NR602 week 8 final exam

NR602 week 8 final exam

A 32-year-old presents with “vaginal bleeding” for 2 weeks. She reports the blood is most noticeable only after urination and denies soaking pads. Which focused history question MOST directly helps localize the bleeding source?

  1. “Do you see blood only after urinating or after a bowel movement?”
  2. “How severe is the bleeding on a 0–10 scale?”
  3. “How many bleeding episodes have you had in the last 6–12 months?”
  4. “Does the bleeding occur after intercourse?”

A 10-year-old presents with daily hand-washing rituals that take over an hour, repeated checking behaviors, and intrusive thoughts about harm coming to family members. The child attempts to hide these behaviors and becomes visibly distressed if unable to complete the routines. Based on this presentation, which interpretation BEST differentiates obsessive compulsive disorder (OCD) from normal childhood rituals?

  1. The behaviors represent typical developmental routines that cause only mild anxiety and do not disrupt the child’s normal activities
  2. The pattern shows intrusive obsessions and distress-driven compulsions that are time-consuming and significantly impair daily functioning
  3. The symptoms suggest generalized worries related to everyday events and are directly connected to identifiable stressors
  4. The presentation indicates superstitious games that children often use to cope with uncertainty without causing distress or disruption

A 19-year-old patient reports severe cramping pain that begins on the first day of menses. She states the pain has been present since early adolescence and improves only slightly with rest. Based on the pathophysiology of her condition, which intervention is MOST appropriate to reduce her symptoms?

Answers: A – D

A Encouraging heat therapy to relax uterine muscle tension during menstruation
B Recommending hormonal suppression to prevent cyclic endometrial proliferation
C Initiating NSAID therapy to block prostaglandin-mediated uterine contractions
D Ordering pelvic imaging to evaluate for structural causes of menstrual pain

 Correct Answer: C

A 29-year-old patient is diagnosed with chlamydia during a routine visit. She expresses concern about confidentiality and does not want anyone notified. According to reporting requirements and ethical standards, what is the NP’s MOST appropriate action?

Answers: A – D

A Defer reporting the case until obtaining written permission from the patient to share her health information
B Report the infection anonymously without informing the patient to ensure public health surveillance
C Choose not to report the case because disclosure may undermine the patient’s sense of privacy and trust
D Inform her that chlamydia is a reportable infection and must be reported to the state health department while reassuring her that all information will be kept confidential

 Correct Answer: D

A patient is diagnosed with chlamydia and prescribed antibiotic therapy. Which patient statement indicates the need for further education?

Answers: A – D

A “My partner should also be tested and treated.”
B “I should avoid sexual activity until treatment is complete.”
C “I can stop taking the medication once my symptoms resolve.”
D “I will complete the entire course of antibiotics even if symptoms improve.”

 Correct Answer: C

A breastfeeding patient with insufficient milk supply asks about medication options to increase production. Which pharmacologic agent increases milk supply but carries a risk of neurologic side effects due to its ability to cross the blood–brain barrier?

Answers: A – D

A Prolactin
 B Metoclopramide
C Domperidone
D Oxytocin

A 6-year-old child presents with dysuria and urinary frequency without fever or flank pain. Urinalysis is consistent with an uncomplicated bladder infection, and the child is well hydrated with no vomiting. Based on current treatment recommendations, which antibiotic management plan is MOST appropriate?

Answers: A – D

A Treat with a 3–5 day course of oral antibiotics guided by resistance patterns
B Prescribe a 7–14 day course of oral antibiotics due to the child’s age
C Admit the child for parenteral antibiotics to prevent renal involvement
D Delay treatment until urine culture results are finalized and reviewed

A patient with a history of sexual trauma presents for gynecologic evaluation. Which statement BEST demonstrates trauma-informed communication?

Answers: A – D

A “Let me know if anything hurts, but I need to finish quickly.”
 B “You are in control, and we can stop or pause anytime.”
C “Most patients tolerate this examination without difficulty.”
D “This examination is necessary, so try to relax.”

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