MN551 MIDTERM EXAM QUESTIONS & ANSWERS

MN551 MIDTERM EXAM QUESTIONS & ANSWERS

A nurse practitioner employed in the emergency department admits a patient who
has experienced severe frostbite to his hands and toes after becoming lost on a ski
trail. The NP recognizes that which of the following phenomena has caused the
tissue damage? (Points : 2)
 Decreased blood viscosity has resulted in interstitial bleeding.
 Reactive vasodilation has compromised perfusion.
 Autonomic nervous stimulation has resulted in injury. Decreased
blood flow has induced hypoxia.
Question 2.2. A 6-year-old boy has been brought to the emergency department by
ambulance after his mother discovered that his heart rate was “so fast I couldn't
even count it.” The child was determined to be in atrial flutter and his mother is
seeking an explanation from the health care team. Which of the following points
should underlie an explanation to the mother? (Points : 2)
 The child is experiencing a reentry rhythm in his right atrium.
 The resolution of the problem is dependent on spontaneous recovery and is resistant to pacing
interventions.
 The child is likely to have a normal ECG apart from the rapid heart rate. The
boy's atria are experiencing abnormal sympathetic stimulation.
Question 3.3. A 14-year-old boy has been diagnosed with infectious
mononucleosis. Which of the following pathophysiological phenomena is most
responsible for his symptoms? (Points : 2)
 The Epstein-Barr virus (EBV) is lysing many of the boy's neutrophils.
 Viruses are killing some of his B cells and becoming incorporated into the genomes of others.
 The EBV inhibits the maturation of white cells within his peripheral lymph nodes. The
virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.
Question 4.4. A patient has suffered damage to his pericardium following a motor
vehicle accident. Which of the following consequences should the nurse
practitioner be most likely to rule out? (Points : 2)
 Impaired physical restraint of the left ventricule
 Increased friction during the contraction/relaxation cycle
 Reduced protection from infectious organisms
 Impaired regulation of myocardial contraction
Question 5.5. Sputum samples from a patient with pneumonia contain an infective
agent that has a peptidoglycan cell wall, expresses endotoxins, replicates readily in
broth and on agar, grows in clusters, has pili, and does not stain when exposed to
crystal violet. This pneumonia is most likely: (Points : 2)
 Chlamydial
 Viral
 Mycoplasmal
 Bacterial
Question 6.6. A nurse practitioner student is familiarizing herself with the
overnight admissions to an acute medical unit of a university hospital. Which of
the following patients would the student recognize as being least likely to have a
diagnosis of antiphospholipid syndrome in his or her medical history? (Points : 2)
 A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident A 90-
year-old female resident of a long-term care facility who has been experiencing transient ischemic attacks
 A 30-year-old female with a diagnosis of left leg DVT and a pulmonary embolism A 21-yearold male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use
Question 7.7. A number of patients have presented to the emergency department
in the last 24 hours with complaints that are preliminarily indicative of myocardial
infarction. Which of the following patients is least likely to have an ST-segment
myocardial infarction (STEMI)? (Points : 2)
 A 70-year-old woman who is complaining of shortness of breath and vague chest discomfort
 A 66-year-old man who has presented with fatigue, nausea and vomiting, and cool, moist skin
 A 43-year-old man who woke up with substernal pain that is radiating to his neck and jaw A 71-
year-old man who has moist skin, fever, and chest pain that is excruciating when he moves but relieved
when at rest
Question 8.8. A 44-year-old female patient presents to the emergency department
with abnormal bleeding and abdominal pain that is later attributed to gallbladder
disease. Which of the following diagnoses would the medical team be most justified in
suspecting as a cause of the patient's bleeding? (Points : 2)
 Calcium deficiency
 Vitamin K deficiency
 Hemophilia B
 Idiopathic ITP
Question 9.9. A 60-year-old male patient with an acute viral infection is receiving
interferon therapy. The nurse practitioner is teaching the family of the patient
about the diverse actions of the treatment and the ways that it differs from other
anti-infective therapies. Which of the following teaching points should the nurse
practitioner exclude? (Points : 2)
 “Interferon can help your father's unaffected cells adjacent to his infected cells produce antiviral
proteins that limit the spread of the infection.”
 “Interferon can help limit the replication of the virus that's affecting your father.”
 “Interferon helps your father's body recognize infected cells more effectively.”
 “Interferon can bolster your father's immune system by stimulating natural killer cells that attack
viruses.”
Question 10.10. A nurse practitioner employed in a hospitalist notices that a
patient is experiencing muscle atrophy following 2 weeks in traction after a motor
vehicle accident. Which of the following factors has most likely contributed to the
atrophy of the patient's muscle cells?
(Points : 2)
 High levels of insulin and IGF-1 in the patient's blood during immobilization Denervation of
the affected muscles during the time of traction
 A reduction of skeletal muscle use secondary to the traction treatment
 Reduced oxygen consumption and cellular function that ensures muscle cell survival

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