Exam (elaborations)
ANCC TEST REVIEW TEST WITH A+ GRADES
ANCC TEST REVIEW TEST WITH A+ GRADES
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ANCC TEST REVIEW
TEST WITH A+ GRADES
Avpatientvwithvtype1vdiabetesvmellitusvwhovisvNPHvandvregularvinsulinvsplitvdosingvp
resentvwithvcomplainsvofvearlyvmorningvrisevfinger-
stickvbloodvglucose.vAvreviewvofvanvat-
homevglucosevtestvrevealsvincreasedvmorningvlevels.vAftervanvincreasevinvtheveveni
ngvinsulinvdose,vthevproblemvworsens.vThisvisvmostvlikelyvanvexamplevof:
a)vInsulinvResistance
b)vInsulinvAllergy
c)vThevSomogyivEffect
d)vHyperglycemia-inducedvhypoglycemia.v-vcorrectvanswer-a)vThevSomogyivEffect
Av25-years-
oldvpresentvwithvavchiefvcomplaintvofvdecreasedvmobilityvandvpainvofvthevrightvshoul
dervexacerbatedvbyvmovements.vThevpatientvreportsvthatvhevparticipatedvinvextensiv
evhousevpaintingv24vhoursvpriorvtovthevonsetvofvpain.vHevdeniesvanyvtrauma.vPassiv
evROMvisvintact.vNovrednessvorvecchymosisvisvpresent.vWhatvisvthevnextvstepvtovbev
takenvinvordervtovmakevavDiagnosis?
,a)vPalpatevthevstructurevaroundvthevshoulder
b)vObtainvanvMIRvtovevaluatevthevshoulder
c)vOrdervandvX-Rayvofvthevshoulder
d)vRequestvanvEMG
ApplyvSOAPEv-vcorrectvanswer-a)vPalpatevthevstructurevaroundvthevshoulder
ApplyvSOAPE
Av65vyears-
oldvmalevpresentsvtovhisvclinicvcomplainingvofvincreasingvfatigue,vdyspneavonvexertio
nv,andvanklevedemavduringvthevday.vHevhasvavhistoryvofvmildvhypertension,vforvwhic
hvhevsawvhisvphysicianvyearsvago.vThevphysicianvadvisedvthevpatientvtovdecreasevhi
svsaltvintakev.Onvphysicianvexaminationvthevpatientvisvtachycardiavpositivevforvjugula
rvvenousvdistension,vandvpositivevforvS3vwithvavsystolicvmurmurvchestvX-
rayvrevealsvcardiomegalyvwithvvascularvredistributionv.Thevnursevpractitionervdiagno
sisvisv:
a)vMyocardialvinfarction
b)vPneumonia
c)vCongestivevheartvfailure
d)vPleuralveffusionv-vcorrectvanswer-c)vCongestivevheartvfailure
Av67-
yearvoldvpatientvwithvtypev2vDM,vcongestivevheartvfailurev(CHF),vandvavmildvarteryvdi
seasevisvcurrentlyvtakingvdailyvhydrochlorothiazidev25vmgvdaily,vglipizidev10vmgvdail
y;vandvatorvastatinv(Lipitor),v20vmgvh.s.vWhichvofvthevfollowingvisvanvaccuratevstate
mentvregardingvthisvregimen?
a)vThevglipizidevwillvincreasevthevriskvofvpotassiumvdepletion....
b)vThevdigoxinvwillvincreasevthevriskvofvhypoglycemia.
c)vThevhydrochlorothiazidevwillvpredisposevthevpatientvtovdigoxinvtoxicity
d)vThevatorvastinvwillvworsenvthevdiabetesv-vcorrectvanswer-
c)vThevhydrochlorothiazidevwillvpredisposevthevpatientvtovdigoxinvtoxicity
Av14vyear-
oldvwhovfellvonvhervoutstretchedvhandvcomplainsvofvproximalvforearmvpainvX-
rayvrevealsvavpositivevfatvpadvsignv,andvthevfullyvextendvthevelbow.vNovdefinitivevbon
yvchangesvarevseenvonvX-ray.vThevmostvlikelyvworkingvdiagnosisvis:
a)vUppervextremelyvsprain.
b)vLateralvepiconditis.
c)vRadialvheadvfracture
d)vOlecranonvbursitisv-vcorrectvanswer-c)vRadialvheadvfracture
Av17vyear-
oldvfemalevisvsuspectedvtovhavevavPolycysticvOvaryvSyndrome.vInvadditionvtovtestost
eronevthevmostvappropriatevdiagnosticvtestvwillvbe:
a)vBUN,vcreatinine,velectrolytes,vandvdenydroeplandrosteronev(DHEA).
b)vCompletevbloodvcountv(BUN)v,creatininevandvestrone
,c)vFastingvbloodvsugar(FBS)v,CBC,vBUNvandvsexvhormonevbindingvglobuline
d)vFolliclevstimulatingvhormonev(FSH)vluteinizingvhormone,vprolactin,vandvthyroidvsti
mulatingvhormonev(TSH)v-vcorrectvanswer-
d)vFolliclevstimulatingvhormonev(FSH)vluteinizingvhormone,vprolactin,vandvthyroidvsti
mulatingvhormonev(TSH)
TovassessvspinalvfunctionvatvS1-level,vwhichvdeepvtendonvreflexvshouldvbevtested?
a)vAchilles
b)vCremasteric
c)vAnalvwink
d)vPatelarv-vcorrectvanswer-a)vAchilles
Av20vyear-
oldvmalevpresentvwithvavmonthvhistoryvofvav"bumpvonvmyvtesticle."vHevreportsvbeingv
sexuallyvactive,vwithvfrequentvintercoursevwithvmultiplevpartners,vwhichvconditionvsho
uldvbevsuspected?
a)vCancervofvtesticles
b)vTorsionvofvthevtesticles
c)vAcutevepididymitis
d)vGonorrheav-vcorrectvanswer-a)vCancervofvtesticles
Anv88vyear-
oldvmalevpresentsvwithvconcernsvaboutvmemoryvlossv.Hevfeelsvgood,vtakesvaspirinvd
ailyv,andvhasvnovchronicvdiseasesv,hevdrivesvhisvownvcarv,andvmanagesvhisvfinancial
vaffairsv.Tovevaluatevhisvmemoryv,whichvofvthevfallowingvtestsvwouldvyouvchoose?
a)vFolsteinvMini-vMental-StatevExamination.
b)vGeriatricvDepressionvScale
c)vMinnesotavMultiphasicvpersonalityvinventory
d)vMyersv-BriggsvTestv-vcorrectvanswer-a)vFolsteinvMini-vMental-StatevExamination
NonviralvMicroorganismsvmostvfrequentlyvfoundvtovcausevacutevsinusitisvare:
a)vStreptococcusvpneumonievandvHaemophilusvinfluenzae
b)vStreptococcusvpneumonievandvstaphylococcusvaureus
c)vStaphylococcusvaureusvandvPseudomonasvaeruginosa
d)vStreptococcusvpneumonievandvPseudomonasvaeruginosav-vcorrectvanswer-
a)vStreptococcusvpneumonievandvHaemophilusvinfluenzae
Av65-
yearvoldvfemalevpresentsvwithvshouldervandvpelvicvgirdlevpainvforvthevpastv6vmonthsv
.Shevreportsvrecentvunintentionalvweighvloss.vOnvphysicalvexamination,vtherevisvpain
vonvROMvwithvnovweaknessvnoted.vLaboratoryvstudiesvshowvlowvhemoglobinvandvel
evatedvsedimentationvrate.Whichvofvthevfallowingvisvthevmostvlikelyvdiagnosis?
a)vPolymyosistis
b)vOsteoarthritis
c)vPolymyalgiavrheumatic
, d)vFibromyalgiav-vcorrectvanswer-c)vPolymyalgiavrheumatic
Av17vyear-
oldvfemalevhasvnevervhadvhervmenses.vShevisvatvtannervstagevIIIvofvsexualvdevelop
ment.vHervphysicalvandvhervweightvisvappropriatevforvhervagevandvheight.vWhatvisvth
evmostvlikelyvdiagnosis?
a)vSecondaryvamenorrhea
b)vPrimaryvamenorrhea
c)vDysmenorrhea
d)vOvarianvdigenesisv-vcorrectvanswer-b)vPrimaryvamenorrhea
Avnursevpractitionervisvsuturingvavsimplevlacerationvonvav11-
yearvoldvpatient.vThevusevofvlidocainevwithvepinephrinevisvnotvusedvinvthevfollowingva
reasvexceptvthe:
a)vScalp
b)vNose
c)vFingers
d)vEarlobev-vcorrectvanswer-a)vScalp
Whichvofvthevfollowingvisvnotvanvindicationvofvpreeclampsia?
a)vVisualvdisturbance
b)vGlycosuria
c)vEdemavofvfacevandvhands
d)vHeadachesv-vcorrectvanswer-b)vGlycosuria
Av10-vmonth-
oldvpresentsvwithvavrash,vrunnyvnose,vandvcough.vExaminationvrevealsvavclustervofvti
nyvofvwhitevpapulesvwithvanverythematousvavbuccalvmucosa.vWhatvdoesvthisvsugges
t?
a)vScarletvFever
b)vRubella
c)vErythemavinfectious
d)vMeaslesv-vcorrectvanswer-d)vMeasles
(DescriptionvofvthevKoplik'svSpot")Smallvwhitevroundvspotsvonvthevbasevofvthevbucca
lvmucosavbyvthevrearvmolars)
Whichvofvthevfollowingvwet-
mountvresultsvconfirmsvavpreliminaryvdiagnosisvofvbacterialvvaginosis?
a)vSquamousvepithelialvcellsvwithvstipplingvappearancevandvindistinctvborders,vnovla
ctobacillusvrods,vmanyvwhitevbloodvcells
b)vSquamousvepithelialvcellsvwithvclearvcytoplasmvandvdistinctvborders,vmanyvlactob
acillusvrods,voccasionalvwhitevbloodvcells
c)vOrganismvaboutvthevsizevofvwhitevbloodvcellsvwithvundulatingvflagellum,voccasion
alvlactobacillusvrods,vmanyvwhitevbloodvcells