NRNP 6531 WEEK 6 MIDTERM EXAM (4 VERSIONS,LATEST-2022/2023, 400 Q & A) WALDEN UNIVERSITY, Exams of Nursing

Download NRNP 6531 WEEK 6 MIDTERM EXAM (4 VERSIONS,LATEST-2022/2023, 400 Q & A) WALDEN UNIVERSITY and more Exams Nursing in PDF only on Docsity! NRNP 6531 MIDTERM EXAM (4 VERSIONS, LATEST-2022/2023, 400 Q & A) NRNP6531 WEEK 6 MIDTERM EXAM: WALDEN UNIVERSITY NRNP 6531 MIDTERM EXAM All Answers, Submitted Answers, Correct Answers • Question 1 0 out of 0 points When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Selected Answer: Ye s Answers: Ye s No • Question 2 The most common cancer found on the auricle is: Selected Answer: Basal cell carcinoma Answers: Actinic keratosis Basal cell carcinoma Squamous cell carcinoma Acral-lentiginous melanoma • Question 3 1 out of 1 points 0 out of 1 points Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient? • Question 8 1 out of 1 points A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect: Selected Answer: Gonococcal conjunctivitis Answers: Viral conjunctivitis Common pink eye Gonococcal conjunctivitis Allergic conjunctivitis • Question 9 0 out of 1 points A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 different thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect: Selected Answer: A complicated case of shingles and prescribe acyclovir, an analgesic, and a topical cortisone cream Answers: A common case of shingles and prescribe an analgesic and an antiviral agent A complicated case of shingles and prescribe acyclovir, an analgesic, and a topical cortisone cream Herpes zoster and consider that this patient may be immunocompromised A recurrence of chickenpox and treat the patient’s symptoms • Question 10 0 out of 1 points Which type of lung cancer has the poorest prognosis? Selected Answer: Adenocarcinoma Answers: Adenocarcinoma Epidermoid carcinoma Small cell carcinoma Large cell carcinoma • Question 11 1 out of 1 points An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3– 4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has: Selected Answer: Chronic diarrhea Answers: Acute diarrhea Chronic diarrhea Irritable bowel Functional bowel disease • Question 12 1 out of 1 points Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect? Selected Answer: Systemic lupus erythematosus Answers: An allergic reaction Relapsing polychondritis Lymphocytoma cutis Systemic lupus erythematosus • Question 13 1 out of 1 points Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes? Selected Answer: Acute bronchitis Answers: Chronic sinusitis Acute bronchitis Bacterial pneumonia Acute exacerbation of chronic bronchitis • Question 14 0 out of 1 points Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in? Selected Answer: Mild persistent Answers: Mild intermittent Mild persistent Diverticulit is Diverticulu m • Question 20 1 out of 1 points Sylvia, age 83, presents with a 3 day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect? Selected Answer: Herpes zoster Answers: Varicella Herpes zoster Syphilis Rubella • Question 21 0 out of 1 points A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is: Selected Answer: Medicatio ns Answers: Alcohol Gallstone s Medicatio ns Pregnanc y • Question 22 1 out of 1 points When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action? Selected Answer: Order an abdominal ultrasound Answers: Order abdominal x-rays Order an abdominal ultrasound Refer the patient to a surgeon for evaluation Prescribe pain medication • Question 23 A false-positive result with the fecal occult blood test can result from: Selected Answer: stool that has been stored before testing Answers: ingestion of large amounts of vitamin C a high dietary intake of rare cooked beef a colonic neoplasm that is not bleeding stool that has been stored before testing • Question 24 0 out of 1 points 0 out of 1 points A 76-year-old male complains of weight loss, nausea, vomiting, abdominal cramping and pain. Physical findings include an abdominal mass and stool positive for occult blood. The nurse practitioner pain suspects a tumor in the small intestine. The best diagnostic test for this patient is: Selected Answer: Colonoscopy Answers: Colonoscopy Small bowel follow- through Barium enema CT abdomen • Question 25 1 out of 1 points A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with: Selected Answer: Systolic heart failure Answers: Mitral regurgitation Systolic heart failure Cardiac myxoma Diastolic heart failure • Question 26 1 out of 1 points Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized? Selected Answer: Multilobar involvement on chest x-ray with the inability to take oral medications Answers: Multilobar involvement on chest x-ray with the inability to take oral medications Selected Answer: Replace water-soluble vitamins Answers: Prevent intestinal obstruction Provide adequate nutrition Promote clearance of secretions Replace water-soluble vitamins • Question 32 1 out of 1 points The nurse practitioner is performing a physical exam on a middle-aged African-American man. Which of the following areas is a common site for melanomas in African-Americans and other dark-skinned individuals? Selected Answer: B and C Answers: Scalp Nails Feet B and C All of the above • Question 33 An adult presents with tinea corporis. Which item below is a risk factor for its development? Selected Answer: Topical steroid use 1 out of 1 points Answers: Topical steroid use Topical antibiotic use A recent laceration Cold climates • Question 34 0 out of 1 points A patient has experienced nausea and vomiting, headache, malaise, low grade fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is elevated with a shift to the left. He is requesting medication for diarrhea. What is the most appropriate response? Selected Answer: Order stool cultures. Answers: Prescribe loperamide (Immodium) or atropine-diphenoxylate (Lomotil) and a clear liquid diet for 24 hours. Prescribe a broad-spectrum antibiotic such as ciprofloxacin (Cipro), and symptom management. Offer an anti-emetic medication such as ondansetron (Zofran) and provide oral fluid and electrolyte replacement instruction. Order stool cultures. • Question 35 1 out of 1 points Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order? Selected Answer: Antihistami nes Answers: Aspirin NSAIDs Opioids Antihistami nes • Question 36 0 out of 1 points Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is: Selected Answer: Peripheral edema Answers: Peripheral edema Weight gain Shortness of breath Nocturnal dyspnea • Question 37 1 out of 1 points A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe? Selected Answer: Amoxicillin Answers: Ibuprofen Erythromyci n Amoxicillin Acetaminop hen • Question 38 1 out of 1 points A 70 year old man who walks 2 miles every day complains of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 2 mile walk. What question asked during the history, if answered affirmatively, would 1 out of 1 points A 70 year old patient presents with a slightly raised, scaly, erythematous patch on her forehead. She admits to having been a “sun worshiper.” The nurse practitioner suspects actinic keratosis. This lesion is a precursor to: Selected Answer: Squamous cell carcinoma Answers: Squamous cell carcinoma Basal cell carcinoma Malignant melanoma Acne vulgaris • Question 44 1 out of 1 points An elderly patient is being seen in the clinic for complaint of “weak spells” relieved by sitting or lying down. How should the nurse practitioner proceed with the physical examination? Selected Answer: Compare the patient’s blood pressure lying first, then sitting, and then standing. Answers: Assist the patient to a standing position and take her blood pressure. Assess the patient’s cranial nerves. Compare the patient’s blood pressure lying first, then sitting, and then standing. Compare the amplitude of the patient’s radial and pedal pulses. • Question 45 1 out of 1 points What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery? Selected Answer: Ursodiol Answers: Ursodiol Ibuprofen Prednisone Surgery is the only answer • Question 46 0 out of 1 points A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is: Selected Answer: Staphylococcus aureus Answers: Staphylococcus aureus Group A beta hemolytic streptococcus Haemophilus influenza Pseudomonas aeruginosa • Question 47 Which of the following is not a symptom of irritable bowel syndrome? Selected Answer: Painful diarrhea Answers: Painful diarrhea Painful constipation Cramping and abdominal pain 0 out of 1 points Weight loss • Question 48 1 out of 1 points A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed? Selected Answer: Any recent trauma Answers: Any recent trauma Difficulty swallowing Stiffness in the right shoulder Change in sleeping habits • Question 49 0 out of 1 points Marvin, age 56, is a smoker with diabetes. He has just been diagnosed as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis? Selected Answer: ACE Inhibitor Answers: ACE Inhibitor Beta Blocker Calcium channel blocker Diuretic • Question 50 1 out of 1 points The differential diagnosis for a patient complaining of a sore throat includes which of the following? Selected Answer: A, B, and C Answers: Gonococcal • Question 55 Treatment of H.pylori includes which of the following? Selected Answer: A, B, and C Answers: Proton pump inhibitor Antibiotic therapy Bismuth subsalicylate A and B A, B, and C • Question 56 1 out of 1 points 1 out of 1 points Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect? Selected Answer: Retinal detachment Answers: Cataracts Glaucoma Retinal detachment Iritis • Question 57 In order to decrease deaths from lung cancer: 1 out of 1 points Selected Answer: Patients should be counseled to quit smoking Answers: All smokers should be screened annually All patients should be screened annually Only high risk patients should be screened routinely Patients should be counseled to quit smoking • Question 58 1 out of 1 points John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia? Selected Answer: Every 5 years Answers: Every 5 years Every 2 years Every year Whenever blood work is done • Question 59 1 out of 1 points Mort is hypertensive. Which of the following factors influenced your choice of using an alpha blocker as the antihypertensive medication? Selected Answer: Mort has benign prostatic hyperplasia Answers: Mort is black Mort also has congestive heart failure Mort has benign prostatic hyperplasia Mort has frequent migraine headaches • Question 60 1 out of 1 points John, age 59, presents with recurrent, sharply circumscribed red papules and plaques with a powdery white scale on the extensor aspect of his elbows and knees. What do you suspect? Selected Answer: Psoriasis Answers: Actinic keratosis Eczema Psoriasis Seborrheic dermatitis • Question 61 1 out of 1 points Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg daily, and Calcium 1500 mg daily. At today’s visit. Her blood pressure is 170/89. According to JNC VIII guidelines, what should you do next to control Harriet’s blood pressure? Selected Answer: Add a thiazide diuretic to the Lisinopril 5mg daily Answers: Increase her Lisinopril to 20mg daily Add a thiazide diuretic to the Lisinopril 5mg daily Discontinue the Lisinopril and start a combination of ACE Inhibitor and calcium channel blocker Discontinue the Lisinopril and start a diuretic • Question 62 0 out of 1 points Corneal abrasion Retinoblastom a • Question 67 0 out of 1 points Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo? Selected Answer: A labyrinthectomy Answers: Pharmacological therapy A labyrinthectomy A vestibular neurectomy Wearing an earplug in the ear with the most hearing loss • Question 68 Which of the following is not a risk factor for coronary arterial insufficiency? Selected Answer: Hyperhomocystein emia Answers: Hyperhomocystein emia Smoking Genetic factors Alcohol ingestion • Question 69 0 out of 1 points 1 out of 1 points An 18-year-old female presents to the urgent care center complaining of severe pruritus in both eyes that started 2 days ago. Associated symptoms include a headache and fatigue. On examination, the nurse practitioner notes some clear discharge from both eyes and some erythema of the eyelids and surrounding skin. Which of the following is the most likely cause of this patient’s symptoms? Selected Answer: Allergic conjunctivitis Answers: Allergic conjunctivitis Bacterial conjunctivitis Gonococcal conjunctivitis Viral conjunctivitis • Question 70 0 out of 1 points A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most effective in keeping him symptom-free? Selected Answer: A long-acting bronchodilator Answers: A long-acting bronchodilator An inhaled corticosteroid and cromolyn Theophylline and a short acting bronchodilator A bronchodilator PRN and an inhaled corticosteroid • Question 71 0 out of 1 points Acute rheumatic fever is an inflammatory disease which can follow infection with: Selected Answer: Β-hemolytic Streptococcus Answers: Group A Streptococcus Staphlococcus areus Β-hemolytic Streptococcus Streptococcus pyogenes • Question 72 0 out of 1 points A 60 year old male diabetic patient presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which “is better.” His temperature is 100°F and pulse is 102 bpm. The most appropriate initial action is to: Selected Answer: Start an oral antibiotic, mouth swishes with an oral anti-infective, and an analgesic Answers: Start an oral antibiotic, refer the patient to a dentist immediately, and follow up within 3 days Order mandibular x-rays and question the patient about physical abuse Start an oral antibiotic, mouth swishes with an oral anti-infective, and an analgesic Initiate a parenteral antibiotic and consider hospital admission • Question 73 1 out of 1 points If a patient presents with a deep aching, red eye and there is no discharge, you should suspect: Selected Answer: Iritis Answers: Iritis tonsils. His uvula is deviated to the left. What is the most likely diagnosis? Selected Answer: Epiglottitis Answers: Peritonsillar abscess Thyroiditis Mononucleosis Epiglottitis • Question 79 1 out of 1 points Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication? Selected Answer: It is not effective during an acute asthma attack. Answers: It is not effective during an acute asthma attack. It may take 2 to 3 days to begin working. This drug works within 10 minutes. This drug may be used by patients 6 years and older. • Question 80 0 out of 1 points Which intervention listed below is safe for long term use by an adult with constipation? Selected Answer: Stool softeners Answers: Bulk-forming agents Stool softeners Laxatives Osmotic agents • Question 81 1 out of 1 points A 40 year old presents with a hordeolum. The nurse practitioner teaches the patient to: Selected Answer: Apply a topical antibiotic and warm compresses. Answers: Apply a topical antibiotic and warm compresses. Apply cool compresses and avoid touching the hordeolum. Use an oral antibiotic and eye flushes. Apply light palpation to facilitate drainage. • Question 82 1 out of 1 points Sarah has allergic rhinitis and is currently being bothered by nasal congestion. Which of the following meds ordered for allergic rhinitis would be most appropriate? Selected Answer: A decongestant nasal spray Answers: An antihistamine intranasal spray A decongestant nasal spray Ipratropium Omalizumab • Question 83 What is the Gold standard for the diagnosis of asthma? Selected Answer: Spirometry Answers: Patient’s perception of clogged airways Validated quality-of-life questionnaires Bronchoscopy Spirometry • Question 84 1 out of 1 points 0 out of 1 points A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough? Selected Answer: Methyldopa Answers: Methyldopa Enalapril Amlodipine Hydrochlorothia zide • Question 85 1 out of 1 points Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by: Selected Answer: Candidiasis Answers: Herpes simplex Air pollution Occupational environment • Question 91 0 out of 1 points Which choice below is least effective for alleviating symptoms of the common cold? Selected Answer: Topical decongestants Answers: Antihistamines Oral decongestants Topical decongestants Antipyretics • Question 92 0 out of 1 points When teaching a patient with hypertension about restricting sodium, you would include which of the following instructions? Selected Answer: Diets with markedly reduced intakes of sodium may be associated with other beneficial effects beyond blood pressure control Answers: Diets with markedly reduced intakes of sodium may be associated with other beneficial effects beyond blood pressure control Sodium restriction can cause serious adverse effects A goal of 3 g of sodium chloride or 1.2 g of sodium per day is easily achievable Seventy-five of sodium intake is derived from processed foods • Question 93 Which of the following heart murmurs warrants the greatest concern? 1 out of 1 points Selected Answer: Diastolic murmur Answers: Systolic murmur Venous hum murmur Diastolic murmur Flow murmur • Question 94 1 out of 1 points A patient presents with an inflamed upper eyelid margin. The conjunctiva is red and there is particulate matter along the upper eyelid. The patient complains of a sensation that “there is something in my eye.” What is the diagnosis and how should it be treated? Selected Answer: Blepharitis; treat with warm compresses and gentle debridement with a cotton swab Answers: Hordeolum; treat with a topical antibiotic and warm compress Conjunctivitis; treat with topical antibiotic and warm compresses Blepharitis; treat with warm compresses and gentle debridement with a cotton swab Chalazion; refer to an ophthalmologist for incision and drainage • Question 95 1 out of 1 points A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory? Selected Answer: Inferior wall Answers: Inferior wall Anterior wall Apical wall Lateral wall • Question 96 0 out of 1 points The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The least likely diagnosis for this patient is: Selected Answer: Otitis media with effusion Answers: Acute otitis media (AOM) Otitis media with effusion Mucoid otitis media Serous otitis media • Question 97 0 out of 1 points Alan, age 54, notices a bulge in his midline every time he rises from bed in the morning. You tell him it is a ventral hernia, also known as: Selected Answer: incisional hernia Answers: inguinal hernia Psychogenic polydipsia results in urine that is: diluted with low osmolality and hyponatremia How would you determine the cause of a patient's AKI who presents with decreased urine output, history of neurogenic bladder, chronic foley, dark urine, and Cr increase from 1.3 to 2.1 over 3 months? Flush the foley catheter to see if urine comes out and assess the patency of the catheter. This action will unblock clogged sediment or biofilm from chronic bacteriuria. When a female patient presents to the ER after sexual assault, what medications should be offered prior to discharge? Ceftriaxone, azithromycin, Plan B, and Metronidazole. Manifestations of Conn syndrome (hyperaldosteronism)? hypernatremia, hypokalemia, and hypertension What causes Cushing syndrome? Increased levels of glucocorticoids, can be exogenous (from therapy) or endogenous (from adenoma or neoplasm). Manifestations of Cushing syndrome? hypertension, truncal obesity, osteoporosis, skin fragility, and hyperglycemia. What differentiates primary adrenocortical insufficiency from secondary adrenocortical insufficiency? Skin hyperpigmentation is present in primary adrenocortical insufficiency What is Trousseau's sign? A carpal spasm elicited by compression of the upper arm with a BP cuff that indicates hypocalcemia. What is Chovstek's sign? A hemifacial tic that is induced by tapping the facial nerve below the maxilla that indicates hypocalcemia. What is Babinski's sign? An upward response (extension) of the hallux when the sole of the foot is stimulated with a blunt instrument. Can identify spinal cord disease in adults. What is Romberg's sign? Loss of balance in standing when eyes are closed. Usually indicating a loss of proprioception or lesion in the cerebellum. What is Homan's sign? pain on passive dorsiflexion of ankle, associated with DVT. What is the clinical presentation of Goodpasture's syndrome? Urinalysis: Specific gravity: 1.020. pH 5.5, 1+ albumin and large blood present. Chest XR positive for bilateral diffuse infiltrates. BUN 30, Cr 3.0 Symptoms: dyspnea with hemoptysis What is Goodpasture syndrome? Damage to alveolar and renal glomerular basement membranes by cytotoxic antibody. Initial treatment for Goodpasture's syndrome? Hospitalization, pulse dose of steroids, begin plasmapheresis and cyclophosphamide therapy. Characteristics of Grave's disease Ophthalmopathy (lid retraction, scleral show, proptosis) and hyperthyroidism What organism causes the formation of a staghorn calculus? Proteus mirabilus What organism causes Toxic shock syndrome? Staphylococcus aureus What electrolyte disturbance is most likely to lead to tetany and neuromuscular irritability? Hypocalcemia Features of hypercalcemia include? "Stones, groans, moans, and bones." Delerium and renal stones When you see hypochloremia, the patient may have? Metabolic Alkalosis Hyperkalemia is associated with what cardiac abnormalities? peaked T-waves, wide QRS, and ventricular arrhythmias. A patient presents with arcus cornea, LDL 285, TG 110, HDL 45, and father died of an MI at age 45. What is his most likely diagnosis? Heterozygous familial hypercholesterolemia A fasting blood glucose level of 130 mg/dL indicates: Diabetes What are risk factors for ectopic pregnancy? smoking, previous tubal surgery, previous ectopic pregnancy, exposure to diethylibestrol, current IUD, PID, advanced maternal age, infertilitiy for more than 2 years. What hormones are most critical to replace in a patient at risk for anterior pituitary insufficiency? Glucocorticoids, and thyroid hormone What is diabetes insipidus? a disorder caused by inadequate amounts of ADH which causes excessive water loss CKD Stage 1 GFR >90 with evidence of renal damage, as indicated by proteinuria. CKD Stage 2 GFR 60-89 CKD Stage 3a GFR 45-59 Upgrade to remove ads Only $2.99/month CKD Stage 3b GFR 30-44 What is the diagnosis and initial treatment of a patient with history of nonfunctional pituitary macroadenoma with severe retro-orbital headache, nausea, vomiting, mental status change, right third nerve palsy with stiff neck, and pituitary adenoma (enlarged) hemorrhage? Define the acronym MUDPILES Acronym for identifying a high anion gap metabolic acidosis: Methanol Uremia Diabetic ketoacidosis Paraldehyde Iron, isoniazid Lactate Ethanol, ethylene glycol Salicylates First-line evaluation of vulvovaginal candidiasis wet mount Prolonged nausea and vomiting can result in: Metabolic alkalosis loss of gastric acid Clinical signs/symptoms of uremic pericarditis worsening anemia, absence of diffuse ST-segment T-wave elevations, fever, pleuritic chest pain, pain that increases in recumbent position. Hemodialysis treatment should be heparin free. What is hepatorenal syndrome? chronic or acute renal disease with advanced hepatic failure and portal hypertension. What complaint is common with patients who have acute on chronic urinary retention? urinary incontinence Aside from potassium chloride as a supplement, what can be used to treat hypokalemia? Magnesium For a patient who is lethargic and hyperkalemic, what is the first line therapy? Calcium gluconate or calcium chloride Priapism is a known side effect of what medication? Trazodone What is the maximum compensation of PaCO2 in metabolic acidosis? 26 signs of preeclampsia BP > 140/90 proteinuria >300 mg of protein in urine in 24 hours headache visual changes 2+ pitting edema Question 2. Which of the following is a potential acquired cause of thrombophilia Homocysteinuria Protein C deficiency Factor V Leiden Antiphospholipid antibodies Question 3 Phalen's test, 90°wrist flexion for 60 seconds, reproduces symptoms of: Ulnar tunnel syndrome Carpal tunnel syndrome Tarsal tunnel syndrome Myofascial pain syndrome Question 4 Which patient would benefit most from screening for type 2 diabetes? A 30 year old female with unintended weight loss. A 25 year old male with family history of type 1 diabetes An obese female with recurrent vaginitis A 50 year old hyperlipidemic male Question 5 A 72 year old female patient reports a 6 month history of gradually progressive swollen and painful distal interphalangeal (DIP) joints of one hand. She has no systemic symptoms but the erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), and rheumatoid factor (RF) are all minimally elevated. What is the most likely diagnosis? Rheumatoid arthritis (RA) Osteoarthritis (OA) Lupus Peripheral neuropathy Question 6 A 32 year old male patient complains of urinary frequency and burning on urination for 3 days. Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial treatment should be: Trimethoprim-sulfamethoxazole for 3 days Ciprofloxacin for 7-10 days Trimethoprim-sulfamethoxazole for 14 days Ciprofloxacin for 3 days A thymectomy is usually recommended in the early treatment of which disease? Parkinson's disease Multiple sclerosis Myasthenia gravis Huntington's chorea Question 8 The diagnosis of human papilloma virus (HPV) infection in males is usually made by Clinical appearance Viral culture Tzanck smear KOH prep Question 9 The most effective intervention(s) to prevent stroke is (are): 81 mg of aspirin daily Carotid endarterectomy for patients with high-grade carotid lesions Routine screening for carotid artery stenosis with auscultation for bruits Smoking cessation and treatment of hypertension Question 10 What is the most common cause of Cushing's syndrome? Excessive ACTH production Administration of a glucocorticoid or ACTH Pituitary adenoma or a non-pituitary ACTH-producing tumor Autonomous cortisol production from adrenal tissue Question 11 Diagnostic radiological studies are indicated for low back pain: Routinely after 3 weeks of low back pain symptoms. To screen for spondylolithiasis in patients less than 20 years of age with 2 weeks of more of low back Traumatic fracture Osteoporosis Question 23 A middle-aged female presents complaining of recent weight loss. The physical exam reveals an enlarged painless cervical lymph node. The differential diagnosis for this patient's problem includes: Infection Toxoplasmosis Mononucleosis All of the above None of the above Question 24 An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects? Weight gain Fracture risk Hypoglycemia Weight loss Question 25 A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is cryptococcosis toxoplasmosis cryptosporidiosis cytomegalovirus Question 26 Which of the following is the most common causative organism of nongonococcal urethritis? Chlamydia trachomatis Ureaplasma urealyticum Mycoplasma hominis Trichonomas vaginalis Question 27 The most common symptoms of transient ischemic attack (TIA) include Nausea, vomiting, syncope, incontinence, dizziness, and seizure. Weakness in an extremity, abruptly slurred speech, or partial loss of vision, and sudden gait changes. Headache and visual symptoms such as bright spots or sparkles crossing the visual field. Gradual onset of ataxia, vertigo, generalized weakness, or lightheadedness Question 28 What is the first symptom seen in the majority of patients with Parkinson's disease? Rigidity Bradykinesia Rest tremor Flexed posture Question 29 A 21-year-old female presents to the office complaining of urinary frequency and urinary burning. The nurse practitioner suspects a urinary tract infection when the urinalysis reveals 1-4 red blood cells per high-powered field Specific gravity 1.012 Urobilinogen 10- white blood cells per high-powered field Question 30 A 26 year old female presents with elbow pain that is described as aching and burning. There is point tenderness along the lateral aspect of the elbow and painful passive flexion and extension. She reports she has been playing tennis almost daily for the past month. The most likely diagnosis is: Radial tunnel syndrome Ulnar collateral ligament sprain Olecranon bursitis Lateral epicondylitis: Tennis Elbow Question 31 Maria, age 17, was raped when she was 13 year old. She is now experiencing sleeping problems, flashbacks, and depression. What is your initial diagnosis? Depression Panic disorder Anxiety Post-traumatic stress disorder Question 32 An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days later, he returns to the office complaining of left great toe pain. On exam, the nurse practitioner notes an edematous, erythematous tender left great toe. The likely precipitant of this patient's pain is: Trauma Tight shoes Arthritis flare Hydrochlorothiazide Question 33 Which of the following is a contraindication for metformin therapy? Insulin therapy Creatinine > 1.5 Edema None of the above Question 34 A positive drawer sign supports a diagnosis of: Sciatica Cruciate ligament injury Meniscal injury Patellar ligament injury Question 35 Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid? Apples Peppermint Cucumbers Popsicles Question 36 A patient taking levothyroxine is being over-replaced. What condition is he at risk for? Osteoporosis Constipation Depression Exopthalmia Question 37 Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following: HbA1C 2-hour 75 gram oral glucose tolerance test C-peptide level A and B All of the above Question 48 Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? Musculoskeletal pain Difficulty sleeping Depression Fatigue Question 49 Differential diagnosis of proteinuria includes which of the following? Orthostatic proteinuria Nephrotic syndrome Infection Trauma A and B Question 50 A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as: Underweight Normal weight Overweight Obese Question 51 Reed-Sternberg B lymphocytes are associated with which of the following disorders: Aplastic anemia Hodgkin's lymphoma Non Hodgkin's lymphoma Myelodysplastic syndromes Question 53 A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects: Arthritis Ulnar neuritis Septic arthritis Olecranon bursitis Question 54 Establishment of a definitive diagnosis of osteomyelitis requires: A known causative injury such as a puncture wound, bite, or decubitus ulcer. Biopsy of culture of the pathogen from blood or bone aspirate. Visualization of purulent material draining into soft tissue. Lucent areas identified on plain x-ray. Question 55 The most accurate measure of diabetes control is: Avoidance of micro- and macro-vascular complications. Insulin sensitivity. Early morning glucose levels. HgbA1c Question 56 A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder? Alprazolam or diazepam Venlafaxine or buspirone Trazodone or sertraline Venlafaxine or hydroxyzine pamoate Question 57 The most common presentation of thyroid cancer is: Generalized enlargement of the thyroid gland. A solitary thyroid nodule. A multinodular goiter. Abnormal thyroid function tests. Question 58 Which of the following accounts for half of the bladder tumors among men and one-third in women? Cigarette smoke, both active and passive inhalation Chemicals from plastic and rubber Chronic use of phenacetin-containing analgesic agents Working long hours and not voiding often Question 59 You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of: Sjogren's syndrome Pancreatic cancer Disseminated malignancy of the hematologic system Cancer of the liver Question 60 Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to: Refer her to a hand surgeon Take a more complete history Try neutral position wrist splinting and oral NSAID Order a nerve conduction study such as am electromyography Question 61 Which drug category contains the drugs that are the first line Gold standard therapy for COPD? Corticosteroids Inhaled beta-2 agonist bronchodilators Inhaled anticholinergic bronchodilators Xanthines Question 62 Potential causes of septic arthritis include which of the following? Lyme disease Prosthetic joint infection Reiter's syndrome A and B All of the above Question 63 The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is: Oral ciprofloxacin (Cipro) Oral doxycycline (Virbamycin) plus intramuscular ceftriaxone Oral trimethoprim-sulfamethoxazole (Bactrim DS) Intramuscular penicillin Question 64 A patient has been taking fluoxetine (Prozac) since being diagnosed with major depression, first episode, 2 months ago. She reports considerable improvement in her symptoms and her intention to discontinue the medication. What should be the nurse practitioner's recommendation? Hypertriglyceridemia and low high-density lipoprotein (HDL) Gestational diabetes and polycystic ovarian syndrome Hispanic, African-American, Native-American, and Pacific Islander ethnicity Postprandial hypoglycemia Question 75 A 28-year-old female presents to the office requesting testing for diagnosis of hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her risk factors. The nurse practitioner explains that: The patient should start anticoagulant therapy immediately. Hereditary thrombophilia does not always require anticoagulation therapy. Women of childbearing age cannot take anticoagulant therapy. Genetic and risk management counseling are recommended. B and D Question 76 The 4 classic features of Parkinson's disease are Mask-like facies, dysarthria, excessive salivation, and dementia. Tremor at rest, rigidity, bradykinesia, and postural disturbances. Depression, cognitive impairment, constipation and shuffling gait. Tremor with movement, cogwheeling, repetitive movement, and multi-system atrophy. Question 77 Which of the following set of symptoms should raise suspicion of a brain tumor? Recurrent, severe headaches that awaken the patient and are accompanied by visual disturbances. Vague, dull headaches that are accompanied by a reported sense of impending doom. Periorbital headaches occurring primarily in the evening and accompanied by pupillary dilation and photophobia. Holocranial headaches present in the morning and accompanied by projective vomiting without nausea. Question 78 The most common cause of elevated liver function tests is: Hepatitis Biliary tract obstruction Chronic alcohol abuse A drug-induced injury Question 79 The physiological explanation of syncope is: Accelerated venous return and increased stroke volume resulting in deactivation of the parasympathetic nervous system. A cycle of inappropriate vasodilation, bradycardia, and hypotension. A sudden rise in blood pressure due to overly efficient vasoconstriction. Emotional stress resulting in hypertension, tachycardia, and increased venous return. Question 80 A 60 year old male patient with multiple health problems presents with a complaint of erectile dysfunction (ED). Of the following, which medication is most likely to be causing the problem? Thiazide diuretic Insulin Famotidine (Pepcid) Albuterol Question 81 The cardinal sign of infectious arthritis is: Affected joint is painful at rest, with movement and weight bearing Rapid onset that wakes the patient during the night Long history of severe pain with associated joint swelling None of the above Question 82 A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains: Primary hyperparathyroidism is treated with Vitamin D restriction Primary hyperparathyroidism is treated with parathyroidectomy Primary hyperparathyroidism is treated with daily magnesium Primary hyperparathyroidism is treated with parenteral parathyroid hormone (PTH) Question 83 Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis? Doxycycline 100 mg qd Nitrofurantoin 100 mg qd Bactrim DS qd Erythromycin qd Question 84 Who is at a higher risk for developing nephrolithiasis? Jack, who exercises every day and drinks copious amounts of water Mary, who watches her weight and eats a low-sodium diet Harvey, a "couch potato" who drinks a lot of no-sodium soda Bill, who runs every day and takes excessive amounts of vitamin C Question 85 Potential side effects of levofloxacin include which of the following? Confusion Hypoglycemia Achilles tendon rupture All of the above Question 86 A patient has just been diagnosed with Bell's palsy. He is understandably upset and has questions about the prognosis. You response should be: Although most of your symptoms will disappear, some will remain but can usually be camouflaged by altering your hairstyle or growing a beard Unfortunately there is no cure but you have a mild case The condition is self-limiting and most likely complete recovery will occur With suppressive drug therapy you can minimize the symptoms Question 87 A diabetic patient is taking low-dose enalapril for hypertension. A record of the patient's blood pressure over 4 weeks ranges from 130 to 142 mmHg systolic and 75 to 85 mmHg diastolic. How should the nurse practitioner respond? Change to a different class of antihypertensive medication to get better control. Increase the dosage of the current BP medication. Continue the current medication and dosage for 4 more weeks. Add a beta-blocker to the current medication regimen. What diabetic complications result from hyperglycemia? 1. Retinopathy 2. Hypertension resistant to treatment 3. Peripheral neuropathy 4.Accelerated atherogenesis 1, 2, 3 2, 3, 4 "You have watched your diet for all these years and as a result, your body is using less insulin." "I will have to change your oral hyperglycemic agents as it seems your body is making more insulin." Question 99 A child with type 1 diabetes mellitus has experienced excessive hunger, weight gain and increasing hyperglycemia. The Somogyi effect is suspected. What steps should be taken to diagnose and treat this condition? Decrease the evening insulin dose and check capillary blood glucose (CBG) at 2:00 am. Instruct the child's parents on physical activities to help weight loss. Increase the evening insulin dose and check CBG at 2:00 am. Refer the child for instruction on a strict diabetic diet. Question 100 At what age is screening most likely to detect scoliosis? 4 to 6 years 8 to 10 years 12 to 14 years 18 to 20 years Question 101 The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are): Patient report of bladder dysfunction, saddle anesthesia, and motor weakness of limbs. History of significant trauma relative to the patient's age. Decreased reflexes, strength, and sensation in the lower extremities. Patient report of pain with the crossed straight leg raise. A patient who has had a swollen, nontender scrotum for one week is found to have a mass within the tunica vaginalis that transilluminates readily. The family nurse practitioner suspects: a.) a hydrocele. b.) a varicocele. c.) an indirect inguinal hernia. d.) carcinoma of the testis. a hydrocele. A client had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute: A) Prerenal inflammation B) Bladder outlet obstruction C) Tubular necrosis D) Intrarenal nephrotoxicity Bladder outlet obstruction Mr. S. comes to you with scrotal pain. The examinations of his scrotum, penis, and rectum are normal. Which of the following conditions outside of the scrotum may present as scrotal pain? A. Inguinal herniation and peritonitis B. Renal colic and cardiac ischemia C. Pancreatitis and Crohn ' s disease D. Polyarteritis nodosa and ulcerative colitis Inguinal herniation and peritonitis The most common type of hernia is a(n): A. indirect inguinal hernia. B. direct inguinal hernia. C. femoral hernia. D. umbilical hernia. indirect inguinal hernia. Max, age 70, is obese. He is complaining of a bulge in his groin that has been there for months. He states that it is not painful, but it is annoying. You note that the origin of swelling is above the inguinal ligament directly behind and through the external ring. You diagnose this as a(n): A. indirect inguinal hernia. B. direct inguinal hernia. C. femoral hernia. D. strangulated hernia. direct inguinal hernia. A 35 year old sexually active man presents with a 1 week history of fever and pain over the left scrotum. It is accompanied by frequency and dysuria. The scrotum is edematous and tender to touch. He denies flank pain, nausea, and vomiting. He reports that eh pain is lessend when he uses scrotal-support briefs. The urinalysis shows 2 + blood and a large number of leukocytes. What is the most likely diagnosis? A. Acute urinary tract infection B. Acute pyelonephritis C. Acute orthitis D. Acute epididymitis Acute epididymitis Orchitis is caused by which of the following? A. Mumps virus B. Measles virus C. Chlamydia trachomatis D. Chronic urinary tract infections that are not treated adequately Mumps virus A 10 year old boy complains of sudden onset of scrotal pain upon awakening that morning. He is also complaining of severe nausea and vomiting. During the physical examination, the nurse practitioner finds a tender, warm, and swollen left scrotum. The cremastic reflex is negative and the urine dipstick is negative for leukocytes, nitrites, and blood. The most likely diagnosis is: A. Acute epididymitis B. Severe salmonella infection C. Testicular torsion D. Acute orchitis Testicular torsion What type of follow up should this patient receive? A. Refer to a urologist within 48 hours B. Refer him to the emergency department as soon as possible C. Prescribe ibuprofen (advil) 600 mg QID for pain D. Order a testicular ultrasound for further evaluation Refer him to the emergency department as soon as possible A 24-year-old man presents with sudden onset of left-sided scrotal pain. He reports having intermittent unilateral testicular pain in the past but not as severe as this current episode. Confirmation of testicular torsion would include all of the following findings except: A. unilateral loss of the cremasteric reflex. B. the affected testicle held higher in the scrotum. C. testicular swelling. D. relief of pain with scrotal elevation. relief of pain with scrotal elevation In assessing a man with testicular torsion, the NP is most likely to note: A. elevated PSA level. B. white blood cells reported in urinalysis. C. left testicle most often affected. D. increased testicular blood flow by color-flow Doppler ultrasound. left testicle most often affected. Anticipated organ survival exceeds 85% with testicular decompression within how many hours of torsion? C. loss of appetite and weight loss. D. irritative voiding symptoms, inability to ambulate, and fever. irritative voiding symptoms, low back pain, and perineal pain. When performing a prostate examination, you note a tender, warm prostate. What do you suspect? A. Benign prostatic hypertrophy B. Prostatic abscess C. Prostate cancer D. Bacterial prostatitis Bacterial prostatitis Gerard is complaining of a scrotal mass; however, the scrotum is so edematous that it is difficult to assess. How do you determine if it is a hernia or a hydrocele? Bowel sounds may be heard over a hernia. Mr. S comes to you with scrotal pain. The examinations of his scrotum, penis, and rectum are normal. Which of the following conditions outside of the scrotum may present as scrotal pain? Inguinal hernia and peritonitis A 17 year old boy reports feeling something on his left scrotum. On palpation, soft and movable blood vessels that feel like a "bag of worms" are noted underneath the scrotal skin. It is not swollen or reddened. The most likely diagnosis is A. Chronic orchitis B. Chronic epididymitis C. Testicular torsion D. Varicocele Varicocele What risk factors contribute to varicocele? A. Younger age B. Current cigarette smoker C. Multiple sex partners D. None of the above None of the above Treatment options for varicocele repair include all of the following except: A. Open surgery B. Laparoscopic surgery C. Treatment with a thrombolytic agent D. Percutaneous embolization Treatment with a thrombolytic agent There is a higher risk of balanitis in which of the following conditions? A. Renal Insufficiency B. Diabetes Mellitus C. Graves' disease D. Asthma Diabetes Mellitus Balanitis is caused by: A. Staphylococcus aureus B. Streptococcus pyogenes C. Candida albicans D. Trichomonads Candida albicans Balanitis is a symptom of which one of the following diseases A. Psoriatic arthritis B. Reactive arthritis C. Alkylosing Spondylitis D. Rheumatoid arthritis Reactive arthritis The average American man has an approximately % lifetime risk of prostate cancer and an approximately % likelihood of clinical disease. A. 15, 5 B. 25, 8 C. 40, 10 D. 60, 15 40, 10 All of the following can cause an elevated PSA level except: A. Current prostate infection B. Recent cystoscopy C. BPH D. Prostatectomy Prostatectomy According to recent epidemiologic studies, prostate cancer is the number cause of cancer death in men residing within the US. (B) A. 1 B. 2 C. 3 D. 4 2 You perform a DRE on a 72-year old man and find a lesion suspicious for prostate cancer. The findings are described as: A. a rubbery, enlarged prostatic lobe. B. an area of prostatic induration C. a boggy gland. D. prostatic tenderness an area of prostatic induration All of the following can cause a elevated PSA level except: A. current prostate infection B. recent cystoscopy C. BPH D. prostatectomy prostatectomy A 54 year old white man with no obvious risk for prostate cancer opted to undergo PSA screening and DRE testing. The DRE findings are normal and his PSA is 3..7ng/ml. You recommend: A. Repeating the PSA test immediately. B. Repeat screening in 1 yr. C. Repeat screening in 2 yrs. D. Repeat screening in 5 yrs. Repeat screening in 1 yr. Which of the following mediations is associated with the highest incidence of erectile dysfunction? a. Lamotrigine (Lamictal) b. Clonazepam (Klonopin) c. Paroxetine (Paxil) d. Doxepin (Sinequan) Paroxetine (Paxil) Which of the following is not a common risk factor for erectile dysfunction (ED)? A. diabetes mellitus C) Acute pyelonephritis D) Renal artery stenosis Renal artery stenosis A 65-year-old carpenter complains of stiffness and pain in both hands and right knee shortly after waking and worsens in the afternoon. He feels some relief with rest. On, exam the nurse practitioner notices the presence of Heberden's nodes. Which of the following is most likely? a. Osteoporosis b. Rheumatoid Arthritis c. Osteoarthritis d. Reiter's syndrome Osteoarthritis Mary, age 72, has severe osteoarthritis of her right knee. She obtains much relief from corticosteroid injections. When she asks you how often she can have them, how do you respond? A. Only once a year in the same joint B. No more than twice a year in the same joint C. No more than three to four times a year in the same joint D. No more than five to six times a year in the same joint No more than three to four times a year in the same joint Your 75-year-old client with osteoarthritis of the knee will be starting on a course of NSAIDs for pain management. The most important teaching point for your patient currently is: A. You should start with a high dose first and taper down the dose as needed. B. You should continue to take your Coumadin as you have been. C. Report any excessive stomach upset or if you notice that your stools become dark or bloody. D. At this point, it will not be helpful to lose weight. Report any excessive stomach upset or if you notice that your stools become dark or bloody. A 45-year-old woman in complaining of generalized stiffness, especially in both her wrist and hands. It is much worse in the morning and last a few hours. She also complains of fatigue and generalized body aches that have been present for the past few months. Which of the following is most likely? a. Osteoporosis b. Rheumatoid arthritis c. Osteoarthritis d. Gout Rheumatoid arthritis Ginny, age 48, has rheumatoid arthritis and gets achy and stiff after sitting through a long movie. This is referred to as A. longevity stiffness B. gelling C. intermittent arthritis D. molding gelling Mrs. Matthews has rheumatoid arthritis. On reviewing an x-ray of her hip, you notice that there is a marked absence of articular cartilage. What mechanism is responsible for this? A. Antigen-antibody formation B. Lymphocyte response C. Immune complex formation D. Lysosomal degradation Lysosomal degradation Karina a client with myasthenia gravis is to receive immunosuppressive therapy. The nurse understands that this therapy is effective because it: A. Stimulates the production of acetylcholine at the neuromuscular junction. B. Promotes the removal of antibodies that impair the transmission of impulses C. Inhibits the breakdown of acetylcholine at the neuromuscular junction. D. Decreases the production of autoantibodies that attack the acetylcholine receptors. Decreases the production of autoantibodies that attack the acetylcholine receptors. Treatment for Myasthenia Gravis Includes: A. IVIG or Plasmapheresis B. Antibiotics C. Analgesic's D. Sedation IVIG or Plasmapheresis What specific treatment is given patients diagnosed with Myasthenia Gravis that will focus on improving conduction? A. Surgery B. Physical Therapy C. Mestinon (pyridostigmine) Neostigmine D. Fluroquinolones Mestinon (pyridostigmine) Neostigmine First-line treatment of SLE in a patient with mild symptoms is: A. systemic corticosteroids. B. hydroxychloroquine plus NSAIDs. C. anakinra. D. methotrexate. hydroxychloroquine plus NSAIDs. Common physical findings of SLE include all the following except: A. weight gain. B. joint pain and swelling. C. fatigue. D. facial rash. weight gain. Which of the following is not characteristic of rheumatoid arthritis (RA)? A. It is more common in women than in men at a 3:1 ratio. B. Family history of autoimmune conditions often is reported. C. Peak age for disease onset in individuals is age 50 to 70 years. D. Wrists, ankles, and toes often are involved. Peak age for disease onset in individuals is age 50 to 70 years. The use of all of the following medications can trigger gout except: A. aspirin. B. statins. C. diuretics. D. niacin. statins. Which of the following dietary supplements is associated with increased risk for gout? A. vitamin A B. gingko biloba C. brewer's yeast D. glucosamine brewer's yeast Which of the following conditions places a patient at an increased risk of plantar fasciitis? A. Diabetes B. Pregnancy C. Alcoholism D. Thyroid disease Diabetes A. " Bend your knees and face the object straight on. " B. " Hold boxes away from your body at arm 's length. " C. " Bend and twist simultaneously as you lift. " D. " Keep your feet firmly together. " " Bend your knees and face the object straight on. " With the straight-leg-raising test, the NP is evaluating tension on which of the following nerve roots? A. L1 and L2 B. L3 and L4 C. L5 and S1 D. S2 and S3 L5 and S1 The most common sites for lumbar disk herniation are: A. L1 to L2 and L2 to L3. B. L2 to L3 and L4 to L5. C. L4 to L5 and L5 to S1. D. L5 to S1 and S1 to S2 L4 to L5 and L5 to S1 Immediate diagnostic imaging for low back pain should be reserved for all of the following EXCEPT: A. presence of signs of the cauda equina syndrome. B. presence of severe neurological deficits. C. presence of risk factors for cancer. D. presence of moderate pain lasting at least 2 weeks. presence of moderate pain lasting at least 2 weeks. First-line therapy for prepatellar bursitis should include: A. bursal aspiration. B. intrabursal corticosteroid injection. C. acetaminophen. D. knee splinting. bursal aspiration. Clinical conditions with a presentation similar to acute bursitis include which of the following? (More than one can apply.) A. rheumatoid arthritis B. septic arthritis C. joint trauma D. pseudogout all of the above Patients with subscapular bursitis typically present with: A. limited shoulder ROM. B. heat over affected area. C. localized tenderness under the superomedial angle of the scapula. D. cervical nerve root irritation localized tenderness under the superomedial angle of the scapula. Which of the following is usually NOT part of treatment of a sprain? A. immobilization B. applying ice to the area C. joint rest D. local corticosteroid injection local corticosteroid injection If any limitation or any increase in range of motion occurs when assessing the musculoskeletal system, the angles of the bones should be measured by using A. Phalen ' s test. B. skeletometry. C. the Thomas test. D. a goniometer. a goniometer. In assessing the skeletal muscles, you turn the forearm so that the palm is up. This is called A. supination. B. pronation. C. abduction. D. eversion. supination. The most common cause of acute bursitis is: A. Inactivity B. Joint overuse C. Fibromyalgia D. Bacterial infection Joint overuse First-line treatment options for bursitis usually include: A. corticosteroid bursal injection. B. heat to area. C. weight-bearing exercises. D. nonsteroidal anti-inflammatory drugs (NSAIDs). nonsteroidal anti-inflammatory drugs (NSAIDs). Likely sequelae of intrabursal corticosteroid injection include: A. irreversible skin atrophy. B. infection. C. inflammatory reaction. D. soreness at the site of injection. soreness at the site of injection. Patients with lateral epicondylitis typically present with: a. electric-like pain elicited by tapping over the median nerve b. reduced joint pain c. pain that is worst with elbow flexion (elbow ROM is usually normal) d. decreased hand grip strength the pain is worse with resisted wrist extension decreased hand grip strength the pain is worse with resisted wrist extension Risk factors for lateral epicondylitis include all of the following EXCEPT: A. repetitive lifting B. playing tennis C. hammering D. gout gout Up to what percentage of patients with medial epicondylitis recover without surgery? A. 35% B. 50% C. 70% D. 95% 95% Initial treatment of lateral epicondylitis includes all of the following EXCEPT: A. rest and activity modifications B. corticosteroid injections C. topical or oral NSAIDS D. counterforce bracing brace centered over the back of the forearm can help relieve symptoms corticosteroid injections What type of muscular dystrophy do females get? A. becker md b. Duchenne md c. myotonic md d. none none The following are causes of scoliosis except: a. unknown b. spinal congenital deformity c. arthritis d. herniated disc. herniated disc. It is defined as a true deformity of the spine a. functional scoliosis b. structural scoliosis c. arthritic scoliosis d. neurofibroma scoliosis structural scoliosis Screening for females are recommended at what age? A. 5 and 12 B. 7 and 11 3. 14 and 15 d. 10 and 12. 10 and 12. Bouchard's nodule is found in which of the following? A) Rheumatoid arthritis B) Degenerative joint disease C) Psoriatic arthritis D) Septic arthritis Degenerative joint disease Podagra is associated with which of the following? A) Rheumatoid arthritis B) Gout C) Osteoarthritis D) Septic arthritis Gout Which of the following statements is most consistent with fibromyalgia? A. It is predominantly diagnosed in African Americans. B. It affects less than 1% of the general population. C. It is four to seven times more common in women than in men. D. It is most often initially diagnosed in adults younger than 20 years old and older than 55 years old. It affects less than 1% of the general population. Fibromyalgia is more common in patients with: A. type 2 diabetes. B. rheumatoid arthritis and systemic lupus erythematosus. C. migraine headaches. D. chronic obstructive pulmonary disorder (COPD). rheumatoid arthritis and systemic lupus erythematosus. Which of the following is inconsistent with the clinical presentation of fibromyalgia? A. widespread body aches B. joint swelling C. fatigue D. cognitive changes fatigue Jonas, age 62, 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? A. Lethargy B. Delirium C. Syncope D. A fugue state Syncope The Hallpike maneuver is performed to elicit A. a seizure. B. vertigo. C. syncope. D. a headache. syncope. Common signs of high-grade aortic stenosis in an individual during exercise include all of the following except: A. dyspnea. B. angina. C. seizure. D. syncope. syncope. All of the following are possible etiologies for papilledema a. Intracranial abscess b. Ruptured aneurysm c. Migraine headaches d. Cerebral edema Migraine headaches The following measures are used for treating various types of headache. Which is not considered to be effective therapy for migraine? a. Propanolol prophylaxis b. Resting in a quiet and darkened room c. Trimethobenzamide suppositories for nausea d. Sodium restriction to decrease water retention Sodium restriction to decrease water retention Which of the following is indicated in the prophylactic treatment of migraine headache a. ibuprofen (Motrin) b. Naproxen sodium (Anaprox) c. Propanolol (Inderal) d. Sumatriptan (Imitrex) Propanolol (Inderal) An adult woman comes to the clinic presenting with gradual onset of throbbing headaches behind one eye worsening over several eyes is diagnosed as a. Cluster headache b. Migraine headache c. Trigeminal neuralgia d. Temporal arteritis Migraine headache In tension-type headache, which of the following statements is true? a. Photophobia is seldom reported. b. The pain is typically described as "pressing" in quality Sedimentation rate Which of the following conditions is most likely? A. cluster headache B. migraine headache with aura C. migraine headache without aura D. Giant cell arteritis Giant cell arteritis Of the four types of strokes, which one is the most common and has a gradual onset? A. Thrombotic B. Embolic C. Lacunar D. Hemorrhagic Thrombotic Which of the following risk factors for a stroke can be eliminated? A. Hypertension B. Carotid artery stenosis C. Smoking D. Hyperlipidemia Smoking Which of the following complications is the leading cause of death shortly after a stroke? A. Septicemia B. Pneumonia C. Pulmonary embolus D. Ischemic heart disease Pneumonia Risk factors for transient ischemic attack (TIA) include all of the following except: A. atrial fibrillation. B. carotid artery disease. C. combined oral contraceptive use. D. pernicious anemia. pernicious anemia. A TIA is characterized as an episode of reversible neurological symptoms that can last: A.1 hour. B.6 hours. C.12 hours. D.24 hours 24 hours When caring for a patient with a recent TIA, you consider that: A. long-term antiplatelet therapy is likely indicated. B. this person has a relatively low risk of future stroke. C. women present with this disorder more often than men. D. rehabilitation will be needed to minimize the effects of the resulting neurological insult. long-term antiplatelet therapy is likely indicated. A 56-year-old man complains of several episodes of severe lacerating pain that shoots up to his right cheek and is precipitated by drinking cold drinks or chewing. These episodes start suddenly and end spontaneously after a few seconds with several episodes per day. He denies any trauma, facial weakness, or difficulty swallowing. He has stopped drinking cold drinks because of the pain. Which of the following is most likely? A. Trigeminal neuralgia B. Cluster headache C. Acute sinusitis D. Sinus headache Trigeminal neuralgia Which of the following cranial nerves is evaluated when a wisp of cotton is lightly brushed against the corner of the eye? A. CN II B. CN III C. CN IV D. CN V CN V You examine a 29-year-old woman who has a sudden onset of right sided facial asymmetry. She is unable to close her right eyelid tightly, frown, or smile on the affected side. Her exam is otherwise unremarkable. This presentation likely represents paralysis of CN: A: lll B. lV C. Vll D. Vlll Vll Which represents the most appropriate diagnostic test for the patient in the previous question? A. CBC with WBC Differential? B. Lyme disease antibody titer? C. CT scan of the head with contrast? D. BUN and Creatine levels? Lyme disease antibody titer? In prescribing prednisone for the patient with Bells palsy, the NP considers that its use: A. Has not been shown to be helpful in improving outcomes in the condition. B. Should be initiated asap after the onset of facial paralysis. C. Is likely to help minimize ocular symptoms. D. May prolong the course of the disease. Should be initiated asap after the onset of facial paralysis. Treatment options for an adult with seizures include all of the following agents EXCEPT: a. Carbamazepine b. Phenytoin c. Gabapentin d. tamsulosin tamsulosin Which of the following best describes patient presentation during tonic-clonic (grand mal) seizure? a. Blank staring lasting 3 to 50 seconds, accompanied by impaired level of consciousness b. Awake state with abnormal motor behavior lasting seconds c. Rigid extension of arms and legs, followed by sudden jerking movements with loss of consciousness d. Abrupt muscle contraction with autonomic signs Rigid extension of arms and legs, followed by sudden jerking movements with loss of consciousness Central obesity, “moon” face, and dorsocervical fat pad are associated with: D None of the above