APEA 3 FINAL EXAM 2024-2025, Exams of Nursing

Download APEA 3 FINAL EXAM 2024-2025 and more Exams Nursing in PDF only on Docsity! 1 | P a g e APEA 3 FINAL EXAM 2024-2025 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |LATEST UPDATE which of the following is NOT a goal for treatment for the patient with cystic fibrosis? a. Prevent intestinal obstruction b. Provide adequate nutrition c. Promote clearance of secretions d. Replace water soluble vitamins d. Replace water soluble vitamins Which red blood cell (RBC) index is most useful for differentiating types of anemias? a. Mean corpuscular volume (MCV) b. Mean corpuscular hemoglobin concentration (MCHC) c. Hematocrit (HCT d. Platelet count a. Mean corpuscular volume (MCV) what is a Tzanck test used to diagnosed? a. Mastoiditis b. Trichomoniasis c. Hyphema d. Herpes virus d. Herpes virus a 16 y/o sexually active female presents to the clinic. She has never had vaccinations for hepatitis A or B. She has had one MMR immunization, and her last tetanus vaccination was 4 years ago. which vaccination would be contraindicated without further testing? a. Hepatitis B b. Hepatitis A c. MMR d. Tetanus 2 | P a g e c. MMR following the finding of prostate gland abnormalities on DRE, The NP orders appropriate labs. When preparing to review with the patient, the NP knows all of the following are true EXCEPT a. Normal PSA is 10 mg/ml or less b. PSA is elevated in the presence of malignant prostate epithelium c. PSA is elevated in the presence of BPH d. Positive serum acid phosphatase reflects malignancy of the prostate gland with bone metastasis. Normal PSA is 10 mg/ml or less in which of the following presentations is further diagnostic testing NOT warranted? a. Bilateral gynecomastia in a prepubertal male of average weight; Tanner stage 1 b. Bilateral gynecomastia in a 13 y/o male with normal testicular size and volume c. Recent onset gynecomastia in a 20-year-old male with breast tenderness d. Unilateral breast mass which is 5 centimeters in diameter b. Bilateral gynecomastia in a 13 y/o male with normal testicular size and volume 59 years old post-menopausal woman has atrophic vaginitis. She has a hx. Of breast cancerat age 40 years. What is the appropriate initial treatment for this patient? a. Oran conjugated estrogens b. Oral medroxyprogesterone aetate c. Topical medroxyprogesterone aetate d. Topical conjugate estrogen cream d. Topical conjugate estrogen cream Advances in obstetric and neonatal care have a. Helped to identify the cause of cerebral palsy b. Demonstrated the cerebral palsy is a direct result of birth asphyxia c. Has no effect on the incident of cerebral palsy d. Resulted in a dramatic decrease in the incidence of cerebral palsy c. Has no effect on the incident of cerebral palsy which of the following physical modalities recommended for treatment of rheumatic arthritis provides the most effective long-term pain relief? a. Superficial and deep heat b. Application of cold c. Transcutaneous electrical nerve stimulation (TENS) d. Exercise d. Exercise 40 y/o female with hx. Of frequent sun exposure present with multicolored lesion on her back it has irregular borders and is about 11 mm in diameter. What should the NP suspect? a. Squamous cell carcinoma b. Malignant melanoma 5 | P a g e a. Superficial and deep heat b. Application of cold c. Transcutaneous electrical nerve stimulation (TENS) d. Exercise d. Exercise The NP is counseling a 25 y/o sexually active male patient about condom use, which of the following statement is INCORRECT a. Adequate lubrication is needed to prevent damage to the condom b. Roll the condom over an erect penis before any sexual contact c. Make sure the condom is tight against the head of the penis d. Withdraw while the penis is erect, so that the condom stays in place Explanation: Condoms following the finding of prostate gland abnormalities on DRE, The NP orders appropriate labs. When preparing to review with the patient, the NP knows all of the following are true EXCEPT a. Normal PSA is 10 mg/ml or less b. PSA is elevated in the presence of malignant prostate epithelium c. PSA is elevated in the presence of BPH d. Positive serum acid phosphatase reflects malignancy of the prostate gland with bone metastasis. Normal PSA is 10 mg/ml or less A patient has been taking fluoxetine (prozar) since being diagnosed with major depression 7 month ago. She reports considerable empowerment in her symptoms and her intention to discontinue the medication what should be the NP's recommendation? a. Advice the patient to stop the antidepressant medication b. Question the patient to determine if the self-assessment is correct before advising her to discontinue the medication c. Recommend that the patient continue the antidepressant medication for at least 4 more month d. Discuss with the patient that need to take the antidepressant medication indefinitely c. Recommend that the patient continue the antidepressant medication for at least 4 more month for the general adult population, total dietary fat intake should be no more than what percent of total calories? a) 10% The NP is counseling a 25 y/o sexually active male patient about condom use, which of the following statement is INCORRECT a. Adequate lubrication is needed to prevent damage to the condom b. Roll the condom over an erect penis before any sexual contact c. Make sure the condom is tight against the head of the penis d. Withdraw while the penis is erect, so that the condom stays in place Explanation: Condoms 6 | P a g e c. Make sure the condom is tight against the head of the penis The NP is counseling a 25 y/o sexually active male patient about condom use, which of the following statement is INCORRECT a. Adequate lubrication is needed to prevent damage to the condom b. Roll the condom over an erect penis before any sexual contact c. Make sure the condom is tight against the head of the penis d. Withdraw while the penis is erect, so that the condom stays in place Explanation: Condoms c. Make sure the condom is tight against the head of the penis Which of the following descriptions of Denver II Developmental Screening Test is most accurate? a. Applicable to children from birth to 2 years; evaluates four major categories of development: motor, intellectual, emotional, and language to determine whether a child is within normal range for various behaviors or is developmentally delayed b. Applicable to children from birth to 5 years; evaluates four major categories of development: motor, vision, hearing and psychosocial to determine whether a child is normal or developmentally compromised d. Applicable to children from birth to 6 years; evaluates four major categories of development: gross motor, fine motor-adaptive, language, and personal social to determine whether a child is within normal range for behaviors or is developmentally delayed. d. Applicable to children from birth to 6 years; evaluates four major categories of development: gross motor, fine motor-adaptive, language, and personal social to determine whether a child is within normal range for behaviors or is developmentally delayed. A 15 years old high school student with a mild sore throat and low-grade fever that has persisted for about 3 weeks. She reports general malaise, fatigue, and loss of appetite. The NP suspects mononucleosis. Which of the following is the LEAST appropriate intervention? a. Palpate the lymph nodes and spleen b. Examine the posterior oropharynx for petechiae c. Obtain a CBC, throat culture, and heterophil antibody test. d. Obtain an urinalyses and serum for LFTs and amylase d. Obtain an urinalyses and serum for LFTs and amylase A 32 years old male patient complaint of urinary frequency and burning on urination for 3 days. Urinalyses reveals bacteriuria and positive nitrites. He denies any past hx of urinary tract infections. The initial treatment should be: a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day b. ciprofloxacin (Cipro) for 3-5 days c. Trimethoprim-Sulfamethoxazole for 3 days d. 750 mg ciprofloxacin as a one-time dose a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day 7 | P a g e Which agent is most effective for the treatment of nodulocystic acne? a. Benzoyl peroxide (Benzac) b. Retinoic acid (Retin A) c. Topical tetracycline d. Isotretinoin d. Isotretinoin An 18 y/o woman is taking a combined hormonal oral contraceptive. She should be instructed to use a backup method for the prevention of pregnancy a. Throughout the week of placebo pills b. If prescribed topiramate (Topamax) for the treatment of migraines. c. If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection d. if she forgets to take a single dose of the contraceptive b. If prescribed topiramate (Topamax) for the treatment of migraines. A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250 mg/dl (6.5mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and triglycerides= 344 mg/dL (8.94 mmol/L). What agent have the greatest effect on improving her lipid profile and reducing morbidity and mortality associates with dyslipidemia? a. Niacin (Niaspan) b. Atorvastatin c. Omega 3 fatty acids d. Fenofibrates b. Atorvastatin A NP has recently been hired to work in a fast track facility. The NP employer asked if she has "a problem prescribing medications for emergency contraception." The NP replies affirmatively. This is: a. Grounds for dismissal b. An ethical dilemma for the NP c. Illegal according to the standards of nursing d. Patient abandonment. b. An ethical dilemma for the NP 30 years old female comes into a clinic with classic signs and symptoms of appendicitis. The NP fails to refer the patient to a surgeon. The appendix ruptures and the woman die. This is an example of a. Failure of diligence b. Professional liability c. Negligence d. Malpractice d. Malpractice A patient presents with pruritic lesions on both knees. There are visible silver scales. How Should this condition be managed? a. Topical antifungal cream or ointment 10 | P a g e c. Crohn's disease d. Foreign body in the GI tract a. Intussusception A 48 y/o female complains of pain and stiffness in her right hip and knee that is mild on awakening in the morning, get worse as the day progresses and is relived with hot baths and ibuprofen. Crepitus is palpated on range of motion of the knee. Signs of inflammation are notably absent. What is the most likely diagnosis? a. Rheumatoid arthritis (RA) b. Gout c. Osteoarthritis (OA) d. Osteoporosis c. Osteoarthritis (OA) A middle-aged female complains of insomnia, night sweats, feeling intensely hot, emotional lability, extreme nervousness and impatience. The LEAST likely cause of her symptoms is a. Thyrotoxicosis b. Menopausal vasomotor instability c. Alcohol or another drug withdrawal d. New onset type 2 diabetes mellitus New onset type 2 diabetes mellitus A young couple is being seen by the NP for preconception counseling. They express a wish for pregnancy within the next 3 month and are very eager to know what they can do now to"make the baby as healthy as possible". Which of the following should the NP encourage to decrease the chance of neural tube defect in the fetus? a. Maternal alpha-fetoprotein level b. Folic acid 0.4 mg daily c. Rubella vaccine today d. Vitamin E 400 IU daily b. Folic acid 0.4 mg daily A patient with a past history of documented coronary arterial blockage less than 70% complains of chest pain several time p.... which is relived with nitroglycerin. Which is the most appropriate initial action for the NP? a. Refer to a cardiologist as soon as possible b. Prescribe long-acting nitroglycerin c. Order treadmill stress test d. Prescribe an ACE inhibitor and re-evaluate in 24 to 48 hours a. Refer to a cardiologist as soon as possible Which of the following indicated need for further evaluation? a. A 7 y/o girl with vaginal bleeding b. A 7 years old girl with no true pubic hair 11 | P a g e c. A 12 years old boy with sparse, slightly pigmented pubic hair d. A 12-year-old girl with breast buds A 7 y/o girl with vaginal bleeding A 3 y/o has enlarged, warm, tender cervical lymph nodes, indicating: a. Infection proximal to the nodes b. A possible cancer diagnosis c. Shorty nodes, a common normal variant in children d. An infectious process distal to the nodes a. Infection proximal to the nodes The NP examines a 2-month-old with unequal gluteal and thigh skin folds. What should the NP do next? a. Send the infant for x-ray of the hips b. Send the infant for ultrasound of the hips c. Perform Ortolani and Barlow test d. Examine the infant for unequal arm length c. Perform Ortolani and Barlow test A very active 35 years old male has painful hemorrhoid, but he does not want hemorrhoidal surgery at this time. His diet has been indiscriminate as his job requires frequent travel. The most appropriate recommendation is for him to select food that are: a. Low in fiber such as milk and other dairy products b. High in simple carbohydrates such as white bread and mashed potatoes c. High in fiber such as bran, complex carbohydrates and fresh fruit d. High protein such a meat, poultry and fish High in fiber such as bran, complex carbohydrates and fresh fruit A 13 y/o pt. complains that he fell while running during football practice. Now his knee hurts and sometimes "lucks". The NP conducts McMurrays test. Which of the following is TRUE about this test? a. An audible or palpated "click" is positive for a torn meniscus b. A various stress is applied to the flexed knee c. The straight leg is internally rotated with the patient supine and flat d. The knee is grasped with the examiner's fingers placed laterally. a. An audible or palpated "click" is positive for a torn meniscus A 20 y/o male patient complains of "scrotal swelling". He states his scrotum feels heavy but denies pain. On examination, the NP notes transillumination of the scrotum. What is the most likely diagnosis? a. Hydrocele b. Orchitis c. Testicular torsion d. Indirect inguinal hernia a. Hydrocele 12 | P a g e Correct instructions to give new parent who are transporting their newborn infant is a. A rear-facing infant car seat secured in the backseat is required until the infant weight 20lbs. b. The infant car set may be secured in the back or front seat, but must rear-facing c. The infant car seat may be front facing when the infant is 1 year old d. A rear or front-facing infant car seat must be secured in the back seat until the infant weight 20 lbs. a. A rear-facing infant car seat secured in the backseat is required until the infant weight 20lbs. A pt. present with classic symptoms of gastroesophageal reflux diseases' (GERD). He is instructed in lifestyle modification, and drug initialed. Two month later, he returns and report that he still has symptoms. The next steps are to. a) Refer for surgical interventions such as partial or complete fundoplication. b) Refer for endoscopy, namometry, and/or PH testing c) Repeat the 8*-week course of drug therapy while continuing lifestyles modifications. d) Review proper proton pump inhibitor dosing time and adherence with the patient. d) Review proper proton pump inhibitor dosing time and adherence with the patient. A 51 -year- old post-menopausal female, request guidance regarding osteoporosis risk. The NP would be correct to recommend all of the following EXCEPT a. Moderate weight bearing exercise 3 times per week b. 1200 - 1500 mg calcium daily c. Avoidance of alcoholic beverages d. Weight loss d. Weight loss 15 y/o male has a hx of cryptorchidism which was surgically repaired. Because of this information, it is essential for the NP to teach him about a. Testicular self-examination b. Protection of the testes during sports activities c. Risk of testicular torsion d. Practicing safer sex a. Testicular self-examination Moderate weight loss, particularly of visceral adipose tissue in patients with type 2 diabetes mellitus may have all of the following beneficial effects EXCEPT: a. Improved insulin sensitivity b. Increased glucose uptake and utilization by the cells c. Increase lean muscle mass' d. Improved lipid profile c. Increase lean muscle mass' According to Erickson, the developmental task of the elderly adult is: a. Intimacy VS isolation b. Ego integrity VS despair 15 | P a g e A 12-month-old has conjunctivitis in his right eye with a mucopurulent discharge. The mother asks if the child can forego for antibiotic eye drops because he does not's like drops in his eyes. The NP replies that: a. If untreated, conjunctivitis may permanently damage the cornea b. Conjunctivitis is usually caused by a virus. Let's wait a few days c. If no one else at the daycare has it, we can wait a few days. d. An oral antihistamine may be prescribed instead of eye drops. a. If untreated, conjunctivitis may permanently damage the cornea Which of the following oral medications should be avoided in a child under 8 years of age? a. Cephalexin (Keflex) b. Tetracycline c. Rifampin d. Metronidazole (flaggyl) b. Tetracycline which oral hypoglycemic agent would be safest for an elderly patient if hypoglycemia is a major concern? a. Tolbutamide (orinase) b. Glipizide (Glucotrol) c. Metformin (Glucophage) d. Chlorpropamide (diabinese) c. Metformin (Glucophage) A patient has been taking fluoxetine (prozar) since being diagnosed with major depression 7 month ago. She reports considerable empowerment in her symptoms and her intention to discontinue the medication what should be the NP's recommendation? a. Advice the patient to stop the antidepressant medication b. Question the patient to determine if the self-assessment is correct before advising her to discontinue the medication c. Recommend that the patient continue the antidepressant medication for at least 4 more month d. Discuss with the patient that need to take the antidepressant medication indefinitely c. Recommend that the patient continue the antidepressant medication for at least 4 more month the components of the Denver II Developmental screening test are: a. Personal/social, fine motor, gross motor, language b. Intelligence, motor performance, language development c. Vocabulary, clarity of speech, abstract thinking d. Problem-solving, speech, gross motor, fine motor a. Personal/social, fine motor, gross motor, language for the general adult population, total dietary fat intake should be no more than what percent of total calories? a) 10% b) 20% 16 | P a g e c) 30% d)40% c) 30% A 30 y/o female patient is being seen by the NP for the first time. She is seeking advice from the NP about becoming pregnant. She is currently taking an oral contraceptive. She gives a hx of having hydatidiform molar pregnancy 2 years ago. An appropriate plan of care for this patient should include b. Delaying pregnancy for 1 more year c. Measuring serum chorionic gonadotropin level d. Discontinuing oral contraceptive e. Recommending permanent sterilization d. Discontinuing oral contraceptive 24 y/o female taking oral contraceptive has missed her last 2 pills. What should the NP advise her to do to minimize her risk of pregnancy? a. Take today's dose and do not miss any more during this month b. Double today's dose and use a barrier method for the rest of this month c. Double today's dose and tomorrow's dose and use a barrier method for the rest of this month d. Stop the pills and restart a new pill pack in one week. c. Double today's dose and tomorrow's dose and use a barrier method for the rest of this month The groove of the metacarpophalangeal joint can be palpated by having the patient... Flex their hand/spread their fingers When auscultating breath sounds in a patient who has left sided heart failure, the breath sounds are... Vesicular with late inspiratory crackles in the dependent portions of the lungs and resonant on percussion The ankle-brachial index is a screening test used to assess a person's risk for... Peripheral Artery Disease (PAD) Olecranon bursitis maybe caused by all of the following except... Frozen shoulder In patients who have allergic rhinitis, the nasal mucosa appears... pale A term used to describe an increase in muscular bulk with diminished strength is... Pseudohypertrophy If abdominal pain persists when the patient raises his head and shoulders, the origin of the tenderness is probably... In the abdominal wall 17 | P a g e On auscultation of the abdomen, rushes of high-pitched sounds are audible and coincide with abdominal cramps. These findings are most consistent with... Intestinal obstruction Ophthalmoscopic examination of the fundus reveals tiny, round, red spots in and around the macular area. These findings are consistent with... microaneurysms Symptoms of subdural hematoma include... Noticeable bleeding between the dura and cerebrum on x-ray On examination of the adult patient, symptoms of fixed posture, tremor, rigidity, and shuffling gait are observed. These findings are consistent with... Parkinson's Disease When discussing the musculoskeletal system, all of the following statements related to articular structure disease are true except which one? Articular disease is usually due to stiffness or pain Focal tenderness over the trochanter confirms... Bursitis Assessing the neurological status of a child with a ventriculoperitoneal shunt should include... Use of the Glasgow coma scale The easiest recognizable clinical manifestation(s) of cystic fibrosis in an infant is... Salty taste on the skin A reddish blue, irregularly shaped, solid, and spongy mass of blood vessels that may be present at birth and enlarge during the first 10 to 15 months is characteristic of a... Cavernous hemangioma The hamstring muscles flex at the knee and are located on the... Posterior aspect of the thigh Ophthalmoscopic examination reveals dark specks noted between the fundus and the lens. These specks are most likely... vitreous floaters When performing the first Leopold maneuver on a pregnant woman, if the buttocks and head are not easily palpated at the fundus, the fetus is said to be in... Transverse lie 20 | P a g e A female patient complains of weakness in both arms when transferring the wet clothes from the washer and placing them in the dryer. This finding could be suggestive of which type of weakness pattern? Symmetric To palpate the right ovary when performing the bimanual vaginal exam, the abdominal hand should be on the right lower quadrant and the pelvic hand needs to be... in the right lateral fornix A serious disturbance in a person's mental abilities that results in a decreased awareness of one's environment and confused thinking is referred to as... delirium Which of the following tests for hearing loss can detect both sensorineural and conductive hearing los? Weber Test Located on the anterior aspect of the distal femur, the patella slides on this groove during flexion and extension of the knee. The name of this groove is the... Trochlear groove An 86-year-old man with uncontrolled hypertension presents with sudden, intense left lower abdominal pain that radiates to the back. The pain is associated with a tearing sensation. These findings are most likely associated with... An abdominal aortic aneurysm Men between the ages of 40 and 64 years should be screened early for... Hypertension A term used to describe drainage from the nose is... rhinorrhea Tenderness over the scapulohumeral muscle group with the inability to abduct the arm over the shoulder level would be consistent with all of the following except... Synovitis of the glenohumeral joint In the older adult, the test for leg mobility is known as the... Timed "get up and go" test Which one of the following procedures would confirm a definitive medication diagnosis of Hirschsprung's Disease? A rectal biopsy Hypo-functioning of the thyroid gland would lead to all of the following disorders except... 21 | P a g e Grave's disease The fleshy projection of the earlobe is known as the... Lobule A 50-year-old male describes difficulty emptying his bladder. On exam, a distended bladder is noted following urination. This finding may be associated with... Overflow incontinence When performing an examination of the external genitalia of a female patient, a small firm, round cystic nodule in the labia is identified. This finding may be most consistent with... Epidermoid cyst Passive flexion, varus stress, and external rotation of the lower leg evaluates the... Medial meniscus When examining the knee, swelling above and adjacent to the patella was noted. This finding could be suggestive of... Synovial thickening over the knee joint While assessing the cranial nerves, the NP touches the cornea lightly with a wisp of cotton. This maneuver tests which cranial nerve? Cranial nerve V (Trigeminal) The NP instructs the patient to look over one shoulder, then the other. This maneuver would assess cervical... Rotation During a speculum exam of the cervix, the speculum is maintained in an open position by... Gently tightening the thumb screw on the speculum The NP is examining the elbow of a 16-year-old male athlete. When he tries to extend his wrist against resistance. This finding is most consistent with... Lateral epicondylitis Which examination finding is defined as a congenital ventral displacement of the meatus on the penis? Hypospadias Bowel sounds may be increased in the presence of... Early intestinal obstruction Eversion of the upper eyelid can be performed by placed the cotton application on the upper lid above the level of the internal tarsal plates and then... 22 | P a g e gently pushing down with the stick and lifting the lashes up and flipping the lid inside out Anticipatory guidance for the family of a pre-adolescent with cognitive impairment should be include information about... Sexual development Assymetry, irregular borders, variation in color, diameter greated than 6mm, and elevation represent the "ACBDE"s of... Malignant melanoma When performing a spinal exam, the NP noted the appearance of poor posure and a "hump" appearance of the upper back. This finding could be suggestive of... Thoracic Kyphosis The area where the iliac crest terminates anteriorly on the ilium is known as the... Anterior superior iliac spine Following injury to the extremities, assessment for neurovascular competency should include the... Skin color, temperature, movement, and sensation of the extremity A patient is experiencing a dull, achy pain in the epigastric are with eating. This type of pain is consistent with... A gastric ulcer Which of the following conditions is NOT related to polyuria? Hyperkalemic nephropathy When examining the elbow for range of motion, the NP instructs the patient to turn his palm upward. This motion is an example of... Supination The forward slippage of one vertebrae resulting in spinal cord compression is referred to as... Spondylythosis Skin conditions such as pruritis, hyperpigmentation, and calciphylaxis may be seen in patients who have... Chronic renal failure The extension of the spine of the scapula located at the highest point of the shoulder is referred to as the... Acromion process A 60-year-old patient with severe, deep left eye pain. Findings reveal dilated and fixed left pupil and the cornea is cloudy. There is no ocular discharge noted. These findings are most likely consistent with... 25 | P a g e Women with hyperthyroidism often experience... Oligomenorrhea, infrequent menstrual periods While auscultating the patients heart, a medium, soft murmur is audible. It is pansystolic and heard loudest at the apex with radiation to the left axilla. These findings are consistent with... Mitral regurgitation A 26-year-old man with a past medication history of sickle cell disease arrives at the office with complaints of a penile erection that has lasted 4 hours. He is experiencing symptoms of... low-flow Priapism On ophthalmoscopic examination, glaucomatous cupping appears... Pale Hairy leukoplakia may be associated with... AIDS To estimate the expected delivery date (EDD) using Nagele's rule, if the last menses was March 3, 2014, the EDD would be... December 10th, 2015 The infraorbital or maxillary, buccinator, and submandibular lymph nodes drain lymphatic fluid from the... Eyelids, the conjunctiva, and the skin and mucous membranes of the nose and cheek A whitish sebaceous secretion that collects between the glans and the foreskin or in the vulva is known as... smegma The bony structures of the shoulder include all of the following except... Teres minor Murmurs audible during pregnancy may suggest... Anemia A fine rhythmic oscillation of the eyes is termed... nystagmus The whispered voice test allows the examiner to screen for... General hearing loss 26 | P a g e A patient experienced a neck injury yesterday and presents to the NP with aching paracervical pain and stiffness. Other complaints include dizziness, malaise, and fatigue. These findings may be associated with... Mechanical neck pain and whiplash When evaluating a patient for weakness of the upper extremities, bilateral distal pain is noted. This finding could be suggestive of... Polyneuropathy Fasciculations in atrophic muscles suggest... A lower motor neuron disease The nerve that provides sensation to the palm and palmar surface of the most of the thumb, second, and third fingers, and half of the fourth digit is the... Median nerve Stools that appear black, tarry, and sticky are referred to as... Melena A patient with cirrhosis develops portal hypertension as indicated by the presence of... Splenomegaly Which of the following is considered an extrinsic risk factor for falls in the older adult? Psychoactive medications The thoracic lymph duct drains lymphatic fluid from all of the following areas except... Right upper thorax Which ethnicity is associated with glucose-6-phosphate dehydrogenase (G^PD) deficiency? Black/African American During pregnancy, which hormone is responsible for increasing insulin resistance and hyperglycemia associated with diabetes? Human placental lactogen On examination of a six-week-old infant, developmental hip dysplasia (DDH) is suspected. If DDH is present, it might be evidenced by... Limited abduction of the affected leg When should a vaginal swab for Group B streptococcus (GBS) be obtained in a pregnant woman? 35-37 weeks Percussion of the abdomen should be avoided when? 27 | P a g e An abdominal aneurysm is suspected Basic self-care activities are referred to as... Activities of daily living (ADLs) Which sexually transmitted disease (STD) is known as the 'silent' infection and often lacks abnormal physical findings? Chlamydia With transillumination of the frontal sinuses, a dim red glow is observed on the forehead. This dim red glow would be indicative of... Clear frontal sinuses During the mental status exam, a 45-year-old woman is easily distractible and seems to have difficulty responding to each question. This is an assessment of... attention The normal fetal heart rate is... 110-160 (notes say 120-160) A patient presents with a productive cough. Which of the following descriptions of the mucous is correct? Tenacious sputum is consistent The posterior cruciate ligament of the knee crosses from the posterior tibia and lateral meniscus to the medial... Femoral condyle On physical exam, the soft palate does not risk, there is an absent gag reflex, and the patient complains of taste abnormalities. This requires further evaluation of cranial nerve... CN IX; Glossopharyngeal nerve When performing a spinal exam, the nurse practitioner notices unequal heights of the iliac crests. This finding could be suggestive of... Unequal leg lengths When examining the ankle and the foot of a patient, the NP instructs the patient to point the foot toward the veiling. This motion assesses... Ankle extension Ophthalmoscopic examination of the retina reveals AV tapering. This appears as if the... vein 'winds' down on either side of the artery The concavities noted on each side and above the patella are known as the... 30 | P a g e Your 70 year old patient complains of a sore mouth that prevents her from eating. On exam you note a beefy red, glossy, smooth tongue. What do you suspect? Pernicious anemia due to insufficient intrinsic factor A 62 year old male presents with leg pain and occasional numbness that is worse with ambulation and improved with lumbar flexion. What is the likely diagnosis? spinal stenosis What is not a typical symptom of late stage HIV? persistent vomiting A pregnant patient presents for her 16 week prenatal visit. Her blood pressure had reduced from 118/79 to 109/68. What hemodynamic change is responsible for this? decrease in systemic vascular resistance Your 62 year old patient has been taking Griseofulvin 500 mg po BID for 3 weeks to treat tinea capitis and has only had marginal improvement. What is your next step? continue current therapy for 6-8 weeks Rapid HIV testing would be more appropriate for a patient with complaints of: painful urination, dyspareunia, and penile or vaginal discharge What is a frequent side effect of SSRIs? sexual dysfunction You might suspect small bowel obstruction in a patient who complains of: vomiting and pain What finding would be suggestive of osteosarcoma in a pediatric patient? pain in the affected bone What clinical manifestation suggests primary syphilis? a single painless genital lesion What medication is used first line for a patient with benign positional vertigo? Meclizinete Which symptom is most associated with testicular torsion? testicular pain A clinical breast exam should include palpation at the tail of Spence. Where is this located? Laterally across the anterior axillary fold 31 | P a g e Which area does not drain to the right lymph duct? the right leg Which presentation is most suspicious for penile cancer? a nontender, indurated penile nodule What is important to consider before prescribing metronidazole for giardiasis? whether the patient drinks alcohol In which condition would the use of triptans for migraine headaches be contraindicated? hypertension Which is a true statement about varicose veins? they are more symptomatic during ovulation When measuring the fundal height of a pregnant woman at 32 weeks, which measurement would prompt the nurse practitioner to suspect fetal growth restriction? 29 cm What is the term for excess fluid that accumulates in the pleural cavity between the visceral and parietal spaces? pleural effusion What pathogen is associated with common UTIs? E. Coli Which medication inhibits blood coagulation by selectively blocking the active site of factor X-a? Eliquis (apixaban) Which is a contraindication for menopausal estrogen replacement therapy in a 55 year old woman? current or past migraine headaches During abdominal exam, which sound over the bulging area of the abdomen would indicate ascitic fluid? dullness What is a typical finding in a patient with a meniscal tear? positive McMurray's test What is the most common presenting symptom of a woman with trichomoniasis? vaginal discharge What is the single dose treatment for chlamydia? 32 | P a g e zithromax (azithromycin) 1 g po What is the mechanism of action of prostaglandin E1 in a patient with transposition of the great arteries? to produce vasodilation and adequate oxygen saturation How do 5-alpha reductase inhibitors work to reduce the symptoms of BPH? decrease the size of the prostate Which condition is best treated by using alpha adrenergic antagonists? overflow incontinence What should not be prescribed for migraine prophylaxis in a 42 year old woman? amitriptyline (elavil) How would a 60 year old man typically describe prostate pain? located in the perineum What is the most common characteristic among patients with migraine headache? family history Which patient would be at highest risk for contracting TB? a low income immigrant Which is not a location of pain associated with kidney and ureter disorders? suprapubic Which medication is appropriate for a woman with bladder sphincter dysfunction and stress incontinence? Urispas (flavoxate) Which condition is associated with chronic, bloody diarrhea? Crohn's disease Which medication is indicated for patients with generalized anxiety disorder? buspirone (buspar) At what point in pregnancy should Rh negative women receive Rhogam (Rho D immune globulin)? 28 weeks Which is common among patients with psoriasis? pitted nails and plaques 35 | P a g e trimethoprim/sulfamethoxazole Corticosteroids, used in the treatment of ulcerative colitis, are produced by the: pituitary gland. hypothalamus. adrenal glands. pancreas. adrenal glands The antibiotics in triple therapy for the treatment of Helicobacter pylori should be administered: daily. twice daily. three times daily. every 6 hours. 2 times a day infliximab (Remicade), a tumor necrosis factor inhibitor, is: used to treat Crohn's disease in children. is not indicated for use in patients who have ulcerative colitis. can increase exacerbations of rheumatoid arthritis. is not approved for patients who have plaque psoriasis. used to tx chrohns disease in children A 54-year-old man is diagnosed with diabetic gastroparesis. The drug that will promote gastrointestinal tract motility and produce an antiemetic effect is: prochlorperazine maleate (Compazine). erythromycin base (Ery-Tab). dronabinol (Marinol). metoclopramide (Reglan). reglan n the patient with an allergy to penicillin, treatment of Helicobacter pylori would include a proton pump inhibitor plus: amoxicillin and clarithromycin. amoxicillin/clavulanate and tetracycline. metronidazole and clarithromycin. amoxicillin and cephalexin. metronidazole and clarithromycin. Due to potential for extrapyramidal symptoms, oral metoclopramide (Reglan) should NOT be administered concomitantly with: sertraline (Zoloft). hydralazine (Apresoline). 36 | P a g e hydromorphone (Dilaudid). lamotrigine (Lamictal). Zoloft Which therapy should be initiated in a patient with moderate Clostridium difficile infection who has failed to respond to treatment with metronidazole (Flagyl)? Nitrofurantoin (Macrobid)Oral vancomycin (Vancocin)Doxycycline (Vibramycin)Trimethoprim-sulfamethoxazole (Bactrim) NextPause Quit oral vanco The brand name of prochlorperazine maleate is:Cyclivert.Thorazine.Phenergan.Compazine. NextPause Quit comparing The antiemetic that does NOT have potential to cause QT prolongation is:promethazine (Phenergan).chlorpromazine (Thorazine).ondansetron (Zofran).prochlorperazine (Compazine). NextPause Quit phenergan In addition to metoclopramide (Reglan), another prokinetic drug used to improve gastric motility is: prochlorperazine maleate (Compazine).erythromycin base (Ery-Tab).dronabinol (Marinol).sucralfate (Carafate). NextPause Quit erythromycin base (ERY-TAB The first-line regimen for the treatment of Helicobacter pylori is a proton pump inhibitor (PPI) plus: amoxicillin and clarithromycin. amoxicillin/clavulanate and tetracycline. clarithromycin and tetracycline. amoxicillin and cephalexin. amoxicillin and clarithromycin. The class of medications most useful in the treatment of chemotherapy induced nausea and vomiting is the: dopamine receptor antagonists. histamine receptor antagonists. muscarinic receptor antagonists. serotonin receptor antagonists. serotonin receptor antagonists 37 | P a g e Which of the following is NOT a 5-HT3 receptor antagonist? Dolasetron (Anzemet) Granisetron (Sustol) Ondansetron (Zofran) Prochlorperazine (Compazine) COMPAZINE The medication that suppresses vestibular end-organ receptors and inhibits activation of central cholinergic pathways is: prochlorperazine (Compazine). dimenhydrinate (Dramamine). cycline (Cyclivert). meclizine (Antivert). ANTIVERT Ondansetron (Zofran) is available as: intramuscular and intravenous solutions only.oral disintegrating tablets and an intravenous solution only.oral elixir and disintegrating tablets only. oral elixir, tablets, soluble film, disintegrating tablets, intramuscular and intravenous solution. NextPause Quit oral elixir, tablets, soluble film, disintegrating tablets, intramuscular and intravenous solution. An example of a dihydropyridine calcium channel blocker is: nebivolol (Bystolic). verapamil (Calan). diltiazem (Cardizem). amlodipine (Norvasc). norvasc negative inotropes are indicated for pt dx with a fib isosorbide denigrate is indicated for tx of acute angina chronic agina MI esophageal spasm chronic angina Gemfibrozil (Lopid) should be discontinued if a mild decrease in hemoglobin is experienced. symptoms of biliary colic are present. the patient complains of syncope. the patient develops cataracts. 40 | P a g e The brand name for hydralazine is: Apresoline. Imdur. Nipride. Vistaril. apresoline The onset of anticoagulation action for warfarin (Coumadin) is: 4-6 hours. 8-10 hours. 12-24 hours. 24-72 hours. 24- 72 hours Enoxaparin (Lovenox) is classified as a(n): ADP receptor antagonist. factor Xa inhibitor. low molecular weight heparin. direct thrombin inhibitor. low molecular weight heparin Concomitant use of beta-blockers with digitalis glycosides can increase the risk of: hypertension. hypokalemia. bradycardia. hyperglycemia. bradycardia An adverse reaction to angiotensin receptor blockers (ARBs) used in the treatment of hypertension is: photosensitivity. hypokalemia. angioedema. Barrett's esophagus. angioedema A 52-year-old man is receiving metoprolol tartrate (Lopressor) after a myocardial infarction. This patient should be educated to: stop the medication abruptly if any side effects occur. take an extra dose if he experiences angina. take two tablets if he misses a dose. avoid abruptly stopping the medication. avoid abruptly stopping the medication 41 | P a g e The diuretic that blocks the reabsorption of sodium and water in the loop of Henle to produce diuresis is: furosemide (Lasix). hydrochlorothiazide (Microzide). spironolactone (Aldactone). triamterene (Dyrenium). lasix t is safe to use ranolazine (Ranexa) concomitantly with: fluconazole (Diflucan). phenytoin (Dilantin). amlodipine (Norvasc). clarithromycin (Cleocin). norvasc Loop diuretics such as bumetanide (Bumex): produce a large volume of diuresis even at very low doses. are more commonly used in patients with a decreased glomerular filtration rate. reduce blood pressure as effectively as thiazide diuretics when used as monotherapy. can be safely administered to patients who have sulfonamide agent allergies. are more commonly used in patients with a decreased glomerular filtration rate. Gemfibrozil (Lopid), for the treatment of hypertriglyceridemia, is classified as a: bile acid sequestrant. nicotinic acid. fibric acid. statin. fabric acid What is the maximum half-life elimination of warfarin (Coumadin)? 8 hours 12 hours 16 hours 60 hours 60 hours The side effect profile of angiotensin receptor blockers (ARBs) is similar to the side effects of: angiotensin-converting enzymes (ACE) inhibitors. beta-blockers. calcium channel blockers. pressors. angiotensin - copertina enzymes (ACE) inhibitors 42 | P a g e Of the angiotensin receptor blockers (ARBs) used in the treatment of hypertension, the one with the longest biological half-life at 24 hours is: irbesartan (Avapro). losartan (Cozaar). olmesartan (Benicar). telmisartan (Micardis). micardis Bile acid sequestrants such as colesevelam (Welchol): are metabolized by the liver and block the formation of low-density lipoproteins by bile acids. bind to bile acids in the stomach and prohibit the absorption of cholesterol in the intestines. bind to bile acids and excrete them in feces, forcing the liver to use cholesterol to produce more bile acids. prohibit the exchange of sodium ions with bile acids, therefore inhibiting the production of cholesterol. bind to bile acids and excrete them in feces, forcing the liver to use cholesterol to produce more bile acids. Which of the following drugs blocks the action of aldosterone in order to produce diuresis? Furosemide (Lasix) Hydrochlorothiazide (Microzide) Spironolactone (Aldactone) Bumetanide (Bumex) Spironolactone (Aldactone) Baseline and periodic monitoring for patients receiving hydralazine (Apresoline) should include serum: liver function tests. thyroid panel. complete blood count. blood urea nitrogen and creatinine. CBC Cardioselective beta-blockers: specifically block beta-1 receptors. should never be administered to patients who have asthma. are recommended as first-line treatment for hypertension. should be discontinued 5 days prior to surgery. specifically block beta-1 receptors. Bile acid sequestrants to treat hypercholesterolemia should be dosed: on an empty stomach. with milk prior to bedtime. mixed in carbonated beverages. 1 hour before or 4 hours after other medications.