Question 1

A 35-year-old woman complaining of lower back pain is suspected of herniated nucleus pulposus. Vertebral herniation is most likely found in which areas?

Accepted Answer

The most common areas of herniation are L4-L5 and L5-S1. Herniated discs usually occur in these areas because it is believed that they bear most of the body's weight.

Question 2

A patient with multiple myeloma is demonstrating signs of hypercalcemia by which of the following?

Accepted Answer

Patients with multiple myeloma are at risk for hypercalcemia. Decreased motility of the gastrointestinal tract is a sign of hypercalcemia. The other options are demonstrating signs of hypocalcemia.

Question 3

Which is not a correct definition of each classification of fracture?

Accepted Answer

Complete fractures refer to the breaking of the entire width of the bone. Greenstick fractures are commonly found in children. As in all fractures, the healing process begins almost immediately. That is why it is important to set the fractured pieces into its natural position as soon as possible.

Question 4

A patient is suspected to have Von Willebrand disease. The statements below are characteristics of the disease. Which of the following is incorrect?

Accepted Answer

Von Willebrand disease is a hereditary deficiency of von Willebrand factor (vWF). vWF promotes the platelet adhesion phase of hemostatis, connecting the platelets to the vessel wall. It also functions together with factor VIII, since vWF is required to maintain normal plasma factor VIII levels. Although the disease causes platelet dysfunction, bleeding tendencies are usually mild.
There are 3 types of Von Willebrand's disease: 1) Type 1, which is a quantitative deficiency; 2) Type 2, which is a qualitative impairment in synthesis; and 3) Type 3, which is a rare autosomal recessive disorder characterized by no detectable vWF.

Question 5

A 20-year-old female sustained multiple long bone fractures after a motorcycle accident. The patient is at risk for fat emboli, a serious complication. Which of the following signs and symptoms indicate fat emboli?

Accepted Answer

Signs and symptoms of fat emboli include tachypnea, tachycardia, elevated temperature, thrombocytopenia, and mild neurological symptoms like confusion. Petechial rash on the upper anterior portion of the body occurs late and disappears within hours. Fractures involving the long bones release a great amount of fat into the marrow vessels that obstruct the pulmonary and systemic vasculature.

Question 6

Of the following lab values, which would be true in a case of iron deficiency anemia?

Accepted Answer

Iron deficiency anemia is characterized, in part, by a decreased MCV (Mean Corpuscular Volume), an increased RDW (Reticulocyte Distribution Width), and a decreased MCHC (Mean Corpuscular Hemoglobin Concentration).

Question 7

A patient who sustained a spinal cord injury 48 hours ago presents with diaphoresis, flushed face and neck, and severe headache. Further assessment reveals bradycardia and severe hypertension. The patient is most likely experiencing:

Accepted Answer

Based on the findings, the patient is having autonomic dysreflexia. Developing severe headache, flushed face and neck, bradycardia, and severe hypertension about 24 to 48 hours after a spinal cord injury indicates autonomic dysreflexia.

Question 8

A nurse determines that the following clients are contraindicated to receive the measles, mumps, and rubella vaccine except:

Accepted Answer

Clients with HIV can still receive the MMR vaccine as long as they are not severely immunocompromised. Clients who are pregnant, allergic to neomycin, and immunodeficient are contraindicated to receive the vaccine.

Question 9

A patient is taken in due to a motorcycle accident. Which of the following is not a warning sign of internal bleeding?

Accepted Answer

Vomiting bile is usually not a sign of internal bleeding; instead, vomiting of blood is more common, especially in cases where the abdomen is affected. Internal bleeding is difficult to identify and can only be evident when signs of shock appear. Internal bleeding usually results from trauma or injury, but it can also occur due to an existing condition (i.e. hemophilia) or medications (i.e anticoagulants). Board-like abdomen occurs when the blood is spilled into the peritoneal cavity.

Question 10

A nurse is assessing a patient for signs and symptoms of severe anemia. Besides the lab values and vital signs what observations in the physical assessment would give indication that the patient is severely anemic?

Accepted Answer

Besides lab values and vital signs, the patient with severe anemia may show abnormalities in the nails such as spoon shape, long shaped striations and clubbing. In addition, the patient may have retinal hemorrhages.

Question 11

A 35-year-old white female tested positive for antinuclear antibody after demonstrating signs of systemic lupus erythematosus. What is the next step?

Accepted Answer

The ANA is the initial screening test for systemic lupus erythematosus. If the patient tests positive, order a more specific test, such as the Anti-DS DNA or Anti-Smith. If the patient tests positive in any of these tests, the diagnosis of systemic lupus erythematosus is confirmed. NSAIDS are prescribed to relieve joint pain and glucocorticoids are prescribed during flare-ups.

Question 12

A 27 year old man had a tonic-clonic seizure and fell down. While admitted, the patient had a recurrent episode of seizure. Which of the following is a priority during this event?

Accepted Answer

Grand-mal seizure, or tonic-clonic seizure, is characterized by sudden tensing of muscles (tonic) and rapid contraction and relaxation of the muscles (clonic). During this episode, the patient shouldn't be restrained and the seizure should be allowed to run its course. No object should be inserted in the mouth, as this can cause choking. Apnea commonly occurs during or after the seizure, therefore, it is important to have oxygen at bedside and keep the airway open.

Question 13

When managing a patient with septic shock, it is important to remember that:

Accepted Answer

Septic shock can cause systemic vasodilation, causing tachycardia and hypotension. Septic shock is mostly caused by gram-negative bacteria and a small percentage of gram positive bacteria. Injury to the NS results in neurogenic shock.

Question 14

A woman was recently diagnosed with osteoarthritis. During patient education, the woman is informed that the following conditions or actions can cause or worsen primary osteoarthritis:

Accepted Answer

Primary osteoarthritis is caused by overuse of joints, obesity, and aging. Secondary osteoarthritis is caused by diabetes mellitus and congenital abnormality.

Question 15

An 18-year-old who had a recent fracture in the left leg is suspected of having compartment syndrome. Assessment findings would include the following signs and symptoms:

Accepted Answer

An extremity with compartment syndrome, the patient is not able to perform active movement. Pain occurs with passive movement. Other signs and symptoms include decreased sensation, pallor, and weakness.

Question 16

You are beginning treatment on a patient with HIV. Besides drugs that are specifically targeted at HIV, what other group of medications would the patient be started on to avoid common complications of HIV?

Accepted Answer

To avoid the common complication of infection in the patient with HIV, the patient would be started on empiric antibiotics. Teaching the patient how to avoid infection is an important part of patient teaching.

Question 17

A 20-year-old man comes to the clinic complaining of anorexia, vomiting, and myalgia. On assessment, maculopapular and petechial rash are found on the ankles and wrists. The patient says he remembers getting bitten by a tick about 2 weeks ago. Based on the physical findings and history, the patient is most likely diagnosed with:

Accepted Answer

The Rocky Mountain Spotted Fever is caused by Rickettsia rickettsii. The signs and symptoms are consistent with the patient's symptoms.

Question 18

A 69-year-old man is taken in for diagnostic tests. The findings showed reversible airway obstruction secondary to bronchial hyperreactivity, airway inflammation, mucus plugging, and smooth muscle hypertrophy. What is his likely diagnosis?

Accepted Answer

Bronchial asthma is a respiratory disorder characterized by reversible airway obstruction due to bronchial hyperreactivity, airway inflammation, mucus plugging, and smooth muscle hypertrophy. In emphysema (option A), there is a progressive destruction of the alveolar walls, causing decreased oxygen-carbon dioxide exchange in the capillary blood vessels.
Pneumonia (Option B) is the inflammation of one or both lungs leading to consolidation. This condition may be caused by bacterial or viral infection, or aspiration of foreign bodies. Pulmonary edema (option C) is the swelling or filling of fluids in the lungs. This condition may be cardiogenic (i.e. CHF) or non-cardiogenic (renal failure, ARDS, pneumothorax, or substance use).

Question 19

On assessment, small to large wart-like growths on the woman's genitals are observed and noted. Some eruptions appear fungating, others appear cauliflower-like. Which of the following is a severe complication of this sexually transmitted disease?

Accepted Answer

Based on the findings, the woman is infected with human papillomavirus. This virus has been associated with cervical changes and cancer. Mental deterioration is a complication of syphilis. Opthalmia neonatorum and pelvic inflammatory disease are complications of gonorrhoeae.

Question 20

Which of the following statements describes decorticate posturing?

Accepted Answer

Decorticate posturing is the flexing of one or both arms onto the chest, with the legs extending rigidly. Decorticate posturing indicates a deterioration in condition. Option B refers to decerebrate posturing, which indicates a brainstem lesion. Option C refers to Babinski reflex. Option D refers to flaccid posturing.

Quiz 1: Adult Nurse Practioner Practice: Medical Conditions and Disorders