NURS502 Midterm Exam NURS 502

NURS502 Midterm Exam NURS 502 Actual Exam Latest Update Questions and Correct Answers Rated A+

Mrs. Pederson is a 74-year-old who presents for a routine blood pressure follow up visit. Her blood pressure is well controlled, but on review of systems she reports dry mouth of several years’ duration that has acutely worsened over the past 2 months. She quit smoking after she developed thyroid cancer that required surgery and neck radiation for cure. She has been drinking more water than usual, but it only improves her symptoms for a few minutes. She drinks wine with dinner and sometimes before bed for insomnia.All of the following are likely contributing to Mrs. Pederson's

xerostomia (the sensation of dry mouth) except:

The aging process Antihypertensive medications Alcohol use Head and neck radiation Sedative medications -ANSWER-The aging process

Mrs. Pederson's active medical problems include Hypertension, Type

• Diabetes Mellitus, and Glaucoma. Her past history is remarkable for

treated thyroid cancer, seasonal allergies, and intermittent insomnia.She smoked when she was younger, but quit 30 years ago. She is widowed and a retired administrative assistant. She enjoys a glass of wine about five times a week with dinner and walks daily for exercise.

Her medications include:

• lisinopril/HCTZ 10/25 mg orally once daily
• metformin 1000 mg orally twice daily
• aspirin 81 mg orally once daily

• zolpidem 10 mg orally at bedtime approximately twice per week
• diphenhydramine 25 mg orally as needed for allergy symptoms in the

spring and fall

• latanoprost ophthalmic drops daily (topical prostaglandin analog for

closed angle glaucoma treatment) Based on the information provided above, which of the following scenarios would most likely contribute to Mrs. Pederson's -ANSWER-

• She has been taking zolpidem nightly for worsening insomnia

following the recent death of her favorite cousin.

Mrs. Pederson reduces her alcohol intake and stops taking diphenhydramine and zolpidem. She understands the need for her antihypertensive and diabetic medications and will continue to take those as directed. After these changes her dry mouth improves to some degree, but is still symptomatic. She inquires what else she can do to improve her symptoms.Which of the following interventions would be contraindicated for Mrs.Pederson?

Use of an over-the-counter saliva substitute Sucking sugarless candy during the day to promote saliva production Starting cevimeline in an effort to increase saliva production Switching to an electric toothbrush from a traditional one Avoiding sugary and caffeinated drinks -ANSWER-Starting cevimeline in an effort to increase saliva production

Tanya is a 20 year old female who presents to your office with a painful mouth sore that has been present for three days. The sore developed spontaneously and has not changed since its appearance.Six months ago, she noticed similar sores that resolved spontaneously after two weeks. She denies fever or systemic symptoms.What is the most likely cause of Tanya's oral lesion?

Primary oral herpes Gingival trauma Coxsackie virus Aphthous ulcer -ANSWER-Aphthous ulcer

Which of the following is true regarding Recurrent Aphthous Ulcers

(RAU)?

These lesions commonly present as a single painful ulcer that resolves after two months.RAUs have been associated with vitamin deficiencies.Most lesions require immediate treatment with topical steroids.These lesions typically occur on keratinized mucosal surfaces such as the gingival and hard palates. -ANSWER-RAUs have been associated with vitamin deficiencies.

Two months later Tanya returns with similar complaints. She has developed recurrent painful month sores that resemble her previous lesions. The lesions have been present for almost 2 weeks. In the past, her pain was minimal, but she now reports that it has become painful to eat, drink and speak. She has tried over the counter mouth rinses without much improvement.Which of the following is the most appropriate next step in management?

Refer Tanya to an oral surgeon for biopsy of her lesion.Prescribe Thalidomide.Prescribe topical steroids.Prescribe an antiviral medication. -ANSWER-Prescribe topical steroids.

James, a 57-year-old man, presents to the community clinic to establish care. He complains of a loose tooth and oral pain. He reports a history of hypertension and type 2 diabetes. He takes lisinopril and metformin. Laboratory tests and examination findings demonstrate that he is in poor glycemic control with his current medication regimen.You are a member of a health care team that works collaboratively to provide James with appropriate and timely oral health care. Which of the following behaviors best exemplifies the mutual respect and trust that are foundational to inter professional collaborative practice?

• Inform the patient that diabetes has no direct effect on his oral

health, but seeing a dietician is important to help control his diabetes.

• Involve dental and primary care providers in the management of

James' oral health.

• Explain to James that a dentist will take care of his teeth but will not

be inv -ANSWER-Involve dental and primary care providers in the management of James' oral health.

During the initial visit with James, you perform an oral health history.You determine that he has not had consistent access to quality health care and has only seen dental providers for acute problems.Additionally, he reports eating frequent sugary snacks and brushing his teeth infrequently. These factors place him at high risk for oral disease.Which of the following behaviors best exemplifies the acknowledgement of roles and responsibilities of participating members of the healthcare team?

• Seek solutions to the patients' oral health needs that primarily

involve medical professionals, as to avoid interprofessional conflicts.

• Remind your staff that the patient centered medical home must be

the anchor for any meaningful interprofessional work.