WGU D027 OA EXAM 2024-2025 ACTUAL EXAM TEST

WGU D027 OA EXAM 2024-2025 ACTUAL EXAM TEST

BANK 100 QUESTIONS AND CORRECT DETAILED

ANSWERS WITH RATIONALES|AGRADE

Students also studied Save Flashcard sets Study guides Dental Management Chpt 20 (Rheu...Teacher 139 terms vincenzoblankenship Preview Pre-Predictor exam review Teacher 132 terms Payooner_Five Preview Rheumatoid Arthritis Teacher 25 terms sleeping10giant What is the gold standard for the suspected diagnosis of Celiac Disease?Endoscopy with small intestine biopsy A 44-year-old woman has recently been diagnosed with advanced metastatic non-small- cell lung cancer. Genetic testing is ordered to determine if the patient's tumor has any genomic alterations and to guide treatment decisions. A few weeks later, the patient's test results come back positive for a genetic mutation. The APN starts osimertinib (Tagrisso). Based on this information, what type of genetic mutation does this patient have?EGFR mutation

A 20-year-old male meets with an advanced professional nurse (APN) to discuss symptoms that have been slowly progressing over the past several years. He is mainly concerned because he has been falling frequently.Since childhood, his gait has consisted of walking on his toes.During middle school, he was able to participate in sports but was unable to participate in high school sports due to difficulty with running and jumping. Lately, he has noticed it takes longer and is more difficult to change positions from sitting to standing than it used to in the past. He has also been waking up with muscle and joint stiffness. The APRN notes that his family history is not significant for any chronic or genetic diseases.Which condition is likely to be the cause of these symptoms?Becker muscular dystrophy --Becker muscular dystrophy (often called Becker MD or BMD) is a form of muscular dystrophy, a genetic disorder that gradually makes the body's muscles weaker and smaller. It causes less severe problems than the most common type, Duchenne muscular dystrophy.Which statement should the provider give the patient regarding the pathophysiology of SLE and its relation to thrombocytopenia?SLE disrupts immune homeostasis and promotes development of self-reactive antibodies.A female patient presents to an office to establish care. Her previous primary care provider told her to follow up regarding an elevated ferritin level. She has no previous medical history and is currently asymptomatic.She is concerned about the elevated ferritin and would like to know if she should be worried. What should the provider do next for this patient?Order a liver function test A 75-year-old female presents to the emergency department with an irregular heart rate of 130.What can be ascertained about this patient's findings given the limited information?She is diagnosed with atrial fibrillation and needs her heart rate controlled with metoprolol (Lopressor).Which condition from this patient's medical history is contributing to the loss of contractility?Acute myocardial infarction

Which condition is this patient suffering from?Diabetic ketoacidosis A 45-year-old female fears that she is having a stroke and takes herself to an emergency room.After several diagnostic and laboratory tests, the patient is diagnosed with Cushing disease.Which lab abnormality would be present in this patient?Increased cortisol SOB when lying down, and moving around --Based on the patient's presentation, which disease process is the patient likely exhibiting?Asthma A two-year-old child presents with a clear runny nose and cough which has lasted 3 days.The child's mother reports the cough sounds like a barking noise. The child is sleeping in the mother's arms and appears to have stridor. The child's mother also reports an axillary temperature of 101°F last night.Which management technique is appropriate for this child's symptoms?Oral steroids and breathing treatments Delerium, urinary incontinence, fever-- Which lab and diagnostic tests should be ordered as part of the patient's assessment?Complete blood count, complete metabolic profile, and urinalysis An 18-year-old male is involved in a motorcycle crash while not wearing a helmet. He is brought into an emergency room and is immediately taken for a CT scan.The provider tells the patient's parents he has bleeding between the dura mater and the skull. What is this patient's condition called?Epidural hematoma -- What is the appropriate diagnosis for this patient?Crohn's disease Which diagnostic test is appropriate to order for this patient?Ultrasound

A 45-year-old male is being seen in the clinic for a yearly check-up and lab work. His history includes hypertension and hyperlipidemia for which he currently takes Norvasc 5 mg daily and Lipitor 20 mg nightly.Patient has a family history of diabetes, hypertension, heart disease, and hyperlipidemia.After obtaining lab work, the provider notices the patient's hgbA1c is elevated at 7.5. The patient is already on a DASH diet and watching the amount of sweets and carbohydrates he eats daily. The patient is not overweight and participates in moderate physical activity at least 4-5 days a week. He was started on Metformin three months ago, and his hemoglobin A1c is now 6.9. The nurse expects to see a class of medication prescribed which is proven to reduce the risk of cardiovascular events. Considering the treatment guidelines from the American College of Cardiology, which medication should be recommended for this patien Invokana 100 mg daily --Invokana is a medication used to treat type 2 diabetes. It is a third-line medication to metformin. It is used together with exercise and diet. It is not recommended in type 1 diabetes. It is taken by mouth.A 78-year-old female presents to the clinic for a checkup and refills on her medications. She is currently taking lisinopril (Zestril), metformin (Glucophage), and levothyroxine (Synthroid). The patient has a history of hypertension, type 2 diabetes, hypothyroidism, GERD, and gastric ulcers. The patient is concerned about heart disease and wants to start taking a low- dose aspirin. Which aspirin regimen recommendation should the advanced professional nurse (APN) give to the patient?Low-dose enteric coated aspirin 81 mg daily

A 28-year-old married female presents to primary care accompanied by her husband with complaints of weight gain, fatigue, muscle aches, bloating, constipation, and difficulty concentrating. The patient explains that she has been experiencing these symptoms with increasing frequency over the last two months and reports feeling upset that she has gained 10 pounds over the past month despite no significant changes in dietary intake or activity level. The patient holds a bachelor's degree and is employed full time as an accountant. The patient reports feeling frustrated with her poor concentration and identifies recent work errors to be due to this symptom. The patient explains that she and her spouse plan to start trying to conceive soon, and she is worried that she may have trouble becoming pregnant. The patient reports using over-the-counter laxative products over the last week to combat constipation. The patient repo 5.31 mIU/L A 74- year-old male with Cushing syndrome presents to the emergency department (ED) with pain in his left leg, and is diagnosed with a deep vein thrombosis (DVT).What is this patient's symptoms related to?Elevated Von Willebrand factor A 42-year-old asthmatic who has been using beta-adrenergic agonists for several years began to experience premature atrial contractions (PACs). To treat the PACs, metoprolol (Toprol XL) therapy was started.What is a likely consequence of this patient taking metoprolol (Toprol XL)?Metoprolol (Toprol XL) worsened asthma symptoms, but improved the PACs.-- Beta blockers are widely used in the management of cardiac conditions and thyrotoxicosis, and to reduce perioperative complications. Asthma and chronic obstructive pulmonary disease (COPD) have been classic contraindications to the use of beta blockers because of their potential for causing bronchospasm.Which inhaler prescription would support long-acting treatment for twice-daily use in controlled asthma management?Fluticasone propionate/salmeterol (Advair Diskus) --Fluticasone and salmeterol is a combination of two medicines that are used to help control the symptoms of asthma and improve breathing.

A 65-year-old male presents for a visit regarding his type 2 diabetes. He has been dealing with diabetes for the last 15 years. He has a history of diabetic neuropathy in his feet.Six months ago his symptoms were mild to almost nonexistent.He currently describes the neuropathy as painful, and it wakes him up at night. Which medication would be the first line treatment for this patient?Pregabalin (Lyrica) A 55-year-old male presents for a new diagnosis of Parkinson's Disease. He has experienced gait disorders and a pill rolling tremor. The patient was a former boxer with a history of multiple concussions. He was started on carbidopa-levodopa (Sinemet), which has decreased his symptoms. How would an antipsychotic medication such as haloperidol (Haldol) cause an interaction with this patient?By antagonizing dopamine A 25-year-old female is 35 weeks pregnant and presents for lower back pain. She has a history of moderate lower back pain that she normally controls with stretching, yoga, and ice.The patient reports not being able to engage in stretching and yoga because of the state of her pregnancy. Ice use has been ineffective. After a benign exam and a negative urinalysis, the provider is convinced that the pain is musculoskeletal. The patient inquires if there are any medications she can take for the pain. Which medication does the provider tell the patient she can safely take?Acetaminophen (Tylenol) A nurse is administering medication to a 67-year-old patient in liver failure, secondary to end-stage cirrhosis. Liver dysfunction can influence drug pharmacokinetics and pharmacodynamics. Which pharmacokinetic phase is affected in this patient?Metabolism

A 17-year-old male patient presents to a clinic for a physical, and he has a diagnosis of moderate glucose-6- phosphate dehydrogenase (G6PD) deficiency. During the exam, he states he is going to study abroad in Egypt during his sophomore year, and he has concerns about his nutrition while being away from home.Which counseling about the patient's deficiency should the advanced professional nurse (APN) give to this patient while he studies abroad?Acetaminophen (Tylenol) is safe to consume.A patient presents with new onset of atrial fibrillation that has proved resistant to cardioversion and ablation. The patient is prescribed Warfarin (Coumadin). Which strategy should be employed when dosing the medication prescribed for this patient?Titrate dosage to an INR of 2.1 seconds Which medication would be contraindicated for a 46-year- old male patient diagnosed with beta thalassemia?Ferrous sulfate (Feosol) --People with thalassaemia may be advised to avoid iron supplements because they are at risk of iron overload.An advanced professional nurse (APN) is administering medications on the pediatric floor and treating an infant with thrush who is currently taking Nystatin oral suspension (Mycostatin). The APN knows the infant is unable to follow the directions of swishing the medication and swallowing.How should the APN administer this infant's suspension?Swab the infected area A two-week-old newborn presents to the pediatric clinic with her mother for a check-up.The nurse discusses the recommended vaccination guidelines from the Centers for Disease Control and Prevention (CDC), including the hepatitis B vaccine.What is the recommended schedule for this patient receiving the hepatitis B vaccination?Three immunizations with one injection now (if not given at birth), one injection at two months, and one injection at six months

On a follow-up appointment, a mother of a newborn reports the infant draws up the legs, clenches fists, and cries as if in pain. The mother reports the symptoms usually occur during the evening but the baby tolerates formula well. The nurse tells the mother that the baby has infantile colic. The mother inquires about the child's prognosis. How should the nurse describe the prognosis of infantile colic to the patient's mother?Children usually outgrow the condition at about three months of age.

-- infantile colic: Predictable periods of significant distress in an

otherwise well-fed, healthy baby.A 40-year-old Trinidadian male comes into a clinic complaining of burning chest pain, indigestion, nausea, and belching after eating certain foods. He is a single father living and working in New York City.He recently obtained his green card after living in the United States for more than 10 years.He has a GED and works as an IT help desk technician earning $42,000 a year. He has health insurance through the New York health marketplace because it is cheaper than his employer's plan. Because of the high cost of living in New York, the patient is unable to afford an apartment on his own; therefore, he and his child share a home with his mother and older sister. As the nurse begins to explore his social history regarding his alcohol use, the patient states, "I have two to three beers every night to help me sleep. I have been doing this for the past year." The patient also states he has trouble falling asleep and stayi The patient's lifestyle structure

A 40-year-old Trinidadian male comes into a clinic complaining of burning chest pain, indigestion, nausea, and belching after eating certain foods. He is a single father living and working in New York City.He recently obtained his green card after living in the United States for more than 10 years.He has a GED and works as an IT help desk technician earning $42,000 a year. He has health insurance through the New York health marketplace because it is cheaper than his employer's plan. Because of the high cost of living in New York, the patient is unable to afford an apartment on his own; therefore, he and his son share a home with his mother and older sister. As the nurse begins to explore his social history regarding his alcohol use, the patient states, "I have two to three beers every night to help me sleep. I have been doing this for the past year." The patient also states he has trouble falling asleep and staying Seeking higher or advanced education in his field

A 72-year-old male patient comes into the clinic complaining of shortness of breath, wheezing, chills, and hot flashes at night for over three weeks. He is currently only prescribed a blood pressure medication but is unsure of the name and has not had any refills in the last several months. He reports being unsure if he has been exposed to any respiratory illnesses. He continues to report he is homeless and lives in different shelters or outside. He is unemployed but does receive assistance money from an unknown donor which averages $300 per month. He states he does not have any family or social support. The patient states he only has an eighth-grade education and is unable to read very well. He is unable to write his name, although he has always learned easily by watching and interacting with live instructions. He denies illegal drug use and uses public transportation.The assessment findings include a blood pressure Lack of income and poverty level A 32-year-old female presents to the emergency room (ER) with headache, fatigue, and shortness of breath on exertion.A complete blood count reveals a hemoglobin of 4.4g/dl. During the gynecological review of systems, she reports a change of a fully saturated pad every two hours for the first three out of six days of a 28-day menstrual cycle. She states she thought this was normal and has never sought gynecological care. She does not follow with a primary care physician.Which factor in the "health and healthcare" domain of the social determinants of health contributed to this patient's hemoglobin of 4.4g/dl?Health literacy

An emergency room (ER) nurse is in a room caring for a patient when the ER suddenly becomes very busy and fills all available rooms. When the nurse completes the care of the current patient, he finds an emergency medical technician (EMT) ready to report on each of the new patients. Which patient from the report should be seen first?The 40-year-old male with crushing chest pain who denies any injury or prior history of heart disease An advanced professional nurse (APN) on the float team was assigned to provide care of four postoperative patients on the medical-surgical unit. Which patient should the APN see first?The patient who is four days post right lobectomy with a heart rate of 120, cold sweats, and lightheadedness Four patients are sitting in an emergency room (ER) waiting to be seen. Each patient checked into the ER using an electronic kiosk that required the reason for the visit. The nurse reviews the data entered by each patient. Which patient should the nurse assist first?A 19-year-old male with a temperature of 101°F and a stiff neck.

A cardiac advanced professional nurse (APN) receives and assesses a report of her patients at the beginning of her shift. Her report includes the following

patients:

a patient who received furosemide (Lasix) two hours ago and is complaining of excessive urination a post-op cardiac catheterization patient who received hydrocodone bitartrate and acetaminophen (Norco) and is now complaining of drowsiness a patient who received metoprolol (Toprol XL) with a heart rate of 42 and who is complaining of extreme weakness and dizziness a patient who is day two post- myocardial infarction and is requesting medication for constipation Which patient should the APN see first?The patient who received metoprolol (Toprol XL) A 72-year-old male patient with chronic atrial fibrillation is currently taking digoxin (Lanoxin). The nurse knows this medication helps with irregular heartbeat but that it can have side effects. What should the nurse do before administering this patient's next dose of digoxin?Obtain the patient's apical pulse -- Apical pulse should be taken for a full minute before administration of this medication. If the apical pulse is less than 60, the dose should be withheld and the prescribing provider notified. Serum digoxin levels should be monitored, with a normal therapeutic range from 0.8 to 2 ng/mL.An intravenous (IV) therapy nurse receives several pages within a few minutes from various places within the hospital on a Saturday morning.The IV therapy nurse returns all the pages to obtain additional triage information. Which patient should the IV therapy nurse see first?A patient in the intensive care unit (ICU) who needs IV access for an insulin drip

A 76-year-old female with a history of hypertension (HTN) and chronic obstructive pulmonary disease (COPD) presents with abdominal pain and approximately three to four watery stools a day. She has a basic metabolic panel (BMP)

revealing the following: sodium

140, potassium 3.3, chloride 90, glucose 155, blood urea nitrogen (BUN) 46, creatinine 1.6, and estimated glomerular filtration rate (eGFR) 40. The patient's medications include lisinopril (Zestril), fluticasone/salmeterol (Advair), and tiotropium (Spiriva). She has no other significant medical

history. Vital signs are as follows:

temperature of 98°F, heart rate of 78, blood pressure of 120/80, respiratory rate of 18, and oxygen saturation (SpO2) of 98%.Which treatment should the nurse administer first based on this patient's lab results?Administer intravenous fluids

A 16-year-old female presents to primary care accompanied by her mother with complaints of chronic fatigue, muscle aches, headaches, and dizziness for the last several months with increasing frequency and severity. The patient is a high school student, and she reports that she passed out today during chemistry. The patient is in a healthy, new relationship with a student at her school. She reports using over-the-counter ibuprofen (Motrin) three times over the last week to manage her symptoms. The assessment findings include a blood pressure of 89/58, P 92 and R 22.The patient is 5 feet, 2 inches tall and weighs 103 pounds. On palpation, the thyroid is not enlarged. The patient has a normal sinus rhythm and regular rate. Lung sounds are clear bilaterally. Her abdomen is soft and bowel sounds are present in all four quadrants. She has a steady gait, though verbally complains of feeling weak and off balance upon ambula Rowing

A 71-year-old male with metastatic prostate cancer and type 2 diabetes mellitus with neuropathy presents to an appointment with his primary care provider to address many physical and emotional complaints secondary to his worsening pain. The patient explains that he has been struggling with increased sadness over arranging his end- of-life care and feels that his exacerbation of pain coincides with the timing of his increased sorrow. Patient reports struggling with poor sleep due to grief and aches and restlessness in his legs. He reports increased fatigue and poor energy. Which pharmacological treatment would be helpful for the patient to manage his symptoms and lead to improved sleep?Mirtazapine (Remeron) --Mirtazapine has been found to reduce the time it takes for a person to fall asleep, as well as reducing the duration of early, light stages of sleep and increasing deep sleep 2. It also slightly reduces REM sleep (dream sleep) and night-time waking and improves the continuity and overall quality of sleep

A 71-year-old male with stage IV metastatic prostate cancer and type 2 diabetes mellitus with neuropathy presents to an appointment with his primary care provider to address many physical and emotional complaints secondary to his worsening pain. The assessment findings include a blood pressure of 128/72, P 74 and R 18.The patient is 6 foot, 1 inch tall and weighs 188 pounds. The patient has a normal sinus rhythm and regular rate. Lung sounds are clear bilaterally, however, the patient complains of pain in his chest at the sternum, which he rates a 4 on a numeric scale of 0-10. He identifies pain in his lower spine post fall yesterday morning and rates it a 7 and aching pain in bilateral lower extremities that has increased from an intermittent 3 to a consistent 5 on a numerical scale of 0-10 over the past month.Additionally, the patient explains that he has been struggling with increased sadness over arranging his Attend weekly group on radical acceptance

A 71-year-old male with stage IV metastatic prostate cancer and type 2 diabetes mellitus with neuropathy presents to an appointment with his primary care provider to address many physical and emotional complaints secondary to his worsening pain. The assessment findings include a blood pressure of 128/72, P 74 and R 18.The patient is 6 foot, 1 inch tall and weighs 188 pounds. The patient has a normal sinus rhythm and regular rate. Lung sounds are clear bilaterally, however, the patient complains of pain in his chest at the sternum, which he rates a 4 on a numeric scale of 0-10. He identifies pain in his lower spine post fall yesterday morning and rates it a 7 and aching pain in bilateral lower extremities that has increased from an intermittent 3 to a consistent 5 on a numerical scale of 0-10 over the past month.Additionally, the patient explains that he has been struggling with increased sadness over arranging his e Bone scan --Bone health It can treat high blood calcium levels. In addition it can treat bone damage caused by Paget's disease, multiple myeloma, and cancers that spread to the bone. It can also treat osteoporosis and reduce the risk of hip fractures in certain patients.

A 70-year-old male with a history of myocardial infarction, chronic obstructive pulmonary disease (COPD), and epilepsy arrives at a neurologist's office for a battery of tests to assess his memory function. His family reports some decline in cognitive functioning, with memory impairment as the primary complaint. The family states they have heard ginkgo biloba is helpful for improving memory. The neurologist asks the family if the patient has ever been prescribed a prescription medication such as donepezil (Aricept) for memory function, which the family denies. The family informs the neurologist that the patient is on the

following medications:

clopidogrel (Plavix) 75 mg every day, ipratropium bromide and albuterol sulfate (Combivent) 1 puff four times daily, and levetiracetam (Keppra) 500 mg twice daily. What is a potential adverse effect of ginkgo biloba based on this patient's profile?Increased risk of bleeding

A 26-year-old male presented to the emergency department accompanied by his mother with complaints of an exacerbation of psychotic symptoms secondary to his diagnosis of schizophrenia. He explained that he was diagnosed at age 20 and has struggled to sustain his typical baseline functioning for any extended period of time despite multiple antipsychotic medication trials. He has been taking risperidone (Risperdal) for approximately six months. A focused assessment revealed

the following: Patient has been

struggling with auditory and visual hallucinations that are command in nature. He reports experiencing suicidal ideation.Patient denies homicidal ideation. He has temporarily been residing with his mother for the past week due to intrusive suicidal thoughts and hallucinations that increase when at his apartment. The mother reported that this morning the patient became increasingly agitated and was screaming and throw Prazosin hydrochloride (Minipress) --Physicians prescribe prazosin, sold under the brand name of Minipress, to treat nightmares for post-traumatic stress disorder

(PTSD).

A 51-year-old female was voluntarily admitted to the inpatient adult unit at the psychiatric hospital with complaints of excessive worry, panic, anhedonia, difficulty concentrating, and endorsed hopelessness and helplessness.Following a focused assessment, depression has been ruled out.Which as-needed (PRN) medication should be started to support the management of this patient's symptoms?Hydroxyzine (Vistaril) --Vistaril is a prescription medicine used to treat the symptoms of anxiety, itching or hives on the skin and as preoperative sedation.

A 51-year-old female was voluntarily admitted to the inpatient adult unit at the psychiatric hospital with complaints of excessive worry, panic, anhedonia, difficulty concentrating, and endorsed hopelessness and helplessness.A focused assessment revealed

the following: The patient

explained that her severe impairment in functioning has progressed due to a vacant relationship with her spouse of 15 years and her stressful job as a Human Resources Benefits Manager. She was recently promoted to this position and reports, "I should never have been promoted. I have never been good at my job, and all I do is mess up all of the time." The patient reports missing work often and has not presented to work in four days. She denies having a support system and reports struggling with isolation and loneliness. She reports poor sleep with difficulty falling and staying asleep, accompanied by frequent stressful dreams about work. Pa Lavender lemon balm A patient has a disorder affecting ventricular depolarization. What ECG finding with the nurse associate with this?

• Absence of P waves
• Short PR interval
• QT interval variability
• Prolonged QRS interval
• Prolonged QRS interval

--The QRS complex represents the sum of all ventricular muscle cell depolarization therefore a prolonged QRS interval would be suggestive ventricular depolarization abnormalities. For example, heart failure or bundle branch block or myocardial infarction.Pharmacotherapy used for a patient with peripheral artery disease and diabetes includes

all of the following except:

• Aspirin
• HMG-CoA reductase

inhibitors (statins)

• Gabapentin
• Metformin
• Gabapentin

What is the intended therapeutic action of inhaled corticosteroids in patients with chronic respiratory conditions

• Reversal of fixed airway

obstruction

• Improvement of central

respiratory drive

• Reduction of airway

inflammation

• mucolytic activity

Reduction of airway inflammation --Topical corticosteroids work to decrease inflammation locally where applied.Which of the following conditions is contraindicated in using thrombotic therapy?

• History of hemorrhagic stroke
• Peptic ulcer disease
• Concurrent use of Coumadin
• Blood pressure of 160/100

mmHg

• History of hemorrhagic stroke

--Thrombolytic therapy can increase risk of recurrent hemorrhagic stroke in patients who have this history.Which hospitalized patient is highest risk for developing delirium?

• An elderly male with COVID-

19

• A woman recently diagnosed

with schizophrenia

• A depressed Hispanic woman
• A 70-year-old diabetic patient
• An elderly male with COVID-19

--Delirium is associated with autonomic nervous system overactivity and typically develops in 2 to 3 days, most commonly in critical care units, post surgically, or during withdrawal from CNS depressants (e.g., alcohol, narcotic agents).A patient with chronic migraines arrives for a neurological evaluation. The neurologist recommends preventative therapy. Which one (1) of the following medications is used to prevent the frequency of chronic migraines?

• Verapamil
• Dihydroergotamine
• Naproxen
• Sumatriptan
• Verapamil

-- Calcium channel blockers have demonstrated efficacy in investigative use for prophylaxis of migraine and cluster headaches. In particular, verapamil, with its low side-effect profile, appears to be a promising alternative to the currently available agents for prophylactic treatment of chronic recurring headaches.

See an expert-written answer!Which of the following antihypertensive mediations should the nurse practitioner avoid when treating a patient with emphysema?

• Calcium channel blockers
• Beta blockers
• Angiotensin converting

enzyme inhibitors

• Diuretics
• Beta blockers

--Beta blockers, specifically the beta-2 blockers result in bronchoconstriction therefore they should be avoided in patients with chronic respiratory conditions.Which vitamin may be used as concomitant therapy in managing a patient with schizophrenia?

• Vitamin B1
• Vitamin C
• Vitamin D
• Vitamin E
• Vitamin B1

Recent evidence shows that the B vitamins decrease both positive and negative features of schizophrenia.A 29 yo pregnant patient presents with a pulmonary embolus (PE). Which medication should the nurse anticipate giving?

• low molecular weight heparin
• Fondaparinux
• Unfractionated heparin
• Vitamin K
• Unfractionated heparin

LMWH has less of an effect on thrombin compared to heparin A nurse notes that a child has discoloration of several teeth.The nurse will ask about which medication group?

• Glucocorticoids
• Tetracyclines
• Sulfonamides
• Salicylates
• Tetracyclines

--Tetracyclines cause discoloration in developing teeth in children. Glucocorticoids are associated with growth suppression. Salicylates are associated with Reye syndrome.Sulfonamides are associated with kernicterus in newborns.Which of the following medications is an alpha 1 and nonselective beta blocker?

• Atenolol
• Metoprolol
• Propanolol
• Carvedilol
• Carvedilol

--Carvedilol is a nonselective β-blocker which, in addition, has alpha vasodilatory effects by blockade of the α-receptor.

If taken with a selective serotonin reuptake inhibitor (SSRI), which herbal product can increase risk of serotonin syndrome?

• St. John's wort
• Kava kava
• Ginkgo biloba
• Valerian root
• St. John's wort

--Taking St. John's wort with antidepressants might increase the risk of the accumulation of high levels of serotonin in your body.Too much serotonin can cause mild to severe side effects.A 12-year-old-child patient presents to the clinic and report signs and symptoms consistent with asthma. How would the healthcare professional objectively confirm this diagnosis?

• Draw serum levels of

immunoglobulin E (IgE) and eosinophils

• Measure expiratory flow rate

and spirometry testing

• Assess for parental history of

asthma

• Give a trial of asthma

medication and check for improvement

• Measure expiratory flow rate and spirometry testing

--To objectively diagnose asthma, pulmonary function testing using spirometry can be accomplished after a child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities found on a PFT.According to CDC risk classification, a PPD measuring 7 mm in a patient living in a

homeless shelter is:

• Negative results because

induration is greater than 5 mm

• Positive result because

induration is less than 15 mm

• Negative result because

induration is less than 10 mm

• Positive result because

induration is greater than 5 mm

• Negative result because induration is less than 10 mm

--In high-risk patients, a PPD must measure at least 10 mm of induration to be positive. High-risk patients include those that live in congregant settings like correctional facilities, nursing homes, etc.

Which of the following is the most consistent finding in a patient with unstable angina?

• 5 minute episode of chest

tightness after stairs but relieved with rest

• Severe, searing pain that

penetrates the chest and last 30 seconds

• Chest pressure lasting 20

minutes that doesn't resolve with resting

• "heartburn" feeling relieved

by position change

• Chest pressure lasting 20 minutes that doesn't resolve with

resting --Key features of unstable angina are severe, unpredictable and prolonged chest pressure or pain lasting longer than 5 minutes.Usual methods to mitigate symptoms do not reliably work.When treating type 2 diabetes,

sulfonylureas are:

• An antagonist of insulin

receptor site activity

• A drug category that

enhances insulin release

• The facilitator of renal

glucose excretion

• A drug category that can

reduce hepatic glucose production

• A drug category that enhances insulin release

--Sulfone areas for example glipizide, work by increasing production of insulin by the beta cells in the pancreas. This increase in insulin transports the glucose in the bloodstream intracellularly.Crohn's disease is associated with increased risk of malignancy in which segments of the G.I. tract?

• Duodenum and colon
• Esophagus and stomach
• Ileum and jejunum
• Ileum and colon
• Ileum and colon

--Patients with poorly controlled Crohn's disease will be at a heightened risk for malignancy in the distal G.I. tract which includes the ileum and colon.Which of the following is not a function of the kidney?

• Release of oxytocin
• Release of antidiuretic

hormone

• Release of erythropoietin
• Release of renin
• Release of oxytocin

--This is a function of the posterior pituitary gland

See an expert-written answer!Short-acting beta 2 agonists reduce symptoms of asthma by causing

• Bronchial smooth muscle

relaxation

• Bronchial smooth muscle

contraction

• Decreased airway sensitivity
• Decreased immune

hypersensitivity

• Bronchial smooth muscle relaxation

--An agonist effect on the beta 2 receptors in the lungs causes bronchiole smooth muscle relaxation which leads to bronchodilation thereby improving air exchange.Which endocrine gland is responsible for regulation of calcium?

• Adrenal gland
• Thyroid gland
• Parathyroid gland
• Pancreas
• Parathyroid gland

--The parathyroid gland regulates calcium through a negative feedback loop similar to all endocrine system organs.The most common mental health disorder that goes

unidentified in primary care is:

• Depression
• Obsessive-compulsive

disorder

• Anxiety
• Schizophrenia
• Depression

--Depression is the most common mental health condition diagnosed yet many go undiagnosed due to inadequate screening practices or patient denial.Which nonpharmacologic strategy is most effective in managing a patient with schizophrenia?

• Cognitive behavioral therapy
• Hypnotherapy
• Herbal therapy
• Nonpharmacologic therapies

do not work with this diagnosis

• Cognitive behavioral therapy

--Schizophrenia is thought to be caused by imbalances of neurotransmitters glutamate and dopamine therefore pharmacotherapy is required. Cognitive behavioral therapy will help redirect hallucinations, delusions and disordered thinking common to this diagnosis which may decrease adjunct medication uses like benzodiazepines.

Recommended duration of using antianxiety agents like the benzodiazepine group, when

treating anxiety disorders is:

• Generally given for 4 to 6

months

• Continued at least six months

after remission is achieved

• Continued indefinitely with

the first diagnosis of the condition

• Titrated to the highest dose

recommended after symptom relief is achieved Continued at least six months after remission is achieved A 36-year-old man with asthma requires antihypertensive therapy. Which one of the medications should be avoided?

• Hydrochlorothiazide
• Propanolol
• Amlodipine
• Enalapril
• Propanolol

--Propanolol is a beta-2 blocker and contraindicated in patients with chronic respiratory conditions due to the bronchoconstrictive risk this drug would pose.To determine a patient's adequacy of alveolar ventilation which assessment would be most helpful?

• Venous blood gas shows a

PaCO2 of 44 mmHg

• Ventilatory pattern is regular

and rhythmic.

• Respiratory effort is strained

with muscle involvement.

• Arterial blood gas shows a

PaCO2 of 44 mmHg

• Arterial blood gas shows a PaCO2 of 44 mmHg

--Observation of the ventilatory rate, pattern, or effort cannot determine the adequacy of alveolar ventilation. If a healthcare professional needs to determine the adequacy of ventilation, then an arterial blood gas would be the most helpful.The mechanism of radioactive iodine in the treatment of

Grave's disease is to:

• Destroy the overactive

thyroid tissue

• Reduce the production of TSH
• Alter thyroid metabolic rate
• Relieve distress caused by

increased thyroid size

• Destroy the overactive thyroid tissue

--By decreasing viability of a portion of the thyroid gland the aim is to have normal levels of thyroid hormone produced.

When norepinephrine binds with alpha-2 receptors, the expected physiologic response is which one of the following?

• Bradycardia
• Tachycardia
• Bladder relaxation
• Hypertension
• Bradycardia

-- A patient receiving the loop diuretic furosemide may experience which "first dose" adverse reaction?

• Hypokalemia
• Ototoxicity
• Nephrotoxicity
• Hypotension
• Hypotension

--The loop diuretic category is the fastest acting diuretic therefore the first dose adverse effect most common would be hypotension. Hypokalemia may also be the case if the patient had borderline low potassium before receiving the medication but that information is not evident. Ototoxicity and nephrotoxicity are more common with repeated doses of this medication category.A 30-week pregnant female should not receive which vaccine?

• Tdap
• Influenza
• Hepatitis B
• varicella
• varicella

--The effects of the varicella vaccine are unknown therefore this vaccine is contraindicated. Congenital defects are a possible consequence to the fetus when live vaccines are administered during pregnancy, particularly the first 2 trimesters. Non- pregnant females should not become pregnant for at least 1 month after receiving the vaccine.The cornerstone of pharmacotherapy in treating

Alzheimer's disease is:

• Cholinesterase inhibitors
• NMDA receptor antagonists
• Psychotropic medications
• Anxiolytics
• Cholinesterase inhibitors