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
The most effective treatment to delay the deterioration of cognition in patients with Alzheimer's disease is:
- A. coenzyme Q-10 and an anti-inflammatory diet.
- B. antidepressants and regular exercise.
- C. cholinesterase inhibitors (ChEIs) and brain exercises (e.g., brain teasers).
- D. atypical neuroleptics and behavioral therapy.
Explanation
Cholinesterase inhibitors (ChEIs), such as donepezil, rivastigmine, and galantamine, are the first-line medications approved for the treatment of Alzheimer's disease. They work by increasing the levels of acetylcholine, a neurotransmitter involved in memory and learning, thereby helping to slow cognitive decline. Brain exercises, like puzzles and memory games, can also help maintain cognitive function and potentially delay further deterioration. Other options, such as coenzyme Q-10, antidepressants, atypical neuroleptics, and behavioral therapy, do not have the same proven effect in delaying cognitive decline in Alzheimer's disease.
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 68-year-old patient presents with a cough that has been present for 9 weeks. On exam, the nurse practitioner palpates an enlarged right supraclavicular lymph node. The differential diagnosis list should include:
- A. chronic obstructive pulmonary disease (COPD).
- B. community-acquired pneumonia.
- C. acute bronchitis.
- D. lung cancer.
Explanation
An enlarged supraclavicular lymph node in a patient with a persistent cough raises concern for a more serious underlying condition, such as lung cancer. The supraclavicular lymph nodes are part of the body's defense system and can become enlarged when cancer cells spread from nearby organs, including the lungs. In lung cancer, persistent cough and lymphadenopathy are common findings. While COPD (A), community-acquired pneumonia (B), and acute bronchitis (C) can cause chronic cough, they are less likely to cause an enlarged supraclavicular lymph node. COPD is generally associated with chronic symptoms and often presents with other signs like wheezing or shortness of breath, but lymphadenopathy is not typically a feature. Pneumonia and bronchitis are more acute in nature and typically do not cause persistent lymph node enlargement unless there is an associated infection or malignancy. Therefore, lung cancer is the most concerning condition to consider in this patient's differential diagnosis.
Primary hypoparathyroidism is a condition of parathyroid hormone (PTH) deficiency in which:
- A. Vitamin D levels fall below the reference range.
- B. Ionized calcium concentration in the extracellular fluid falls below the reference range.
- C. The parathyroid hormone concentration is low and the serum calcium concentration is elevated.
- D. Hyperalbuminemia causes a drop in total calcium concentration.
Explanation
In primary hypoparathyroidism, the parathyroid glands fail to produce enough parathyroid hormone (PTH), which is responsible for regulating calcium and phosphate levels in the body. PTH deficiency leads to low ionized calcium levels in the extracellular fluid (the active form of calcium in the blood). Without enough PTH, the kidneys do not retain calcium, and the bones do not release calcium into the bloodstream as they should, leading to hypocalcemia (low blood calcium).
Which of the following signs or symptoms is typical of hypothyroidism?
- A. Cold intolerance
- B. Heat intolerance
- C. Weakness
- D. Increased perspiration
Explanation
Cold intolerance (A) is a classic symptom of hypothyroidism. People with hypothyroidism have an underactive thyroid, which leads to a slower metabolism and difficulty regulating body temperature, making them more sensitive to cold. Heat intolerance (B) is typically seen in hyperthyroidism, where an overactive thyroid causes an increased metabolism and the body becomes more sensitive to heat. Weakness (C) is also common in hypothyroidism due to muscle weakness associated with the condition, but cold intolerance is more specifically associated with it. Increased perspiration (D) is generally seen in hyperthyroidism due to an elevated metabolic rate, not in hypothyroidism.
When counseling the sex partner of a symptomatic patient with gonorrhea, the NP should advise that to prevent reinfection, unprotected sexual intercourse should be avoided for:
- A. the next 24 hours.
- B. 3 days.
- C. 7 days.
- D. 1 month.
Explanation
To prevent reinfection, it is important for the sex partner to avoid unprotected sexual intercourse for 7 days after receiving treatment for gonorrhea. Both the symptomatic patient and their sexual partner(s) should be treated concurrently to prevent reinfection. Additionally, the patient should complete their prescribed antibiotic regimen and avoid sexual activity until they and their partner(s) have completed treatment and are symptom-free. 24 hours (A) or 3 days (B) would be too short a time frame to ensure that the infection is fully treated, and 1 month (D) is excessive once both partners have been adequately treated.
A 63-year-old homeless male patient with a cough is suspected of having pulmonary tuberculosis. To confirm the diagnosis, the nurse practitioner would need to order a:
- A - Mantoux skin test.
- B - chest X-ray.
- C - sputum specimen.
- D - interferon-gamma release assay (IGRA).
Explanation
To confirm the diagnosis of pulmonary tuberculosis (TB), the most definitive test is to obtain a sputum specimen. This allows for direct identification of Mycobacterium tuberculosis through smear microscopy or culture, which is the gold standard. Sputum testing can also be used for drug susceptibility testing, which is critical for determining the appropriate treatment regimen.
Current evidence suggests that the risk of developing Alzheimer's disease may be reduced or delayed by:
- A - treating testosterone deficiency.
- B - treating estrogen deficiency.
- C - eating a gluten-free diet.
- D - increasing physical activity.
Explanation
Increasing physical activity has been shown in numerous studies to have a protective effect against the development of Alzheimer's disease. Regular exercise, particularly aerobic exercise, improves brain health, enhances cognitive function, and helps reduce the risk of neurodegenerative diseases. Physical activity increases blood flow to the brain, supports the growth of new neurons, and helps manage other risk factors such as vascular health and diabetes, which are linked to Alzheimer's disease.
A 24-year-old female is diagnosed with trichomoniasis. In addition to initiating metronidazole (Flagyl), the nurse practitioner instructs the patient:
- A - to avoid spermicides.
- B - that it was likely contracted from a partner in the last 6 weeks.
- C - to clean sexual aids or toys.
- D - that there is no need to treat female partners.
Explanation
Trichomoniasis is a sexually transmitted infection caused by the protozoan parasite Trichomonas vaginalis. In addition to initiating treatment with metronidazole (Flagyl), it is important to advise the patient to clean sexual aids or toys thoroughly, as they can harbor the organism and contribute to reinfection. The parasite can survive on these surfaces, so cleaning them properly helps reduce the risk of transmission.
A patient who presents with fluid retention, pruritus, and breath with an ammonia odor is likely to have:
- A. Helicobacter pylori infection.
- B. heart failure.
- C. pancreatitis.
- D. uremia.
Explanation
Uremia is a condition that occurs when there is a build-up of waste products, including nitrogen, in the blood due to kidney dysfunction. Common symptoms include fluid retention, pruritus (itching), and uremic fetor (breath with an ammonia odor). The ammonia odor in the breath is a characteristic sign of uremia. Heart failure (B) can cause fluid retention but does not typically present with ammonia breath or pruritus. Helicobacter pylori infection (A) is linked to gastric issues and ulcers, and pancreatitis (C) presents with abdominal pain, not the symptoms described here.
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