APEA STU 25FL2 NUR 611 Univ Predictor Exam 111525
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Free APEA STU 25FL2 NUR 611 Univ Predictor Exam 111525 Questions
A 54-year-old male reports seeing progressively distorted images that are not corrected by wearing eyeglasses. During the physical assessment, the NP identifies a decrease in peripheral vision. The diagnosis that is most likely in this patient is:
- A. uveitis.
- B. cataracts.
- C. glaucoma.
- D. retinoblastoma.
Explanation
The symptoms of progressively distorted images not corrected by eyeglasses and a decrease in peripheral vision are suggestive of glaucoma, particularly open-angle glaucoma. Glaucoma is a group of eye conditions that can lead to damage to the optic nerve, often due to increased intraocular pressure. The loss of peripheral vision is a characteristic sign of glaucoma. Cataracts (B) can cause blurry or cloudy vision, but they typically do not cause peripheral vision loss. Uveitis (A) involves inflammation of the uvea and typically causes eye pain, redness, and sensitivity to light, rather than visual distortions and peripheral vision loss. Retinoblastoma (D) is a rare eye cancer that usually presents in children, not typically in adults, and would not primarily cause peripheral vision loss.
An 8-year-old child presents for a preparticipation physical. On examination, an audible medium-pitched murmur is detected. The murmur is loudest at the second intercostal space (ICS) to the right of the sternum. The nurse practitioner estimates it to be a Grade 3 (III/I) systolic ejection murmur and suspects:
- A - a ventricular septal defect.
- B - mitral stenosis
- C - aortic stenosis.
- D - an innocent murmur.
Explanation
The description of a medium-pitched systolic ejection murmur that is loudest at the second intercostal space to the right of the sternum is most consistent with an innocent murmur, also known as a functional or physiologic murmur. These types of murmurs are common in children and are harmless, often occurring due to increased blood flow through the heart and great vessels. They typically have the following characteristics:
The most appropriate treatment for a child with mild croup is:
- A. A bronchodilator.
- B. An antibiotic.
- C. A decongestant.
- D. A cool mist vaporizer.
Explanation
Mild croup, which is typically caused by a viral infection (often parainfluenza), usually presents with symptoms like a "barking" cough, stridor, and mild respiratory distress. For mild cases, a cool mist vaporizer or humidified air is often the most appropriate treatment. The moist air helps soothe the airway, reduce inflammation, and ease breathing. This treatment is effective in managing the symptoms without the need for medications.
A 20-year-old college student presents with complaints of persistent nasal congestion, hoarseness, and nosebleeds. On examination, the NP observes boggy mucous membranes and a perforated nasal septum. The differential diagnosis that the nurse practitioner should consider is:
- A - allergic rhinitis.
- B - sinonasal malignancy.
- C - cocaine abuse.
- D - topical antihistamines.
Explanation
The presence of a perforated nasal septum, along with persistent nasal congestion, hoarseness, and nosebleeds, is highly suspicious for cocaine abuse. Cocaine use, especially when snorted, can cause chronic irritation of the nasal mucosa, leading to damage of the septum and perforation. This damage is often seen in individuals who have frequent nasal drug use, and they may also experience frequent nosebleeds and other symptoms like congestion or hoarseness due to the drying effect of the drug on the mucous membranes.
An 18-year-old mother who is breastfeeding her 2-week-old infant female expresses concern about how much milk the baby is getting. Which of the following parameters is reassuring to the nurse practitioner that the infant is receiving adequate nutrition?
- A. The infant is nursing six times per day.
- B. The infant has at least six wet diapers per day.
- C. The infant has a formed stool once daily.
- D. The infant is sleeping 3 hours between meals.
Explanation
One of the key indicators that an infant is receiving adequate nutrition while breastfeeding is the number of wet diapers. A well-nourished infant typically has at least six wet diapers per day, which indicates adequate hydration and that the baby is getting enough breast milk. Nursing six times per day (A) may not be enough to ensure sufficient milk intake. Formed stool once daily (C) is not a reliable indicator, as newborns, especially those breastfeeding, typically have multiple soft or loose stools daily. Sleeping 3 hours between meals (D) is not a specific indicator of adequate nutrition and can vary based on the infant's growth and development.
A 57-year-old obese female presents with orthopnea and paroxysmal nocturnal dyspnea for the past 3 months. The diagnostic test that will provide the BEST information is a(n):
- A. Chest X-ray.
- B. Serum troponin level.
- C. Pulmonary function test.
- D. Serum pro b-type natriuretic peptide.
Explanation
The symptoms of orthopnea and paroxysmal nocturnal dyspnea are highly suggestive of heart failure, particularly left-sided heart failure. Serum pro b-type natriuretic peptide (BNP) is a biomarker that is elevated in heart failure due to ventricular stretch and increased workload. It helps in the diagnosis and assessment of heart failure, especially when the clinical presentation is uncertain. It is more specific for heart failure than other tests listed and will provide the best diagnostic information in this case.
A 2-year-old child presents with symptoms of respiratory syncytial virus (RSV). This diagnosis can be confirmed by performing:
- A. a tonsillar culture.
- B. an oral-buccal swab.
- C. a nasal swab.
- D. a serum sample.
Explanation
RSV, which causes respiratory infections like bronchiolitis and pneumonia in young children, is commonly diagnosed by performing a nasal swab (C) to collect samples from the respiratory tract. This sample can then be tested using PCR, antigen detection, or viral culture to confirm the presence of RSV. Tonsillar culture (A) and oral-buccal swabs (B) are not typically used for RSV diagnosis. Serum samples (D) are generally used for detecting antibodies or other infections, not for diagnosing RSV directly. Therefore, a nasal swab is the most appropriate and effective test for confirming RSV.
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.
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 40-year-old patient is suspected of having a thyroid nodule. Initial evaluation begins with ordering a(n):
- A - CT scan and a thyroid-stimulating hormone level.
- B - thyroid-stimulating hormone (TSH) level and thyroid ultrasound.
- C - thyroid panel and thyroid scintigraphy.
- D - 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.
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