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CMN 577 Unit 5 Student Question Bank.
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CMN 577 Unit 5 Student Question BankA 55 year-old male presents to the office with his wife for evaluation of the
patient's left arm tremors. The symptoms are increased when he gets upset. The
wife has noticed that the patient's movements are slowed, "It seems as if he's
shuffling his feet when he walks". The Nurse Practitioner knows these are signs
of:
a. Huntington Disease
b. Parkinson's Disease
c. Dementia
d. Bell's Palsy - CORRECT ANSWER-* b. Parkinson's Disease
Rationale: According to Papadakis and McPhee (2015), In Parkinson's Disease,
tremor is commonly confined to one limb and is exacerbated by emotional stress.
The disease is also manifested by slowed voluntary movements and gait is
characterized by shuffling steps. Page 988
A twenty-five year old college student presents to the outpatient clinic today with
complaints of a "bug in my ear." The FNP is able to visualize the insect with an
otoscope. The next best action is to:
a. Use a cotton tipped applicator to remove the insect.
b. Use an aqueous solution to irrigate the ear
c. Fill the ear with lidocaine prior to removing.
d. Apply heat to the ear to make the bug crawl out. - CORRECT ANSWER-*c. Fill
the ear with lidocaine prior to removing.
Rationale: Lidocaine helps to immobilize insect for easier removal.
A 46 year old male presents to the office with complaints of the room "spinning",
noting that these symptoms last several seconds after he rolls over to get out of
bed in the mornings. He denies symptoms of the 'spinning' otherwise. Which of
the following would be the best initial treatment?
a. Prescribe steroid dose pack
b. Valsalva maneuver
,c. Hall Pike
d. Epley Maneuver - CORRECT ANSWER-*d. Epley Maneuver
Rationale: Benign Paroxysmal Positioning Vertigo (BPPV) is recognized by
positional changes, most often described as spinning or dizziness that occurs
with head position changes such as rolling over in bed. This is caused by loose,
freely moving otoconia located in the semicircular canal. Treatment includes the
Epley maneuver which can cause the otoliths to settle back into place.
Source: (Lustig & Schindler, 2015) (page 211 in McPhee 2015)
A mom brings her 6 year old who is complaining with headache and sore throat
for 2 days. Temperature on arrival is 102.1 F orally. Examination reveals tonsillar
erythema and edema and soft palate petechiae. What is your first best action?
a. Start Amoxicillin immediately
b. Perform rapid strep throat culture
c. Have patient gargle with warm salty water
d. Refer to ENT specialist - CORRECT ANSWER-*b. Perform rapid strep throat
culture
Rationale: None listed
Which of the following statements is true regarding the treatment of patients with
HIV-associated nephropathy?
a. A patient with ESRD, who is otherwise in good health, is a potential candidate
for renal transplant.
b. Calcium channel blockers are the best choice to control blood pressure
c. HAART has not been shown to slow progression in these patients
d. Serum blood values can be used for diagnosis - CORRECT ANSWER-* a. A
patient with ESRD, who is otherwise in good health, is a potential candidate for
renal transplant.
Rationale: In McPhee & Papadakis (2015), Watnick and Dirkx note several key
points for the treatment of patients with HIV-associated nephropathy. Kidney
biopsy is needed to locate a focal segment of glomerulosclerosis pattern of injury
with glomerular collapse. Studies have shown that HAART slows progression of
disease. ACE inhibitors and ARBs can be used to control blood pressure
,and slow disease progression. Patients who progress to ESRD and are
otherwise healthy are good candidates for renal transplantation (Watnick & Dirkx,
2015).
A 65-year-old man has a 10-month history of dysphagia, noted primarily with
solid foods. The dysphagia has progressed and he has noted a 20 lb. weight loss
over that same period of time. His wife states he now eats very slowly and throws
his shoulders back when he swallows. Barium esophagography shows a "bird's
beak" tapering of the distal esophagus. The most likely diagnosis is:
a. Esophageal Cancer
b. Achalasia
c. Esophageal Stricture
d. Zencker's Diverticulum - CORRECT ANSWER-* b. Achalasia
Rationale: Rationale: Achalasia is an idiopathic motility disorder in which
peristalsis is absent or diminished in the distal 2/3 of the esophagus. Incidence of
the disorder steadily increases with age. Most patients complain of dysphagia for
solid foods, which gradually includes liquids also. Symptoms are often present for
months to years before the patient seeks treatment. Patients with achalasia
typically eat more slowly and use certain maneuvers, such as lifting the neck or
throwing the shoulders back to increase esophageal emptying. Weight loss is
common. (McPhee & Papadakis, 2015, pp. 601-602).
An 11-year-old female develops gross hematuria approximately 10 days after a
sore throat. Her blood pressure is 160/100 and she has 2+ pedal and pre-tibial
edema. Which of the following is the most likely diagnosis?
a. Post-streptococcal Glomerulonephritis
b. Hemolytic Uremic Syndrome
c. Minimal Change Disease
d. Urinary Tract Infection - CORRECT ANSWER-*a. Post-streptococcal
Glomerulonephritis
Rationale: Rationale: The post-streptococcal GN diagnosis is supported by a
recent history (usually 7-14 days prior) of a group A beta-hemolytic streptococcal
infection of the skin or throat. This infection causes acute kidney injury. The
, typical clinical presentation includes gross hematuria, which may appear as
coffee or tea-colored urine, edema, and hypertension. (Hay, Levin, Deterding, &
Abzug, 2014, pp. 757-758).
Mammogram screenings used to detect a disease process or identify a lesion is
what method of prevention?
a. Primary Prevention
b. Secondary Prevention
c. Tertiary Prevention
d. Quinary Prevention - CORRECT ANSWER-*b. Secondary Prevention
Rationale: According to Pigone and Salazar (2015), the primary goal of screening
is to promote early detection of a disease, disease precursor, or disease process.
A screening tool utilized to detect breast cancer is a mammogram thus would be
recognized as a method of secondary prevention (p.2). It is secondary and not
primary because it is a tool used for screening, primary prevention aims to
remove or reduce risk factors.
A mother brings her infant into your clinic and states she needs her second
Rotavirus vaccine. What is the maximum age limit for administration for the first
vaccination?
a. 17 weeks 6 days
b. 14 weeks 6 days
c. 6 weeks 2 days
d. Can be administered anytime - CORRECT ANSWER-* b. 14 weeks 6 days
Rationale: According to Daley, O'Leary, and Nyquist (2014), the lack of safety
data around administering the initial dose of the rotavirus is the reason for the
maximum age for administration is 14w 6d.
A 22-year-old female presents to the office with a diffuse, oval, fawn-colored,
scaly, mildly pruritic rash present on her abdomen. Upon examination, the center
of the
lesions have a crinkled, "cigarette paper" appearance. This skin disorder is most
likely:
a. Plaque psoriasis
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