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 65-year-old male has acute prostatitis. Which of the following is NOT considered a possible complication?
- Prostatic abscess
- Epididymitis
- Bacteremia
- Erectile dysfunction
Explanation
Acute prostatitis is an infection of the prostate gland, typically caused by bacteria. Possible complications of acute prostatitis include prostatic abscess (A), bacteremia (C), and erectile dysfunction (D). A prostatic abscess can form when the infection causes localized pus collection, bacteremia can occur if the infection spreads into the bloodstream, and erectile dysfunction can be a consequence due to inflammation and damage to the prostate or surrounding structures. Epididymitis (B) is not a direct complication of prostatitis. Epididymitis refers to the inflammation of the epididymis, which is usually a separate condition but may occur in conjunction with other urinary tract infections or sexually transmitted infections.
A 20-year-old patient presents with a complaint of painful vaginal "sores." This is the patient's first episode of genital herpes. The recommended course is:
- to allow spontaneous resolution without pharmacologic treatment.
- oral acyclovir (Zovirax) 400 mg TID x 7-10 days.
- oral acyclovir (Zovirax) 800 mg TID for 3 days.
- penciclovir (Denavir) cream applied every 2 hours while awake, for 3 days.
Explanation
For a first episode of genital herpes, antiviral therapy with oral acyclovir is recommended to reduce the severity and duration of symptoms, accelerate healing, and decrease the risk of transmission. The standard dosing for a first episode is 400 mg TID for 7-10 days. Early treatment during the initial outbreak can help prevent complications and promote faster resolution of the lesions.
Which class of antihypertensive agents should not be considered as initial therapy for a 43-year-old patient who has uncomplicated essential hypertension?
- Angiotensin-converting enzyme (ACE) inhibitors
- Beta blockers
- Calcium channel blockers
- Angiotensin receptor blockers
Explanation
Beta blockers are generally not recommended as first-line therapy for uncomplicated essential hypertension. While they can be effective in lowering blood pressure, they are less effective than other classes of antihypertensive medications (such as ACE inhibitors, calcium channel blockers, and angiotensin receptor blockers) in preventing cardiovascular events like stroke or heart attack in patients with uncomplicated hypertension. Beta blockers are usually reserved for specific indications, such as post-myocardial infarction, heart failure, or arrhythmias.
A widowed 85-year-old female was recently moved from her home of 65 years to a bedroom in her adult child's home. According to reports by family members, she is now "cantankerous," gets "mixed up" easily, and cries for no apparent reason. The factor or factors in the patient history that are NOT consistent with delirium are:
- insidious onset and chronic progressive course.
- a new anticholinergic medication.
- dehydration and/or malnutrition.
- recent changes in surroundings and routines.
Explanation
Delirium typically has an acute onset and a fluctuating course, with symptoms appearing suddenly and varying in intensity throughout the day. The insidious onset and chronic progressive course described in option A are more consistent with dementia, not delirium. Dementia develops gradually over months or years and is characterized by a slow and steady decline in cognitive function.
When considering a diagnosis of Addison's disease, the MOST appropriate diagnostic study is the:
- comprehensive metabolic panel.
- adrenocorticotrophic hormone (ACTH) stimulation test.
- thyroid-stimulating hormone (TSH) levels.
- prolactin testing.
Explanation
Addison's disease is characterized by primary adrenal insufficiency, where the adrenal glands do not produce enough cortisol. The ACTH stimulation test is the most appropriate diagnostic study for this condition. In this test, synthetic ACTH is administered, and the cortisol response is measured. In Addison's disease, the adrenal glands fail to produce an adequate cortisol response. A comprehensive metabolic panel may reveal electrolyte imbalances (e.g., hyponatremia, hyperkalemia), but it is not a definitive test for Addison’s disease. TSH levels and prolactin testing are used to assess thyroid and pituitary function, respectively, and are not specific to Addison's disease.
A 40-year-old patient is suspected of having a thyroid nodule. Initial evaluation begins with ordering a(n):
- CT scan and a thyroid-stimulating hormone level.
- thyroid-stimulating hormone (TSH) level and thyroid ultrasound.
- thyroid panel and thyroid scintigraphy.
- referral to a surgeon for fine-needle biopsy.
Explanation
The initial evaluation of a suspected thyroid nodule includes measuring TSH levels to assess thyroid function and determine if the nodule is functioning or non-functioning. If the TSH is normal or low, a thyroid ultrasound is the next step. The ultrasound provides detailed information about the nodule's size, shape, and characteristics (e.g., solid or cystic, presence of calcifications, etc.), which helps determine the likelihood of malignancy. If the ultrasound suggests suspicious features, fine-needle aspiration biopsy may be recommended for further evaluation.
The type of nursing leader who is comfortable making decisions without input from the team and has little tolerance for mistakes is known as a(n):
- servant leader
- democratic leader
- transformational leader
- autocratic leader
Explanation
An autocratic leader is characterized by a centralized decision-making style, where the leader makes decisions independently without seeking input from the team. This type of leader often has little tolerance for mistakes and prefers to maintain strict control over all aspects of the work. In nursing, an autocratic leader may impose their will on the team and expect compliance without much collaboration or feedback from others.
A 49-year-old male with chronic alcoholism presents with complaints of headache and poor appetite. In patients with chronic alcoholism, precursor cells cannot divide properly and large immature cells accumulate in the blood stream. The MOST likely cause of this process is:
- iron deficiency anemia.
- sideroblastic anemia.
- folate deficiency.
- drug-induced macrocytosis.
Explanation
In patients with chronic alcoholism, folate deficiency is the most likely cause of macrocytic anemia. Chronic alcohol use leads to poor dietary intake, reducing folate levels, which are necessary for the proper maturation and division of red blood cell precursors. Without adequate folate, these precursor cells cannot divide properly, causing them to accumulate in the bloodstream as large, immature cells. The macrocytic cells seen in folate deficiency are a result of impaired DNA synthesis. Folate deficiency is commonly seen in alcoholics due to malnutrition, decreased absorption in the gastrointestinal tract, and liver dysfunction, further exacerbating the anemia. Symptoms like headache and poor appetite in this patient are also consistent with folate deficiency anemia.
A 21-year-old sexually active male reports watery urethral discharge and complaints of dysuria. The MOST likely diagnosis is:
- prostatitis
- epididymitis
- urethritis
- chlamydial proctitis
Explanation
The most likely diagnosis in this patient is urethritis, characterized by symptoms of dysuria (painful urination) and watery urethral discharge. Urethritis is often caused by sexually transmitted infections (STIs), such as gonorrhea or chlamydia, and is common in sexually active young men. Prostatitis (A) typically presents with symptoms such as pelvic pain, fever, and difficulty urinating, along with painful ejaculation, but it is less likely to present with only dysuria and urethral discharge. Epididymitis (B) involves pain and swelling in the scrotum and is often associated with testicular pain rather than isolated dysuria and discharge. Chlamydial proctitis (D) is associated with anal infection and typically causes rectal pain, discharge, and bleeding, not urethral discharge.
Which of the following is the LEAST important to the history assessment of a young couple presenting for preconception counseling?
- Infectious diseases and vaccinations
- Health conditions and prescribed medications
- Over-the-counter and "natural" treatments
- 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.
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