Labs
In the early stages of iron deficient anemias, blood studies show:
-macrocytic normochromic
-microcytic hypochromic
-normochromic normocytic
-pancytopenic hypocytic
normochromic normocytic
A patient has hyperactive reflexes of the lower extremities. The adult-gerontology primary care nurse practitioner assesses for ankle clonus by:
-firmly applying a low-pitched tuning fork to the lateral malleolus.
-flexing the leg at the knee, rotating it externally, and striking the Achilles tendon with the percussion hammer.
-sharply dorsiflexing the foot and maintaining this position while supporting the knee.
-stroking the lateral aspect of the sole from
sharply dorsiflexing the foot and maintaining this position while supporting the knee.
A patient's adult child telephones the nurse practitioner to inquire about the patient's illness. The patient's child reports that the parent relies upon the child to explain everything to him or her. The nurse practitioner:
- asks the child to provide a copy of the patient's advance directive document.
- assures the child that the nurse practitioner can disclose requested information.
- informs the child that he or she must come to the clinic to discuss the parent's case.
- tells the child that the nurse practitioner can discuss the information only with the patient.
tells the child that the nurse practitioner can discuss the information only with the patient.
The adult-gerontology primary care nurse practitioner treats several patients for biological exposure. In the patients' records, the nurse practitioner documents which epidemiological factors for each exposure?
-Comorbidities and length of exposure.
-Location and event intensity.
-Mode of transmission and incubation.
-Premorbid conditions and surveillance rates.
Mode of transmission and incubation
When disseminating research findings in a peer-reviewed journal, the adult-gerontology primary care nurse practitioner:
- concludes that the study proves the hypothesis.
- excludes the discussion section, because the conclusion contains this information.
- recommends incorporating the results directly into clinical practice.
- uses the methodology section to support the validity of the study.
uses the methodology section to support the validity of the study.
84-year-old patient seen today for an initial visit. The patient questions the need for colorectal screening, since 10 years have passed since the last colonoscopy. The nurse practitioner recommends:
- a colonoscopy.
- a fecal DNA test.
- flexible sigmoidoscopy.
- watchful waiting.
watchful waiting
A 70-year-old, female patient is having her yearly evaluation. The adult-gerontology primary care nurse practitioner gives which physical examination finding the highest priority for immediate treatment?
-Atrophy of vaginal rugae.
-Cystocele present.
-Palpable ovary.
-Pessary in place.
palpable ovary
The nurse practitioner reminds a 16-year-old, male patient who just received his driver's license to wear a seat belt at all times when in a car. The patient replies that he does not need to wear a seat belt, because nothing will happen to him if he is involved in an automobile collision. According to the health belief model, what chief component does the patient lack?
- Enabling factors
- Motivation
- Perceived role conflict.
- Perceived severity.
Perceived severity
The adult-gerontology primary care nurse practitioner evaluates an 80-year-old patient with cognitive deficits, who is unaccompanied by the adult child who typically is present. The patient has urinary symptoms, for which the nurse practitioner considers ordering sulfamethoxazole-trimethoprim (Bactrim). The patient's previous medical record is unavailable. Before prescribing the medication, the nurse practitioner:
-contacts the patient's adult child.
-queries the other staff members.
-relies on the patient's self-report.
-waits until the patient's chart is available.
contacts the patients adult child
A 65 yo female patient has a osteopenia and a FRAX score reporting an 18% risk of major osteoporotic fracture and 5% risk of hip fracture in the next 10 years
- encourage calcium and vitamin D
- start a bisphosphonate
- get spine films to see if she has a compression fracture
- start an anabolic agent such as teriparatide
start a bisphosphonate
To evaluate for heart failure, which diagnostic test does the nurse practitioner order for a patient with swelling in the lower extremities?
- ankle-brachial index.
- Brain natriuretic peptide test.
- D-dimer assay
- Spirometry study.
Brain Natriuretic Peptide
For two to three months, a 78-year-old patient has not been taking levothyroxine (Synthroid) as prescribed. The patient now has symptoms of increasing constipation, lethargy, and weakness. The nurse practitioner anticipates that laboratory tests will show that the patient's:
- T4 level decreased, and TSH level increased.
- T4 level increased, and TSH level decreased.
- T4 level increased, and TSH level is unchanged.
- T4 level is unchanged, and TSH level decreased
T4 level decreased, and TSH level increased
The adult-gerontology primary care nurse practitioner is appointed to a hospital's multidisciplinary medical ethics review committee. The nurse practitioner's role is to:
-evaluate standards, risks, benefits, and outcomes.
-identify how to anticipate and resolve similar future situations.
-investigate the need for disciplinary action.
- obtain agreement of all parties with a chosen solution.
evaluate standards, risks, benefits, and outcomes.
The adult-gerontology primary care nurse practitioner evaluates a patient with cold symptoms who reports smoking half a pack of cigarettes a day and shows no interest in quitting. The nurse practitioner's most appropriate approach is to treat the cold symptoms and:
- advise the patient to stop smoking.
- prescribe bupropion (Zyban).
- raise the issue of smoking cessation at the next visit.
- recommend that the patient select a low nicotine cigarette.
advise the patient to stop smoking
You are taking care of an elderly diabetic, He is on Metformin and Glargine. He has metastatic cancer and a life expectancy of 2-3 years. His A1C is 8.9%. What is your next step in his care
- increase his Glargine insulin to get his A1C down
- add a GLP-1 to see if you can get his A1C down
- keep his regimen the same
- decrease his insulin to prevent hypoglycemia
- start Aspart insulin to help with blood sugar control
Don't change anything
Before placing a patient with onychomycosis on a pulsed dose of itraconazole (Sporanox), which laboratory values does the nurse practitioner obtain?
- Liver function studies.
- Platelet count.
- Renal function studies.
- White blood cell count.
liver function studies
A 68-year-old patient has sustained an unintended weight loss of 15 lb (6.8 kg) over the last two months but reports feeling well. The patient's problems include depression, tobacco abuse, obesity, and dyslipidemia. His medications are sertralizine (Zoloft), simvastatin (Zocor), and famotidine (Pepcid). The nurse practitioner performs which three actions?
- Adds a probiotic.
- Conducts a depression screening.
- Decreases the dosage of the statin medication.
- Obtains a chest x-ray.
- Orders a thyroid-stimulating hormone.
Conducts a depression screening
Obtains a chest x-ry
orders a TSH
To improve the quality of clinical practice, the adult-gerontology primary care nurse practitioner:
-charges a fee for patients who arrive late to clinic appointments.
-disseminates research study results to colleagues.
-expresses opinions about alternative therapies with patients who consider such treatments.
-schedules time during clinic hours to meet with pharmaceutical representatives.
disseminates research study results to colleagues.
The adult-gerontology primary care nurse practitioner plans to provide smoking cessation education at a community center to older adults and their families. The nurse practitioner designs the program based on knowledge that older adult smokers:
- are likely to be optimistic about their ability to quit.
- are more likely to be successful at quitting than younger smokers.
- have a decreased risk of morbidity and mortality than do younger smokers.
- receive more instruction to quit from health care providers than younger smokers.
are more likely to be successful at quitting than younger smokers.
A 71 yo white male with well controlled Diabetes on Metformin and Jardiance, HTN controlled on two medications and hyperlipidemia is in clinic for a routine exam. You are reviewing his chart and realize he is not on a statin. His LDL is 110. You decided to:
- start a high intensity statin such as Atorvastatin or Rosuvastatin
- avoid statin therapy since he is over 70 years old
- start a low intensity statin since he is not high risk
-
Start a high intensity statin such as Atorvastatin or Rosuvastatin.
A 64-year-old, female patient has a two-week history of nausea, vomiting, decreased weight, and abdominal pain. The patient's physical examination reveals abdominal tenderness with icteric sclerae and skin. Which laboratory test confirms active hepatitis B?
- Antibody.
- Enzyme-linked immunosorbent assay.
- Immune globulin G.
- Surface antigen.
Surface Antigen
What factors does the nurse practitioner need to consider when discussing advanced care planning with a patient?
- Autonomy and patient safety are rarely competitive considerations.
- Decisions regarding a health care representative are a family group decision.
- Family members are not integral components in care planning.
- Trust and rapport with patients are key to patient satisfaction in decisions for care.
Trust and rapport with patients are key to patient satisfaction in decisions for care.
The adult-gerontology primary care nurse practitioner conducts a small group class on weight management. The nurse practitioner anticipates that the patient who may have the greatest difficulty implementing the counseling is the:
-extroverted patient raising his or her grandchildren.
-introverted patient who does not speak in the group.
-personable patient who lives with his or her children.
- worried patient whose son is serving in military
worried patient whose son is serving in military
The adult-gerontology primary care nurse practitioner working in an urban community health center recognizes that asthma-related health issues commonly result in higher morbidity and mortality for persons with:
- alcohol dependency.
- lower socioeconomic status.
- persistent social isolation.
- recent immigrant status.
lower socioeconomic status
Eight nurse practitioner students have completed the requirements for their Adult-Gero Nurse Practitioner Program. These eight students are excited to graduate, but must answer one more question correctly before they can officially be eligible to take their boards.
Where was the first Nurse Practitioner Program Founded and who started it?
- In Grand Forks by Jackie, Amy and Karen at UND Grand Forks
- Loretta Ford and Henry Silver University of Colorado
- By Meredith Grey in Seattle Washington
- There was no first, multiple schools were started at the same time
Loretta Ford and Henry Silver University of Colorado