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NR 601 Final Exam

1. Which of the following statements is NOT true about palliative care teams?

 A: Provide weekly home visits

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2. A 55-year-old women has type 2 DM she had three UTIs in the last 9 months and she is concerned

about her kidneys. She has no report of dysuria, frequency or urgency at this time. Which of the

following is the best action to follow?

 A: Recheck UA dipstick today

3. According to the sexuality presentation, atrophic vaginitis (AV)

 A: Is a contributing factor for frequent UTIs

4. Ms. L 55-year-old women with BMI of 28, has 20-year hx of primary HTN and has been on

hydrochlorothiazide 25 mg daily for years with excellent response. During follow up visit Mrs L reports

that for the last 6 months she has felt thirsty all of the time even though she drinks at least 10 glasses

of water a day. Upon chart review the N notes that the last two fasting blood glucose levels have been

136 mg/dl and 165 mg/dl. The NP checks a random blood glucose, which is 210 mg/dl. What is the

next appropriate test?

 A: Prescribe Metformin 500 mg PO BID

5. A patient has been prescribed Metformin (Glucophage). One week later he returns with lowered

blood sugars but complaints of some loose stools during the week. How should the NP respond?

 A: Reassure the patient that this is an anticipated side effect

6. A 60-year-old obese male client has type 2 DM and a lipid panel of TC= 250, HDL = 32, LDL= 165. The

NP teaches the patient about his modifiable cardiac risk factors which include:

 A: Diabetes, obesity, and hyperlipidemia

7. Lifestyle approaches to postmenopausal symptom management include

 A: avoiding sugar, coffee, chocolate and alcohol

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8. When treating depression associated with dementia, which of the following would be a poor choice

and should not be prescribed?

 A: Amitriptyline

9. How does women’s anatomy make them more susceptible to UTIs?

 A: the urethra is shorter

10. A 48-year-old male patient screened for diabetes has a fasting plasma glucose level of 120 mg/dl. The

NP plan includes

 A: Educate the patient of lifestyle changes to lower blood glucose

11. Which of the following assessments are commonly noted in a client with Parkinson’s disease?

 A: Micrographia and bradykinesia

12. A 76-year-old man is seen in the office for c/o urinary incontinence. The clinician should explore which

of these causes of incontinence in men?

 A: Urinary Tract Infection (UTI)

13. Which of the following maneuvers is contraindicated in acute prostatis?

 A: Massaging the infected prostate

14. Mrs. N a 65-year-old women with BMI of 29 on Medicare , has a 20-year hx of primary HTN and has

been on HCTZ 25 mg daily for years , reports that for the past 6 months she has felt thirsty all of the

time even though she drinks at least 10 glasses of water a day. Upon charting NP notes that the last

two fasting blood glucose levels have been 136 mg/dl and 165 mg/dl. What actions should the NP

perform next?

 A: order a fasting blood glucose??? PRESCRIBE METFORMIN XR 500MG PO

15. According to the WHO analgesic ladder, which drug combination would be most appropriate in an

opiate-naïve patient who presents with moderate pain?

 A: Indomethacin/ hydrocodone

16. The cornerstone of pharmacotherapy in treating Alzheimer’s disease is :

 A: Cholinesterase inhibitors

17. The highest level of evidence to support interventions at the end of life is with:

 A: opioids for dyspnea

18. The comorbid psychiatric problem with the highest frequency in dementia is:

 A: Anxiety

19. All of the following are true statements regarding elder abuse EXCEPT:

 A : common signs of abuse include decreased anxiety and depression

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20. Which of the following is a role of the advanced nurse in ?????

 A: All of the above

21. The proposed mechanism by which diphenhydramine causes delirium is:

 A: Anticholinergic effect

22. A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea)

is :

 A : Morphine

23. According to the Palliative Care presentation, hospice care may be provided to:

 A: those with a life expectancy < 6 months

24. A 68-year-old women is being worked up for stress incontinence. UA reveals positive leukocyte

esterase, positive nitrites, 15 WBCs, no RBS, no protein, no casts. She denies frequency, urgency,

suprapubic pressure or urgency. What is the first treatment for her US results?

 A: no treatment is necessary

25. The elderly are at higher risk for delirium because of:

 A: All of the above

26. A 63-year-old man is seen in the clinic with a c/o nocturia. Which of the following should be included

in the differential diagnosis?

 A: Benign prostatic hypertrophy (BPH)

27. A 75-year-old man is being treated as an outpatient for metastatic prostate cancer. Which of the

following statements is true regarding the management of pain with opioids in the elderly?

 A: none of the above

28. The highest level of evidence with the use of adjuvant analgesics is with:

 A: neuropathic pain patients are candidates for adjuvant analgesia

29. The 56-year-old man with chronic prostatis should initially be treated with antibiotics for how long?

 A: 14 days

30. A 50-year-old female patient screened for diabetes has a fasting plasma glucose level of 124 mg/dl.

The NP plan includes:

 A: repeat fasting plasma glucose in one year

31. When assessing a patient who complains of a tremor, the NP must differentiate essential tremor from

the tremor of Parkinson’s disease. Which of the following findings are consistent with essential

tremor?

 A: The tremor occurs with purposeful movement

32. Which characteristic of delirium helps to distinguish it from dementia?

 A: abrupt or Acute onset

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