WT FNP study guide Questions with verified Answers 100% correct, Exams of Nursing

Download WT FNP study guide Questions with verified Answers 100% correct and more Exams Nursing in PDF only on Docsity! WT FNP study guide Questions with verified Answers 100% correct Your patient Kenneth, age 62, presents to the clinic with pruritis and complaints of lymphadenopathy in his neck. He also complains of night sweats and a low grade fever. He has no weight loss and otherwise feels well today. He is widowed and has been dating a new woman recently. On physical exam, you find enlarged supraclavicular nodes. You suspect a diagnosis of - Correct Answer -hodgkins lymphoma The majority of the body's iron is obtained from: - Correct Answer -recycled iron content from aged RBCs Physical examination findings in otitis externa include: - Correct Answer - increased ear pain with tragus palpation When should a rescue course of prednisolone be initiated for an attack of asthma? - Correct Answer -Whenever the client needs it, at any time and any step Decongestants work primarily through: - Correct Answer -Vasoconstriction The first choice of therapy for a client who is positive for HIV and has oral candidiasis is : - Correct Answer -Clotrimazole troches (10mg) five times daily or nystatin (Mycostatin) suspension 500,000-1,000,000 units three to five times daily - Because of the common recurrence of oral candidiasis and increased rates of drug resistance, systemic fungicides, such as fluconazole, ketoconazole, and griseofulvin, should be reserved for severe cases, such as esophageal candidiasis and clients with dysphagia. When a neonate is initially protected against measles, mumps, and rubella because the mother is immune, this is an example of which type of immunity? - Correct Answer -natural passive Which of the following best describes asthma? - Correct Answer -chronic airway inflammation with superimposed bronchospasm One of the most prominent clinical features of bronchiolitis is: - Correct Answer -Wheezing Antihistamines work primarily through: - Correct Answer -action on the histamine-1 (H1) receptor sites What would you expect to find in a patient with acute rhinosinusitis? - Correct Answer -Erythematous & edematous nasal mucosa w/o purulence & watery discharge Which of the following best describes hearing loss associated with presbycusis? - Correct Answer -slowly progressive, usually symmetric, and predominantly high frequency A risk factor for external otitis is: - Correct Answer --Swimming -Hot/humid climates -Trauma (qtips, pens etc) -Hearing aids (trauma) -Atopic dermatitis Treatment of viral conjunctivitis can include: - Correct Answer -No Antibiotic Therapy Needed The Epstein-Barr virus is primarily transmitted via: - Correct Answer - oropharyngeal secretions Joanne, age 16, has had her asthma well controlled by using only a beta- adrenergic metered-dose inhaler. Lately, she has had difficult breathing during the night, and her sleep has been interrupted about three times a week. What do you do? - Correct Answer -Prescribe an inhaled steroid Careful observation for 24 hours post ingestion In patients with varicose veins, which vessel is most often affected? - Correct Answer -Saphenous Deep vein thrombosis may result in: - Correct Answer -generalized edema of the involved extremity After a history, exam and lab tests, a patient is diagnosed with irritable bowel syndrome. Which initial treatment is considered most appropriate? - Correct Answer -Either adoption of high fiber diet or excluding trigger foods from diet Sue has an acute exacerbation of Crohn's disease. Which laboratory test value(s) would you expect to be decreased? - Correct Answer -Vitamins A, B complex, and C levels The proper order of assessing the abdomen is: - Correct Answer -Inspection, auscultation, percussion, palpation The clinical presentation of Irritable Bowel Syndrome most likely includes which set of symptoms? - Correct Answer -abdominal pain, diarrhea, constipation Kathy has celiac disease. You place her on which diet? - Correct Answer - Gluten-free diet Dan, age 76, has GERD. When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid? - Correct Answer -Peppermint Which of the following laxatives listed below is safe for long-term use? - Correct Answer -*With this text there was no option for polyethylene glycol, which has been the answer on previous exams* Bulk-forming laxatives (Metamucil, Citrucel, etc.) A patient asks for advice about a medication that will produce rapid relief if he is having heartburn symptoms. What should the nurse practitioner recommend? - Correct Answer -Calcium carbonate Urinary tract infections in the male patient are divided into upper and lower tract infections. What is an example of an upper tract infection in a male patient? - Correct Answer -Pyelonephritis Which of the following medications can cause acute urinary retention in a man with BPH? - Correct Answer -Amitriptyline Therapy for hemorrhoids includes all of the following EXCEPT: - Correct Answer -Low-fat diet You receive a urinalysis back from the lab with a finding of RBC casts and microscopic hematuria. What is the patient's likely diagnosis? - Correct Answer -Glomerulonephritis Dietary management for the patient in acute renal failure includes: - Correct Answer -limiting fluids, eating a low-protein diet, limiting salt, potassium, phosphorous, and other electrolytes The presentation of acute epididymitis includes: - Correct Answer -the presence of a positive Prehn sign. Scrotal elevation relieves pain in epididymitis but not torsion What is a causative factor in the formation of blood clots causing deep venous thrombus? - Correct Answer -Hypercoagulability Urine specific gravity is increased in patients with: - Correct Answer - Dehydration Rectal bleeding associated with hemorrhoids is usually described as: - Correct Answer -streaks of bright red blood on stool Which physical examination maneuver for diagnosing appendicitis is done by deep palpation over the left lower quadrant with resultant pain in the right lower quadrant? - Correct Answer -Rovsing's test Finasteride is helpful in the treatment of BPH because of its effect on - Correct Answer -blocks the conversion of testosterone to dihydrotestosterone, reduces prostate size Which of the following is most consistent with a person presenting with unstable angina? - Correct Answer -chest pressure lasting 20 minutes that occurs at rest Signs of right-sided heart failure include: - Correct Answer -signs of fluid retention The American Diabetes Association recommends intensive management of diabetes for - Correct Answer -persons who already have a dx of beginning nephropathy, neuropathy, or retinopathy Which brand name medication is a Glucagon like peptide? - Correct Answer - I don't remember the options, but the more popular ones are Byetta and Victoza Virginia, age 62, has type 1 diabetes that is well controlled by insulin. Recently, she has developed an ingrown toenail. As a result of this infection, it is possible that she will - Correct Answer -Require an increase in her daily insulin dosage Daniel, a patient with type 1 diabetes, is hospitalized with a diagnosis of diabetic ketoacidosis. Which of the following signs and symptoms would be consistent with this condition? - Correct Answer -Dry skin and ketonuria and polyuria In order to determine how much T4 replacement a patient needs to re- establish a euthyroid state, the FNP considers: - Correct Answer -the patient's body weight Which of the following characteristics BEST applies to type 1 Diabetes Mellitus? - Correct Answer -significant hyperglycemia and ketoacidosis result from lack of insulin Which of the following lab values would most likely confirm a diagnosis of hyperthyroidism? - Correct Answer -Low TSH, increased free T3, normal free T4 smoking diet sedentary lifestyle alcohol use - Correct Answer - According to DSM-5, a diagnosis of depression must include either depressed mood or which of the following? - Correct Answer -loss of interest or pleasure You are performing some neurological assessment tests on Daniel. When you ask Daniel to lie supine and flex his head to his chest, what are you assessing? - Correct Answer -Brudzinski sign You are a nurse practitioner who is initiating levothyroxine for primary hypothyroidism in a 71 year old female. The usual starting dose of levothyroxine is 50-100 mcg per day. What dose would be the most appropriate initial therapy for this patient? - Correct Answer -25 mcg per day Use of flunitrazepam (Rohypnol) has been associated with: - Correct Answer -Amnesia John, age 65, experienced a temporary loss of consciousness that was associated with an increased rate of respiration, tachycardia, pallor, perspiration, and coolness of the skin. How would you describe this? - Correct Answer -Syncope Mrs. Jones, age 82, has a curvature of the spine. This is likely to indicate which age-related change? - Correct Answer -Kyphosis What is the duration of action for Humulin R insulin? - Correct Answer -6-10 hours Criteria for the diagnosis of type 2 DM include:* a plasma glucose level of 126 mg/dL or greater after an 8 hour or greater fast on more than one occasion Which of the following should be periodically monitored with the use of a thiazolidinedione? - Correct Answer -ALT All of the following are causes of secondary hyperlipidemia except: - Correct Answer -renal failure Which of the following should be periodically monitored with the use of a biguanide? - Correct Answer -creatinine (Cr) A 43 year old patient comes to your office presenting with nausea and a fever of 104 degrees Fahrenheit. The patient said the fever appeared earlier in the day, and that he has vomited more than once prior to arriving to your office. During the examination, he states that he feels dizzy and lightheaded whenever he stands up. His vital signs indicate that he has low blood pressure. Based on these findings, which of these is the most likely diagnosis?* -Sorry guys I don't recall the options or answer What is the earliest detectable glycemic abnormality in a patient with type 2 diabetes mellitus?z Postprandial glucose elevation - Correct Answer - With regards to pathology of diabetes mellitus, which of the following factors plays a principal role in causing type 1 DM? - Correct Answer -β-cells of the pancreas do not produce sufficient insulin As a FNP, you know that all of the following are insulin analogs that can be used to manage DM except: - Correct Answer -Sorry guys, I don't recall the options to choose from Which of the following is a sign of hypothyroidism? - Correct Answer -Brittle hair • Anna, age 2, had a CBC drawn at her last visit. It indicates that she has a microcytic hypochromic anemia. What should you do now at this visit? - Correct Answer -Obtain lead level • Question 2 Folate-deficiency anemia causes which of the following changes in the RBC indices? - Correct Answer -Macrocytic, Normochromic • Question 3 Which presentation best describes a typical case of chicken pox? - Correct Answer - • Question 4 A 78 year old man comes to the clinic after having knee surgery. When examining his eyes you notice lens opacity. What is this finding a sign of? - Correct Answer -Cataracts • Question 5 Increased severity of underlying illness, presence of an indwelling urethral catheter, and use of broad-spectrum antibiotics are risk factors predisposing patients to the development of: - Correct Answer -Nosocomial PNE • Question 6 • Question 17 An 18 year old baseball player was hit in the eye with a baseball last evening. He went to the ER for evaluation and was cleared and told to follow up with his primary care provider in 1-2 days. He came in today to see you and complaints of visual changes and a dark visible fluid line at the bottom of his cornea. What is your most appropriate action? - Correct Answer -Refer to Opthamology • Question 18 Sonia, age 72, is complaining of dry skin. What do you advise her to do? - Correct Answer -Bathe or shower w lukewarm water and use a mild soap or skin cleanser • Question 19 Which of the following is a predisposing condition for furunculosis? - Correct Answer -DM • Question 20 Approximately 50% of children with viral croup have a(n) - Correct Answer -Tapered symmetric subglottic narrowing on x-ray • Question 21 Increased tactile fremitus occurs with? - Correct Answer -Lobar PNE • Question 22 What significant finding(s) in a child with otitis media with effusion would prompt more aggressive treatment? - Correct Answer -There is a change in the child's hearing threshold to greater than or equal to 25 decibels • Question 23 A 15 year old female presents to your clinic with rough, slightly red, bumps on the back and outer sides of her arms. She has had the outbreak for 2 years and wants treatment now that she is entering high school. Which condition do you suspect? - Correct Answer -Keratosis Pilaris • Question 24 A Wood's light is especially useful in diagnosing which of the following? - Correct Answer -Tinea Versicolor • Question 25 To best help parents foster social-emotional development in their preschooler, age 4, you should advise them to: - Correct Answer -Provide frequent opportunities to interact w other children • Question 26 Diagnosis of pseudomembranous colitis can be made from subjective symptoms and which of the following? - Correct Answer -Recent Antibiotic use • Question 27 According to Hale's Lactation Risk Category, a medication in which there is no controlled study on its use during lactation or controlled study shows minimal, non-life-threatening risk is listed as category: - Correct Answer -L3 • Question 28 How long after contact does the onset of clinical manifestations of syphilis typically occur? - Correct Answer -2-4 weeks • Question 29 The progestin component of hormone therapy is given to: - Correct Answer - Minimize Endometrial Hyperplasia • Question 30 The clinical presentation of peptic ulcer disease includes all of the following symptoms EXCEPT: - Correct Answer - • Question 31 A 24 year old man presents with a 3 month history of upper abdominal pain. He describes it as an intermittent, centrally located "burning" feeling Diagnosis of pseudomembranous colitis can be made from subjective symptoms and which of the following? - Correct Answer -Recent Antibiotic use • Question 42 Select the true statement regarding hyperbilirubinemia in an infant? - Correct Answer -Sclera, mucous membranes and palmar aspects of the hands and feet are good indicators • Question 43 Which of the following pharmacologic agents used to treat constipation may cause flatulence and bloating and requires adequate fluid intake? - Correct Answer -Bulking agents • Question 44 What is the most common cause of melena? - Correct Answer -Upper GI bleed • Question 45 You have diagnosed an infant with pyloric stenosis. What is the classic physical finding to help determine this diagnosis? - Correct Answer -Olive shape mass • Question 46 What choice below is most commonly associated with pancreatitis? - Correct Answer -Gallstones & alcoholism • Question 47 The use of which of the following medications can precipitate acute renal failure in a patient with renal artery stenosis? - Correct Answer - Angiotension II receptor antagonists • Question 48 You are performing a well child check on Andrew, age 5. You are unable to retract his foreskin over the glans penis while inspecting his penis. This is referred to as? - Correct Answer -Phimosis • Question 49 Which treatment is the best for infant viral gastroenteritis? - Correct Answer -Give sips of an oral rehydration solution • Question 50 Which of the following patients is at risk of developing a prerenal type of acute renal failure? - Correct Answer -Dehydrated patient • Question 51 You receive a urinalysis back from the lab with a finding of RBC casts and microscopic hematuria. What is the patient's likely diagnosis? - Correct Answer -Glomerulonephritis • Question 52 A 19 year old male presents with sudden onset of left-sided scrotal pain and unilateral loss of the cremasteric reflex. This patient most likely has: - Correct Answer -Testicular torsion • Question 53 A 58 year old woman with congestive heart failure presents with tachycardia, S3 heart sounds, and basilar crackles bilaterally. Her blood pressure is 90/68 mm Hg - Correct Answer - BUN level is 58 mg/dL - Correct Answer - creatinine level is 2.4 mg/dl. The most likely diagnosis is: - Correct Answer - Prerenal azotemia • Question 54 Which of the following medications is an alpha/beta-adrenergic antagonist? - Correct Answer -Carvedilol • Question 55 Rectal bleeding associated with hemorrhoids is usually described as: - Correct Answer -Streaks of bright red blood in stool • Question 56 glucose, while improving sensitivity by increasing peripheral glucose utilization and uptake? - Correct Answer -Metformin • Question 66 Your patient is a 55 year old female with Type 2 Diabetes Mellitus. She is currently on metformin and glipizide. Her most recent lab indicated an A1C value of 10.2%. What medication change is most appropriate? - Correct Answer -Stop Glipizide and add insulin • Question 67 You are a nurse practitioner who is initiating levothyroxine for primary hypothyroidism in a 71 year old female. The usual starting dose of levothyroxine is 50-100 mcg per day. What dose would be the most appropriate initial therapy for this patient? - Correct Answer -25 mcg • Question 68 Joe, age 64, has rheumatoid arthritis. Which of the following drugs would be of the least benefit?* Acetaminophen • Question 69 With the straight-leg raising test, the NP is evaluating tension on which of the following nerve roots? - Correct Answer -L5-S1 • Question 70 To aid in the diagnosis of meniscus damage, which test should you perform? - Correct Answer -Apley's compression test • Question 71 What type of fracture is characteristic of metastatic lung cancer? - Correct Answer -Pathological fracture • Question 72 An x-ray report of a patient's painful right knee indicates "joint space narrowing". What does this mean? - Correct Answer -Cartilage deterioration • Question 73 Anna presents to your clinic with an ankle sprain. She is unable to walk unassisted, and has egg-shaped swelling around the affected area. How should her ankle sprain be classified? - Correct Answer -Grade 3 • Question 74 A common cause of in-toeing in childhood is? - Correct Answer -Internal tibial torsion • Question 75 Management of fibromyalgia would include? - Correct Answer - • Question 76 An 18 year old high school female is irritable and moody with a pervasive feeling of sadness. She is becoming increasingly isolated, spending much time alone in her room. She finds it hard to concentrate and do homework. She is experiencing loss of appetite and fatigue. These symptoms began approximately two months ago when she broke off a year-long relationship with a boyfriend. She is most likely experiencing: - Correct Answer - Depression • Question 77 What is the medication of choice for obsessive-compulsive disorders? - Correct Answer -Clomipramine (Anafranil) • Question 78 Once a competent adult is identified as a victim of spousal abuse, the best plan is to: - Correct Answer -Teach survival skills • Question 79 What is the preferred medication for treating alcohol withdrawal symptoms? - Correct Answer - • Question 80 As discussed by Dr. Fiaud this semester, a small variation of mass movement would be commonly found in which of the following patients? - Correct Answer - • Question 90 Cushing's disease is the specific type of Cushing's syndrome that is caused by: Excess cortisol release - Correct Answer - • Question 91 Hemoglobin A1C increases the proportion to the amount of circulating glucose. (true or false) - Correct Answer -True • Question 92 Metformin has all of the following effects except: - Correct Answer - Enhanced fibrinolysis • Question 93 Which medication should be initiated for the relief of tremors associated with hyperthyroidism? - Correct Answer -Propranolol • Question 94 Which of the following characteristics applies to type 1 DM? - Correct Answer -Significant hyperglycemia and ketoacidosis result from lack of insulin • Question 95 Cardiovascular effects of hyperinsulinemia include: - Correct Answer - Greater responsiveness to angiotensin II • Question 96 Which of the following processes is most commonly associated with type 2 DM? - Correct Answer -Heredity and Obesity • Question 97 Which is the best screening test for both hyperthyroidism and hypothyroidism? - Correct Answer -TSH • Question 98 A 35 year old female and complains of palpitations, weight loss, agitation, and sweating. She is diagnosed with Graves disease and will be started on radioactive iodine therapy. What is a possible long term complication of this treatment regimen? - Correct Answer - • Question 99 Which of the following characteristics BEST applies to type 1 Diabetes Mellitus? - Correct Answer -Significant hyperglycemia and ketoacidosis result from lack of insulin • Question 100 Sarah, age 23, presents to the clinic with an altered level of consciousness, Kussmaul's breathing, polyuria, and fruity breath. Upon looking at her medical file, you note that she has type 1 DM. You immediately direct the patient to an emergency room for treatment and further evaluation. Which of the following lab results would you least expect Sarah to have? - Correct Answer - Which of the following is consistent with the visual problems associated with presbyopia? - Correct Answer -Blurring of near vision A Wood's light is especially useful in diagnosing which of the following? - Correct Answer -Tinea versicolor Choose the correct description of fissure - Correct Answer -. Linear tear at anal opening Which presentation best describes a typical case of chicken pox? - Correct Answer -Single dermatome Choose the correct description of patch. - Correct Answer -Flat area of skin discoloration larger than 1 cm/larger than a macule You examine a 25 year old male who has infectious mononucleosis with tonsillar hypertrophy, exudative pharyngitis, difficulty swallowing, and a patent airway. Your prescribe the following: - Correct Answer -Prednisone What is the most effective treatment for urticaria? - Correct Answer - Risk factors for folate-deficiency anemia include: - Correct Answer -Chronic ingestion of overcooked foods A 22 year old female taking ethinyl estradiol combination oral contraceptive pills calls after forgetting to take her pills for 2 consecutive days. She is 2 weeks into the pack. You advise her to: - Correct Answer -Take 2 pills today and 2 pills tomorrow The inability to empty the bladder resulting in overdistention and frequent loss of small amounts of urine describes: - Correct Answer -Over flow Which of the following is the most important preventable cause of premature death in women? - Correct Answer -Smoking You are trying to differentiate between functional constipation and Hirschsprung's disease in a neonate. Distinguishing features of Hirschsprung's disease includes which of the following? - Correct Answer - Current jelly stool The classic symptoms of an ectopic pregnancy are: - Correct Answer - Bleeding, abdominal pain and Marvin asks you for a prescription for sildenafil (Viagra). The only medication he takes is isosorbide mononitrate. He has a history of diet controlled diabetes. What do you tell him? - Correct Answer -Find a different medication since he is taking sildenafil. Using both medications together can cause profound vasodilation effect that cause complications Gastroesophageal reflux in children may present differently in the clinic setting. Physical exam findings in the pediatric population may include which of the following? - Correct Answer -Pneumonia Because children are curious about sexual feelings and developmental changes in their bodies from the preschool years onward, education about these feelings and changes should begin during: - Correct Answer -Preschool years Daniel is a 12 month old male who is new to your practice. His mother brings him in one day with a chief complaint of vomiting for 2 days. Before you step into the exam room to see him you know the most frequent cause of vomiting in this age group is related to which of the following? - Correct Answer -Viral You suspect Nikki has a gastroduodenal ulcer caused by H. pylori and plan to treat her empirically. What medications should you order? - Correct Answer - The clinical presentation of Irritable Bowel Syndrome most likely includes which set of symptoms? - Correct Answer - Diagnosis of pseudomembranous colitis can be made from subjective symptoms and which of the following? - Correct Answer -Recent antibiotic use/hospitalization Daniel is a 12 month old male who is new to your practice. His mother brings him in one day with a chief complaint of vomiting for 2 days. Before you step into the exam room to see him you know the most frequent cause of vomiting in this age group is related to which of the following? - Correct Answer -Viral Encopresis is a chronic disorder frequently seen in the pediatric population Which of the following statements is true regarding retentive encopresis? - Correct Answer -Leakage of stools Joseph, age 68, complains of an abrupt change in his defecation pattern. You evaluate him for: - Correct Answer -Colorectal cancer Which of the following pharmacologic agents used to treat constipation may cause flatulence and bloating and requires adequate fluid intake? - Correct Answer -Burk Agent What is the most common cause of chronic renal failure? - Correct Answer - Diabetic Nephropathy Cardiovascular failure is a major cause of which type of acute renal failure? - Correct Answer -Prerenal The most common source of Hepatitis A infection is: - Correct Answer - contaminated Water Which of the following is not a common risk factor for erectile dysfunction? - Correct Answer - Erectile dysfunction is a complex phenomenon with a variety of causes. The predominant cause is - Correct Answer -Vascular Marty, age 26 states he feels like he has a bag of worms on his left scrotum. Even before examining him you suspect: - Correct Answer -Varicocele A 19 year old male presents with sudden onset of left-sided scrotal pain and unilateral loss of the cremasteric reflex. This patient most likely has: - Correct Answer -Testicular Torsion An 80 year old woman presents to your clinic for evaluation of palpitations and shortness of breath. You obtain an electrocardiogram, which reveals an irregularly irregular rhythm without discrete P waves. You diagnose her with atrial fibrillation. The most likely physical finding upon auscultation of her heart is: - Correct Answer -Irregular heart rhythm Greg has hypertension. Which of the following factors influence your choice of using an alpha blocker as the antihypertensive medication? - Correct Answer -Benign prostate hyperplasia (BPH) Which classification of antihypertensive drugs is the most effective for treating hypertension in African American clients and the elderly? - Correct Answer -Calcium channel blockers/Diuretics The most common cause of elevated total and low-density lipoprotein cholesterol levels in the United States is: - Correct Answer -Process food/high sodium content A 46 year old overweight male has the following lipid values: Total cholesterol - 265, HDL - 18, LDL - 190, and Triglycerides - 369. What should be prescribed to treat this patient initially? - Correct Answer -Atorvastin 20 mg daily and Gibro...48 mg Which treatment is the best for infant viral gastroenteritis? - Correct Answer -No treatment Evelyn, a 59 year old cashier, presents with back pain with no precipitating event. The pain is located over her lower back and muscles without sciatica, and it is aggravated by sitting, standing, and certain movements. it is alleviated with rest. Palpation localizes the pain, and muscle spasms are felt. There was an insidious onset with progressive improvement. What is your initial diagnosis? - Correct Answer - Kimberly, age 35, states that she wants to be tested for thyroid disease because it runs in her family. Her TSH level comes back mildly high, and she has a normal T3 and T4 levels. What is the diagnosis? - Correct Answer - Subclinical hypothyroidism Which of the following is most consistent with the diagnosis of dysthymia? - Correct Answer -A 38-year-old with fatigue and anhedonia for the past 2 years When caring for a patient with DM and hypertension, the nurse practitioner considers prescribing: - Correct Answer -fosinopril In providing care for a patient with post-traumatic stress disorder (PTSD), you consider that all of the following are likely to be reported except: - Correct Answer -satisfaction/happiness An 18 year old high school female is irritable and moody with a pervasive feeling of sadness. She is becoming increasingly isolated, spending much time alone in her room. She finds it hard to concentrate and do homework. She is experiencing loss of appetite and fatigue. These symptoms began approximately two months ago when she broke off a year-long relationship with a boyfriend. She is most likely experiencing: - Correct Answer - Which of the following diagnostic tests is the most cost-effective method of distinguishing a malignant from a benign thyroid nodule? - Correct Answer - Fine-needle aspiration biopsy Which of the following statements is true regarding headaches? - Correct Answer - Diabetes and coronary artery disease (CAD) have a close interrelationship. Which of the following statements about the relationship between diabetes and CAD is true? - Correct Answer -Hyperinsulinemia causes a large number of vascular smooth muscle cells to be formed and deposited on the walls of vessels, eventually decreasing space for blood flow Hal, age 56, has just been diagnosed with Bell's palsy. He is understandably upset and has questions about the prognosis. Your response should be - Correct Answer - Persistent depressive disorder, also known as dysthymia, is characterized by: - Correct Answer -Low level depression A person with a Grade III ankle sprain presents with: - Correct Answer - Complete ankle instability, significant swelling and moderate to severe ecchymosis Robert, age 52, has diabetes and is overweight. You now find that he is hypertensive. How should you treat his hypertension? - Correct Answer - Aggressively A common cause of in-toeing in childhood is: - Correct Answer -internal tibial torsion A 32 year old Asian female is in your clinic after being assaulted by her husband. The medical record indicates that she has been seen two times within the past 6 weeks for bruises. Which of the following statements best demonstrates the NPs ethical responsibility to this patient? - Correct Answer - Criteria for the diagnosis of type 2 DM include: - Correct Answer -a plasma glucose level of 126 mg/dl or higher after an 8-hour fast on more than one occasion All of the following are causes of secondary hyperlipidemia except: - Correct Answer - Clinical presentation of type 1 DM usually includes all of the following except: - Correct Answer -report of recent unintended weight gain Increased insulin resistance is associated with which finding? - Correct Answer -Acanthosis Nicragan The mechanism of action of radioactive iodine in the treatment of Graves disease is to: - Correct Answer -Destroy overactive thyroid What is the earliest detectable glycemic abnormality in a patient with type 2 diabetes mellitus? - Correct Answer -Postprandial glucose elevation A 55 year old female patient with Diabetes Mellitus has the following fasting lipid values: None are at goal Total cholesterol 200 mg/dL HDL 45 mg/dL LDL levels of 120 mg/dL Triglyceride 309 mg/dL According to the American Diabetes Association, which patient lipid value(s) meet(s) the goal for this patient? - Correct Answer -None are at goal Diabetes and coronary artery disease (CAD) have a close interrelationship. Which of the following statements about the relationship between diabetes and CAD is true? - Correct Answer -Hyperinsulinemia causes a large number of vascular smooth cells to be formed and deposited on the walls of the vessels, eventually decreasing space for blood flow You are seeing a patient who was diagnosed with hyperthyroidism and had treatment for thyroid storm. When reviewing the patient's medical history for any medications that the patient takes either regularly or as needed, you advise the patient that which of the following should be avoided to decrease the risk of developing another thyroid crisis? - Correct Answer -Asprin Sarah, age 23, presents to the clinic with an altered level of consciousness, Kussmaul's breathing, polyuria, and fruity breath. Upon looking at her medical file, you note that she has type 1 DM. You immediately direct the when they are rubbed. You also not areas of hypopigmentation. What is your initial diagnosis? - Correct Answer -Tinea versicolor One of the more common sites for atopic dermatitis in an adult is: - Correct Answer -Flexor surfaces Which treatment is considered the gold standard in tissue-conservative skin cancer removal? - Correct Answer -Mohs' micrographic surgery According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPD guidelines, which of the following medications is indicated for use in all COPD stages? - Correct Answer -Short-acting inhaled beta2-agonist A 15 year old student presents asking for a letter stating that he should not participate in gym class because he has asthma. The most appropriate action is to: - Correct Answer -Assess his level of asthma control and make changes in his treatment plan if needed so he can participate Peak expiratory flow meters: - Correct Answer -Convenient, allows the patient to measure levels at home (not exact verbiage) Andrew, age 8, just started taking amoxicillin for otitis media. His mother said that he woke up this morning with a rash on his trunk. She states he has had amoxicillin in the past. What is your first action? - Correct Answer - Stop the amoxicillin Which medication listed below could potentially exacerbate heart failure in a susceptible individual? - Correct Answer -Metoprolol Marvin asks you for a prescription for sildenafil (Viagra). The only medication he takes is isosorbide mononitrate. He has a history of diet controlled diabetes. What do you tell him? - Correct Answer -It's contraindicated with isosorbide mononitrate, let's discuss other options What immunizations may be safely administered during the first trimester of pregnancy? - Correct Answer -Tdap and inactive influenza The clinical presentation of peptic ulcer disease includes all of the following symptoms EXCEPT: - Correct Answer -Diarrhea- I believe Which human papilloma virus types are most often associated with cervical cancer? - Correct Answer -16 and 18 First-line treatment options for syphilis include: - Correct Answer -Penicillin The most likely causative pathogen in a 26 year old woman with PID is: - Correct Answer -Chlamydia trachomatis A 14 year old girl's BMI is plotted between the 85th and 95th percentiles. Based on developmental characteristics, which strategy is best to use when educating her about self-care changes that are needed? - Correct Answer - Emphasize the benefits of diet and activity changes that she identifies as most important. Which drugs are used to lower blood pressure in a patient with coexisting benign prostatic hypertrophy? - Correct Answer -Alpha adrenergic blockers A patient with testicular torsion will most likely have a: - Correct Answer - Negative cremasteric reflex on the affected side You are trying to differentiate between functional constipation and Hirschsprung's disease in a neonate. Distinguishing features of Hirschsprung's disease includes which of the following? - Correct Answer - Small ribbon-like stools Bob presents with substernal chest pain that is provoked by exertion and relieved by rest and nitroglycerin. What do you suspect is his diagnosis? - Correct Answer -Stable angina Which of the following patients is at risk of developing a prerenal type of acute renal failure? - Correct Answer -2 year old with dehydration (Don't remember the exact verbiage) Prevention of diverticulitis includes: - Correct Answer -High fiber diet During a cardiovascular assessment, why is it important to note funduscopic changes? - Correct Answer -Changes may suggest the possibility of target organ involvement You are suspecting an appendicitis in Andrew, who is age 18 years. With his right hip and knee flexed, you slowly rotate his right leg internally to stretch a muscle. He states that it is painful over his right lower quadrant area. Which sign did you elicit? - Correct Answer -Obturator sign Which of the following laxatives listed below is safe for long-term use? - Correct Answer -Metamucil When percussing the abdomen, hyperresonance is present: - Correct Answer -Gaseous distention You suspect that George has a peptic ulcer and tell him that it has been found to be strongly associated with: - Correct Answer -H. Pylori Kathy has celiac disease. You place her on which diet? - Correct Answer - Gluten free diet Which of the following is likely to be reported in a patient with severe GERD? - Correct Answer -Chronic sore throat Which of the following pharmacologic agents used to treat constipation may cause flatulence and bloating and requires adequate fluid intake? - Correct Answer -Bulking agents A 40 year old male patient is diagnosed with an uncomplicated UTI. Trimethoprim-sulfamethoxazole is prescribed. How many days of therapy is indicated for this patient? - Correct Answer -7-10 days Among the following genetic diseases, which is the most common cause of chronic renal disease? - Correct Answer -Polycystic kidney disease Which of the following is most accurate information in caring for a 41 year old man with cystitis? - Correct Answer -Referral to Urologist Cloudy urine is usually indicative of which of the following conditions? - Correct Answer -UTI Therapy for hemorrhoids includes all of the following EXCEPT: - Correct Answer -Low-fat diet Which hormone is secreted by the adrenal cortex? - Correct Answer - Aldosterone Ben has insulin-dependent diabetes mellitus and has been experiencing hyperglycemia before dinner. A possible solution to this problem is to: - Correct Answer -Add physical activity between lunch and dinner The drop arm test is used to assess patients with suspected: - Correct Answer -Rotator cuff injury First line bursitis treatment options likely include: - Correct Answer - NSAIDS In assessing an infant for developmental dysplasia of the hip, the nurse practitioner places the infant supine, flexes the knees by holding the thumbs on the inner midthighs, with fingers outside on the hips touching the greater trochanters, stabilizes one hip, and abducts and gently pulls anteriorly on the other thigh. if this external rotation feels smooth with no sound present, there is no hip dislocation. This is: - Correct Answer - Ortolani maneuver Which of the following choices best describes the proper order of steps for performing the Lachman's test? - Correct Answer -Bend the knee 20 degrees, apply pressure to proximal tibia and stabilize the thigh A 32 year old male tripped and fell on outstretched hands about 2 hours ago. He complains of wrist pain. The APRN should: - Correct Answer -Scaphoid fracture As part of the evaluation of patients with osteoarthritis, the FNP anticipated finding: - Correct Answer -No disease-specific laboratory abnormalities Which of the following statements best describes the pathogenesis of depression? - Correct Answer -A feeling of overwhelming sadness that usually follows a traumatic event (I believe) Which of the following drugs is likely to be the most dangerous when taken in an intentional overdose equivalent to a standard adult therapeutic dose? - Correct Answer -2 week supply of notriptyline Stimulant therapy includes all of the following except: - Correct Answer - Dexilant A patient complains of insomnia, indecisiveness, and fatigue. His physical examination indicates that he has lost a considerable amount of weight since his last visit two months prior. When asked if anything is wrong, the patient explains that he is about to graduate college soon, and he has no job lined up or other future prospects. Which of the following signs or symptoms would best support depression in his case? - Correct Answer - Anhedonia Once a competent adult is identified as a victim of spousal abuse, the best plan is to: - Correct Answer -Develop a plan (Don't remember exactly the wording) A 37 year old female with a history of single episode depression and frequent complaint of 'PMS" is being followed for hypothyroidism. Today she is complaining of poor concentration and appears distraught. The correct plan is: - Correct Answer -Check her TSH Kristen, age 15, is 5 ft tall and weighs 85 lbs. You suspect anorexia and know that the best initial approach is to: - Correct Answer -Confront her about an eating disorder When you elicit a painful Finkelstein's sign, you are testing for: - Correct Answer -DeQuervain's tenosynovitis Shawn, age 42, has asymptomatic hyperuricemia. What is your initial therapy? - Correct Answer -Dietary counseling Usual treatment for anorexia nervosa includes: - Correct Answer - Antidepressant therapy Jeff, age 45, has two small children. He states that his wife made him come to this appointment because she thinks he has been impossible to live with lately. He admits to being stressed and depressed because he is working two jobs, and he says he sometimes takes his stress out on his family. About twice a week he complains of palpitations along with nervous energy. What is the most important question to ask him at this time? - Correct Answer - Have you thought about committing suicide? You are a nurse practitioner who is initiating levothyroxine for primary hypothyroidism in a 71 year old female. The usual starting dose of levothyroxine is 50-100 mcg per day. What dose would be the most appropriate initial therapy for this patient? - Correct Answer -25 mcg daily Helen, age 74, presents with a complaint of low back pain. Red flags in her history of a minor fall, having osteopenia, and prolonged steroid use for systemic lupus erythematosus suggest the possibility of which of the following serious underlying conditions as the cause of her low back pain? - Correct Answer -Spinal fracture The typical perpetrator in a domestic violence situation is the one who: - Correct Answer -Has been abused before Robert, age 52, has diabetes and is overweight. You now find that he is hypertensive. How should you treat his hypertension? - Correct Answer -ACE inhibitor "prils" You are assessing Daniel, age 18, after a football injury to this right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to the: - Correct Answer -Cruciate ligament A patient at 26 weeks gestation is screened for DM with a 1 hour glucose tolerance test. The result is 150 mg/dL. Appropriate follow up is to: - Correct Answer -Needs a 3hr OGTT-suspicious of DM Which lab test is the most helpful test to confirm an abnormal TSH level? - Correct Answer -Free T4 12. An 18 year old baseball player was hit in the eye with a baseball last evening. He went to the ER for evaluation and was cleared and told to follow up with his primary care provider in 1-2 days. He came in today to see you and complaints of visual changes and a dark visible fluid line at the bottom of his cornea. What is your most appropriate action? - Correct Answer - 13. During a routine physical examination of a 23 year old male, the NP notes a septal perforation. This finding may be significant for which of the following causes? - Correct Answer -Illicit drug use (cocaine) 14. Which of the following is a common vision problem in the person with untreated open-angle glaucoma? - Correct Answer -Peripheral vision loss 15. Acute otitis media is diagnosed when there is: - Correct Answer -middle ear effusion AND a sign of acute inflammation, such as distinct fullness or bulging of the TM, ear pain, or marked redness of the TM. Both must be present for the diagnosis of AOM. 16. What is a common inhaled allergen in allergic asthma? - Correct Answer -Pet Dander 17. A 27-year old female presents with a "bump" on her left eyelid. Examination reveals a 2-mm hard, nontender swelling on the lateral border of the right eyelid margin. This is most consistent with: - Correct Answer - Hordeolum 18. Choose the correct description of fissure. - Correct Answer -Ulcer or tear of the margin of the anus, usually posteriorly 19. What is the most common rosacea trigger? - Correct Answer -Sun Exposure 20. Steve, age 29, has a carbuncle on his neck. After an incision and drainage, an antibiotic is ordered. What is the most common organism involved? - Correct Answer -Staphylococcus aureus 21. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPD guidelines, which of the following medications is indicated for use in all COPD stages? - Correct Answer -short-acting inhaled beta2-agonist 22. Approximately 50% of children with viral croup have a(n) - Correct Answer -History of allergic rhinitis. 23. You just diagnosed Greg, age 67, with pneumonia. Which of the following is an indication that he should be hospitalized?* Inability to take oral medications and multilobar involvement on chest x- ray 24. A 15 year old student presents asking for a letter stating that he should not participate in gym class because he has asthma. The most appropriate action is to: - Correct Answer -assess his level of asthma control and make changes in his treatment plan if needed so he can participate. 25. A 22 year old female taking ethinyl estradiol combination oral contraceptive pills calls after forgetting to take her pills for 2 consecutive days. She is 2 weeks into the pack. You advise her to: - Correct Answer -Take two now and two tomorrow 26. Melissa takes her young son Max to day care every day. He has begun to cry loudly and try to cling to her when she leaves. Max is likely what age? - Correct Answer -8-9 months 27. Among the following genetic diseases, which is the most common cause of chronic renal disease? - Correct Answer -polycystic kidney disease 28. Which food is known to reduce lower esophageal sphincter? - Correct Answer -Peppermint, caffeine ? 29. In a person with hypertension, which of the following yields the greatest potential reduction in BP in a patient with a BMI of 30%? - Correct Answer - 10-kg (22-lb) weight loss 30. How can GERD be diagnosed? - Correct Answer -Most commonly, GERD is diagnosed based on history of heart burn and regurgitation of gastric contents, especially if relieved by antiacids. More severe disease warrants endoscopy to confirm the diagnosis and to assess for epithelial damage. 31. Which classification of antihypertensive drugs is the first-choice therapy for treating hypertension and angina in patients with known coronary artery disease? - Correct Answer - 32. The most common form of acquired anemia during pregnancy is: - Correct Answer -Iron deficiency 33. In patients with varicose veins, which vessel is most often affected? - Correct Answer -Saphenous 34. The psoas sign can best be described as abdominal pain elicited by:* passive extension of the hip. 35. Which statement is true regarding acute tubular necrosis? - Correct Answer -???? Ischaemic tubular necrosis is uncommon after haemorrhagic shock, The non-oliguric form has a better recovery, Predominantly PCT and ascending loop of Henle necrosis 36. Which of the following medication(s) is appropriate for empiric treatment of a patient with suspected gonorrhea? - Correct Answer - Rocephin with either azithromycin or doxycycline 37. The NP suspects that a pregnant patient may have been physically abused by a domestic partner. The NP knows that: - Correct Answer -Abuse can worsen during pregnancy 38. What is the best treatment for a child with asymptomatic swallowed foreign body? - Correct Answer - 39. Signs of right-sided heart failure include: - Correct Answer -congestion, jvd, hepatomegaly, dependent edema (lower extremities, thighs, abdomen- ascites), ascites in the peritoneum 40. Which physical examination maneuver for diagnosing appendicitis is done by deep palpation over the left lower quadrant with resultant pain in the right lower quadrant? - Correct Answer -Rosvings 59. The use of which of the following medications can precipitate acute renal failure in a patient with renal artery stenosis? - Correct Answer - angiotensin II receptor antagonists 60. Which classification of antihypertensive drugs is the most effective for treating hypertension in African American clients and the elderly? - Correct Answer -Diuretics 61. You are a nurse practitioner who is initiating levothyroxine for primary hypothyroidism in a 71 year old female. The usual starting dose of levothyroxine is 50-100 mcg per day. What dose would be the most appropriate initial therapy for this patient? - Correct Answer -25 mcg 62. You are seeing a diabetic patient who regularly monitors her blood glucose levels. She says that she has noticed a spike in her levels when she wakes up in the morning. You tell her to record her levels at 3 am over the next 3 days. During the follow visit, the patient reports that her glucose is slightly elevated at 3 am. Based on this information, which treatment would be most beneficial in managing the patient's early morning hyperglycemia? - Correct Answer - 63. Which of the following is true regarding Klinefelter's syndrome? - Correct Answer -Affects males only, results from an extra X chromosome on the 23rd pair in males, Individuals have cognitive development issues, undeveloped testes, and gynecomastia 64. Peggy has had Cushing's disease for 20 years and has been taking hydrocortisone since then. Today, she appears with a thick trunk and thin extremities. She has a "moon face", a "buffalo hump", thin skin with visible capillaries, and a number of bruises that appear to be slow in healing. To what do you attribute these symptoms? - Correct Answer -excessive levels of circulating cortisol 65. What is the earliest detectable glycemic abnormality in a patient with type 2 diabetes mellitus? - Correct Answer -Postprandial glucose elevation 66. Kimberly, age 35, states that she wants to be tested for thyroid disease because it runs in her family. Her TSH level comes back mildly high, and she has a normal T3 and T4 levels. What is the diagnosis? - Correct Answer - Subclinical hypothyroid 67. Polydipsia occurs in diabetes as a result of a high serum glucose level, which - Correct Answer -Has an osmotic effect on fluids and eventually trigger the thirst mechanism for compensation 68. Greg is a 54 year old man complaining of low back pain. His physical exam is negative for neurologic involvement. You recommend all of the following interventions except: - Correct Answer -Bedrest for 5 days 69. Which of the following tests assesses for carpal tunnel syndrome? - Correct Answer -Phalen and Tinel 70. Kathy, age 49, has recently begun a rigorous weight-lifting program. She presents to your clinic with a shoulder dislocation. Which of the following clinical manifestations make your suspect an anterior shoulder dislocation over a posterior dislocation? - Correct Answer -Inability to shrug the shoulder 71. The "get up and go" test in an elderly patient is used to evaluate: - Correct Answer -Fall risk 72. Ben has insulin-dependent diabetes mellitus and has been experiencing hyperglycemia before dinner. A possible solution to this problem is to - Correct Answer -Add in physical activity in the afternoon after lunch and before dinner 73. The Phalen test is described as: - Correct Answer -Reproduction of symptoms with forced flection of the wrists 74. A common cause of in-toeing in childhood is - Correct Answer -Internal tibial torsion 75. Kaitlyn, age 14, is markedly obese and has a poor self-image. How do you differentiate between compulsive eating and bulimia? - Correct Answer - A compulsive eater does not induce vomiting. 76. With the straight leg raising test, the NP is evaluating tension on which of the following nerve roots? - Correct Answer -L5 and S1 77. Physical examination findings in patients with bulimia nervosa often include: - Correct Answer -Dental surface erosion 78. As you develop the initial treatment plan for a woman with panic disorder, you consider prescribing: - Correct Answer -citalopram (Celexa) 79. An 18 year old high school female is irritable and moody with a pervasive feeling of sadness. She is becoming increasingly isolated, spending much time alone in her room. She finds it hard to concentrate and do homework. She is experiencing loss of appetite and fatigue. These symptoms began approximately two months ago when she broke off a year- long relationship with a boyfriend. She is most likely experiencing: - Correct Answer - 80. Management of fibromyalgia would include - Correct Answer - Antidepressants 81. Which of the following is most consistent with the diagnosis of dysthymia? - Correct Answer -a 38 year old woman with fatigue and anhedonia for the past 2 years 82. Peggy has had Cushing's disease for 20 years and has been taking hydrocortisone since then. Today, she appears with a thick trunk and thin extremities. She has a "moon face", a "buffalo hump", thin skin with visible capillaries, and a number of bruises that appear to be slow in healing. To what do you attribute these symptoms? - Correct Answer -High levels of circulating cortisol Which medications are considered when treating PCOS: - Correct Answer - metformin, simvastatin When caring for a pt with DM and HTN, the FNP considers prescribing: - Correct Answer -ACE, statin, asa Metformin's mechanism of action is as: - Correct Answer -increases insulin action in the peripheral tissues and reduces haptic glucose excretion What is the first symptom seen in the majority of patients with Parkinson's disease? - Correct Answer -Bradykinesia Robert, age 52, has diabetes and is overweight. You now find that he is hypertensive. How should you treat his HTN? - Correct Answer -Aggressively You assess for cogwheel rigidity in Wilma, age 78. What is cogwheel rigidity a manifestation of? - Correct Answer -Parkinson's The major risk factor for development of thyroid cancer is: - Correct Answer -exposure to radiation Vicki, age 36, presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome. Which of the following is more characteristic of fibromyalgia than of chronic fatigue syndrome? - Correct Answer - Musculoskeletal pain In providing care for a pt with PTSD, you consider that all the following are likely to be reported except: - Correct Answer -satisfaction Cushing's disease is the specific type of Cushing's syndrome that is caused by: - Correct Answer - Sarash, who is post menopausal, is taking 1500mg calcium but does not understand why she also needs to take vitamin D. You tell her that: - Correct Answer -vit D helps calcium absorb All of the following increase the risk for osteoporosis except: - Correct Answer - Janelle, age 81, has postherpetic neuralgia. She has been in significant pain with episodes recently and she would like to start therapy. What do you recommend? - Correct Answer -Gabapentin Kaitlyn, age 14, is markedly obese and has a poor self-image. How do you differentiate between compulsive eating and bulimia? - Correct Answer - Compulsive eating doesn't induce vomiting Which of the following is most consistent with the diagnosis of dysthymia? - Correct Answer - Don, age 82, recently lost his wife to breast cancer. He presents with weight loss, fatigue, and difficulty sleeping. What should your first response be? - Correct Answer -Ask if he is suicidal An xray report of a pt's painful right knee indicates "joint space narrowing". What does this mean? - Correct Answer -Loss of cartilage What is the medication of choice for OCD? - Correct Answer - In assessing an infant for developmental dysplasia of the hip, the NP places infant supine, flexes the knees by holding the thumbs on the inner midthighs, with fingers outside on the hips touching the greater trochanters, stabilizes one hip, and abducts and gently pull anteriorly on the other thigh. If this external rotation feels smooth with no sound present, there is no hip dislocation. This is: - Correct Answer -Ortalani maneuver What is the preferred medication for treating alcohol withdrawal symptoms? - Correct Answer -Ativan When should a rescue course of prednisolone be initiated for an attack of asthma? - Correct Answer -Any time they need it, at any stage Which of the following best describes the tympanic membrane? - Correct Answer -Transparent membrane separating middle ear and outer ear. The most common cause of sensorineural hearing loss is... - Correct Answer - presbycusis A 4 year old appears in the clinic with an intense red eruption of both cheeks and has circumoral pallor. The child has low grade fever but no other symptoms. This child probably has... - Correct Answer -fifth disease The gold standard for definitive diagnosis of sickle cell anemia is: - Correct Answer -electrophoresis A 78 year old man comes to the clinic after having knee surgery. When examining his eyes you notice lens opacity. What is this finding a sign of? - Correct Answer -cataract The herald patch is present in almost all cases of: - Correct Answer - pityrasis rosea What is the most common rosacea trigger? - Correct Answer -Sunlight/sun exposure You examine a 57 year old female with rheumatoid arthritis and find the following results. Hgb - 10.5, Hct- 33%, MCV - 88. The most likely diagnosis is: - Correct Answer -anemia of chronic disease Which anemias are described as microcytic, hypochromic anemias? - Correct Answer -Iron deficiency The Epstein-Barr virus is primarily transmitted via: - Correct Answer -oral secretions A 78 year old female has early bilateral senile cataracts. Which of the following situations would likely pose the greatest difficulty? - Correct Answer -Reading road signs George is a 58 year old lawyer. He has throbbing pain in his left eye, an irregular pupil shape, marked photophobia, and redness around the iris. What is your initial diagnosis? - Correct Answer -Iritis The antibiotic of choice for recurrent acute otitis media and/or treatment failure in children is: - Correct Answer -augmentin While assessing the skin of an infant, you note café-au-lait spots. Which disease should be ruled out? - Correct Answer -Neurofibromatosis Jeff is complaining of a scrotal mass. The scrotum is so edematous that it is difficult to assess. How do you determine if it is a hernia or a hydrocele? - Correct Answer -You can hear bowel sounds over a hernia Which of the following meds has a disulfiram type reaction when taken with alcohol? - Correct Answer -Flagyl What choice below is most commonly associated with pancreatitis? - Correct Answer -Alcoholism and gallstones Which of the following laxatives listed below is safe for long term use? - Correct Answer - You suspect that George has a peptic ulcer and tell him that it has been found to be strongly associated with : - Correct Answer -H pylori In thinking of the pathogenesis of PUD, H pylori cause which of the following? - Correct Answer -Damage to mucosa leading to ulcer formation Kathy has celiac disease. You place her on which diet? - Correct Answer - Gluten free Dan, age 76, had GERD. When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend he avoid? - Correct Answer -Peppermint L.S. is a 28 year old white female. She has 3 children and a full time job as a waitress. She is divorced and uses tobacco. She comes in to you with complaints of abdominal pain, bloating, diarrhea alternating with constipation. What is her most likely diagnosis? - Correct Answer -IBS Gastroesophageal reflux in children may present differently in the clinic setting. Physical exam finding in the pediatric population may include which of the following? - Correct Answer -Pneumonia Which history is commonly found in a pediatric patient with glomerulonephritis? - Correct Answer - All of the following are likely to be reported by patients with acute bacterial prostatitis except: - Correct Answer -discharge When should a pt with cryptorchidism be referred to urology? - Correct Answer - Therapy for hemorrhoids includes all the following except: - Correct Answer -low fiber diet The psoas sign can best be described as abdominal pain elicited by: - Correct Answer -passive extension of hip Urine specific gravity is increased in clients with: - Correct Answer - dehydration During a cardiovascular assessment, why is it important to note funduscopic changes: - Correct Answer -end organ damage Impaired blood flow to the extremities is caused by which of the following common disorders? - Correct Answer -PVD Characteristics of a limb with a venous insufficiency ulcer includes: - Correct Answer - Deep vein thrombosis may result in: - Correct Answer -swelling and pain to affected limb What is a common fundoscopic change associated with hypertension? - Correct Answer -AV nicking While much teaching is needed for your pt with CHF, the most beneficial thing you can teach him that might prevent hospitalization may be: - Correct Answer -to report 5 pound weight gain in one week Leonard is a 72 year old male. He has been diagnosed with DM 2. What is a reasonable A1C goal for him? - Correct Answer -Less than 8 Melinda is pregnant. She has hypothyroidism and has been on the same levothyroxine dose for years. What might you expect to do with her levothyroxine dose? - Correct Answer -Monthly TSH, probably increase In order to determine how much T4 replacement a pt needs to reestablish a euthyroid state, the FNP considers: - Correct Answer -weight Polydipsia occurs in diabetes as a result of a high serum glucose level, which: - Correct Answer - Ben has insulin dependent diabetes and has been experiencing hyperglycemia before dinner. A possible solution to the problem is to: - Correct Answer -add physical activity after lunch and before dinner Your patient is a 55 year old female with DM2. She is currently on metformin and glipizide. Her most recent lab indicated an A1C of 10.2. What med change is most appropriate? - Correct Answer -DC glipizide and add glyburide Kathy, age 49, has recently begun a rigorous weight lifting program. She presents to your clinic with a shoulder dislocation. Which of the clinical manifestations make you suspect an anterior shoulder dislocation over a posterior shoulder dislocation? - Correct Answer - Joe, age 64, had rheumatoid arthritis. Which of the following drugs would be of the least benefit? - Correct Answer - Which symptom can be used to rule out a fracture? - Correct Answer -No symptom can rule out a fracture A 26 year old male was recently diagnosed with plantar fasciitis. He says he experiences sharp pain and stiffness in the affected foot eatch morning. However, this pain usually fades by the time he is ready for work. Which of the following treatments would have the lowest priority at this time? - Correct Answer -