NUR 6121 EXAM 3 NUR 6121 ADVANCED NURSING II EXAM 3

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NUR 6121 EXAM 3/ NUR 6121 ADVANCED NURSING II EXAM 3

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The preferred diagnostic test in a patient with acute lumbar

radiculopathy is a(n):

• lumbosacral radiograph series

B. ESR

C. MRI

• Bone scan - Correct Answer - C. MRI

Which of the following laboratory tests is used in primary care to evaluate renal function?

• Electrolyte panel
• Creatinine
• Alkaline phosphatase
• Blood urea nitrogen (BUN) to creatinine ratio - Correct Answer - B)

Creatinine Serum creatinine is measured to evaluate renal function. Creatinine is the end product of creatine metabolism. Creatinine clearance is not affected by fluid or dietary intake of meat.**NOTE - GFR is the BEST indicator!**

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pg. 2 An elderly woman has been on digoxin (Lanoxin) for 10 years. Her electrocardio- graph (EKG) is showing a new onset of atrial fibrillation.Her pulse is 64/min. She denies syncope and dizziness. Which of the following interventions is most appropriate?

• Order an electrolyte panel and a digoxin level
• Order a serum thyroid-stimulating hormone (TSH), digoxin level, and

an electrolyte panel

• Order a serum digoxin level and decrease her digoxin dose by half

while waiting for results

• Discontinue the digoxin and order another 12-lead EKG - Correct

Answer - B) Order a serum thyroid-stimulating hormone (TSH), digoxin level, and an electrolyte panel Obtaining baseline blood work to evaluate for causes of new- onset atrial fibrillation is recommended prior to decreasing or stopping medications.Thyroid disease is a common cause of new-onset atrial fibrillation.

A 55-year-old woman who has type 2 diabetes is concerned about her kidneys. She has a history of 3 urinary tract infections within the past 8 months. She denies dysuria and frequency at this visit. Which of the following is the best initial course to follow?

• Recheck the patient's urine and order a urine for culture and

sensitivity

• Order an IVP (intravenous pyelogram)
• Advise the patient to follow up with a urologist
• Evaluate the patient for a possible kidney infection - Correct Answer
• Recheck the patient's urine and order a urine for culture and

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pg. 3 A urinary tract infection is defined as the presence of 100,000 organisms per mL of urine in asymptomatic patients or greater than 100 organisms per mL or urine with pyuria (more than 7 WBCs/mL) in a symptomatic patient

Mr. Jones, who has been on pravastatin (Pravachol) 20 mg at bedtime for the past few months, complains of lately feeling extremely fatigued.The patient also noticed that his urine has been a darker color during the past 2 weeks. Which of the following is the best treatment plan to follow?

• Discontinue his pravastatin and order a liver function profile
• Continue the pravastatin but on half the dose
• Schedule him for a complete physical exam
• Schedule him for a liver function profile - Correct Answer - A)

Discontinue his pravastatin and order a liver function profile Side effects of statin drugs include myalgia, fatigue, and elevated liver enzymes. Routine labs should include liver enzymes to assess the effects on the liver.

The Phalen test is used to evaluate:

• Inflammation of the median nerve
• Rheumatoid arthritis
• Degenerative joint changes
• Chronic tenosynovitis - Correct Answer - A) Inflammation of the

median nerve The Phalen test is used to identify inflammation of the median nerve seen with carpal tunnel syndrome. Phalen's test is performed by 3 / 4

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pg. 4 examining the wrist with full flexion of the wrist for 60 seconds.Positive findings are reproduction of the symptoms such as numbness and tin- gling of the thumb, index finger, and middle finger areas.

Which of the following viral infections is associated with occasional abnormal forms of lymphocytes during an acute infection?

• Cytomegalovirus (CMV)
• Epstein-Barr virus (EBV)
• Human papilloma virus (HPV)
• Coxsackie virus - Correct Answer - B) Epstein-Barr virus (EBV)

John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

• Valgus stress test
• McMurray circumduction test
• Lachman test
• Varus stress test - Correct Answer - B. McMurray circumduction test

Debbie is a 43-year-old female being evaluated for a wrist injury. The clinician is assessing for median nerve compression by having Debbie maintain forced flexion of her wrist for 1 minute with the dorsal surface of each hand pressed together. Which of these tests did the clinician just perform?

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