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ANCC


ANP-BC


ANCC Adult Nurse Practitioner


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Question: 64

Which is the most significant procedure in screening for benign prostatic hypertrophy?


  1. PSA

  2. DRE

  3. TRU

  4. Prostate biopsy

Answer: B - PSA, or Protein Specific Antigen, is a tool for detecting prostate disease; however, digital rectal examination, where the prostate can be palpated through the rectal wall, would be a more definitive diagnosis. Hard nodule or benign enlargement of the prostate can be felt through DRE. An increasing PSA may indicate prostate cancer.


Question: 65

A patient is diagnosed with diabetes insipidus after a series of diagnostic tests. Which of the following signs and symptoms is indicative of this disorder?


  1. Polydipsia

  2. Weight gain

  3. Hypertension

  4. Changes in level of consciousness


Answer: A


Diabetes insipidus is hyposecretion of aldosterone, a hormone that increases the absorption of sodium and water. This disorder is manifested by signs of fluid deficit. Diabetes insipidus is manifested by polydipsia, polyuria, dehydration, fatigue, inability to concentrate urine, and postural hypotension. Options B, C, and D are common signs of syndrome of inappropriate antidiuretic hormone.


Question: 66

You suspect a patient has Type I Diabetes. The following statements are true

about Type I Diabetes except:


  1. May be linked to autoimmunity

  2. Onset usually prior to age 20

  3. Beta islet cells destroyed

  4. Does not require insulin injections


Answer: D


Type 1 Diabetes Mellitus is caused by the destruction of Beta islet cells in the pancreas, which ensue a deficiency of insulin. Type 1 DM is formerly known as juvenile-onset DM since it afflicts the younger population, usually prior to the age of 20. The recommended treatment for this condition is insulin replacement (thru injection) therapy.


Question: 67

A female patient complains of an enlarged thyroid gland, and protruding eye ball.

Further evaluation reveals that the patient has hypertension, nervousness, and fine tremors of the hands. Which of the following medications should be ordered for the patient?


  1. Propylthiouracil (PTU)

  2. Levothyroxine (Synthroid)

  3. Liotrix (Thyrolar)

  4. Liothyronine (Cytomel)


Answer: B


Propylthiouraciis an anti-thyroid medication that inhibits the synthesis of thyroid hormones. The other medications are thyroid hormones that control the metabolic balance rate of tissues.


Question: 68

A newly diagnosed client is prescribed with insulin. The patient is taught to rotate

injection sites when administering insulin to prevent which of the following reasons complications?


  1. Increased resistance to insulin

  2. Insulin lipodystrophy

  3. Hypersensitivity

  4. Increased bleeding and bruises


Answer: B


Rotating injection sites are essential to prevent insulin lipodystrophy, which may result in decreased or altered absorption of insulin. The other options are not correct.


Question: 69

The following statements are true regarding Burkitt’s lymphoma, except:


  1. Close association with Epstein Barr virus

  2. High-grade T-cell malignancy

  3. Cytogenic chromosomal change is seen

  4. It is a form of non-Hodgkin lymphoma


Answer: B

Burkitt’s lymphoma is a rare and highly aggressive type of Non-Hodgkin’s lymphoma that usually affects children. It is a rapid-growing B-cell lymphoma that involves parts of the body other than the lymph nodes. Burkitt’s lymphoma is highly associated with the chromosomal translocation of the c-myc gene. Numerous cases of this lymphoma have decreased resistance to EBV (Epstein- Barr virus).


Question: 70

The following are characteristics of nephrogenic diabetes insipidus, except:


  1. Sensitized kidney tubules to ADH

  2. A genetic (sex-linked) predilection in men

  3. Normal ADH production and secretion

  4. Large volumes of dilute urine are produced


Answer: A


Unlike Central Diabetes Insipidus, Nephrogenic diabetes insipidus is caused by the kidney’s resistance to ADH rather than a deficiency of this hormone. This results in a decreased ability of the kidneys to concentrate the urine. The disease is rare, but 90% of the known cases are believed to be X-linked, which causes the vasopressing receptor to not function properly. The primary symptom of NDI is excessive thirst and excretion of large amount of urine. Dehydration is a common complication of the disease.