NR 601 Final exam 2023 2024
QUESTIONS AND ANSWERS GRADED A
Mr. A, experienced a brief onset of right sided weakness, slurred speech and confusion
yesterday. The symptoms have resolved and the CT is normal. What is the next step of
the plan for Mr. A?
a. assure the patient that he will not experience the symptoms again
b. identify modifiable cardiovascular risk factors
c. order ASA 81mg stat
d. order a stat EEG and administer O2 by mask - CORRECT ANSWER b. identify
modifiable cardiovascular risk factors
A 56-year old male patient screened for diabetes has a fasting plasma glucose level of
96mg/dl. The nurse practitioner management plan includes:
a. repeat fasting plasma glucose in three years
b. prescribe Metformin 500mg po BID
c. repeat fasting plasma glucose in one year
d. refer to ophthalmology for eye exam - CORRECT ANSWER a. repeat fasting
plasma glucose in three years
RW, a 57 year old native American female, presents to the office. RW states she feels
irritable and has difficulty concentrating as well as fallingn asleep and staying aleep.
She states she is worried about her finances, her husband has just lost his job. The NP
diagnoses anxiety. The NP prescribes a first line treatment which is
a. Diazepam
b. Clonazepam
c. Ariprprazole
d. Paroxetine - CORRECT ANSWER d. Paroxetine
The most common sustained rhythmic disorder, which consists of fibrillatory p waves is:
a. AV block
b. atrial tachycardia
c. atrial fibrillation
d. atrial flutter - CORRECT ANSWER c. atrial fibrillation
According to the Sexually presentation, atrophic vaginitis
a. the symptomsm are the same for each woman
b. creates a more acidic vaginal environment

c. is a contributing factor for frequent urinary tract infections
d. is not treated with vaginal lubricants - CORRECT ANSWER c. is a contributing
factor for frequent urinary tract infections
Which of the following is the most appropriate screening tool for delirium?
a. St Louis University Mental Status Exam (SLUMS)
b. Montreal Cognitive Assessment
c. Lawton Scale of instrumental Activities of Daily Living
d. Confusion Assessment Model - CORRECT ANSWER d. Confusion Assessment
Model
A drug that can be used to treat two very common symptoms in a dying patient (pain
and dyspnea_ is:
a. lorazepam
b. Gabapentin
c. Methadone
d. Morphine - CORRECT ANSWER d. Morphine
Which of the following would you recommend annually for the elderly type 2 diabetic?
a. periodic visits to a gastroenterologist
b. colonoscopy
c. follow up with a urologist
d. eye exam with an opthlamologist - CORRECT ANSWER d. eye exam with an
opthlamologist
Which characteristic of delerium helps to distinguish it from dementia?
a, short term memory impairment
b. personality changes
c. acute onset
d. impaired attention - CORRECT ANSWER c. acute onset
The majority of patients enrolled in hospice care die:
a. in the hospital
b. in an inpatient hospice facility
c. in a nursing home
d. at home - CORRECT ANSWER d. at home
A middle aged patient has been diagnosed with Parkinson's disease. What influences
the nurse practitioners descision to begin pharmacological treatment for this patient?
a. medications initiated at first sign of unilateral involvement

b. gait instability requiring the use of a cane
c. intentional tremors
d. symptoms interfering with functional ability - CORRECT ANSWER d. symptoms
interfering with functional ability
Which of the following is a role of the advanced practice nurse in palliative cancer care?
a. detecting cancer in asymptomatic paitents or those with specific symptoms
b. arranging for follow up including patiennts
c. identifying and managing complications of care
d. all of the above - CORRECT ANSWER d. all of the above
A 58 year old Caucasian mane with type 2 diabetes mellitus presents to the clinic as a
new patient. He takes metformin 500mg twice a day. His last Hgb A1c was 7%. He is up
to date on eye and foot examinations. His BP is 142/96. According to ACC 2017
guidelines for high blood pressure in adults, what is the most appropriate first line
medication?
a. lisinopril
b. furosemide
c. amlodipine
d. clonidine - CORRECT ANSWER a. lisinopril
An older male patient is experiencing acute onset of right sided weakness, slurred
speech and confusion. What should the nurse practitioner do promptly?
a. order an EKG and administer O2 by cannula immediately
b. Do a through medication review and stat blood sugar
c. evaluate for a stroke and arrange transport to the hospital right away
d. administer an aspirin by mouth - CORRECT ANSWER c. evaluate for a stroke and
arrange transport to the hospital right away
The NP knows that medications can trigger or worsen heart failure. With this knowledge
in mind, the NP will avoiding prescribing the following classes of medications
a. benzodiazepines
b. macrolides
c. muscle relaxants
d. NSAIDS - CORRECT ANSWER d. NSAIDS
MG, a 60 year old female presents with complaints of her "heart flipping in her chest"
The NP wants to evaluate for arrhythmia. The nP knows that the cornerstone for
arrhythmia evaluation includes:
a. electrocardiogram
b. physical examination

c. all options are appropriate
d. history - CORRECT ANSWER c. all options are appropriate
The elderly are at high risk for delerium because of:
a. multiple medical problems
b. multisensory deficits
c. polypharmacy
d. all of the above - CORRECT ANSWER d. all of the above
A 68 year old woman presents with a complaint of urine leakage whenever she
sneezes, laughs or strains for the past 4 months. She denies dysuria, frequency and
nocturia. US dipstick is negative for RBC's leukocyte esterase, nitrates, ketones and
urobilinogen. What is the diagnosis?
a. stress incontinence
b. urinary incontinence
c. urge incontinence
d. overflow incontninence - CORRECT ANSWER a. stress incontinence
Which of the following signs or symptoms are not characteristics of delirium
a. patient is coherent
b. short duration
c. sudden onset
d. symptoms are worse in the evenings - CORRECT ANSWER a. patient is coherent
A 52 year old female patient screened for diabetes has a fasting plasma glucose level of
123 mg/dl. The nurse practitioners plan includes:
a. repeat fasting glucose in 1 month
b. prescribe memformin 500mg BID po
c. repeat fasting plasma glucose in one year
d. repeat fasting glucose in three years - CORRECT ANSWER c. repeat fasting
plasma glucose in one year
According to the palliative care presentation, most elderly patients die:
a. alone
b. at home
c. in institutions
d. in pain - CORRECT ANSWER c. in institutions
Older adults with dementia sometimes suffer from agnosia, which is defined as the
inability to

a. remember events and places
b. understand language
c. use language
d. recognize objects - CORRECT ANSWER d. recognize objects
When treating depression associated with dementia, which of the following would be a
poor choice and not be prescribed
a. desimpramine
b. amitryptyline
c. fluoxitine
d. mirtazapine - CORRECT ANSWER b. amitryptyline
Male patient presents with a BMI of 30 presents to the office for an annual exam. You
are reviewing the lab results. You ordered a CMP as part of routine labs. The fasting
glucose was 130. Your next action is:
a. repeat the fasting glucose
b. start metformin 500mg BID
c. repeat fasting glucose in 1 year
d. call the patient and report lab results as normal - CORRECT ANSWER a. repeat the
fasting glucose
The task of grieving include all of the following except
a. begin to disengage
b. acknowledge the reality of death
c. work through the pain of grief
d. restructure relationships - CORRECT ANSWER a. begin to disengage
All of the following are true statements regarding elder abuse except:
a. a new STI in an elderly patient can be a sign of abuse
b. persons over 80 years of age are at highest risk for abuse
c. missing scheduled appointments and delays in medical care are common
d. common signs of abuse include decreased anxiety and depression - CORRECT
ANSWER d. common signs of abuse include decreased anxiety and depression
Hospice care differs from palliative care in that:
a. it cannot be provided in the nursing home
b. the majority of those admitted to hospice die within 7 days
c. it is not covered by insurance
d. it is designed for the last six months of life - CORRECT ANSWER d. it is designed
for the last six months of life

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When assessing an elderly client who reports a tremor, which assessment findings
would be most reliable in identifying Parkinsons disease?
a. congwheel rigidity, bradykinesia, and macrorgraphia
b. any presence of fever
c. symptoms of slowed movement, unstable angina and tremor
d. resting tremor, slow unsteady gait and cogwheel rigidity - CORRECT ANSWER d.
resting tremor, slow unsteady gait and cogwheel rigidity
How dies womans anatomy make them more susceptible to UTI's
a. the female urethra is shorter
b. aymptomatic UTI's do not resolve themselves without treatment
c. women tend to get UTI's when they are pregnant
d. there is a longer distance between the urethra and anus - CORRECT ANSWER a.
the female urethra is shorter
Mrs. Smith, a 64 year old woman presents to the clinic for the first time and complains
of uruinary incontinece and dyspareunia. She went through menipause 10 years ago
without any hormone replacement therapy and had a hysterectomy for a fibroid. Her
mother had a hip fracture at 87 years of age. The patiennt's most recent mammogram
was 7 years ago and no known family history of breast cancer. She is not taking any
medications. Her physical exam is unremarkable except for findings consistant with
atrophic vaginitis. You prescribed topical hormone replacement therapy today. Which of
the following evaluations should also be ordered today
a. bone mineral density measurement
b. mammogram - CORRECT ANSWER b. mammogram
All of the following patients should be screened for diabetes except:
a. a 44 year old caucasian male with hypertension
b. a 42 year old femal on disability from back injury from back injury who is unable to
exercise
c. an overweight middle aged african american woman with a family history of type 2
diabetes mellitus
d. an obese hispanic man - CORRECT ANSWER a. a 44 year old caucasian male with
hypertension
A 60 year old obese male client has type 2 diabetes mellitus and a lipid panel of
TC=250 HDL=32 LDL=165. The nurse practitioner teaches the patient about his
modifiable cardiac risk factors, which include:
a. diabetes, obesity and hyperlipidemia
b. advancing age, diabetes, hyperlipidemia, and male gender
c. hyperlipidemia, smoking and family history of heart disease

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