Quiz Questions for Midterm Flashcards
Which of the following statements about Helicobacter pylori is false?
The organism is often resistant due to the production of
beta-lactamase
Which of the following hepatitis forms is most effectively transmitted from man to woman via heterosexual vaginal intercourse?
hepatitis B
Treatment options for streptococcal pharyngitis for a patient with penicillin
allergy include all of the following except:
trimethoprim-sulfamethoxazole.
Which of the following viruses is a potent teratogen?
rubella
Common causative organisms of acute suppurative conjunctivitis include all of
the following except:
Pseudomonas aeruginosa
In a well adult with modest hepatic enzyme elevation and hepatitis B surface
antigen (HBsAg) positive, these findings are most consistent with
chronic hepatitis B
The most likely causative pathogen in a 23-year-old woman with PID is:
trachomatis
Infectious mononucleosis is caused by
Epstein Barr Virus
How is the varicella virus most commonly transmitted?
droplet transmission
The most likely causative organism in community-acquired UTI in women during the reproductive years is:
Escherichia coli
The most common causative organism of bronchiolitis is:
respiratory syncytial virus
In patients with infectious mononucleosis, which medication should be avoided because of a risk of rash development?
amoxicillin
Treatment options for bacterial vaginosis include all of the following except:
oral azithromycin
Most AOM (acute otitis media) is caused by:
certain gram-positive and gram-negative bacteria and select respiratory viruses
Treatment of vulvovaginitis caused by Candida albicans includes:
clotrimazole cream
You see a 48-year-old woman with nonalcoholic fatty liver disease. Evaluation of infectious hepatitis includes the following:
immunization against hepatitis A and B
Which of the following is not a gram-negative organism?
saprophyticus
S. pyogenes is transmitted primarily through:
saliva and droplet contact
An 18-year-old woman has a chief complaint of a “sore throat and swollen
glands” for the past 3 days. Her physical examination includes a temperature of
101°F (38.3°C), exudative pharyngitis, and tender anterior cervical
lymphadenopathy. Right and left upper quadrant abdominal tenderness is
absent. The most likely diagnosis is:
Streptococcus pyogenes pharyngitis
In the treatment of acute otitis media in the child, which of the following
antimicrobial agents affords the most effective activity against Streptococcus
pneumoniae?
cefuroxime
The purpose of nitrates in acute coronary syndrome therapy are due to their ability to:
Cause vasodilation
A woman in her 60’s presents to your clinic preceding an ACS event. Rank the following signs and symptoms in the order of most common to least common.
Unusual fatigue, sleep disturbance, dyspnea, indigestion
Which of the following is a characteristic of a physiological murmur?
Becomes softer when the patient moves from supine to sitting and standing
TT is a 21-year-old female with the diagnosis of with mitral valve prolapse (MVP). Which of the following physical examination findings may also be present?
Pectus excavatum
Risk factors for heart failure with preserved ejection fraction include all of the following except:
Long-term corticosteroid use
Which of the examples below best characterizes the pathophysiology of heart failure?
Inadequate cardiac output to meet oxygen and metabolic demands of the body.
Which of the following would demonstrate important considerations for heart failure management?
A patient or caregiver monitoring for shortness of breath, cough, or abdominal bloating
B.
Restricting fluid intake to 2L per day
C.
Monitor weight daily, using a stand-up scale
ALL OF THE ABOVE!
An 87-year-old woman comes into your clinic and upon auscultation, you note a grade 3/6 crescendo-decrescendo systolic murmur with radiation to the neck and carotids. Which of the following explains the most likely cause?
Aortic Stenosis
Of the following patients, who is in greatest need of endocarditis prophylaxis when planning dental work?
A 60-year-old woman with a prosthetic aortic valve
A toddler with congenital heart disease is seen for a 1-week history of facial and lower-extremity edema accompanied by shortness of breath. The child’s mother reports that the child’s appetite has been poor. The chest x-ray reveals that the child has congestive heart failure (CHF). Which of the following heart sounds are found in patients with CHF?
S1, S2 and S3
In the event a heart valves fails to close properly, it is noted to be:
Incompetent
What is anemia’s mechanism for contributing to heart failure?
Decreased oxygen-carrying capacity of blood
A 15-year-old male presents to your clinic for a sports physical and clearance. Upon auscultation, you note a mid-systolic murmur that gets louder when he stands. Which of the following conditions may this represent?
Hypertrophic cardiomyopathy
Which of the following would you least likely seen in a new onset acute coronary syndrome (ACS)?
Pain reproduced with palpation
A very important component in the management of heart failure with preserved ejection fraction is:
Determining risk factors and comorbidities.
In the event a heart valve fails to open to the normal orifice size, it is called:
Stenotic
Which of the following is the most sensitive marker for myocardial damage when an abnormality is seen?
Troponin I (cTnI)
Aortic stenosis in a 16-year-old male is most likely due to:
A congenital defect
In diastolic dysfunction heart failure,
The left ventricle loses the ability to relax and fill properly
Which of the following persons is most likely to have a physiologic split S2 heart sound when being seen in your family medicine clinic?
17-year-old healthy and highly conditioned soccer player in for a sports physical
Comprehensive treatment for a person with peripheral arterial occlusive disease and diabetes mellitus includes all of the following except:
Application of a topical antimicrobial to the affected area.
In patients with chronic venous insufficiency, the earliest sign is typically:
Lower-extremity edema
When the nurse practitioner is evaluating a patient for intermittent claudication, he or she would first:
Check the ankle and brachial blood pressures before and after exercise.
The NP is seeing a 69-year-old woman with the diagnosis of superficial thrombophlebitis, which of the following should be considered?
The linear pattern of induration can help differentiate the process from cellulitis or other inflammatory processes.
Which of the following medications that are often helpful in relieving symptoms associated with Raynaud’s phenomenon?
ACEIs
The clinical presentation of peripheral arterial occlusive disease with acute occlusion most likely includes:
Pain and paresthesia.
A 32-year-old woman who works as a hotel housekeeper has a history of varicose veins and asks about wearing support hose to minimize her symptoms. What is the most appropriate response regarding the best type of product she should purchase?
A medium- to heavyweight prescription product.
AA is a 45-year-old woman who presents to your clinic with suspected DVT. Which of the following is most likely to be noted on her physical examination?
Unilateral leg edema
Which of the following is the most potent risk factor for lower-extremity peripheral arterial occlusive disease?
Cigarette smoking
Which of the following tests is helpful in determining if peripheral arterial occlusive disease is present?
Ankle brachial index
The patients noted below are all at risk for developing secondary Raynaud’s phenomenon EXCEPT:
A 48-year-old woman with well-controlled hypertension.
Which vessel is most commonly affected in patients with varicose veins?
Saphenous vein
Which of the following is true regarding peripheral arterial disease (PAD)?
Individuals with the diagnosis of diabetes have 2-4 times higher risk of developing PAD, coronary artery disease, and ischemic stroke.
All of the following chronic venous insufficiency therapies enhance venous flow EXCEPT:
Cryotherapy
A 26-year-old woman presents to your clinic with the diagnosis of Raynaud’s phenomenon, which of the following would demonstrate appropriate advice for lifestyle modifications?
Pay attention to hand skin care to avoid dry skin and fissures.
TW is a 68-year-old male with a history of atrial fibrillation. He is recently was prescribed warfarin. During his follow-up appointment, he asks if there is a medication that could help him if his INR is too high. Which of the following medications is preferred medication to reverse or minimize the anticoagulant effects of warfarin?
Oral or injectable vitamin K
You are seeing a patient with a new diagnosis of peripheral arterial occlusive disease. The patient has been experiencing symptoms of claudication, especially after walking a few minutes from his house to the barn. You explain that claudication is:
The result of leg vessels failing to dilate which cause inadequate blood flow to meet the metabolic demands of physical activity
Which of the following is true regarding spider varicosities?
Typically they respond to laser therapy.
Which of the following patients is most likely to have acute occlusive lower-extremity atherosclerotic arterial disease?
A 70-year-old woman with new-onset atrial fibrillation
How long does it usually take for a patient to achieve anticoagulation effects with warfarin?
3 days
Physical examination findings in patients with Graves’ disease include:
Eyelid retraction
Increased risk of thyroid disorder is found in individuals who are:
elderly
Which of the following findings is associated with thyroid hypofunction?
Myxedema
Which of the following is an unlikely consequence of untreated metabolic syndrome and insulin resistance in a woman of reproductive age?
hyperovulation
Untreated Cushing’s syndrome can lead to all of the following except:
Rheumatoid arthritis.
Which of the following groups has been recommended to be screened for thyroid disease?
Women aged 50 or older
Which of the following symptoms are associated with both hypothyroidism and hyperthyroidism?
goiter
The best screening test for both hyperthyroidism and hypothyroidism is:
Thyroid-stimulating hormone (TSH)
Epidemiological studies show that Hashimoto’s disease occurs most commonly in:
Middle-aged to older women
A 43-year-old man is experiencing an acute adrenal/addisonian crisis and presents with prominent nausea, vomiting, and low blood pressure. He appears cyanotic and confused. The most appropriate treatment is an injection of:
Hydrocortisone
Possible consequences of excessive levothyroxine use include:
KL is a 63-year-old woman with a diagnosis of hypothyroidism asks how to appropriately take her levothyroxine. KL also takes a calcium supplement. Which of the following instructions is incorrect?
All of the following tests should be performed on individuals with obesity EXCEPT:
ANA
Cushing’s disease is the specific type of Cushing’s syndrome that is caused by:
A benign pituitary tumor.
Obesity is defined as having a BMI equal to or greater than ___________ kg/m2.
30
Which of the following best explains the clinical criteria used to make a metabolic syndrome diagnosis?
Criteria include at least three components related to obesity, insulin resistance, dyslipidemia, and high blood pressure
Which of the following is used to confirm a diagnosis of Hashimoto’s thyroiditis?
Anti-thyroid peroxidase and anti-thyroglobulin antibodies
Addison’s disease is caused by an inadequate amount of hormone produced in which of the following glands?
Adrenal
The hormone cortisol plays a role in all of the following processes except:
Maintaining thyroid function.
A 46-year-old woman complains of fatigue, weakness, lethargy, decreased concentration and memory, and increased facial hair over the past 12 months. She also reports gaining over 30 pounds (13.6 kg) in the past 2 months. She has a history of asthma with repeated flares during the past 6 months requiring multiple courses of prednisone therapy. A likely diagnosis for this patient is:
Cushing’s syndrome
Diagnostic confirmation of glomerulonephritis typically requires:
Kidney biopsy
Medications which increase the risk of renal stones include all of the following except:
Moxifloxacin
The most common renal stones are composed of:
calcium
A 21-year-old woman complains to you of a 1-week episode of dysuria, frequency, and a strong odor to her urine. This is her second episode of the year. The previous urinary tract infection occurred 3 months ago. What is the most appropriate follow-up for this patient?
Order a urinalysis and urine for culture and sensitivity (C&S), and treat the patient with antibiotics
The nurse practitioner is evaluating patients who are at high risk for complications due to urinary tract infections (UTIs). Which of the following patients does not belong in this category?
A 21-year-old woman who has a history of irritable bowel syndrome
Common signs and symptoms of renal stones include all of the following except:
fevers
The most effective strategy for preventing renal stones is:
Adequate hydration.
Risk factors for acute glomerulonephritis include all of the following except:
Crohn’s disease.
Common causes of chronic kidney disease include all of the following except:
hypotension
A 38-year-old male has been diagnosed with a right 3 mm renal stone. Which of the following class of medications would be prescribed to relax the muscle of the ureter to allow the stone to pass?
alpha blocker
Which of the following laboratory tests is a sensitive test for evaluating renal function?
Estimated glomerular filtration rate (eGFR)
Poststreptococcal glomerulonephritis typically occurs how long following a bacterial pharyngitis infection?
1-2 weeks
Which of the following is found early in the development of chronic kidney disease?
Persistent proteinuria
All of the following are common precipitating factors in acute kidney injury except:
Type 1 Diabetes.
All of the following electrolyte disorders are commonly found in a person with chronic kidney disease except
Hypophosphatemia
A possible complication of glomerulonephritis is:
nephrotic syndrome
Risk factors for renal stones include all of the following except:
vegetarian diet
Creatinine clearance usually:
Approximates GFR.
Mr. Smith is a 35-year-old man presenting with a 4-day history of edema of the face, hands, and ankles along with hypertension (175/115 mm Hg). He reports that he was seen by a health-care provider about 2 months ago and his blood pressure was, “Normal, like it always is.” He also describes recent changes in urine, “Looks like dark tea and foams like beer.” You suspect acute glomerulonephritis and would expect urinalysis results to include all of the following findings except:
Abnormally high glucose levels.
Objective findings in patients with glomerulonephritis include all of the following except:
Hypotension
Risk factors for prostate cancer include all of the following EXCEPT:
History of genital trauma.
Your 35-year-old patient is being worked up for microscopic hematuria. All of the following are differential diagnoses of microscopic hematuria except:
Renal artery stenosis
An 8-year-old boy with type 1 diabetes is being seen for a 3-day history of urinary frequency and nocturia. He denies flank pain and is afebrile. The urinalysis result is negative for blood and nitrites but is positive for a large amount of leukocytes and ketones. He has a trace amount of protein. Which of the following is the best test to order initially?
Urine for culture and sensitivity
A 70-year-old man with suspected BPH presents to your clinic. Which of the following should you consider?
Prostate size does not correlate well with severity of symptoms
Treatment of vulvovaginitis caused by Candida albicans includes:
Tioconazole cream
A 23-year-old man has a nontender “bag of worms” mass within the left scrotum that disappears when he is in the supine position. He reports this has been present since he was an early teenager and has not changed over this time period. When assessing the patient for varicocele, the NP recommends:
No additional diagnostic testing is needed.
A 71-year-old woman comes into your clinic and complains of a strong sensation of needing to void. She reports often having anxiety that she would not make it to a bathroom in time. This best describes which type of incontinence?
urge incontinence
What does a potassium hydroxide (KOH) prep help the nurse practitioner diagnose?
Fungal infections
A 32-year-old male presents to your clinic with genitourinary symptoms. Which of the following symptoms would NOT typically be present in a patient with acute epididymitis?
Ulcerative lesion
Risk factors for acute bacterial prostatitis include all of the following except:
The presentation of acute epididymitis in an otherwise-well 24-year-old man would include:
A 75-year-old patient has a history of benign prostatic hyperplasia (BPH). Which of the following clinical findings is expected during the prostatic exam of this patient?
Prostate feels rubbery and uniformly enlarged
Which of the following actions is contraindicated in patients with acute prostatitis?
Massaging the infected prostate
Which of the following is not a common risk factor for erectile dysfunction?
testosterone deficiency
Which of the following statements is true in regards to BPH?
The use of a validated patient symptom tool is an important part of diagnosing the condition.
During acute bacterial prostatitis, the DRE usually reveals a gland described as:
Boggy, soft/sponge-like.
Patient education about the use of sildenafil (Viagra®) includes the following:
With use of the medication, sexual stimulation also is needed to achieve an erection.
Optimal management of testicular torsion would consist of which of the following?
. Surgical intervention
A likely causative pathogen in a 34-year-old man who has sex with men with acute epididymitis:
e coli
A 55-year-old woman who has had type 2 diabetes for 20 years is concerned about her kidneys. She has a history of three urinary tract infections (UTIs) within the past 8 months, but is currently asymptomatic. Which of the following is the best course to follow?
Correct A. Recheck urine during the visit, send a urine specimen for culture and sensitivity, and refer to a nephrologist
The presentation of acute epididymitis in an otherwise-well 24-year-old man would include:
A positive Prehn sign
A 75-year-old patient has a history of benign prostatic hyperplasia (BPH). Which of the following clinical findings is expected during the prostatic exam of this patient?
Prostate feels rubbery and uniformly enlarged
