503 theory exam 2

When caring for a client with total hearing loss, the nurse is instructing the client about the many options that are available to function in a hearing world. Which of the following should the nurse include? (Select all that apply.) 1.Flashing lights for alarms 2.TV with closed captions 3.Talking computer 4.Lip reading and sign language 5.Cell phones with headsets 6.Loud ringers on telephones ANS: 1, 2, 4

1.Flashing lights for alarms 2.TV with closed captions 4.Lip reading and sign language

2.A client tells the nurse that she experiences a stuffy nose, nasal pain, and postnasal drip every time she works in her companys office. Which of the following types of allergic rhinitis is this client most likely experiencing? 1.Infectious 2.Perennial 3.Occupational 4.Seasonal

3.Occupational

4.A client diagnosed with hypertension is experiencing allergic rhinitis. The nurse realizes that the medication that would not be indicated for this client would be: 1.loratadine. 2.montelukast. 3.pseudoephedrine. 4.zafirlukast.

3.pseudoephedrine.

3.The nurse is trying to communicate with a hearing-impaired client. The best way to do this is to: 1.write down all of the message. 2.shout in the impaired ear. 3.speak slowly and clearly while facing the client. 4.talk in a regular voice in the good ear.

3.speak slowly and clearly while facing the client.

3.A client is diagnosed with a congenital hearing loss. Which causes does the nurse realize are reasons for this type of hearing loss? (Select all that apply.) 1.Genetics 2.Natal infections 3.Physical deformities 4.Noise levels 5.Maternal ototoxic drugs 6.Maternal TORCH infections

1.Genetics 2.Natal infections 3.Physical deformities 5.Maternal ototoxic drugs 6.Maternal TORCH infections

6.Which of the following should the nurse instruct a client diagnosed with type 2 diabetes mellitus regarding vision care? (Select all that apply.) 1.Maintain good glucose control. 2.Stop smoking. 3.Limit exercise. 4.Reduce reading. 5.Frequently rest the eyes. 6.Rub eyes daily.

1.Maintain good glucose control. 2.Stop smoking.

5.A client is complaining of dizziness, unilateral ringing in the ear, feeling of pressure or fullness in the ear, and unilateral hearing loss. The nurse would suspect the client is experiencing: 1.Mnires disease. 2.osteosclerosis. 3.otitis media. 4.mastoiditis.

1.Mnires disease.

4.While instructing a client on stroke prevention, the nurse mentions medications that are useful in stroke prevention. The following medications are effective in preventing a stroke, EXCEPT: 1. anticoagulants. 2. antiplatelets. 3. anticholinergics. 4. neuroprotective agents.

3. anticholinergics.

9.A client is diagnosed with tonic-clonic seizures. Which are the characteristics of these types of seizures? (Select all that apply.) 1. Progressing through all of the seizure phases 2. Beginning before age 5 3. Lasting 2 to 3 minutes 4. Causing injury to the client 5. Occurring at any time, day or night 6. Being highly variable

1. Progressing through all of the seizure phases 3. Lasting 2 to 3 minutes 4. Causing injury to the client 5. Occurring at any time, day or night 6. Being highly variable

5.A client is experiencing a grand mal seizure. Which of the following should the nurse do during this seizure? 1. Protect the clients head. 2. Leave the client alone. 3. Give water to the client to avoid dehydration. 4. Place a finger in the clients mouth to avoid swallowing the tongue.

1. Protect the clients head.

3.A client is being evaluated for a stroke. The nurse knows that one of the easiest and most common diagnostic tests used to differentiate between strokes is: 1. computed tomography (CT). 2. magnetic resonance imaging (MRI). 3. electrocardiography (EEG). 4. positron emission tomography (PET).

1. computed tomography (CT).

3.A client is diagnosed with seizures occurring because of hepatic encephalopathy. The nurse realizes that the cause for this clients seizures would be: 1. physiological. 2. iatrogenic. 3. idiopathic. 4. psychokinetic.

1. physiological.

8.One of the most important things a nurse can teach a client about seizure control is to: 1. take the medication every day as prescribed by the doctor. 2. eat a balanced diet. 3. get lots of exercise. 4. take naps during the day.

1. take the medication every day as prescribed by the doctor.

12.Which of the following would prohibit an elderly client from wanting to obtain and use a hearing aid? 1.Fears sounds will be too loud 2.Thinks not necessary for a temporary problem 3.Fears the cost 4.Prefers silence

3.Fears the cost

2.The family of a client diagnosed with a stroke asks the nurse if this health problem is very common. The nurse should respond that in the United States a person has a stroke every: 1. 40 seconds. 2. 1 minutes. 3. 2 minutes. 4. 5 minutes.

1. 40 seconds.

6.A client diagnosed with an embolic stroke is not a candidate for tPA. The nurse realizes that the client might be eligible for which of the following forms of treatment? 1. Carotid stenting 2. Antiarrhythmic medication 3. Intravenous fluid therapy 4. Carotid endarterectomy

1. Carotid stenting

7.A client, being tested for a stroke, is not a candidate for tPA. Which of the following would be contraindicated for the use of tPA? (Select all that apply.) 1. Minor ischemic stroke within 30 days 2. Glucose level 120 mg/dL 3. Blood pressure 190/120 mmHg 4. Lumbar puncture 2 days ago 5. Stroke onset 5 hours ago 6. INR 1.0

1. Minor ischemic stroke within 30 days 3. Blood pressure 190/120 mmHg 4. Lumbar puncture 2 days ago 5. Stroke onset 5 hours ago

2. The nurse is instructing a client diagnosed with a brain tumor on symptoms to immediately report to her physician. Which of the following should be included in these instructions? (Select all that apply.) 1. New onset of seizures 2. One-sided weakness 3. Loss of balance 4. Problems with vision 5. Inability to talk 6. Loss of appetite

1. New onset of seizures 2. One-sided weakness 3. Loss of balance 4. Problems with vision 5. Inability to talk

1.The nurse is instructing a client diagnosed with otitis media on management during the acute phase. Which of the following should the nurse include in the teaching? (Select all that apply.) 1.Take the antibiotics as ordered. 2.Take over-the-counter analgesics for mild pain as recommended. 3.It is okay to go swimming. 4.It is okay to go on vacation and trips that require flying. 5.If excruciating pain develops, seek medical care. 6.Limit fluids.

1.Take the antibiotics as ordered. 2.Take over-the-counter analgesics for mild pain as recommended. 5.If excruciating pain develops, seek medical care.

8.The nurse is planning to assess a client diagnosed with conductive hearing loss. When performing the Weber test, the nurse would expect which of the following findings? 1.The sound will be louder in the affected ear. 2.The sound will be louder in the good ear. 3.Air conduction is shorter than bone conduction. 4.No sounds will be heard.

1.The sound will be louder in the affected ear.

4.The nurse is utilizing the Wells Scale to assess a client for deep vein thrombosis. Which of the following is assessed when using this scale? (Select all that apply.) 1.Treatment for cancer 2.Recent immobility for greater than 3 days 3.Recovery from surgery with general anesthesia within 12 weeks 4.Entire leg edematous 5.Pitting edema of the symptomatic leg 6.Blood pressure 130/86 mmHg

1.Treatment for cancer 2.Recent immobility for greater than 3 days 3.Recovery from surgery with general anesthesia within 12 weeks 4.Entire leg edematous 5.Pitting edema of the symptomatic leg

A client with a family history of hearing loss asks the nurse what he can do to prevent this disorder as he ages. Which of the following should the nurse instruct this client? (Select all that apply.) 1.Turn down radio and television volume. 2.Avoid noisy areas such as rock concerts. 3.Wear protective devices. 4.Use plain cotton balls in the ears. 5.Avoid sun exposure.

1.Turn down radio and television volume. 2.Avoid noisy areas such as rock concerts. 3.Wear protective devices.

1.A client is diagnosed with a headache from a secondary cause. The nurse realizes this type of headache can be caused by: 1.a tumor. 2.tension. 3.a migraine. 4.cluster

1.a tumor.

A client is diagnosed with a headache from a secondary cause. The nurse realizes this type of headache can be caused by: 1.a tumor. 2.tension. 3.a migraine. 4.cluster

1.a tumor.

5.A client is being seen in the emergency department experiencing symptoms of a stroke. The nurse realizes that the administration of a medication to break clots, such as tPA, should be administered within how many minutes of the client presenting to the emergency department? 1. 30 minutes 2. 60 minutes 3. 90 minutes 4. 120 minutes

2. 60 minutes

4.A client tells the nurse that he sees flashing lights that occur prior to the onset of a seizure. Which of the following phases of a seizure is this client describing to the nurse? 1. Prodromal phase 2. Aural phase 3. Ictal phase 4. Postictal phase

2. Aural phase

1. A client asks the nurse to explain symptoms that would indicate the presence of a brain tumor. Which of the following should the nurse respond to this client? (Select all that apply.) 1. There are no symptoms specific to a brain tumor. 2. Dizziness is a common symptom. 3. Ringing or buzzing in the ears can occur. 4. Seizures may occur. 5. A headache that gets worse in the afternoon is specific to a brain tumor.. 6. A headache is usually experienced by 50% of all people diagnosed with a brain tumor.

2. Dizziness is a common symptom. 3. Ringing or buzzing in the ears can occur. 4. Seizures may occur. 6. A headache is usually experienced by 50% of all people diagnosed with a brain tumor.

7.The nurse is unable to insert an intravenous access line into a client who is currently experiencing a seizure. Which of the following routes can the nurse use to provide medication to the client at this time? 1. Oral 2. Intranasal 3. Rectal 4. Intramuscular

2. Intranasal

6.A client is prescribed phenytoin (Dilantin) for a seizure disorder. Which of the following would indicate that the client is adhering to the medication schedule? 1. The client is sleepy. 2. The client is not experiencing seizures. 3. The client no longer has headaches. 4. The client is eating more food

2. The client is not experiencing seizures.

1.For the client who is at risk for stroke, the most important guideline the nurse should teach is to: 1. increase drinks with caffeine. 2. monitor blood pressure. 3. increase amounts of sodium in the diet 4. monitor weight and activity.

2. monitor blood pressure.

7.The hearing of an unresponsive client needs to be assessed. Which of the following will be used to assess the hearing of this client? 1.Audiometer 2.Brainstem auditory evoked responses (BAER) test 3.Rinne test 4.Weber test

2.Brainstem auditory evoked responses (BAER) test

4.A client is diagnosed with a conductive hearing loss. The nurse realizes type of hearing loss is not associated with: 1.cerumen. 2.brain damage. 3.otitis media. 4.otosclerosis.

2.brain damage.

11.A client is experiencing redness, burning, itching, and pain of the eyes. The nurse suspects the client is experiencing: 1.blepharitis. 2.conjunctivitis.

2.conjunctivitis.

2.A client is prescribed a medication that is ototoxic. The nurse realizes that this medication may cause: 1.permanent or temporary vision loss. 2.permanent or temporary hearing loss. 3.nausea and vomiting. 4.central nervous system (CNS) depression.

2.permanent or temporary hearing loss.

13.Which of the following should the nurse instruct a client who is being fitted for a hearing aid? 1.Keep the appliance turned on at all times. 2.Store the hearing aid in a warm, moist place. 3.Batteries last for at least 1 month. 4.Clean ear molds at least once a week.

4.Clean ear molds at least once a week.

10.A client diagnosed with mitral valve prolapse is experiencing palpitations. Which of the following should the nurse instruct this client? 1.Avoid tobacco 2.Ingest alcohol in moderation 3.Avoid weight loss 4.Limit caffeine intake

4.Limit caffeine intake

7.A client who has experienced signs of Virchows triad has developed a deep vein thrombosis. Which of the following is not a part of this triad? 1.Venous stasis 2.Vessel wall injury 3.Alteration in blood clotting 4.Pregnancy

4.Pregnancy

2.The nurse should instruct a client diagnosed with migraine headaches to be careful not to overdose on acetaminophen (Tylenol). Which drug should the nurse tell the patient to avoid? 1.Aleve 2.Aspirin 3.Ibuprofen 4.Vicodin

4.Vicodin

2.The nurse should instruct a client diagnosed with migraine headaches to be careful not to overdose on acetaminophen (Tylenol). Which drug should the nurse tell the patient to avoid? 1.Aleve 2.Aspirin 3.Ibuprofen 4.Vicodin ANS: 4

4.Vicodin

9. Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing? a. CN V b. CN VII c. CN IX d. CN X

CN V

11. Which patient is more likely to have a cluster headache? a. A female in her reproductive years b. A 40-year-old African American male c. A 55-year-old female who drinks 10 cups of coffee daily d. A 45-year-old male awakened at night

D. A 45-year-old male awakened at night

2. Sondra's peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear? a. Meclizine b. Diphenhydramine c. Diamox d. Promethazine

c. Diamox

7. The nurse is assessing a patient who may have hearing loss. Which of these statements is trueconcerning air conduction? a. Air conduction is the normal pathway for hearing. b. Vibrations of the bones in the skull cause air conduction. c. Amplitude of sound determines the pitch that is heard. d. Loss of air conduction is called a conductive hearing loss.

a. Air conduction is the normal pathway for hearing.

2. You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is: a. Articular b. Inflammatory c. Nonarticular d. A and B

a. Articular

22. What antiplatelet agent is most widely used for secondary prevention of stroke? a. Aspirin b. Ticlopidine c. Clopidogrel d. Aspirin and clopidogrel

a. Aspirin

7. A patient is prescribed an antiplatelet agent to prevent strokes. Which agent was this patient most likely prescribed? a. Aspirin b. Warfarin (Coumadin) c. Acetaminophen (Tylenol) d. Tissue-type plasminogen activator (tPA)

a. Aspirin

9. Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing? a. CN V b. CN VII c. CN IX d. CN X

a. CN V

8. Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome? a. Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel. b. Only people with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel. c. An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel. d. Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.

a. Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel.

7. Which drug for Alzheimer's disease should be administered beginning at the time of diagnosis? a. Cholinesterase inhibitors b. Anxiolytics c. Antidepressants d. Atypical antipsychotics

a. Cholinesterase inhibitors

14. Which is the most sensitive neuroimaging test to evaluate patients with encephalitis? a. MRI b. CT c. Electroencephalogram (EEG) d. An initial lumbar puncture

a. MRI

29. When performing an otoscopic examination of a 5-year-old child with a history of chronic ear infections, the nurse sees that his right tympanic membrane is amber-yellow in color and that air bubbles are visible behind the tympanic membrane. The child reports occasional hearing loss and a popping sound with swallowing. The preliminary analysis based on this information is that the child: a. Most likely has serous otitis media. b. Has an acute purulent otitis media. c. Has evidence of a resolving cholesteatoma. d. Is experiencing the early stages of perforation.

a. Most likely has serous otitis media.

7. As diabetic retinopathy progresses, the presence of ̳cotton wool' spots can be detected. Cotton wool spots refer to: a. Nerve fiber layer infarctions b. Blood vessel proliferation c. Venous beading d. Retinal hemorrhage

a. Nerve fiber layer infarctions

38. During an examination, the nurse notices that the patient stumbles a little while walking, and,when she sits down, she holds on to the sides of the chair. The patient states, It feels like the room is spinning! The nurse notices that the patient is experiencing: a. Objective vertigo. b. Subjective vertigo. c. Tinnitus. d. Dizziness.

a. Objective vertigo.

12. A 31-year-old patient tells the nurse that he has noticed a progressive loss in his hearing. He says that it does seem to help when people speak louder or if he turns up the volume of a television or radio. The most likely cause of his hearing loss is: a. Otosclerosis. b. Presbycusis. c. Trauma to the bones. d. Frequent ear infections.

a. Otosclerosis.

29. The ̳freezing phenomenon' is a cardinal feature of? a. Parkinson's disease b. Alzheimer's disease c. A CVA d. Bell's palsy

a. Parkinson's disease

15. What is the first- -hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis? a. Penicillin b. Quinolone c. Cephalosporin d. Macrolide

a. Penicillin

3. Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause? a. Serum calcium b. Electrocardiogram (ECG) c. Thyroid-stimulating hormone test d. Complete blood cell count

a. Serum calcium

8. A patient with symptoms of impending stroke is scheduled to have a cerebral angiogram. Which statement should the nurse include when assisting with patient teaching? a. This test is designed to detect vascular lesions in the brain. b. The angiogram is done to help identify swelling in the brain. c. We need to do this to evaluate electrical function of the brain. d. This test is done to examine cerebrospinal fluid for signs of bleeding.

a. This test is designed to detect vascular lesions in the brain.

8. A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of ―my feet feel like they are on fire.‖ He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment? a. Tricyclic antidepressants b. Capsaicin cream c. Vitamin B12 injections d. Insulin

a. Tricyclic antidepressants

16. Gabby, aged 22, has Bell's palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her? a. ―Most patients have complete recovery in 3 to 6 months.‖ b. ―Unfortunately, you'll probably have a small amount of residual damage.‖ c. ―Don't worry, I'll take care of everything.‖ d. ―You may have a few more episodes over the course of your lifetime but no permanent damage.‖

a. ―Most patients have complete recovery in 3 to 6 months.‖

11. The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs? a. ―You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.‖ b. ―You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication.‖ c. ―You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.‖ d. ―It is important to take NSAIDs on an empty stomach in order to increase absorption.‖

a. ―You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.‖

27. Which statement is true regarding driving and patients with a seizure disorder? a. Once diagnosed with a seizure disorder, patients must never drive again. b. After being seizure free for 6 months, patients may drive. c. Each state has different laws governing driving for individuals with a seizure disorder. d. These persons may drive but never alone.

c. Each state has different laws governing driving for individuals with a seizure disorder.

17. A patient began experiencing manifestations of a stroke at 0800 hours. By which time should thrombolytic medications be provided to reverse stroke symptoms? a. 0900 hours b. 1250 hours c. 1400 hours d. 1660 hours

b. 1250 hours

34. Intravenous thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset? a. 1 hour b. 3 hours c. 6 hours d. 12 hours

b. 3 hours

8.Which patient is most likely to develop osteoporosis? a. 43-year-old African American woman b. 57-year-old white woman c. 48-year-old African American man d. 62-year-old Latino woman

b. 57-year-old white woman

3. The hallmark of an absence seizure is: a. No activity at all b. A blank stare c. Urine is usually voided involuntarily d. The attack usually lasts several minutes

b. A blank stare

15. What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster? a. A stabbing pain on one small area of the body b. A vesicular skin lesion on one side of the body c. A pain that is worse upon awakening d. A lesion on the exterior ear canal

b. A vesicular skin lesion on one side of the body

26. While performing the otoscopic examination of a 3-year-old boy who has been pulling on his left ear, the nurse finds that his left tympanic membrane is bright red and that the light reflex is not visible. The nurse interprets these findings to indicate a(n): a. Fungal infection. b. Acute otitis media. c. Perforation of the eardrum. d. Cholesteatoma.

b. Acute otitis media.

17. Which of the following antibiotics provides the best coverage in acute or chronic sinusitis when gram-negative organisms are suspected? a. Penicillin V b. Amoxicillin c. Levofloxacin d. Clindamycin

b. Amoxicillin

4. How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate? a. Every 3 months b. Every 6 months c. Annually d. Whenever there is a problem

b. Every 6 months

21. Carotid endarterectomy should be considered only for symptomatic patients with greater than what percentage of stenosis? a. Greater than 25% b. Greater than 50% c. Greater than 75% d. Only for 100% occlusion

b. Greater than 50%

33. The barrel chest characteristic of emphysema is a result of: a. Chronic coughing b. Hyperinflation c. Polycythemia d. Pulmonary hypertension

b. Hyperinflation

31. The nurse suspects that a patient has otitis media. Early signs of otitis media include which of these findings of the tympanic membrane? a. Red and bulging b. Hypomobility c. Retraction with landmarks clearly visible d. Flat, slightly pulled in at the center, and moves with insufflation

b. Hypomobility

1. Which group would most benefit from statins? a. Those with a low density lipoprotein-cholesterol greater than 100 mg/dL b. Individuals with clinical arteriosclerotic cardiovascular disease c. Individuals with a 10-year risk greater than 10% d. Individuals of all ages with diabetes mellitus (DM)

b. Individuals with clinical arteriosclerotic cardiovascular disease

28. Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help given intravenously once a month? a. Glatiramer acetate b. Natalizumab c. Fingolimod d. Glucocorticoids

b. Natalizumab

31. Clinical features of insidious onset, slow progression, and a lack of other findings to explain the symptoms are fairly diagnostic of which condition? a. Guillain-Barré syndrome b. Parkinson's disease c. Alzheimer's disease d. Huntington's disease

b. Parkinson's disease

19. Which of the following is the most commonly experienced symptom of migraine? a. Light sensitivity b. Pulsatile pain c. Sound sensitivity d. Experiencing an aura

b. Pulsatile pain

10. A patient in her first trimester of pregnancy is diagnosed with rubella. Which of these statements is correct regarding the significance of this in relation to the infants hearing? a. Rubella may affect the mothers hearing but not the infants. b. Rubella can damage the infants organ of Corti, which will impair hearing. c. Rubella is only dangerous to the infant in the second trimester of pregnancy. d. Rubella can impair the development of CN VIII and thus affect hearing.

b. Rubella can damage the infants organ of Corti, which will impair hearing.

24. Which herbal preparation may cause delirium and should be avoided in an elderly patient? a. Sam-e b. Saint John's Wort c. Melatonin d. Saw Palmetto

b. Saint John's Wort

8. Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery? a. Epidural hematoma b. Subdural hematoma c. Subarachnoid hematoma d. Intraparenchymal hemorrhage

b. Subdural hematoma

Identify the choice that best completes the statement or answers the question. 1. One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular structure? a. Bone b. Synovium c. Tendons d. Fascia

b. Synovium

5. Lifestyle modifications to manage hypertension (HTN) include: a. Maintaining a body mass index of 17 b. Restricting dietary sodium to 2 grams per day c. Engaging in exercise or physical activity for 90 minutes a day d. Limiting beer intake to 24 ounces per day

c. Engaging in exercise or physical activity for 90 minutes a day

20. Which of the following characteristics differentiates peripheral vertigo from central vertigo? a. The duration of central vertigo is shorter than that of peripheral vertigo. b. There is an auditory-associated symptom with peripheral vertigo and a visual- associated symptom with central vertigo. c. Central vertigo is positional, and peripheral vertigo is not. d. The onset of central vertigo is more sudden than that of peripheral vertigo.

b. There is an auditory-associated symptom with peripheral vertigo and a visual- associated symptom with central vertigo.

21. Mrs. Allen is a 60-year-old woman who has been diagnosed with osteoporosis. She is very concerned about the risk of breast cancer associated with hormone replacement therapy and is wondering what other treatments are available to her. The clinician explains that bisphosphonates are another class of drugs used in the prevention and treatment of osteoporosis. What teaching should the clinician give Mrs. Allen in regard to taking bisphosphonates? a. Taking bisphosphonates can result in hypercalcemia, so calcium intake should be decreased while taking this class of drugs. b. There is potential for upper GI irritation, so these medications are contraindicated in people with abnormalities of the esophagus or delayed esophageal emptying. c. This class of drugs can be taken at any time of the day without regard to meals. d. None of the above

b. There is potential for upper GI irritation, so these medications are contraindicated in people with abnormalities of the esophagus or delayed esophageal emptying.

10. Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? a. Morning stiffness and limited mobility of the lumbar spine b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain c. Fever, chills, and elevated erythrocyte sedimentation rate d. Pathologic fractures, severe night pain, weight loss, and fatigue

b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

36. A 17-year-old student is a swimmer on her high schools swim team. She has had three bouts of otitis externa this season and wants to know what to do to prevent it. The nurse instructs her to: a. Use a cotton-tipped swab to dry the ear canals thoroughly after each swim. b. Use rubbing alcohol or 2% acetic acid eardrops after every swim. c. Irrigate the ears with warm water and a bulb syringe after each swim. d. Rinse the ears with a warmed solution of mineral oil and hydrogen peroxide.

b. Use rubbing alcohol or 2% acetic acid eardrops after every swim.

17. Sam, aged 65, is started on L-dopa for his Parkinson's disease (PD). He asks why this is necessary. You tell him: a. ―L-dopa is neuroprotective.‖ b. ―The primary goal of therapy is to replace depleted stores of dopamine.‖ c. ―This is the only drug that can provide symptomatic benefit.‖ d. ―This is the initial monotherapy drug.‖

b. ―The primary goal of therapy is to replace depleted stores of dopamine.‖

5. Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)? a. A teenage male b. A 65-year-old male c. A 25-year-old female d. A 60-year-old female

c. A 25-year-old female

The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be? a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment. b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen. c. A throat culture should be performed to confirm the results of the rapid strep test. d. The patient should

c. A throat culture should be performed to confirm the results of the rapid strep test.

28. In the CHADS2 Index for the stroke risk score for AF, the ̳A' stands for: a. Anticoagulation b. Autoimmune disease c. Age d. Antihypertension

c. Age

32. Which condition is characterized by the impaired ability to learn new information along with either a cognitive disturbance in language, function, or perception? a. Guillain-Barré syndrome b. Parkinson's disease c. Alzheimer's disease d. Delirium

c. Alzheimer's disease

32. Which condition is characterized by the impaired ability to learn new information along with either a cognitive disturbance in language, function, or perception? a. Guillain-Barré syndrome b. Parkinson's disease c. Alzheimer's disease d. Delirium

c. Alzheimer's disease

6. Mary has hypertension and previously had a stroke. Which hypertensive drug would you order for her? a. Angiotensin converting enzyme inhibitor b. Calcium channel blocker c. Angiotensin converting enzyme inhibitor d. Beta Blocker

c. Angiotensin converting enzyme inhibitor

13. Which type of meningitis is more benign, self-limiting, and caused primarily by a virus? a. Purulent meningitis b. Chronic meningitis c. Aseptic meningitis d. Herpes meningitis

c. Aseptic meningitis

8. A patient has been shown to have a sensorineural hearing loss. During the assessment, it would be important for the nurse to: a. Speak loudly so the patient can hear the questions. b. Assess for middle ear infection as a possible cause. c. Ask the patient what medications he is currently taking. d. Look for the source of the obstruction in the external ear.

c. Ask the patient what medications he is currently taking.

25. Which of the following activities is part of the functional activities questionnaire? a. Asking the patient to unravel a Rubik's cube b. Determining if the patient can drive on the highway c. Asking the patient about a news event from the current week d. Seeing if the patient can keep his or her home clean

c. Asking the patient about a news event from the current week

2. The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis? a. Viral conjunctivitis b. Keratoconjunctivitis c. Bacterial conjunctivitis d. Allergic conjunctivitis

c. Bacterial conjunctivitis

19. Which of the following tests is considered the gold standard for definitively diagnosing osteoporosis? a. Bone alkaline phosphatase levels b. Urinary N-telopeptide assay c. Bone mass density measurement by densitometry d. Magnetic resonance imaging

c. Bone mass density measurement by densitometry

18. A patient is diagnosed with a stroke that occurred at 12 noon the previous day. When should the nurse plan to begin bedside physical therapy with this patient? a. After 5 days b. Within 2 to 3 days c. By 12 noon on the current day d. At least one week after the occurrence

c. By 12 noon on the current day

9. The nurse is caring for a hospitalized patient who has had a stroke and is waiting to be transferred to a rehabilitation facility. What nursing action can best maximize the patients rehabilitation potential while awaiting the transfer? a. Teach the patient what to expect at the rehabilitation facility. b. Keep the patient on bedrest to conserve energy for rehabilitation. c. Call the physical therapist for bedside rehabilitation until the transfer. d. Turn the patient every 2 hours to prevent pressure ulcers and contractures.

c. Call the physical therapist for bedside rehabilitation until the transfer.

35. When administered at the beginning of an attack, oxygen therapy may help this kind of headache? a. Tension b. Migraine c. Cluster d. Stress

c. Cluster

30. A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as? a. Spinothalamic dysfunction b. Ratcheting c. Cogwheeling d. Hand tremors

c. Cogwheeling

5. The nurse is documenting care provided to a patient with left-sided flaccidity caused by a stroke. Which term should the nurse use to document this patients motor status? a. Ipsilateral paraplegia b. Ipsilateral hemiparesis c. Contralateral hemiplegia d. Contralateral quadriparesis

c. Contralateral hemiplegia

4. A patient with a cerebrovascular accident (stroke) has left-sided flaccidity and is unable to speak but seems to understand everything the nurse says. Which term should the nurse use to document the patients communication impairment? a. Sensory aphasia b. Motor dysphagia c. Expressive aphasia d. Receptive dysphagia

c. Expressive aphasia

6. Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and limited movement in her right shoulder. She denies any history of trauma. Her examination reveals a 75% reduction in both active and passive ROM of the right shoulder. Mrs. Gray also is experiencing tenderness with motion and pain at the deltoid insertion. Her medical history is significant for type 1 diabetes mellitus and hypertension. Her social history reveals that she is a secretary and that she is right-handed. Based on her examination and medical history, you suspect adhesive capsulitis, or ―frozen shoulder.‖ Which clue in Mrs. Gray's history supports this diagnosis? a. History of hypertension b. Her affected shoulder is also her dominant arm. c. Her history of diabetes mellitus d. Her work as a secretary predisposes her to repetitive motions.

c. Her history of diabetes mellitus

13. Which of the following statements is true concerning the management of the client with a herniated disc? a. Muscle relaxants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use. 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. All of the above

c. Intolerable pain for more than a 3-month period is an indication for surgical intervention.

16. A patient is diagnosed with giardia after a backpacking trip in the mountains. Which of the following would be an appropriate treatment? a. Vancomycin b. Penicillin c. Metronidazole d. Bactrim

c. Metronidazole

3. Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? a. Decreased C-reactive protein b. Hyperalbuminemia c. Morning stiffness d. Weight gain

c. Morning stiffness

16. The nurse is reviewing teaching provided to a patient with transient ischemic attack (TIA). Which statement indicates that further teaching is required? a. The risk factors and symptoms of a TIA are just like those of a stroke. b. I need to stop smoking to help lower my chances of this happening again. c. My risk for Alzheimers disease is increased now, so Ill have to stop driving. d. I recognize how important it is to take my anti-hypertension medications regularly.

c. My risk for Alzheimers disease is increased now, so Ill have to stop driving.

13. A 70-year-old patient tells the nurse that he has noticed that he is having trouble hearing, especially in large groups. He says that he cant always tell where the sound is coming from and the words often sound mixed up. What might the nurse suspect as the cause for this change? a. Atrophy of the apocrine glands b. Cilia becoming coarse and stiff c. Nerve degeneration in the inner ear d. Scarring of the tympanic membrane

c. Nerve degeneration in the inner ear

4. A blood pressure (BP) of 150/90 is considered: a. Stage 2 hypertension b. Hypertensive c. Normal in healthy older adults d. Acceptable if the patient has DM

c. Normal in healthy older adults

9. The clinician is assessing a patient complaining of hearing loss. The clinician places a tuning fork over the patient's mastoid process, and when the sound fades away, the fork is placed without restriking it over the external auditory meatus. The patient is asked to let the clinician know when the sound fades away. This is an example of which type of test? a. Weber test b. Schwabach test c. Rinne test d. Auditory brainstem response (ABR) test

c. Rinne test

14. The patient is diagnosed with a cerebral vascular accident that has the slowest rate of recovery and the highest probability of causing extensive neurological deficits. For which type of stroke should the nurse plan care for this patient? a. Thrombotic stroke b. Cerebral aneurysm c. Subarachnoid hemorrhage (SAH) d. Reversible ischemic neurological deficit (RIND)

c. Subarachnoid hemorrhage (SAH)

10. The nurse is assisting in preparing a patient for transfer to a rehabilitation facility after a stroke. What should the nurse explain as the goal for rehabilitation? a. To monitor neurological status b. To cure any effects of the stroke c. To maximize remaining abilities d. To determine the extent of neurological deficits

c. To maximize remaining abilities

12. The most significant precipitating event leading to otitis media with effusion is: a. Pharyngitis b. Allergies c. Viral upper respiratory infection (URI) d. Perforation of the eardrum

c. Viral upper respiratory infection (URI)

7. The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been effective? a. ―As long as I don't need glasses, I don't have to worry about going blind.‖ b. ―I know I need to have my eyes checked every year.‖ c. ―My optometrist checks my eyes.‖ d. ―I will see my eye doctor when my vision gets blurry.‖

c. ―My optometrist checks my eyes

6. The nurse is reviewing the function of the cranial nerves (CNs). Which CN is responsible for conducting nerve impulses to the brain from the organ of Corti? a.I b.III c.VIII d.XI

c.VIII

11. Which patient is more likely to have a cluster headache? a. A female in her reproductive years b. A 40-year-old African American male c. A 55-year-old female who drinks 10 cups of coffee daily d. A 45-year-old male awakened at night

d. A 45-year-old male awakened at night

2. The nurse is assisting with teaching a patient who has had a transient ischemic attack (TIA). On which understanding should the nurse base teaching? a. TIAs are not serious, and the patient should have no further problems. b. A TIA is predictive that the patient will have a heart attack within 1 year. c. A TIA is a medical emergency that requires immediate surgical intervention. d. A TIA is a forewarning that the patient is at risk for a cerebrovascular accident (stroke).

d. A TIA is a forewarning that the patient is at risk for a cerebrovascular accident (stroke).

14. Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of: a. Severe asthma b. A common valvular lesion c. Severe hypertension d. A prosthetic heart valve

d. A prosthetic heart valve

11. Otitis media is considered chronic when: a. Inflammation persists more than 3 months with intermittent or persistent otic discharge. b. There are more than six occurrences of otitis media in a 1-year period. c. Otitis media does not resolve after two courses of antibiotics. d. All of the above

d. All of the above

13. Patients with acute otitis media should be referred to a specialist in which of the following situations? a. Concurrent vertigo or ataxia b. Failed closure of a ruptured tympanic membrane c. If symptoms worsen after 3 or 4 days of treatment d. All of the above

d. All of the above

9. Which of the following statements is true regarding the treatment of carpal tunnel syndrome? a. The goal of treatment is to prevent flexion and extension movements of the wrist. b. Splints are used in carpal tunnel syndrome, because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position. c. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection. d. All of the above

d. All of the above

24. One of the most frequent presenting signs/symptoms of osteoporosis is: a. Goiter b. Abnormal serum calcium c. Elevated urine biochemical markers d. Bony fracture

d. Bony fracture

4. A patient with hypertension comes in and insists that one of his new medications is causing him to cough. When looking at his list of medications, you think the cough must be from: a. Metoprolol b. Clopidogrel c. Tadalafil d. Captopril

d. Captopril

12. Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of? a. Dementia b. Alzheimer's disease c. Parkinson's disease d. Delirium

d. Delirium

23. Which adjunctive diagnostic test should be used in the work-up of a patient with suspected Creutzfeldt-Jakob disease or transient epileptic amnesia? a. MRI b. CT c. Cerebrospinal fluid analysis d. EEG

d. EEG

28. In an individual with otitis externa, which of these signs would the nurse expect to find on assessment? a. Rhinorrhea b. Periorbital edema c. Pain over the maxillary sinuses d. Enlarged superficial cervical nodes

d. Enlarged superficial cervical nodes

17. How often should the clinician examine the feet of a person with diabetes? a. Once a year b. Every 6 months c. Every 3 months d. Every visit

d. Every visit

7. Which high-density lipoprotein (HDL) level is considered cardioprotective? a. Greater than 30 b. Greater than 40 c. Greater than 50 d. Greater than 60

d. Greater than 60

33. A score of 20 to 25 on this test indicates early-stage Alzheimer's disease: a. SLUMS b. MoCA c. FAST d. MMSE

d. MMSE

10. A patient presents to the clinician complaining of ear pain. On examination, the clinician finds that the patient has tenderness on traction of the pinna as well as when applying pressure over the tragus. These findings are classic signs of which condition? a. Otitis media b. Meniere's disease c. Tinnitus d. Otitis externa

d. Otitis externa

12. Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? a. Gastrocnemius weakness b. A reduced or absent ankle reflex c. Numbness in the lateral foot d. Paresthesia of the perineum and buttocks

d. Paresthesia of the perineum and buttocks

1. Which statement about confusion is true? a. Confusion is a disease process. b. Confusion is always temporary. c. Age is a reliable predictor of confusion. d. Polypharmacy is a major contributor to confusion in older adults.

d. Polypharmacy is a major contributor to confusion in older adults.

18. Which of the following signs is seen in a patient with more advanced PD? a. Resting tremor b. Bradykinesia c. Rigidity d. Postural instability

d. Postural instability

8. Which of the following is an example of sensorineural hearing loss? a. Perforation of the tympanic membrane b. Otosclerosis c. Cholesteatoma d. Presbycusis

d. Presbycusis

14. Your patient states he has a strep throat infection. Which of the following symptoms makes you consider a viral etiology instead? a. Fever b. Headache c. Exudative pharyngitis d. Rhinorrhea

d. Rhinorrhea

2. During ocular examinations, the nurse keeps in mind that movement of the extraocular muscles is: a. Decreased in the older adult. b. Impaired in a patient with cataracts. c. Stimulated by cranial nerves (CNs) I and II. d. Stimulated by CNs III, IV, and VI.

d. Stimulated by CNs III, IV, and VI

2. During ocular examinations, the nurse keeps in mind that movement of the extraocular muscles is: a. Decreased in the older adult. b. Impaired in a patient with cataracts. c. Stimulated by cranial nerves (CNs) I and II. d. Stimulated by CNs III, IV, and VI.

d. Stimulated by CNs III, IV, and VI.

10. Which statement best describes a carotid bruit? a. It is felt with the middle three fingers over the carotid artery. b. A bruit becomes audible when the lumen is narrowed to 1 mm or less. c. A low-pitched bruit is a medical emergency. d. The higher the pitch of the bruit, the higher the degree of stenosis.

d. The higher the pitch of the bruit, the higher the degree of stenosis.

6. Which of the following is a specific test to MS? a. Magnetic resonance imaging (MRI) b. Computed tomography (CT) scan c. A lumbar puncture d. There is no specific test.

d. There is no specific test.

6. A patient comes into the emergency department with symptoms of a stroke. Which medication should the nurse expect may be given to the patient if diagnostic testing confirms an ischemic stroke? a. Heparin b. Clopidogrel (Plavix) c. Warfarin (Coumadin) d. Tissue-type plasminogen activator (tPA)

d. Tissue-type plasminogen activator (tPA)

13. A patient is experiencing bilateral hemiparesis, dysphasia, visual changes, and altered level of consciousness, ataxia, and dysphagia. Which artery was most likely affected in this patients stroke? a. Carotid b. Middle cerebral c. Posterior cerebral d. Vertebrobasilar/cerebellar

d. Vertebrobasilar/cerebellar

26. About 90% of all headaches are? a. Tension b. Migraine c. Cluster d. Without pathological cause

d. Without pathological cause

13. Which heart sound may be heard with poorly controlled hypertension, angina, and ischemic heart disease? a. A physiologic split S2 b. A fixed split S2 c. S3 d. S4

s4

indicate whether the statement is true or false. 1. Osteoarthritis is primarily a noninflammatory condition.

t