NUR 611 AP1 25 FL2 Adult Health
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Free NUR 611 AP1 25 FL2 Adult Health Questions
Debbie is a 43-year-old female being evaluated for a wrist injury. The clinician is assessing for median nerve compression by having Debbie maintain forced flexion of her wrist for 1 minute with the dorsal surface of each hand pressed together. Which of these tests did the clinician just perform?
- A. Finkelstein’s test
- B. Phalen’s test
- C. Tinel’s sign
- D. Allen’s test
Explanation
Phalen’s test is used to diagnose carpal tunnel syndrome, which involves compression of the median nerve at the wrist. The test is performed by flexing the wrists and pressing the dorsal surfaces of both hands together for about 60 seconds. A positive result occurs when the patient experiences tingling, numbness, or pain in the thumb, index, middle, or radial half of the ring finger—areas supplied by the median nerve.
After 6 months of Synthroid therapy, the clinician should expect which result in the repeat thyroid-stimulating hormone studies?
- A. Elevated
- B. Undetectable
- C. Low
- D. Normal
Explanation
Synthroid (levothyroxine) replaces deficient thyroid hormone in patients with hypothyroidism. After about 6 months of consistent therapy and proper dosage adjustment, the thyroid-stimulating hormone (TSH) level should return to the normal reference range (typically 0.4–4.5 mIU/L). This indicates adequate thyroid hormone replacement and restoration of euthyroid function. TSH normalization is the primary goal of therapy and guides ongoing dose management and monitoring.
Based on these patients’ histories, which of the following should receive fungal serology testing for their chronic cough?
- A. A patient with a history of celiac disease
- B. A patient with a history of AIDS
- C. A patient with a history of sickle cell disease
- D. A patient with a history of multiple sclerosis
Explanation
A patient with AIDS is immunocompromised and highly susceptible to opportunistic fungal infections such as histoplasmosis, cryptococcosis, or coccidioidomycosis. These infections can cause chronic cough, fever, and weight loss, and fungal serology or antigen testing is essential for diagnosis. Early detection and antifungal therapy are critical, as fungal infections can disseminate rapidly in immunosuppressed individuals.
Which of the following is associated with celiac disease (celiac sprue)?
- A. Malabsorption
- B. Esophageal ulceration
- C. Constipation
- D. Rectal bleeding
Explanation
Celiac disease (celiac sprue) is an autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. The immune reaction damages the villi of the small intestine, leading to malabsorption of nutrients such as iron, calcium, folate, and fat-soluble vitamins. This results in symptoms like chronic diarrhea, steatorrhea (fatty stools), weight loss, and fatigue. Long-term complications include osteoporosis, anemia, and infertility if untreated.
Which ethnic group has the highest lung-cancer incidence and mortality rates?
- A. Caucasian women
- B. African American men
- C. Asian men
- D. Scandinavian men and women
Explanation
African American men have the highest incidence and mortality rates from lung cancer in the United States. This disparity is linked to a combination of higher smoking prevalence, limited access to early screening and healthcare, socioeconomic barriers, and delayed diagnosis. Studies show that African American men are often diagnosed at more advanced stages, which significantly impacts survival outcomes. Culturally tailored prevention, early screening (such as low-dose CT scans), and smoking cessation programs are critical for reducing these rates.
Which of the following treatments is appropriate for a patient who has acute otitis media and has an allergy to penicillin?
- A. Suprax 400 mg daily for 7 days
- B. Augmentin 875 mg two times daily for 10 days
- C. Zithromax 500 mg on day 1, and then 250 mg daily for 4 days
- D. Amoxicillin 500 mg every 8 hours for 10 days
Explanation
Azithromycin (Zithromax) is a macrolide antibiotic that serves as an effective alternative for patients allergic to penicillin. It covers common pathogens in acute otitis media, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Its convenient once-daily dosing and short course improve compliance while avoiding the risk of allergic reactions associated with beta-lactam antibiotics like penicillins and cephalosporins.
Which of the following statements concerning the musculoskeletal examination is true?
- A. The uninvolved side should be examined initially and then compared to the involved side.
- B. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.
- C. The part of the body that is causing the patient pain should be examined first.
- D. When possible, the patient should not be asked to perform active ROM exercises to avoid causing pain.
Explanation
In a proper musculoskeletal examination, the clinician should first assess the uninvolved (normal) side to establish a baseline for comparison. This approach allows for the detection of subtle abnormalities in strength, range of motion (ROM), or symmetry when the injured or painful side is examined next. It also helps put the patient at ease before examining the more painful area. Comparison is key for accurate musculoskeletal assessment.
A 28-year-old patient is seen in the clinic with colicky abdominal pain, particularly after meals. She has frequent constipation, flatulence, and abdominal distension. Which of the data make a diagnosis of diverticulitis unlikely?
- A. Frequent constipation
- B. Her age
- C. Pain after meals
- D. Colicky abdominal pain
Explanation
Diverticulitis is uncommon in individuals under 40 years old, making age 28 atypical for this diagnosis. The disease is most prevalent in adults over 50, especially in those with low-fiber diets and chronic constipation. While her symptoms—abdominal pain, constipation, flatulence, and distension—are consistent with diverticular disease, her young age makes diverticulitis unlikely and suggests other conditions such as irritable bowel syndrome (IBS) or functional bowel disorder should be considered instead.
Fredericka is a 40-year-old Hispanic female with a history of diabetes mellitus, hypertension, and HIV. She has a tuberculosis (TB) skin test. What is the smallest diameter of induration that would indicate a positive result?
- A. 10 mm
- B. 8 mm
- C. 5 mm
- D. 2 mm
Explanation
An induration of 5 mm or greater is considered positive for tuberculosis (TB) in individuals at high risk, including those who are HIV-positive, have recent contact with active TB cases, or are immunocompromised. HIV infection significantly weakens the immune system, lowering the threshold for a positive result because the body’s reaction to the tuberculin antigen is diminished. This means even a small induration represents a meaningful immune response and warrants further evaluation with chest imaging and sputum testing.
Which of the following statements is true concerning the management of the client with a herniated disc?
- A. Most disc hernias require opioids for long-term pain relief.
- B. An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred.
- C. Intolerable pain for more than a 3-month period is an indication for surgical intervention.
- D. Muscle relaxants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use.
Explanation
In clients with lumbar disc herniation, most cases improve with conservative management, including rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and physical therapy. However, if radicular leg pain (sciatica) persists beyond 3 weeks despite these measures, epidural corticosteroid injections can provide significant short-term relief by reducing inflammation around the affected nerve root. This approach often delays or prevents the need for surgery and helps patients regain function.
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