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It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic - ANSWER A 72 yo woman has been on hydrochlorothiazide 12.5mg for many years to control her Stae 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 - ANSWER The NP would test the obturator and iliopsoas muscle to evaluate for what? A prescription of methyldopa (Aldomet) to control BP - ANSWER 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 (Aldomet) to control BP. Nursing home care - ANSWER 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 - ANSWER A 28 yo 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 99.9 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/uL. What is the likely diagnosis? 10mm - ANSWER A 39 yo 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 - ANSWER 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 - ANSWER The following statement regarding Munchausen syndrome is false: Beta-blockers - ANSWER Which antihypertensive medications should the NP avoid when treating patient with emphysema? Perform a complete and thorough history - ANSWER 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 - ANSWER Which finding is most likely in young primigravidas with pregnancy induced hypertension? Tingling and numbness of both feet - ANSWER Which symptom is associated with B deficiency anemia? Order an ultrasound - ANSWER A second triple screen on a 35 yo 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 - ANSWER Pts. diagnosed with gonorrhea should also be treated for what other infections? Osteoporosis - ANSWER Kyphosis is a late sign of Higher than normal - ANSWER 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 - ANSWER Which of the following antihypertensive medications has beneficial effects for an elderly white female with osteoporosis? Knee instability - ANSWER The Lachman maneuver is used to detect which of the following?
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 - ANSWER 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 - ANSWER 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 - ANSWER 1. anhedonia
- unintentional weight loss or gain
- fatigue
- change in appetite
- insomnia or hypersomnia
- Feelings of guilt and worthlessness
- recurrent thought of suicide. Anhedonia - ANSWER loss of interest in activities that the patient finds pleasurable What does Chronic NSAID use do? - ANSWER 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? - ANSWER To evaluate renal function. Creation is the end product of creatine metabolism. Creatinine clearance is not affected by fluid or dietary intake of meat. After 20 wks - ANSWER At how many weeks gestation should fundal height equal weeks gestation? 2cm or greater - ANSWER When measuring fundal height, how many centimeters variation should warrant further testing to evaluate fetal growth The drawer sign - ANSWER 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. Heberden's nodes - ANSWER These are commonly seen in degenerative joint disease, and are bony nodules located on the distal interphalangeal joints (DIPs) Laryngeal neoplasia - ANSWER HPV infection of the larynx has been associated with:
Cervical cancer. - ANSWER HPV infection of the cervix is associated with: Tanner Stage III: Male - ANSWER Consist of penis lengthening and darker, course pubic hair, which begins to curl. The Lachman maneuver - ANSWER Test performed to assess for knee instability. Knee instability indicated a tear of the anterior cruciate ligament. Calcium channel blockers - ANSWER 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 osteoporoisis Both gram negative and gram positive bacteria - ANSWER Diverticula in the colon can be infected with In the fetal and maternal liver. - ANSWER Where is AFP produced? Multiple gestations d/t growing fetuses and enlargement of the livers - ANSWER When are higher levels of AFP commonly seen? Kyphosis - ANSWER a curvature of the spine that causes a rounding of the back, which leads to slouching posture. Osteoporosis - ANSWER Severe thinking of the bones that contributes to this curvature in the spine. Symptoms that may occur with severe cases of kyphosis - ANSWER 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. - ANSWER 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 - ANSWER What can Vitamin B12 deficiency anemia cause if not treated? Symptoms of B12 deficiency anemia? - ANSWER tingling and numbness of fingers and toes difficulty walking mood changes depression memory loss disorientation
Munchausen sudrowme - ANSWER 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?
- ANSWER 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? - ANSWER 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 - ANSWER 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 - ANSWER Occurs when abnormal implantation of the placenta occurs. What is a common sign of placenta prevue? - ANSWER Painless, bright red bleeding Middle aged to older women - ANSWER Epidemiological studies show the Hashimoto's disease occurs most commonly in: Severe vaginal atrophic changes - ANSWER 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? - ANSWER Hot flashes irregular menstrual cycles cyclic mood swings Thinning of vaginal tissue Dryness of vagina Hepatomegaly, AV nicking, bibasilar crackles - ANSWER 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 - ANSWER 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 - ANSWER 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 likelydiagnosis? Bacterial Vaginosis - ANSWER A bacterial infection of the vagina. S/Sx 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 - ANSWER 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 - ANSWER The heart sound S2 is caused by Just rising above the suprapubic bone - ANSWER A pelvic exam on a woman who is 12 wks pregnant would reveal that her uterus is located where? 12wks gestation uterus size - ANSWER The approximate size of a grapefruit: just above the suprapubic bone Anesthesiologists services - ANSWER All of the following are covered under Medicare Part B except: A) Persons age 65 or older B) Durable medial equipment C) Mammograms annually starting at age 50 D) Anesthesiologists services What does Medicare part B cover? - ANSWER Outpatient physician visits, labs, x-rays durable medical equipment mammograms/colonoscopy after age 50 rehabilitation A 17 y/o teen who has only one close friend in school - ANSWER All of the following patients are at higher risk for suicide except: A) A 66 y/o with male whose wife of 40 yrs recently died B) A high school student with a history of bipolar disorder
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. - ANSWER 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 - ANSWER 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 - ANSWER 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 S ,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 - ANSWER A 53 yo 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 - ANSWER Erythromycin 200mg with sulfisoxazole 600mg suspension (Pediazole) is contraindicated in which condition? Glucose-6-phosphate dehydrogenase - ANSWER 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 - ANSWER 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. - ANSWER Positive combo test on an Rh negative pregnant woman means what? Prevent anencephaly - ANSWER Folic acid supplementation is recommended for women who are planning pregnancy in order to Causes of secondary hypertension - ANSWER Pheochromocytoma Reno vascular stenosis
Coarctation of the aorta Chlamydia trahomatis - ANSWER Fitz-Hugh-Curtis syndrome is associated with which infection? Pelvic Inflammatory disease - ANSWER What is Fitz-Hugh-Curtis syndrome a complication of? 5mm - ANSWER 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 - ANSWER In small children with acquired immunodeficiency syndrome (AIDS), which vaccines is contraindicated? Inevitable abortion - ANSWER A 44 y/o female who 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 symphysis pubis. The cervical os is dilated to 3cm. What is the most likely diagnosis? What is inevitable abortion? - ANSWER Vaginal bleeding with pain and cervical dilation and/or effacement. What is incomplete abortion? - ANSWER Moderate to diffuse vaginal bleeding, with the passage of tissue and painful uterine cramping or contractions. Acute Pelvic Inflammatory Disease - ANSWER A sudden onset of inflammation and pain that affects the pelvic area, cervix uterus and ovaries, which is caused by infection. Td and HepB vaccine - ANSWER A 14y/o female who is sexually active is brought in by her mother for an immunization update. According to the mother, her daughter had 1 dose of hepatitis B vaccine. Which vaccines would you administer at this visit? During the postpartum period - ANSWER An Rhpneative pregnant woman with negative Rubella titers should be vaccinated at what time period in pregnancy? Eyeglasses and routine dental care - ANSWER Medicare part B will pay for outpatient physician visits that are medically necessary, Durable medical equipment, outpatient laboratory and radiology test. But it will NOT pay for: Ishihara chart - ANSWER What is used to screen for color blindness in a 7 y/o boy?
Pregnancy induced hypertension (preeclampsia) - ANSWER You note the following results on a routine urinalysis of a 37y/o primigravida who is 30 weeks gestation. Leuk=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 - ANSWER The NP who suspects that one of her hypertensive patients has Cushing's syndrome would expect to find what laboratory result? Incisors - ANSWER The first teeth to erupt during infancy are which of the following? The positive signs of pregnancy - ANSWER 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 - ANSWER Blue coloration of the cervix and vagina Presumptive signs of pregnancy - ANSWER Pregnancy symptoms experienced by the woman such as amenorrhea, breast tenderness, N/V, fatigue and increased urinary frequency. Probable signs of pregnancy - ANSWER Pregnancy signs detected by the examiner such as an enlarged uterus Apply acetic acid to the penile shaft and look for acetowhite changes. - ANSWER A studen has recently been informed that he has HPV infection on the shaft of his penis. What may reveal subclinical lesions on the penile skin?
- Ritualistic behaviors that pt feels compelled to repeat
- Attempts to ignore or suppress the repetitive behaviors which increase anxiety
- Frequent intrusive and repetitive thoughts and impulses - ANSWER 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), Luvox, Prozac, and Zoloft - ANSWER Which medications are indicated for the treatment of OCD? She should not get pregnant within the next 4wks - ANSWER 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 - ANSWER 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 - ANSWER A 55y/o woman who has type 2 diabetes is concerned about her kidneys. She has a hx 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 - ANSWER 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. - ANSWER 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 - ANSWER Heger's Sing is considered what? The the umbilicus - ANSWER When palpating a woman who is at 20 wks, the NP should be able to feel the uterus at what level? COPD - ANSWER 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? It is a precancerous lesion and should be followed up with her dermatologist. - ANSWER Your patient of 10 yrs is concerned about her most recent diagnosis. She was told by her dermatologist that she has an advanced case of Actinic Keratosis. What would you recommend for this patient? Medical information is given to a spouse - ANSWER Pt confidentiality is breached when? Pt records are subpoenaed Records are sent to the public health dept. Records are released to insurance companies - ANSWER Pt confidentiality is NOT breached when? Angina pectoris - ANSWER A 55y/o male pt describes to you an episode of chest tightness in his substernal area that radiated to his back while jogging. It was relieved immediately when he stopped. What condition does this best describe? Consult with a cardiologist for further evaluation - ANSWER In a 55 y/o patient with Angina Pectoris what would the NP recommend? TIA - ANSWER A 73 y/o patient, complains of episodic vertigo, slight confusion, and weakness that lasts nearly an hour each time. Movement does not worsen he vertigo. She "rests" and her symptoms subside, but she is puzzled because the weakness
BV wet mount - ANSWER 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 - ANSWER 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 - ANSWER Your 35 y/o pt is being worked up for microscopic hematuria. What wold be appropriate differential diagnoses? Pterygium - ANSWER 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 - ANSWER A ring around the edge of the cornea Chalazion - ANSWER A stye in the eye that may cause pain or swelling Pinguecula - ANSWER 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. - ANSWER 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 - ANSWER Myalgia, fatigue, elevated liver enzymes Probable Sign - ANSWER A young primigravida reports to you that she is starting to feel the baby's movements. What is this considered Phalen test - ANSWER What is used to evaluate inflammation of the median nerve; used to test for carpal tunnel syndrome. Physiological anemia - ANSWER 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. - ANSWER These statements are true regarding the affects of aspirin on platelet function. Triamcinolone (Azmacort)
Muntelukast (Singular) Cromolyn sodium inhaler (Intal) - ANSWER The following agents are used to control the inflammatory changes seen in asthmatics. Breast buds and some straight pubic hair. - ANSWER 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 - ANSWER This sign is associated with an acute abdomen, such as during a ruptured appendix Intravaginal ultrasound - ANSWER This is contraindicated in the care of a pregnant woman with placenta previa. Order the HepC PCR (polymerase chain reaction)test. - ANSWER A patient is positive for anti-HCV (hepatitis C virus antibody). What is the next step the NP would do to evaluate this patient? Cauda Equina syndrome - ANSWER A 62yr old female complains of chronic severe low back pain. She also reports mild episodes of fecal incontinence and numbness in her lower legs over the past week. What would the NP suspect, Cauda Equina Syndrome presentation - ANSWER This condition is a surgical emergency. S/SX include a change in bowel and bladder control(incontinence). Acuter pressure on the sacral nerve root causes inflammatory and ischemic changes to the nerve and can lead to permanent nerve damage. Rovsign's Sings - ANSWER A 40 yr old white female with a BMI of 32 complains of colicky pain in the right upper quadrant of her abdomen that gets worse if she eats fried food. During the physical exam, the NP presses deeply on the left lower quadrant of the abdomen. After releasing her hand, the patient complains of pain on the right side of the lower abdomen. What is the name of this happing Epstein-Barr Syndrome - ANSWER Which viral infection is associated with occasional abnormal forms of lymphocytes during acute infection? Spina bifida - ANSWER A faun tail nevus is a sign of what? Order a UA with C&S and treat with abx - ANSWER A 21 y/o complains to you of a 1-wk episode of dysuria, frequency, and a strong odor to her urine. This is her second episode of the year. What is the most appropriate f/u for this patient? Neurofibromatosis or Von Recklinghausen's disease - ANSWER Café-Au-Alit spots look like tan-to-light brown stains that have irregular borders. They can be located anywhere on the body. What are they associated with?
This is a normal finding in some young athletes - ANSWER During a sports physical exam of a 14 y/o might school athlete, the nurse practitioner notices a split of the S 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 - ANSWER 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 - ANSWER A common side effect of metformin therapy is? Atrial fibrillation - ANSWER 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 - ANSWER 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 - ANSWER 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) - ANSWER During a sports physical, you note that the vision of an 18 y/o male athlete is 20/30 in both eyes. What dose this mean? Somogi phenomenon - ANSWER A 30 y/o type 2 diabetic is on reg insulin and lente 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/dL very early in the morning. Her fasting glucose before breakfast is now elevated and higher than normal. How is this best described? HCV RNA - ANSWER 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. - ANSWER When the NP is evaluating a patient for intermittent claudication he/she would first do what?
Erythromycin Phenytoin (Dilantin) Cimetidine (Tagamet) - ANSWER The following drugs interact with theophylline Mitral regurgitation - ANSWER 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 - ANSWER The cover/uncover test is a screening tool for what? Color blindness - ANSWER The Ishihara tool is a screening for what condition? Visual Aquity - ANSWER The Snellen chart is a tool used to evaluate what? Advise the mother that this is normal in infants up to 2 months old - ANSWER 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: Height, Age, Gender - ANSWER What factors are important in determining the peak expiratory flow volume? Squamous epithelial cells and endocervical cells - ANSWER You are reviewing a Pap smear report on a 25 y/o female. What cells should be on the pap smear to be considered an adequate specimen? A sensation of spinning or rotating - ANSWER When assessing a patient suspected of having vertigo, what description given by the patient is most consistent with the symptom? Trigeminal Neuralgia - ANSWER A 56 y/o man complains of episodes of lancinating painthat shoots up to his right cheek when he eats or drinks. He has stopped drinking cold drinks because of the pain. What is most likely cause of this? Yeast infections - ANSWER What does a KOH prep help the NP diagnose? Prozac, Zoloft, Paxil CR - ANSWER The following medications are SSRIs Egophony, Tactile fremitus, Whispered pectoriloquy - ANSWER The following tests require the patient's voice to perform Retinoblastoma of the left eye - ANSWER When checking for a red-reflex on a 3 y/o boy during a well child visit, a white reflection is seen on a child's left pupil. What condition should be ruled out? Lyme Disease
