Comprehensive NR 667/NR 667 Chamberlain CEA Final Exam Review NR 667 CEA prep with 100% accurate solutions + rationales -Chamberlain

Where would the S1 heart sounds correlate with the electrocardiographic waves?

Peak of the R wave.

What are NOT priority medical decisions for a patient with ST segment depression in leads V3 and V4?

Prescribe metoprolol (Lopressor) 12.5mg PO BID, Prescribe aspirin 81mg PO daily.

What will you document if you hear a nasally 'a' sound while assessing voice sounds?

Positive for egophony.

During which phase of the cardiac cycle would you anticipate auscultation of an S3 or S4 heart sound?

Diastole.

Where is the point of maximum impulse (PMI) most commonly palpable in healthy adults?

Left 5th intercostal space, midclavicular line.

How does percussion of the thorax assist the provider during the physical examination?

To identify if underlying tissues are air-filled, fluid-filled or consolidated.

What result would you expect from a diaphragmatic excursion test in a patient with interstitial lung disease?

Approximately equal level of change in the descent of the diaphragm bilaterally during maximal inspiration and expiration, with a decreased overall inspiratory capacity.

What condition is indicated by sparse hairline, thin lateral eyebrows, and periorbital edema?

Severe hypothyroidism.

What diagnosis would be highest on the differential for a patient with severe exophthalmos?

Hyperthyroidism.

What does a pulmonary function test (PFT) evaluate?

Forced Vital Capacity.

What are typical signs of hyperthyroidism expected on examination?

Tachycardia.

What should the nurse practitioner's evaluation of a patient with Diabetes Mellitus type 2 include?

All of these are appropriate options: Renal function panel, Urinalysis, Non-dilated eye exam.

What is the correct order of assessment for the abdomen?

Inspection, auscultation, palpation, percussion.

Which exam finding is NOT supportive of a perforated gastric ulcer diagnosis?

Absence of pain with withdrawal of palpation.

What diagnosis is suspected for a patient with an enlarged scrotum?

Varicocele.

Which sinus should be palpated for sinus pressure and congestion?

Frontal.

What assessment finding would be INCONSISTENT with a diagnosis of lymphoma?

Non-tender, minimally palpable anterior cervical chain node palpation.

What lab should be ordered first for microcytic hypochromic anemia?

TIBC and Ferritin.

What finding would be considered suspicious for melanoma?

Dual color, particularly white-reddish or blue-black.

Which dermatologic lesion is precancerous due to prolonged UV-B exposure?

Actinic Keratosis.

What neurotransmitter deficit is associated with clinical depression?

Serotonin.

What test differentiates anxiety from hyperthyroidism?

TSH and free T4.

What type of hallucination is described by a patient stating 'what is that awful taste'?

Gustatory.

What is the most common co-diagnosis in patients who have made attempts of self-harm?

Depression.

What injury is suspected if a patient experiences pain when attempting to touch the opposite scapula?

Rotator cuff injury.

What spinal deformity is associated with unequal shoulder height and curvature?

Scoliosis.

Which cranial nerve would cause abnormal sensation to sharp/dull testing on the left cheek?

Trigeminal nerve.

Which cranial nerve is associated with the abnormality?

Cranial nerve V

What is the most effective protocol for assessing cranial nerve I?

Have the patient close their eyes and accurately identify two different scents with one nostril closed at a time.

What test involves a patient identifying an object placed in their hand?

Stereognosis

Which cranial nerve is responsible for taste in the posterior third of the tongue?

Glossopharyngeal

What diagnosis can be made with RBC casts on urinalysis?

Glomerulonephritis

What finding confirms a diagnosis of pyelonephritis?

WBC casts on urinalysis with microscopy.

What test may elicit a confirmatory response in suspected pyelonephritis?

Renal punch test

What assessment tool should be ordered first for early renal dysfunction in diabetic patients?

Urinalysis with micro/macro albumin.

What lab test should be ordered first for dysfunctional uterine bleeding?

Serum beta human chorionic gonadotropin (HCG)

Which test is not used to identify bacterial vaginosis?

Gonorrhea and Chlamydia DNA probe

What classification of heart failure is indicated by symptoms with daily activities but not at rest?

Class III

What is the first priority intervention for a patient with a rapid heart rate that is irregularly irregular?

Perform an ECG

What is the diagnosis for a patient with chest pressure and arm numbness who has stable angina?

Stable angina, and initiate a long-acting oral nitrate.

What potential cardiac complication should be evaluated in a patient with a history of CABG and aortic valve replacement?

Bioprosthetic aortic valve stenosis

What condition is suspected if crackles are heard in the left lower lobe and clear breath sounds follow coughing?

Atelectasis

What happens to the trachea during inspiration and expiration in the presence of a pneumothorax?

The trachea shifts toward the unaffected side.

What diagnosis is indicated by dull percussion sounds over lung tissue in a post-operative patient?

Atelectasis.

Which patient is most likely to complain of hemoptysis?

Lung cancer.

What clinical sign would you expect in a patient with a TSH of 5.9 and Free T4 of 0.3 ng/dL?

Cold intolerance.

What is the most consistent examination finding in a patient experiencing tachycardia during a hyperthyroid crisis?

Tachycardia.

What percussion finding raises suspicion of splenomegaly?

Percussion that changes from dull to tympany as you percuss from the left anterior axillary line to the left sternal border.

What exam finding is consistent with acanthosis nigricans?

Central obesity.

What condition is indicated by a positive Murphy sign in a patient with right upper quadrant pain?

Cholecystitis.

What condition is indicated by floaters, flashes of light, and a curtain over the visual field?

Retinal detachment.

What examination finding is most consistent with acute closed angle glaucoma?

Increase in intraocular pressure.

What does increased hearing of vibrations in the right ear during a Weber test suggest?

Left side sensorineural hearing loss.

What is considered the highest level of research quality?

Systematic review.

What condition is indicated by a diagnosis of endometriosis?

Endometriosis.

What findings would you expect on a CBC for a patient with chronic alcoholism?

Elevated MCV and MCH.

What is the correct diagnosis for a patient with a platelet count of 80,000?

Thrombocytopenia.

What is not a potential cause of elevated WBC?

Diabetes Mellitus Type 2.

What is the likely item related to myasthenia gravis that needs to be removed?

Thymoma.

What is the most common diagnosis for a patient experiencing swelling of the face and difficulty breathing after a bee sting?

IgE mediated type 1 hypersensitivity reaction.

What CD4 count indicates a well-managed patient with HIV?

CD4 count of 500.

What finding is most commonly associated with Systemic Lupus Erythematosus (SLE)?

Butterfly rash on the face.

What diagnosis is indicated by darkened or velvety skin in the neck, groin, and/or axilla?

Acanthosis nigricans.

What is the diagnosis for a patient exhibiting mood changes with euphoria and depression?

Bipolar disorder.

What condition may represent despondency and lack of motivation in a patient after a major medical procedure?

Situational depression.

What diagnosis is suggested by a patient who always has to face the entrance of the room?

Post traumatic stress disorder.

What diagnosis is indicated by fear of abandonment and intense interpersonal relationships?

Borderline personality disorder.

What is the best leading diagnosis for a patient with leg pain and numbness after ambulation?

Peripheral arterial disease.

What condition is referred to when a patient has severe generalized edema and weight gain after stopping diuretics?

Nephrotic syndrome.

What skin lesion appears darkened, round, and raised, resembling 'stuck on' skin?

Seborrheic Keratosis.

What disease is characterized by erythema on the face surrounding the nasolabial folds?

Seborrheic Dermatitis.

What virus type is associated with human papillomavirus type 6 and 1?

Human papillomavirus.

What is the diagnosis for a patient with a history of diabetes and progressive leg pain?

Peripheral arterial disease.

What is the syndrome of inappropriate antidiuretic hormone (SAIDH)?

A condition where excessive secretion of antidiuretic hormone leads to water retention and hyponatremia.

What examination finding is expected in a patient with a cerebrovascular accident affecting the left hand?

Patient has a hyper-reactive response to any painful stimulus in their left hand.

What is the correct diagnosis if a patient's tongue deviates to the left?

Cranial XII (Hypoglossal nerve) lesion on the left.

What causes a transient ischemic attack (TIA)?

TIAs are caused by focal brain, spinal cord or retinal ischemia, without acute infarction.

What is the expected finding in a patient with a left peripheral lesion?

Normal upper and lower facial movements on the right.

How would you describe a patient who appears drowsy but responds appropriately?

Lethargic.

What condition is suggested by elevated blood pressure and a history of poor kidney function with medication?

Renal artery stenosis.

Which agent is least likely to cause a urinary tract infection in a patient with gram-negative rods?

Enterococcus.

What is the likely cause of renal issues in an elderly patient with elevated creatinine?

Acute tubular necrosis.

What concept should a patient understand about hemodialysis?

My blood is cleaned by diffusing across a semipermeable membrane.

What is the most likely diagnosis for a sexually active 19-year-old female with inguinal pain?

Pelvic inflammatory disease, treat for Gonorrhea and Chlamydia.

What are common risk factors for uterine cancer?

Obesity and smoking.

What symptom should be evaluated in a patient with migraines?

Do you have any visual, sight, or taste symptoms before your migraine symptoms present?

What is the most likely intravenous agent to treat supraventricular tachycardia (SVT)?

Adenosine

Which agent should be avoided in a patient with heart failure with reduced ejection fraction (HFrEF)?

Amlodipine (Norvasc)

What is the safest beta blocker for a patient with severe COPD and coronary artery disease (CAD)?

Carvedilol (Coreg)

Which medication is most likely causing lower extremity edema and constipation in a patient prescribed multiple medications?

Amlodipine (Norvasc)

Which drug must never be used as monotherapy for asthma management?

Long acting beta agonists

What is the first prescription for a patient newly diagnosed with asthma?

Albuterol (Xopenex) MDI PRN for wheezing

What medication may benefit a patient experiencing status asthmaticus?

Terbutaline (Bricanyl)

Which agent should include rinsing the mouth to prevent oral candidiasis?

Inhaled corticosteroids

What common side effect should be notified for the first agent prescribed for type 2 diabetes mellitus?

Diarrhea

Which medication is most likely responsible for symptoms of hypotension and pallor after abrupt withdrawal?

Prednisone (Deltasone)

At which Hgb A1C level should a second oral anti-diabetic agent be considered?

Hgb A1c of 7.0

Which pharmacologic agent may help with weight gain concerns in a patient with type 2 diabetes?

Ozempic (Semaglutide)

What question is most useful to rule out serious conditions in a patient with gnawing abdominal pain?

Have you been taking any non-steroidal anti-inflammatory medications lately?

Which agent is likely to assist in managing side effects of cancer treatment in a patient with acute myeloid leukemia?

Allopurinol (Zyloprim)