Advanced Practice Nursing in the Care of Older Adults By Laurie Kennedy – Test Bank

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Advanced Practice Nursing in the Care of Older Adults By Laurie Kennedy – Test Bank

Chapter 6: Skin and Lymphatic Disorders

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   Which of the following dermatological conditions results from reactivation of the dormant varicella virus?

A. Tinea versicolor
B. Seborrheic keratosis
C. Verruca
D. Herpes zoster

 

 

____    2.   An older adult male presents with pain in his right chest wall for the past 48 hours. Upon examination, the nurse practitioner notices a vesicular eruption along the dermatome and identifies this as herpes zoster. The NP informs the gentleman that:

A. All symptoms should disappear within three days
B. Oral medications can dramatically reduce the duration and intensity of his symptoms
C. He has chickenpox and can be contagious to his grandchildren
D. He has a sexually transmitted disease

 

 

____    3.   A 70-year-old white male comes to the clinic with a slightly raised, scaly, pink, and irregular lesion on his scalp. He is a farmer and works outside all day. You suspect actinic keratosis, but cannot rule out other lesions. What recommendation would you give him?

A. Ignore the lesion, as it is associated with aging.
B. Instruct him to use a nonprescription hydrocortisone cream to dry up the lesion.
C. Perform a biopsy or refer to a dermatologist.
D. Advise him to use a dandruff shampoo and return in one month if the lesion has not gone away.

 

 

____    4.   The immunofluorescent antibody (IFA) is a laboratory test used to diagnose which of the following disorders?

A. Tinea versicolor
B. Herpes zoster
C. Squamous cell carcinoma
D. Human papilloma virus

 

 

____    5.   A wound with drainage and foul odor should be cleansed with:

A. Normal saline
B. Hydrogen peroxide
C. 20% acetic acid
D. Betadine

 

 

____    6.   A full thickness pressure ulcer is partially covered with eschar and the surrounding tissue is reddened. Which of the following is the most appropriate treatment for this condition?

A. Apply an occlusive dressing
B. Debride mechanically or chemically
C. Saline moistened gauze dressings
D. Vacuum-assisted wound closure

 

 

____    7.   In examining the skin of your nursing home patient, you note a “stained glass” brownish mark on the face. Which of the following lesions best describes a stained glass brownish mark?

A. Actinic keratosis
B. Seborrhea keratosis
C. Lentigo maligna
D. Superficial spreading malignant melanoma

 

 

____    8.   Patients who have an underlying tinea infection to the cellulitis should also be treated with which one of the following?

A. An anti-fungal medication
B. Topical steroids
C. Oral steroids
D. Zinc oxide

 

 

____    9.   Identify the type of malignant melanoma that is associated with the Hutchinson’s sign of the cuticle of the finger.

A. Lentigo maligna
B. Acral lentiginous
C. Nodular
D. Superficial spreading malignant melanoma

 

 

____  10.   A smooth round nodule with a pearly gray border and central induration best describes which skin lesion?

A. Seborrheic keratosis
B. Malignant melanoma
C. Herpes zoster
D. Basal cell carcinoma

 

 

____  11.   Cellulitis is a deep skin infection involving the dermis and subcutaneous tissues. The nurse practitioner suspects cellulitis in a 70-year-old Asian diabetic male presenting with reddened edematous skin around his nares. Which statement below will the nurse practitioner use in her decision-making process for the differential diagnosis pertaining to reddened edematous skin?

A. Cellulitis is two times more common in women
B. Facial cellulitis is more common in people >55
C. There is low incidence of cellulitis in patients with diabetes
D. Cellulitis is only a disease of the lower extremities of patients with known arterial insufficiency

 

 

____  12.   An 82-year-old female has a “pimple” on his nose that occasionally bleeds and may have increased in size in the past year. The lesion is a 0.7-cm, dome-shaped, umbilicated papule with pearly translucence. There is also a hemorrhagic crust covering the central portion. Which of the following is the most likely diagnosis?

A. Squamous cell carcinoma
B. Basal cell carcinoma
C. Keratocanthoma
D. Sebaceous hyperplasia

 

 

____  13.   Which of the following is generally not a first-line treatment for post herpetic neuralgia?

A. Intrathecal methylprednisolone
B. Gabapentin
C. 5% lidocaine patch
D. Topical capsaicin

 

 

____  14.   A nursing home resident with a Stage 4 pressure ulcer that extends to the muscle layer and has significant undermining with heavy exudate should be treated with:

A. Dry gauze dressings
B. Duoderm
C. Chemical debridement
D. Calcium alginate dressings

 

 

____  15.   Which of the following descriptions accurately documents cellulitis?

A. Cool, erythematous, shiny hairless extremity with decreased pulse
B. Scattered, erythematous ring-like lesions with clear centers
C. Clearly demarcated, raised erythematous area of face
D. Diffusely inflamed skin that is warm and tender to palpation

 

 

____  16.   Asymmetrical bi-color lesion with irregular border measuring 8 mm is found on the right lower arm of an adult patient. This assessment finding is consistent with:

A. Melanoma
B. Basal cell carcinoma
C. Leukoplakia
D. Senile lentigines

 

 

____  17.   Which of the following descriptions best illustrates assessment findings consistent with tinea capitis?

A. Circular erythematous patches with papular, scaly annular borders and clear centers
B. Inflamed scaly dry patches with broken hairs
C. Web lesions with erythema and scaling borders
D. Scaly pruritic erythematous lesions on inguinal creases

 

 

____  18.   A hyperkeratatotic nodule formed as the result of exposure of the foot to moisture from perspiration is called:

A. Hard corn
B. Tinea pedis
C. Soft corn
D. Plantar warts (verrucae)

 

 

____  19.   A 64-year-old male presents with an exacerbation of psoriasis. His social history includes 50-year two packs a day of cigarettes and a six-pack a week of beer. He states he had a recent sore throat, which he attributes to minding his young grandson. He reports that until recently the pruritis was only minimal. His BMI is 37. Which of the following factors most likely contributed to the acute presentation of psoriasis?

A. Alcohol abuse
B. Smoking
C. Streptococcal infection
D. Obesity

 

 

____  20.   Treatment of complicated cellulitis of the lower extremity resulting from an anaerobe requires all of the following except:

A. Extended antibiotic medication lasting at least 7-10 days
B. Topical antifungal medication
C. Inquiry when last tetanus toxoid booster was given
D. Elevation of limb and consideration of compression bandaging

 

Chapter 6: Skin and Lymphatic Disorders

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  D                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  C                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  A                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  C                    PTS:   1

 

  1. ANS:  A                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  D                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  A                    PTS:   1

 

  1. ANS:  D                    PTS:   1

 

  1. ANS:  D                    PTS:   1

 

  1. ANS:  A                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  C                    PTS:   1

 

  1. ANS:  C                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

Chapter 7: Head, Neck, and Face Disorders

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   A 64-year-old male presents with erythema of the sclera, tearing, and bilateral pruritus of the eyes. The symptoms occur intermittently throughout the year and he has associated clear nasal discharge. Which of the following is most likely because of the inflammation?

A. Bacterium
B. Allergen
C. Virus
D. Fungi

 

 

____    2.   One of the first-line treatments in patients with allergic rhinitis is the use of nasal corticosteroid sprays. What is the anticipated onset of symptom relief with the use of these medications?

A. Two weeks or more
B. Immediate
C. 1 to 2 days
D. A minimum of one week

 

 

____    3.   The nurse practitioner knows that antihistamines work primarily through which of the following mechanisms?

A. Vasodilatation
B. Blocking leukotriene effects
C. Inhibiting histamine receptor sites
D. Vasoconstriction

 

 

____    4.   Cromolyn sodium may also be used in the treatment of allergic rhinitis. What is the mechanism of action of this medication?

A. Mast cell stabilization
B. Blocking the effects of IgE
C. Leukotriene inhibition
D. Histamine blockade

 

 

____    5.   Patients that have atopic disorders are mediated by the production of IGE will have histamine stimulated as an immediate phase response. This release of histamine results in which of the following?

A. Sinus pain, increased vascular permeability, and bronchodilation
B. Bronchospasm, vascular permeability, and vasodilatation
C. Contraction of smooth muscle, decreased vascular permeability, and vasoconstriction
D. Vasodilatation, bronchodilation, and increased vascular permeability

 

 

____    6.   Which of the following maneuvers is used to induce symptoms of benign paroxysmal positional vertigo?

A. The Fukuda stepping test
B. The Dix-Hallpike maneuver
C. Forced hyperventilation
D. The head thrust test

 

 

____    7.   You have a patient complaining of vertigo and want to know what could be the cause.  Knowing there are many causes for vertigo, you question the length of time the sensation lasts. She tells you several hours to days and is accompanied by tinnitus and hearing loss. You suspect which of the following conditions?

A. Ménière’s disease
B. Benign paroxysmal positional vertigo
C. TIA
D. Migraine

 

 

____    8.   Sensory impairment (vision and hearing) in the elderly is associated with:

A. Impaired quality of life
B. Decreased function
C. Increased mortality
D. All of the above

 

 

____    9.   Which of the following conditions is the leading cause of blindness in the United States?

A. Macular degeneration
B. Diabetic retinopathy
C. Glaucoma
D. Cataracts

 

 

____  10.   A slightly elevated elastic tissue deposit in the conjunctiva that may extend to the cornea but does not cover it is known as a:

A. Pterygium
B. Pinguecula
C. Xanthelsma
D. Limbal nodule

 

 

____  11.   A nonmodifiable risk factor for the development of cataracts is:

A. Long-term exposure to ultraviolet B radiation
B. High alcohol intake
C. Strong family history
D. Diabetes mellitus

 

 

____  12.   Causes of sensorineural hearing loss include:

A. Ototoxicity
B. Ménière’s disease
C. Otosclerosis
D. Inner ear fistula

 

 

____  13.   Clinical findings in patients with nonproliferation retinopathy include:

A. Cotton wool spots
B. Microaneursyms
C. Deep hemorrhages
D. Neovascularization

 

 

____  14.   In examining the mouth of an older adult with a history of smoking, the nurse practitioner finds a suspicious oral lesion. The patient has been referred for a biopsy to be sent for pathology. Which is the most common oral precancerous lesion?

A. Fictional keratosis
B. Keratoacanthoma
C. Lichen planus
D. Leukoplakia

 

 

____  15.   A gross screening for hearing is the whisper tests. Which cranial nerve is being tested when the nurse practitioner conducts this test?

A. Cranial nerve V
B. Cranial nerve VII
C. Cranial nerve VIII
D. Cranial nerve IV

 

Chapter 7: Head, Neck, and Face Disorders

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  C                    PTS:   1

 

  1. ANS:  C                    PTS:   1

 

  1. ANS:  A                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  A                    PTS:   1

 

  1. ANS:  D                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  C                    PTS:   1

 

  1. ANS:  C                    PTS:   1

 

  1. ANS:  B                    PTS:   1

 

  1. ANS:  D                    PTS:   1

 

  1. ANS:  C                    PTS:   1

 

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