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CHRONIC CONDITIONS EXAM 1 QUESTIONS WITH ACCURATE ANSWERS
Typology: Exams
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The foods that are richest in Vitamin K are: leafy greens A 56-year-old male presents to the emergency department with dyspnea, fatigue, and poor exercise tolerance that has increased over the past month. He reports that he has been on a diet but has gained 20 pounds over the last month. An echocardiogram is ordered and shows an ejection fraction of 35%. You would describe and classify his type of heart failure as: HFrEF HFpEF Left ventricular failure Right ventricular failure HFrEF Abruptly discontinuing an alpha2 agonist such as clonidine can cause rebound hypertension: T/F T If a dose of warfarin is missed, the patient should take a triple dose the next day. T/F
Children with ADHD treated with stimulant medications have lower rates of academic failure than children who were not treated or received only behavioral therapy. T/F T Which of the following is true regarding allergy skin tests to detect specific IgE sensitization? Helpful in detecting airborne allergies such as dust and cat dander but not helpful in detecting food allergies Can be done on children of any age Will be more accurate if an antihistamine is taken the morning of the test Will not be useful if child has taken an inhaled corticosteroid in the past 6 hours Can be done on children of any age Mara is 8 years old, has many inattentive symptoms in school, problems completing chores and homework, and difficulties with peer interactions. She has been diagnosed with ADHD and her parents would prefer to try behavioral interventions before starting her on medication. Which of the following statements about behavioral interventions is most accurate? The combination of medication and behavioral treatments result in improved academic performance for children who have anxiety in addition to ADHD. Children with ADHD can qualify for school-based behavioral interventions without an Individualized Educational Plan in place. Behavioral interventions are just as effective as medication for the CORE symptoms of ADHD
in school-aged children. In general, parents prefer medication alone to a combination of medication and behavioral treatments. The combination of medication and behavioral treatments result in improved academic performance for children who have anxiety in addition to ADHD. When obtaining an accurate feeding history is hampered by poor parental recall or inconsistency, it may be necessary to hospitalize an infant to more optimally evaluate calorie intake and observe feeding interactions. T/F T Who is more likely to be diagnosed with asthma? Children from low-income families Asian children Non-Hispanic black children Children from low-income families and Non-Hispanic black children Children from low-income families and Asian children Children from low-income families and Non-Hispanic black children A patient recently diagnosed with type 1 diabetes mellitus is in clinic for a follow-up evaluation. The provider notes that the patient appears confused and irritable and is sweating and shaking. What intervention will the provider expect to perform once the point of care blood glucose level is known? Dipstick urinalysis for ketones Giving a rapid-acting carbohydrate Injection of rapid-acting insulin Performing a hemoglobin A1C
Giving a rapid-acting carbohydrate A patient has unexplained weight loss and the provider notes increased skin pigmentation on light-exposed skin folds along with darkened palmar creases. Which laboratory tests will the provider order? Serum ACTH TB skin testing Chest X ray Serum ACTH How often should a patient with either type 1 or type 2 diabetes have their blood pressure measured to screen for hypertension? Annually Every 3 months At every visit Only when symptomatic At every visit Which of the following sulfonylureas is on the Beers Criteria and to be avoided among elderly patients. Glyburide due to its prolonged half - life and higher risk of prolonged hypoglycemia. Glipizide due to its prolonged half-life and higher risk of prolonged hypoglycemia. Neither one; they are both appropriate for elderly patients. All sulfonylureas are to be avoided in elderly patients. Glyburide due to its prolonged half - life and higher risk of prolonged hypoglycemia. Which is the preferred pharmacological agent in the management of type 1 and type 2 diabetes in pregnancy? Metformin
Insulin Januvia Glipizide Insulin Your 34-year-old female patient visits the clinic with a new onset of anxiety, hair loss, and palpitations. She has also lost weight but has an increased appetite. Which findings would you expect on her blood work? High TSH and low T High TSH and high T Low TSH and low T Low TSH and high T Low TSH and high T A patient has thyroid nodules and the provider suspects thyroid cancer. To evaluate thyroid nodules for potential malignancy, which test is performed? Radionucleotide imaging Serum calcitonin Serum TSH level Thyroid ultrasound Thyroid ultrasound Which of the following symptoms and signs are consistent with a person with primary hypothyroidism? Palpitations and fine tremor Diarrhea and exophthalmos Dysthymia and weight gain Nervousness and hyperactive bowel sounds
Dysthymia and weight gain Which of the following pharmaceutical options might you give a newly diagnosed patient with hypothyroidism? 5mg Tapazole 25mg Inderal 25mcg Cytomel 25mcg Synthroid 25mcg Synthroid A medication that should be immediately ordered to blunt symptoms of hyperthyroidism is: Radioactive iodine (123I) Propylthiouracil Propanolol Amiodarone Propanolol A patient who has dyspnea and chest pain along with occasional chills and night sweats has a chest radiograph that shows bilateral hilar lymphadenopathy and pulmonary infiltrates. The provider suspects which classification of sarcoidosis? Stage 1 Stage 2 Stage 3 Stage 4 Stage 2 A patient with stage 1 sarcoidosis who is taking a nonsteroidal anti-inflammatory medication to treat joint discomfort develops mild dyspnea and cough. Which medication will be added
to treat this symptom? A beta-adrenergic medication An antimalarial agent An immunosuppressant drug An oral corticosteroid An oral corticosteroid A non-smoking adult with a history of cardiovascular disease reports having a chronic cough without fever or upper airway symptoms. A chest radiograph is normal. What will the provider consider initially as the cause of this patient's cough? ACE inhibitor medication use Chronic obstructive pulmonary disease Gastroesophageal reflux disease Psychogenic cough ACE inhibitor medication use Which is characteristic of chronic bronchitis and not emphysema? Damage to the alveolar wall Destruction of alveolar architecture Mild alteration in lung tissue compliance Mismatch of ventilation and perfusion Mild alteration in lung tissue compliance Which of the following carries the highest risk of developing COPD? Smoking Asthma
Occupation as airline mechanic Seasonal allergies Smoking Most COPD exacerbations are due to weather changes. True False F Triggers of asthma symptoms include allergens, irritants, medications, and sulfite-containing foods. Which of the following is the most important airway irritant exposure to teach your patient to avoid? Dust mites Animal dander Perfume Tobacco smoke Tobacco smoke The strongest predictor for developing asthma is: Upper respiratory infections Atopy Acute bronchitis Cigarette smoking Atopy An adult develops chronic cough with episodes of wheezing and shortness of breath. The provider performs chest radiography and other tests and rules out infection, upper
respiratory, and gastroesophageal causes. Which test will the provider order initially to evaluate the possibility of asthma as the cause of these symptoms? Allergy testing Methacholine challenge test Peak expiratory flow rate Spirometry Spirometry In purely chronic bronchitis, one form of COPD, all of the following are pathophysiological changes except: Increased sputum production Airway obstruction Loss of airway integrity Loss of alveolar-capillary bed surface area Loss of alveolar-capillary bed surface area Mara is 8 years old, has many inattentive symptoms in school, problems completing chores and homework, and difficulties with peer interactions. She has been diagnosed with ADHD and her parents would prefer to try behavioral interventions before starting her on medication. Which of the following statements about behavioral interventions is most accurate? The combination of medication and behavioral treatments result in improved academic performance for children who have anxiety in addition to ADHD. Who is more likely to be diagnosed with asthma? Children from low-income families and Non-Hispanic black children
Which of the following medications is approved by the Food and Drug Administration (FDA) as an add-on to stimulants in the treatment of ADHD? Extended release guanfacine (Intuniv) According to the National Institutes of Health (NIH) guidelines, when classifying asthma severity, a component of severity known as "risk" needs to be considered. "Risk" refers to which of the following? Number of asthma exacerbations requiring oral corticosteroids within a certain period of time For children under 17 years of age, a diagnosis of ADHD using the DSM-V criteria requires recognition of symptoms of inattentive behaviors and hyperactive behaviors. Which of the following behaviors most accurately reflects these symptoms? Inability to take turns, blurts out answers Which patient would benefit from a polysomnography (Sleep Study) evaluation to assess a potential sleep disorder? A child with enlarged tonsils who has daytime sleepiness / The American Academy of Pediatrics (AAP) developed a policy statement, "Identifying Infants and Young Children with Developmental Disorders: An Algorithm for Developmental Surveillance and Screening," to: Provide a strategy to incorporate ongoing developmental surveillance and screening of all children into primary care visits The psychometric properties of a developmental screening tool include assessing specificity. Specificity is defined as: The ability of a screening tool to be accurate and identify children who do not have a developmental delay Children with ADHD treated with stimulant medications have lower rates of academic failure than children who were not treated or received only behavioral therapy.
True The Ages and Stages Questionnaire, Third Edition (ASQ-3) has a sensitivity of 0.70 to 0.90. This means that different studies found the sensitivity to range from 0.70 to 0.90. The interpretation of a sensitivity of 0.90 is that: 90% of the children who receive positive screening results truly have a developmental problem The criteria for determination of FTT include: Weight below the third-fifth percentile using a reliable, standardized curve When establishing a growth trend in infants and toddlers, which of the following is currently recommended: World Health Organization growth chart until the infant reaches the age of 2 years Which of the following statements about stimulant dosage is true? Most children have some appetite suppression while they are taking an adequate dose of the medication. Screening for autism is particularly important for which population of children? Boys under 24 months of age Peter is 4 years old and has been dismissed from two preschools for disruptive behavior and inability to sit in circle time. His father wants him evaluated for ADHD. Which of the following statements about 4 year-olds and ADHD is most accurate? If medication is needed, methylphenidate is recommended for children in this age group. Which of the following is true regarding allergy skin tests to detect specific IgE sensitization? Can be done on children of any age The prevalence of depression in adolescence:
Is reported at 15-25%, A: All of the above, Increases with history of abuse or neglect, Mirrors the prevalence in adults When obtaining an accurate feeding history is hampered by poor parental recall or inconsistency, it may be necessary to hospitalize an infant to more optimally evaluate calorie intake and observe feeding interactions. True Children with ADHD seldom present with coexisting conditions such as oppositional defiant disorder, mood disorders, or anxiety disorders. False Safety concerns, especially for suicidal or self-harm behaviors, should be reviewed at each medication management visit with the child adolescent. / True Which of the following is an uncommon side effect of stimulants when used at appropriate doses for treating ADHD? Hallucinations Which of the following sulfonylureas is on the Beers Criteria and to be avoided among elderly patients. Glyburide due to its prolonged half - life and higher risk of prolonged hypoglycemia. Which of the following are expected findings in a patient with Cushing disease? (Select 3) Central obesity, Moon face and buffalo hump, Purple striae Which of the following medications is commonly used in the management of Addison's disease? Oral hydrocortisone
Which of the following would be an appropriate recommendation for the treatment of confirmed hypertension in a patient with diabetes presenting an initial blood pressure of > = 160/100 and no other complications? / Lifestyle management and Lisinopril A patient recently diagnosed with type 1 diabetes mellitus is in clinic for a follow-up evaluation. The provider notes that the patient appears confused and irritable and is sweating and shaking. What intervention will the provider expects to perform once the point of care blood glucose level is known? Giving a rapid-acting carbohydrate A patient reports she is having symptoms of hypoglycemia at 11am at least three times a week. She reports skipping breakfast and taking her glipizide 10 mg at 7am with water. She also takes metformin 1,000 mg twice daily and glargine 23 units at bedtime. Patient weighs 90 kg and has had diabetes for 10 years. You explain that: Her symptoms of hypoglycemia are likely due to her lack of food intake in the morning (breakfast) and the timing of her glipizide. At which level of renal impairment should a clinician discontinue the use of metformin? GFR < 30 ml/min A patient has unexplained weight loss and the provider notes increased skin pigmentation on light-exposed skin folds along with darkened palmar creases. Which laboratory tests will the provider order? Serum ACTH The leading cause of morbidity and mortality in patients with diabetes is Atherosclerotic cardiovascular disease (ASCVD) Which of the following is not an acceptable test to use to screen for type 2 diabetes? Urine glucose level
Which is the preferred pharmacological agent in the management of type 1 and type 2 diabetes in pregnancy? Insulin The NP is seeing a 56-year-old patient with type II diabetes for a regularly scheduled check-up. Today the NP will order administration of the influenza vaccine. This is an example of what level of prevention? Primary prevention How often should a HgbA1c be monitored in a patient with diabetes not at goal? Every 3 months How often should a patient with either type 1 or type 2 diabetes have their blood pressure measured to screen for hypertension? At every visit A patient who has diabetes has a blood pressure of 160 90 mm Hg and albuminuria. Which initial action by the primary care provider is indicated for management of this patient? / Starting the patient on a low dose ACE or ARB A 12-year old female patient diagnosed with type 1 diabetes last year is complaining of periodic, temporary episodes of blurry vision over the last two weeks. During this time she also notes she has been urinating much more frequently and has been incredibly thirsty. Her mother notes her daughter has been much more irritable during this time. What is the most likely cause of this patients blurred vision? Hyperosmolarity-induced changes in the lens A postpartum woman develops fatigue, weight gain, and constipation. Laboratory values reveal elevated TSH and decreased T3 and T4 levels. What will the provider tell this patient? This condition may be transient.
You are concerned that a person presenting with fatigue, altered menses, and weight changes may have a thyroid disorder. To rule in rule out thyroid dysfunction, the initial diagnostic test(s) that you should order is/are: / Highly sensitive thyroid-stimulating hormone (TSH) and T4 (free) A patient who is taking a statin drug to treat dyslipidemia has begun a diet and exercise program. The patient reports new onset of muscle pain several weeks after beginning therapy. He describes this pain as mild. What is the initial action by the provider? Obtain a creatine kinase level A medication that should be immediately ordered to blunt symptoms of hyperthyroidism is: Propanolol Tendon xanthomas are most likely to be seen in which patients? Patients with primary hyperlipidemias Which findings are part of the 2009 diagnostic criteria for metabolic syndrome? (Select 3.) Elevated waist circumference, Fasting plasma glucose ≧100 mg/dL, Triglycerides ≧150 mg/dL Your 60-year-old female patient visits the clinic stating her fingers have been cold and her hair has been dry and brittle. She is also complaining of fatigue, constipation and weight gain. Which laboratory findings would you expect on her lab work? High TSH and low T4 (free) Which of the following pharmaceutical options might you give a newly diagnosed patient with hypothyroidism? 25mcg Synthroid Abruptly discontinuing an alpha2 agonist such as clonidine can cause rebound hypertension. True
A 70-year-old patient has a blood pressure of 138 85 on three occasions. The patient denies headaches, palpitations, snoring, muscle weakness, and nocturia and does not take any medications. What will the provider do next to evaluate this patient? / Continue to monitor blood pressure at each health maintenance visit A child with a history of asthma is brought to the clinic with a rapid heart rate. A cardiac monitor shows a heart rate of 225 beats per minute. The provider notifies transport to take the child to the emergency department. What initial intervention may be attempted in the clinic? Using a vagal maneuver or carotid massage The normal International Normalized Ratio (INR) range for a patient without liver disease is: 0.8-1. The mainstay of treatment of heart failure with preserved ejection fraction (HFrEF) includes which of the following? Beta blocker, Angiotensin-converting enzyme inhibitor (ACEI), Diuretic, All of the above Hypertension is a risk factor that can lead to heart failure. True Which are causes of secondary hypertension? (Select all that apply.) Nonsteroidal anti-inflammatory drugs, Oral contraceptives, Sleep apnea The reversal agent for warfarin is: Vitamin K Which of the following symptoms are most commonly associated with heart failure? Fatigue, dyspnea, fluid retention, exercise intolerance If a dose of warfarin is missed, the patient should take a triple dose the next day.
False A patient reports sustained, irregular heart palpitations. What is the most likely cause of these symptoms? Atrial fibrillation A 75-year-old patient reports pain and a feeling of tiredness in both legs that only relieves after sitting for 30 minutes or more. What does the provider suspect as the cause for these symptoms? Peripheral arterial disease Many medications interact with warfarin. The following medications can cause significant alteration of the INR: Amiodarone, Sulfamethazole/Trimethorpin, Erythromycins, A: All of the above A patient has a cardiac murmur with a mid-systolic click. The provider determines that the murmur decreases in intensity when the patient changes from standing to squatting and increases in intensity with the Valsalva maneuver. Which cause will the provider suspect for this murmur? Mitral valve prolapse Heart failure is a clinical diagnosis. True A 56-year-old male presents to the emergency department with dyspnea, fatigue, and poor exercise tolerance that has increased over the past month. He reports that he has been on a diet but has gained 20 pounds over the last month. An echocardiogram is ordered and shows an ejection fraction of 35%. You would describe and classify his type of heart failure as: Right ventricular failure, Left ventricular failure, HFpEF, HFrEF