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Nursing

AGCNS-BC

Adult-Gerontology Clinical Nurse Specialist

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A 35-year-old patient presents with painless gross hematuria. Urinalysis reveals the presence of red blood cells without casts. The most likely diagnosis is:

urinary tract infection.
bladder cancer.

omerulonephritis. wer: B
anation: Painless gross hematuria, especially in an adult, should raise cion for bladder cancer. Urinary tract infection typically presents with ria, urgency, frequency, and pyuria. Glomerulonephritis often present
ematuria along with proteinuria, hypertension, and edema. Renal cal ause hematuria but are often associated with flank pain and renal col

stion: 2

-year-old patient with type 2 diabetes mellitus presents with polyuria, dipsia, and unexplained weight loss. On physical examination, the pati ars thin and dehydrated. Laboratory findings reveal hyperglycemia, nemia, and metabolic acidosis. The most likely diagnosis is:

ypoglycemia.
renal calculi.
gl Ans

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hyperosmolar hyperglycemic state.
diabetic ketoacidosis.
hyperthyroidism.

ntolerance, palpitations, and tremor.

stion: 3

-year-old patient presents with recurrent episodes of epistaxis, easy ing, and bleeding gums. Laboratory findings reveal a prolonged bleed nd a normal platelet count. The most likely diagnosis is:

on Willebrand disease.

mmune thrombocytopenic purpura. emophilia A.

sseminated intravascular coagulation.

anation: The recurrent episodes of epistaxis, easy bruising, bleeding g onged bleeding time, and normal platelet count are consistent with von

Explanation: The symptoms of polyuria, polydipsia, unexplained weight loss, hyperglycemia, ketonemia, and metabolic acidosis are indicative of diabetic ketoacidosis (DKA), which is a severe complication of uncontrolled diabetes. Hyperosmolar hyperglycemic state presents with similar symptoms but typically occurs in type 2 diabetes and is characterized by extreme hyperglycemia without significant ketosis. Hypoglycemia would present with symptoms like shakiness, diaphoresis, confusion, and relief with glucose administration. Hyperthyroidism presents with symptoms such as weight loss, heat i

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Willebrand disease, which is an inherited bleeding disorder characterized by a deficiency or dysfunction of von Willebrand factor. Immune thrombocytopenic purpura typically presents with a low platelet count and mucocutaneous bleeding. Hemophilia A is an X-linked recessive disorder characterized by a deficiency of factor VIII, resulting in prolonged bleeding. Disseminated intravascular coagulation is a condition characterized by widespread activation of coagulation leading to both bleeding and thrombosis.

A 64-year-old patient presents with dyspnea, orthopnea, and bilateral ankle edema. Physical examination reveals jugular venous distention, hepatojugular reflux, and a displaced apical impulse. The most likely diagnosis is:

hronic obstructive pulmonary disease. ongestive heart failure.

ulmonary embolism.

anation: The combination of dyspnea, orthopnea, bilateral ankle edem ar venous distention, hepatojugular reflux, and displaced apical impul y suggestive of congestive heart failure. Chronic obstructive pulmona se primarily presents with respiratory symptoms and signs such as co ezing, and decreased breath sounds. Pneumonia typically presents with productive cough, and focal chest findings. Pulmonary embolism

ically presents with sudden-onset pleuritic chest pain, dyspnea, and ycardia.

stion: 5

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A patient with a history of major depressive disorder is experiencing persistent feelings of sadness, loss of interest, and difficulty sleeping. Which medication is commonly prescribed as a first-line treatment for depression?

Methylphenidate (Ritalin).
Alprazolam (Xanax).
Quetiapine (Seroquel).
Fluoxetine (Prozac). Answer: D

stion: 6

tient with rheumatoid arthritis presents with joint pain, swelling, and ning stiffness lasting more than an hour. Which medication is common cribed to manage the symptoms of rheumatoid arthritis?

cetaminophen (Tylenol). uprofen (Advil). rednisone (Deltasone). ethotrexate (Trexall).

anation: Methotrexate (Trexall) is a disease-modifying antirheumatic ARD) commonly prescribed to manage the symptoms of rheumatoid itis. It helps reduce joint inflammation, pain, and swelling, and can al the progression of the disease.

Explanation: Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed as a first-line treatment for depression. It helps increase the availability of serotonin in the brain, which can improve mood, reduce feelings of sadness, and alleviate other symptoms of depression.

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Question: 7

A 50-year-old patient presents with a non-healing ulcer on the lower extremity. Physical examination reveals a punched-out ulcer with a necrotic base and surrounding erythema. The most likely diagnosis is:

venous stasis ulcer.
pressure ulcer.
diabetic foot ulcer.
arterial ulcer. Answer: D

arance, necrotic base, and surrounding erythema is highly suggestive ial ulcer. Venous stasis ulcers typically present with a shallow, irregul ed ulcer with a granulating base and surrounding hemosiderin staining etic foot ulcers often occur in patients with diabetes and are typically ed on the plantar surface of the foot. Pressure ulcers develop over bon minences due to prolonged pressure and typically have an overlying es

anulation tissue.

stion: 8

tient with human immunodeficiency virus (HIV) infection is schedule ve a vaccine to prevent pneumococcal infections. Which type of vacci ld the nurse administer to the patient?

ive attenuated vaccine. activated vaccine. oxoid vaccine. ecombinant vaccine.

Explanation: The non-healing ulcer on the lower extremity with a punched-out appe of an

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Explanation: In patients with HIV infection, inactivated vaccines are generally recommended over live attenuated vaccines due to the risk of vaccine-induced disease in individuals with compromised immune systems.

Question: 9

A patient with a diagnosis of chronic lymphocytic leukemia (CLL) presents with fatigue, pallor, and increased susceptibility to infections. Which laboratory finding is consistent with the patient's diagnosis?

levated hemoglobin level. creased lymphocyte count.

ecreased erythrocyte sedimentation rate (ESR).

anation: Chronic lymphocytic leukemia (CLL) is characterized by the mulation of mature lymphocytes in the bone marrow, peripheral blood hoid tissues. Therefore, an increased lymphocyte count is consistent w iagnosis of CLL.

Decreased platelet count.