Leik bank

Question 1

The NP is managing a stable middle-aged adult with emphysema. In addition to reinforcing smoking cessation and med schedules, which annual intervention will the NP recommend?

Answer 1

Quadrivalent inactivated influenza vaccine (QIV)

An older adult with chronic respiratory disease should receive this

Question 2

Who can receive the Live Attenuated Influenza vaccine?

Answer 2

2 years - 49 years
administered via nasal spray

Question 3

PPSV23 is recommended for people that are….

Answer 3

65+
aged 19 to 64 who smoke

Question 4

PCV13 is recommended for

Answer 4

children <2 years

Question 5

What is the Murphy’s sign?

Answer 5

deeply press RUQ during inspiration. Mid inspiratory arrest = cholecystitis

Question 6

What is rovsing’s sign

Answer 6

Deep palpation of the LLQ of the abdomen.

Question 7

What is the Markle test

Answer 7

patient raises their heels and drops them suddenly

Question 8

What is the psoas test?

Answer 8

When patient experiences abdominal pain while flexing the hip and knee

Question 9

what causes PSA testing to be falsely elevated?

Answer 9

urinary retention
UTI
DRE
Ejaculation within 48 hours

Question 10

A young adult with myasthenia gravis is diagnosed with pertussis. Which antibiotic is contraindicated in a patient with this condition?
Why?
What would you give instead?

Answer 10

Erythromycin
Telithromycin

Potential for respiratory collapse.

Give Azithromycin
or Clarithromycin

Question 11

The NP who is evaluating a patient with polycystic kidney disease wil pay close attention to which area of the kidney?

Question 12

A 29-year-old female patient presents to the clinic with complaints of painful sexual intercourse and pain when urinating. The patient’s temperature is 100.1F. Upon physical examination, the nurse practitioner notes a healthy appearance of the internal and external genitalia. The patient has lower abdominal and cervical motion tenderness in response to palpation. What will the NP order to confirm the diagnosis and determine the appropriate treatment?

Answer 12

Cervical culture

Patient findings associated with endometritis. blood cultures only when signs of sepsis. US if post partum for retained products

Question 13

The NP is reviewing the chart of an 8 month old infant scheduled to receive immunizations. Which vaccine woudl the NP question if noted in teh infant’s chart?
MMR?
Hep B?
Hib?
Rotavirus

Answer 13

MMR because it is not given until 12 months of age

Question 14

What is the first line treatment for osteoporosis?

Answer 14

Bisphosphonates
EX: alendronate, risedronate, “-ronate”

Question 15

What are the 1st and 2nd line treatment for acne?

Answer 15

1st: OTC topical antibiotic gels and medicated soap
2nd Tetracycline

Question 16

What hemopoietic disorder will the NP assess for in a 3 y/o with lead poisoning?

Answer 16

iron deficiency anemia

irone defiency has been shown to increase in lead retention

Question 17

What is pernicious anemia?

Answer 17

inability to absorb vitamin B12

Question 18

What is the cause of normocytic anemia? who does it normally effect?

Answer 18

long-term chronic disease

Elderly

Question 19

A male patient presents with urethritis, migratory arthritis in the large joints, and ulcers on the glans penis secondary to chlamydial infection. The NP will implement all of the following interventions except?
a. Tx w/ NSAID
b. antibiotics to tx infection
c. treat with alpha-linolenic acid

Answer 19

This is Reiter’s syndrome
immune mediated reaction 2ndary to chlamydia infection.

EXCEPT!!! alpha-linolenic acid (treats ankylosing spondylosis)

Question 20

What are the ACS guidelines for screening for colon cancer?

Answer 20

Annual colonoscopy and/or fecal occult blood testing starting at 50 years old

Question 21

hat is Bowen’s disease?

Answer 21

SCC of epidermis that has not invaded the dermis.
well defined, primary lesions <20 mm over trunk and extremities

Tx: Curettage and electrodessication

Question 22

What is the mnemonic for high risk hearing loss ?

Answer 22

HEARS
Hyperbilirubinemia
ear infection frequency
low Apgar scores
Exposure to rubella
CMV
Seizures

Question 23

For women that are not high risk, what should we start mammograms for breast cancer screening? How often should we repeat?

Answer 23

Start at age 50
Repeat every 2 years

Question 24

What is the screening for congenital heart defects for a newborn?

Answer 24

O2 saturation measure greater than/equal to 95% and no more than a 3% difference between the hand and feet

Question 25

What are common signs of pregnancy induced hypertension?

Answer 25

edema of face and upper extremities Weight gain Blurred vision Elevated BP proteinuria Headaches

Question 26

What would you prescribe for urinary incontinence for a women?

Answer 26

Oxybutynin (Ditropan)

Question 27

What drug class is Chlorthalidone (Hygroton)?

Answer 27

thiazide

Question 28

What diuretics are contraindicated in patients who are allergic to sulfa poducts?

Answer 28

thiazides Loop diuretics

Question 29

what does a 24 hr urine collection measure?

Answer 29

creatinine clearance to assess for proteinuria, albuminuria, and GFR

Question 30

What are hematologic findings with beta thalassemia?

Answer 30

decreased hemoglobin a hypochromic RBCs MCV decreased MCHC decreased

Question 31

What would you prescribe to treat HTN and BPH

Answer 31

Terazosin (Hytrin)

Question 32

What type of tear would produce a positive McMurray?

Answer 32

meniscus

Question 33

What can cause a false positive ovulation test?

Answer 33

PCOS menopause endometriosis ovarian insufficiency

Question 34

What do you prescribe to treat an 18 months old with a symptomatic UTI?

Answer 34

Augmentin and Bactrim

Question 35

At 12 weeks gestation, the fundus of the uterus should be located approximately at ____

Answer 35

symphysis pubis

Question 36

a patient with Grave's disease for 2 years is found to have afib....what do you prescribe?

Answer 36

Warfarin (Coumadin) People with hyperthyroid are at higher risk of osteoporosis and afib.

Question 37

What would an EKG show for someone that took too much TCA (Elavil (Amitriptyline)

Answer 37

Sinus tachycardia

Question 38

What is the recommended care for a women with preeclampsia?

Answer 38

bedrest with bathroom privileges weight & BP monitoring Urine protein & serum protein, creatinine Platelet counts MEDS ARE NOT FIRST LINE

Question 39

What is HBsAg a marker of?

Answer 39

positive = acute or chronic Hep B infection

Question 40

What is anti-HBs a marker of?

Answer 40

marker of immunity

Question 41

what is anti-HBc a marker of?

Answer 41

antibody to hep B core antigen acute, chronic, or resolved Hep B infection

Question 42

What are contraindications to Timolol (Betimol) opthalmic drops?

Answer 42

Bronchial asthma Asthma severe COPD uncompensated HF heart block sinus bradycardia shock

Question 43

A patient presents with epigastric pain and intermittent diarrhea that worsens with food. She has a history of multiple ulcers. The NP reviews the results of the serum fasting gastrin level and finds there is no inhibition of gastrin levels. Whats your diagnosis?

Answer 43

Zollinger-Ellison Neuroendocrine tumor that causes gastrin hypersecretion and peptic ulcer formation

Question 44

What are the signs and symptoms of tennis elbow?

Answer 44

Lateral epicondylitis -lateral tenderness at insertion site -pain is worse with grasping or twisting movements

Question 45

What symptoms are associated with golfers elbow?

Answer 45

medial epicondylitis -pulling pain

Question 46

What is the MOA of probenecid (Probalan)?

Answer 46

Increases uric acid excretion exreted through kidneys

Question 47

An adult visits the UC with a fever of 104.2F, vomiting, and petechiae on hands and feet progressing to the trunk over the past 3 days. Dx? Tx?

Answer 47

Rocky Mountain spotted fever Tx: doxy

Question 48

In the US the most common cause of cancer deaths in men is?

Answer 48

lung cancer

Question 49

A patient presents with c/o acute epigastric pain that is relieved by taking OTC antacids. The NP discovers the patient takes NSAID TID for joint pain. All of the following diagnostic tests should be ordered to verify the suspected diagnosis, except: a. fecal occult b CBC c. HbA1c d. urea breath test

Answer 49

A1c

Question 50

Define Inevitable abortion

Answer 50

vaginal bleeding with pain cervical dilation AND/OR cervical effacement

Question 51

Define threatened abortion

Answer 51

vaginal bleeding with absent or minimal pain closed, long, and thick cervix

Question 52

Define incomplete abortion

Answer 52

moderate to diffuse vaginal bleeding, with the passage of tissue and painful uterine cramping/contractions

Question 53

What should patients taking HCTZ and nifedipine be monitored for?

Answer 53

Acquired neutropenia

Question 54

In an adolescent with scoliosis, what degree of spinal curvature requires a referral for surgical correction? When is bracing necessary?

Answer 54

>40 degrees 20 to 40 degrees

Question 55

What are symptoms of Vit B12 deficiency

Answer 55

-Paresthesia -Hyperreflexia -Balance disorders (Romberg)

Question 56

First-line therapy for an elderly patient diagnosed with isolated systolic htn?

Answer 56

HCTZ

Question 57

What age should healthy full-term infants be screened for anemia?

Answer 57

9 to 12 months (at birth hemoglobin is elevated from maternal RBCs mixed with fetal RBCs)

Question 58

Signs of a syphilis infection dx

Answer 58

wartlike lesions rash on palms and soles of feet dx RPR or VDRL >> if reactive order confirmatory test

Question 59

What are the triad of symptoms for preeclampsia?

Answer 59

hypertension edema (weight gain) proteinuria

Question 60

What is the first line treatment for an unvaccinated infant diagnosed with pertussis?

Answer 60

Macrolides -azithromycin -erythromycin -clarithromycin

Question 61

what should you test for before treating hep c?

Answer 61

hepB it can reactivate during treatment and cause serious liver problems

Question 62

How do you calculate ABI

Answer 62

right/left ankle/ highest sbp of both arms

Question 63

What is the most common cause of dementia in the elderly

Answer 63

alzheimer's

Question 64

What is CN5 how is it tested?

Answer 64

trigeminal nerve chewing and clenching teeth

Question 65

elderly adult c/o centra vision blurred and cannot see when driving...dx?

Answer 65

macular degeneration

Question 66

What tanner stage do the areola, nipple, and breast tissue develop and become elevated as one mound?

Answer 66

Tanner III

Question 67

What tanner stage do the areola and nipple separate to form a distinct secondary mound?

Answer 67

Tanner IV

Question 68

The NP sees an adult patient who reports frequent headaches over the past few months. The patient has tried acetaminophen and ibuprofen without relief. The patient has a history of MI, bradycardia, and kidney stones. What meds are most appropriate? why are the others not? a. topiramate (topamax) b. sumatriptan (imitrex) c. imipramine (elavil) d. atenolol (tenormin)

Answer 68

Imipramine (Elevil) is most appropriate Topiramate contraindicated d/t kidney stones Atenolol contraindicated d/t bradycardia sumatriptan contraindicated d/t MI

Question 69

What is a positive Kernig sign?

Answer 69

Resistance to leg straightening from back pain this causes painful hamstrings from lumbar nerve root inflammation

Question 70

Is it ulcerative colitis or CD that has mucosal inflammation throughout the colon?

Answer 70

UC

Question 71

is it CD or UC that has skip lesions

Answer 71

CD

Question 72

What meds help with IBS with diarrhea?

Answer 72

Amtriptyaline (Elavil) anticholinergic effects Dicyclomine (Bentyl) anticholinergic Alosetron

Question 73

What is recommended to treat COPD category A B C

Answer 73

A: SABA B: LABA C: LAMA

Question 74

Pioglitazone is contra indicated in what disease?

Answer 74

This is a diabetic medication that causes water retention - CHF -Bladder Cancer

Question 75

Who should not take Biguanides

Answer 75

Renal disease alcoholism hypoxia

Question 76

How do you treat a cluster headache?

Answer 76

100% oxygen at 12L via mask Intranasal 4% lidocaine

Question 77

How do you treat trigeminal neuralgia?

Answer 77

Phenytoin (Dilantin)

Question 78

What is first line med for tinea unguium?

Answer 78

Oral terbinafine (Lamisil) (fungal infection of big toe nail)

Question 78

What is first line med for tinea unguium?

Answer 78

Oral terbinafine (Lamisil) (fungal infection of big toe nail)