discussion section, because the conclusion contains this information.
(c) recommends incorporating the results directly into clinical practice.
(d) uses the methodology section to support the validity of the study. -
\(d) uses the methodology section to support the validity of the study.
A patient's adult child telephones the adult-gerontology primary care nurse practitioner
to inquire about the patient's illness. The patient's child reports that the parent relies
upon the child to explain everything to him or her. The nurse practitioner:
(a) asks the child to provide a copy of the patient's advance directive document.
,(b) assures the child that the nurse practitioner can disclose requested information.
(c) informs the child that he or she must come to the clinic to discuss the parent's case.
(d) tells the child that the nurse practitioner can discuss the information only with the
patient. -
\(d) tells the child that the nurse practitioner can discuss the information only with the
patient.
The adult-gerontology primary care nurse practitioner is appointed to a hospital's
multidisciplinary medical ethics review committee. The nurse practitioner's role is to:
(a) evaluate standards, risks, benefits, and outcomes.
(b) identify how to anticipate and resolve similar future situations.
(c) investigate the need for disciplinary action.
(d) obtain agreement of all parties with a chosen solution. -
\(a) evaluate standards, risks, benefits, and outcomes.
To improve the quality of clinical practice, the adult-gerontology primary care nurse
practitioner:
(a) charges a fee for patients who arrive late to clinic appointments.
(b) disseminates research study results to colleagues.
(c) expresses opinions about alternative therapies with patients who consider such
treatments.
(d) schedules time during clinic hours to meet with pharmaceutical representatives. -
\(b) disseminates research study results to colleagues.
One effect of using electronic health record applications, such as telemedicine and
portable monitoring systems, has been to:
(a) create stand-alone clinics.
(b) decrease billable visits.
(c) increase risks to patients.
(d) open access to care. -
\(d) open access to care.
The adult-gerontology primary care nurse practitioner evaluates an 80-year-old patient
with cognitive deficits, who is unaccompanied by the adult child who typically is present.
The patient has urinary symptoms, for which the nurse practitioner considers ordering
, sulfamethoxazole-trimethoprim (Bactrim). The patient's previous medical record is
unavailable. Before prescribing the medication, the nurse practitioner:
(a) contacts the patient's adult child.
(b) queries the other staff members.
(c) relies on the patient's self-report.
(d) waits until the patient's chart is available. -
\(a) contacts the patient's adult child.
The adult-gerontology primary care nurse practitioner conducts a small group class on
weight management. The nurse practitioner anticipates that the patient who may have
the greatest difficulty implementing the counseling is the:
(a) extroverted patient raising his or her grandchildren.
(b) introverted patient who does not speak in the group.
(c) personable patient who lives with his or her children.
(d) worried patient whose son is serving in military conflict. -
\(d) worried patient whose son is serving in military conflict.
The adult-gerontology primary care nurse practitioner evaluates a patient with cold
symptoms who reports smoking half a pack of cigarettes a day and shows no interest in
quitting. The nurse practitioner's most appropriate approach is to treat the cold
symptoms and:
(a) advise the patient to stop smoking.
(b) prescribe bupropion (Zyban).
(c) raise the issue of smoking cessation at the next visit.
(d) recommend that the patient select a low nicotine cigarette. -
\(a) advise the patient to stop smoking.
The adult-gerontology primary care nurse practitioner plans to provide smoking
cessation education at a community center to older adults and their families. The nurse
practitioner designs the program based on knowledge that older adult smokers:
(a) are likely to be optimistic about their ability to quit.
(b) are more likely to be successful at quitting than younger smokers.
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