FREE Adult-Gerontology Primary Care Nurse Practitioner Questions and Answers

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For the past two days, a 26-year-old patient has been experiencing stomach pain, shaking chills, and a cough that produces rust-colored sputum. A 103°F (39.4°C) temperature and radiologic evidence of pulmonary consolidation in the right middle lobe are among the findings. White blood cell count for the patient is 14,000/mm3 with a shift to the left. The sputum's Gram stain reveals many Gram-positive diplococci. Which kind of pneumonia is the official diagnosis?

Correct! Wrong!

Explanation:
The official diagnosis, based on the symptoms, findings, and laboratory results provided, is pneumococcal pneumonia, which is caused by the bacteria Streptococcus pneumoniae. Streptococcus pneumoniae is a common cause of bacterial pneumonia in adults and can present with symptoms such as high fever, chills, productive cough, chest pain, shortness of breath, and rust-colored sputum. Radiologic evidence of pulmonary consolidation, elevated white blood cell count with a left shift, and the presence of Gram-positive diplococci on Gram stain of the sputum support the diagnosis of pneumococcal pneumonia. Early and appropriate antibiotic therapy is usually necessary to treat the infection and prevent complications.

Which member of the family receives the majority of the support and advice from an African American family in order to keep good health and make healthcare decisions?

Correct! Wrong!

Explanation:
African American families may look primarily to the wife/mother for guidance and support in maintaining good health and making healthcare decisions, others may have different patterns of decision-making and rely on different family members for support. It is important for healthcare providers to approach each patient and family with cultural humility, actively listen to their needs and preferences, and work collaboratively to develop a plan of care that is appropriate and effective for the individual patient.

A fourteen-year-old patient is worried about eczema because their twin was just given this diagnosis. A personal history of allergic rhinitis, a family history of eczema, and a history of ____ are the three things that increase the patient's chance for developing eczema.

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Explanation:
The third factor that puts the patient at risk for eczema is having asthma or other allergic conditions. Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition that often occurs in people who have a genetic predisposition to allergic diseases such as asthma and allergic rhinitis. In fact, having a family history of eczema, asthma, or hay fever is one of the strongest risk factors for developing eczema. Allergic conditions are closely related and often occur together, which is known as the atopic march. Therefore, it is not uncommon for someone with eczema to also have asthma or hay fever, and vice versa.

Which medication does the adult-gerontology primary care nurse practitioner cautiously recommend while treating an older adult patient for gastroparesis due to potential central nervous system toxicity?

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Explanation:
When treating an older adult patient for gastroparesis, the drug that an adult-gerontology primary care nurse practitioner may prescribe cautiously because of possible central nervous system toxicity is metoclopramide (Reglan). Metoclopramide is a medication that works by increasing the motility of the upper gastrointestinal tract and is commonly used to treat gastroparesis. However, it is associated with a risk of neurological side effects, such as restlessness, agitation, and extrapyramidal symptoms, especially in older adults. Therefore, the drug should be used with caution in this population, and the dosage should be adjusted carefully. In addition, treatment with metoclopramide should be limited to the shortest duration possible to minimize the risk of adverse effects. Alternative treatments may be considered in older adults with gastroparesis, depending on the underlying cause and comorbidities.

The interprofessional medical ethics review committee of a hospital appoints the adult-gerontology primary care nurse practitioner. The duties of a nurse practitioner include:

Correct! Wrong!

Explanation:
As a member of the hospital's interprofessional medical ethics review committee, the adult-gerontology primary care nurse practitioner's role is to evaluate ethical dilemmas that may arise in patient care. The nurse practitioner works collaboratively with other healthcare professionals to identify and evaluate ethical issues, review relevant policies and regulations, and make recommendations for appropriate action. This may involve evaluating standards of care, assessing the risks and benefits of different treatment options, and considering the potential outcomes of various courses of action. The goal of the committee is to ensure that ethical principles are upheld and that patient care is provided in a manner that is consistent with the highest standards of professionalism and integrity.

A 15-year-old female patient is found to have gotten 5 inches (12.7 cm) taller during her annual checkup. Menarche has not yet occurred for the patient. The patient's mother is worried since she went through menarche at age 12, while the patient's sibling did so at age 11. The patient's breasts are enlarged, with the areolae creating a mound above the general shape of each breast, and the left breast is larger than the right breast, according to an examination. The pubic hair has a similar pattern to that of adult females and is dark, coarse, curling, and dense. These results support the following diagnoses:

Correct! Wrong!

Explanation:
The findings described are consistent with normal development in the 15-year-old female patient. The patient's rapid growth, breast development, and pubic hair growth are signs of normal puberty progression. The fact that the patient has not yet reached menarche (the onset of menstruation) is not uncommon at this age and can occur up to age 16.

It is important to continue monitoring the patient's development and discussing any concerns with a healthcare provider. Regular annual check-ups are an important part of ensuring overall health and development in adolescents.

A 16-year-old patient who recently earned their driver's license is reminded to always buckle up in a car by the adult-gerontology primary care nurse practitioner. The patient responds that they don't need to use a seat belt because if they are in a motor accident, nothing will happen to them. Which primary component does the patient lack, as per the health belief model?

Correct! Wrong!

Explanation:
Perceived severity refers to the individual's perception of the seriousness of the health condition or outcome, and how much harm it could cause. While the patient in this scenario may also underestimate the severity of a potential car accident, their primary issue is the perceived susceptibility to such an event.

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