NUR 611 AP1 25 FL2 Adult Health at St. Thomas University

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Ace Your Test with NUR 611 AP1 25 FL2 Adult Health Actual Questions and Solutions - Full Set

Free NUR 611 AP1 25 FL2 Adult Health at St. Thomas University Questions

1.

A 28-year-old patient is seen with complaints of diarrhea. Which of the following responses to the history questions would help the primary-care provider (PCP) establish the diagnosis of irritable bowel syndrome (IBS)?

  • A. Feels relief after urination​
  • B. Pain wakes up patient from sleep​
  • C. Pain is precipitated by eating​
  • D. Defecates in the middle of the night

Explanation

Explanation
In irritable bowel syndrome (IBS), abdominal pain or discomfort is often triggered by eating and relieved by defecation. The Rome IV diagnostic criteria emphasize recurrent abdominal pain associated with altered bowel habits—diarrhea, constipation, or both—without structural or biochemical abnormalities. Meals can stimulate gut motility and hypersensitivity, causing postprandial cramping, bloating, and urgency that support an IBS diagnosis.
2.

Which of the following is essential for diagnosing thyroid cancer?

  • A. Thyroid ultrasound​
  • B. Magnetic resonance imaging​
  • C. Fine needle aspiration biopsy​
  • D. Computed tomography scan

Explanation

Explanation
A fine needle aspiration (FNA) biopsy is the definitive diagnostic test for thyroid cancer. It involves using a thin needle to extract cells from a thyroid nodule for cytological examination under a microscope. This procedure helps determine whether a nodule is benign or malignant, guiding treatment decisions such as surgical removal or monitoring. It is minimally invasive, highly accurate, and considered the gold standard for confirming thyroid malignancy.
3.

A male patient with diabetes asks the clinician why he needs to check his blood sugar at home even when he feels good. Which response by the clinician would be most appropriate?

  • A. "Regularly checking blood sugar will help you."​
  • B. "Monitoring glucose will promote a sense of connectedness."​
  • C. "Because you know it is the right thing to do for your disease."​
  • D. "Control of glucose will help postpone or delay complications."

Explanation

Explanation
The most appropriate and therapeutic response emphasizes the importance of glucose control in preventing or delaying long-term complications of diabetes, such as neuropathy, nephropathy, retinopathy, and cardiovascular disease. Even when patients feel well, blood glucose can fluctuate silently. Regular monitoring allows for timely adjustments in diet, medication, and activity, maintaining glucose within the target range and preserving overall health.
4.

George has COPD and an 80% forced expiratory volume in 1 second. How would you classify the severity of his COPD?

  • A. Stage 3 severe COPD​
  • B. Stage 5 very severe COPD​
  • C. Stage 1 mild COPD​
  • D. Stage 2 moderate COPD

Explanation

Explanation
According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, Stage 1 (mild) COPD is defined as a FEV₁ ≥ 80% of predicted after bronchodilator use. Patients may have mild airflow limitation and chronic cough or sputum production but often are asymptomatic. Management focuses on smoking cessation, vaccination (influenza and pneumococcal), and bronchodilator use as needed to prevent progression.
5.

The barrel-chest characteristic of emphysema is a result of:

  • A. Chronic coughing​
  • B. Polycythemia​
  • C. Pulmonary hypertension​
  • D. Hyperinflation

Explanation

Explanation
In emphysema, the destruction of alveolar walls and loss of lung elasticity trap air in the lungs, causing hyperinflation. Over time, this expands the thoracic cavity, flattening the diaphragm and giving the chest a rounded or “barrel” appearance. The increased anteroposterior diameter reflects structural adaptation to chronic air trapping and lung overdistention. This feature often accompanies dyspnea, decreased breath sounds, and prolonged expirations characteristic of chronic obstructive pulmonary disease (COPD).
6.

The patient with type 1 diabetes is exhibiting Kussmaul respirations, anorexia, fatigue, and increased thirst. Which condition should the clinician manage?

  • A. Hyperosmolar hyperglycemic syndrome​
  • B. Hypoglycemia​
  • C. Somogyi effect​
  • D. Diabetic ketoacidosis

Explanation

Explanation
Diabetic ketoacidosis (DKA) is an acute, life-threatening complication primarily seen in type 1 diabetes mellitus. It results from insulin deficiency, causing the body to break down fats for energy, leading to ketone accumulation and metabolic acidosis. The hallmark features include Kussmaul respirations (deep, rapid breathing to compensate for acidosis), anorexia, fatigue, and polydipsia (increased thirst). Immediate management includes IV insulin therapy, fluid replacement, and electrolyte correction, particularly potassium.
7.

Which of these patients needs a cervical cancer screening?

  • A. Sondra, a 66-year-old patient who had a negative Pap with negative HPV 11 years, 6 years, and 1 year ago​
  • B. Lisa, a 45-year-old patient who has atypical squamous cells of uncertain significance (ASCUS) and a human papillomavirus (HPV) positive Pap 1 month ago​
  • C. Gillian, a 33-year-old patient who had a negative Pap with negative HPV 5 years ago​
  • D. April, a 26-year-old patient who had a negative Pap with negative HPV 1 year ago

Explanation

Explanation
Women aged 30 to 65 should have cervical cancer screening with a Pap and HPV co-test every 5 years or a Pap test alone every 3 years. Gillian’s last co-test was 5 years ago, which means she is due now for her next screening. Regular screening during this age range helps detect early precancerous or malignant cervical cell changes associated with HPV infection.
8.

A 26-year-old woman tells the clinician that she has endometriosis because she has frequent pelvic pain. The clinician also should consider which of these differential diagnoses?

  • A. Kidney stones​
  • B. Diverticulitis​
  • C. Cholelithiasis​
  • D. Ovarian cysts

Explanation

Explanation
Ovarian cysts are a key differential diagnosis in women presenting with pelvic pain, as they can cause symptoms similar to endometriosis, including cyclic pelvic discomfort, pressure, or sudden sharp pain if the cyst ruptures or twists (torsion). Both conditions affect reproductive-age women and may present with pain that worsens during menstruation. Pelvic ultrasound is essential for distinguishing between endometriosis (characterized by endometriomas or adhesions) and functional or pathological cysts.
9.

Which of the following signs would a health-care provider expect to see in a patient with Parkinson-plus disorder?

  • A. Bradykinesia​
  • B. Postural instability​
  • C. Resting tremor​
  • D. Rigidity

Explanation

Explanation
Bradykinesia, or slowness of voluntary movement, is the cardinal clinical feature of all parkinsonian syndromes, including Parkinson-plus disorders such as progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and corticobasal degeneration (CBD). It manifests as delayed initiation of movement, decreased amplitude of repetitive actions, and reduced facial expression. The presence of bradykinesia is required for the diagnosis of any parkinsonian syndrome, making it the most consistent finding across all types.
10.

Why do you suspect that your patient may have a decreased response to the tuberculin skin test (TST)?

  • A. She is an adolescent.​
  • B. She has been on a long-term corticosteroid therapy.​
  • C. She just got over a cold.​
  • D. She is on a high-protein diet.

Explanation

Explanation
Long-term corticosteroid therapy suppresses the immune system, particularly the cell-mediated immune response required for a positive tuberculin skin test (TST). Corticosteroids inhibit T-lymphocyte activation and cytokine release, reducing delayed-type hypersensitivity reactions. As a result, patients on chronic corticosteroids may have a false-negative TST despite latent or active tuberculosis infection. Immunosuppression from corticosteroids can also increase susceptibility to infections, necessitating alternative TB testing methods like interferon-gamma release assays (IGRAs).

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