LEIK FNP Health practice Questions with Answers Solved by Expert 2024 Update, Exams of Health sciences

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LEIK FNP Health practice Questions with

Answers Solved by Expert 2024 Update

It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic - Correct Answers A 72 you woman has been on hydrochlorothiazide 12.5mg for many years to control her Sate I HTN. Her blood pressure at this visit is 168/96. She is currently complaining of pain in her right hip and on both knees. She has increased her dose of ibuprofen from 400mg 3 times a day to 800mg 3 times a day. She is still in pain and would like something stronger. Which of the following statements is the best explanation of the effects of ibuprofen on her disease. Acute appendicitis - Correct Answers The NP would test the obdurate and iliopsoas muscle to evaluate for what? A prescription of methyldopa (Aldose) to control BP - Correct Answers Treatment for mild preeclampsia includes all of the following except: A) Bed rest except for bathroom privileges B) Close monitoring of weight and blood pressure C) Close follow-up of urinary protein, serum creatinine, and platelet count D) A prescription of methyldopa (Aldose) to control BP. Nursing home care - Correct Answers All of the following services are covered under Medicare Part A except: A) Inpatient hospitalizations B) Medicines administered to a patient while hospitalized C) Nursing home care D) Surgeons Mycoplasma pneumonia - Correct Answers A 28 you student is seen in the school health clinic with complaints of hacking cough that is productive of small amounts of sputum and runny nose. He does not take any meds, denies any allergies, and has no significant medical history. Physical exam reveals a low-grade temperature of 99. degrees F, respirations of 16/min, pulse =90, and diffuse fine crackles in the base of the lungs. A chest x-ray shows diffuse infiltrates in the lower lobe of the right lung. The total white blood cell count is 10,500/lug. What is the likely diagnosis? 10mm - Correct Answers A 39 you migrant worker presents to the clinic 2.5 days after a purified protein derivative (PPD) test. What minimum size of induration would be considered positive for this patient?

The patient's spouse has the right to override the agent's decisions - Correct Answers All of the following are correct statements regarding the role of the person named in a durable power of attorney except: A) The agent's decisions are legally binding B) The agent can make decisions in other areas of the patient's life such as financial issues. C) The agent can decide for the patient who is on life support when that life support can be terminated. D) The patient's spouse has the right to override the agent's decisions The patient has a medical illness that causes an anxiety reaction and denial - Correct Answers The following statement regarding Munchausen syndrome is false: Beta-blockers - Correct Answers Which antihypertensive medications should the NP avoid when treating patient with emphysema? Perform a complete and thorough history - Correct Answers A 30 y/o chef complains of pruritic hives over her chest and arms but denies difficulty breathing. She reports a family history of allergic rhinitis and asthma. What intervention is most appropriate? Edema of the face and upper extremities - Correct Answers Which finding is most likely in young primigravidas with pregnancy induced hypertension? Tingling and numbness of both feet - Correct Answers Which symptom is associated with B12 deficiency anemia? Order an ultrasound - Correct Answers A second triple screen on a 35 you primigravida reveals abnormal low levels of the alpha fetoprotein and estriol and high levels of human chorionic gonadotropin. Which of the following interventions is the best choice for this patient? Chlamydia trachoma's - Correct Answers Pts. diagnosed with gonorrhea should also be treated for what other infections? Osteoporosis - Correct Answers Kyphosis is a late sign of Higher than normal - Correct Answers A 35 y/o primigravida who is at 28wks gestation is expecting twins. What would you would expect her alpha fetal protein (AFP) to be? Calcium channel blockers - Correct Answers Which of the following antihypertensive medications has beneficial effects for an elderly white female with osteoporosis? Knee instability - Correct Answers The Lachlan maneuver is used to detect which of the following?

A) Upon deep inspiration by the patient, palpate firmly in the right upper quadrant of the abdomen below the cost vertebral angle B) Bend the patient at the hips and knees at 90 degrees, then passively rotate hip externally, then internally C) Ask the patient to quit, then place the stethoscope on the apical area. D) Press into the abdomen deeply, then released it suddenly Murphy's Sign - Correct Answers Positive if pain occurs when performing RUQ palpation while patient takes a deep breath, causing the patient to abruptly stop the deep breath due to pain. As the liver is palpated, it will descend and push up against the inflamed gallbladder and cause sharp pain (cholecystitis) Apraxia - Correct Answers a disorder of the nervous system in which the brain is affected and the patient is unable not move the arms/legs when asked to do so. Common signs of depression - Correct Answers 1. anhedonia

2. unintentional weight loss or gain
3. fatigue
4. change in appetite
5. insomnia or hypersomnia
6. Feelings of guilt and worthlessness
7. recurrent thought of suicide. Anhedonia - Correct Answers loss of interest in activities that the patient finds pleasurable What does Chronic NSAID use do? - Correct Answers Disrupts the product of prostaglandins, which decreases blood supply and then breaks down the protective layer of the mucosa, which leads to gastric disease. Why is Serum creatinine in measured? - Correct Answers To evaluate renal function. Creation is the end product of creative metabolism. Creatinine clearance is not affected by fluid or dietary intake of meat. After 20 wks. - Correct Answers At how many weeks gestation should fundal height equal weeks gestation? 2cm or greater - Correct Answers When measuring fundal height, how many centimeters variation should warrant further testing to evaluate fetal growth The drawer sign - Correct Answers Performed on the knee or ankle to assess for knee instability. The affected knee/ankle will have more laxity when compared to the unaffected knee/ankle. Heber den’s nodes - Correct Answers These are commonly seen in degenerative joint disease, and are bony nodules located on the distal interphalangeal joints (DIPs)

Laryngeal neoplastic - Correct Answers HPV infection of the larynx has been associated with: Cervical cancer. - Correct Answers HPV infection of the cervix is associated with: Tanner Stage III: Male - Correct Answers Consist of penis lengthening and darker, course pubic hair, which begins to curl. The Lachlan maneuver - Correct Answers Test performed to assess for knee instability. Knee instability indicated a tear of the anterior cruciate ligament. Calcium channel blockers - Correct Answers Antihypertensive medication that acts by blocking the calcium channels in the heart muscle and the blood vessels, thereby keeping more calcium in the bones. Should be used in elderly patients with osteoporosis Both gram negative and gram positive bacteria - Correct Answers Diverticula in the colon can be infected with In the fetal and maternal liver. - Correct Answers Where is AFP produced? Multiple gestations d/t growing fetuses and enlargement of the livers - Correct Answers When are higher levels of AFP commonly seen? Kyphosis - Correct Answers a curvature of the spine that causes a rounding of the back, which leads to slouching posture. Osteoporosis - Correct Answers Severe thinking of the bones that contributes to this curvature in the spine. Symptoms that may occur with severe cases of kyphosis - Correct Answers difficulty breathing fatigue back pain An abnormal during pregnancy. An U/S should be ordered to further evaluate the fetus for characteristics of Down syndrome and/or fetal demise. - Correct Answers What do abnormally low levels of alpha fetoprotein and estriol and high levels of human chorionic gonadotropin indicate and what should be done? Nerve cell damage - Correct Answers What can Vitamin B12 deficiency anemia cause if not treated?

Common signs and symptoms of pregnancy-induced hypertension - Correct Answers Edema of the face and upper extremities, weight gain, blurred vision, elevated BP, proteinuria, and headaches When and why should Beta-blockers should be avoided? - Correct Answers In patients with a history of emphysema. Studies have shown evidence of a reduction in forced expiratory volume in 1 second (FEV1), increased airway hyper responsiveness, and inhibition of bronchodilator response to beta agonists in patients receiving non-selective beta-blockers and high doses of cardio selective beta-blockers. Munchausen sudrowme - Correct Answers A psychiatric disorder in which the patient fakes a medical illness or disorder to gain attention from health care providers. These patients commonly use the emergency department frequently to gain attention. What is the person named in a durable power of attorney (the agent) designated to do?

• Correct Answers This person is designated by the patient to make all medical decisions, as well as any decisions regarding the patient's private affairs in the event that the patient becomes incompetent and unable to make his/her own decisions. No one has the ability to override the agent's decision How does The PPD administrations work? - Correct Answers It is administered on the volar aspect of the lower arm and read 48 hrs. after the test is given. The PPD result must have induration and measure 10mm or greater to be positive in a low risk patient. Induration (firmness with palpation) must be present. If the site has erythema but no induration, results would be negative. Color is not important. Placenta previa - Correct Answers A 28 y/o multipara who is 32 wks. of gestation presents to your office comparing of sudden onset of small amounts of bright red vaginal bleeding She has had several episodes and appears anxious. On exam, her uterus is soft on palpation. What is the most likely diagnosis? Placenta previa - Correct Answers Occurs when abnormal implantation of the placenta occurs. What is a common sign of placenta prevue? - Correct Answers Painless, bright red bleeding Middle aged to older women - Correct Answers Epidemiological studies show the Hashimoto's disease occurs most commonly in: Severe vaginal atrophic changes - Correct Answers A 48 y/o woman is told by a physician that she is starting menopause. All of the following are possible findings except: A) Hot flashes B) Irregular menstrual periods C) Severe vaginal atrophic changes

D) Cyclic mood swings What types of changes occur in a menopausal woman? - Correct Answers Hot flashes irregular menstrual cycles cyclic mood swings Thinning of vaginal tissue Dryness of vagina Hepatomegaly, AV nicking, bibasilar crackles - Correct Answers A 63 y/o patient with a 10 yr. history of poorly controlled hypertension presents with a cluster of physical exam findings. What indicates target organ damage commonly seen in hypertensive patients? Vaginal bleeding and cramping are present, but the cervix remains closed - Correct Answers A 30 y/o primigravida is diagnosed with a possible threatened abortion. The result of the urine pregnancy test is positive. Which of the following statements is true regarding a threatened abortion? Bacterial Vaginosis - Correct Answers A 30 y/o female who is sexually active complains of a large amount of milk-like vaginal discharge for several weeks. A microscopy slide reveals a large amount of squamous epithelial cells that have blurred margins. Very few white blood cells are seen. The vaginal pH is at 6.0. What is the most likely diagnosis? Bacterial Vaginosis - Correct Answers A bacterial infection of the vagina. S/Six include copious off-white to gray discharge w/foul odor without erythema or irritation. Wet-prep will be positive for clue cells. "Whiff" test will be positive for strong "fishy" odor when vaginal discharge is mixed with a drop of KOH. Lichens Sclerosis - Correct Answers A disease of the skin, in which white spots appear on the skin and change over time. It is most commonly seen in the genital and rectal areas, but can appear in other areas. The spots are usually shiny and smooth and can eventually spread into patches. The skin appears thin and crinkled. Then the skin tears easily, and bright red or purple bruises are common. Sometimes, the skin becomes scarred. If the disease is a mild case, there may be no symptoms. Closure of the semilunar valves - Correct Answers The heart sound S2 is caused by Just rising above the suprapubic bone - Correct Answers A pelvic exam on a woman who is 12 wks. pregnant would reveal that her uterus is located where? 12wks gestation uterus size - Correct Answers The approximate size of a grapefruit: just above the suprapubic bone Anesthesiologists services - Correct Answers All of the following are covered under Medicare Part B except:

Bedrest on the left side with bathroom privileges - Correct Answers The following is recommended for the outpatient treatment of mild preeclampsia except: Tonometry - Correct Answers The best test for diagnosing congenital glaucoma is? What is Tonometry? - Correct Answers used to measure the intraocular pressure (IOP) of the eye to screen for glaucoma. Normal range IOP is 10-22mm/Hg Tick - Correct Answers Rocky Mountain Spotted Fever is caused by the bite of a: Rickettsia Rickettsii; 1%-7% - Correct Answers What is the parasite called that infects the tick causing Rocky Mountain spotted fever, and what is the mortality rate? Viral conjunctivitis - Correct Answers A mother brings in her 4 y/o daughter who just started attending preschool. She tells the nurse practitioner that her child is complaining of boring and itching in both eyes along with a runny nose. During the physical exam, the child's eyes appear injected bilaterally. The throat is red and her inferior nasal turbinates are swollen. What is the most likely diagnosis? Urine pregnancy test to rule out ectopic pregnancy. - Correct Answers A sexually active woman is complaining of amenorrhea and vaginal spotting. On exam, her left adnexa is tender and cervical motion tenderness is positive. Which test should the nurse practitioner initially order? S1, S2 and S3 - Correct Answers A toddler with congenital heart disease is seen for a 1-wk history of facial and lower extremity edema accompanied by shortness of breath. The child's mother reports that the child's appetite has been poor. The best x-ray reveals that the child has CHF. What heart sounds are found in this patient? Congestive Heart Failure - Correct Answers The inability of the heart to pump a sufficient amount of blood to the organs to meet the body's requirements. It is common to hear S1 ,S2 and S3 heart sounds on exam. Common signs and symptoms include fatigue, SOB with activity, and edema of lower extremities. Elevation of the affected limb and intermittent applications of cold packs for the next 48hrs - Correct Answers A 53 you crossing guard complains of twisting his right knee while working that morning. The knee is swollen and tender to palpation. The NP diagnoses a Grade II Spain. The initial treatment plan includes? G6PD deficiency anemia - Correct Answers Erythromycin 200mg with sulfisoxazole 600mg suspension (Diazole) is contraindicated in which condition? Glucose-6-phosphate dehydrogenase - Correct Answers A hereditary condition that occurs when the red blood cells break down, causing hemolysis, due to a missing or lack of sufficient enzyme that is needed to help the red blood cells work efficiently. Certain foods and medications may trigger this reaction and hemolysis will occur. Some

of these medications include antimalarial drugs, aspirin, nitrofurantoin, NSAIDs quinidine, quinine, and sulfa meds. Recommend immediate referral to ER - Correct Answers The mother of an 11 y/o boy with sickle cell anemia calls on the phone complaining that her son woke up because of a painful penile erection that will not go away. The NPs most appropriate intervention is: The mother has auto antibodies against Rh-positive red blood cells. - Correct Answers Positive combo test on an Rh negative pregnant woman means what? Prevent anencephaly - Correct Answers Folic acid supplementation is recommended for women who are planning pregnancy in order to Causes of secondary hypertension - Correct Answers Pheochromocytoma Reno vascular stenosis Coarctation of the aorta Chlamydia trahomatis - Correct Answers Fitz-Hugh-Curtis syndrome is associated with which infection? Pelvic Inflammatory disease - Correct Answers What is Fitz-Hugh-Curtis syndrome a complication of? 5mm - Correct Answers A string home resident reports to his physician that his previous roommate was recently started on tuberculosis treatment. A Mantoux test and chest x-ray are ordered for the patient. What is the minimum size of induration considered positive for this patient? (Remember he is high risk d/t exposure) Varicella - Correct Answers In small children with acquired immunodeficiency syndrome (AIDS), which vaccines is contraindicated? Inevitable abortion - Correct Answers A 44 y/o female that is undergoing treatment for infertility complains of not having a menstrual cycle for a few months. The night before, she started spotting and is now having cramp-type pains in her pelvic area. Her blood pressure is 160/80, the pulse rate is 110 and she is afebrile. Her labs reveal a mild anemia with mild leukocytosis. On pelvic exam, the uterine funds is found above the syphilis pubis. The cervical so is dilated to 3cm. What is the most likely diagnosis? What is inevitable abortion? - Correct Answers Vaginal bleeding with pain and cervical dilation and/or effacement. What is incomplete abortion? - Correct Answers Moderate to diffuse vaginal bleeding, with the passage of tissue and painful uterine cramping or contractions.

Mycoplasma pneumoniae Streptococcus pneumonia - Correct Answers An elderly patient with a productive cough and fever is diagnosed with pneumonia. Which organisms are capable of causing community acquired pneumonia? Placenta - Correct Answers hCG is produced by what? Fetal liver - Correct Answers The majority of serum alpha fetoprotein is produced by the? Order an enzyme-linked immunosorbent assay (ELISA) test as soon as possible - Correct Answers Stella works in the housekeeping department of a hospital. She presents to the employee health clinic with complaints of a needle stick to her left thumb. The needle was in one of the garbage bags from the emergency room. The patient had a little bleeding that stopped spontaneously. What is the next step? Order serum TSH, digoxin level, and electrolyte panel. - Correct Answers An elderly woman has been on digoxin (Lanoxin) for 10yrs. Her electrocardiogram (EKG) is showing a new onset of A-fib. Her pulse is 64/min. She denies syncope and dizziness. What intervention is appropriate? Pregnancy induced hypertension (preeclampsia) - Correct Answers You note the following results on a routine urinalysis of a 37y/o primigravida who is 30 weeks gestation. Leak=trace, Nit= negative, Pro=2+, blood=negative. Her weight has increased by 5 lbs during the past week. What is the most likely diagnosis? Elevated serum cortisol levels - Correct Answers The NP who suspects that one of her hypertensive patients has Cushing's syndrome would expect to find what laboratory result? Incisors - Correct Answers The first teeth to erupt during infancy are which of the following? The positive signs of pregnancy - Correct Answers Palpation of the fetus and auscultation of fetal heart tones by the NP. Audible fetal heart tones or cardiac activity on U/S. Chadwick's sign - Correct Answers Blue coloration of the cervix and vagina Presumptive signs of pregnancy - Correct Answers Pregnancy symptoms experienced by the woman such as amenorrhea, breast tenderness, N/V, fatigue and increased urinary frequency. Probable signs of pregnancy - Correct Answers Pregnancy signs detected by the examiner such as an enlarged uterus

Apply acetic acid to the penile shaft and look for acetowhite changes. - Correct Answers A student has recently been informed that he has HPV infection on the shaft of his penis. What may reveal subclinical lesions on the penile skin?

1. Ritualistic behaviors that pt. feels compelled to repeat
2. Attempts to ignore or suppress the repetitive behaviors which increase anxiety
3. Frequent intrusive and repetitive thoughts and impulses - Correct Answers Carol M. is a 40 y/o bank teller who has recently been diagnosed with OCD by her therapist. What would her symptoms include? Paxil, clomipramine (Anafranil), Lenox, Prozac, and Zoloft - Correct Answers Which medications are indicated for the treatment of OCD? She should not get pregnant within the next 4wks - Correct Answers You advise an 18y/o female student who has been given a booster dose of MMR at the college health clinic that? Mini mental status exam - Correct Answers A 68 y/o female is suspected of having Alzheimer's disease. What is the best initial method for assessing this condition? Recheck the pt.’s urine and order a C&S for urine - Correct Answers A 55y/o woman who has type 2 diabetes is concerned about her kidneys. She has a hex of 3 UTIs within the past 8 months. She denies dysuria and frequency at this visit. What is the best course to follow? Spinach, liver, whole wheat bread - Correct Answers An NP is giving dietary counseling to a male alcoholic who has recently been diagnosed with folic acid deficiency anemia. What foods should the NP recommend for the patient? NO, the Western Blot is needed to confirm diagnosis. - Correct Answers The ELISA and Western Blot tests are both used to test for HIV. Does a positive ELISA test mean the patient has HIV? A probable sign of pregnancy - Correct Answers Hager’s Sing is considered what? The umbilicus - Correct Answers When palpating a woman who is at 20 wks., the NP should be able to feel the uterus at what level? COPD - Correct Answers A 67 y/o female with a 50pk/yr. history of smoking presents for a routine annual physical examination. She complains of being easily short of breath and is frequently fatigued. Physical examination reveals diminished breath sounds, hype-resonance, and hypertrophied respiratory accessory muscles. Her CBC results reveal that her hematocrit level is slightly elevated. Her pulmonary function test (PFT) results show increased total lung capacity. What is the most likely diagnosis of this patient?

Chronic bronchitis Allergic rhinitis Gastroesphageal reflux disease - Correct Answers What are some of the causes of chronic cough? Jarisch-Herxheimer reaction - Correct Answers An immune mediated reaction precipitated by the destruction of a large number of spirochetes due to an antibiotic injection Tell her to return 1 wk. after her period so her breasts can be rechecked. - Correct Answers During a breast exam of a 30 yr. old nulliparous female, the NP palpates several rubbery mobile areas of breast tissue. They are slightly tender to palpation. Both breasts have symmetrical findings. There are no skin changes or any nipple discharge. The patient is expecting her menstrual period in 5 days. What would you recommend? The BP is higher in the arms than in the legs. - Correct Answers When evaluating the BP on both arms and legs of an infant who has a diagnosis of coarctation of the aorta, what is a correct finding? Coarctation of the Aorta - Correct Answers In this condition, BP is higher in the arms than in the legs due to the narrowing in the aorta. BP must rise to get adequate blood flow to the lower extremities, therefore, the blood pressure able the coarctation rises to compensate BV wet mount - Correct Answers What is the diagnosis if you see a wet mount with a large amount of bacteria coating the squamous cells and very few leukocytes. Mitral Valve prolapse - Correct Answers A 40 yr. old woman is in the office complaining of palpitations and some light headedness for the past 6 months. These are random episodes. The NP notices and mid-systolic click with a late systolic murmur that is best heard in the apical area during auscultation of the chest. The NP should suspect what? Kidney Stones Bladder cancer Acute Pyelonephritis - Correct Answers Your 35 y/o pt. is being worked up for microscopic hematuria. What would be appropriate differential diagnoses? Pterygium - Correct Answers During a routine physical exam of an elderly woman, a triangular thickening of the bulbar conjunctiva on the temporal side is noted to be encroaching on the cornea. She denies any eye pain or visual changes. What is the most likely diagnosis? Corneal Arcus - Correct Answers A ring around the edge of the cornea

Chalazion - Correct Answers A stye in the eye that may cause pain or swelling Pinguecula - Correct Answers A benign growth on the conjunctiva caused by the degeneration of its collagen fibers. Thick yellow fibers may be seen Discontinue his pravastatin and order a liver function profile. - Correct Answers A patient who has been on Pravastatin 20mg at bedtime for the past few months, complains of lately feeling extremely fatigues. The patient also noticed that his urine has been a darker color during the past 2 wks. What is the treatment plan for this patient? Side effects of statins - Correct Answers Myalgia, fatigue, elevated liver enzymes Probable Sign - Correct Answers A young primigravida reports to you that she is starting to feel the baby's movements. What is this considered Halen test - Correct Answers What is used to evaluate inflammation of the median nerve; used to test for carpal tunnel syndrome. Physiological anemia - Correct Answers An increase of up to 50% of the plasma volume in pregnant women is the reason for this type of problem It is reversible, lasts only 1 wk., and has minimal affect. - Correct Answers These statements are true regarding the effects of aspirin on platelet function. Triamcinolone (Azmacort) Montelukast (Singular) Cromolyn sodium inhaler (Intel) - Correct Answers The following agents are used to control the inflammatory changes seen in asthmatics. Breast buds and some straight pubic hair. - Correct Answers A 14 y/0 teen is worried that she has not started to menstruate like most of her friends. During the gynecological exam, the NP tells the mother, who is in the room with the pt., that her daughter is starting Tanner Stage II. What are the physical exam findings during this stage? Rovsing's sign - Correct Answers This sign is associated with an acute abdomen, such as during a ruptured appendix Intravaginal ultrasound - Correct Answers This is contraindicated in the care of a pregnant woman with placenta previa. Order the Hip PCR (polymerase chain reaction)test. - Correct Answers A patient is positive for anti-HCV (hepatitis C virus antibody). What is the next step the NP would do to evaluate this patient?

and routine labs are all negative. The vital signs are normal. His appetite is normal. The most likely diagnosis is? Delirium - Correct Answers An acute decline in mental status that is temporary. Common causes: fever, shock, drugs, alcohol, and dehydration Leukoplakia and oral cancer - Correct Answers What is a condition associated with chronic use of chewing tobacco? Doxycycline (Vibramycin) 100mg PO BID x 21 days - Correct Answers The recommended treatment for erythema migrans or Lyme Disease is? The Nurse Practice Act of the state where they practice - Correct Answers NPs and Clinical nurse specialists derive their legal right to practice from:? Order a mammogram and refer her to a breast surgeon - Correct Answers You are checking a 75 you woman’s breast during an annual gynecological exam. The left nipple and areola are scaly and reddened. The patient denies pain or pruritus. She has noticed this scariness on her left nipple for the past 8 months. Her dermatologist gave her a potent topical steroid, which she used twice a day for 1 month. The patient never went back for the follow-up. She still has the rash and wants an evaluation. What is the best intervention for this patient? A child recently diagnosed with leukemia An infant whose family is homeless A Hispanic child with asthma who is using a steroid inhaler - Correct Answers What are some of the high risk signs for Tuberculosis? This is a normal finding in some young athletes - Correct Answers During a sports physical exam of a 14 y/o might school athlete, the nurse practitioner notices a split of the S2 component of the heart sound during deep inspiration. She noted that it disappears upon expiration. The heart rate is regular and no murmurs are auscultated. What can we determine from this exam 3: 55y/o woman, hypertension, hypercholesterolemia - Correct Answers A 55 y/o female with a BMI of 24 and history of asthma has hypertension that has been under control with HCTZ 12.5mg daily. Her total cholesterol is 230g/dl. How may risk factors for coronary heart disease does she have? Gastrointestinal problems - Correct Answers A common side effect of metformin therapy is? Atrial fibrillation - Correct Answers While doing a cardiac exam on a 45 y/o male, you note an irregular rhythm with a pulse rate of 110 ppm. The patient is alert and is not in distress. What is the most likely diagnosis?

Congestive Heart Failure - Correct Answers A 68 y/o woman with hypertension and diabetes is seen buy the NP, for dry cough that worsens at night when she lies in bed. She has SOB which worsens when she exerts herself. The pt.’s pulse is 90/min and regular. The patient has gained 6 lbs. over the past 2 months. She is on a nitroglycerine patch and furosemide daily. The best explanation for her symptoms is: Advise the patient that she has a normal exam - Correct Answers A NP is doing a fundoycopic exam on a 35 y/o female during a routine physical exam. He notices that she has sharp disc margins and a yellowish orange color in the macular area. The ration of the veins to arteries is 3:2. What is the most appropriate action? The patient can see at 20ft what a person with normal vision can see at 30 ft (near- sided) - Correct Answers During a sports physical, you note that the vision of an 18 y/o male athlete is 20/30 in both eyes. What does this mean? Smog phenomenon - Correct Answers A 30 y/o type 2 diabetic is on rig insulin and lent insulin in the morning and evening. She denies changes in her diet or any illness, but recently started attending aerobic classes in the afternoon. Because of her work- outs, her blood sugars have dipped below 50mg/ld. very early in the morning. Her fasting glucose before breakfast is now elevated and higher than normal. How is this best described? HCV RNA - Correct Answers A 40 y/o female is positive for anti-hepatitis C virus (HCV). Which test is appropriate for follow up? Check the ankle and brachial blood pressure before and after exercise. - Correct Answers When the NP is evaluating a patient for intermittent claudication he/she would first do what? Erythromycin Phenytoin (Dilantin) Cimetidine (Tagamet) - Correct Answers The following drugs interact with theophylline Mitral regurgitation - Correct Answers You note a high pitched and blowing pan- systolic murmur in a 70 y/o male. It is Grade II/VI and is best heard in the apical area. What is the most likely diagnosis? Strabismus - Correct Answers The cover/uncover test is a screening tool for what? Color blindness - Correct Answers The Ishihara tool is a screening for what condition? Visual Equity - Correct Answers The Snelling chart is a tool used to evaluate what? Advise the mother that this is normal in infants up to 2 months old - Correct Answers The mother of a 4-wk old infant is concerned that her infant's eyes are crossed for a few seconds occasionally. The NP would: