NR511 Final Exam Study Guide: Key Concepts and Practice Questions, Exams of Nursing

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NR511 Final exam NR 511 midterm

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Assesses the clients HPI - Correct Answer OLDCARTS TRUE or FALSE... The history of present illness is a breakdown of the clients chief complaint - Correct Answer TRUE What is needed to make a sound clinical decision - Correct Answer Evidence based research clinical practice guidelines published evidence-based algorithms (few false positives) high percentage of healthy people will show a normal result - Correct Answer high specificity high number of false positives - Correct Answer low specificity if a diagnostic study has ____________, then a high number of healthy people will show a normal result - Correct Answer high specificity proportion of true positives - Correct Answer sensitivity ______________ will lead to positive findings for patients with a disease - Correct Answer high sensitivity how clients cover out of pocket expenses when on medicare - Correct Answer secondary insurance to cover 20% out of pocket expense inpatient hospital, skilled nursing care, hospice, home care - Correct Answer Part A medicare outpatient, provider visits, surgery, labs, medical equipment, preventative exams - Correct Answer Part B Medicare Wellness services, eye exams, hearing exams, hearing aides, glasses - Correct Answer Part C Medicare Prescription drugs - Correct Answer Part D Medicare NP's are reimbursed at _______of the physician fee - Correct Answer 85%

what is the purpose of medicare advantage plans - Correct Answer lower co payments , add additional benefits Third party payers fall into 7 categories...( name 7) - Correct Answer Medicare, Medicaid, indemnity, managed care, Workers comp, Veterans admin, auto liability Papular rash, satellite lesions = what kind of skin issue - Correct Answer fungal those at risk for fungal skin infections - Correct Answer immunocompromised young - diaper rash Diabetic antibiotic therapy Aids corticosteroid treatment chemo flat to slightly elevated brown papules and plaques, scale when rubbed, hypopigmentation, puritic, found on trunk and shoulders - Correct Answer tinea vesicolor candidiasis in tip of penis - Correct Answer balanitis annual lesions with scaly borders, ring shape scaly borders on exposed skin and trunk - Correct Answer tinea corporis Athletes foot - Correct Answer tinea pedis jock itch - Correct Answer tinea cruis white or yellow nail discoloration, thickening of nail, separation from nail bed - Correct Answer tinea unguium dry skin teaching - Correct Answer use tepid water and mild soaps,older adults at risk spreading skin infection of epidermis and subcutaneous tissue,begins after a break in the skin - Correct Answer cellulitis bacterial infection characterized by papules - Correct Answer folliculitis' highly contagious bacterial skin infection, most common in young children - Correct Answer impetigo Nonpharmacologic Treatment of impetigo - Correct Answer use of solutions to debride lesions

bacterial skin infections that produce burning and pruritis, regional lymphadenopathy - Correct Answer bullous and non-bullous impetigo chronic history of cyst on same site for months to years, cheesy white discharge with strong odor - Correct Answer epidermal inclusion cyst acute process , only takes several days to form - Correct Answer furuncles if rash is around neck/face and difficulty breathing/hoarsness occurs... - Correct Answer give EPI hives or wheals that occur on trunk and arms after exercise, anxiety, elevated body temps, hot baths - Correct Answer cholinergic uticaria treatment for cholinergic uticaria - Correct Answer antihistamines long term inflammation of the skin, characterized by extremely low threshhold for puritis, referred to as the itch that rashes/itch occurs before the rash. Scratching makes it worse

• Correct Answer atopic dermatitis What is the cardinal sign of atopic dermatitis - Correct Answer severe pruritus what is the primary locations for atopic dermatitis in children - Correct Answer antecubital fossa popliteal fossa Common treatment of immunocompromised patients with Herpes simplex - Correct Answer Famvir or valtrex/valacyclovir unilateral vesicular rash along a dermatome, begins as erythema, changes to papular lesions then vesicles - Correct Answer herpes zoster/shingles First line treatment for acne - Correct Answer benzoyl peroxide good candidates for oral antibiotic treatment with acne - Correct Answer at risk for pigmentation changes, scarring, nodulocystic acne ance teaching - Correct Answer sunscreen needs to be used with all acne medicaiton Skin condition that causes blushing/flushing and visible blood vessles in the face - Correct Answer rosacea mainstay treatment for Rosacea - Correct Answer metronidazole, takes 6-8 weeks

lesions are superficial epithelial growths that originate from the horny layer of epidermis, result of benign proliferation. May reveal dark keritin plugs or horny cysts - Correct Answer Seborrhea keratosis at risk population for seborrhea keratosis - Correct Answer older white female Considered epidermal tumors, not malignant or premalignant - Correct Answer seborrhea keratosis pre cancerous lesions, can progress into squamous cell carcinoma - Correct Answer actinic keratosis flesh colored, hard, sandpaper like rash, lesions found on sun-exposed, damaged skin , refer to dermatology - Correct Answer acintinic keratosis Most aggressive skin cancer, thickness of lesion impacts prognosis. Risk factors include age, immunosupression, indoor tanning exposure - Correct Answer malignant melanoma benign , rubbery , smooth and round mass - Correct Answer lipoma intense itchy rash, can last several days or weeks - Correct Answer scabies Scabies treatment - Correct Answer Ivermectin lice education - Correct Answer itching may continue up to a week after treatment painful red bumps under the skin due to infection of the hair follicles or oil glands - Correct Answer furuncle if located in axilla, diff diagnosis for furuncle /carbuncle is... - Correct Answer hidradenitis suppurativa caused by human papilloma virus, abrading skin can spread virus - Correct Answer warts easiest types of warts to treat - Correct Answer filiform, digitate causative organism of viral conjunctivits - Correct Answer adenovirus hallmark symptoms of red, itchy eyes, clear to no drainage, preauricular lymph node swelling and tenderness indicate - Correct Answer viral conjunctivitis red eye, crusted lid, normal visual acuity ,watery, itchy eyes, photophobia indicate - Correct Answer bacterial conjunctivitis

gradual, painless, progressive loss of vision - Correct Answer cataracts tend to be bilateral in nature, may manifest as blurry/distorted vision, c/o glare with driving - Correct Answer age related cataracts small lump,or swelling which develops in the eye lid as result of blockage in a gland - Correct Answer chalazion/cyst inflammation around eyelid margins,caused by staphylococcal infection at lash base - Correct Answer blepharitis treatment for blepharitis - Correct Answer bacitracin 0.5 ointment treatment for resistant stapylococcal infections - Correct Answer d/c bacitracin, start quinolone ointment/erythromycin when to refer to a chalazion to ophthalmologist - Correct Answer persist for more than 4 weeks Tests for dry eye include: - Correct Answer slit lamp,shermer test first level education for dry eyes - Correct Answer client education overflow of tears onto the face - Correct Answer epiphora treatment for epiphora should not include... - Correct Answer corticosteroid or anesthetic eye gtts, may block healing and increase infection red,hot, tender swelling at edge of eyelid, most improve on their own - Correct Answer hordeolum/stye sinus pain felt behind the eye include what sinuses - Correct Answer ethmoid sinuses pressure over the cheek include what sinuses, - Correct Answer maxillary sinuses symptoms that confirm diagnosis of sinusitis - Correct Answer URI x 7 days plus 2 or more of the following colored nasal drainage poor response to decongestants facial/sinus pain/positional headache tender pinna/tragus erythematous ear canal swimming history - Correct Answer otitis externa

red bulging tympanic membrane - Correct Answer otitis media standard treatment for otitis media - Correct Answer amoxicillin 40-45 mg/kg/day divided in two doses x 10 days results in increased intraocular pressure, an emergency if left untreated, can cause blindness, occurs suddenly, dramatic onset of symptoms of blurry vision, red eyes, unilateral pain, pressure, headache, seeing halos, photophobia, loss of peripheral vision then central vision - Correct Answer Acute Angle-Closure glaucoma strategy to relieve middle ear pressure due to barotrauma - Correct Answer oral decongestants and nasal steroids type of hearing loss that occurs due to loud noises - Correct Answer sensorineural bone conduction is greater than air conduction, produces high frequency hearing loss that is bilateral and symmetrical - Correct Answer conductive hearing loss/presbycusis is cerumen impaction sensorineural or conductive hearing loss - Correct Answer conductive tests used to determine if hearing loss in conductive or sensorineural - Correct Answer Weber test & Rinne test if a client has persistent sore throat ,fever, throat pain ,difficulty swallowing, secretions, respiratory difficulty, stridor, but no pharyngeal erythema or cough... - Correct Answer Epiglottis posterior cervical lymph node swelling ,persistent sore throat, fever , malaise, not responding to treatment - Correct Answer test for mono using monospot test Treatmetn for group A strep pharyngitis - Correct Answer penicillin V 500mg BID or 250mg 4 x daily x 10 days or benzathine penicillin 1.2 million units IM once infection is almost always unilateral ,located between the tonsil and superior pharyngeal constrictor muscle - Correct Answer peritonsillar abscess Ig3 mediated, type 1 sensitivity. Turbinates pale - Correct Answer rhinitis/hay fever watery rhinorrhea nasal congestion nasal speech, mouth breathing - Correct Answer viral rhinitis

atopic triad consists of: - Correct Answer allergic rhinitis, asthma, eczema Janet is a 30 year old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspician of cauda equna compression. Which of the following is a sign or symptom of cauda equina compression? a. gastrocnemius weakness b. reduced or absent ankle refles c. numbness of the lateral foot d. paresthesia of the perineum and buttocks - Correct Answer d. paresthesia of the perineum and buttocks The patient has acute pancreatitis with 7 of the diagnostic criteria from Ranson's Criteria. In order to plan care, the clinician understands that this criteria score has which of the following meanings? a. a high mortality rate b. an increased chance of recurrence c. 7% chance of the disease becoming chronic d. all of the above - Correct Answer a. a high mortality rate Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load What does this indicate a. a favorable diagnostic trend b. disease progression c. the need to be more aggressive with Reuben's medications d. the eradication of the HIV - Correct Answer a. a favorable diagnostic trend Which is the differentiating symptom mbetween labyrinthitis and vestibular neuritis? a. symptoms with vestibular neuritis are usually acute in onset, whereas with labyrinthitis the onet is more gradual b. hearing loss may be associated with vestibular neuritis, but not with labyrinthitis c. symptoms with labyrinthitis are usually acute in onset, ,whereas with vesticular neuritis the onset is more gradual d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis. - Correct Answer d. hearing loss may be associated with labyrinthitis ,but not with vestibular neuritis. A 27 year old female presents with a chief complaint of burning and pain on urination. She has no previous history of urinary tract infection. what are some additional symptoms consistant with a diagnosis of lower UTI? a. back and abdominal pain b. fever, chills, costovertebral angle (CVA) tenderness

c. blood in urine and frequency d. foul-smelling discharge, perineal itch - Correct Answer c. blood in urine and frequency The differential diagnosis for vertigo can be classified into which of the following categories: a. peripheral vestibular disease b. CNS disorders c. Systemic disorders d. all of the above - Correct Answer d. all of the above Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? a. morning stiffness and limited mobility of the lumbar spine b. unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain c. Fever, chills, and elevated erythrocyte sedimentation rate d. pathologic fractures, severe night pain, weight loss and fatigue - Correct Answer b. unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain Preceptors must always see the patients that the students see in the clinical setting a. true b. false - Correct Answer a. true An 82 year old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differentials? a. BPH b. Prostate cancer c. UTI d. all of the above - Correct Answer d. all of the above Which causes the greatest percentage of mammalian bites? a. dogs b. cats c. humans d. rodents - Correct Answer a. dogs

Endoscopic report reveals the presents of Barrett's epithelium. Which of the following information should the clinician include in the explaination of the pathology report? a. this is a premalignant tissue b. this tissue is resistant to gastric acid c. this tissue supports healing of the esophagus d. all of the above - Correct Answer d. all of the above Which of the following data are indicative of testicular torsion? a. absent cremasteric reflux b. pain relived on testicular elevation c. testicle very low in the scrotum d. swollen scrotum with a red dot sign - Correct Answer a. absent cremasteric reflux Most nosocomial pneumonias are caused by: a. Fungi. b. Viruses c. Gram-negative bacteria. d. Pneumococcal pneumonia. - Correct Answer c. Gram-negative bacteria. A family practice office for all 5 of your clinical rotations will guarantee that you will gain the required pediatric exposure a. true b. false - Correct Answer b. false The most common precancerous skin lesion found in Caucasians is a. skin tags b. actinic keratosis c. melanoma d. basal skin lesion - Correct Answer b. actinic keratosis Which obstructive lung disease is classified as reversible? a. Asthma b. Chronic bronchitis c. Emphysema d. COPD - Correct Answer a. Asthma Which of the following is an example of an articular structure a. bone b. synovium c. tendons

d. fascia - Correct Answer b. synovium Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation? a. posterior dislocations are more common than anterior dislocations b. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses - Correct Answer b. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses Which of the following statements is true concerning the management of the client with a herniated disc? a. muscle relaxants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use b. an epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred. c. intolerable pain for more than 3 months is an indication for surgical intervention d. all of the above - Correct Answer c. intolerable pain for more than 3 months is an indication for surgical intervention After 6 months of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? a. elevated TSH b. normal TSH c. low TSH d. undetectable TSH - Correct Answer b. normal TSH The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit? a. thryoid stimulating hormone (TSH) and free T b. TSH and thyrotoxin antibodies •High sensitivity thyroid stimulating hormone TSH and free T

• Free T4 and serum calcium - Correct Answer a. thryoid stimulating hormone (TSH) and free T Cat bites are commonly associated with which of the following pathogens? a. pasteurella multocida b. vibri vulnificus c. group B streptococcus

d. Group A beta hemolytic streptococcus - Correct Answer a. pasteurella multocida The 56 year old man with chronic prostatitis should be treated with trimethoprim 80mg- sulfamethoxazole 400 (TMP-SMX, Bactrim) for how long? a. 3-7 days b. 14-21 days c. 3-6 weeks d 6-12 weeks - Correct Answer d 6-12 weeks The A in SNAPPS stands for Assessment a. true b. false - Correct Answer b. false A patient is diagnosed with Giardia after backpacking trip in the mountains. Which of the following would be the appropriate treatement? a. Vancomycin b. Penicillin c. Metronidazole d. Bactrim - Correct Answer c. Metronidazole The most cost effective screening test to determine HIV status is which of the following? a. western blot b. enzyme-linked immunosorbent assay (ELISA) c. venereal disease research laboratory test (VDRL) d. Viral load - Correct Answer b. enzyme-linked immunosorbent assay (ELISA) The clinician sees a patient who is 5 feet tall and weighs 150 pounds (:BMI 29.3). How would the clinician classify this patient? a. overweight b. Mild Obesity c. Moderate Obesity d. morbid obesity - Correct Answer b. Mild Obesity One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular srtucture? A. Fascia B. Bone C. Synovium D. Tendons - Correct Answer C. Synovium

Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation? a. posterior dislocations are more common than anterior dislocations b. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses - Correct Answer b. there is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses Which of the following types of cellulitis is a streptococcal infection of the superficial layers of the skin which does not involve the subcutaneous layers? a. necrotizing fascitis b. periorbital cellulitis c. erysipelas d. flesh eating bacteria - Correct Answer c. erysipelas A 76 year old man is seen in the office for complaints of urinary incontinence. The clinican should suspect which of these causes of incontinence in men? a. urethral polyps b,. urinary tract infection (UTI) c. anticholinergic medications d. all of the above - Correct Answer d. all of the above Sally, aged 25, presents with impetigo that has been diagnosed as infected with staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. She has not been adequately treated recently. Which type of impetigo is this? a. Bullous impetigo b. Staphylococcal scalded skin syndrome (SSSS) c. Nonbullous impetigo d. Ecthyma - Correct Answer d. Ecthyma A 42 year old woman is seen in the clinic with fever, chills, vomiting and severe dysuria. She is diagnosed with acute pyelonepritis. How should this patient be managed? a. 3 day course of oral antibiotics b. hospitalization - Correct Answer b. hospitalization Which of the following are risk factors associated with obesity? a. diabetes b. skin infections

c. arthritis d. all of the above - Correct Answer d. all of the above Which of the following information is essential before prescribing Bactrim DS to a 24 year old woman witht urinary tract infection? a. last menstrual period b. method of birth control c. last unprotected sexual contact d. all of the above - Correct Answer d. all of the above A 22 year old male is seen in the clinic because he found a hard lump in his testicle during a testicular self exam (TSE). which of the following shoud be included in the differential diagnosis. a. testicular cancer b.. inguinal hernia c. varicocele d. all of the above - Correct Answer d. all of the above Which of the following dietary information should be given to a patient with gastroesophageal reflux disease (GERD)? a. eliminate coffee b. drink peppermint ice to relieve stomach distress c. recline and rest after meal d. limit the amount of antacids - Correct Answer a. eliminate coffee Which of the following are predisposing factors for pyelonephritis? a. pregnancy d. dehydration c. smoking d. alkaline urine - Correct Answer d. alkaline urine A patient is seen in the clinic with right upper quadrant pain (RUQ) that is radiating to the middle of the back. The clinical suspects acute cholelithasis. The clinician should expect with of the following laboratory findings? a. Decreased alanine anminotransferase (ALT) and aspartate aminotransferase (AST) b. elevated alkaline phosphatase c. elevated indirect biliruben d. decreased white blood cell (WBC) count - Correct Answer b. elevated alkaline phosphatase

A 25 year old patient presents to the clinic with fatigue, cold intolerance, weght gain and constipation for the past 3 months. On physical exam, the clinican notices a sinus bradycardia, muscular stiffness, coarse dry hair and a delay in relaxation in deep tendon reflexes (DTR's). Which of the following tests should be ordered next? a. Serum Calcium b. Thyroid Stimulating Hormone (TSH) c. electrolytes d. urine specific gravity - Correct Answer b. Thyroid Stimulating Hormone (TSH) You are preforming muscle strength testing on a patient presenting with musculoskeletal pain and find that the patient has complete range of motion with gravity eliminated. Which numeric grade of muscle strength would you give this patient? a. 1 b. 2 c. 3 d. 4 - Correct Answer b. 2 The patient is diagnosed with overactive bladder (OAB). Which of the following instructions should be given to this woman? a. Limit the amount of water that you drink b. eliminate caffeine from your diet c. wear panty liners d. all of the above - Correct Answer b. eliminate caffeine from your diet A 28 year old patient is seen in the office with colicky abdominal pain, particularly with meals. She has frequent constipation, flatulence and abdominal distention. Which of the data makes a diagnosis of diverticulitis unlikely? a. her age b. frequent constipation c. flatulence d. colicky abdominal pain - Correct Answer a. her age Treatment for epididymitis includes which of the following? a. warm sitz baths b. scrotal elevation c. masturbation d. all of the above - Correct Answer b. scrotal elevation Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition?

a. there are round hypopigmented macules on his back b. there are red papules on his face c. there are crusted placques in Josh's groin area d. there are white streaks on his neck - Correct Answer a. there are round hypopigmented macules on his back The clinican has instructed Sam, a 25 year old patient with low back strain, to use NSAID's to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate withn teaching sam about the use of NSAID' to manage his pain a. you should start with the lowest dose that is effective in managing your pain because long term use of NSAIDS can result in gastrointestinal (GI) disorders such as ulcers and hemmorhage b. you should start with the lowest dose that is effective in managing your pain in order to avoid developing tolerance to the medication c. you should take the maximum recommended dose of NSAID's so that you will not need to take narcotics to control your pain - Correct Answer a. you should start with the lowest dose that is effective in managing your pain because long term use of NSAIDS can result in gastrointestinal (GI) disorders such as ulcers and hemmorhage Which of the following patients are at risk for developing urinary tract cancer? a. the 45 year old woman who is 100 pounds overweight b. the 78 year old man who smokes three packs of cigarettes a day c. the 84 year old man who worked in the asbestos mines d. all of the above - Correct Answer d. all of the above SNAPPS pneumonic used to describe a technique in orally presenting a patient. A. true b. false - Correct Answer A. true The clinician is caring for Diane, a 22 year old woman who presents with an injured ankle. Diane asks if she will need an x-ray. The clinician explains to Diane that an x-ray is not always necessary for an injured ankle and that the decision to obtain radiography is dependent on the exam and Diane's description of the injury. Which of the following clues in Diane exam or history would alert the clinician to the need for obtaining radiographs a. if she was not able to bear weight immediately after the injury b. if the ankle developed marked swelling and discoloration after the injury c. if crepitation occurs with palpation or movement of the ankle d. all of the above - Correct Answer d. all of the above

A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting and diaphoresis. In addition to nephrolithasis, which of the following should be added to the list of differential diagnosis a. Pancreatitis' b. peptic ulcer disease c. diverticulitis d all of the above - Correct Answer d all of the above Acute angle-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure a. 0 to 7 mmHg b 8 to 21 mmHg c. 22 to 40 mmHg d. 40-80mmHg - Correct Answer b 8 to 21 mmHg A 28 year old patient is seen with complaints of diarrhea. Which of the following questions would help the clinician establish the diagnosis of irratible bowel syndrome? a. Feels relief after a bowel movement b. sometimes is constipated c. does not defecate in the middle of the night d. all of the above - Correct Answer d. all of the above The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection? a. HSV Type 2 b HIV c Pneumonia d. Syphilis - Correct Answer b HIV Mrs. Gary is a 55 year old woman who presents with tightness, pain and limited movement in her right shoulder. She denies any history of trauma. Her exam reveals a 75% reduction in both active and passive range of motion of the right shoulder. Mrs. Gray is also experiencing tenderness with motion and pain at the deltoid insertion. HEr medical history is significant for type 1 DMm and HTN. HEr social history reveals that she is a secretary ant that she is right handed. Based on her exam and medical history, you suspect adhesive capulitis or "frozen shoulder" Which clue in Mrs. Grays history supports the diagnosis? a. history of hypertension b. her affected shoulder is also her dominant hand c. her history of diabetes - Correct Answer c. her history of diabetes

A 63 year old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis? a. Psychogenic nocturia b. Urethral polyp c. Irritative posterior urethral lesion d. Benign prostatic hypertrophy - Correct Answer d. Benign prostatic hypertrophy Joyce is seen in the clinic complaining of vague symptoms of feeling nervous and irritable, and that her hair will not hold a curl anymore. On physical exam, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis could be which of the following?

• Myxedema
• Cushing's Syndrome
• Pan-hypopituitism
• Thyrotoxicosis - Correct Answer • Thyrotoxicosis As diabetic retinopathy progresses, the presence of "cotton wool" spots can be detected. Cotton wool spots refer to: a) Venous beading. b) Retinal hemorrhage. c) Nerve fiber layer infarctions. d) Blood vessel proliferation - Correct Answer c) Nerve fiber layer infarctions. Which of the following instructions should be given to a patient with nephrolithasis? a. take ibuprofen 600mg every 8 hours b. take tums for upset stomach c. drink more black tea d. increase intake of vegetables like spinach - Correct Answer a. take ibuprofen 600mg every 8 hours Joyce is taking a long-acting beta agonist for her moderate persistent asthma. What additional medication should she be taking? a. Inhaled corticosteroid (Flovent) b. Leukotriene receptor antagonist c. Systemic corticosteroid (Prednisone) d. Methyl xanthenes (Theophylline - Correct Answer a. Inhaled corticosteroid (Flovent) You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is: A. Articular

B. Inflammatory C. Nonarticular D. A and B - Correct Answer A. Articular Harvey has a rubbery, smooth, round mass on his chest which is compressible and has a soft to very firm texture. What do you diagnose this as? a. Lipoma b. Nevi c. skin tag d. Adenoma - Correct Answer a. Lipoma The patient with Gastroesophageal reflux disease (GERD) should be instructed to eliminate which of these activities? a. Swimming b. weight lifting c. Golfing d. Walking - Correct Answer b. weight lifting ...responded to antibiotic therapy. Which of the following actions should be taken next? a. send a urine specimen for microscopy looking for fungal colonies b. increase the dose of the antibiotic c. order a cystoscopy d. order a different antibiotic - Correct Answer a. send a urine specimen for microscopy looking for fungal colonies Cydney was just diagnosed with mild, intermittant asthma. Which if the most appropriate medication for her? a. short acting beta-agonist as needed b. short acting beta-agonist twice a day c. long acting beta agonist as needed d. long acting beta agonist twice a day - Correct Answer a. short acting beta-agonist as needed A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that may cause hematuria a. NSAIDS b. Beets c. Vitamin A d. Red meat - Correct Answer a. NSAIDS

What is the most common cause of anemia a. anemia of chronic disease b. sideroblastic anemia c. iron deficiency anemia - Correct Answer c. iron deficiency anemia The clinical suspects that a client has patellar instability. In order to test for this, the client is seated with the quadriceps relaxed and the knee is placed in extension. NExt the patella is displaced laterally and the knee flexed to 30 degrees. IF instability is present, this maneuver displaces the patella to an abnormal position on the lateral femoral condyle, and the client will perceive pain. Testing for patellar instability in this way is known as: a. apprehension sign b. bulge sign c. thumb sign d. none of the above - Correct Answer a. apprehension sign If your preceptor is out ill on a day that you are scheduled to be in the clinical setting, another preceptor can supervise you as long as they are willing to take you on as a student and they meet the minimum preceptor qualifications. a. true a. false - Correct Answer a. false Which of the following should be considered in a patient presenting with erectile dysfunction a. diabetes mellitus b. hypertension c. atherosclerosis d. all of the above - Correct Answer d. all of the above A 23 year old sexually active man is seen in the clinic with unilateral painful testicular swelling and diagnosed with epididymitis. In order to prescribe the correct drub, the clinician understands that which of these is them most common causative organism? a. escheichia coli b. staphylococcus aureus c. chlamydia trachomatis d. pseudomonas aerugonisa - Correct Answer c. chlamydia trachomatis The most common offending agents for medication induces resting tremor are: a. selective serotonin reuptake inhibitore (SSRIs) b. Beta-Blockers

c. Floroquinolone antibiotics d. anti-psychotics - Correct Answer d. anti-psychotics Which of the following type of tremor is characterized by an increase in amplitude when the patient attemps voluntary movements a. resting tremor b. postural tremor c. intention tremor d. medication-induced tremor - Correct Answer c. intention tremor Ian, age 62, presents with a wide, diffuse area of erythematous skin on his left lower leg that is warm and tender to palpation. There is some edema involved. You suspect: a. Necrotizing fasciitis. b. Kaposi's sarcoma. c. Cellulitis. d. A diabetic ulcer. - Correct Answer c. Cellulitis. Parkinsons disease is a progressive neurological disorder that is associated with which type of tremor? a. resting tremor b. postural tremor c. intention tremor d. medication induced tremor - Correct Answer a. resting tremor Which information should be included when you are teaching your patient about the use of nicotine gum? a. the gum must be correctly chewed to a softened state then placed in the buccal mucosa b. patients should not eat for 30 minutes prior to or during the use of the gum c. initially, one piece is chewed every 30 minutes while awake d. acidic foods and beverages should be encouraged during nicotine therapy - Correct Answer a. the gum must be correctly chewed to a softened state then placed in the buccal mucosa Severe pain associated with acute otitis media signifies perforation of the tympanic membrane. a. true b. false - Correct Answer b. false Jason, aged 62, has obstructive sleep apnea. What do you think is one of his contributing factors?

a. He is a recovering alcoholic of 6 years. b. His collar size is 19 inches. c. He is the only person in his family who has this. d. He is extremely thin. - Correct Answer b. His collar size is 19 inches. The "B" in the ABCDEs of assessing skin cancer represents: a. biopsy b. best practice c. boundary d. border irregularity - Correct Answer d. border irregularity The patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication? a. diarrhea b. Parkinson's disease c. closed-angle Glaucoma d. Breast cancer - Correct Answer c. closed-angle Glaucoma A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinican expect as a manifestation of the disease? a. sinus bradycardia b. atrial fibrillation c. supraventricular tachycardia d. U-waves - Correct Answer a. sinus bradycardia Tori is on systematic antifungals for a bad tinena infection. You understand that serum labs should be monitored for: a. renal failure b. hepatotoxicity c. electrolyte imbalance d. leukocytosis - Correct Answer b. hepatotoxicity Which of the following signs or symtoms indicate an inflammatory etiology to musculoskeletal pain? a. decreased C-reactive protein b. hyperalbuminemia c. morning stiffness - Correct Answer c. morning stiffness A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis?

a. very early b 3-4 hours after perforation c. late in inflammation d. appendicitis never presents with vague pain - Correct Answer a. very early A patiennt presents to the clinicians office with a sore throat, fever of 100.7 and tender anterior cervical lymphadenopathy. The clinican suspects strep throat and performs a rapid strep test that is negative. What would the next step be? a. the patient should be instructed to rest and increase fluid intake as the infection is most likely viral and resolve without antibiotic therapy b. because the patient does not have strep throat, the clinican should start broad spectrum antibiotics in order to cover the offending pathogen c. a throat culture should be preformed to confirm the results of the rapid strep test - Correct Answer c. a throat culture should be preformed to confirm the results of the rapid strep test Which of the following statements is true regarding the treatment of carpel tunnel syndrome? a. the goal of treatment is to prevent flexion and extension movements of the wrist b. splints are used in carpal tunnel syndrome because the allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position c. corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring and infection d all of the above - Correct Answer d all of the above Which statement about HIV post-exposure prophylaxis (PEP) for healthcare workers is most accurate? a. PEP should be started within hours after the exposure b. PEP should be started within 73 hours after the exposure c. Renal and hepatic function tests should be done 6 weeks after beginning PEP d. PEP will prevent potential hepatitis-C infection if present - Correct Answer a. PEP should be started within hours after the exposure Sinusitis is considered when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater then: a. 4 weeks

b. 8 weeks c. 12 weeks d. 16 weeks - Correct Answer c. 12 weeks A patient presents with the following signs and symptoms: gradual onset of low grade fever, marked fatigue, severe sore throat and posterior cervical lymphadenopathy. Based on the signs and symptoms alone, which of the following conditions is most likely the cause? a. gonorrhea b. mononucleosis c. influenza d. herpes zoster - Correct Answer b. mononucleosis In which of the following situations would referral to a specialist be needed for sinusitis a. recurrent sinusitis b. allergic sinusitis c. sinusitis that is refractory to antibiotic therapy d. all of the above - Correct Answer d. all of the above Heart valve damage resulting from acute rheumatic fever is a long-term sequelae resulting from infection with which of the following pathogens? a. coxsackievirus b. cytomegalovirus c. francisella tularensis d. group A streptococcus - Correct Answer d. group A streptococcus What is the recommended calcium intake for adults over the age of 50 with low bone mass? a. 1200mg/day b 1000mg/day c. 1300mg/day d. 1500mg/day - Correct Answer d. 1500mg/day A 14 year old is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action? a. obtain a scrotal ultrasound b. obtain a computed tomography scan (CT) c. instruct the patient to elevate the scrotum d. send the patient to the Emergency room - Correct Answer c. instruct the patient to elevate the scrotum d. send the patient to the Emergency room

All students are subject to review of clinical logs to ensure that they have received a well-rounded experience a. true b. false - Correct Answer a. true A 30 year old patient presents with pain on urination. The urine microscopy of unspun urine showed greater than 10 leukocytes/ml and a dipstick was possible for nitrates. What is the probable diagnosis? a. lower urinary tract infection b. chlamydia infection c. candidiasis d. pyelonephritis - Correct Answer b. chlamydia infection Fluctuations and reductions in estrogen may be a contributing factor in which type of rhinitis? a. vasomotor rhinitis b. rhinitis medicamentosum c. atophic rhinitis d. viral rhinitis - Correct Answer a. vasomotor rhinitis John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear? a. valgus stress test b. McMurray circumduction test c. Lachman's test d. Varus stress test - Correct Answer b. McMurray circumduction test Your patient has decided to give Chantix a try to quit smoking. YOu are discussing his quit date, and he will begin taking the medication starting tomorrow. When should he plan to quit smoking? a. he should stop smoking today b. he should stop smoking tomorrow c. his quit date should be in one week d. he will be ready to quit after the first 30 days - Correct Answer c. his quit date should be in one week

The patient is prescribed radioactive iodine (RAI) and asks the clinician how this drug works. The clinicans response should include which of the following data? a. RAI prevents the peripheral conversion of T4 to T3 b. RAI binds to free T4 c. RAI destroys thyroid tissue d. RAI reduces freely circulating iodine - Correct Answer c. RAI destroys thyroid tissue Not sure of the question...something about the oral mucosa membranes a. vincents stomatitis b. allergic stomatitis c. apthous stomatitis d. herpetic stomatitis - Correct Answer a. vincents stomatitis