Please follow the instructions below

Zero Plagiarism

5 references not more than 5 years 

Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.

Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.

To Prepare:

• Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
• Select an existing healthcare program or policy evaluation or choose one of interest to you.
• Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

The Assignment: (2–3 pages)

Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

• Describe the healthcare program or policy outcomes.
• How was the success of the program or policy measured?
• How many people were reached by the program or policy selected?
• How much of an impact was realized with the program or policy selected?
• At what point in program implementation was the program or policy evaluation conducted?
• What data was used to conduct the program or policy evaluation?
• What specific information on unintended consequences was identified?
• What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
• Did the program or policy meet the original intent and objectives? Why or why not?
• Would you recommend implementing this program or policy in your place of work? Why or why not?
• Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

Assignments

1. Answer to Discussion question two.
2. DQ replies to 3 DQs.

Instructions for  Answer to Question

1. After Each DQ (question), write down references
2. 300 minimum words for every DQ, you can go up to 700 words but answer should be complete.
3. 2-3 references for each question
4. References should be within 5 years
5. I am in acute care nurse practitioner program.
6. The response to the DQ is expected to be a minimum of 300 words. A minimum of two resources are expected. These need to be appropriate for a clinical professional to guide decisions about patient care. If a textbook is used for one of these responses, the other needs to be journal or professional-level website. The references need to be correctly formatted, as do the citations for those references.  “ Question words” don’t count towards 300 minimum count”

Instructions for  DQ Replies to 3 DQS

DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION.

1. Each reply should be at least 200 words.
2. Minimum One scholarly reference ( NO MAYO CLINIC/ AHA)
3. APA 6th edition style needs to be followed.
4. Each response should have reference at the end of each reply
5. Reference should be within last 5 years

 

• Type of paperResearch Paper
• SubjectNursing
• Number of pages6
• Format of citationAPA
• Number of cited resources4
• Type of serviceWriting

Overview Schedule an interview with a (1) family based on personal/professional acquaintance, to complete a comprehensive, written assessment/analysis using the criteria listed below (based on class notes and readings). DO NOT use your family of orientation (family of origin) or your nuclear (conjugal) family. (For definitions, see the Glossary of Terms in Friedman et al, Family Nursing textbook. Note: Please follow the attached rubric for this assignment. Thank you.

  

One example of a measurement tool is the Healthcare Effectiveness Data and Information Set (HEDIS) comprehensive care measures. Review the components of HEDIS comprehensive diabetes care; then consider the following scenario.

You are a staff nurse working in a private primary care practice. It is a small practice with 2 MDs (internists), 2 nurses, 1 medical assistant, and an office staff for billing. There are approximately 1,000 patients in the practice. You have had no EHR until the last year, but all charts are manual, historically. Your physicians are starting to inquire about quality incentives, particularly regarding patients with diabetes. 

Take on the role of the staff nurse in the scenario, and post an explanation of how you would go about finding out how many diabetics are in your practice and how many meet all components of HEDIS comprehensive diabetes care.

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist).

Notes Initial Post: This should be a 5-paragraph (at least 550 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).

Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Chicago, IL: Health Administration Press.

• Chapter 3, “Measuring      Performance” (pp. 35-78)
• Chapter 4, “Evaluating Performance” (pp.      79-118)

Yoder-Wise, P. S. (2019). Leading and managing in nursing (7th ed.). St. Louis, MO: Mosby.

• Chapter 23, “Managing      Quality and Risk” (pp. 406-427)
• Chapter 24, “Translating Research Into      Practice” (pp. 427-449)

Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality and Safety, 20(1), 46–51. 

  

NURS 6531 FINAL EXAM (2 VERSIONS) / NURS6531 FINAL EXAM (100 CORRECT Q & A IN EACH VERSION, TOTAL: 200 Q & A)

  

NURS 6531 Final Exam / NURS6531 Final Exam (Latest): Walden University

Walden NURS 6531 Final Exam / Walden NURS6531 Final Exam (Latest)

· Question 1

       

When   completing this quiz, did you comply with Walden University’s Code of Conduct   including the expectations for academic integrity?

            

· Question 2

       

A   patient complains of generalized joint pain and stiffness associated with   activity and relieved with rest. This patient history is consistent with   which of the following disorders?

            

· Question 3

       

What   diabetic complications result from hyperglycemia?

1.  

1.  

1.  Retinopathy

2.  Hypertension resistant to treatment

3. Peripheral neuropathy

4.  Accelerated atherogenesis

            

· Question 4

       

Which   factors are associated with high risk for foot complications in a patient   with diabetes mellitus?

1. Obesity

2. Abnormal nails

3. Abnormal gait

4. Poorly controlled lipids

            

· Question 5

       

Which of the following is not a   common early sign of benign prostatic hyperplasia (BPH)?

A. Nocturia
B. Urgency incontinence
C. Strong urinary stream flow
D. Straining to void

            

· Question 6

       

A 63-year-old man presents to the   office with hematuria, hesitancy, and dribbling. Digital rectal exam (DRE)   reveals a moderately enlarged prostate that is smooth. The PSA is 1.2. What   is the most appropriate management strategy for you to follow at this time?

A.   Prescribe an alpha adrenergic blocker.
  B. Recommend saw palmetto.
  C. Prescribe an antibiotic
  D. Refer the client to urology.

            

· Question 7

       

A 30 year old female patient   presents to the clinic with heat intolerance, tremors, nervousness, and   weight loss inconsistent with increased appetite. Which test would be most   likely to confirm the suspected diagnosis?

            

· Question 8

       

Which   history is commonly found in a patient with glomerulonephritis?

Ask about recent infections (skin or upper   respiratory); 

recent travel (possible exposure to viruses,   bacteria, fungi, or parasites); 

recent illnesses, surgery, or invasive procedures (possible   infection); 

any systemic diseases (Systemic Lupus   Erythematosus -SLE)

            

· Question 9

       

A   60 year old male patient with multiple health problems presents with a   complaint of erectile dysfunction (ED). Of the following, which medication is   most likely to be causing the problem?

            

· Question 10

       

Which   of the following is not a characteristic of type 2 diabetes mellitus?

            

· Question 11

       

A   patient has been diagnosed with hypothyroidism and thyroid hormone   replacement therapy is prescribed. How long should the nurse practitioner   wait before checking the patient’s TSH?

            

· Question 12

       

A   patient has been diagnosed with generalized anxiety disorder (GAD). Which of   the following medications may be used to treat generalized anxiety disorder?

            

· Question 13

       

What   is the most common cause of Cushing’s syndrome? 

            

· Question 14

       

Which   of the following is the most cause of   low back pain?

            

· Question 15

       

Warfarin   (Coumadin) is prescribed for a frail, elderly male with new onset atrial   fibrillation. The goal INR for this patient should be:

            

· Question 16

       

A 72   year old patient exhibits sudden onset of fluctuating restlessness,   agitation, confusion, and impaired attention. This is accompanied by visual   hallucinations and sleep disturbance. What is the most likely cause of this   behavior? 

            

· Question 17

       

Which   of the following is the most common causative organism of nongonococcal   urethritis?

which of the following does not cause   nongonococcal urethritis
 

a chlamydia – most common
b. mycoplasma
c. neisseria
d. ureaplasma

            

· Question 18

       

Which   appropriate test for the initial assessment of Alzheimer’s disease provides   the performance ratings on 10 complex, higher order activities?

            

· Question 19

       

What   conditions must be met for you to bill “incident to” the physician, receiving   100% reimbursement from Medicare?

            

· Question 20

       

Diagnostic   evaluation for urinary calculi includes:

  

                   

A.

Urinalysis     and culture

 

 

B.

Non     contrast CT

 

 

C.

Serum     calcium

 

 

D.

All     of the above

            

· Question 21

       

Reed-Sternberg   B lymphocytes are associated with which of the following disorders:

            

· Question 22

       

Marsha   presents with symptoms resembling both fibromyalgia and chronic fatigue   syndrome, which have many similarities. Which of the following is more   characteristic of fibromyalgia?

A.   Musculosckeletal pain
  B. Difficulty sleeping
  C. Depression
  D. Fatigue

            

· Question 23

       

Beth,   age 49, comes in with low back pain. An x-ray of the lumbosacral spine is   within normal limits. Which of the following diagnoses do you explore   further?

            

· Question 24

       

Steve,   age 69, has gastroesophageal reflux disease (GERD). When teaching him how to   reduce his lower esophageal sphincter pressure, which substances do you   recommend that he avoid?

            

· Question 25

       

The   cornerstone of treatment for stress fracture of the femur or metatarsal stress   fracture is:

Rest the affected part of the body
– Once pain free, the person can gradually begin the   sporting activity again
– Air splinting can reduce pain and decrease the time   until return to full participation or intensity of exercise.
– NSAIDs to reduce pain and inflammation

            

· Question 26

       

Which   of the following is not a risk factor associated with the development of   syndrome X and type 2 diabetes mellitus?

            

· Question 27

       

A   thymectomy is usually recommended in the early treatment of which disease?

            

· Question 28

       

The   most common cause of elevated liver function tests is:

            

· Question 29

       

A 14   year old female cheerleader reports gradual and progressive dull anterior   knee pain, exacerbated by kneeling. The nurse practitioner notes swelling and   point tenderness at the tibial tuberosity. X-ray is negative. What is the   most likely diagnosis?

            

· Question 30

       

Which   of the following is a contraindication for metformin therapy?

Creatinine > 1.5

· Renal dysfunction.

· Congestive   cardiac failure needing   drug treatment.

· Hypersensitivity to metformin.

· Acute   or chronic metabolic acidosis.

· Impaired hepatic function.

            

· Question 31

       

The   best test to determine microalbuminuria to assist in the diagnosis of   diabetic neuropathy:

            

· Question 32

       

Which   is the most common cause of end-stage renal disease in the United States?

            

· Question 33

       

A   middle-aged female presents complaining of recent weight loss. The physical   exam reveals an enlarged painless cervical lymph node. The differential   diagnosis for this patient’s problem includes:

            

· Question 34

       

Risk factors for prostate cancer include all of the   following except:

            

· Question 35

       

Phalen’s   test, 90°wrist flexion for 60 seconds, reproduces symptoms of:

            

· Question 36

       

The most effective   intervention(s) to prevent stroke is (are):

            

· Question 37

       

A   diabetic patient is taking low-dose enalapril for hypertension. A record of   the patient’s blood pressure over 4 weeks ranges from 130 to 142 mmHg   systolic and 75 to 85 mmHg diastolic. How should the nurse practitioner   respond?

            

· Question 38

       

Microalbuminuria is a measure of:

            

· Question 39

       

Martin,   age 24, presents with an erythematous ear canal, pain, and a recent history   of swimming. What do you suspect?

            

· Question 40

       

A   32 year old male patient complains of urinary frequency   and burning on urination for 3 days. Urinalysis reveals bacteriuria. He   denies any past history of urinary tract infection. The initial treatment   should be:

            

· Question 41

       

A   21-year-old female presents to the office complaining of urinary frequency   and urinary burning. The nurse practitioner suspects a urinary tract   infection when the urinalysis reveals

            

· Question 42

       

Which   of the following medications increase the risk for metabolic syndrome? 

            

· Question 43

       

The   most accurate measure of diabetes control is:

            

· Question 44

       

The 4 classic features of Parkinson’s disease are:

            

· Question 45

       

A child   with type 1 diabetes mellitus has experienced excessive hunger, weight gain   and increasing hyperglycemia. The Somogyi   effect is suspected. What steps should be taken to diagnose and treat this   condition?

            

· Question 46

       

A   patient presents with dehydration, hypotension, and fever. Laboratory testing   reveals hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are   corrected, but the patient returns 6 weeks later with the same symptoms of   hyperpigmentation, weakness, anorexia, fatigue, and weight loss. What   action(s) should the nurse practitioner take?

            

· Question 47

       

Other than smoking cessation, which of the following   slows the progression of COPD in smokers?

            

· Question 48

       

A 75-year-old   female is diagnosed with primary hyperparathyroidism and asks the nurse   practitioner what the treatment for this disorder is. The nurse practitioner   explains:

            

· Question 49

       

The   hallmark of neurofibromatosis (von Recklinghausen’s disease) present in   almost 100% of patients is:

                        

· Question 50

       

A   patient has HIV infection and is having a problem with massive diarrhea. You   suspect the cause is:. 

            

· Question 51

       

How do   you respond when Jessica, age 42, asks you what constitutes a good minimum   cardiovascular workout?

            

· Question 52

       

The   treatment of choice for chronic bacterial prostatitis (CBP) is:

            

· Question 53

       

Sally, a computer programmer, has just been given a new   diagnosis of carpal tunnel syndrome. Your next step is to:

            

· Question 54

       

Urine cultures should be obtained for which of the   following patients?

            

· Question 55

       

Which   of the following is the best response to a woman who has just admitted she is   a victim of spousal abuse?

            

· Question 56

       

The   diagnosis which must be considered in a patient who presents with a severe   headache of sudden onset, with neck stiffness and fever, is:

            

· Question 57

       

An 81-year-old   female is diagnosed with type 2 diabetes. When considering drug therapy for   this patient, the nurse practitioner is most concerned with which of the   following side effects?

            

· Question 58

       

Which patient would benefit most from screening for   type 2 diabetes?

            

· Question 59

       

The intervention known to be most effective in the   treatment of severe depression, with or without psychosis, is:

            

· Question 60

       

Jennifer   says that she has heard that caffeine can cause osteoporosis and asks you   why. How do you respond?

            

· Question 61

       

Which   of the following patients most warrants screening for hypothyroidism?

            

· Question 62

       

Successful   management of a patient with attention deficit hyperactivity disorder (ADHD)   may be achieved with:

            

· Question 63

       

Diabetes   screening recommendations for asymptomatic adults age 45 and over include   which of the following:

  

A.

HbA1C

 

B.

2-hour 75 gram oral glucose tolerance test

 

C.

C-peptide level

 

D.

A and B

 

E.

All of the above

            

· Question 64

       

Prolonged PT suggests:

            

· Question 65

       

Diagnostic confirmation of acute leukemia is based on:

            

· Question 66

       

Which   of the following is not appropriate suppression therapy for chronic bacterial   prostatitis?

            

· Question 67

       

The most effective treatment of non-infectious bursitis   includes:

            

· Question 68

       

Differential   diagnosis of proteinuria includes which of the following?

  

 

A.

Orthostatic     proteinuria

 

 

B.

Nephrotic     syndrome

 

 

C.

Infection

 

 

D.

Trauma

 

 

E.

A     and B

            

· Question 69

       

You are   assessing a patient after a sports injury to his right knee. You elicit a positive   anterior/posterior drawer sign. This test indicates an injury to the:

            

· Question 70

       

A   positive drawer sign supports a diagnosis of:

            

· Question 71

   

  

A   patient presenting for an annual physical exam has a BMI of 25 kg/m2 This   patient would be classified as:

            

· Question 72

       

A   patient has been taking fluoxetine (Prozac) since being diagnosed with major   depression, first episode, 2 months ago. She reports considerable improvement   in her symptoms and her intention to discontinue the medication. What should   be the nurse practitioner’s recommendation?

            

· Question 73

       

Diagnostic   radiological studies are indicated for low back pain: 

            

· Question 74

       

A 32   year old female patient presents with fever, chills, right flank pain, right   costovertebral angle tenderness, and hematuria. Her urinalysis is positive   for leukocytes and red blood cells. The nurse practitioner diagnoses   pyelonephritis. The most appropriate management is:

            

· Question 75

       

Which   of the following symptoms suggests a more serious cause of back pain? 

            

· Question 76

       

What is the first step in the treatment of uric acid   kidney stones?

            

· Question 77

       

A 20 year old male patient complains of “scrotal   swelling.” He states his scrotum feels heavy, but denies pain. On   examination, the nurse practitioner notes transillumination of the scrotum.   What is the most likely diagnosis?

            

· Question 78

       

What is the first symptom seen in the majority of   patients with Parkinson’s disease?

            

· Question 79

       

A 60   year old female patient complains of sudden onset unilateral, stabbing,   surface pain in the lower part of her face lasting a few minutes, subsiding,   and then returning. The pain is triggered by touch or temperature extremes.   Physical examination is normal. Which of the following is the most likely   diagnosis?

            

· Question 80

       

Which of the following set of symptoms should raise   suspicion of a brain tumor?    

            

· Question 81

       

The most reliable indicator(s) of neurological deficit   when assessing a patient with acute low back pain is(are):

            

· Question 82

       

A   25 year old overweight patient presents with a complaint of dull achiness in   his groin and history of a palpable lump in his scrotum that “comes and   goes”. On physical examination, the nurse practitioner does not detect a   scrotal mass. There is no tenderness, edema, or erythema of the scrotum, the   scrotum does not transilluminate. What is the most likely diagnosis?

            

· Question 83

       

Which   of the following characteristics are associated with prepatellar bursitis?

            

· Question 84

       

Which   drug category contains the drugs that are the first line Gold standard   therapy for COPD?

            

· Question 85

       

Which of the following physical modalities recommended   for treatment of rheumatoid arthritis provides the most effective long term pain   relief?

            

· Question 86

       

Which   of the following accounts for half of the bladder tumors among men and   one-third in women? 

            

· Question 87

       

A 35 year old male presents with a complaint of   low pelvic pain, dysuria, hesitancy, urgency, and reduced force of stream.   The nurse practitioner suspects acute bacterial prostatitis. Which of the   following specimens would be least helpful for diagnosis?

            

· Question 88

       

In which of the following presentations is further   diagnostic testing not warranted?

            

· Question 89

       

Martin   is complaining of erectile dysfunction. He also has a condition that has   reduced arterial blood flow to his penis. The most common cause of this   condition is:

            

· Question 90

       

Which of the following is the   most common complication of the myelodysplastic syndromes?

            

· Question 91

       

. You   know that this is indicative of:

A. Infection
B. Malignancy
C. Inflammation
D. Drug
E. Endocrine

B. A. Infection
– Viral: infectious mononucleosis (CMV, EBP),   HIV
– Bacterial: skin infection, TB
– Fungal: cryptococcal
 

B. Malignancy
– Hematological: lymphoma, leukemia
– Solid tumour LN met
 

C. Inflammatory
– Castleman ds
– Kimura ds
– Kikuchi ds
– SLE, RA
– Amyloidosis, sarcoidosis
 

D. Drug
– Phenytoin (anti-seizure)
– Hydralazine (HF)
 

E. Endocrine [rare]
– Addison’s disease
– Hypothyroidism

            

· Question 92

       

A 15   year-old female patient is 5 feet tall and weighs 85 pounds. You suspect   anorexia and know that the best initial approach is to:

            

· Question 93

       

A   patient taking levothyroxine is being over-replaced. What condition is he at   risk for?

            

· Question 94

       

A nurse   practitioner diagnoses a 60 year old male with balanitis. Which disease is   commonly associated with balanitis?

            

· Question 95

       

The   diagnosis of human papilloma virus (HPV) infection in males is usually made   by: 

            

· Question 96

       

Martin,   a 58 year old male with diabetes, is at your office for his PRO follow up. On   examining his feet with monofilament, you discover that he has developed   decreased sensation in both feet. There are no open areas or signs of   infection on his feet. What health teaching should Martin receive today regarding   the care if his feet?

            

· Question 97

       

Which   of the following is a potential acquired cause of thrombophilia?

            

· Question 98

       

Deficiency   of which nutritional source usually presents with an insidious onset of   paresthesias of the hands and feet that are usually painful?

            

· Question 99

       

What information should patients with diabetes and   their families receive about hypoglycemia?

            

· Question 100

       

Josh,   age 22, is a stock boy and has an acute episode of low back pain. You order   and NSAID and tell him which of the following?

· Question 101

A 28-year-old female presents to the office requesting testing for diagnosis of hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her risk factors. The nurse practitioner explains that:

   

A.

The patient should start   anticoagulant therapy immediately.

  

B.

Hereditary thrombophilia does not   always require anticoagulation therapy.

  

C.

Women of childbearing age cannot   take anticoagulant therapy.

  

D.

Genetic and risk management   counseling are recommended.

  

E.

B and D

  

NURS 6531 Final Exam / NURS6531 Final Exam (Latest): Walden University

Walden NURS 6531 Final Exam / Walden NURS6531 Final Exam (Latest)

· Question 1

       

When   completing this quiz, did you comply with Walden University’s Code of Conduct   including the expectations for academic integrity?

· Question 2

       

Central obesity, “moon” face, and dorsocervical fat pad   are associated with:

  

A.

Metabolic     syndrome

 

B.

Unilateral     pheochromocytoma

 

C.

Cushing’s     syndrome

 

D.

None     of the above

            

· Question 3

       

An elderly man is started on lisinopril and   hydrochlorhiazide for hypertension. Three days later, he returns to the   office complaining of left great toe pain. On exam, the nurse practitioner   notes an edematous, erythematous tender left great toe. The likely   precipitant of this patient’s pain is:

  

A.

Trauma

 

B.

Tight     shoes

 

C.

Arthritis     flare

 

D.

Hydrochlorothiazide

            

· Question 4

       

The most effective treatment of non-infectious bursitis   includes:

            

· Question 5

       

What conditions must be met for you to bill “incident to”   the physician, receiving 100% reimbursement from Medicare?

      

Answers:

You must initiate the plan     of care for the patient

  

The physician must be     on-site and engaged in patient care

  

You must be employed as an     independent contractor

  

You must be the main health     care provider who sees the patient

            

· Question 6

       

Which of the following is not a risk factor associated   with the development of syndrome X and type 2 diabetes mellitus?

            

· Question 7

       

Which of the following is not a common early sign of   benign prostatic hyperplasia (BPH)?

A.   Nocturia
B. Urgency incontinence
C. Strong urinary stream flow
D. Straining to void

            

· Question 8

       

Steve, age 69, has gastroesophageal reflux disease (GERD).   When teaching him how to reduce his lower esophageal sphincter pressure,   which substances do you recommend that he avoid?

§ Food that is very hot or very cold 

§ Fatty or fried foods 

§ Peppermint or spearmint, including flavoring 

§ Coffee, tea, and soft drinks that contain caffeine 

§ Spicy, highly seasoned foods 

§ Fried foodDT caffeine, chocolate and anticholinergics

            

· Question 9

       

Which drug category contains the drugs that are the first   line Gold standard therapy for COPD?

            

· Question 10

       

The most commonly recommended pharmacological treatment   regimen for low back pain (LBP) is:

            

· Question 11

       

Which of the following is not appropriate suppression   therapy for chronic bacterial prostatitis?

            

· Question 12

       

A patient presents with dehydration, hypotension, and   fever. Laboratory testing reveals hyponatremia, hyperkalemia, and   hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks   later with the same symptoms of hyperpigmentation, weakness, anorexia,   fatigue, and weight loss. What action(s) should the nurse practitioner take?

.A Obtain a   thorough history and physical, and check serum cortisol and ACTH levels.
 

  B. Perform a diet history and check CBC and FBS.
 

  C. Provide nutritional guidance and have the patient return in one month.
 

  D. Consult home health for intravenous administration

                                                

· Question 13

The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is:  

· Question 14

How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout?

· Question 15

       

The intervention known to be most effective in the   treatment of severe depression, with or without psychosis, is:

· Question 16

       

You are assessing a patient after a sports injury to his   right knee. You elicit a positive anterior/posterior drawer sign. This test   indicates an injury to the: he
  A. lateral meniscus
  B. cruciate ligament
  C. medial meniscus
  D. collateral ligament.

            

· Question 17

   

  

A 32 year old female patient presents with fever, chills,   right flank pain, right costovertebral angle tenderness, and hematuria. Her   urinalysis is positive for leukocytes and red blood cells. The nurse   practitioner diagnoses pyelonephritis. The most appropriate management is:

                        

· Question 18

       

A 21-year-old female presents to the office   complaining of urinary frequency and urinary burning. The nurse practitioner   suspects a urinary tract infection when the urinalysis reveals

· Question 19

       

A middle-aged man presents to urgent care complaining of   pain of the medial condyle of the lower humerus. The man works as a carpenter   and describes a gradual onset of pain. On exam, the medial epicondyle is   tender and pain is increased with flexion and pronation. Range of motion is   full The most likely cause of this patient’s pain is: 

                        

· Question 20

       

The initial clinical sign of Dupuytren’s contracture is:

·  

· Question 21

       

The best test to determine microalbuminuria to assist in   the diagnosis of diabetic neuropathy

            

· Question 22

       

What is the first symptom seen in the majority of patients   with Parkinson’s disease?

            

· Question 23

       

The most commonly recommended method for prostate cancer   screening in a 55 year old male is:

            

· Question 24

       

Martin, age 24, presents with an erythematous ear canal,   pain, and a recent history of swimming. What do you suspect?

            

· Question 25

       

Which of   the following symptoms suggests a more serious cause of back pain?

                                    

· Question 26

       

Josh, age 22, is a stock boy and has an acute episode of   low back pain. You order and NSAID and tell him which of the following?

· Question 27

       

A 72 year old female patient reports a 6 month   history of gradually progressive swollen and painful distal interphalangeal   (DIP) joints of one hand. She has no systemic symptoms but the erythrocyte   sedimentation rate (ESR), antinuclear antibody (ANA), and rheumatoid factor   (RF) are all minimally elevated. What is the most likely diagnosis?

· Question 28

       

A patient taking levothyroxine is being   over-replaced. What condition is he at risk for?

            

· Question 29

       

Which of the following is the most common cause of low   back pain?

  

A.

Lumbar     disc disease

 

B.

Spinal     stenosis

 

C.

Traumatic     fracture

 

D.

Osteoporosis

            

· Question 30

       

Which is the most common cause of end-stage renal disease   in the United States?

            

· Question 31

       

A 77-year-old female presents to the office complaining a   sudden swelling on her right elbow. She denies fever, chills, trauma, or   pain. The physical exam reveals a non-tender area of swelling over the   extensor surface over the right elbow with evidence of trauma or irritation.   The nurse practitioner suspects:

  

A.

Arthritis

 

B.

Ulnar     neuritis

 

C.

Septic     arthritis

 

D.

Olecranon     bursitis

            

· Question 32

       

A 60 year old female patient complains of sudden onset   unilateral, stabbing, surface pain in the lower part of her face lasting a   few minutes, subsiding, and then returning. The pain is triggered by touch or   temperature extremes. Physical examination is normal. Which of the following   is the most likely diagnosis?

            

· Question 33

       

Beth, age 49, comes in with low back pain. An x-ray of the   lumbosacral spine is within normal limits. Which of the following diagnoses   do you explore further?

            

· Question 34

       

A patient exhibits extrapyramidal side effects of   antipsychotic medications. Which of the following symptoms would lead you to   look for another diagnosis?

            

· Question 35

       

Phalen’s test, 90°wrist flexion for 60 seconds, reproduces   symptoms of:

                        

· Question 36

       

Jennifer says that she has heard that caffeine can cause   osteoporosis and asks you why. How do you respond?

· Question 37

       

The most common cause of elevated liver function tests is:

            

· Question 38

       

Reed-Sternberg B lymphocytes are associated with which of   the following disorders:

  

A.

Aplastic anemia

 

B.

Hodgkin’s lymphoma

 

C.

Non Hodgkin’s lymphoma

 

D.

Myelodysplastic syndromes

            

· Question 39

       

Which of the following is a potential acquired cause of   thrombophilia?

  

A.

Homocysteinuria

 

B.

Protein C deficiency

 

C.

Factor V Leiden

 

D.

Antiphospholipid antibodies

                        

· Question 41

       

A 75-year-old female is diagnosed with primary   hyperparathyroidism and asks the nurse practitioner what the treatment for   this disorder is. The nurse practitioner explains:

  

Primary     hyperparathyroidism is treated with Vitamin D restriction

 

Primary     hyperparathyroidism is treated with parathyroidectomy

 

Primary     hyperparathyroidism is treated with daily magnesium

 

Primary     hyperparathyroidism is treated with parenteral parathyroid hormone (PTH)

                         

· Question 42

       

Diagnostic confirmation of acute leukemia is based on:

·  

· Question 43

       

A 25 year old overweight patient presents with a   complaint of dull achiness in his groin and history of a palpable lump in his   scrotum that “comes and goes”. On physical examination, the nurse   practitioner does not detect a scrotal mass. There is no tenderness, edema,   or erythema of the scrotum, the scrotum does not transilluminate. What is the   most likely diagnosis?

A. Testicular   torsion
 

  B. Epididymitis
 

  C. Inguinal hernia
 

  D. Varicocele

            

· Question 44

       

Dave, age 38, states that he thinks he has an ear   infection because he just flew back from a business trip and feels unusual   pressure in his ear. You diagnose barotrauma. What is your next action?

A. Prescribe nasal steroids and oral decongestants
  B. Prescribe antibiotic eardrops
  C. Prescribe systemic eardrops
  D. Refer David to an ear, nose, and throat specialist

                        

· Question 45

       

Which of the following antibiotics should not be   prescribed for a pregnant woman in the 3rd trimester?

· Question 46

       

The physiological explanation of syncope is:

            

· Question 47

   

  

A 20 year old male patient complains of “scrotal   swelling.” He states his scrotum feels heavy, but denies pain. On   examination, the nurse practitioner notes transillumination of the scrotum.   What is the most likely diagnosis?

            

· Question 48

       

A 32 year old male patient complains of urinary   frequency and burning on urination for 3 days. Urinalysis reveals   bacteriuria. He denies any past history of urinary tract infection. The   initial treatment should be: nclude nitrofurantoin monohydrate/macrocrystals,   trimethoprim-sulfamethoxazole (TMP-SMX), or fosfomycin. 

            

· Question 49

       

Diagnostic radiological studies are indicated for low back   pain:

                        

· Question 50

      

Who is at a higher risk for developing nephrolithiasis?

·  

· Question 51

      

An 81-year-old female is diagnosed with type 2 diabetes.   When considering drug therapy for this patient, the nurse practitioner is   most concerned with which of the following side effects?

  

A.

Weight     gain

 

B.

Fracture     risk

 

C.

Hypoglycemia

 

D.

Weight     loss

                        

· Question 52

       

A 28-year-old female presents to the office requesting   testing for diagnosis of hereditary thrombophilia. Her father recently had a   deep vein thrombosis and she is concerned about her risk factors. The nurse   practitioner explains that:

· Question 53

       

The diagnosis of human papilloma virus (HPV) infection in   males is usually made by:

            

· Question 54

       

Which history is commonly found in a patient with   glomerulonephritis?

            

· Question 55

       

A   patient complains of generalized joint pain and stiffness associated with   activity and relieved with rest. This patient history is consistent with   which of the following disorders?

            

· Question 56

       

The most common presentation of thyroid cancer is:

            

· Question 57

       

The obligatory criteria for diagnosis of muscular   dystrophy (MD) are:

            

· Question 58

       

The diagnosis which must be considered in a patient who   presents with a severe headache of sudden onset, with neck stiffness and   fever, is:

            

· Question 59

       

A 60 year old male patient with multiple health   problems presents with a complaint of erectile dysfunction (ED). Of the   following, which medication is most likely to be causing the problem?

            

· Question 60

       

A 72 year old patient exhibits sudden onset of fluctuating   restlessness, agitation, confusion, and impaired attention. This is   accompanied by visual hallucinations and sleep disturbance. What is the most   likely cause of this behavior?

A. Dementia
 

  C. Parkinson’s disease
 

  D. Depression

            

· Question 61

       

Which of the following set of symptoms should raise   suspicion of a brain tumor?  

            

· Question 62

       

The cornerstone of treatment for   stress fracture of the femur or metatarsal stress fracture is: 

            

· Question 63

       

Sally, a computer programmer, has just been given a new diagnosis   of carpal tunnel syndrome. Your next step is to:

            

· Question 64

       

Marsha presents with symptoms resembling both fibromyalgia   and chronic fatigue syndrome, which have many similarities. Which of the   following is more characteristic of fibromyalgia?

A.   Musculosckeletal pain
  B. Difficulty sleeping
  C. Depression
  D. Fatigue

            

· Question 65

       

The cardinal sign of infectious arthritis is:

             

            

· Question 66

       

Diagnostic evaluation for urinary calculi includes:

                                                

· Question 67

       

Martin, a 58 year old male with diabetes, is at your   office for his diabetes follow up. On examining his feet with monofilament,   you discover that he has developed decreased sensation in both feet. There are   no open areas or signs of infection on his feet. What health teaching should   Martin receive today regarding the care if his feet?

See a   podiatrist yearly; wash your feet daily with
  warm, soapy water and towel dry between the
  toes; inspect your feet daily for any lesions; and
  apply lotion to any dry areas.

· Question 68

       

Potential causes of septic   arthritis include which of the following?

· Question 69

       

Which of the following is the best response to a woman who   has just admitted she is a victim of spousal abuse?

· Question 70

       

A 15 year-old female patient is 5 feet tall and weighs 85   pounds. You suspect anorexia and know that the best initial approach is to:

Having   the client in view of staff for 90 minutes after each meal

            

· Question 71

       

A 63-year-old man presents to the office with hematuria,   hesitancy, and dribbling. Digital rectal exam (DRE) reveals a moderately   enlarged prostate that is smooth. The PSA is 1.2. What is the most   appropriate management strategy for you to follow at this time?

A. Prescribe   an alpha adrenergic blocker.
  B. Recommend saw palmetto.
  C. Prescribe an antibiotic
  D. Refer the client to urology.

                        

· Question 72

       

A patient has been diagnosed with generalized anxiety disorder   (GAD). Which of the following medications may be used to treat generalized   anxiety disorder?

· Question 73

       

A positive drawer sign supports a diagnosis of:

                        

· Question 74

       

Sam, age 67, is a diabetic with worsening renal function.   He has frequent hypoglycemic episodes, which he believes means that his   diabetes is getting “better.” How do you respond?

·  

· Question 75

       

A 14 year old female cheerleader reports gradual and   progressive dull anterior knee pain, exacerbated by kneeling. The nurse   practitioner notes swelling and point tenderness at the tibial tuberosity.   X-ray is negative. What is the most likely diagnosis?

                        

· Question 76

       

A 35 year old male presents with a complaint of low   pelvic pain, dysuria, hesitancy, urgency, and reduced force of stream. The   nurse practitioner suspects acute bacterial prostatitis. Which of the   following specimens would be least helpful for diagnosis?

· Question 77

       

Jack, age 55, comes to the office with a blood pressure of   144/98 mm Hg. He states that he did not know if it was ever elevated before.   When you retake his blood pressure at the end of the exam, it remains at   144/98. What should your next action be?

                        

· Question 78

       

A patient has just been diagnosed with Bell’s palsy. He is   understandably upset and has questions about the prognosis. You response   should be:

·  

· Question 79

       

Martin is complaining of erectile dysfunction. He also has   a condition that has reduced arterial blood flow to his penis. The most   common cause of this condition is:

            

· Question 80

       

Successful management of a patient with attention deficit hyperactivity   disorder (ADHD) may be achieved with:

            

· Question 81

       

What diabetic complications result from hyperglycemia?

1.  

1.  

1.  Retinopathy

2.  Hypertension   resistant to treatment

3. Peripheral   neuropathy

4.  Accelerated   atherogenesis

            

· Question 82

                        

· Question 83

       

The most common symptoms of transient ischemic attack   (TIA) include:

                        

· Question 84

       

What is the first step in the treatment of uric acid   kidney stones?

· Question 85

       

Establishment of a definitive diagnosis of osteomyelitis   requires:

            

· Question 86

       

Which of the following is the most common causative   organism of nongonococcal urethritis?

  

A.

Chlamydia     trachomatis

 

B.

Ureaplasma     urealyticum

 

C.

Mycoplasma     hominis

 

D.

Trichonomas     vaginalis

                        

· Question 87

       

Urine cultures should be obtained for which of the   following patients?

·  

· Question 88

       

A 30 year old female patient presents to the clinic with   heat intolerance, tremors, nervousness, and weight loss inconsistent with   increased appetite. Which test would be most likely to confirm the suspected   diagnosis?

                        

· Question 89

       

A patient has been diagnosed with   hypothyroidism and thyroid hormone replacement therapy is prescribed. How   long should the nurse practitioner wait before checking the patient’s TSH?

· Question 90

       

Potential causes of hypocalcemia include which of the   following?

                        

· Question 91

       

Which of the following patients most warrants screening   for hypothyroidism?

· Question 92

       

Which of the following is a contraindication for metformin   therapy?

            

· Question 93

       

The organism most often associated with prostatitis is:

  

A.

Klebsiella

 

B.

Neiserria     gonorrhoaes

 

C.

Chlamydia     trachomatis

 

D.

Escherichia     coli

            

· Question 94

       

The most effective intervention(s)   to prevent stroke is (are):

            

· Question 95

       

What is the most commonly abused substance?

                                    

· Question 96

       

The hallmark of neurofibromatosis (von Recklinghausen’s   disease) present in almost 100% of patients is:

· Question 97

       

Diagnostic evaluation of   hypothyroidism reveals:

· Question 98

       

An obese hyperlipidemic patient, newly diagnosed with type   2 diabetes mellitus, has fasting glucose values 180 to 250 mg/Dl. What is the   most appropriate initial treatment to consider?

A. A   low-calorie diet and exercise
  B. Sliding-scale NPH insulin every 12 hours
  C. A sulfonylurea and/or metformin (Glucophage® -XR)
  D. Sliding-scale regular insulin every 6 hours

                        

· Question 99

   

The correct treatment for ankle sprain during the first 48   hours after injury includes:

· Question 100

       

Prolonged PT suggests:

  

A.

Platelet abnormality

 

B.

Abnormality in intrinsic     coagulation pathway

 

C.

Abnormality in extrinsic     coagulation pathway

 

D.

None of the above

       

Question 101 

·  

A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as:

· Question 102

       

The most reliable indicator(s) of neurological deficit   when assessing a patient with acute low back pain is(are):

· Question 103

       

Risk factors for Addison’s disease   include which of the following? 

            

· Question 104

       

Major depression occurs most often   in which of the following conditions?

            

· Question 105

       

Which of the following medications increase the risk for   metabolic syndrome?

                                                

· Question 106

       

A 27 year old female patient with epilepsy is well   controlled with phenytoin (Dilantin). She requests information about   contraception. The nurse practitioner should instruct her that while taking   phenytoin:

            

· Question 107

       

Risk factors for prostate cancer include all of the   following except: 

                                    

· Question 108

       

Maria, age 17, was raped when she was 13 year old. She is   now experiencing sleeping problems, flashbacks, and depression. What is your   initial diagnosis?Post-traumatic stress disorder