bonus 6

Question 1

Which of the following findings is most consistent with a diagnosis of acute bacterial rhinosinusitis?

Fever >100.7⁰F (38.2⁰C)
Upper respiratory tract infection-like signs and symptoms persisting for ≥10 days
Concomitant presence of facial pressure
Copious amounts of nasal discharge

Answer 1

Correct—Upper respiratory tract infection-like signs and symptoms persisting for ≥10 days

Question 2

Meeting the eligibility requirements for national NP certification signifies that the nurse practitioner:

Attained the required academic and clinical skills for specialty practice.
Graduated from an accredited nurse practitioner educational program.
Has achieved select prerequisites determined by a nongovernmental professional organization
Has permission to practice as a nurse practitioner

Answer 2

Correct—Has achieved select prerequisites determined by a nongovernmental professional organization

Question 3

Radiographic assessment of a patient with early osteoarthritis will most likely reveal:

Soft tissue swelling.
Involvement of the metacarpals.
Osteophyte formation.
Joint space narrowing on X-ray.

Answer 3

Correct—Joint space narrowing on X-ray

Question 4

The mechanism of action of a GLP-1 agonist includes:

Attenuation of insulin resistance.
Promotion of renal glucose excretion.
Increase in insulin release in response to rising glucose.
Decrease in gastric emptying.

Answer 4

Correct—Increase in insulin release in response to rising glucose.
(Liraglutide)
Victoza

Question 5

The nurse practitioner has diagnosed acute bacterial rhinosinusitis (ABRS) and is considering antibiotic choices. He recognizes that the most common causative pathogen is:

H. influenzae.
S. aureus.
S. pneumoniae.
M. catarrhalis.

Answer 5

Correct—S. pneumoniae.

Question 6

One of the preferred pharmacologic options of persistent cough in an otherwise well 25-year-old woman with acute uncomplicated bronchitis would most likely include:

Antibiotic therapy to cover atypical pathogens.
An inhaled short-acting muscarinic antagonist.
An inhaled corticosteroid.
A dextromethorphan-based cough suppressant

Answer 6

Correct—An inhaled short-acting muscarinic antagonist.

Question 7

A 64-year-old man presents complaining of difficulty initiating urination, a weak urine stream, and inability to completely empty the bladder. Suspecting benign prostatic hyperplasia, you prescribe tamsulosin and advise the patient that this will:

Decrease the size of the prostate.
Relax the bladder neck muscles to ease urination.
Eradicate bacteria that cause inflammation of the prostate.
Reverse hormonal changes that cause prostate enlargement

Answer 7

Correct—Relax the bladder neck muscles to ease urination.

Question 8

The use of pioglitazone is not recommended in which of the following clinical scenarios in T2DM?

A 57-year-old man with hypertension.
A 62-year-old woman with heart failure.
A 45-year-old woman with hypothyroidism.
A 35-year-old man with asthma

Answer 8

Correct—A 62-year-old woman with heart failure

TZD (Actos)

Question 9

Caleb, a 9-month-old boy, is presented for evaluation with a four-hour history of sudden onset of what his mother suspects is abdominal pain, as “He cries when I touch his stomach.” He also draws his knees to his abdomen with most forceful, distressed crying. The mother reports that he has had 3 episodes of diarrhea that contain a mixture of blood and mucous since his distress began. He has not vomited during this time, but also has a lack of appetite. The most appropriate next diagnostic test for Caleb is:

Ultrasound of the abdomen
Flat plate of the abdomen
Stool culture with susceptibility testing
Stool sample to check for ova and parasites

Answer 9

Feedback
Correct answer:
Ultrasound of the abdomen. Clinical scenario describes likely intussusception.

Question 10

In advising a woman with menstruation-related migraine without aura and combined oral contraceptive use, the nurse practitioner considers that:

A high-dose estrogen pill should be prescribed.
Uninterrupted use can help minimize headache frequency and severity.
Headache severity is likely to increase.
Cardiovascular risk is markedly increased

Answer 10

Feedback
Correct answer:
Uninterrupted use can help minimize headache frequency and severity.

Question 11

Your patient has been using a progestin implant for contraception for the last three years and is now ready to start a family. She asks how long she should wait after ending the use of the contraceptive. You advise that it is safe to conceive:

Immediately.
After 1–2 months.
After 3–4 months.
After 2 normal menstrual cycles

Answer 11

Feedback
Correct answer:
Immediately

Question 12

A 15-week-old infant presents with a fever of 100.5􀀀F (38.1􀀀C) and bilateral erythematous tympanic membranes. The infant is alert with excellent skin turgor, no evidence of difficulty breathing, acknowledges her mother’s face, and is wearing a wet diaper. Her parents report that she is vigorously nursing every 3 hours without vomiting or excessive stooling. The appropriate management would be to:

Counsel the mother to observe for 72 hours and return to clinic if there is no improvement.
Start topical therapy with otic antibiotic drops.
Initiate a sepsis workup.
Begin a systemic antibiotic regimen.

Answer 12

Feedback
Correct answer:
Begin a systemic antibiotic regimen.