Question 1

Where are fungal infections usually found?

Accepted Answer

Fungal infections are usually found on the skin. These are biological agents, such as yeasts and molds. Fungal infections can be highly contagious. Use universal precautions when dealing with patients.

Question 2

A patient administered with pilocarpine hydrochloride (Isopto Carpine) is demonstrating the toxic effects of the drug if the following signs and symptoms are seen except:

Accepted Answer

Pilocarpine toxicity is manifested by hypotension, vertigo, tremors, bradycardia, and cardiac dysrhythmias.

Question 3

A 35-year-old man is suspected of a cataract in its early stage. Which of the following manifestations is considered as the main indicator of cataract formation?

Accepted Answer

Gradual and painless blurring of central vision is the main clinical manifestation of cataracts. The other options are not signs of a cataract.

Question 4

A 75-year-old female client comes to the office complaining of severe angina unresolved by nitroglycerin, which started 2 hours earlier. Physical examination reveals hypotension, clear lung fields, and elevated jugular pressure. A deep and labored breathing pattern is noted. Infarct in the right ventricle is diagnosed.
Which of the following 12-lead ECG findings is the single most powerful predictor of right ventricular infarction involvement within 10 hours of the onset of symptoms?

Accepted Answer

The ST-segment elevation in lead V4R is the most predictive indicator of right ventricular involvement. This finding is 93% sensitive and 95% specific to right ventricular infarct. This elevation is transient, disappearing in less than 10 hours after the onset of the symptoms. ST-elevations in leads V1 and V3R are less sensitive and less specific in detecting the involvement of the right ventricle.

Question 5

A pregnant woman is diagnosed with bacterial vaginosis. Which of the following findings is consistent with the diagnosis?

Accepted Answer

Bacterial vaginosis is caused by Gardnerella vaginalis. This sexually transmitted disease is manifested by gray and thin discharge with a strong fish-like odor. Vaginal irritation is also reported.

Question 6

A patient scheduled for cataract surgery is administered with cyclopentolate hydrochloride (Cyclogyl) eye drops. This medication is used to:

Accepted Answer

Mydriatics, such as cyclopentolate, are used to dilate the pupil and relax the ciliary muscles. Topical anesthetics result in corneal anesthesia. Eye lubricants add moisture to the eyes. Miotics constrict the pupil and contract the ciliary muscles.

Question 7

Which of the following diagnostic tests is ordered to obtain a detailed imaging and recording of ocular circulation?

Accepted Answer

Fluorescein angiography is a diagnostic test used to evaluate ocular circulation of the eye. Computed tomography scans the skull and orbits of the eye. Slit lamps allow examination of the anterior ocular structures. Corneal staining is used to indicate non-intact areas of the corneal epithelium.

Question 8

An immobile patient presents with a decubitus ulcer in an area in which the top layer of the skin is missing. The ulcer is shallow with a pink to red base. These signs and symptoms describe an ulcer at stage ________ :

Accepted Answer

A Stage I ulcer is characterized by a shallow ulcer with pink to red base. Stage III is manifested by a deep ulcer that extends deep into the dermis and subcutaneous tissues. Stage IV is manifested by a deep ulcer that extends into the muscle and bone.

Question 9

A 43-year-old woman presents with difficulty breathing and distended neck veins. Pulsus paradoxus is recognized on assessment. No pulse is detected on palpation of the femoral artery. Other significant findings include muffled heart sounds, dyspnea, and tachycardia. What is the most likely diagnosis?

Accepted Answer

Cardiac tamponade is commonly manifested by pulsus paradoxus. Cardiac tamponade is a medical emergency, requiring immediate treatment. Rapid collection of fluid in the pericardial sac interferes with ventricular filing and pumping, critically reducing cardiac output.

Question 10

Which of the following statements is true about the electrophysiologic properties of the cardiac cells?

Accepted Answer

Myocardial cells do not possess an inherent ability to generate an electrical impulse. The pacemaker cells are the ones that spontaneously initiate electrical impulses. Myocardial cells respond in an all-or-nothing manner in such a way that stimulation of one muscle fiber causes the entire muscle mass to contract as a unit. When myocardial cells are stimulated, the impulse spreads throughout the heart muscle. Automaticity, excitability, and conductivity are classified as electrical properties, whereas contractility is classified as electrical.

Question 11

An elderly patient who complains of chest pain, dizziness, and shortness of breath is about to be connected to a cardiac monitor. To monitor lead III:

Accepted Answer

To monitor lead III, the positive electrode should be placed on the left leg and the negative electrode on the left arm. Lead III, together with lead II, is used to monitor changes associated with myocardial infarction in the inferior wall. Option A refers to lead I and Options C and D refers to lead I.

Question 12

Which of the following problems is most likely associated with the left bundle branch block (LBBB)?

Accepted Answer

LBBB is a marker of one of four conditions: severe aortic valve disease, ischemic heart disease, long-standing hypertension, and cardiomyopathy. On the other hand, RBBB (right bundle branch block is usually caused by congenital heart disease (i.e. Atrial septal defect), MI, myocarditis, scar formation in the heart due to heart surgery, and pulmonary embolism.

Question 13

A 70-year-old woman is scheduled to have a colonoscopy in the next three days. Pre-procedure instructions and actions would include:

Accepted Answer

The patient is positioned lying on the left side with the knees drawn up to the chest during colonoscopy; however, the position may be changed during the examination. A clear liquid diet is usually started at noon on the day before the procedure. NPO is started after midnight on the day before the test. Enemas are given until the returns are clear.

Question 14

A 45-year-old man is on chronic hemodialysis. Which of the following conditions is not linked to dialysis?

Accepted Answer

Hepatitis B, instead of Hepatitis A, is a typical occurrence during hemodialysis due to prolonged period of exposure to contaminated devices and equipments or health care personnel. Although Hepatitis B vaccination was recommended for susceptible patients and staff, there is still a continuing outbreak of Hepatitis A and Hepatitis C infection among chronic hemodialysis patients.

Question 15

Which of the following medications are not administered during the active phase of peptic ulcer disease?

Accepted Answer

Non-steroidal inflammatories like aspirin are not administered because these medications are irritating to the ulcer and may aggravate the symptoms. Anti-cholinergics are used to reduce gastric motility. Prostaglandins protect the ulcer and have anti-secretory actions. Antacids neutralize gastric secretions.

Question 16

A woman with pancreatitis is noted to have bluish discoloration of the periumbilical area on physical examination. This finding is called:

Accepted Answer

Cullen's sign is the bluish discoloration of the periumbilical area caused by hemorrhagic, severe pancreatitis. Turner's sign is the bluish discoloration of the left flank area that is seen in peritonitis. Murphy's sign is experiencing pain with inspiration as the examiner's fingers are placed under the right costal margin. This is positive for acute cholecystitis. Spider angioma is the abnormal collection of blood under the skin. This is usually seen in pregnant women and those with liver disease.

Question 17

An 18-year-old female has been diagnosed with hepatitis A. Which of the following assessment findings indicates that she is in the icteric stage of hepatitis?

Accepted Answer

Pruritus, jaundice, brown-colored urine, and lighter-colored stools are usually manifested during the icteric stage of hepatitis. Options A and D are usually seen during the pre-icteric stage. Option B is seen during the post-icteric stage.

Question 18

Which of the following groups of individuals has the greatest risk for celiac disease?

Accepted Answer

The cause of celiac sprue is not yet fully determined, but an individual's race is known to play a role in its development. Caucasians of European descent are most commonly affected by celiac disease. Asians, Native Americans, and African Americans are the leading groups with lactase deficiency.

Question 19

While assisting a physician in the diagnosis of Cushing's syndrome, the following symptoms should be considered:

Accepted Answer

Option A is incorrect because the patient gains weight due to fluid retention; however, hirsutism and purple striaes are commonly seen in these patients. Option B is incorrect because the patient with this condition has amenorrhea (not dysmenorrhea). Renal calculi and osteoporosis are present due to bone demineralization. There is an increased urinary output due to inhibited ADH secretion. Option C is incorrect because of hypotension. In Cushing's syndrome, there is hypertension due to fluid and salt retention.

Question 20

During assessment, the nurse touches the client's cornea with a wisp of cotton. Which of the following cranial nerves is the nurse assessing?

Accepted Answer

The nurse is assessing the sensory division of the client's cranial nerve V. Cranial nerve II is assessed through the Snellen chart, cranial nerve IV is assessed by asking the client to follow the direction of the object held by the examiner by eye movements, and cranial nerve VI is examined by asking the client to turn eyes laterally.

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