Misc

Question 1

Which of the following symptoms is associated with B12 deficiency anemia? A)​Spoon-shaped nails and pica B)​Abnormal neurological exam C)​Vegan diet D)​Tingling and numbness of both feet

Answer 1

D

Question 2

Which of the following antihypertensive medications has beneficial effects for an elderly White woman with osteoporosis? A)​Calcium channel blockers B)​Angiotensin-converting enzyme (ACE) inhibitors C)​Beta-blockers D)​Thiazide diuretics

Answer 2

D

Question 3

A 75-year-old woman has been on nifedipine (Procardia XL) 10-mg capsule for many years to control her stage II hypertension. Her blood pressure at this visit is 165/80 mmHg. She is currently complaining of pain at her right hip and in both knees. She has increased her dose of ibuprofen (Motrin) from 400 mg three times daily (TID) to 800 mg TID. She is still in pain and would like something stronger. Which of the following statements is the best explanation of the effects of ibuprofen (Motrin) on her disease? A)​It increases the chances of adverse effects to her health B)​It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic C)​It prolongs the therapeutic effects of hydrochlorothiazide and other diuretics D)​None of the statements are true

Answer 3

B

Question 4

16.​A 28-year-old student is seen in the school health clinic with complaints of a hacking nonproductive cough, rhinorrhea, pharyngitis, and malaise for the past 2 weeks. He does not take any medications, denies any allergies, and has no significant medical history. Physical examination reveals a low-grade temperature of 99.9°F, respirations of 16 breaths/min, pulse of 90 beats/min, and scattered rales and wheezing of the lungs. The patient does not appear toxic. The total white blood cell count is 10,500/µL. What is the most likely diagnosis? A)​Bacterial pneumonia B)​Atypical pneumonia C)​Acute bronchitis D)​Pertussis

Answer 4

B

Question 5

All of the following are true statements regarding Munchausen syndrome except: A)​It is considered a mental illness B)​The patient has a medical illness that causes an anxiety reaction and denial C)​The patient fakes an illness in order to gain attention from health care providers D)​The patient has an inconsistent medical history along with a past history of frequent hospitalizations

Answer 5

B

Question 6

Which of the following antihypertensive medications should the nurse practitioner avoid when treating patients with emphysema? A)​Calcium channel blockers B)​Angiotensin-converting enzyme (ACE) inhibitors C)​Beta-blockers D)​Diuretics

Answer 6

C

Question 7

A 28-year-old multipara who is at 32 weeks gestation presents to your office complaining of a sudden onset of small amounts of bright-red vaginal bleeding. She has had several episodes and appears anxious. On exam, her uterus is soft to palpation. Which of the following is most likely? A)​Placenta abruptio B)​Placenta previa C)​Acute cervicitis D)​Molar pregnancy (hydatidiform mole)

Answer 7

B

Question 8

A 30-year-old primigravida is diagnosed with a possible threatened abortion. The result of the urine pregnancy test is positive. Which of the following statements is true regarding a threatened abortion? A)​Vaginal bleeding and cramping are present, but the cervix remains closed B)​Vaginal bleeding and cramping are present along with a dilated cervix C)​The fetus and placenta are both expelled D)​The products of conception and the placenta remain inside the uterus along with a dilated cervix

Answer 8

A

Question 9

The S2 heart sound is caused by: A)​Closure of the atrioventricular valves B)​Closure of the semilunar valves C)​Opening of the atrioventricular valves D)​Opening of the semilunar valves

Answer 9

B

Question 10

A 65-year-old carpenter complains of morning stiffness and pain in both his hands and right knee upon awakening. He feels some relief after warming up. 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

Answer 10

C

Question 11

What does a positive posterior drawer sign in a 10-year-old soccer player signify? A)​Normal knee B)​Instability of the knee C)​Swelling on the knee D)​Injury to the meniscus

Answer 11

B

Question 12

A multigravida who is at 28 weeks gestation has a fundal height of 29 cm. Which of the following is the best recommendation for this patient? A)​Advise the mother that her pregnancy is progressing well B)​Order an ultrasound of the uterus C)​Refer her to an obstetrician for an amniocentesis D)​Recommend bed rest with bathroom privileges

Answer 12

A

Question 13

A multigravida who is at 34 weeks gestation wants to know at what level her uterine fundus should be. The best answer is to advise the mother that her fundus is: A)​Midway between the umbilicus and the lower ribs B)​At the level of the umbilicus C)​From 33 to 35 cm D)​From 32 to 34 cm

Answer 13

C

Question 14

Which of the following laboratory tests is a sensitive test for evaluating renal function? A)​Electrolyte panel B)​Estimated glomerular filtration rate (eGFR) C)​Creatinine D)​Blood urea nitrogen (BUN)

Answer 14

B

Question 15

Signs and symptoms of depression include all of the following except: 
A)​Anhedonia 
B)​Low self-esteem 
C)​Apathy 
D)​Apraxia

Answer 15

D

Question 16

Erythromycin 200 mg with sulfisoxazole 600 mg suspension (Pediazole) is contraindicated in which of the following conditions? A)​G6PD deficiency anemia B)​Lead poisoning C)​Beta thalassemia minor D)​B12 deficiency anemia

Answer 16

A

G6PD deficiency anemia Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a hereditary condition that occurs when the red blood cells break down, causing hemolysis, due to absence or lack of sufficient G6PD, an enzyme that is needed to help the red blood cells work efficiently. Certain foods and medications may trigger this reaction. Some of the medications include antimalarial drugs, aspirin, nitrofurantoin, nonsteroidal anti-inflammatory drugs (NSAIDs), quinidine, quinine, and sulfa medications.

Question 17

A positive Coombs test on an Rh-negative pregnant woman means: A)​The mother has autoantibodies against Rh-positive red blood cells (RBCs) B)​The fetus has autoantibodies against Rh-negative red blood cells RBCs C)​The mother does not have Rh factor antibodies D)​The fetus does not have Rh factor antibodies

Answer 17

A

The mother has autoantibodies against Rh-positive red blood cells (RBCs) The mother’s autoantibodies can attack the fetus’s Rh-positive RBCs and cause destruction of these cells, which can cause severe anemia and complications in the fetus. Today this is preventable with the administration of anti-RhD immunoglobulin (Rho[D] immune globulin) to an Rh-negative mother at 28 weeks gestation and after birth if the newborn is Rh positive.

Question 18

Fitz-Hugh–Curtis syndrome is associated with which following infection? A)​Syphilis B)​Chlamydia trachomatis C)​Herpes genitalis D)​Lymphogranuloma venereum

Answer 18

B

B)​Chlamydia trachomatis Fitz-Hugh–Curtis syndrome (or perihepatitis) is a complication of pelvic inflammatory disease (PID). It is more common with chlamydial PID, but it can also occur with gonorrheal PID infection. It is caused by inflammation of the liver capsule, which leads to scarring. Signs and symptoms include sharp pain on the right upper quadrant (pleuritic-like) with PID symptoms. Like PID, it is treated with antibiotics.

Question 19

A pelvic exam on a woman who is 12 weeks pregnant would reveal that her uterus is located at which of the following areas? A)​Between the umbilicus and the suprapubic bone B)​Just rising above the suprapubic bone C)​Between the suprapubic bone and the xiphoid process D)​Between the umbilicus and the xiphoid process

Answer 19

B

Question 20

All of the following are covered under Medicare Part B except: A)​Persons aged 65 years or older B)​Durable medical equipment C)​Mammograms annually starting at age 50 D)​Outpatient anesthesiologist’s services

Answer 20

D

Question 21

All of the following patients are at higher risk for suicide except: A)​A 66-year-old White man whose wife of 40 years recently died B)​A high school student with a history of bipolar disorder C)​A depressed 45-year-old woman with family history of suicide D)​A 17-year-old teen who has only one close friend in school

Answer 21

D

Question 22

Koplik’s spots are associated with: A)​Poxvirus infections B)​Rubeola C)​Kawasaki’s disease D)​Rubella

Answer 22

B

Question 23

Human chorionic gonadotropin (hCG) is produced by the: A)​Placenta B)​Hypothalamus C)​Anterior pituitary D)​Ovaries

Answer 23

A

Question 24

An elderly woman has been taking digoxin (Lanoxin) for 10 years. Her EKG is showing a new onset of atrial fibrillation. Her pulse is 64 beats/min. She denies syncope and dizziness. Which of the following interventions is most appropriate? A)​Order an electrolyte panel and a digoxin level B)​Order a serum thyroid-stimulating hormone (TSH), digoxin level, and an electrolyte panel C)​Order a serum digoxin level and decrease her digoxin dose by half while waiting for results D)​Discontinue the digoxin and order another 12-lead EKG

Answer 24

B

Question 25

A nursing home resident reports to his physician that his previous roommate was recently started on tuberculosis treatment. A Mantoux test and chest x-ray are ordered for the patient. What is the minimum size of induration considered positive for this patient? A)​3 mm B)​5 mm C)​10 mm D)​15 mm

Answer 25

B

Question 26

A 14-year-old girl who is sexually active is brought to the health clinic by her mother for an immunization update. According to the mother, her daughter has had one dose of hepatitis B vaccine. Which of the following vaccines would you administer at this visit? A)​Tdap, hepatitis B, and HPV vaccine B)​DTaP (diphtheria, tetanus, acellular pertussis) and hepatitis B C)​Hepatitis B only D)​MMR (measles, mumps, rubella), Td, and HPV vaccine

Answer 26

A

Question 27

81.​Hegar’s sign is considered a: A)​Positive sign of pregnancy B)​Probable sign of pregnancy C)​Presumptive sign of pregnancy D)​Problem in pregnancy

Answer 27

B