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NSG 6440 Practice Test MAJORITY Which of the following antihypertensive medications would you avoid prescribing for an elderly white female with the comorbid diagnosis of osteoporosis? a.Beta blockers b.Calcium channel blockers c.Ace inhibitors
d.Diuretics - correct answer Calcium channel blockers
Which of the following class of drugs is preferred treatment for a diabetic with stage II hypertension? a.Calcium channel blockers b.Alpha blockers c.Angiotensin converting enzyme inhibitor
d.Loop diuretics - correct answer Angiotensin converting enzyme inhibitor
You are caring for a 30-year-old white male in your office with a BP of 144/90. He has never had a diagnosis of hypertension. He doesn't check his blood pressure at home. He has a family history of hypertension. What are your recommendations? a.Start HCTZ 12.5mg daily, purchase a blood pressure cuff, and return to your office in 1 mth b.Instruct to purchase a BP cuff, record blood pressures, call if over 140's over 90's, low salt diet, return in 2 weeks. c.Order EKG, CMP, CBC, and lipid panel, and refer to cardiology.
d.Order a cardiac stress test and lipid panel. - correct answer Instruct to
purchase a BP cuff, record blood pressures, call if over 140's over 90's, low salt diet, return in 2 weeks
You are treating a young adult female with HTN and migraine headaches. Which class of medications could you choose to treat both? Ace inhibitors Calcium channel blockers Beta blockers
Angiotensin receptor blockers - correct answer Beta blockers
A 42-year-old male presents with the following lipid profile. He is not on any medications for cholesterol or herbal supplements. Total: 210 LDL: 145 TG 162 HDL 52 What medication would you recommend? a.Low dose statin b.Low dose bile acid sequestrant c.Low dose fibrate
d.Fish oil - correct answer Low dose statin
You are caring for a 68-year-old male who has been taking atorvastain (Lipitor) for 8 weeks. He complains of fatigue, muscle aches, and dark- colored urine. Which of the following is the most appropriate treatment plan? a.Order a CBC and CMP. b.Order lipid level and serum creatine phosphokinase (CPK, creatine kinase) c.Order a 24 hr urine
d.Recommend increasing his fluids and rest. - correct answer Order
lipid level and serum creatine phosphokinase (CPK, creatine kinase).
S1, S2, and S
S1, S2, and S3 - correct answer S
While performing a routine physical exam on a 60-year-old hypertensive male, you notice a bruit over the carotid area on the left side of the neck. There is no induration of the skin. This patient is at higher risk for: Stroke and coronary heart disease Temporal arteritis and brain aneurysms Abdominal aneurysm and congestive heart gailure
Dizziness and headaches - correct answer Stroke and coronary heart disease
A 72-year-old female presents to your office with gradual difficulty breathing, non-productive cough, bilateral swelling of her feet, and a 10 pound weight gain. Upon examination you hear crackles and rhonchi with an S3 heart sound. What is the most likely diagnosis? COPD Renal hypertension Congestive heart hailure
Asthma - correct answer Congestive heart failure
What is your treatment plan for this patient with difficulty breathing, cough, weight gain, edema, and S3 heart sounds? Rest and increase fluids Diuretics, digoxin, and anti-hypertensive medications Nebulized albuterol and prednisone
Anti-coagulation and cardiology evaluation - correct answer Diuretics,
digoxin, and anti- hypertensive medications You are treating a 49-year-old female who presents with fatigue and palpitations. You check her apical pulse and she is irregular and tachycardic. You obtain an EKG and it reveals afib with rapid ventricular response. What is your treatment plan?
You order a 2D echo. You admit her to the hospital for new onset afib. You perform cardiac massage and have her relax.
You order a cardiology consult. - correct answer You admit her to the
hospital for new onset afib. Upon examination of a 17-year-old during a sports physical, you hear a split S2 during inspiration that disappears during expiration. The patient denies chest pain and dyspnea. What will you tell the mother and patient regarding your findings? You advise the patient to avoid strenuous physical activity until further investigation You recommend a referral to cardiology. Due to the patient being an athlete, you recommend a stress echo Educate the mother and patient that this is a benign
finding - correct answer Educate the mother and patient that this is
a benign finding. The first sign of an asthma exacerbation is: Cough Wheez e Dyspn ea
Chest tightness - correct answer Cough
According to the NAEPP-3 Guidelines for the Treatment and Management of Asthma, what is the gold standard for daily treatment of mild-persistent asthma?
Albuterol/Atrovent inhaler 2 puffs QID 7 - 10 day prednisone spurt, Albuterol/Atrovent inhaler 2 puffs QID Z-pak, 7 - 10 day prednisone spurt, Atrovent inhaler
2 puffs QID - correct answer 7-10 days prednisone spurt,
Albuterol/Atrovent inhaler 2 puffs QID All of the following are useful in treating patients with COPD except: Antihistamine s Anticholinergi cs Oral steroids
Short-acting beta2-agonists - correct answer Antihistamines
Which of the following is less likely to be found in a patient with emphysema dominant COPD? A cough that is productive with large amounts of sputum Prolonged expiration Exertional dyspnea
Weight loss - correct answer A cough that is productive with large amounts of
purulent sputum You are treating a patient in your office whom you suspect has chronic lung disease, but you are unsure if you should start treatment today. What do you consider ordering first? A pulmonary consult A chest
x-ray An office spirometry
A pulmonary function test - correct answer An office spirometry
a.Asthma.. b.Sinusitis. c.Allergic or vasomotor rhinitis.
d.Influenza. - correct answer c. Allergic or vasomotor rhinitis.
Your patient with hypertension comes in and insists that one of his new medications is causing him to cough. When looking at his list of medications, you think the cough must be from: a.Metoprolol (Toprol XL). b.Tadalafil (Cialis). c.Clopidogrel (Plavix).
d.Captopril (Capoten). - correct answer d. Captopril (Capoten).
African American patients seem to have a negative reaction to which of the following asthma medications? a.Inhaled corticosteroids b.Long-term beta-agonist bronchodilators c.Leukotriene receptor agonist
d.Oral corticosteroid - correct answer b. Long-term beta-agonist
bronchodilators Sam, age 78, presents to the clinic with respiratory symptoms. His pulmonary function tests (PFTs) are as follows: a normal total lung capacity, a decreased PaO2, and an increased PaCO2. On assessment, you auscultate coarse crackles and forced expiratory wheezes. What is your diagnosis? a.Asthma b.Emphysema c.Chronic bronchitis
d.Influenza - correct answer c. Chronic bronchitis
You are using the CURB-65 clinical prediction tool to decide whether Mabel whom you have diagnosed with community-acquired pneumonia (CAP) should be hospitalized or could be treated at home. Her score is 3. What should you do? a.Consider home treatment. b.Plan for a short inpatient hospitalization. c.Closely supervise her outpatient treatment. d.Hospitalize and consider admitting her to the intensive care unit (ICU). -
correct answer d. Hospitalize and consider admitting her to the
intensive care unit (ICU). Why do you suspect that your patient may have a decreased response to the tuberculin skin test (TST)? a.She is on a high-protein diet. b.She is an adolescent. c.She has been on long-term corticosteroid therapy.
d.She just got over a cold. - correct answer c. She has been on long-
term corticosteroid therapy. Marci has been started on a tuberculosis (TB) regimen. Because isoniazid (INH) may cause peripheral neuropathy, you consider ordering which of the following drugs prophylactically? a.Pyridoxine b.Thiamine c.Probiotic
d.Phytonadione - correct answer a. Pyridoxine
Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean? a.The tumor size cannot be evaluated, the cancer has not spread to the lymph nodes, and the distant spread cannot be evaluated.
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 the nicotine
therapy. - correct answer a. The gum must be correctly chewed to a
softened state and then placed in the buccal mucosa. Your patient states he has a strep throat infection. Which of the following symptoms makes you consider a viral etiology instead? a.Fever b.Headache c.Exudative pharyngitis
d.Rhinorrhea - correct answer d. Rhinorrhea
What is the first-line recommended treatment against Group A B -hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis? a.Penicillin b.Quinolone c.Cephalosporin
d.Macrolide - correct answer a. Penicillin
Cydney presents with a history of asthma. She has not been treated for a while. She complains of daily symptoms but not continual, greater than 1 week and at nighttime. She has been using her rescue inhaler. Her FEV1 is 60% to 80% predicted. How would you classify her asthma severity? a.Mild intermittent b.Mild persistent
c.Moderate persistent
d.Severe persistent - correct answer c. Moderate persistent
Joyce is taking a long-acting beta agonist for her asthma. What additional medication should she be taking? a.Inhaled corticosteroid b.Leukotriene receptor antagonist c.Systemic corticosteroid
d.Methyl xanthenes - correct answer a. Inhaled corticosteroid
Your patient is on Therabid for his asthma. You want to maintain his serum levels between: a.0 to 5 μg/mL. b. 5 to 10 μg/mL. c. 5 to 15 μg/mL.
d. 10 to 20 μg/mL. - correct answer c. 5 to 15 μg/mL.
George has chronic obstructive pulmonary disease (COPD) and an 80% forced expiratory volume in 1 second. How would you classify the severity of his COPD? a.Stage 1 mild COPD b.Stage 2 moderate COPD c.Stage 3 severe COPD
d.Stage 5 very severe COPD - correct answer a.
Stage 1 mild COPD Most nosocomial pneumonias are caused by: a.Fungi. b.Viruses c.Gram-negative bacteria.
d.Pneumococcal pneumonia. - correct answer c. Gram-negative bacteria.
Which of the following statements is true regarding tuberculin skin testing (TST)? a.Tests should be read 48 hours after the injection.
c.It is more common in men than in women and occurs almost entirely in cigarette smokers. d.It is aggressive, with rapid growth and early local and distant
metastases via the lymphatic and blood vessels. - correct answer b. It is
the most prevalent carcinoma of the lung in both sexes and in nonsmokers, representing 35% to 40% of all tumors. 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 17 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 17 inches.
A patient is seen in the clinic with a chief complaint of hematuria. Which of the following data should be collected in order to make a differential diagnosis? a."Do you have a history of liver disease?" b."What medications are you currently taking?" c."Have you noticed swelling in your ankles?"
d.All of the above - correct answer b. "What medications are you currently
taking?" The result of the patient's 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions? a.Repeat the test. b.Refer to a nephrologist. c.Measure the serum protein.
d.Obtain a blood urea nitrogen (BUN) and creatinine. - correct
answer b. Refer to a nephrologist.
The patient is seen complaining of "leaking urine when I sneeze." Which of the following actions should the clinician take first? a.Order a cystometrogram b.Obtain a computed tomography (CT) scan c.Instruct the patient on Kegel exercises
d.Prescribe Imipramine - correct answer c. Instruct the patient on Kegel
exercises 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 might be the cause of hematuria? a.NSAIDs b.Beets c.Vitamin A
d.Red meat - correct answer a. NSAIDs
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 (UTI). What are some additional symptoms consistent 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 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 positive for nitrites. What is probable diagnosis? a.Lower urinary tract infection b.Chlamydia infection c.Candidiasis
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 34-year-old patient was treated for a urinary tract infection (UTI) and has not 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 antibiotic. c.Order a cytoscopy.
d.Order a different antibiotic. - correct answer a. Send a urine specimen for
microscopy looking for fungal colonies. Which of the following are predisposing factors for pyelonephritis? a.Pregnancy b.Dehydration c.Smoking
d.Alkaline urine - correct answer a. Pregnancy
A 42-year-old woman is seen in the clinic with fever, chills, vomiting, and severe dysuria. She is diagnosed with acute pyelonephritis. How should this patient be managed? a.3-day course of oral antibiotics b.Hospitalization
c.Encourage cranberry juice intake
d.6-week course of antibiotics - correct answer b. Hospitalization
A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses? a.Pancreatitis b.Peptic ulcer disease c.Diverticulitis
d.All of the above - correct answer d. All of the above
Which of the following instructions should be given to the patient with nephrolithiasis? a.Take ibuprofen 600 mg every 8 hours. b.Take Tums for stomach upset. c.Drink more black tea.
d.Increase intake of vegetables like spinach. - correct answer a. Take
ibuprofen 600 mg every 8 hours. Which of the following patients is at risk for developing urinary tract cancer? a.The 45-year-old woman who is 100 lbs 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
A patient is seen in the clinic and diagnosed with Stage I renal cancer. The provider should refer to a nephrologist for which of these appropriate treatments? a.Chemotherapy b.Nephrectomy
