Midterm Exam ANP 652 Essay 2


Midterm Exam ANP 652 Essay 2

Midterm Exam ANP 652 Essay 2

1 Patients with central nervous system injury may commonly have a specific type of gastric ulcer known as (select the best answer):

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Curling’s ulcer

Duodenal ulcer

H. pylori ulcer

Barrett’s ulcer

Question Points: 1.0 / 1.0

2 How do you differentiate a cholinergic crisis from a myasthenia crisis? Select the best answer.

Perform a Tensilon (edrophonium) test.

Order a stat plasmapheresis trial.

Obtain a stat cortisol stimulation test.

Administer rapid immunomodulating therapies (IVIG).

Question Points: 1.0 / 1.0

3 Complications of giant cell arteritis include:





Question Points: 1.0 / 1.0

4 On the Folstein Mini-Mental State Exam, the maximum score is 30, but a score of 23 or less indicates _____.

Cognitive impairment

Mental retardation

Alzheimer’s dementia

Parkinson’s dementia

Question Points: 1.0 / 1.0

5 Atypical antipsychotics like Seroquel, Zyprexa, and Risperdol are the preferred treatments for dementia-related aggression.

True False

Question Points: 1.0 / 1.0

6 A 67-year-old male with a past medical history significant for lung cancer is admitted with sepsis. On assessment, you notice petechiae and bruising. Which of the following statements about DIC is not true?

Results from activation of the clotting cascade and results in clotting factor consumption. Midterm Exam ANP 652 Essay 2

Diffuse clothing occurs simultaneously with bleeding.

Heparin may improve lab parameters, but may aggravate bleeding.

Lab results indicate increased platelet, increased fibrinogen, and prolonged PT/INR.

Question Points: 0.0 / 1.0

7 Rickettsial infections include which of the following:

Rocky Mountain spotted fever and Q fever

Malaria and toxoplasmosis

Histoplasmosis and cryptococcosis

Epstein-Barr virus and cytomegalovirus

Question Points: 1.0 / 1.0

8 A 20-year-old female has periodic episodes that begin with decreased vision that lasts for about 30 minutes and is followed by a throbbing occipital headache. Which of the following is the most likely diagnosis?


Vertebral-basilar insufficiency

Tension headache

Panic attack

Question Points: 1.0 / 1.0

9 Conductive hearing loss and sensorineural hearing loss are common in the elderly. What are three differential diagnoses for sensorineural hearing loss to include the most common pattern?

Barotraumas, viral cochleitis, osteoma

Acoustic neuroma, ototoxic drugs, presbycusis

Exostosis, meningioma, vascular disease

Presbycusis, trauma, Paget’s disease

Question Points: 1.0 / 1.0

10 Fever of unknown origin, by definition, is a fever of 101 Fahrenheit or greater rectally persisting over at least how many weeks?

2 weeks

3 weeks

1 week

6 weeks

Question Points: 1.0 / 1.0

11 Brain death criteria vary from state to state and involve the absence of breathing, absence of spontaneous movement, and several other neurological findings. Ancillary tests to prove brain death include all of the following except:

Transcranial Doppler


Cerebral blood flow study

Nerve conduction studies

Question Points: 1.0 / 1.0

12 The classic triad of Parkinson’s includes all of the following except:

Resting tremor

Rigidity arms, legs, and neck stiffness


Severe cognitive deficits

Question Points: 1.0 / 1.0

13 Focal seizures are often accompanied by automatisms, which are behaviors that include all of the following except:

Lip smacking

Picking at clothes



Question Points: 1.0 / 1.0

14 Loss of central vision is a hallmark of:

Macular degeneration


Retinal detachment


Question Points: 1.0 / 1.0

15 Which of the following diseases cause degeneration or loss of nerve cells in the brain?

Alzheimer’s, Parkinson’s, and Huntington’s

Sepsis, chronic kidney disease, and scleroderma

Rheumatoid Arthritis, Alzheimer’s, and Scleroderma

Parkinson’s, B12 deficiency, and Myasthenia Gravis

Question Points: 1.0 / 1.0

16 Immunologic mediators that play a role in the pathophysiology of fever include all of the following except:

Interleukin 1 – primary

Interleukin 2

Interleukin 6

Tumor necrosis factor

Question Points: 1.0 / 1.0

17 The most common causes of fever in a geriatric patient include all of the following except:


Medication effect

Connective tissue disorders (rheumatoid arthritis, sarcoidosis, temporal arteritis)

Sexually transmitted infections (chlamydia, herpes)

Question Points: 1.0 / 1.0

18 Anemia is the reduction of one or more of the following major red blood cell measurements:

Hemoglobin, hematocrit, RBC count

B12, folic acid, hemoglobin

Hemoglobin, folic acid, fibrinogen

Hemoglobin, RBC, and B12

Question Points: 1.0 / 1.0

19 Areas of occult infection include:

Sinuses, teeth, central nervous system

Lung, ear, throat

Skin, joints, lymph nodes

Pelvis, abdomen, and chest

Question Points: 1.0 / 1.0

20 A 62-year-old African American male with a past medical history significant for diabetes presents with sudden onset of headache on the right side and blurred vision in his right eye. Fundoscopic exam reveals a deeply cupped optic disc. Which of the following disorders is this patient likely experiencing?

Acute angle-closure glaucoma


Bacterial conjunctivitis


Question Points: 1.0 / 1.0

21 Dementia is characterized by many things, except:

General decrease in level of cognition

Behavioral disturbance

Interference with daily function and independence

Focused attention to detail and obsession with dates and numbers

Question Points: 1.0 / 1.0

22 Although the etiology of Guillain-Barre syndrome is largely unknown, which of the following possible triggers for this disease are most likely:

Campylobacter jejuni enteritis, cytomegalovirus, Epstein-Barr, HIV, or mycoplasma infection

Streptococcus pneumonia, Staph aureus, and E. coli Midterm Exam ANP 652 Essay 2

Cytomegalovirus, Epstein Barr, strep throat, or thrush

Any bacterial pneumonia or herpes zoster

Question Points: 1.0 / 1.0

23 Parasitic infections include which of the following:

Rocky Mountain spotted fever and Q fever

Malaria and toxoplasmosis

Histoplasmosis and cryptococcosis

Epstein-Barr virus and cytomegalovirus

Question Points: 1.0 / 1.0

24 A 65-year-old patient complains of recurrent temporal headaches, malaise, muscle aches, and low grade fever. The headache is described as superficial tenderness rather than deep pain. Temporal arteritis is suspected. Appropriate treatment is:

Aspirin or acetaminophen every 4 hours as needed for pain and fever

Refer for a temporal artery biopsy and initiation of oral prednisone

CT scan of the head and lumbar puncture for CSF evaluation

A daily three-blocker such as propranolol

Question Points: 1.0 / 1.0

25 Which of the following lists of medications is generally contraindicated in geriatric patients?

Beers list

Anticholinergic list

Universal list

Alzheimer’s list

Question Points: 1.0 / 1.0

26 Myasthenia gravis is a disorder of the neuromuscular junction, a pure motor syndrome, caused by an autoimmune attack on the acetylcholine receptor complex at the postsynaptic membrane of the neuromuscular junction. All of the following are true about this disease except (select the best answer):

Ptosis occurs in up to 40% of these patients initially, and eventually in 80% of these patients with disease progression.


Proximal limb weakness with upper limbs more noticeable than lower

Loss of sensation with weakened or absent reflexes

Question Points: 1.0 / 1.0

27 The most common causes of fever in a geriatric patient include all of the following except:

Malignancies Midterm Exam ANP 652 Essay 2

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