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Title of test: Board APRN Exist Exam AGM Description: 51 - 60 Author: anamedico82@yahoo.es Other tests from this author Creation Date: 21/12/2024 Category: Others Number of questions: 50

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51. The APRN is instructing the parents about the use of antipyretics for their toddler who has a febrile upper respiratory infection. Which information is most important for the ARNP to recommend the parents to do. A. Give acetaminophen and antihistamine preparations at night before hour of sleep B. Alternate acetaminophen and Ibuprofen per label for core temperatures over 102.2 ℉ C. Offer liquids and any foods that the child will accept and tolerate during fever. D. For core body temperature over 104 ℉, give toped bath and watch for reactions. 52. The APRN is conducting routine employee screening. A new employee ask how long it takes to get rid of marihuana in the body. The APRN should inform patient that recreational drugs such as marihuana, yield positive results for how long after used? A. 1 month B. 2 days C. 24 hours D. 2 weeks. 53. Other than for its use in acute inflammatory conditions, what special use does intravenous indomethacin (Indocin) have? A. To activate uterine contractions and initiate labor in uterine inertia B. To improve renal blood flow in acute renal failure C. As an antidote for acetaminophen toxicity D. For promoting the closure of a patent ductus arteriosus in children. 54. A patient presents with watery soft diarrhea after taking a prescribed antibiotic for one week, in a stool culture test which organism should be obtained by the APRN? A. Helicobacter Pylori B. Salmonella Sp C. Clostridium Difficile D. Staphylococcus aureus. 55. For a menopausal woman, what is the main advantage of administering progestin concurrently with estrogens? A. Relief of depression and insomnia in women with postmenopausal symptoms B. A reduction in endometrial cancer risk in women who have not had a hysterectomy C. A reduction in cardiovascular risk in women with a family history of heart disease. D. Improvement in the bone density in women with a family history of osteoporosis. 56. The APRN is examining an elderly female client and notices that she has a motor dysfunction in her hip region. Which procedure should the APRN consider to perform to further assess for hip dysfunction? A. Abduct and internally rotate each hip while the client is supine B. Have the client balance first on one foot and then the other C. Flex the hip and knee while lying flat with other leg extended D. Ask the patient to stand and bend over the examination table. 57. Which procedures should the APRN recommend for a healthy 67 years old female patient who has not seen a health care provider for an annual physical exam in the past 5 years? A. Papanicolau smear, sigmoidoscopy, thyroid screen B. Papanicolau smear, thyroid exam, chemistry screen C. Papanicolau smear, mammogram, stool for blood D. Mammogram, chemistry screen, sigmoidoscopy. 58. A 67 years old female patient presents to the clinic with a glossy red tongue, angular stoma, and dry, cracking lips. Her weight is within normal limits and her skin is dry and intact. A decrease in which laboratory finding is most consistent with this clinical presentation? A. Albumin B. Iron binding Capacity C. B Vitamins D. Vitamin C. 59. While conducting a routine health screening the mother of 7 years old reports that her child is having difficulty adjusting to pre-school. The APRN noted several café-au-lait pigmented areas on the child's trunk. What presumptive diagnosis should the APRN make? A. Neurofibromatosis B. Fetal alcohol syndrome C. Multiple sclerosis D. Williams syndrome. 60. The APRN asks a female patient about the "What does a vacuum do? And she replies, "It will break the windows". What conclusion should be documented according this patient's response? A. Normal mental status for age B. Impaired concentration C. Impaired memory D. Impaired thinking. 61. A client at 12 weeks gestation comes to the ante partum clinic complaining of excessive nausea and vomiting. Based on the following laboratory values: hematocrit 36%, hemoglobin 12 g/dl, fasting serum glucose 73 mg/dl, human chorionic Gonadotropin (HCG) 290, 00 mLu/ml. What test should the APRN prescribe? A. Glycosylated Hemoglobin B. Amniocentesis C. Chorionic Villi sampling D. Ultrasound. 62. An older Caucasian adult is at highest risk for poverty substandard house, institutionalization based on documented probabilities? A. A 70 years old rural female with Alzaimer's disease B. A 75 years old urban female with osteoarthritis C. A 70 years old urban male with coronary artery disease D. A 75 years old rural male with a left hemispheric stroke. 63. A patient presents with gnawing, mid epigastric pain that occurs 2 hours after eating as well as at night. Based on the pathogenesis of ulcers, which interventions should the APRN implement? A. Educate the patient about reflux caused by alcohol, caffeine and cigarette smoking. B. Test the patient for the presence of Helicobacter Pylori C. Schedule a gastroscopy to determine the presence of stomach ulcers. D. Prescribe a medication other than a non- steroidal antinflamatory agent. 64. A patient 3 years old is being seen in the clinic for a well child visit. The APRN notes that the child skin is dry and scaly but otherwise intact and the child is in good health. Which is the best recommendation for dry skin care? A. Use a soap substitute B. Shampoo hair at end of bath C. Run rapid water for the bath D. Allow extra time for soaking. 65. A patient with metastatic cancer is preparing to make decisions about end of life and is completing a durable medical power of attorney, which description is best for the APRN to provide? A. It is a hospital form that is required of all people that are entering a hospital B. It will identify someone that can make decisions for your health care if you are in a coma or vegetative state. C. It is not a legal document, but it will help the healthcare provider know exactly what medical Treatments you want. D. It allows you to document your wishes regarding life-sustaining treatment if you can't speak for yourself. 66. A 24 years old is seen the APRN because pernicious anemia. Which high folic acid foods should the APRN teach the client to eat? A. Cottage cheese, skim milk, and yogurt B. Brussels sprouts, lima beans, and potatoes. C. Carrots, salmon, and avocados D. Cereals, nuts and green vegetables. 67. A cross sectional design was used to compare the sleep quality of third trimester pregnant women with non-pregnant women. Findings indicated that pregnant suffer significantly more from poor sleep quality than non- pregnant women and that sleep quality of pregnant woman was related to stress and depression. Based on the findings of this study, which intervention should the APRN working in a women's health clinic implement? A. Develop a counseling program for depressed pregnant women B. Evaluate sleep quality and depression of all pregnant woman. C. Replicate the study using the clinic's population D. Screen all woman. 68. A freshman in collage presents to the woman's requesting the "morning after pill", the young woman reports that she was engaged in consensual intercourse this morning when the condom broke. A review of the client's PMH reveals no contraindications to estrogen use, on the information, what actions should the APRN take? A. Provide the client with information about natural family planning so that this situation can be avoided in the future B. Prescribe post-coital contraception with instructions to take the medication immediately after is obtained C. Advise the client to wait until her next period is due, and if late, return to postcoital contraception. D. Request a pregnancy test and then prescribe postcoital contraception (such as Plan B) to be taken within the next week. X. 69. What pharmacological agent should the APRN prescribe to achieve the best results initially in the management of patients with erosive reflux esophagitis? A. Barrier paste medications, such as sucralfate (Carafate) B. Proton Pump Inhibitors, such as omeprazole (Prilosec) C. The H2 antagonist, such as famotidine (Pepcid) D. Promotility agents, such cisapride (Propulsid). 70. At a parenting class, a mother has concerns that her child does not seen to have any close friends. Which age do children begin to develop friendships? A. Two years B. Twelve mounts C. Eighteen months D. Three years. 71. Woman who is gravid 2, para 1 has been in labor for 10 hours and arrives into the clinic experiencing intensifying contractions that are occurring every 2 minutes. The APRN determines that the patient cervix is 100% effaced, dilated and the fetal head is in the right occipital posterior (ROP). The APN starts a saline lock when client begins screaming for pain medication. Which action should the APN implement first? A. Reposition the patient laterally B. Reinforce relaxation techniques and controlled breathing C. Obtain a precipitation tray and call for transport to L&D D. Apply an external Fetal monitor. 72. The APRN prescribe lipid lowering medication and diet modifications for a patient three months ago, On review of the latest patient related data which findings requires the APRN to take action? A. New onset insomnia from calf pain B. Intermittent episodes of constipation C. Reduction in low density lipoprotein of 65% D. Elevation of liver transaminases of 5%. 73. When a middle age male client performs range of motion with his left arm the APRN notes that he is able to flex the arm without difficulty, however he is unable to abduct the arm without causing pain. If the APRN passively abducts the arm it falls back in place hen released. What do these findings suggest? A. Rotator cuff lesions B. Shoulder dislocation C. Crepitation D. Tennis Elbow. 74. The nursing staff in a busy care wishes to adopt a new procedure that is recognizes as a best practice on a healthcare related web page on the internet. What step should the nurses take before initiating a change in the current unit policy? A. Ask the healthcare professionals if they agree with this change in nursing practice on the unit B. Verify the legitimacy of the practice by determining the source of this web page. C. Teach the experienced nurses how to implement the new procedure first. D. Validate the procedure by conducting a study that compares the old with the new. 75. A client at 39 weeks gestation comes to the clinic and tells the APRN that her bag of waters has ruptured. Which finding provides the best determination that the client's membranes are ruptured? A. Contractions occurring 3 minutes apart. B. A positive Fern test C. An elevated serum white count D. Nitrazine paper that turns blue when placed in vagina. 76. Which pathophysiologic characteristic should the APRN identify in an older patient who is manifesting signs of Alzheimer's disease? A. Intracranial pressure greater than 30 mmHg B. Obstruction of cerebrospinal fluid (CSF) flow C. Senile plaques and neurofibrillatory tangles D. Marked degeneration of the basal ganglia. 77. The APRN diagnoses a child with psoriasis and encourages the child's parent to allow the child moderate sun exposure. What is the best evaluation to choose this intervention? A. Lesions improve when exposed to ultraviolet light. B. Mild sunburn can cause lesions to worsen C. Exposure to sunlight can prevent recurrence D. Sunlight alleviates psoriasis lesions. 78. A 25 years old nulligravida and her 27 years old spouse are seen the APRN because theymhave not been able to get pregnant for the last 2 years. The wife has regular menstruation every 30 days that last for 4 days. Which intervention should the APRN order next? A. A semen analysis B. A clomiphene challenge test C. A follicle stimulant hormone level D. A post coital test. 79. Of the following, which is the least common gram-negative pathogen responsible for pneumonia in the elderly population? A. Haemophilus influenzae B. Klebsiella pneumoniae C. Moraxella catarrhalis D. Neisseria meningitidis. 80. A man and his elderly father come to the clinic because the father has been continuously coughing for the past few days. After examination of the patient, the son pulls you aside to tell you that he fears that his father cannot continue to watch after himself in old age. The son is looking into the possibility of putting his father into a continuing care community. Which of the following is most likely required for the father to enter a continuing care community? A. He must have a serious health condition not requiring hospitalization B. He must buy property and pay monthly fees for utilities and services. C. He must be independent when he enters the community. D. He must be admitted by prescription of a physician. 81. It is recommended that older patients take at least 0.8 grams/kg of protein a day. Which of the following findings is most often directly linked to low protein intake? A. Decreased healing ability B. Decreased calcium absorption C. Decreased heat production D. Decreased percentage of body water. 82. Julie, a 72-year-old female, comes to see you because of complaints of memory loss, extreme drowsiness, and dizziness. Which of the following drugs would most likely lead to these side effects? A. Paromomycin B. Furosemide C. Phenytoin D. Doxazosin. 83. Which of the following types of drugs should elderly patients take 1 hour before or 4 hours after other medications? A. Beta-blockers B. Antacids C. Benzodiazepines D. Diuretics. 84. Which of these is least representative of typical chest X-ray findings of pneumonia in the elderly population? A. Bacterial pneumonia presenting with bronchopneumonia B. Aspiration pneumonia localized to the right middle lobe C. Viral pneumonia showing diffuse involvement D. Bacterial pneumonia presenting with lobar pneumonia. 85. You are considering prescribing furosemide to an elderly patient, believing it to be the drug best-suited for treatment. After looking over the patient's recent lab tests, however, yo notice decreased serum albumin levels. Which of the following choices would be the best course of treatment at this time? A. Treat the underlying cause of decreased albumin B. Decrease the dosage of furosemide C. Switch to torsemide D. Start the patient on metolazone. 86. Which of the following most closely resembles an instrumental activity of dailymliving for the geriatric population? A. Going to work B. Paying bills C. Going to the bathroom D. Reading the newspaper. 87. Alice, an 87-year-old female, arrives at your clinic complaining of fatigue during the day. After looking up some of her symptoms on the Internet, she thinks she may have hypersomnia. In evaluating Alice's medical history, which of the following would you be least likely to associate with hypersomnia? A. Sleep apnea as a cause B. Chronic use of hypnotic medications as a cause C. Unusual daytime sleepiness as a symptom D. Nocturnal confusion as a complaint. 88. A 79-year-old patient with chronic hypertension comes to your practice with complaints of dizziness and feeling like the inside of his head is spinning. He adds that these symptoms began about a week after being diagnosed with and prescribed medication for congestive heart failure 2 months prior. Which of the following is the best first line treatment choice to prescribe for this patient's condition? A. Enalapril B. Atenolol C. Hydralazine D. Furosemide. 89. You are prescribing niacin to one of your geriatric patients as a treatment for hyperlipidemia. Knowing the potential interactions of niacin, you review the patient's history. Which of these medications would warrant the most caution for adverse interactions? A. Phenylephrine B. Naproxen C. Levothyroxine D. Methyldopa. 90. Of the following, which is the least common condition in older adults? A. Diabetes mellitus B. Osteoarthritis C. Atherosclerosis D. Parkinson's disease. 91. Which of these statements is not true regarding aging skin? A. Skin loses sensation and immune response. B. The amount of cell layers in the skin decreases. C. Skin is not as resistant to the development of pressure ulcers. D. No warning signs may precede pressure ulcer formation. 92. William, a 68-year-old, had been suffering from shingles and complained of extreme continual burning pain on his head and legs. He was given medication to treat the intense burning sensations but has now returned to the clinic with complaints of blurry vision and the inability to urinate or have a bowel movement. Which of the following drugs is most likely the cause of his latest complaints? A. Phenytoin B. Acyclovir C. Ibuprofen D. Amitriptyline. 93. Which of the following is least true regarding the physiologic changes and findings in the immune systems of the elderly? A. Innate immunity functions decline while adaptive immune responses remain constant B. Decreased thymic hormone production results in a decreased number of functioning T-cells C. Decreased antibody production and response to antigens occurs D. Vaccine-induced antibody response wanes. 94. The most common trigger for delirium is: A. alcohol withdrawal B. fecal impaction C. head trauma D. acute infection. 95. Older adults are at greater risk of subdural hematoma, even with minor head trauma due to: A. lower bone density in the skull B. relatively fragile blood vessels. C. decreased adipose tissue reserves. D. age-related reduction in circulating clotting factors. 96. Potential noncognitive reasons for behavioral issues observed in older adults include all of the following except: A. ADHD B. pain C. infection D. depression. 97. When managing depression in older adults, all of the following should be considered except: A. start at the highest dose possible of antidepressant and then titrate down once symptoms resolve B. encourage psychotherapy in addition to pharmacotherapy. C. utilize electroconvulsive therapy for severe depression D. conduct a medication review to minimize potential drug-drug interactions. 98. When considering end-of-life decisions, which of the following statements is false? A. Advanced directives include living wills and do not resuscitate (DNR) orders. B. A video or audiotaped discussion may include advanced directives C. Advanced directives are legally binding in all states D. Advanced directives are only recognized when the patient is hopelessly and terminally ill. 99. All of the following are typical physiologic changes in the central nervous system of the elderly population except: A. Decreased beta-adrenergic responsiveness B. Increased alpha responses C. Decreased dopamine receptors D. Increased muscarinic parasympathetic responses. 100. Which of the following is attributed to decreased renal function in the elderly with regard to prescription medication? A. Decreased drug metabolism B. Inhibited drug absorption C. Impaired drug elimination D. Limited drug distribution.

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