APEA STU 25FL2 NUR 611 Univ Predictor Exam 111525 at St. Thomas University
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Free APEA STU 25FL2 NUR 611 Univ Predictor Exam 111525 at St. Thomas University Questions
A 15-year-old male presents with a slapped cheek appearance and complains of joint pain. Fifth disease would be confirmed by ordering a serology test for:
- A. Enterovirus
- B. Coxsackie A virus
- C. Parvovirus B19
- D. Rubeola
Explanation
Fifth disease, also known as erythema infectiosum, is caused by parvovirus B19. It is characterized by a "slapped cheek" rash on the face, often followed by a lacy, red rash on the body, and sometimes joint pain or swelling, especially in adolescents and adults. A serology test for parvovirus B19 would confirm the diagnosis by detecting antibodies to the virus.
A 32-year-old female has tested positive for primary syphilis. She reports having four partners in the past year. The patient should notify the partners with whom she has had sexual intercourse in the past:
- A. month.
- B. 3 months.
- C. 6 months.
- D. 12 months.
Explanation
For primary syphilis, which is characterized by the presence of a painless ulcer (chancre) at the site of infection, the Centers for Disease Control and Prevention (CDC) recommends that individuals with syphilis notify all sexual partners from the past 6 months. This is because the syphilis ulcer is highly infectious, and the window of potential transmission to partners extends back up to 6 months. Informing partners helps ensure that they are tested and treated to prevent further spread of the infection.
The nurse practitioner has reasonable cause to suspect physical and emotional neglect in a 7-year-old female. The next approach should be to:
- A - confront the child's guardians about possible abuse.
- B - refer to a child counselor to talk with the child alone.
- C - interview the child alone, in order to ask questions about the suspicious symptoms.
- D - report the possible abuse to the local child protection services agency.
Explanation
When suspecting child abuse or neglect, the first and most important step is to report the concern to the appropriate authorities, such as the local child protection services agency. It is the responsibility of healthcare professionals to ensure the safety of the child, and reporting suspected abuse or neglect is legally mandated in many jurisdictions. After reporting, child protective services will initiate an investigation and handle interviews or further actions.
The most common laboratory finding in a 16-year-old patient with infectious mononucleosis is:
- A. neutrophilia.
- B. thrombocytosis.
- C. lymphocytosis.
- D. monocytosis.
Explanation
Infectious mononucleosis, typically caused by the Epstein-Barr virus (EBV), commonly presents with lymphocytosis, characterized by an increased number of lymphocytes in the blood. This is a hallmark finding in the laboratory evaluation of a patient with mononucleosis. The lymphocytes may also appear atypical (reactive) in the blood smear. Neutrophilia (A), thrombocytosis (B), and monocytosis (D) are not as commonly seen in this condition. Lymphocytosis with atypical lymphocytes is a more specific and frequent finding in infectious mononucleosis.
When considering a diagnosis of contact dermatitis, the nurse practitioner would expect to observe:
- A. inflammation limited to the site of contact and systemic urticaria.
- B. absence of scaling, crusting and oozing at the affected area.
- C. redness, itching, papules, and surrounding erythema.
- D. a sudden appearance of urticaria over the entire body.
Explanation
Contact dermatitis is an inflammatory skin condition caused by direct contact with an irritant or allergen. The typical signs include redness, itching, papules, and surrounding erythema, often localized to the area of contact with the irritant or allergen. Scaling, crusting, and oozing may also occur in more severe cases. Systemic urticaria (A) is not a typical finding for contact dermatitis, which is primarily localized. Absence of scaling, crusting, and oozing (B) is not characteristic, as these symptoms can often be present. Urticaria (D) is more commonly associated with allergic reactions, not contact dermatitis.
A patient has been diagnosed with hypothyroidism and the NP prescribes thyroid hormone replacement therapy. When should the nurse practitioner check the patient's thyroid-stimulating hormone (TSH) level?
- A. 2 weeks
- B. 6 weeks
- C. 12 weeks
- D. 16 weeks
Explanation
After initiating thyroid hormone replacement therapy for hypothyroidism, the TSH level should be checked after 6 weeks. This allows enough time for the therapy to take effect and for the body to adjust. At this time, the NP can assess if the medication dosage needs adjustment. Typically, a follow-up check is done at 6 weeks to ensure the patient’s TSH level is within the desired range. A 12-week check (C) may be used in some cases, but 6 weeks is the standard time frame for the first check.
The therapeutic international normalized ratio (INR) for a patient taking warfarin (Coumadin) to manage chronic atrial fibrillation is expected to be:
- A. increased.
- B. decreased.
- C. the same as the partial thromboplastin time (PTT).
- D. three times the expected prothrombin time (PT).
Explanation
The therapeutic INR for a patient on warfarin (Coumadin) for chronic atrial fibrillation is typically targeted between 2.0 and 3.0. This corresponds to a prothrombin time (PT) that is approximately 2 to 3 times longer than the normal PT. The INR helps standardize PT results across different laboratories. Warfarin therapy increases the INR, but the most accurate description is that the INR is approximately three times the normal PT when it is therapeutically adjusted for anticoagulation therapy in patients with atrial fibrillation.
The nurse practitioner needs to order a wheelchair to assist with long-term transportation in a patient with left-sided hemiparesis resulting from a cerebrovascular accident. The nurse practitioner verifies that the patient has Medicare Part A coverage only. This provides payment for:
- A - inpatient/hospital services.
- B - outpatient/clinic services.
- C - durable medical equipment.
- D - prescription drugs.
Explanation
Medicare Part A primarily covers inpatient hospital services, including care in a hospital, skilled nursing facility, hospice, and some home health care. It does not typically cover outpatient services, durable medical equipment (such as wheelchairs), or prescription drugs, which are generally covered by other parts of Medicare. Durable medical equipment like wheelchairs is covered under Medicare Part B, not Part A, which would be important for the nurse practitioner to note when verifying coverage for the patient’s long-term transportation needs.
Which of the following is the LEAST important to the history assessment of a young couple presenting for preconception counseling?
- A. Infectious diseases and vaccinations
- B. Health conditions and prescribed medications
- C. Over-the-counter and "natural" treatments
- D. Age at menarche
Explanation
While age at menarche is important for understanding reproductive health history, it is least important in the context of preconception counseling compared to other factors. The other elements, such as infectious diseases and vaccinations (A), health conditions and prescribed medications (B), and over-the-counter and "natural" treatments (C), are crucial for evaluating the couple's health and any potential risks for pregnancy, including immune status, chronic conditions, and any substances that could affect fertility or pregnancy. Age at menarche is generally not as directly relevant for preconception counseling unless there are concerns about menstrual irregularities or fertility.
A 24-year-old patient is seen in urgent care for a sinus infection at the end of August. The patient is 4 weeks' pregnant and inquires about the influenza vaccine. The patient should be advised to:
- A - receive the vaccine around the first of October.
- B - avoid the vaccine in the first trimester.
- C - wait until the third trimester to receive the vaccine.
- D - avoid the vaccine during pregnancy.
Explanation
The influenza vaccine is recommended for all pregnant women during flu season, which typically begins in the fall. It is safe to administer the flu vaccine at any stage of pregnancy, including the first trimester, as it helps protect both the mother and the fetus from complications of influenza. The vaccine should ideally be received before flu activity peaks, which is typically around October. There is no evidence suggesting that receiving the flu vaccine in the first trimester poses any risk to the pregnancy, so the patient can safely receive it even at 4 weeks pregnant.
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