Medical Practice Exam Questions and Answers, Exams of Nursing

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When completing this quiz, did you comply with Walden University’s Code

of Conduct including the expectations for academic integrity?

 Solution 2

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What is the Gold standard for the diagnosis of asthma? Answer: Spirometry

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Which of the following is not a goal of treatment for the patient with cystic fibrosis? Answer: Replace water-soluble vitamins

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An 18 year old basketball player complains of itching in the crural folds, buttocks, and upper thighs. The lesions are well demarcated and are half-moon shaped. The area is red, irritated, and there are small breaks in the skin from scratching. What is this patient’s diagnosis and how should it be treated?

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A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough?

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If a patient presents with a deep aching, red eye and there is no discharge, you should suspect:

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Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is:

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The nurse practitioner is performing a physical exam on a middle-aged African-American man. Which of the following areas is a common site for melanomas in African-Americans and other dark-skinned individuals?

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A 55 year old patient has a work-up for hypertension and is noted to have elevated BUN and creatinine. Which of the following should the nurse practitioner suspect?

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An elderly patient is being seen in the clinic for complaint of “weak spells” relieved by sitting or lying down. How should the nurse practitioner proceed with the physical examination?

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Which of the following can result from chronic inflammation of a meibomian gland?

 Solution 12

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Risk factors for acute otitis media (AOM) include all of the following except:

 Solution 13

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Which of the following heart murmurs warrants the greatest concern?

 Solution 14

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The most common cancer found on the auricle is:

 Solution 15

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A cashier complains of dull ache and pressure sensation in her lower legs. It is relieved by leg elevation. She occasionally has edema in her lower legs at the end of the day. What is the most likely cause of these problems?

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A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is:

 Solution 17

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Which of the following patient characteristics are associated with chronic bronchitis?

 Solution 18

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Which of the following dermatologic vehicles are the most effective in absorbing moisture and decreasing friction?

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A 58-year-old man is diagnosed with Barrett’s esophagus after an endoscopy. He has no known allergies. Which of the following medications is MOST appropriate to treat this patient’s disorder?

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A patient presents with an inflamed upper eyelid margin. The conjunctiva is red and there is particulate matter along the upper eyelid. The patient complains of a sensation that “there is something in my eye.” What is the diagnosis and how should it be treated?

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A 40 year old presents with a hordeolum. The nurse practitioner teaches the patient to:

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Which choice below is least effective for alleviating symptoms of the common cold?

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The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The least likely diagnosis for this patient is:

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A 76-year-old male complains of weight loss, nausea, vomiting, abdominal cramping and pain. Physical findings include an abdominal mass and stool positive for occult blood. The nurse practitioner pain suspects a tumor in the small intestine. The best diagnostic test for this patient is:

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Of the following choices, the least likely cause of cough is:

 Solution 26

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A false-positive result with the fecal occult blood test can result from:

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A 40 year old female with history of frequent sun exposure presents with a multicolored lesion on her back. It has irregular borders and is about 11mm in diameter. What should the nurse practitioner suspect?

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Jennifer, age 49, who has a history of hyperlipidemia, has symptoms that lead you to suspect unstable angina. Your next action would be to:

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Your patient Jerry has gout. What do you suggest?

 Solution 30

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Which of the following is not a symptom of irritable bowel syndrome?

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Your well-nourished 75-year-old patient has come into the office for a physical exam and states that she recently had two nosebleeds. She does not take any anticoagulants, and you have ruled out any coagulopathies. The most likely cause of these nosebleeds is:

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A 58 year old complains of tightness in his chest while cutting firewood. It disappears quickly if he stops chopping. He denies shortness of breath, his total cholesterol level is less than 200 mg/dL, and he is a non-smoker. What is the most appropriate action for the nurse practitioner to take with this patient?

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Expected spirometry readings when the patient has chronic emphysema include:

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Appropriate therapy for peptic ulcer disease (PUD) is:

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Acute rheumatic fever is an inflammatory disease which can follow infection with:

 Solution 36

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After thorough history, physical examination, and laboratory tests, a patient is diagnosed with irritable bowel syndrome (IBS). Which of the following initial treatment plans is currently considered most effective?

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Marvin has sudden eye redness that occurred after a strenuous coughing episode. You diagnose a subconjunctival hemorrhage. Your next step is to:

 Solution 38

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Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect?

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A 47 year old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On examination, external hemorrhoids are noted. How should the nurse practitioner proceed?

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What prophylactic medication is commonly recommended for the patient under 35 years of age with a positive PPD?

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A middle-aged male presents to urgent care complaining of fever, dysphagia, and shortness of breath. The nurse practitioner notes the patient leaning forward in a tripod position and drooling. The clinical presentation of this patient suggests:

 Solution 42

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An AST that is more than twice the level of ALT is suggestive of:

 Solution 43

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What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?

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Mark has just been given a diagnosis of congestive heart failure. Which of his medications should be discontinued?

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Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?

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A patient presents with classic symptoms of gastroesophageal reflux disease (GERD). He is instructed on life style modifications and drug therapy for 8 weeks. Three months later he returns, reporting that he was “fine” as long as he took the medication. The most appropriate next step is:

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An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3– 4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has:

 Solution 48

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Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?

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A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed?

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Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect?

 Solution 51

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Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes?

 Solution 52

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Marvin, age 56, is a smoker with diabetes. He has just been diagnosed as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis?

 Solution 53

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Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg daily, and Calcium 1500 mg daily. At today’s visit. Her blood pressure is 170/89. According to JNC VIII guidelines, what should you do next to control Harriet’s blood pressure?

 Solution 54

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Which of the following is the most appropriate therapeutic regimen for an adult patient with no known allergies diagnosed with group A B-hemolytic strep?

 Solution 55

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Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized?

 Solution 56

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Dana has ischemic arterial ulcers. What is your first priority when counseling her?

 Solution 57

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Sandra has celiac disease. You place her on which diet?

 Solution 58

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An 18-year-old female presents to the urgent care center complaining of severe pruritus in both eyes that started 2 days ago. Associated symptoms include a headache and fatigue. On examination, the nurse practitioner notes some clear discharge from both eyes and some erythema of the eyelids and surrounding skin. Which of the following is the most likely cause of this patient’s symptoms?

 Solution 59

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The differential diagnosis for a patient complaining of a sore throat includes which of the following?

 Solution 60

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A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical

adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe?

 Solution 61

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A patient with elevated lipids has been started on lovastatin. After 3 weeks of therapy, he calls to report generalized muscle aches. The nurse practitioner should suspect:

 Solution 62

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A 70 year old man who walks 2 miles every day complains of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 2 mile walk. What Solution asked during the history, if answered affirmatively, would suggest a diagnosis of arteriosclerosis obliterans?

 Solution 63

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A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent care with new onset left lower quadrant pain. Her current medications include omeprazole 20 milligrams po daily, lisinopril 20 milligrams po daily, simvastatin 20 milligrams po daily, and prednisone 12 milligrams po daily. The nurse practitioner suspects acute diverticulitis and possibly an abscess. The most appropriate diagnostic test for this patient at this time is:

 Solution 64

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Your 31-year-old patient, whose varicella rash just erupted yesterday, asks you when she can go back to work. What do you tell her?

 Solution 65

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The most common correlate(s) with chronic bronchitis and emphysema is(are):

 Solution 66

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Treatment of acute vertigo includes:

 Solution 67

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Which of the following best describes hypertrophic cardiomyopathy?

 Solution 68

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Which of the following is a predisposing condition for furunculosis?

 Solution 69

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A 70 year old patient presents with left lower quadrant (LLQ) abdominal pain, a markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition?

 Solution 70

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A 45 year old with diabetes has had itching and burning lesions between her toes for 2 months. Scrapings of the lesions confirm the diagnosis tinea pedis. What is the best initial treatment option for this patient?

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A 60 year old male diabetic patient presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which “is better.” His temperature is 100°F and pulse is 102 bpm. The most appropriate initial action is to:

 Solution 72

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Impetigo and folliculitis are usually successfully treated with:

 Solution 73

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An 18 year old complains that his “throat hurts” with swallowing. His voice is very “throaty” and he is hyperextending his neck to talk. Examination reveals asymmetrical swelling of his tonsils. His uvula is deviated to the left. What is the most likely diagnosis?

 Solution 74

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In the initial evaluation of a patient with new onset hypertension, the nurse practitioner should:

 Solution 75

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The Centor criteria for diagnosis of Group A B-hemolytic streptococcus includes which of the following?

 Solution 76

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Alan, age 54, notices a bulge in his midline every time he rises from bed in the morning. You tell him it is a ventral hernia, also known as:

 Solution 77

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John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia?

 Solution 78

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Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication?

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Martha had a less than 7% value on her Schilling test. What medication do you anticipate she might need?

 Solution 80

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Sheila, age 78, presents with a chief complaint of waking up during the night coughing. You examine her and find an S3 heart sound, pulmonary crackles that do not clear with coughing, and peripheral edema. What do you suspect?

 Solution 81

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When teaching a patient with hypertension about restricting sodium, you would include which of the following instructions?

 Solution 82

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Treatment of H.pylori includes which of the following?

 Solution 83

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Which of the following is not a risk factor for coronary arterial insufficiency?

 Solution 84

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A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect:

 Solution 85

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Sarah has allergic rhinitis and is currently being bothered by nasal congestion. Which of the following meds ordered for allergic rhinitis would be most appropriate?

 Solution 86

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Mort is hypertensive. Which of the following factors influenced your choice of using an alpha blocker as the antihypertensive medication?

 Solution 87

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The American Cancer Society recommends a flexible sigmoidoscopy for colorectal cancer screening in persons at average risk every:

 Solution 88

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Marian, age 52, is obese. She complains of a rapid onset of severe right upper quadrant abdominal cramping pain, nausea, and vomiting. Your differential diagnosis might be:

 Solution 89

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What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery?

 Solution 90

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An adult presents with tinea corporis. Which item below is a risk factor for its development?

 Solution 91

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A patient reports “something flew in my eye” about an hour ago while he was splitting logs. If there were a foreign body in his eye, the nurse practitioner would expect to find all except:

 Solution 92

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A patient presents to the primary care provider complaining of a rash on his right forehead that started yesterday and is burning and painful. The physical exam reveals an erythematous, maculopapular rash that extends over the patient’s right eye to his upper right forehead. Based on the history and examination, the most likely cause of this patient’s symptoms is:

 Solution 93

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Which intervention listed below is safe for long term use by an adult with constipation?

 Solution 94

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Of the following, the patient who should be referred for periodic colonoscopy is the patient with:

 Solution 95

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A patient presents with periorbital erythema and edema, fever, and nasal drainage. The nurse practitioner should:

 Solution 96

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A patient has experienced nausea and vomiting, headache, malaise, low grade fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is elevated with a shift to the left. He is requesting medication for diarrhea. What is the most appropriate response?

 Solution 97

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A 15 year old male presents with abdominal pain that began in the peri-umbilical area then localized to the right lower quadrant (RLQ). He complains of anorexia, and low grade fever. A complete blood count (CBC) reveals moderate leukocytosis. What is the most likely diagnosis?

 Solution 98

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Risk factors for acute arterial insufficiency include which of the following?

 Solution 99

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Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by:

 Solution 100

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Which antibiotic would be the most effective in treating community acquired pneumonia (CAP) in a young adult without any comorbid conditions?

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A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is:

Monday, July 6, 2020 1:33:59 PM EDT