FNP PRACTICE QUESTIONS WITH 100% CORRECT ANSWERS 2024 UPDATED LATEST GRADED 100% PASS., Exams of Nursing

Download FNP PRACTICE QUESTIONS WITH 100% CORRECT ANSWERS 2024 UPDATED LATEST GRADED 100% PASS. and more Exams Nursing in PDF only on Docsity! FNP PRACTICE QUESTIONS WITH 100% CORRECT ANSWERS 2024 UPDATED LATEST GRADED 100% PASS. 3-1. All of the following are true of Healthy People 2020 except: A. It is funded by the pharmaceutical industry B. It is a national agenda that communicates a vision for improving health and achieving health equity of the U.S. population C. It provides a set of more than 1,200 specific, measurable objectives with targets to be achieved over the decade D. Initiatives are organized by general health and wellness topics, age, and special needs populations such as maternal health or vulnerable population groups - SolutionA. It is funded by the pharmaceutical industry 3-2. The Lesbian, Bay, Bisexual, and Transgender (LGBT) population is included as a special population in the Healthy People 2020 initiative due to which of the following health concerns? A. LGBT population experiences few social barriers to healthcare caused by discrimination B. LGBT youth can be at special risk, with increased suicide rates 2-3 times higher than the general population C. LGBT individuals have less access to healthcare due to living in poorly served rural areas D. LGBT individuals experience a lower risk of violence and victimization, which has long-lasting effects on the individual and the community - SolutionB. LGBT youth can be at special risk, with increased suicide rates 2-3 times higher than the general population 3-3. Many objectives of Healthy People 2020 focus on broader population issues including which of the following? A. Increasing health disparities B. Reducing equal access to quality healthcare C. Increasing services to identified minority populations D. Decreasing the availability and dissemination of health-related information - SolutionC. Increasing services to identified minority populations 3-4. Improvement in sleep health is an objective of Healthy People 2020 for what reason? A. Inadequate sleep has implications for driving safety, work productivity, and quality of life B. 75% of adult population in the U.S. reports some sort of sleep disturbance C. Sleep apnea can be successfully treated with zolpidem D. Sleep apnea significantly increases the risk of diabetes and glaucoma - SolutionA. Inadequate sleep has implications for driving safety, work productivity, and quality of life 3-5. Which organization, created by Congress in 1984, is an independent, volunteer panel of national experts that develops screening recommendations based on evidence-based medicine? A. The World Health Organization B. American Association of Family Physicians C. National Screening Program D. The U.S. Preventive Services Task Force (USPSTF) - SolutionD. The U.S. Preventive Services Task Force (USPSTF) 3-6. Daily exercise and staying current with routine-recommended immunizations are examples of what level of prevention? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Primordial prevention - SolutionA. Primary prevention 3-7. A patient with type 2 diabetes who sees a podiatrist for monthly foot examinations is practicing what type of prevention? A. Tertiary prevention B. Primary prevention C. Secondary prevention A. Conjugate B. Live C. Polysaccharide D. Toxoid - SolutionA. Conjugate 3-17. In which of the following scenarios might it be acceptable to postpone immunization? A. Low-grade fever or mild illness B. Moderate to severe illness C. Prior localized reaction D. All of the above - SolutionB. Moderate to severe illness 3-18. Which type of vaccine is always contraindicated in pregnancy? A. Polysaccharide B. Toxoid C. Killed D. Live - SolutionD. Live 4-1. All of the following may effect a drug's absorption except: A. Size of the drug molecule B. Food in the gut C. Available surface area D. P450 enzyme system - SolutionD. P450 enzyme system 4-2. The primary means of medication excretion is through: A. The liver B. The kidneys C. Exhaled air D. Sweat from pores - SolutionB. The kidneys 4-3. Which of the following describes and agonist? A. A chemical that has a harder time crossing the blood-brain barrier B. A chemical that binds to a receptor and stimulates cellular activity C. A chemical that binds to a receptor and blocks or inhibits cellular activity D. A chemical that has a longer half-life than a competing chemical - SolutionB. A chemical that binds to a receptor and stimulates cellular activity 4-4. Chirality refers to: A. The shape of the medication molecule B. The shape of a drug receptor C. A drug that blocks a matching receptor D. A drug that shows affinity for certain receptors - SolutionA. The shape of the medication molecule 4-5. The P450 enzyme system affects the way medications are metabolized. Which of the following is an example of the P450 system in action? A. The ease that a medication is bound by plasma binding proteins B. A bigger molecule having a harder time crossing membranes C. Grapefruit juice interacting with a medication's metabolism D. The need to lower the dose of a medication because of poor kidney function - SolutionC. Grapefruit juice interacting with a medication's metabolism 4-6. An 88-year-old male is being treated for complicated pyelonephritis with gentamicin IM daily. His wife called the office to report that he didn't hear his alarm clock go off this morning. In addition, when their granddaughter called earlier that day, he had to hand the phone to his wife because he couldn't understand what she was saying. Based on this information, you are most concerned about which possible serious adverse effect of gentamicin? A. Dementia B. Hepatotoxicity C. Xerophthalmia D. Ototoxicity - SolutionD. Ototoxicity 4-7. A 56-year-old male presents to the office as a new patient. When reviewing his medical history you notice "medication-induced tendonitis with subsequent tendon rupture" listed under past problems. Even though he connote remember the medication, you know that it is a serious adverse effect of which of the following drugs? A. ceftriaxone (Rocephin) B. ciprofloxacin (Cipro) C. darifenacin (Enablex) D. phenazopyridine (Pyridium) - SolutionB. ciprofloxacin (Cipro) 4-8. A 33-year-old female presents to the office with complaints of urinary urgency, frequency, pressure, and dysuria. You would like to prescribe nitrofurantoin (Macrobid) 100mg PO BID X 5 days for her uncomplicated UTI. Which medical information would cause you to choose a different antibiotic? A. She reports bright orange urine after taking Pyridium earlier today B. She sometimes takes diphenhydramine to sleep at night C. She has a history of an allergic reaction to amoxicillin D. She is currently 39 weeks pregnant - SolutionD. She is currently 39 weeks pregnant 4-9. Edith L. is a 36-year-old pregnant woman who presents at the clinic with symptoms of fever, chills, and body aches. Symptoms started last night, and she tests positive for influenza A. Which of the following would you prescribe? A. oseltamivir (Tamiflu) B. zanamivir (Relenza) C. peramivir (Rapivab) D. amantadine (Symmetrel) - SolutionA. oseltamivir (Tamiflu) 4-10. Phillip R. is a 42-year-old male who presents to the clinic with recurrent genital herpes. Which of the following is recommended for the treatment of genital herpes in this individual? A. ganciclovir (Zirgan) B. atazanavir (Reyataz) C. valacyclovir (Valtrex) D. ribavirin (Virazole) - SolutionC. valacyclovir (Valtrex) diabetes. It is important to include what information when teaching her about this new medication? A. Signs and symptoms of low blood sugar may not be as apparent B. It is okay to stop the propranolol if her migraines don't improve C. If a rash occurs, it is a minor side effect and should go away D. She should expect her total cholesterol and LDL levels to improve - SolutionA. Signs and symptoms of low blood sugar may not be as apparent 4-20. Which patient is a candidate for warfarin (Coumadin) following a diagnosis of DVT? A. 45-year-old on Irbesartan and fluvastatin B. 34-year-old with coffee ground emesis C. 18-year-old who is 36 weeks pregnant D. 29-year-old female with von Willebrand disease - Solution 4-21. Which calcium channel blocker has little to no effect on conduction through the SA and AV nodes? A. procainamide (Pronestyl) B. verapamil (Calan) C. amlodipine (Norvasc) D. diltiazem (Cardizem) - SolutionC. amlodipine (Norvasc) The nurse practitioner is seeing a patient for acute exacerbation of asthma. The patient reports increasing shortness of breath and wheezing the last two days. He ran out of his albuterol inhaler and has been using his grandmother's inhaler (formoterol) with no improvement. What is the best rationale for the ineffectiveness of the formoterol? A. His grandmother nay have used all of the medicine in her inhaler B. formoterol is a long-acting beta agonist and is not effective for acute symptoms C. formoterol is an inhaled corticosteroid and is not effective for acute symptoms D. He is not using the inhaler correctly - SolutionB. formoterol is a long- acting beta agonist and is not effective for acute symptoms Which medication has the following mechanism of action: decreases inflammation and mucus production and causes bronchodilation by selectively binding leukotriene receptors? A. zafirlukast (Accolate) B. omalizumab (Xolair) C. ciclesonide (Alvesco) D. cromolyn sodium (Intal) - SolutionA. zafirlukast (Accolate) Which medication would cause concern prior to prescribing ipratropium bromide (Atrovent)? A. albuterol (Proair) B. fluoxetine (Prozac) C. montelukast (Singulair) D. Tamsulosin (Flomax) - SolutionD. Tamsulosin (Flomax) Kayla complains of pain on her tongue and a white coating to her tongue. She is diagnosed with oral candidiasis. The nurse practitioner knows this diagnosis is a complication of which medication? A. metoprolol tartrate (Lopressor) B. mometasone (Asmanex) C. lamotrigine (Lamictal) D. colchicine (Colcrys) - SolutionB. mometasone (Asmanex) In order to cover meals eaten within 30-60 minutes, which type of insulin should be prescribed by the nurse practitioner? A. Intermediate-acting insulin B. Long-acting insulin C. Rapid-acting insulin D. Short-acting insulin - SolutionD. Short-acting insulin A patient has recently been diagnosed with hyperthyroidism. Which medication will the nurse practitioner prescribe? A. hydrocortisone (Cortef) B. levothyroxine (Levoxyl) C. methimazole (Tapazole) D. metformin (Glucophage) - SolutionC. methimazole (Tapazole) What is the mechanism of action of sulfonylureas used for type 2 diabetes? A. Decrease hepatic production of glucose B. Enhance insulin secretion by binding to pancreatic beta cell receptor sites C. Mimic endogenous insulin by binding to cell wall receptors D. Stimulate insulin secretion in a short-acting manner - SolutionB. Enhance insulin secretion by binding to pancreatic beta cell receptor sites The nurse practitioner is caring for a patient with Addison disease with low aldosterone levels. Which medication will the nurse practitioner prescribe for aldosterone replacement? A. cortisone (Cortone) B. fludrocortisone (Florinef) C. hydrocortisone (Cortef) D. prednisone (Deltasone) - SolutionB. fludrocortisone (Florinef) Which type of insulin should be prescribed specifically to cover insulin needs for about half the day or overnight? A. Intermediate-acting insulin B. Long-acting insulin C. Rapid-acting insulin D. Short-acting insulin - SolutionA. Intermediate-acting insulin The nurse practitioner is prescribing antipyrine and benzocaine for a child with otitis externa. Which is the correct prescription? A. Fill affected ear canal and repeat daily B. 2 drops to affected ear canal twice daily C. 2 drops to affected ear canal 4 times daily D. Fill affected ear canal, repeat every 2 hours as needed - SolutionD. Fill affected ear canal, repeat every 2 hours as needed Which medication should be discontinued if eye pain or irritation occurs? A. cyclosporin D. omega-3 fish oil - SolutionC. solifenacin (VESIcare) An 18-year-old female presents to the office for insertion of the Skyla LNG IUD. As you prepare for the procedure, which information in her chart would cause you to reschedule her appointment for a later date? A. She was recently diagnosed with a right-sided ovarian cyst B. She is currently being treated for pelvic inflammatory disease C. She has poorly controlled type 1 diabetes mellitus D. She takes amphetamine/dextroamphetamine for attention deficit disorder - SolutionB. She is currently being treated for pelvic inflammatory disease A 33-year-old presents to the office with the desire to start combined oral contraceptives. This method is contraindicated if which of the following is part of her health history? A. First-degree relative with breast cancer B. Gestational hypertension during her second pregnancy C. Smoking five cigarettes per day D. Factor V Leiden - SolutionD. Factor V Leiden Which statement is true regarding the use of backup contraception following the initial start of combined oral contraceptives (COC)? A. Backup contraception should be used for the first seven days of the menstrual cycle after a Sunday start B. Backup contraception is not needed with the quick start method C. Backup contraception is needed for the first full menstrual cycle following the first day start method D. Backup contraception should be used for the first 14 days of the menstrual cycle with the Sunday start method - SolutionA. Backup contraception should be used for the first seven days of the menstrual cycle after a Sunday start Which complaint would not be of concern in a patient newly started on norethindrone/ethinyl estradiol? A. Headache B. Abdominal pain C. Diplopia D. Irregular bleeding - SolutionD. Irregular bleeding The nurse practitioner (NP) is evaluating a teenager who reports having taken 42 extra-strength acetaminophen (Tylenol) caplets. What will the NP order as an antidote? A. magnesium sulfate (Epsom salt) B. Calcium gluconate (Kalcinate) C. acetylsalicylic acid (Aspirin) D. acetylcysteine (Mucomyst) - SolutionD. acetylcysteine (Mucomyst) Which of the following medications is least likely to be associated with Stevens-Johnson syndrome? A. acetaminophen (Tylenol) B. allopurinol (Zyloprim) C. morphine (Roxanol) D. naproxen (Anaprox) - SolutionC. morphine (Roxanol) A patient has had repeat attacks of gout over a one-to two-year period. Which medication should the nurse practitioner choose for long-term treatment for this patient? A. ibuprofen (Motrin) B. allopurinol (Zyloprim) C. hydrocortisone (Cortef) D. colchicine (Colcrys) - SolutionB. allopurinol (Zyloprim) The nurse practitioner has just diagnosed a patient with mild rheumatoid arthritis. Which medication will the nurse practitioner likely prescribe? A. Corticosteroid B. Disease-modifying anti-rheumatic drug (DMARD) C. Nonsteroidal anti-inflammatory drug (NSAID) D. Opioid - SolutionC. Nonsteroidal anti-inflammatory drug (NSAID) Which testing is needed prior to initiation of biologic response modifiers for rheumatoid arthritis? A. Complete blood count B. Chest x-ray C. Hepatitis B and C D. All of the above - SolutionD. All of the above For the adult patient, what is the maximum amount of acetaminophen that can be taken per day? A. 1 gram B. 2 grams C. 4 grams D. 5 grams - SolutionC. 4 grams Regarding benzodiazepines, which of the following is true? A. They provide sedative effects B. They produce general anesthesia C. They have analgesic actions D. They require weeks for an effect - SolutionA. They provide sedative effects What is sumatriptan used for? A. Treatment of a severe headache B. Prophylaxis of migraine headaches C. Acute treatment of a migraine headache D. Acute treatment of a tension headache - SolutionC. Acute treatment of a migraine headache The nurse practitioner is caring for a 28-year-old woman with myoclonic seizures that are well controlled on valproic acid. The woman states that she would like to become pregnant in the next year. What should the NP consider regarding the woman's anticonvulsant medication? A. Continue the present therapy B. Consider changing to lamotrigine C. Decrease the valproic acid dose D. Add a second anticonvulsant - SolutionB. Consider changing to lamotrigine A. Are allowed, and a new Rx is needed after one year of treatment B. Are allowed, and a new Rx is needed after three months of treatment C. Are allowed, and a new Rx is needed after six months of treatment D. Are not allowed - SolutionC. Are allowed, and a new Rx is needed after six months of treatment The FDA is in the process of eliminating the pregnancy categories (A, B, C, D, and X) and replacing them with a new labeling system. All of the following are benefits of the new system, except: A. It will include information for females and males of reproductive potential, pregnancy, and lactation B. It will summarize the specific risks associated with each medication C. The Organization will be much simpler than using the five categories D. If a medication is absorbed systemically, it will state whether the information is based on animal or human studies - SolutionC. The Organization will be much simpler than using the five categories Fluorescein stain and a Wood's lamp are useful in diagnosing which disorders? A. Corneal abrasions and herpes keratitis B. Glaucoma and allergic conjunctivitis C. Herpes keratitis and bacterial conjunctivitis D. Corneal abrasions and glaucoma - SolutionA. Corneal abrasions and herpes keratitis Which of the following sets of clinical manifestations is consistent with acute angle-closure glaucoma? A. Gradual increase in intraocular pressure resulting in eye pain B. sudden increase in intraocular pressure without eye pain C. Gradual increase in intraocular pressure without eye pain D. sudden increase in intraocular pressure with eye pain - SolutionD. sudden increase in intraocular pressure with eye pain Which of the following is not a symptom of herpes keratitis? A. Eye pain B. Photophobia C. Seeing halos D. Blurred vision - SolutionC. Seeing halos The FNP is assessing a young child and notes a 2mm pustule on the left lower eyelid margin accompanied by erythema, swelling, and a small amount of purulent discharge. This finding is most consistent with which condition? A. Blepharitis B. Chalazion C. Conjunctivitis D. Hordeolum - SolutionD. Hordeolum What should the FNP prescribe for acute dacryocystitis? A. Antiviral medication B. Dacryocystorhinostomy C. Antimicrobial medication D. Cold compresses - SolutionC. Antimicrobial medication What is a key diagnostic finding in open-angle glaucoma? A. Papilledema B. Increased intraocular pressure C. Eye pain D. Sluggish pupils - SolutionB. Increased intraocular pressure Which of the following would the NP use to determine hearing loss? A. Audiogram B. Tympanogram C. Pneumatic otoscopy D. Computed tomography - SolutionA. Audiogram In a child with ototis media with effusion (OME), which characteristic will the tympanic membrane have upon otoscopic examination? A. Erythematous B. Bulging C. Retracted D. Vascular in appearance - SolutionC. Retracted When educating a patient with Meniere disease about prevention of episodes, the NP teaches the patient to restrict all of the following except: A. Sodium B. Nicotine C. Fluid intake D. Caffeine - SolutionC. Fluid intake Of the following measures, which is recommended for preventing otitis media? A. Allowing supine bottle feeding B. Avoiding secondhand smoke C. Placing in a day care setting D. Allowing pacifier use - SolutionB. Avoiding secondhand smoke The NP has diagnosed an older adult patient with benign paroxysmal positional vertigo (BPPV). Which of the following tests aids in diagnosis? A. Positive Epley maneuver B. Pneumatic otoscopy C. Computed tomography D. Positive Dix-Hallpike test - SolutionD. Positive Dix-Hallpike test Which of the following objective findings would be consistent with the diagnosis of otitis externa? A. Bullae on the tympanic membrane B. Red, bulging tympanic membrane C. Increased pain with tragus palpation D. Tympanic membrane immobility - SolutionC. Increased pain with tragus palpation Which of the following is not a preventive measure for epistaxis? A. Using a water-based lubricant in the nares B. Not taking hot showers The FNP is caring for a patient who describes recent stress in her life and presents with a recurrent mouth lesion. The lesion came up again 2 days ago, is on the interior lip border, is ulcerative and painful, and has an erythematous base. What is the medication treatment of choice for this patient? A. Colchicine (Colcrys) B. amoxicillin (Amoxil) C. acyclovir (Zovirax) D. mycostatin (Nystatin) - SolutionC. acyclovir (Zovirax) Which of the following describes a peritonsillar abscess? A. Inflammation of the tonsils B. Decreased blood supply to the tonsils C. Autoimmune destruction of the tonsils D. Palpable collection of pus around the tonsils - SolutionD. Palpable collection of pus around the tonsils Of the following treatments, which is not included in the plan for strep pharyngitis? A. throat lozenges B. ibuprofen (Motrin) C. prednisone (Deltazone) D. penicillin V (PenVK) - SolutionC. prednisone (Deltazone) Which of the following is not a common manifestation of infectious mononucleosis? A. Paroxysmal coughing B. Fatigue C. Sore throat D. Lymphadenopathy - SolutionA. Paroxysmal coughing Group A strep pharyngitis may result in which of the following? A. Rheumatic fever, Kawasaki syndrome, acute glomerulonephritis B. Scarlet fever, acute glomerulonephritis, hemolytic uremic syndrome C. Hemolytic uremic syndrome, rheumatic fever, scarlet fever D. Rheumatic fever, acute glomerulonephritis, scarlet fever - SolutionD. Rheumatic fever, acute glomerulonephritis, scarlet fever When treating infectious mononucleosis, the NP should recommend which of the following? A. Antibiotics, analgesics, fluids, rest B. Antivirals, analgesics, fluids, rest C. Fever and pain reduction, fluids, rest D. Allow sports participation, fluids, analgesics - SolutionC. Fever and pain reduction, fluids, rest Which laboratory tests are appropriate for evaluating a patient with suspected mononucleosis? A. Complete blood count (CBC), heterophile antibody test B. Rapid antigen detection test, complete blood count (CBC) C. Only a heterophile antibody test is necessary D. Lymphocyte count, rapid plasma regain test - SolutionA. Complete blood count (CBC), heterophile antibody test Which common findings should the NP monitor for in a patient diagnosed with infectious mononucleosis? A. Hepatomegaly, splenomegaly, heart failure B. Hepatomegaly, lymphocytosis, splenomegaly C. Heart failure, lymphocytosis, hepatomegaly D. Renal failure, hepatomegaly, splenomegaly - SolutionB. Hepatomegaly, lymphocytosis, splenomegaly Which statement is true concerning pharyngitis? A. All sore throats require antibiotic treatment B. Most cases of pharyngitis are bacterial in nature C. Most cases of pharyngitis are viral in nature D. Empiric treatment of pharyngitis is important - SolutionC. Most cases of pharyngitis are viral in nature The NP is caring for a 10-year-old with a score throat and rash. Which test should be ordered to verify the most common cause of bacterial pharyngitis? A. Anti-streptolysin O B. Heterophile antibody test C. Rapid antigen detection test D. Rapid plasma reagin - SolutionC. Rapid antigen detection test Manny is a 45-year-old male who comes to your clinic complaining of shortness of breath since starting his new job at a saw mill. He smokes one pack per day and states he had asthma when he was younger but "grew out of it." Which objective finding is most suggestive of a diagnosis of asthma? A. Productive cough noted during exam, respiratory rate of 16, and wheezing on auscultation of posterior left upper lobe B. Pale, boggy nasal turbinates, clear air fluid level behind bilateral tympanic membranes, barrel chest, FEV1 <80% predicted and FEV1 increased 5% after administration of albuterol C. SpO2=94%, heart rate of 88, and bilateral wheezes on auscultation D. Dry cough noted during exam, SpO2=95%, FEV1 <80% predicted, and FEV1 increased 15% after administration of albuterol - SolutionD. Dry cough noted during exam, SpO2=95%, FEV1 <80% predicted, and FEV1 increased 15% after administration of albuterol An 18-year-old male patient presents for routine follow-up on asthma that was diagnosed at age 6. The current medication regimen includes fluticasone (Flovent) 44mcg/actuation 2 puffs BID inhaled with albuterol (ProAir FHA) as a rescue inhaler. The patient tells you he uses fluticasone daily as prescribed, and he has used the albuterol inhaler twice daily for the last month. What would be your plan of care for this patient using a stepwise approach? A. Add Montelukast (Singulair) to his current regimen B. Change fluticasone (Flovent) to 110mcg/actuation, 2 puffs BID C. Have patient keep track of peak flow measurements and return to clinic for follow-up in 1 week D. Refer to a pulmonologist - SolutionB. Change fluticasone (Flovent) to 110mcg/actuation, 2 puffs BID D. Group D - SolutionD. Group D According to GOLD, pharmacologic treatment regimen should be guided by: A. Severity of symptoms B. Abnormal findings on chest radiograph C. Impaired FEV1 measurement on spirometry D. Immunization status - SolutionA. Severity of symptoms All of the following induce a bronchodilation response except: A. Fluticasone HFA B. Albuterol HFA C. Tiotropium HFA D. Theophylline - SolutionA. Fluticasone HFA According to the guidelines by the American College of Chest Physicians (ACCP), annual screening with low-dose computed tomography (LDCT) for lung cancer should occur in which of the following patient populations? A. Current smokers aged 50 and older with at least a 20 pack-year smoking history B. Current smokers aged 55-74 years with at least a 30 pack-year smoking history C. Former smokers aged 55-74 years with at least a 30 pack-year smoking history who have quit within the past 20 years D. Current smokers aged 50 and older with at least a 20 pack-year smoking history and at least one additional risk factor - SolutionB. Current smokers aged 55-74 years with at least a 30 pack-year smoking history A 72-year-old male has just been diagnosed with lung cancer. Which of the following recommendations should be made by the nurse practitioner as part of his immediate treatment plan? A. Morphine IVP for pain control B. Chest x-ray every three months C. Smoking cessation D. Serial CT scans every 3 months to monitor the size of the tumor - SolutionC. Smoking cessation Presenting symptoms of lung cancer may include all of the following except: A. Wheezing B. Dyspnea C. Chest discomfort D. Anorexia - SolutionA. Wheezing Which of the following diagnostic tests provides a definitive diagnosis for lung cancer? A. MRI B. CT scan C. Chest x-ray D. Cytology - SolutionD. Cytology Risk factors for infection with DRSP include all of the following except: A. Comorbidities B. Systemic antibiotic use in the last 90 days C. Non-smoking D. Age >65 - SolutionC. Non-smoking What is the appropriate treatment of community-acquired pneumonia in a 52-year-old male who has a dry cough, fatigue, no recent antimicrobial use, and no comorbidity? The patient currently takes no routine medications. A. amoxicillin (Amoxil) B. clarithromycin (Biaxin) C. levofloxacin (Levaquin) D. ceftriaxone (Rocephin) - SolutionB. clarithromycin (Biaxin) A 65-year-old female with congestive heart failure and diabetes mellitus presents with productive cough, fever, and dyspnea. Which diagnosis is most likely? A. Asthma exacerbation B. Acute bronchitis C. Influenza D. Pneumonia - SolutionD. Pneumonia A previously healthy 68-year-old patient presents with a 4-day history of productive cough, temperature of 101.5 F, BP 115/80, pulse 90, and respiratory rate of 25. Physical examination shows the patient to be alert and oriented, with diminished breath sounds in the RLL. BUN is 16 and WBC is elevated. On CXR, the RLL demonstrates infiltrates. Which of the following is true? A. According to CURB-65, this patient has a score of 1 and can be treated as an outpatient B. According to CURB-65, this patient has a score of 2 and can be treated as an outpatient C. According to CURB-65, this patient has a score of 4 and can be treated as an outpatient with a combination of antibiotics rather than a single-agent regimen D. According to CURB-65, this patient has a score of 4 and hospitalization is needed - SolutionA. According to CURB-65, this patient has a score of 1 and can be treated as an outpatient A 53-year-old male presents to the clinic with a chief complaint of sudden onset shortness of breath and non-radiating chest pain that he describes as sharp and substernal. He rates it 6/10. His vital signs are: T 100.5 F, HR 119, RR 21, BP 152/90. Upon exam, he appears anxious and you note an accentuated second heart sound and rales. The FNP suspects which of the following diagnoses? A. Acute myocardial infarction B. Pneumothorax C. Pleurisy D. Pulmonary embolism - SolutionD. Pulmonary embolism A patient presents with acute onset of dyspnea, pleuritic chest pain, and hypoxia. No clear cause can be determined by clinical examination. General chemistries are normal and a chest x-ray is negative. The FNP suspects a pulmonary embolism and will order which of the following diagnostic tests to confirm the diagnosis? A. Meltidetector-row computed tomography angiography B. Coagulation studies Paige is a 35-year-old female who calls the primary care clinic about a sneeze, runny nose, and cough. She wants to know if she should come into the clinic. (The most important question to ask the patient is: A. "Do you smoke?" B. "How long have you had the symptoms?" C. "Have you traveled out of the country recently?" D. "Are you running a fever?" - SolutionB. "How long have you had the symptoms?" An 18-year-old patient complaining of a two-day history of fever, running nose, nasal congestion, and a sore throat is suspected of having a URI. All of the following will be included in the appropriate diag- nostic workup except: A. Chest x-ray B. Rapid strep test C. Rapid influenza test D. Throat culture - SolutionA. Chest x-ray You receive a callback from the mother of a 5-year-old patient seen in clinic yesterday by another provider. The mother is requesting antibiotics. She states her child is not getting better and that the other provider did nothing to help her child. Prior to getting on the phone with the mother, you look through the on the patient's chart for which piece of information? A. Patient's height and weight at most recent visit B. Mother's history of calling the clinic C. Patient's allergy list D. Patient's diagnosis and treatment plan from most recent visit - SolutionD. Patient's diagnosis and treatment plan from most recent visit All of the following are appropriate treatments in a patient diagnosed with an URI except: A. oxymetazoline 0.05% nasal (Afrin) B. theophylline 300 mg (Theo-Dur) C. loratadine 10 mg (Claritin) D. dextromethorphan 10 mg (Robitussin) - SolutionB. theophylline 300 mg (Theo-Dur) Which of the following lab tests will be the most useful to determine if a patient is having an MI? A. Troponin B. Myoglobin C. CK-MB D. ESR - SolutionA. Troponin A patient who suffered a recent MI presents two weeks after undergoing revascularization via PTCA. He was prescribed metoprolol 25 mg PO BID but has developed dry mouth and erectile dysfunction. Which medication should be substituted due to betablocker intolerance? A. Calcium channel blocker B. ARB C. Anti-arrhythmic D. ACE inhibitor - SolutionA. Calcium channel blocker An 85-year-old patient with a history of hypertension and hyperlipidemia presents to the office with his wife for a routine annual physical. She is concerned about her husband's risk for developing an MI and asks about warning signs. What do the patient and his spouse need to know? A. Patients over the age of 80 may present with atypical symptoms such as confusion and disorientation B. Extreme fatigue and epigastric discomfort are usually the initial symptoms of MI in men C. Assure the patient and his wife that he will not have an MI if he continues his daily aspirin D. Cough and gum pain are the classic symptoms of MI in older men - SolutionA. Patients over the age of 80 may present with atypical symptoms such as confusion and disorientation Therapeutic lifestyle changes are recommended for a patient who recently experienced an MI. What should be included as part of the plan? A. Decreasing sodium in the diet B. Cutting down to smoking half a pack of ciga rettes a day C. Walking for 15 minutes once a week D. Lowering the amount of fiber consumed - SolutionA. Decreasing sodium in the diet On a routine visit, a 62-year-old female with type 1 DM presents to the office reporting chest pain unrelieved by rest, diaphoresis, and tachycardia. The EKG reveals changes in leads II, III, and aVF. What should the nurse practitioner do next? A. Call 911 immediately B. Repeat the ECG once the heart rate comes dowm C. Order an exercise stress test D. Order an anticoagulant - SolutionA. Call 911 immediately All of the following are non-atherosclerotic etiologies of MI except: A. Sarcoidosis B. Cocaine use C. Chest trauma D. Aortic stenosis - SolutionA. Sarcoidosis A.J. is a 22-year-old college student who complains of feeling his heart race. He states it is intermittent and has happened 3-4 times weekly for the last month. Each episode lasts 5-10 minutes. His vital signs are HR 92 and regular, BP 124/82, RR 16, SpO2 99%, pain 0/10. Pertinent history would include all of the following except: A. Caffeine usage B. Prescription medications C. Sodium intake D. Illicit drug use - SolutionC. Sodium intake Appropriate next steps for a patient newly diagnosed with sinus bradycardia who is stable and without symptoms would include: A. Cardiology referral B. Preparing for immediate transport C. Giving atropine IV D. Tilt table test - SolutionA. Cardiology referral On a 12-lead ECG, which leads normally exhibit upright QRS? A. Chest pain relieved by sitting forward B. Chest pain relieved by lying down C. Chest pain relieved by deep inspiration D. Chest pain relieved by rest - SolutionA. Chest pain relieved by sitting forward The NP is performing a physical exam on a 58-year-old male with a long- standing history of HTN and COPD. The NP detects JVD with HOB 60 degrees, an S3 gallop, and 2+ pitting pedal edema. What is the most likely diagnosis? A. Right-sided heart failure B. Biventricular failure C. Left-sided heart failure D. Diastolic failure - SolutionA. Right-sided heart failure A patient suspected of having heart failure is sent for further diagnostic examination, including a blood test to assess BNP levels. What is the significance of the BNP level? A. BNP is secreted by the ventricles of the heart in response to excessive stretching of cardiomyocytes B. BNP elevations are only accurate in diagnosing diastolic dysfunction C. BNP is a good marker for differentiating between renal and pulmonary causes of dyspnea D. In decompensated heart failure, BNP levels decrease - SolutionA. BNP is secreted by the ventricles of the heart in response to excessive stretching of cardiomyocytes During a routine follow-up appointment, an echocardiogram of a patient with a history of hypertension reveals left ventricular dysfunction and an ejection fraction of 45 %. The patient denies weight gain, difficulty breathing, or shortness of breath and is currently taking atenolol to manage HTN. Based on this finding, which medication is likely to be initiated? A. ACE inhibitor B. ARB C. Calcium channel blocker D. Digitalis - SolutionA. ACE inhibitor A patient with a history of Stage-C HF presents to the office for a routine follow-up. The patient is currently being managed on lisinopril (Zestril), digitalis (Lanoxin), and furosemide (Lasix). What should be included as part of the plan? A. Monitor potassium B. Discontinue digitalis (Lanoxin) C. Assess liver function D. ECG monthly - SolutionA. Monitor potassium The NP sees a patient with a history of HF for a one-month follow-up. Digoxin was previously added to his regimen of enalapril and furosemide. AV heart block is present on the patient's ECG. Which of the following manifestations of digoxin toxicity is the patient most likely to report? A. Visual disturbances B. Constipation C. Polyphagia D. Hyperactivity - SolutionA. Visual disturbances Which of the following objective findings does not result from embolic events related to infective endocarditis? A. Janeway lesions B. Osler nodes C. Impetigo D. Roth spots - SolutionC. Impetigo A patient presents to the ER with fever, chills, and Roth spots and reports a history of rheumatic valvular disease. The nurse practitioner is suspicious of infective endocarditis. It is appropriate to order which of the following tests initially? A. Chest x-ray and lipid panel B. Blood culture and transthoracic echocardiogram C. Cardiac MRI and guaiac stool test D. Initial blood culture and cardiac stress test - SolutionB. Blood culture and transthoracic echocardiogram Which of the following patients would be at greatest risk for infective endocarditis? A. 35-year-old patient who is a chronic injection drug user В. 49-year-old patient undergoing chemo treat- ments for stage II breast cancer C. 55-year-old patient who has coronary artery disease D. 64-year-old patient with chronic migraines - SolutionA. 35-year-old patient who is a chronic injection drug user A 55-year-old female with a history of mitral valve prolapse is being discharged from the hospital and sent home with antibiotic therapy for infective endocarditis (IE). Which statement indicates an under- standing of the patient's future prophylactic needs? A. "I will not require antibiotic prophylaxis after I have completed my current antibiotic therapy B. "I will require antibiotic prophylaxis but only for the next 6 months after discharge." C. "I will only require antibiotic prophylaxis for dental procedures that require general anesthesia." D. "I will require antibiotic prophylaxis before all dental procedures with the exception of x-rays and minor orthodontic adjustments." - SolutionD. "I will require antibiotic prophylaxis before all dental procedures with the exception of x-rays and minor orthodontic adjustments." A 56-year-old female patient who is allergic to penicillin with a prosthetic heart valve is visiting her dentist to undergo a tooth implant. Which antibiotic is recommended at this time? A. doxycycline (Vibramycin) B. clindamycin (Cleocin) C. ampicillin (Amoxil) D. cefaclor (Ceclor) - SolutionB. clindamycin (Cleocin) An IV drug user is being treated for infective endocarditis (IE) and complains of dyspnea, chest pain, and lightheadedness. The nurse practitioner understands that these are common signs of which finding seen in IE? Thomas is a 55-year-old with a history of diabetes and COPD. His medications include metformin (Glucophage) 500 mg BID, simvastatin (Zocor) 10 mg nightly, lisinopril/HCTZ (Zestoretic) 20/12.5 mg every AM and salmeterol (Serevent) 50 mg/dose 1 puff BID albuterol (ProAir HFA) 90 mcg/actuation prn, which he uses 2-3 times daily. He presents for follow-up on HTN. His home readings have been 145-155/92-105 for the last 3 months. What would be the next step in the treatment plan? A. Advise to start walking 45 mins/day, 5 days/week B. Increase lisinopril to 30 mg daily C. Increase the HCTZ to 25 mg daily and change to PM dosing D. Add carvedilol (Coreg) 6.25 mg daily and have patient follow up in 1 month - SolutionB. Increase lisinopril to 30 mg daily Patients with HTN should be educated regarding: A. Stopping smoking B. Decreasing alcohol intake to 3 drinks/day C. Exercising 60 mins/day, 6 days/week D. Avoiding over-the-counter guaifenesin - SolutionA. Stopping smoking The nurse practitioner notes a grade 3 systolic murmur with an ejection click at the right sternal border. Which finding does the nurse practitioner expect to see in this patient? A. Pericarditis B. Mitral valve prolapse C. Aortic regurgitation D. Aortic stenosis - SolutionD. Aortic stenosis The nurse practitioner suspects mitral valve prolapse in a 62-year-old female patient complaining of shortness of breath and dizziness. Which test would the nurse practitioner order initially to confirm this diagnosis? A. Cardiac stress test B. Transthoracic echocardiogram C. Blood culture D. Cardiac catheterization - SolutionB. Transthoracic echocardiogram During an annual wellness check of an asymptomatic 22-year-old male patient, the nurse practitioner notes an S3 sound that is short in duration. Which statement should the nurse include in her teaching instructions to patient? A. "Please refrain from exercise at this time. B. "A prompt evaluation with a cardiologist is needed" C. "This is a normal variant and no further testing is required at this time." D. "A transthoracic echocardiogram will be ordered today" - SolutionC. "This is a normal variant and no further testing is required at this time." A 42-year-old male presents to clinic complaining of fatigue and mild edema. Upon auscultation of his chest wall, the NP hears a loud systolic murmur, but it has no palpable thrill. Upon documentation, how would the nurse practitioner grade this murmur? A. Grade 1 B. Grade 3 C. Grade 4 D. Grade 6 - SolutionB. Grade 3 A 62-year-old patient with a history of mild aortic stenosis reports a recent episode of syncope and more frequent angina. Which action by the nurse practitioner is best? A. Obtain a chest x-ray to look for heart enlargement B. Explain to patient that this is a normal finding with aortic stenosis C. Obtain an echocardiogram and refer to a cardiologist D. Discuss the addition of nitroprusside for angina pain - SolutionC. Obtain an echocardiogram and refer to a cardiologist A 55-year-old female patient with a history of mitral stenosis presents to your clinic for follow-up. The nurse practitioner may expect to see which finding in the patient's history? A. Rheumatoid arthritis B. Rheumatic fever C. Alopecia areata D. Graves disease - SolutionB. Rheumatic fever Which subjective and objective findings suggest an arterial cause of leg pain? A. Complaint of aching to legs that improves with elevation, varicose veins, and dependent rubor B. Dorsalis pedis and posterior tibial pulses 1+ bilaterally and right calf pain, warmth, and edema that started 2 days after driving from Michigan to Florida C. Pain in buttocks and thighs with walking, capil- lary refill greater than 5 secs, ABI 0.80 D. Bilateral leg edema that improves with elevation, legs with increased pigmentation and multiple telangiectasias - SolutionC. Pain in buttocks and thighs with walking, capil- lary refill greater than 5 secs, ABI 0.80 Esme is a 42-year-old hair dresser who complains of bilateral aching and swelling in her legs. The swelling and pain are worse at the end of the day. She is a nonsmoker. BMI is 32, HR 75, BP 126/84, RR 18, and SpO2 98 %. She walks 45 minutes twice a week for exercise without difficulty. She has tried to change her shoes and add insoles to her shoes with no improvement. Proper treatment for this patient would include: A. Wearing graded compression socks of 20-30 mmHg for 3 months and then return for follow-up B. Starting an exercise program that includes walking to the point of pain, resting until pain resolves, and start walking once pain has resolved C. Referring to vascular surgery D. Taking an aspirin 325 mg daily - SolutionA. Wearing graded compression socks of 20-30 mmHg for 3 months and then return for follow- up Initial diagnostic workup for a DVT includes: A. Obtaining a D-dimer B. Ordering a doppler ultrasound of the affect extremity C. Ordering a spiral CT of the chest D. Determining pretest probability - SolutionD. Determining pretest probability Rob is a 65-year-old with a 5-year history of bilateral lower leg arterial disease. BMI is 24, HR 75, BP 126/75, RR 18, and SpO2 99%. His A. Is confined to the colon (beginning at the rectum) B. Involves noncontiguous inflammation of all tissue layers C. Affects only the mucosal layer of the colon lining D. Is noted for its hallmark feature of bloody diarrhea - SolutionB. Involves noncontiguous inflammation of all tissue layers All of the following are risks for IBD except for: A. Being of Caucasian or Ashkenazi Jewish descent B. The patient's age C. Having a first-degree relative with IBD D. Alcohol use - SolutionD. Alcohol use Bone loss from irritable bowel disease generally results from: A. Malabsorption from the inflamed GI tract B. Increased osteoblast activity related to insulin resistance C. Chronic antibiotic use D. NSAID use - SolutionA. Malabsorption from the inflamed GI tract On physical exam, a 53-year-old Caucasian female patient presents with an anterior perianal fistula, mouth ulcers, weight loss, fever, and crampy abdominal pain. The nurse practitioner will do more testing, but she suspects the patient has: A. Ulcerative colitis B. Crohn's disease C. Diverticulitis D. Irritable bowel syndrome - SolutionB. Crohn's disease Which of the following clinical symptoms is most commonly seen with the initial presentation of colorectal cancer? A. Iron deficiency anemia B. Nausea C. Flatulence D. Indigestion - SolutionA. Iron deficiency anemia A 68-year-old male presents to the clinic with complaints of a recent change in the shape and size of his bowel movements, along with lower abdominal pain. He is given a home stool collection kit and is instructed to collect at least two samples from three consecutive specimens. The results are positive for occult blood. What should be the nurse practitioner's next step? A. Order a CT scan B. Order a CEA, CBC, and abdominal x-ray series C. Order a colonoscopy D. Perform a DRE to confirm the gFOBT - SolutionC. Order a colonoscopy Which of the following statements regarding colorectal cancer is false? A. Colon cancer is more common than cancers involving the rectum B. Early manifestations include colicky abdominal pain and constipation W C. Most colorectal cancers are not found during physical examination D. Colorectal cancer is the third leading cause of cancer deaths for both sexes in the U.S. - SolutionB. Early manifestations include colicky abdominal pain and constipation W All of the following are included in the treatment plan for early stage colorectal cancer except: A. Radiation and palliative care B. Surgery C. Smoking cessation D. Colostomy - SolutionA. Radiation and palliative care Screening guidelines for colorectal cancer begin at age 50 and include a(n): A. Annual DRE and colonoscopy every 5 years B. Flexible sigmoidoscopy every 5-10 years C. Double-contrast barium enema every 10 years D. Annual GFOBT and a colonoscopy every 10 years - SolutionD. Annual GFOBT and a colonoscopy every 10 years A nurse practitioner is obtaining a medical history from a patient. Which preexisting condition may lead the nurse practitioner to suspect that a patient has colorectal cancer? A. Polyps B. Duodenal ulcers C. Hemorrhoids D. Weight gain - SolutionA. Polyps Constipation is considered chronic if it lasts longer than _____________ weeks. A. 8 В. 10 С. 12 D. 14 - SolutionС. 12 Constipation is defined as hard, lumpy stool that occurs fewer than __________ times per week. A. two B. three C. four D.five - SolutionB. three Based on the Rome III criteria, all of the following are considered diagnostic for constipation except: A. Hard, lumpy stool B. Straining C. Tenesmus D. Bright red rectal bleeding - SolutionD. Bright red rectal bleeding A 68-year-old male presents to the clinic with complaints of abdominal pain and increased flatulence. He has only had 2 bowel movements in the past week. You diagnose him with constipation and recommend lifestyle changes for initial treatment. You recommend that he increase his water intake to at least 8 cups a day and ingest how many grams of fiber per day? D. 40-50, typically due to disruption of gut bacteria and food allergies - SolutionC. 55-65, typically due to H. pylori infection and NSAID use Duodenal ulcers often present with: A. Pain 1-3 hours after a meal that can typically be relieved by eating again B. Pain 1-3 hours after a meal that typically cannot be relieved by eating again C. Pain immediately after a meal that can be relieved by eating again ldns D. Pain immediately after a meal that cannot be relieved by eating again - SolutionA. Pain 1-3 hours after a meal that can typically be relieved by eating again GERD food triggers include: A. Wintergreen B. Cheddar cheese C. Chocolate D. Saltine crackers - SolutionC. Chocolate An undesirable late-onset complication of GERD is: A. Testicular torsion B. Gastroparesis C. Gastric structure D. Diverticulum formation - SolutionC. Gastric structure Which of the following symptoms is not common to GERD? A. Regurgitation B. Heartburn C. Diverticulitis D. Dysphagia - SolutionC. Diverticulitis Hemorrhoids and perianal/anal fissures have many characteristics in common, yet each condition has unique qualities. Which of the following statements is true regarding hemorrhoids? A. Hemorrhoids commonly affect infants and older adults B. Risks for hemorrhoids include constipation, trauma, and childbirth C. Blood from hemorrhoids tends to be tarry black 39 D. Complications may include iron deficiency anemia - SolutionD. Complications may include iron deficiency anemia abon A patient reports to the nurse practitioner perianal discomfort and pain. The patient has a history of constipation. Which of the following traits has an increased risk for perianal fissures? A. Patients aged 45-65 B. History of trauma and childbirth C. Intake of low-fiber diet and adequate hydration D. Presence of both internal and external hemorrhoids - SolutionB. History of trauma and childbirth Rectal bleeding associated with hemorrhoids is usually described as: A. Bloody clot with mucus B. Dark brown/black stool C. Tarry black stool D. Bright red streaks with normal appearing stool - SolutionD. Bright red streaks with normal appearing stool Treatment for hemorrhoids includes: A. Adequate hydration and low fiber to bulk and soften the stool B. Cool sitz baths to reduce itchiness and irritation C. Analgesic creams for pain management D. Oral nitroglycerin to promote relaxation of the anal sphincter - SolutionC. Analgesic creams for pain management The nurse practitioner knows the most likely patients to succumb to chronic viral hepatitis of the following are: A. Any patients with hepatitis A B. Adults with hepatitis B C. Adults with hepatitis C D. Any patients with hepatitis D - SolutionC. Adults with hepatitis C __________ is a medication that is not strongly associated with drug- induced hepatitis/hepatotoxicity. A. Metformin (Glucophage) B. Tetracycline (Sumycin) C. Morphine (Roxanol) D. Griseofulvin (Gris-PEG) - SolutionA. Metformin (Glucophage) Type 2 auto-immune hepatitis (AIH) usually strikes __________. A. the elderly B. children and young womenm C. young adults, typically male D. middle-aged adults - SolutionB. children and young womenm Which is a true statement about viral hepatitis? A. 1 in 2 acute cases of hepatitis E will end with liver failure B. Concurrent hepatitis B and hepatitis D infection tends to result in a poorer prognosis than hepatitis B infection alone C. Hepatitis D can only be contracted by a patient who already has hepatitis A D. There is no immunization for hepatitis A - SolutionB. Concurrent hepatitis B and hepatitis D infection tends to result in a poorer prognosis than hepatitis B infection alone The first-line treatment for alcoholic hepatitis is: A. Paracentesis for the ascites B. Topical steroid ointment for the pruritic skin C. Opiates for the abdominal pain D. Cessation of alcohol intake - SolutionD. Cessation of alcohol intake Which of the following is more characteristic of irritable bowel syndrome than inflammatory bowel disease? A. Fecal urgency B. Bloody stools C. Weight loss D. Tenesmus - SolutionA. Fecal urgency According to Rome III criteria, a patient diagnosed with irritable bowel syndrome must incur all of the following except: C. CT scan and MRCP D. Ultrasound and ERCP - SolutionA. CT scan and EUS Patients eventually diagnosed with pancreatic cancer may present with all of the following symptoms except: A. Rectal bleeding B. Dark-colored urine ) C. Jaundice D. Stomach bloating - SolutionA. Rectal bleeding An adult male has been diagnosed with nephrolithiasis. Which of the following is the correct patient education? A. Take cranberry supplements on a daily basis B. Once the stone passes, recurrence is unlikely C. Increase daily amounts of fluid intake D. Avoid eating bananas, potatoes, and oranges - SolutionC. Increase daily amounts of fluid intake An 8-year-old has been diagnosed with acute post- streptococcal glomerulonephritis. Which finding does the nurse practitioner anticipate? A. Blood pressure 128/88 B. Blood pressure 105/73 C. Heart rate 80 D. Urine output 2 mL/kg/hr - SolutionA. Blood pressure 128/88 The nurse practitioner is assessing the results of a urine dipstick for a patient with a suspected renal disorder. The urine is 3+ for blood. This finding rules out which disorder? A. Glomerulonephritis B. Nephrolithiasis C. Nephrotic syndrome D. Urinary tract infection - SolutionC. Nephrotic syndrome An adult patient is being scheduled for an intravenous pyelogram (IVP). What is an important preprocedure assessment the nurse practitioner should make? A. Ability to urinate independently B. Mobility status C. Oral fluid intake D. Current medication list - SolutionD. Current medication list The nurse practitioner is reviewing the results ofa urinalysis. Which set of results is most indicative of urinary tract infection? A. Protein 2+, blood 2+, nitrites negative B. Protein negative, nitrites 2+, leukocyte esterase 2+ C. Bacteria 1+, nitrites negative, leukocyte esterase negative D. Protein negative, blood negative, WBC 4 - SolutionB. Protein negative, nitrites 2+, leukocyte esterase 2+ The nurse practitioner has diagnosed a young adult with acute uncomplicated pyelonephritis. Which is the appropriate first-line treatment? A. amoxicillin-clavulanate (Amoxil) B. trimethoprim-sulfamethoxazole (Bactrim DS) C. nitrofurantoin (Macrobid) D. ciprofloxacin (Cipro) - SolutionD. ciprofloxacin (Cipro) A 56-year-old male presents to the office with complaints of painful, frequent, and urgent urination. He also states that sometimes when he tries to void he has difficulty emptying. This is the third time he has been seen with these same symptoms in the last 8 months, and each time his urine culture showed E. coli. Based on his symptoms, you know that your patient is most likely suffering from which of the following conditions? A. Asymptomatic bacteriuria B. Interstitial cystitis C. Chronic prostatitis D. Varicocele - SolutionC. Chronic prostatitis A 22-year-old male calls the answering service at 2 AM with a report that he was awakened from sleep with severe, debilitating testicular pain that lasted 10 minutes and then spontaneously resolved. He denies pain at this time but is afraid it will happen again. Which of the following is the nurse practitioner's best response? A. Go to the emergency room now for further evaluation B. Take acetaminophen 650 mg PO x 1 in case the pain comes back, and make an appointment to be seen as soon as the office opens C. Explain that this can be a normal symptom that is more common with younger men and it is nothing to worry about D. Prescribe azithromycin (Zithromax) 1 gram PO x 1, as this is a symptom of chlamydia - SolutionA. Go to the emergency room now for further evaluation A 60-year-old male presents to the office with complaints of sexual dysfunction. He reports that over the past 6 months he has had difficulty maintaining an erection. He denies any UTI symptoms and denies any recent trauma or psychological component, but does feel anxious about his situation. After examining the patient, you find no physical abnormalities and decide to start him on which of the following medications? A. sertraline (Zoloft) B. sildenafil (Viagra) C. ciprofloxacin (Cipro) D. testosterone (AndroGel) - SolutionB. sildenafil (Viagra) A 36-year-old man presents to the office with complaint of a lump in his chest. On exam, you note a 1 cm x 1 cm hard, non-tender mass beneath the right areola at 3 oclock. Based on these findings, you make which of the following plans? A. Schedule the patient for a right-breast ultrasound B. Refer to a breast surgeon for removal C. Continue to monitor for one month, and return for care if still present D. Schedule the patient for a diagnostic mammogram and breast ultrasound - SolutionD. Schedule the patient for a diagnostic mammogram and breast ultrasound A 30-year-old man presents to the office for an annual visit. His best friend was recently diagnosed with testicular cancer and is asking whether he should get himself tested. He states he has completed a thorough testicular self exam and has not felt any masses, but he is still worried. Based on the current cancer screening guidelines, you give him what advice? Which is the safest contraceptive method for a woman with active breast cancer? A. Copper IUD (Paragard) B. Depo-Provera C. Combined oral contraceptives D. Mirena IUD - SolutionA. Copper IUD (Paragard) A 19-year-old female presents to the office for a well-woman exam. She has been sexually active with her first partner for 6 months. She denies any complaints and states, "I'm just here for my birth control refill." Her exam should include which of the following? A. Pap smear, gonorrhea test, and chlamydia test B. Full physical exam including clinical breast exam and pelvic exam C. Complete health history and vital signs only; no physical exam is necessary D. Gonorrhea test and chlamydia test - SolutionD. Gonorrhea test and chlamydia test A 53-year-old female presents to the office with complaints of vaginal discomfort and burning on urination. Her last period was two years ago. Your exam findings are as follows: pregnancy test is negative, external vagina with normal appearance, internal vagina is pale light pink, cervix with mild stenosis, scant clear vaginal discharge, bimanual exam without tenderness, vaginal pH is 5, whiff test is negative, wet mount shows no buds/clue cells/trichomonads, urine DIP is negative. Which of the following prescriptions do you recommend for this patient? A. hydrocortisone 1% topical cream (Cortef) B. metronidazole gel 0.75% (MetroGel) C. estradiol 0.01% cream (Estace) D. clotrimazole 1 % cream (Cleocin) - SolutionC. estradiol 0.01% cream (Estace) A 36-year-old G3P2 female presents to the office with pelvic and back pain, as well as painful intercourse and burning on urination. Your exam reveals tenderness in the LLQ and RLQ of the abdomen, cervical motion tenderness, and exquisite pain on palpation of the uterus and right adnexa. Her urine dipstick is positive for leukocytes and ketones and negative for blood and nitrites. Based on these findings, you diagnose and treat her with which of the following? A. Urinary tract infection: nitrofurantoin (Macro- bid) 100 mg PO BID x 5 days B. Pelvic inflammatory disease: ceftriaxone (Rocephin) 250 mg IM x 1 and doxycycline (Vibramycin) 100 mg PO BID x 14 days C. Trichomoniasis: tinidazole (Tindamax) 2 g PO x 1 D. Endometriosis: continuous combined oral contraceptives - SolutionB. Pelvic inflammatory disease: ceftriaxone (Rocephin) 250 mg IM x 1 and doxycycline (Vibramycin) 100 mg PO BID x 14 days A 23-year-old female presents to the office with a desire for birth control. She is generally healthy and has no drug allergies but is lactose intolerant. She denies any PMH/PSH and denies smoking cigarettes. She takes a multivitamin "most of the time," though she often forgets. She reports her period is regular and she likes having it because it reassures her she's not pregnant. Based on this information, the nurse practitioner recommends which of the following birth control methods? A. Combined oral contraceptive pills B. DMPA (Depo-Provera) injections C. Vaginal ring (NuvaRing) D. LNG-IUD (Skyla) - SolutionC. Vaginal ring (NuvaRing) A 60-year-old female presents to the office for follow-up after being seen two weeks ago for a painless labial lesion and associated swollen, though non-painful, inguinal lymph nodes. She had a VDRL drawn, which resulted positive, so reflex testing was performed. Today you will tell her that her FTA-ABS was also positive and give her which of the following diagnoses? A. Primary syphilis B. Hepatitis B virus C. Human immunodeficiency virus D. Herpes zoster virus - SolutionA. Primary syphilis A 22-year-old nulliparous female presents to the office with complaints of burning on urination and vaginal itching. She broke up with her boyfriend three months ago and recently became sexually active with someone new. Her symptoms began three days ago and she has already tried OTC miconazole, which made the burning worse. She denies any urinary frequency, urgency, pressure, vaginal odor or postcoital bleeding. On exam, you note multiple blistering lesions with red, swollen bases, in varying stages of healing. You culture the lesions, but tell her you are most confident she has which diagnosis? A. Molluscum B. Secondary syphilis C. Primary HSV infection D. Condyloma acuminatum caused by HPV - SolutionC. Primary HSV infection A 41-year-old female calls the answering service to report a possible anxiety attack. She is feeling short of breath and has palpitations and mild chest pain. The symptoms began this evening when she got home from the airport after traveling on a business trip. A thorough review of her chart reveals she is a healthy nonsmoker and that her only medication is combined oral contraceptives. Based on this information, you give her which advice? A. Make an appointment in the office as soon as it opens tomorrow B. Practice slow deep breaths, take a warm shower, and try to rest C. Call in a prescription for alprazolam to the pharmacy D. Do not take any more COCS and go immediately to the nearest emergency department - SolutionD. Do not take any more COCS and go immediately to the nearest emergency department A 30-year-old female was recently seen for her annual well-woman exam. As is recommended by the ASCCP, she had a Pap smear with HPV co- testing completed. Her results are ASCUS and HPV negative. You take which of the following actions? A. Refer the patient for a colposcopy B. Repeat Pap with co-testing in three years C. Return for cytology only in six months D. Repeat Pap with co-testing in one year - SolutionB. Repeat Pap with co-testing in three years Select the appropriate GTPAL score for the woman with the following obstetrical history: vaginal births at 39w3d and 40w0d, cesarean delivery B. Osteoarthritis; x-rays of the knees, CBC, ESR, RF, anti-CCP C. Rheumatoid arthritis; x-rays of the knees, CBC, ESR, RF, anti-CCP D. Gouty arthritis; aspiration of the knee joints - SolutionA. Osteoarthritis; x-rays of the knees A 47-year-old obese man presents to the clinic with nocturnal acute onset pain and swelling to the right foot. He denies previous incidence of symptoms and denies known injury. The patient is on high blood pressure medication, is a borderline diabetic, and consumes alcohol regularly. What diagnostic test is essential for diagnosis of this patient's condition? A. CBC B. Uric acid C. X-ray of the foot D. Aspiration of the joint - SolutionD. Aspiration of the joint A 54-year-old woman with known rheumatoid arthritis is in the office for a routine visit. She has swelling in her 2nd and 3rd MCP joints bilaterally and reports morning stiffness lasting for more than 1 hour. She has been taking naproxen twice daily for the past several years, but she no longer feels this medication is helping with her arthritis. Which DMARD medication would you consider using for treatment of this patient? A. leflunomide (Arava) B. etanercept (Enbrel) C. methotrexate (Rheumatrex) D. adalimumab (Humira) - SolutionC. methotrexate (Rheumatrex) B.W. is a 34-year-male who complains that his left knee has been painful for three days and is getting progressively worse. He describes the pain as throb- bing and rates the pain as a 7/10. ROS is positive for fever. He denies fatigue, weight loss, and rash. PMH is unremarkable. He denies past gastrointestinal or genitourinary infection. Surgical history includes previous arthroscopic surgery to left knee two years ago. Social history includes smoking 2 packs per day. On exam, the left knee is erythematous, warm, and edematous. Which diagnosis is most probable? A. Septic arthritis B. Fibromyalgia C. Reactive arthritis D. SLE - SolutionA. Septic arthritis Which is not included in the ACR criteria to diagnose SLE? A. Proteinuria B. Leukopenia C. Elevated potassium D. Malar rash - SolutionC. Elevated potassium Which type of bacteria is a common cause of reactive arthritis? A. Pseudomonas aeruginosa B. Mycobacterium tuberculosis C. Beta-hemolytic Streptococcus D. Chlamydia trachomatis - SolutionD. Chlamydia trachomatis Kallie is a 35-year-old female who complains of widespread musculoskeletal pain and fatigue for the last year. After ruling out other possible diagnosis, she is diagnosed with fibromyalgia. You are educating her on her diagnosis. Which information is correct teaching for fibromyalgia? A. Adequate sleep and exercise are often first-line treatment B. Opioid medications are first-line treatment for pain control C. She should avoid sulfa antibiotics going forward to prevent exacerbations D. She will need to have her ANA level checked every three months to predict exacerbations - SolutionA. Adequate sleep and exercise are often first-line treatment A 45-year-old female complains of neck pain after lifting boxes while moving into a new apartment. Sharp pain radiates down the left arm, 8/10, aggravated by flexion and rotation. She has a history of a cervical fusion at C5-C6 three years ago. On exam, how would you anticipate C4-C7 radiculopathy to present? A. Tingling that starts at the neck and radiates down the shoulder, to the back of the left arm, to the tips of fingers 1-3 B. Left biceps reflex 2+ C. Positive Patrick sign D. Decreased sensation to left ear - SolutionA. Tingling that starts at the neck and radiates down the shoulder, to the back of the left arm, to the tips of fingers 1-3 Which of the following is not a danger sign for neck or back pain? A. Patient with neck pain who was involved in an MVA two days ago B. Patient with low back pain who is currently tak- ing chemotherapy for stage III colon cancer C. Patient with neck pain and a history of smoking two packs per day for 30 years D. Patient with neck pain that is worsening and radiates to the left jaw - SolutionC. Patient with neck pain and a history of smoking two packs per day for 30 years A 45-year-old male presents with low back pain that radiates down the posterior right buttock and the thigh to his knee. He noticed the pain when lifting heavy boxes while helping a friend move late yesterday afternoon. He reports urinary incontinence since the onset of pain and now notices decreased sensation in the perianal region. On exam, straight-leg raises cause an increase in pain in the leg and posterior thigh. These symptoms suggest: A. Spondylolisthesis B. Lordosis C. Sciatica D. Cauda equina syndrome - SolutionD. Cauda equina syndrome A 74-year-old female complains of low back pain. She reports a history of osteopenia, steroid use for her chronic rheumatoid arthritis, and a fall yesterday down the back two steps. What is the likely cause of her low back pain? A. Kyphosis B. Spinal fracture C. Poor posture D. Cauda equina syndrome - SolutionB. Spinal fracture B. Treatment for Bell palsy is controversial, and little data exists that suggests the drug will be effective C. A low dose steroid over four weeks is recommended D. Medication will strengthen the nerve to help eliminate facial and eye drooping - SolutionA. Early implementation of treatment is correlated with better recovery of nerve function 11-3. Which cranial nerves are associated with extraocular movements? A. CN II, III, IV B. CN II, IV, V C. CN III, IV, V D. CNIII, IV, VI - SolutionD. CNIII, IV, VI 11-4. The nurse practitioner asks the patient to "open up and say AHH." This assesses which cranial nerves? A. CN IX and XI B. CN IX and X C. CN X and XI D. CN XI and XII - SolutionB. CN IX and X 11-5. A 72-year-old patient presents with unilateral facial drooping, slurred speech, and vision changes. The first step in management is: A. Aspirin B. Echocardiogram C. Referral to the emergency department D. CBC, CMP, and troponin levels - SolutionC. Referral to the emergency department 11-6. When considering the diagnosis of acute stroke, which of the following are likely to be a part of the presentation? A. Ataxia, unilateral facial numbness, headache B. Slurred speech, coordinated gait, orientation x 3 C. Severe headache, confusion, bilateral facial weakness D. Myopia, altered level of consciousness, severe headache - SolutionA. Ataxia, unilateral facial numbness, headache 11-7. An 82-year-old patient presents with a history of TIA and confusion. Which test is the most sensitive for stroke? A. Ataxic gait B. Troponin, elevated C. Arm weakness/pronator drift D. Facial drooping, bilateral - SolutionC. Arm weakness/pronator drift 11-8. George, age 65, has had several transient ischemic attacks. After a complete physiological exam and workup, the nurse practitioner would prescribe which medication? A. atenolol (Tenormin) B. warfarin (Coumadin) C. clopidogrel (Plavix) D. nitroglycerine (Nitrostat) - SolutionC. clopidogrel (Plavix) 11-9. The NP is aware that in order to make a diagnosis of dementia as per DSM-5 criteria, a decline in memory and a decline in at least one of the following must be present except the ability to: A. Generate coherent speech and understand spoken or written language B. Recognize or identify objects C. Execute motor activities D. Think objectively without prejudice - SolutionD. Think objectively without prejudice 11-10. A medication like donepezil can be useful to treat mild and moderate dementia because it: A. Blocks cholinesterase, resulting in a reverse of cognitive symptoms B. Stimulates the release of cholinesterase, stopping the progression of cognitive decline C. Blocks cholinesterase, resulting in stabilization of cognitive decline D. Stimulates the release of cholinesterase, improv- ing cognitive function - SolutionC. Blocks cholinesterase, resulting in stabilization of cognitive decline 11-11. A 72-year-old male is brought in by his daughter who reports that her father seems to have had some changes in his memory. He recently lost his car downtown and had to take a cab home. She asks if her father has Alzheimer's dementia. What response by the NP is best? A. "Don't worry. This is a normal part of aging" B. "As long as he can still perform activities of daily living, this is not dementia." C. "We will need further testing" D. Probably not, since women are more likely to develop dementia." - SolutionC. "We will need further testing" 11-12. The NP is providing care for a patient diagnosed with Alzheimer's dementia. The patient's son states that his mom often wanders. The NP discusses with the son ways to ensure that his mom remains safe. Which response requires immediate follow-up by the NP? A. "I heard that using motion detectors on doors within the home can be helpful" B. "I usually leave the house keys and car keys on a rack by the door because I often misplace them." C. "I keep emergency phone numbers posted on the refrigerator. D. "I was able to get a home health aide to stay with my mom during the day when I am not home. - SolutionB. "I usually leave the house keys and car keys on a rack by the door because I often misplace them." 11-13. The NP is aware that which of the following are appropriate techniques for communicating with patients with dementia? A. Ask open-ended questions B. Maintain good eye contact and use a relaxed and unhurried approach C. Rephrase a statement if the patient does not seem to understand D. Finish the patient's statements - SolutionB. Maintain good eye contact and use a relaxed and unhurried approach 11-14. Which of the following is most indicative of delirium (as opposed to dementia)? A. Memory impairment B. Sleep disturbance C. Permanence D. Inattention - SolutionD. Inattention D. Kernig and Brudzinski - SolutionD. Kernig and Brudzinski 11-24. When considering the possibility of bacterial menin- gitis, which is the most likely presentation? A. Intermittent fever, neck pain B. Rapid onset of fever, headache, and nuchal rigidity C. Severe headache with low-grade fever D. Gradual onset of fever, headache, and nuchal rigidity - SolutionB. Rapid onset of fever, headache, and nuchal rigidity 11-25. Of the following cerebrospinal fluid (CSF) results, which is most consistent with bacterial meningitis? A. Low opening pressure B. Lymphocytosis C. Low glucose, high protein D. Normal protein, normal glucose - SolutionC. Low glucose, high protein 11-26. Of the following bacterial causes of meningitis, which is not vaccine- preventable? A. Neisseria meningitidis B. Group B Streptococcus C. Haemophilus influenzae type B D. Streptococcus pneumoniae - SolutionB. Group B Streptococcus 11-27. Multiple sclerosis can be described as a(n): A. Autoimmune disorder typically featuring upper and lower motor neuron dysfunction, hyperre- flexia, atrophy, and fasciculations B. Demyelinating autoimmune disorder with damage typically seen in the white matter of the brain and spinal cord; seen predominately in children/teens C. Autoimmune disorder typically featuring inflammation of the spinal cord, an inflamed optic nerve, and ataxia D. Autoimmune disorder typically featuring ascending paraplegia and potentially fatal respi- ratory muscle weakness - SolutionC. Autoimmune disorder typically featuring inflammation of the spinal cord, an inflamed optic nerve, and ataxia 11-28. A 40-year-old Caucasian male with hypertension who presents with fatigue, tingling, numbness in the left lower extremity, and changes in vision asks the nurse practitioner if he has multiple sclerosis. Which of the following additional risk factors below are also symptoms that are suggestive of the disorder? A. Age, ethnicity B. Ethnicity, gender C. Gender, medical condition D. Medical condition, age - SolutionA. Age, ethnicity 11-29. Which is most accurate about the progression of multiple sclerosis? A. All MS patients experience occasional remissions B. Most MS patients completely lose the ability to walk C. About one-half of MS patients eventually experience cognitive deficits D. MS patients' life expectancy is the same as the general population - SolutionC. About one-half of MS patients eventually experience cognitive deficits 11-30. Primary progressive multiple sclerosis (PPMS) is notable for: A. Being the MS type featuring the most inflammatory activity B. Not featuring periods of remission; patients experience progressive deterioration C. Being the most common type of MS D. Always leading to cognitive deficits - SolutionB. Not featuring periods of remission; patients experience progressive deterioration 11-31. Which of the following statements by a patient with suspected multiple sclerosis indicates an understanding of blood work and the diagnosis of multiple sclerosis? A. "A CBC will show an underlying hematologic disorder." B. "A TSH will show evidence of thyroid issues." C. "A CMP will show a metabolic disturbance" D. "No blood test will confirm the diagnosis of multiple sclerosis." - SolutionD. "No blood test will confirm the diagnosis of multiple sclerosis." 11-32. Which of the following treatments is matched correctly with the targeted symptom? A. Neurontin for fatigue B. baclofen for nerve pain C. propranolol for tremors D. dalfampridine for nystagmus - SolutionC. propranolol for tremors 11-33. Common signs of Parkinson disease include all of the following except: A. Shuffling/short steps B. Bradykinesia C. Masked face D. Hyperphonia - SolutionD. Hyperphonia 11-34. The nurse practitioner is considering a clinical diag- nosis of Parkinson disease for her 62-year-old male patient. Which of the following statements would lead to a reconsideration of the diagnosis and a look at alternative diagnoses? A. On a smell test, the patient shows signs of hypos- mia (reduced ability to smell) B. On gait assessment, the patient walks in short shuffling steps C. On a levodopa medication trial, the patient shows no improvement in motor function D. On a motor assessment, the patient shows rest- ing tremor in one hand - SolutionC. On a levodopa medication trial, the patient shows no improvement in motor function 11-35. The nurse practitioner's 40-year-old patient has a recent diagnosis of early-onset Parkinson disease. The patient's tremor is very mild. Which treatment is the most appropriate for this patient? A. Deep brain stimulation (DBS) B. levodopa (Larodopa) C. haloperidol (Haldol) D. ropinirole (Requip) - SolutionD. ropinirole (Requip) B. Electromyography and nerve conduction studies are routinely measured in the workup of GBS C.A cerebrospinal fluid (CSF) level with normal protein levels and elevated WBC is suggestive of GBS D. MRI is both sensitive and specific for diagnosis of GBS - SolutionB. Electromyography and nerve conduction studies are routinely measured in the workup of GBS 11-44. Which of the following is accurate regarding the treatment of GBS? A. Patients frequently require treatment for tachycardia; they rarely require treatment for bradycardia B. Long-term antihypertensive medications will be part of the treatment plan C. Corticosteroids (oral and intravenous) are com- monly used as monotherapy D. Plasma exchange and IVIG (immunoglobulin therapy) are commonly used to hasten recovery - SolutionD. Plasma exchange and IVIG (immunoglobulin therapy) are commonly used to hasten recovery 11-45. Atonic seizures are known to typically: A. Involve uncoordinated movements/thrashing. thus putting the patient at risk for accidentally hitting nearby objects B. Involve muscle weakness/limpness, thus putting the patient at high risk for falls C. Last more than five minutes, thus putting the patient at risk for status epilepticus D. Involve a loss of awareness resembling day- dreaming, thus putting the patient at risk for poor academic performance - SolutionB. Involve muscle weakness/limpness, thus putting the patient at high risk for falls 11-46. The nurse practitioner provides instructions for the family of a patient ("Joe") with a seizure disorder. Which of the following statements by a family member suggests further teaching is needed? A. "I will not restrain Joe when he is having a seizure." B. "I will assist Joe to the floor when he is having a seizure." C. "I will turn Joe's head to the side when he is hav- ing a seizure." D. "I will hold Joe's head to protect it when he is having a seizure." - SolutionD. "I will hold Joe's head to protect it when he is having a seizure." 11-47. The patient with epilepsy is morbidly obese and lets the nurse practitioner know she is trying to lose weight. The patient states that she is willing to take an anti-seizure medication, but she does not want to take any medication associated with weight gain. The nurse practitioner knows to avoid prescribing: A. lamotrigine (Lamictal) B. topiramate (Topamax) C. phenytoin (Dilantin) D. valproic acid (Depakote) - SolutionD. valproic acid (Depakote) 11-48. The nurse practitioner knows that febrile seizures are most highly associated with which age group? A. Newborns B. Infants C. Young adults D. Older adults - SolutionB. Infants 11-49. The nurse practitioner is providing patient education to a newly diagnosed epileptic patient. The nurse practitioner lets the patient know that seizure triggers can include: A. Hypersomnolence B. Herbal tea C. Inadequate insulin D. Cigarette use - SolutionD. Cigarette use 11-50. Mr. R. is a 63-year-old patient with a history of hypertension, hyperlipidemia, and lung cancer. He has had a new onset of fatigue, nausea/vomiting, and memory loss for the last two weeks. Which statement is true regarding the patient's symptoms? A. The symptoms would be expected based on the patient's age B. The symptoms could be related to metastases of lung cancer to the brain C. The symptoms could be related to a transient ischemia attack (TIA) D. The symptoms could be related to worsening of hypertension - SolutionB. The symptoms could be related to metastases of lung cancer to the brain 11-51. Which of the following is not a differential diagnosis for a brain tumor? A. Meningitis B. Toxoplasmosis C. Pseudotumor cerebri D. Acute angle glaucoma - SolutionD. Acute angle glaucoma 11-52. The purpose of debulking of a brain tumor is to: A. Remove all of the tumor B. Disrupt cancer cells' ability to multiply C. Improve quality and length of life D. Prevent further growth of the tumor - SolutionC. Improve quality and length of life 11-53. Following recent eradication of a brain tumor, the nurse practitioner should counsel the patient to: A. Report new hearing changes B. Follow up yearly C. Follow a low-protein diet D. Drive with extra caution - SolutionA. Report new hearing changes 11-54. Which statement is true regarding brain tumors? A. Secondary brain tumors are most common in adolescents B. High-dose glucocorticoids are used in treatment if lymphoma is suspected C. Seizures are the most common symptom associ- ated with a brain tumor D. CT scan with contrast is the imaging modality of choice to diagnose a brain tumor - SolutionC. Seizures are the most common symptom associ- ated with a brain tumor 12-9. Which of the following patients meets the criteria for major depressive disorder? A. A 32-year-old female with symptoms of emptiness, lack of pleasure, weight loss, insomnia, inappropriate guilt, and lack of focus nearly every day for the past month B. A 32-year-old female with symptoms of a depressed mood for the past two months after losing her job C. A 20-year-old male with inability to initiate or maintain sleep and lack of motivation for the past two weeks D. A 20-year-old male with symptoms of fatigue, being tired, insomnia, and lack of focus for the past month - SolutionA. A 32-year-old female with symptoms of emptiness, lack of pleasure, weight loss, insomnia, inappropriate guilt, and lack of focus nearly every day for the past month 12-10. A diagnosis of major depressive disorder must include either a depressed mood or which of the following symptoms? A. Feelings of worthlessness B. Loss of interest or pleasure C. Sleep issues D. Recurrent thoughts of death - SolutionB. Loss of interest or pleasure 12-11. A 38-year-old male has been taking an SSRI for the past four months for depression. He is experiencing new symptoms of sexual dysfunction and is having difficulty reaching orgasm. You advise him that: A. Sexual dysfunction is a common side efffect to an SSRI and may not resolve without changing the classification of his medication B. Changing to another SSRI will would most likely be beneficial C. This is a common side effect to an SSRI, but is only transient and the symptoms will resolve D. This is an uncommon side effect to SSRIS, and he will be need to be referred to a urologist - SolutionA. Sexual dysfunction is a common side efffect to an SSRI and may not resolve without changing the classification of his medication 12-12. You are assessing a 24-year-old female who received a score of 12 on the PHQ-9. According to her questionnaire, the severity of her depression is: A. Minimal B. Mild C. Moderate D. Severe - SolutionC. Moderate 12-13. Anorexia nervosa must be considered in children and adolescents who: A. Fail to maintain the normal developmental trajectory B. Lose weight without physiological cause C. Think they are overweight despite maintaining a normal BMI D. Participate in multiple sports to maintain weight - SolutionA. Fail to maintain the normal developmental trajectory 12-14. A 20-year-old male is evaluated and reports recurrent episodes of binge eating, vomiting, and the use of laxatives to control weight several times a week for the past three months. The NP determines the criteria for a diagnosis of: A. Binge eating disorder is met B. Anorexia nervosa with binge-eating/purging type is met C. Bulimia nervosa is met D. Binge-purge disorder is met - SolutionC. Bulimia nervosa is met 12-15. When assessing a patient with a diagnosis of anorexia nervosa, it is very important at every encounter to evaluate for: A. Associated eating disorders B. Suicide ideation, behaviors, and risk factors for self-harm C. Family history of eating disorders D. Substance use disorder - SolutionB. Suicide ideation, behaviors, and risk factors for self-harm 12-16. Evidence-based practice treatment for eating disorders include(s): A. Medications to decrease symptoms B. Therapy to address unhealthy thoughts regarding food and weight in order to decrease symptoms C. Strict monitoring of food intake and limiting exercise D. A combination of medications, therapy, and nutritional and medical care - SolutionD. A combination of medications, therapy, and nutritional and medical care 12-17. You are evaluating a 20-year-old college student who presents with symptoms of moodiness, not sleeping well, feeling more down than usual. The student asks if he has bipolar disorder. What is true about this patient? A. The patient meets the criteria for bipolar disor- der, and you start medication B. The patient meets the criteria for bipolar disorder, and you refer to a mental health provider C. The patient does not meet the criteria for bipolar disorder but does warrant further evaluation D. The patient does not meet the criteria for bipolar disorder but does meet criteria for depressive disorder - SolutionC. The patient does not meet the criteria for bipolar disorder but does warrant further evaluation 12-18. You are concerned your patient is exhibiting possible symptoms of bipolar disorder and need to evaluate further. The best choice of screening tool is: A. PHQ-9 B. GAD-7 C. MDQ D. DAST-10 - SolutionC. MDQ 12-19. A patient who is new to your practice states she has been treated for bipolar disorder. She requests you continue her current medications, which are lamotrigine, dextroamphetamine, and sertraline. She has current prescription bottles in her name for these medications. Your plan includes a diagnostic assessment and: A. Prescribing all three medications, since these medications are evidenced-based practice for bipolar disorder B. Not prescribing any medications until you receive her records from previous healthcare providers C. Not prescribing any medications and referring her to a mental health provider B. Wean off the current stimulant, start another stimulant to minimize weight loss, and reevaluate in one month C. Stop the stimulant, prescribe another classification of medication, and reevaluate in one month D. Explain that loss of appetite is a common side effect of stimulant medications, help the family identify healthy and calorie-rich snacks, and reevaluate in one month - SolutionD. Explain that loss of appetite is a common side effect of stimulant medications, help the family identify healthy and calorie-rich snacks, and reevaluate in one month 12-28. It is important to screen for autism spectrum disorders (ASD) at: A. The 18- and 24-month well-child check B. Every well-child check C. The 18- and 24-month well-child check and any time there is a concern for delays D. The 12-, 18-, 24-, and 36-month well-child check - SolutionC. The 18- and 24-month well-child check and any time there is a concern for delays 12-29. Which of the following statements is true about the risk of suicide? A. Suicidal patients will present with overt statements about self-harm B. A screening tool such as SPS is the primary means of assigning a patient for suicide potential C. Married individuals are more likely to attempt suicide than single individuals D. Mental illness, including substance use, contributes to suicidality - SolutionD. Mental illness, including substance use, contributes to suicidality 12-30. The FNP is asked to evaluate a new patient who presents as clinically depressed. The FNP develops a concern about the patient's risk of suicide based on all of the following factors except: A. The patient stating, "Everything is fine" B. The patient describing his impulsive nature C. The patient's wife sending him to see the NP D. The patient having taken fluoxetine for several months - SolutionC. The patient's wife sending him to see the NP 12-31. Treatment of depression may include all of the following except: A. Selective serotonin reuptake inhibitors B. Dialectical behavior therapy C. Cognitive behavioral therapy D. Interpersonal therapy - SolutionB. Dialectical behavior therapy 12-32. Which of the following patients may be most at risk for a completed suicide? A. A 75-year-old recent widower B. A 19-year-old female college student C. A married mother with financial concerns D. A Roman Catholic 22-year-old male - SolutionA. A 75-year-old recent widower 13-1. The most common cause of Addison's disease is: A. A malfunctioning immune system that attacks the adrenal glands B. Metastatic cancer that attacks the kidneys and adrenal glands C. Steroid use that leads to the suppression of the hypothalamic-pituitary- adrenal axis D. Medication use - SolutionA. A malfunctioning immune system that attacks the adrenal glands 13-2. Which of the following is a sign of Addison's disease? A. Glucose intolerance B. Hypotension C. Acne D. Hypertension - SolutionB. Hypotension 13-3. The gold standard test for Addison's disease is: A. Elevated BUN B. Elevated plasma renin C. Morning serum cortisol D. Serum electrolytes (showing hypokalemia and hyponatremia) - SolutionC. Morning serum cortisol 13-4. Which statement is true regarding Addison's disease? A. It is easily diagnosed, as its classic signs of hyperkalemia, hyponatremia, hyperpigmentation, and fatigue are readily recognizable B. It is difficult to pinpoint due to its vague symptoms, such as weakness or fatigue-symptoms that can be found in conditions as wide-ranging as depression or anorexia nervosa C. It is similar to Cushing syndrome, especially because it features hyperglycemia D. It only involves the hypothalamus - SolutionB. It is difficult to pinpoint due to its vague symp- toms, such as weakness or fatigue-symptoms that can be found in conditions as wide-ranging as depression or anorexia nervosa 13-5. Symptoms of adrenal crisis can include A. Excitability В. Нурertension C. Severe leg, back, or abdominal pain D. Craving of sweets - SolutionC. Severe leg, back, or abdominal pain 13-6. When considering a diagnosis of Addison's disease, potential differential diagnoses include: A. Cushing syndrome B. Osteoporosis C. Depression D. Hyperthyroidism - SolutionD. Hyperthyroidism 13-7. A hallmark sign of gestational diabetes (GD) in the expectant mother is/are: A. Glycosuria B. Vision changes C. Polydipsia D. No signs - SolutionD. No signs 13-8. Prediabetic patients can be identified by a fasting glucose blood test of: