NR601 final exam 2022

Primary Care of the Maturing and Aged Family Practicum

 

“Which FSH value is consistent with complete cessation of ovarian function?”

 

A. Less than 10

 

B.            10-25

 

C.            25-35

 

D.            Greater than 40

 

 

 

Diabetes is one of the leading causes of which disease:

 

A chronic lung disease

 

B kidney failure

 

C disability

 

D cardiac death.

 

 

 

Which antihypertensive medication can be used to treat hot flashes in menopause?

 

A.            Labatelol

 

B.            Clonidine However it has adverse effects such as dry mouth, drowsiness and

hypotension which may make it undesirable.

C.            Hydrochlorothiazide

 

D.            Hydralazine

 

 

 

What is the least diabetogenic statin?

 

A.            Rosuvastatin

 

B.            Simvastatin

 

C.            Atorvastatin

 

D.            Pravastatin

 

 

 

Bence Jones proteins found in a urinalysis may be indicative of:

 

A.            Leukemia

 

B.            Lymphosarcoma

 

C.            Multiple myeloma

 

D.            All of the above

 

 

 

What is the first line medication for new type 2 diabetic? A.Novolog

 

B.            Penicillin

 

C.            Metformin

 

D.            Glyburide

 

 

 

Protein on a urinalysis usually has a renal pathology, specific to which renal structure?

 

A.            Glomerulous

 

B.            Renal cortex

 

C.            Medulla

 

D.            Nephron

 

 

 

What is the hA1C goal for diabetic patients with complex health status (multiple chronic conditions)?

 

A.            <7.5

 

B.            <8.0  Its B. VERY complex is 8.5. I feel like that’s tricky

C.            <8.5

 

D.            < 9

 

 

Type 2 diabetes factors include?

 

A.            Polycystic

 

B.            Obesity

 

C.            Hypotension

 

D.            Liver disease

 

 

 

Gastric bypass surgery can be performed on a patient with a BMI off.

 

A.            20-25

 

B.            40

 

C.            30-34

 

D.            25- 29

 

 

 

Signs of indicative abuse includes?

 

1)            Weight Gain

 

2)            Poor Hygiene

 

3)            Lack of control

 

4)            Increase interested in daily activities

 

 

 

What age related changes does NOT affect urologic functioning?

 

A. Decreased bladder capacity

 

B. Normal aging

 

C. Increased PVR urine volume

 

D. Increased urethral resistance

 

 

 

Painful, irregular-shaped,deep red ulcers with a red halo and undermined edges. Which STD is most likely?

 

A.            Syphilis

 

B.            HSV (Herpes)

 

C.            Chancroid (Haemophilus ducreyi)

 

D.            Molluscum contagiosum (Pox virus)

 

 

 

What is the average BG level of a HB A1C of 9.5?

 

A.            226

 

B.            216

 

C.            197

 

D.            240

 

A way I remember this is know that an A1C of 6 is always 126 and add 14 to get your next AIC bG level.

 

 

 

Which STI increases in those over the age of 50 years old? A. Syphilis

 

B. HSV (Herpes)

 

C.            HIV

 

D.            Gonorrhea

 

Which type of incontinence is a result of bladder hypermobility?

 

A.            Urge

 

B.            Overflow

 

C.            Stress

 

D.            Functional

 

Especially for those who have had vaginal deliveries. Pee when you sneeze/cough. Do some kegals to manage

 

 

What test can detect interstitial cystitis?

 

A. Potassium sensitivity

 

B. Sodium sensitivity

 

C.            CBC

 

D.            Bladder ultrasound

 

What is the first line opioid for dyspnea?

 

A.            Percocet B.Morphine C. Tramadol

 

D.            Tylenol

 

 

 

A male complains of dysuria. Urinalysis is positive for nitrates, leukocyte esterase, and bacteria. Which medication should be given?

 

A Doxycycline X 7 days

 

B             Trimethoprim-sulfamethoxazole X 7-10 days C Ciprofloxacin X 3 days

 

D Nitrofurantoin X 14 day

 

 

 

 

 

Which patient is a contraindication for Cipro?

 

A Pregnant

 

B 19 years old

 

C             hypertensive D pyelonephritis

 

 

What is the difference between palliative care and hospice services?

 

A. Hospice is provided with life expectancy of six months or less B. Palliative care can be involves at any stage of illness.

 

C. Palliative care integrates psychological and spiritual aspects of care throughout the illness from diagnosis to death D. All of the above.

 

 

The Crede’s maneuver is an effective management in which UI?

 

A.            Functional

 

B.            Urge

 

C.            Overflow

 

D.            Stress

 

Which UI is associated due to UTI, vaginitis, bladder stones, and tumors?

 

A.            Urge

 

B.            Stress

 

C.            Functional

 

D.            Overflow

 

 

 

Which of the following is not part of the SPIKES protocol?

 

A.            Setting

 

B.            Planning

 

and obviously add a testosterone level to those labs

C.            Strategy

 

D.            Invitation

 

Answer is B

 

P actually stands for perception (Kennedy page 496

 

What is a common characteristic of dysuria-pyuria syndrome

 

(acute urethral syndrome)?

 

A. Painful urination

 

B. WBCs on microscopic UA

 

C. Absence of positive bacterial culture D. All of the above

 

Often caused by Chlamydia

 

 

Contraindication for testosterone therapy injection, all EXCEPT:

 

A. Liver disease

 

B. Mercury allergy

 

C. Latex allergy

 

D. Prostrate cancer

 

 

 

If the testosterone level is below 300, what is the next step?

 

A. Order a serum prolactin level

 

B. Initiate testosterone therapy

 

C. Repeat the level in 1 month

 

D. Refer to urologist

 

 

 

All of the following labs should be ordered in a patient with

 

complaints of ED EXCEPT:

 

A. Lipod profile

 

B. CMP

 

 

C.            TSH

 

D.            Fasting blood sugar

 

 

 

 

 

 

 

 

Risk factors for urinary in continence include:

 

A.            Age

 

B.            Residing in long term care setting

 

C.            Cognitive impairment

 

D.            Female gender

 

E.            All of the above  Kennedy of 84. UI. Is twice as common in women as men incidence

 

increases with age being institutionalized and those with a deficit in ADLs

 

 

A patient with impaired glucose intolerance is at an increased risk of developing type 2 diabetes within how many years of onset?

 

A)           2 to 5 years

 

B)            5 to 10 years

 

C)            3 to 6 years

 

D)           within 1 year

 

 

 

What is the most commonly identified infectious agent or toxic insult in a person with genetic predisposition for DM1?

 

A.) Herpes

B.) Congenital Rubella

C.) Chicken pox

D.) MMR vaccine while pregnant

 

 

All are contraindications of Metformin except

A. Stroke

B. MI

C. Renal disease

D. Septicemia

 

When should insulin therapy begin in the management of DM2?

 

A.            Initially

 

B.            If A1C is >9.0 and symptomatic C.If A1C is >8% and asymptomatic

 

D.            Patients with DM2 do not require insulin therapy.

 

Which A1C indicates strong glycemic control?

 

A.            6%

 

B.            <7%

 

C.            8.5%

 

D.            5.7%

 

 

 

A patient who is experiencing menopausal symptoms and has a uterus can be treated with?

 

A.            Estrogen-only therapy

 

B.            Estrogen plus progestin

 

C.            Neither are recommend

 

D.            Either one can be used

 

 

 

Viagra: how long after injection does it last?

 

A.            15-45 minutes

 

B.            30-60 minutes

 

C.            60-90 minutes

 

D.            90- 120 minutes

 

 

 

Viagra: how often can it be used?

 

A.            Every 24 hours, 2-3 times/week

 

B.            Every 24 hours, 4-5 times/week

 

C.            Every 12 hours, 2-3 times/week

 

D.            Every 12 hours, 4-5 times/week

 

 

 

The trasdermal testosterone gel or solution (AndroGel) can be applied to?

 

A.            Scrotum

 

B.            Axillary

 

C.            Upper arm

 

D.            B&C

 

 

 

Testosterone implantable pellets (Testopel) produce steady blood levels if implanted into the subcutaneous tissue:

 

A.            Monthly

 

B.            Weekly

 

C.            Every 5-6 months

 

D.            Every 3-4 months

 

 

 

Which is true regarding nitrates and Viagra(Sildenafil)? A. Nitrates are alway contraindicated with Viagra B. Can give nitrites within 12 hours of taking Viagra

 

C. Must wait 24 hours after taking Viagra to give nitrites D. There are no restrictions when giving the 2 medications

 

 

A patient presents with complaints of changes in behavior (socially inappropriate, easily frustrated, impulsive), language dysfunction, and difficulty reading and writing. Which type of dementia would you suspect?

 

A. Lewy Body/Parkinson S

 

B. Frontotemporal lobe/Picks Disease

 

C. Vascular Dementia

 

D. Mixed Dementia

 

 

 

Which is true regarding early onset dementia?

 

A. It affects those 65 and younger

 

B. It affects those 55 and younger

 

C. It is usually familial

 

D.A&C

 

 

 

 

 

 

 

 

Which ethinc group is at the highest risk for developing

 

Alzheimers disease?

 

A. African American

 

B.            Caucasian

 

C.            Hispanic

 

D.            A and C

 

Ok this is one of those weird which is MOST right questions. According to the study guide I have, both AA and Hispanic are more at risk than Caucasian, but AA are twice as likely to develop it? If anyone finds anything confiming this let me know. Confusing

 

 

Which one is not correct with incontinence mneumonic DRIP

 

 

A.            Diabetes

 

B.            Polyuria

 

C.            Restricted mobility

 

D.            Infection

 

 

 

 

 

The “D” stands for delirium

 

 

 

 

Poor judgment and decisions first presents in which phase of Alzheimers disease?

 

A.            Preclinical

 

B.            Mild-moderate

 

C.            Severe

 

D.            None of the above

 

 

 

Which is true regarding the onset and half life of codeine?

 

A. Onset: 30 minutes, HL: 2-4 hrs

 

B. Onset: 15 minutes, HL: 4-6 hrs

 

C. Onset: 60 minutes, HL: 4-6 hrs

 

D. Onset 60 minutes, HL: 2-4 hrs

 

 

 

 

 

 

 

 

Dilauded is:

 

A. 5 times more potent than Morphine

 

B. 2 times more potent than Morphine

 

C. Half as potent as Morphine

 

D. 3 times more potant than Morphine

 

 

 

Which medication is most appropriate for very severe, intractable pain?

 

A.            Codeine

 

B.            Morphine

 

C.            Fentynal

 

D.            Hydrocodone

 

 

 

Pain arising from the muscles, joints and cutaneous tissue is?

 

A. Visceral pain

 

B. Somatic pain

 

C..           Neuropathic pain

 

D.            None of the above

 

 

 

All of these medications can be used for neuropathic pain EXCEPT?

 

A.            Gabapentin

 

B.            Methadone

 

C.            Amitriptyline

 

D.            All are correct

 

 

 

In AD, Preclinical changes in the brain can begin in _________ years

 

before symptoms present.

 

A.            2-5

 

B.            10-20

 

C.            1

 

D.            5-10

 

Women are more at risk for which type of abuse?

 

A.            Neglect

 

B.            Physical

 

C.            Sexual

 

D.            Both B & C

 

 

 

Those with cognitive function are more at risk for which type of abuse?

 

A.            Exploitation

 

B.            Sexual

 

C.            Abandonment

 

D.            Physical

 

 

 

Which type of dementia is caused by the blockage of bloody supply to neurons?

 

A. Lewy Body Dementia

 

B. Alzheimer’s disease

 

C. Vascular Dementia

 

D. Frontotemporal dementia

 

 

 

How would you best treat an uncomplicated UTI of a non-pregnant 55 year old female with no known drug allergies?

 

A:            Cipro 7-10 days

 

B:            Bactrim 7-10 days

 

C:            Bactrim 3 days

 

D:            it’s uncomplicated. No treatment is needed.

 

 

 

 

 

 

 

 

 

 

 

Age-related changes in the bladder, urethra and ureters include all of the following in older women except:

 

a. decline in ureteral resistance pressure

 

b. increased estrogen produciton’s influence on the bladder and ureter

 

c. laxity of the pelvic muscle

 

d. decline in bladder outlet functi

 

 

 

The proposed mechanism by which diphenhydramine caused delerium is:

 

a. anticholinergic effects

 

b. dopaminergic effects

 

c. gabanergic effectis

 

d. serotinergic effects

 

 

 

According to the Palliative Care Presentation, palliative care may be provided to

 

a. only cancer patients

 

b. anyone regardless of their life expectancy or disease progression c. those with a life expectancy > 6 months d. those with a life expectancy< 6 months

 

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

 

a. hycosamine for respiratory secretions

 

b. stimulant laxatives for treating constipation c. opioids for pain control d. opioids for dyspnea

 

 

 

 

 

 

 

According to the World Health Orginazition’s analgesic ladder, which drug would be most appropriate in opiate-niave patient who presents with moderate pain

 

a.            naproxen/morphine

 

b.            asprin/fentanyl

 

c.             acetaminophen/hydrocodone

 

d.            ibuprofen/impraminen

 

 

 

According to the American College of Cardiology 2017 Guidelines for High blood pressure in adults, hypertension stage 2 is defined as

 

a. >150 or >90 mmHG

 

b. >140 or >90 mmHG

 

c.             120-129/<80 mmHg

 

d.            130-139 or 80-89 mm HG

 

 

 

Pain which results from pathology or damage to the nervous system is classified as

 

a.            chronic

 

b.            neuropathic

 

c.             acute

 

d.            nociceptive

 

 

 

What helps a clinician to differentiate between Delirium and Dementia? a. Patients are agitated in dementia

b. Patients are usually alert with Dementia c. Both have the same symptoms d. a & b

 

 

 

Tom was just brought in and physical exam identifies tachycardia, sweating, flushed face, dilated pupils, disorientation with elevated blood pressure. What is most likely going to be Tom’s diagnosis?

a. Withdrawal delirium

b.            Dementia

c.             Psychosis

d.            Any of the above

 

 

 

 

The first way to Distinguish between T1DM and T2 DM?

 

a:            BMI, Age, Ketones

 

b:            Cpeptide levels

 

c:             A1C

 

d:            Fasting Glucose

 

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