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Various: Multiple Choice & Other Questions > Various: Multiple Choice & Other Questions > Flashcards

Various: Multiple Choice & Other Questions Flashcards

1
Q

Which statements are consistent with polycystic ovarian syndrome? Select all.

  1. Patients with PCOS are at low risk for endometrial cancer
  2. Diagnosis of PCOS requires ultrasound studies
  3. The diagnostic workup for suspected PCOS should be individualized to the patient
  4. The risks and complications associated with PCOS are numerous and potentially serious
A
  1. The diagnostic workup for suspected PCOS should be individualized to the patient
  2. The risks and complications associated with PCOS are numerous and potentially serious
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2
Q

Select all correct statements about contraception:

  1. Long-acting reversible contraceptives (LARCs) may be safely used in nulliparous women
  2. For patients with polycystic ovarian syndrome, combination oral contraceptives are generally safe and effective, and can be helpful with PCOS symptoms
  3. LARCs should not be inserted by primary care providers
  4. The management of heavy menses requires low-dose estrogen- and progestin-containing hormonal contraceptives
A
  1. Long-acting reversible contraceptives (LARCs) may be safely used in nulliparous women
  2. For patients with polycystic ovarian syndrome, combination oral contraceptives are generally safe and effective, and can be helpful with PCOS symptoms
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3
Q

Select all correct statements about cervical cancer:

  1. Women between ages 21 and 29 should be screened every 5 years with Pap testing only
  2. The cervical cancer screening intervals per the American Cancer Society and the ASCCP are safe and were developed according to evidence-based guidelines
  3. Immunization against HPV is most effective when administered before age 26 years
  4. Two HPV vaccine doses are recommended for patients who are younger than 15 years and not sexually active
A
  1. The cervical cancer screening intervals per the American Cancer Society and the ASCCP are safe and were developed according to evidence-based guidelines
  2. Two HPV vaccine doses are recommended for patients who are younger than 15 years and not sexually active
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4
Q

A 19 year-old patient has been diagnosed with bacterial vaginosis. Select all appropriate diagnostic or management considerations.

  1. The patient should be treated with oral or vaginal metronidazole or an alternate antibiotic
  2. While undergoing treatment, the patient’s partner should wear a condom for sexual intercourse
  3. The patient should douche for symptom relief
  4. The patient should be informed that she has a sexually-transmitted infection (STI)
  5. This patient should be screened for the most common STIs
A
  1. The patient should be treated with oral or vaginal metronidazole or an alternate antibiotic
  2. While undergoing treatment, the patient’s partner should wear a condom for sexual intercourse
  3. This patient should be screened for the most common STIs
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5
Q

A 24 year-old woman calls the office stating that she thinks she has a vaginal yeast infection again. She requests her provider call in a prescription. Select all correct statements:

  1. Ask her to come in for an exam asap
  2. Take a brief history before deciding if she should be seen in the office
  3. Call in a prescription for an anti fungal; this patient is known to you
  4. Recommend an OTC external cream for symptom relief until she can be seen in the office
A
  1. Ask her to come in for an exam asap
  2. Recommend an OTC external cream for symptom relief until she can be seen in the office
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6
Q

Select all of the following that can be a secondary cause of osteoporosis:

  1. Type 1 diabetes
  2. Longstanding hyperthyroidism
  3. Oral glucocorticoid use for > 3 months
  4. Chronic malnutrition
  5. Chronic kidney disease
A

ALL:

  1. Type 1 diabetes
  2. Longstanding hyperthyroidism
  3. Oral glucocorticoid use for > 3 months
  4. Chronic malnutrition
  5. Chronic kidney disease
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7
Q

Select all correct statements about folic acid:

  1. All pregnant women should take 1 mcg folic acid daily
  2. When planning to become pregnant, women should take 0.4 mg folic acid daily
  3. Maternal folic acid use can prevent cleft palate in the developing fetus
  4. Maternal folic acid use can prevent neural tube defects in the developing fetus
A
  1. When planning to become pregnant, women should take 0.4 mg folic acid daily
  2. Maternal folic acid use can prevent neural tube defects in the developing fetus
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8
Q

What statements are true about pregnancy testing?

  1. In a normal pregnancy, urine and blood tests are about equally accurate
  2. If an ectopic pregnancy is suspected, a “qualitative” HCG serum test should be ordered
  3. If a home urine test is positive, an in-office test is not needed
  4. Urine testing can be done as soon as a missed period occurs
A
  1. In a normal pregnancy, urine and blood tests are about equally accurate
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9
Q

What are domestic violence clues?

  1. Missed prenatal visits
  2. Overly supportive partner
  3. Bipolar disorder
  4. History of childhood abuse
  5. Improbable injury
A
  1. Missed prenatal visits
  2. Bipolar disorder
  3. History of childhood abuse
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10
Q

Select all vaccines that are safe for pregnant patients:

  1. Tetanus and diphtheria
  2. MMR
  3. 9V HPV
  4. Influenza
  5. Pneumococcal
A
  1. Tetanus and diphtheria
  2. Influenza
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11
Q

A 32 year-old female presents to your office with LMP 45 days ago and lower right quadrant pain. Select all possible differential diagnoses:

  1. Cholecystitis
  2. Urinary tract infection
  3. Ectopic pregnancy
  4. Gastroenteritis
  5. Ovarian cyst
A
  1. Urinary tract infection
  2. Ectopic pregnancy
  3. Gastroenteritis
  4. Ovarian cyst
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12
Q

A pregnant patient (first trimester) is taking fluoxetine (Prozac) for depression. What should be done with this medication during pregnancy?

  1. Discontinue and consider sertraline (Zoloft)
  2. Discontinue and start TCAs
  3. Continue at the same dose
  4. Continue but reduce the dose
A
  1. Discontinue and consider sertraline (Zoloft)
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13
Q

Which antibiotic(s) are not contraindicated in pregnancy?

  1. Amoxicillin
  2. Keflex
  3. Trimethoprim sulfamethoxazole
  4. Doxycycline
A
  1. Amoxicillin
  2. Keflex
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14
Q

Select all true statements about gestational diabetes:

  1. Screening should be conducted in the 2nd trimester
  2. One abnormal reading on the 3 hour OGTT = gestational diabetes
  3. GD affects about 18% of pregnant women
  4. GD is associated with maternal and fetal abnormalities
A
  1. Screening should be conducted in the 2nd trimester
  2. GD affects about 18% of pregnant women
  3. GD is associated with maternal and fetal abnormalities
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15
Q

Which symptom is not common with ectopic pregnancy?

  1. Lower abdominal pain
  2. High grade fever
  3. Vaginal bleeding
  4. Missed menses
A
  1. High grade fever
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16
Q

A pregnancy mother is Rh negative. When should she receive RhoGAM (Anti D immune globulin)? Select all that apply.

  1. At diagnosis of pregnancy
  2. At 12 - 14 weeks
  3. About 28 weeks
  4. Within 72 hours of delivery
A
  1. About 28 weeks
  2. Within 72 hours of delivery
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17
Q

A pregnant mother who is Rh negative has had a suspected miscarriage early this morning. LMP 8 weeks ago. How should this be handled?

  1. She does not need RhoGAM
  2. She should receive it now
  3. She needs RhoGAM only if miscarriage occurs in the 2nd trimester
  4. She needs RhoGAM only if miscarriage occurs in the 3rd trimester
A
  1. She should receive it now
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18
Q

Select all signs of preterm labor:

  1. Low or dull backache
  2. Increased uterine activity
  3. Menstrual-like cramps
  4. Constipation
  5. Vaginal spotting or bleeding
A
  1. Low or dull backache
  2. Increased uterine activity
  3. Menstrual-like cramps
  4. Vaginal spotting or bleeding
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19
Q

Select all true statements about placenta previa:

  1. It causes painless vaginal bleeding
  2. It usually occurs in the 2nd trimester
  3. Obstetric referral is not needed unless symptoms worsen
  4. It may progress to placenta abruptio
A
  1. It causes painless vaginal bleeding
  2. It usually occurs in the 2nd trimester
  3. It may progress to placenta abruptio
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20
Q

According to the CDC, what is the recommended daily dose of folic acid for pregnant women?

  1. 0.5 mg (500 mcg) per day
  2. 1000 mcg (1 mg) per day
  3. 0.4 mg (400 mcg) per day
  4. 2000 mcg (2 mg) per day
A
  1. 1000 mcg (1 mg) per day
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21
Q

Which statement is not true about ectopic pregnancy?

  1. Fallopian tube rupture may occur shortly after the onset of symptoms
  2. Symptoms typically develop about 6 - 8 weeks after the last menstrual period
  3. Serum hCG levels double every 24 - 72 hours
  4. Lower abdominal pain may occur on the right or left side
A
  1. Serum hCG levels double every 24 - 72 hours
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22
Q

Folic acid is recommended prior to and during the first 3 months of pregnancy to prevent neural tube defects. Select all of the following that are examples of neural tube defects:

  1. Cleft palate
  2. Spina bifida
  3. Anencephaly
  4. Encephalocele
A
  1. Spina bifida
  2. Anencephaly
  3. Encephalocele
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23
Q

A patient has a fundal height measurement of 32 cm. Which of the following is a correct statement about this patient?

  1. She is 14 - 18 weeks pregnant
  2. She is 18 - 22 weeks pregnant
  3. She is 32 weeks pregnant
  4. She is at term and is ready to deliver
A
  1. She is 32 weeks pregnant
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24
Q

The uterine funds should be palpable at 20 weeks’ gestation:

  1. At the level of the umbilicus
  2. Just above the level of the symphysis pubis
  3. Midway between the symphysis pubis and the umbilicus
  4. Below the symphysis pubis
A
  1. At the level of the umbilicus
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25
Q

A patient who is 14 days postpartum has a positive screen for depression. What is the most likely diagnosis?

  1. Postpartum “blues”
  2. Postpartum depression
  3. Major depressive disorder
  4. Postpartum psychosis
A
  1. Postpartum depression
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26
Q

Common side effects of selective serotonin reuptake inhibitors (SSRIs) include:

  1. Diarrhea
  2. Nausea
  3. Sexual dysfunction
  4. Somnolence
  5. Weight loss
A
  1. Diarrhea
  2. Nausea
  3. Sexual dysfunction
  4. Somnolence
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27
Q

Amsel’s criteria for bacterial vaginosis (BV) diagnosis include/s:

  1. Homogenous white discharge coating the vulva/vagina
  2. Vaginal pH > 4.7
  3. Fishy odor of vaginal discharge before or after addition of KOH (“whiff test”)
  4. Clue cells on microscopic exam
A

ALL

  1. Homogenous white discharge coating the vulva/vagina
  2. Vaginal pH > 4.7
  3. Fishy odor of vaginal discharge before or after addition of KOH (“whiff test”)
  4. Clue cells on microscopic exam
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28
Q

Polycystic ovarian syndrome (PCOS) reflects an excess of which hormone?

  1. Androgen
  2. Estrogen
  3. Testosterone
  4. Progestin
A
  1. Androgen
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29
Q

What is the most common causative agent in mononucleosis?

  1. Adenovirus
  2. Coxsackie B virus
  3. Epstein Barr virus
  4. Herpes Simplex virus
A
  1. Epstein Barr virus
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30
Q

What is the instrument used to measure intraocular pressure?

  1. Dermatoscope
  2. Ophthalmoscope
  3. Tonometer
  4. Pachymeter
A
  1. Tonometer
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31
Q

Which of the following is the most useful to a clinician in making a correct diagnosis of asthma?

  1. Chest x-ray
  2. Spirometry
  3. Peak flow monitoring
  4. History
A
  1. Spirometry
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32
Q

The mother of a newborn is HBsAg positive. How should immunization for the infant proceed?

  1. Do not immunize the infant against Hepatitis B
  2. Call the CDC for recommendations on how to proceed
  3. Immunize the newborn against Hepatitis B within 24 hours of birth
  4. Immunize the newborn against Hepatitis B and administer Hepatitis B immune globulin within 12 hours of birth
A
  1. Immunize the newborn against Hepatitis B and administer Hepatitis B immune globulin within 12 hours of birth
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33
Q

Each of the following children has received the PCV13 vaccine. Select all who need the PPSV23 immunization.

  1. A 5 year-old patient who has cyanotic heart disease
  2. A 3 year-old patient with functional asplenia
  3. A 7 year-old patient with a cochlear implant
  4. A 4 year-old patient who will be traveling internationally
A
  1. A 5 year-old patient who has cyanotic heart disease
  2. A 3 year-old patient with functional asplenia
  3. A 7 year-old patient with a cochlear implant
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34
Q

A 4 month-old infant will be traveling with his parents to South Africa. What should the NP do to learn which vaccines this child requires?

  1. Visit the CDC Vaccines and Immunizations webpage: https://cdc.gov/vaccines
  2. Call the CDC to ask for guidance
  3. Consult an infectious disease specialist
  4. Refer the parents to a travel medicine clinic
A
  1. Visit the CDC Vaccines and Immunizations webpage: https://cdc.gov/vaccines
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35
Q

A mother reports that her 1 year-old child has an allergy to eggs that produces a nonpruritic rash. The NP knows that this:

  1. Contraindicates most immunizations
  2. Requires careful monitoring and follow-up
  3. Is not IgE mediated
  4. Contraindicates influenza immunization
A
  1. Is not IgE mediated
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36
Q

The CDC recommends monitoring a child after immunization for:

  1. 15 minutes
  2. 30 minutes
  3. 45 minutes
  4. 60 minutes
A
  1. 15 minutes
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37
Q

A 48 year-old patient who works in a daycare setting asks which immunizations she should receive, based on CDC guidance. The NP advises that:

  1. She should receive the shingles immunization to prevent chicken pox
  2. She should receive a Tdap vaccine if she has not had one within the past 10 years
  3. She should get a pneumococcal vaccine
  4. The CDC has no specific immunizations for her
A
  1. She should receive a Tdap vaccine if she has not had one within the past 10 years
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38
Q

A 12 month-old girl received the varicella vaccine 3 weeks ago. How long must she wait before receiving the MMR vaccine?

  1. 1 week
  2. 2 weeks
  3. 3 weeks
  4. She may receive it today
A
  1. 1 week
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39
Q

The most commonly prescribed and tested medications for attention deficit disorder are on Schedule II. What does this mean? Select all that apply.

  1. The medications are highly effective
  2. The medications have a high potential for abuse
  3. Use of the medications may lead to physical and psychological dependence
  4. The medication are highly abused
A
  1. The medications have a high potential for abuse
  2. Use of the medications may lead to physical and psychological dependence
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40
Q

A 15 year-old girl has a viral upper respiratory infection. she has experienced symptoms for 3 days. She is wheezing but is in no distress. How should the NP handle this?

  1. Monitor her status
  2. Prescribe nebulizer albuterol
  3. Prescribe an oral steroid
  4. Prescribe an inhaled steroid
A
  1. Prescribe nebulizer albuterol
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41
Q

The chest x-ray for a 7 year-old boy shows infiltrates in the LLL. How should this be managed?

  1. Symptomatic treatment only
  2. Amoxicillin with clavulanate 45 mg/kg/day once daily
  3. Azithromycin 10 mg/kg x 5 days
  4. Amoxicillin 90 mg/kg/day
A
  1. Amoxicillin 90 mg/kg/day
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42
Q

A 16 month-old child has been diagnosed with bronchitis. He has nasal flaring, intercostal retractions, and poor appetite. How should he be managed?

  1. As an outpatient with close follow-up
  2. As an outpatient with nebulizer albuterol
  3. As an inpatient, due to his age
  4. As an inpatient because of his symptoms
A
  1. As an inpatient because of his symptoms
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43
Q

A 3 year-old with a history of asthma presents with symptoms of croup. the NP notes mild intercostal retractions in the patient. How should this be managed?

  1. Nebulizer albuterol for cough
  2. Guaifenesin/dextromethorphan
  3. Single dose of oral dexamethasone (0.6mg/kg)
  4. Oral prednisone dosed for 3 days
A
  1. Single dose of oral dexamethasone (0.6mg/kg)
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44
Q

A febrile child is in the exam room with his mother. Assessment findings include a croupy cough, intercostal retractions, stridor, and drooling. How should this patient be managed right now? Select all that apply.

  1. Call 911
  2. Administer nebulized epinephrine
  3. Administer a steroid injection
  4. Instruct the mother to drive the child to the nearest emergency department
  5. Administer nebulizer cool mist until EMS arrives
A
  1. Call 911
  2. Administer nebulized epinephrine
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45
Q

An infant who has suspected cystic fibrosis (CF) has a positive sweat test. This means:

  1. He has cystic fibrosis
  2. He should be screened again in 6 months
  3. The test should be repeated
  4. He should be referred to a cystic fibrosis clinic
A
  1. The test should be repeated
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46
Q

What symptoms might be present in a child who has cystic fibrosis?

  1. Excessive sweating
  2. Frequent episodes of diarrhea
  3. Persistent productive cough
  4. Persistent watery eyes
A
  1. Persistent productive cough
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47
Q

A pediatric patient has sickle cell disease. Which of the following should not be performed or provided at the 1-year well child check?

  1. Assessment of growth and development
  2. Review of immunization status
  3. Caregiver education about the importance of adequate hydration
  4. Discontinuation of daily penicillin for prophylaxis
A
  1. Discontinuation of daily penicillin for prophylaxis
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48
Q

Which finding/s are typically associated with leukemia?

  1. Bruising
  2. Bleeding
  3. Frequent nosebleeds
  4. Fatigue
  5. Swollen lymph nodes
A

ALL:

  1. Bruising
  2. Bleeding
  3. Frequent nosebleeds
  4. Fatigue
  5. Swollen lymph nodes
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49
Q

An NP has filed a report of suspected child abuse based on her findings in a child she has just examined. Which statement is correct?

  1. NPs are mandatory reporters in all states
  2. Suspected child abuse requires concrete evidence of abuse
  3. Child neglect does not constitute child abuse
  4. the parents should be informed that the report is being made
A
  1. NPs are mandatory reporters in all states
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50
Q

An 8 year-old girl presents with a spiral fracture of the arm. The NP suspects abuse because the mother’s explanation of the injury doesn’t match the child’s. How should the NP proceed?

  1. Confront the mother about positive abuse
  2. Ask the child to repeat her recollection of how the injury occurred
  3. Separate the child from the mother
  4. Tell the mother you are concerned about the child’s safety
A
  1. Tell the mother you are concerned about the child’s safety
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51
Q

An infant has physiologic hyperbilirubinemia. at what age does this usually appear?

  1. Within 24 hours of birth
  2. About 2 - 3 days after birth
  3. 3 - 5 days after birth
  4. Within the first week after birth
A
  1. About 2 - 3 days after birth
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52
Q

A 4 day-old term infant who is being breastfed has hyperbilirubinemia (18 mg/dL). This is most often treated with:

  1. Cessation of breastfeeding
  2. Phototherapy
  3. Hydration
  4. Blood transfusion
A
  1. Phototherapy
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53
Q

At what age are symptoms of colic most likely to occur?

  1. 1 - 2 weeks
  2. 4 - 6 weeks
  3. 3 months
  4. 6 months
A
  1. 4 - 6 weeks
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54
Q

A 6 week-old infant has visible peristaltic waves in the upper abdomen just before emesis.Which of the following is likely to be included in the differential diagnosis?

  1. Gastroesophageal reflux
  2. Milk protein intolerance
  3. Intestinal obstruction
  4. Pyloric stenosis
A
  1. Pyloric stenosis
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55
Q

At what age are symptoms of pyloric stenosis most likely to develop?

  1. 3 - 6 weeks
  2. 3 months
  3. 6 months
  4. 12 months
A
  1. 3 - 6 weeks
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56
Q

A week-old infant has suspected pyloric stenosis. What imaging study is most commonly used to diagnose this condition?

  1. Upper endoscopy
  2. Barium endoscopy
  3. Ultrasound
  4. pH manometry
A
  1. Ultrasound
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57
Q

The NP observes abdominal guarding in an 18 month-old patient. An abdominal ultrasound reveals a “coiled spring appearance” in the mid-upper abdomen. What is the mist likely diagnosis?

  1. Intussusception
  2. Intestinal obstruction
  3. Constipation
  4. Pathologic reflux
A
  1. Intussusception
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58
Q

Select all of the following that are symptoms of mild dehydration in pediatric patients.

  1. Normal pulse
  2. Normal systolic blood pressure
  3. Normal respirations
  4. Normal anterior fontanel
  5. Normal skin turgor
A

ALL:

  1. Normal pulse
  2. Normal systolic blood pressure
  3. Normal respirations
  4. Normal anterior fontanel
  5. Normal skin turgor
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59
Q

What is a preferred means of rehydration for a child who has viral gastroenteritis?

  1. Beverage of choice
  2. IV hydration
  3. Commercially-prepared electrolyte solution
  4. Chicken broth or other salty beverage
A
  1. Commercially-prepared electrolyte solution
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60
Q

The NP is assessing a 6 month-old boy and identifies a single palpable testicle in the scrotum. This increases the infant’s risk for:

  1. Testicular cancer
  2. Penile cancer
  3. Epididymitis
  4. Hydrocele
A
  1. Testicular cancer
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61
Q

A 6 month-old boy has one palpable testicle. When should the NP refer this patient to urology?

  1. Now
  2. At age 3 months
  3. At age 6 months
  4. A age 1 year
A
  1. Now
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62
Q

A 4 month-old boy has a hydrocele. at what age is a hydrocele expected to resolve?

  1. Between ages 4 and 6 months
  2. Around age 6 months
  3. Between ages 6 and 9 months
  4. Before age 12 months
A
  1. Before age 12 months
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63
Q

During a well child exam, a 1 year-old boy is found to have a hydrocele. What is most important for the NP to include in the assessment?

  1. A rectal exam
  2. Assessment for inguinal hernia
  3. Assessment for hypospadias
  4. Assessment of testicle placement
A
  1. Assessment for inguinal hernia
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64
Q

A 2 year-old girl has a suspected urinary tract infection. What is the least important part of the NP’s evaluation of this patient?

  1. Blood pressure
  2. Abdominal tenderness
  3. Abdominal mass
  4. Lower extremity edema
A
  1. Lower extremity edema
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65
Q

A 3 year-old girl has a urine dipstick result that indicates UTI. She is afebrile. Based on the most likely pathogen, which antibiotic is a good first choice?

  1. TMP-SMX (Bactrim)
  2. Cephalexin (Keflex)
  3. Cefuroxime (Ceftin)
  4. Amoxicillin (Amoxil)
A
  1. Cefuroxime (Ceftin)
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66
Q

An NP is examining an 8 year-old patient and identifies raised, red papillae on the tongue. What might be the cause of this? Select all that apply.

  1. Kawasaki disease
  2. Streptococcal pharyngitis
  3. Hand, foot and mouth disease
  4. Thrush
A
  1. Kawasaki disease
  2. Streptococcal pharyngitis
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67
Q

When should routine blood pressure screening begin in children?

  1. Age 3 years
  2. Age 5 years
  3. Age 6 years
  4. Age 10 years
A
  1. Age 3 years
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68
Q

At what age should dyslipidemia risk assessment begin?

  1. 2 years
  2. 5 years
  3. 6 years
  4. 10 years
A
  1. 2 years
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69
Q

To perform Ortolani’s test, where should the examiner’s 2nd through 5th fingers be placed?

  1. On the greater trochanter
  2. On the buttocks
  3. The medial aspect of the knee
  4. the lower abdomen
A
  1. On the greater trochanter
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70
Q

A 2 month-old patient has suspected hip dysplasia. What might be present on assessment?

  1. Unequal gluteal folds
  2. Inability to lie prone on hips
  3. Pain with straightening of the legs
  4. Difficulty externally rotating the hips
A
  1. Unequal gluteal folds
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71
Q

Which scenario is most concerning for scoliosis?

  1. A 13 year-old girl with a 10-degree curve in the spine
  2. a 17 year-old girl with a 10-degree curve in the spine
  3. A 12 year-old boy with a 5-degree curve in the spine
  4. An 18 year-old boy with a 5-degree curve in the spine
A
  1. A 13 year-old girl with a 10-degree curve in the spine
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72
Q

Osgood Schlater disease occurs in conjunction with:

  1. Closure of the bone apophyses
  2. Development of secondary sexual characteristics
  3. A rapid growth spurt
  4. Increasing bone and muscle density
A
  1. A rapid growth spurt
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73
Q

Select all applicable characteristics of Osgood Schlater disease.

  1. Erythema, warmth of the tibial tuberosity
  2. Pain reproduced by extending the knee against resistance
  3. Pain over patellar tendon
  4. Straight leg raise is painless
A
  1. Pain reproduced by extending the knee against resistance
  2. Straight leg raise is painless
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74
Q

A 3 week-old infant has white pinpoint papule on his face and cheeks. What is this?

  1. Mongolian spots
  2. Eczema
  3. Milia
  4. Hemangioma
A
  1. Milia
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75
Q

What lip/oral cavity symptoms are characteristics in the patient who has herpangina?

  1. The pharynx is unaffected
  2. Tonsillar exudate is present
  3. Painful vesicles are present on the soft palate and mouth
  4. Pustules appear unilaterally on tonsils and blisters appear on the lips
A
  1. Painful vesicles are present on the soft palate and mouth
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76
Q

A 4 year-old patient presents with a lacy, macular rash and fever. What illness is a common cause of these symptoms?

  1. Herpangina
  2. Hand, foot and mouth disease
  3. Fifth disease
  4. Measles
A
  1. Fifth disease
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77
Q

A 3 year-old girl is diagnosed with Fifth disease. Her mother is in the first trimester of pregnancy and has significant exposure to the sick child. If her mother has a positive IgM test (Parvo B19), what is the risk to the fetus?

  1. Intrauterine fetal death
  2. Significant fetal neurological delay
  3. Congenital heart defects
  4. Significant orthopedic anomalies
A
  1. Intrauterine fetal death
78
Q

An NP has diagnosed a child with roseola. How old is this child likely to be?

  1. 7 - 13 months old
  2. 2 - 4 years old
  3. 3 - 6 years old
  4. 6 - 12 years old
A
  1. 7 - 13 months old
79
Q

Measles is characterized by what clinical finding? Select all that apply.

  1. Cough
  2. Runny nose
  3. Conjunctivitis
  4. Anemia
A
  1. Cough
  2. Runny nose
  3. Conjunctivitis
80
Q

The NP has examined Mr. Jones. He has mild dyspnea and bilateral lower extremity edema. what diagnostic test or finding is sensitive in identifying heart failure?

  1. Calcium score
  2. BNP > 100 pg/mL
  3. Atrial fibrillation
  4. A 3-lead EKG
A
  1. BNP > 100 pg/mL
81
Q

A 67 year-old man complains of pain in his left calf when he walks. The pain is relieved by rest. The patient’s ankle brachial index (ABI) is 0.75. He probably:

  1. Has peripheral vascular disease
  2. Does not have peripheral vascular disease
  3. Has atypical leg symptoms
  4. Has normal pedal pulses
A
  1. Has peripheral vascular disease
82
Q

A 34 year-old pregnant patient has mitral valve prolapse. Where is this best auscultated?

  1. Mitral valve listening point
  2. Aortic listening point
  3. Tricuspid listening point
  4. Pulmonic listening point
A
  1. Mitral valve listening point
83
Q

A 46 year-old sales clerk has been diagnosed with mitral stenosis. what choice best describes this murmur?

  1. A late diastolic click near the apex
  2. Radiation of soft diastolic sounds into the next and carotid arteries
  3. Diastolic sounds heard loudest near the apex
  4. Soft diastolic sounds in the left midsternal area
A
  1. Diastolic sounds heard loudest near the apex
84
Q

An 80 year-old man complains of chest pressure when walking up a flight of stairs at his home. The NP auscultates a 2/6 systolic murmur near the 2nd intercostal space (2ICS) to the right of the sternum. Which murmur is likely present?

  1. Aortic regurgitation
  2. Mitral valve prolapse
  3. Aortic stenosis
  4. Mitral stenosis
A
  1. Aortic stenosis
85
Q

A 62 year-old truck driver has aortic regurgitation. What would you expect to hear when auscultating this murmur?

  1. A late diastolic click near the apex
  2. Diastolic sounds heard loudest near the 2nd intercostal space, right sternal border
  3. Diastolic sounds heard in the midsternal area
  4. Intermittent diastolic murmur heard near the left sternal border
A
  1. Diastolic sounds heard loudest near the 2nd intercostal space, right sternal border
86
Q

Which of the following is not a symptom of heart failure?

  1. Peripheral edema
  2. Shortness of breath
  3. Urinary retention
  4. Hypertension
A
  1. Urinary retention
87
Q

Which cranial nerves are associated with eye movement?

  1. III
  2. IV
  3. VI
  4. V
A
  1. V
88
Q

A 45 year-old woman arrives with sudden complaints of facial drooping and numbness on the right side. She is unable to close the right eye or lift the right eyebrow. The NP assessment findings show no other neurological deficits. The NP suspects:

  1. Bell’s palsy
  2. A transient ischemic attack (TIA)
  3. A cerebral vascular accident (CVA)
  4. Trigeminal neuralgia
A
  1. Bell’s palsy
89
Q

A 52 year-old man complains of left lower extremity swelling, erythema, fever, chills, and malaise. The NP suspects:

  1. Deep vein thrombosis
  2. Cellulitis
  3. Peripheral neuropathy
  4. Heart failure
A
  1. Cellulitis
90
Q

A common health condition related to the aging process is:

  1. Presbycusis
  2. Depression
  3. Hypertension
  4. Diabetes
A
  1. Presbycusis
91
Q

An older adult has lost his spouse of 55 years. If the NP suspects alcohol abuse, how could he be screened?

  1. CAGE questionnaire
  2. GAGE screening tool
  3. AAA screen
  4. Geriatric alcohol tool
A
  1. CAGE questionnaire
92
Q

Which patient would derive the most benefit from prostate screening?

  1. A 40 tar-old white man
  2. A 60 year-old black man
  3. A 70 year-old man of Japanese descent
  4. A 75 year-old Native American man
A
  1. A 60 year-old black man
93
Q

Which older adult patient is a lowest risk for falls?

  1. A patient who visits a primary care provider after an acute fall
  2. A patient who has experienced one fall in the past 12 months
  3. A patient who has experienced two falls in the past 12 months
  4. A patient with a slowed gait speed
A
  1. A patient who has experienced one fall in the past 12 months
94
Q

A 66 year-old man awakened with a painful R shoulder this morning. He has had intermittent R shoulder pain for several months. The three likely differential diagnoses are:

  1. Muscle strain
  2. Bursitis
  3. Tendinitis
  4. Rotator cuff dislocation
A
  1. Muscle strain
  2. Bursitis
  3. Tendinitis
95
Q

An NP student has severe test anxiety. Which medication could he take to relieve his anxiety prior to taking his certification exam?

  1. 50 mg sertraline daily for 6 - 8 weeks
  2. Low-dose alprazolam 45 minutes before exam
  3. Propanolol 60 minutes before the exam
  4. Buspirone 60 minutes before the exam
A
  1. Propanolol 60 minutes before the exam
96
Q

What history or actions are expected for a presentation of primary dysmenorrhea in a 28 year-old woman? Select all that apply.

  1. Dysmenorrhea since menarche
  2. OBGYN referral
  3. Worsening dysmenorrhea over time
  4. NSAIDs and/or oral contraceptives for symptom relief
A
  1. Dysmenorrhea since menarche
  2. NSAIDs and/or oral contraceptives for symptom relief
97
Q

A 20 year-old man has suspected acute HIV infection. What lab test should be ordered?

  1. HIV IgM antibodies
  2. Antigen/antibody immunoassay (ELISA/EIA)
  3. HIV1/HIV2 antibody differentiation immunoassay
  4. HIV-1 RNA assay (NAT)
A
  1. HIV1/HIV2 antibody differentiation immunoassay
98
Q

Which treatment is inappropriate for treatment of a patient who has acute rhinosinusitis?

  1. Analgesics
  2. Saline irrigation
  3. intranasal glucocorticoids
  4. Antihistamines
A
  1. Antihistamines
99
Q

A 30 year-old patient with allergic rhinitis has been using OTC oxymetazoline for the past 3 months. she has developed rhinitis medicamentosa. What symptom is associated with this?

  1. Rhinorrhea
  2. Nasal congestion
  3. Cough
  4. Epistaxis
A
  1. Nasal congestion
100
Q

A patient has allergic rhino sinusitis. What would be unusual to find in him?

  1. Infraorbital edema
  2. Accentuated lower eyelid folds
  3. Transverse nasal crease
  4. Erythematous sclera
A
  1. Erythematous sclera
101
Q

What is the most common bacterial cause of pharyngitis?

  1. Mycoplasma pneumoniae
  2. Streptococcus Groups A
  3. Streptococcus Group C
  4. Haemophilus influenzae
A
  1. Streptococcus Groups A
102
Q

Which agent used to treat otitis external is most associated with allergic reactions?

  1. Ofloxacin
  2. Levofloxacin
  3. Neomycin-polymyxin B
  4. Acetic acid
A
  1. Neomycin-polymyxin B
103
Q

A patient with otitis externa (OE) should be taught:

  1. To avoid swimming while OE is present
  2. That hearing will be diminished for about 1 week after OE resolution
  3. That tinnitus is common with OE
  4. That the infection rarely occurs unilaterally
A
  1. To avoid swimming while OE is present
104
Q

A 36 year-old woman complains of irritated, dry, itchy eyes. There is eyelid margin erythema. What is the likely diagnosis?

  1. Conjunctivitis
  2. Blepharitis
  3. Iritis
  4. Chalazion
A
  1. Blepharitis
105
Q

A 60 year-old woman with a 30 pack-year smoking history visits the NP clinic for an initial visit. How should she be screened for lung cancer?

  1. Chest x-ray
  2. Low-dose CT of chest
  3. MRI of chest
  4. No screening is indicated in this patient
A
  1. Low-dose CT of chest
106
Q

Which one of the following is most useful to a clinician in making a correct diagnosis of asthma?

  1. Chest x-ray
  2. Spirometry
  3. Peak flow monitoring
  4. History
A
  1. Spirometry
107
Q

A patient has been diagnosed with thrombocytopenia. if this is secondary to poorly controlled lupus, what lab tests might be expected to be abnormal? Select all that apply.

  1. INR
  2. PT/PTT
  3. Hgb/Hct
  4. Platelet count
A
  1. Hgb/Hct
  2. Platelet count
108
Q

Which condition may be associated with gout?

  1. Peptic ulcer disease
  2. Nonalcoholic fatty liver disease
  3. Chronic renal disease
  4. Gastric ulcer disease
A
  1. Chronic renal disease
109
Q

A 76 year-old woman has a BMI of 30. She takes metformin, lisinopril, empagliiflozin, liraglutide, pravastatin, and Vitamin D. Her blood pressure is 120/64 mmHg. Her heart rate is 72, and her respiratory rate is 15/min. Her A1C is 9.8%. she has agreed to start insulin. What is her AM fasting glucose goal?

  1. < 100 mg/dL
  2. 100 - 140 mg/dL
  3. 80 - 130 mg/dL
  4. 90 - 130 mg/dL
A
  1. 90 - 130 mg/dL
110
Q

You are examining a 72 year-old man with aortic stenosis. What would you expect to auscultate when listening to the murmur?

  1. A late diastolic click near the apex
  2. Systolic sounds heard loudest near the 2nd intercostal space at the right sternal border
  3. Diastolic sounds heard in the midsternal area
  4. Intermittent diastolic murmur heard near the left sternal border
A
  1. Systolic sounds heard loudest near the 2nd intercostal space at the right sternal border
111
Q

A 36 year-old man presents with a silvery, scaly, pruritic rash. Which statement is not true about this presentation?

  1. These symptoms may be associated with inflammatory bowel disease
  2. The patient is at high risk for cataracts
  3. Monoclonal antibodies may be used to treat this presentation
  4. This patient may have associated arthritis
A
  1. The patient is at high risk for cataracts
112
Q

Which vehicle is least appropriate for treating a steroid-responsive condition on thickened skin of the elbows and knees of an adult?

  1. Gel
  2. Cream
  3. Ointment
  4. Lotion
A
  1. Lotion
113
Q

All of the organisms listed can produce pruritus. Which one is treated with an oral agent?

  1. Pinworms
  2. Bed bugs
  3. Pubic lice
  4. Scabies
A
  1. Pinworms
114
Q

A patient has scabies. Which asymptomatic contacts do not need to be treated for scabies?

  1. Household contacts
  2. Sexual contacts
  3. Office mates
  4. Close personal contacts
A
  1. Office mates
115
Q

Steroid selection should be based on which of the following? Select all that apply.

  1. Site of involvement
  2. Steroid potency
  3. Severity of condition
  4. Gender of patient
  5. Cost of medication
A
  1. Site of involvement
  2. Steroid potency
  3. Severity of condition
116
Q

Mr. Boudreaux has suspected benign prostatic hyperplasia (BPH). select all urinary symptoms you would expect him to report.

  1. Erectile dysfunction
  2. Weak urinary stream
  3. Burning
  4. Urgency
  5. Hesitancy
A
  1. Weak urinary stream
  2. Urgency
  3. Hesitancy
117
Q

Mr. Boudreaux’s only symptoms is urinary frequency. Select all appropriate differential diagnoses.

  1. Undiagnosed diabetes
  2. Urinary tract infection
  3. Acute prostatitis
  4. Prostate cancer
A
  1. Undiagnosed diabetes
  2. Urinary tract infection
118
Q

If Mr. Boudreaux’s findings/symptoms include microscopic hematuria and urinary frequency, what might be included in the differential diagnosis?

  1. Undiagnosed diabetes
  2. Urinary tract infection
  3. Acute prostatitis
  4. Prostate cancer
A
  1. Urinary tract infection
119
Q

Mr. Boudreaux has been diagnosed with benign prostatic hyperplasia (BPH). His daily symptoms include frequency, urgency, and weakened urinary stream. Select all that might help to manage his symptoms quickly.

  1. Tamsulosin (Flomax)
  2. Dutasteride (Avodart)
  3. HCTZ
  4. Tadalafil (Cialis)
A
  1. Tamsulosin (Flomax)
  2. Tadalafil (Cialis)
120
Q

Mrs. Boudreaux calls your office the day after Mr. Boudreaux’s visit and states that he is not taking the tamsulosin you prescribed. The most likely reason is:

  1. The high cost
  2. New onset erectile dysfunction
  3. Somnolence
  4. Dizziness
A
  1. Dizziness
121
Q

When prescribing tamsulosin, the NP should educate the patient about common side effects, such as:

  1. Abdominal pain
  2. Dizziness
  3. Urinary hesitancy
  4. Fatigue
A
  1. Dizziness
122
Q

A 50 year-old man presents with fever, chills, tenderness on digital rectal exam, and pelvic pain. What should be included in the differential diagnosis?

  1. Urinary tract infection
  2. Benign prostatic hypertrophy
  3. Acute prostatitis
  4. Epididymitis
A
  1. Acute prostatitis
123
Q

When are symptoms of groin hernia most evident? Select all that apply.

  1. After eating
  2. Before a bowel movement
  3. After sitting for an extended period of time
  4. With heavy lifting
  5. After prolonged standing
A
  1. After sitting for an extended period of time
  2. With heavy lifting
  3. After prolonged standing
124
Q

In what position should a patient be examined to identify the presence of a hernia?

  1. Seated
  2. Lying supine
  3. Standing
  4. Squatting
A
  1. Standing
125
Q

How is an inguinal hernia most commonly diagnosed?

  1. Ultrasound
  2. CT scan of the groin
  3. Physical examination
  4. MRI of the groin
A
  1. Physical examination
126
Q

Which of the following conditions could contribute to diastasic recti? Select all that apply.

  1. Obesity
  2. Pregnancy
  3. Prior abdominal surgery
  4. Constipation
A
  1. Obesity
  2. Pregnancy
  3. Prior abdominal surgery
127
Q

A 17 year-old boy presents with a sensation of heaviness in his scrotum. On exam, the NP palpates a small nodule on his L testicle. How should the NP proceed?

  1. Urethral swab
  2. Abdominal CT
  3. Scrotal ultrasound
  4. Evaluation of cremasteric reflex
A
  1. Scrotal ultrasound
128
Q

A 19 year-old patient is in the urgent care center with a complaint of scrotal pain 9/10. He has an absent cremasteric reflex. Select all of the following that should be included in the NP’s differential diagnosis.

  1. Testicular torsion
  2. Epididymitis
  3. Testicular cancer
  4. Possible sexually transmitted infection
A
  1. Testicular torsion
129
Q

Which conditions make NSAID use for osteoarthritis riskier? Select all that apply.

  1. Heart failure
  2. Chronic renal disease
  3. History of myocardial infarction
  4. Gastric ulcer disease
  5. Nonalcoholic fatty acid disease
A
  1. Heart failure
  2. Chronic renal disease
  3. Gastric ulcer disease
130
Q

What is the most common cause of lateral epicondylitis?

  1. Osteoarthritis
  2. Overuse
  3. Deconditioning
  4. Aging
A
  1. Overuse
131
Q

What common overuse syndrome produces dorsal thumb pain?

  1. Carpal tunnel syndrome
  2. Osteoarthritis
  3. Trigger finger
  4. DeQuervain’s tenosynovitis
A
  1. DeQuervain’s tenosynovitis
132
Q

What two tests might be used to assess for carpal tunnel syndrome?

  1. Tinel’s sign
  2. Snuffbox tenderness
  3. Phalen’s test
  4. McMurray test
A
  1. Tinel’s sign
  2. Phalen’s test
133
Q

A patient with a recent history of breast cancer presents with sudden, severe, low back pain. What is a likely etiology?

  1. Bone metastasis
  2. Pathologic fracture
  3. Soft tissue infection
  4. Osteomyelitis
A
  1. Pathologic fracture
134
Q

A patient with a complaint of acute low back pain has a positive straight leg raise test. When he is distracted, the straight leg raise improves. He is observed to move easily when getting dressed. These can be documented as:

  1. Waddell’s sign
  2. Organic disease
  3. Nondermatomal pain
  4. Nonspecific back pain
A
  1. Waddell’s sign
135
Q

Popping, locking, catching, and “giving out” are common patient descriptions for a:

  1. Torn anterior cruciate ligament
  2. Torn posterior cruciate ligament
  3. Torn medial collateral ligament
  4. Torn meniscus
A
  1. Torn meniscus
136
Q

A 36 year-old woman has a BMI of 30, a family history of T2DM, and hypothyroidism. She takes no medication and had a normal menstrual period 2 weeks ago. Her BP is 135/82 mmHg and HR is 78 and RR is 16/min. Her fasting glucose is 135 mg/dL. What should be the initial pharmacological intervention for this patient’s elevated blood glucose?

  1. Sitagliptin (Januvia)
  2. Glipizide (Glucotrol)
  3. Metformin (Glucophage)
  4. Rosiglitazone (Avandia)
A
  1. Metformin (Glucophage)
137
Q

Prior to prescribing metformin for a 32 year-old patient with a BMI of 30, what abs should be checked? Select all that apply.

  1. CBC
  2. Vitamin B12 level
  3. Vitamin D level
  4. eGFR
  5. ALT, AST
A
  1. eGFR
  2. ALT, AST
138
Q

The NP has prescribed 850 mg of immediate release (IR) metformin BID. On Day 3 of metformin, the patient calls the office stating she is having “profound diarrhea.” Select all that apply for how this should be managed.

  1. Stop metformin for a day, then restart it
  2. Stop metformin and try another medication
  3. Decrease the dosing interval of metformin to once daily
  4. Stop metformin until diarrhea stops, then restart it at once daily. Evaluate response at next visit in 2 weeks.
A
  1. Stop metformin until diarrhea stops, then restart it at once daily. Evaluate response at next visit in 2 weeks.
139
Q

Select all common etiologies of cellulitis:

  1. Staph aureus
  2. MRSA
  3. Group A strep
  4. H. influenza
  5. E. coli
A
  1. Staph aureus
  2. MRSA
140
Q

The NP is evaluating a patient who has sub-clinical hypothyroidism (TSH 6.2). What are the major risks of prescribing levothyroxine?

  1. There are few risks
  2. Hyperlipidemia and atrial fibrillation are risks
  3. Accelerated bone loss and atrial fibrillation are risks
  4. The patient may develop hypertension and tachycardia
A
  1. Accelerated bone loss and atrial fibrillation are risks
141
Q

You have diagnosed a 28 year-old woman with primary hypothyroidism. Her calculated thyroid hormone replacement is 108 mcg daily. How much should she be given initially?

  1. 25 mcg daily
  2. 50 mcg daily
  3. 100 mcg daily
  4. 112 mcg daily
A
  1. 100 mcg daily
142
Q

The appropriate pharmacological management choice for a patient with symptomatic hyperthyroidism is:

  1. A beta blocker
  2. An ACE inhibitor
  3. Thyroid hormone
    4, Aspirin
A
  1. A beta blocker
143
Q

A 44 year-old obese woman presents with abdominal pain. She is afebrile. What is the most likely etiology?

  1. Appendicitis
  2. Cholecystitis
  3. Diverticulitis
  4. Pancreatitis
A
  1. Cholecystitis
144
Q

A 36 year-old obese woman presents with abdominal pain. If the most likely differential diagnosis is cholecystitis, what is the diagnostic test of choice?

  1. CT of the abdomen
  2. MRI of the abdomen
  3. Ultrasound of the abdomen
  4. Kidney, ureter, and bladder x-ray
A
  1. Ultrasound of the abdomen
145
Q

A 46 year-old woman with abdominal pain in the right lower quadrant has suspected diverticulitis. What should be part of the initial work-up Choose all that apply.

  1. CBC
  2. Electrolytes
  3. Pregnancy test
  4. Urinalysis
  5. CT scan with and without contrast
A
  1. CBC
  2. Electrolytes
  3. Pregnancy test
  4. Urinalysis
  5. CT scan with and without contrast
146
Q

What is the gold standard treatment for gastroesophageal reflux disease?

  1. Antacids
  2. H2 receptor agonists (H2RAs)
  3. Proton pump inhibitors (PPIs)
  4. PPIs plus H2RAs
A
  1. Proton pump inhibitors (PPIs)
147
Q

How many weeks should a patient with GERD be treated with a proton pump inhibitor (PPI)?

  1. 2 weeks
  2. 4 weeks
  3. 8 weeks
  4. 12 weeks
A
  1. 8 weeks
148
Q

A 56 year-old man relocated to your area from another state. You will be his primary care provider. He is a past smoker, and he has an elevated BMI and a history of Barrett’s esophagus. He takes OTC proton pump inhibitors (PPIs) and is asymptomatic. What should be part of his plan of care?

  1. Use of OTC PPIs
  2. Referral to a gastroenterologist due to the history Barrett’s esophagus
  3. Weaning off PPIs and using H2 blockers
  4. Prescribing regular usage of prescription-strength PPIs
A
  1. Referral to a gastroenterologist due to the history Barrett’s esophagus
149
Q

Which of the following health conditions may be associated with constipation? Select all that apply.

  1. Hemorrhoids
  2. Anal fissure
  3. Anorexia nervosa
  4. Parkinson’s disease
  5. Hypothyroidism
A
  1. Hemorrhoids
  2. Anal fissure
  3. Anorexia nervosa
  4. Parkinson’s disease
  5. Hypothyroidism
150
Q

A 52 year-old woman states that for the last 3 mornings, she has seen pink drops of “blood” in the toilet water after she had a bowel movement. She had a normal colonoscopy at age 50 and has no family history of colorectal cancer. What should be done first?

  1. Abdominal CT
  2. CBC with ferritin level
  3. Stool for occult blood
  4. Referral to GI for repeat colonoscopy
A
  1. CBC with ferritin level
151
Q

A 57 year-old woman was diagnosed with Crohn’s disease about 5 years ago. You are her primary care provider. Which findings today might be related to her Crohn’s disease. Select all that apply.

  1. Likely deep vein thrombosis in right calf
  2. Elevated platelet count
  3. Iritis
  4. Arthritis
A
  1. Likely deep vein thrombosis in right calf
  2. Iritis
  3. Arthritis
152
Q

Routine blood work in a 48 year-old patient identifies elevation in his liver function tests (LFTs). He states that he feels well and has no physical complaints. What are common etiologies of elevated LFTs?

  1. Medications
  2. Alcohol use
  3. Fatty liver disease
  4. Hemochromatosis
  5. Infiltration from malignancy
A
  1. Medications
  2. Alcohol use
  3. Fatty liver disease
153
Q

Which of the following could be the cause of an elevated alkaline phosphatase level?

  1. Age
  2. Pregnancy
  3. Recent healing fracture
  4. Hyperthyroidism
  5. Bone metastasis
A

ALL:

  1. Age
  2. Pregnancy
  3. Recent healing fracture
  4. Hyperthyroidism
  5. Bone metastasis
154
Q

A 35 year-old woman tried to donate blood but was unable due to a “low blood count.” Which lab test should the NP order today to evaluate this patient?

  1. Hgb
  2. CBC
  3. CBC, peripheral smear
  4. CBC, iron studies
A
  1. CBC
155
Q

A 35 year-old woman was diagnosed today with iron deficiency anemia (IDA). The NP has prescribed once daily ferrous sulfate for the patient. What labs should be ordered when she returns in 4 weeks?

  1. CBC
  2. CBC serum iron
  3. CBC, serum ferritin
  4. CBC, serum ferritin, red cell distribution width (RDW)
A
  1. CBC
156
Q

A patient has been diagnosed with anemia of chronic disease. Select all that may be part of the reason for this.

  1. Colorectal cancer
  2. Iron deficiency anemia
  3. Poorly controlled lupus
  4. Metastatic breast cancer
  5. Severe ulcerative colitis
A
  1. Colorectal cancer
  2. Poorly controlled lupus
  3. Metastatic breast cancer
  4. Severe ulcerative colitis
157
Q

A malnourished older adult is in your exam room today. What common symptoms might warrant a serum potassium and magnesium level? Select all that apply.

  1. Muscle cramping
  2. Jaundice
  3. Visual disturbances
  4. Lower extremity numbness and tingling
  5. Anorexia
A
  1. Muscle cramping
  2. Lower extremity numbness and tingling
158
Q

A 45 year-old patient has suspected B12 deficiency. What symptoms might warrant a serum B12 and folate level?

  1. Increased appetite
  2. Abdominal pain
  3. Burning in the hands or feet
  4. Joint aches and lower extremity swelling
A
  1. Burning in the hands or feet
159
Q

Which symptoms are associated with depression in older adults? Select all that apply.

  1. Tremors
  2. Impaired memory
  3. Low energy (anergy)
  4. Inability to concentrate
  5. Social withdrawal
A
  1. Impaired memory
  2. Low energy (anergy)
  3. Inability to concentrate
  4. Social withdrawal
160
Q

If a patient has a positive screen for bipolar disorder. What two choices should be part of the NP’s initial plan of care?

  1. Refer to mental healthcare provider
  2. Prescribe an SSRI
  3. Avoid SSRIs
  4. Prescribe a benzodiazepine
  5. Prescribe an atypical antipsychotic medication
A
  1. Refer to mental healthcare provider
  2. Avoid SSRIs
161
Q

Which of the following are effective approaches to the management of moderate depression? Select all that apply.

  1. Psychotherapy
  2. Medication
  3. Lifestyle changes
  4. Combination of therapy and medication
  5. Combination of therapy, medication, and lifestyle changes
A

ALL:

  1. Psychotherapy
  2. Medication
  3. Lifestyle changes
  4. Combination of therapy and medication
  5. Combination of therapy, medication, and lifestyle changes
162
Q

A 35 year-old woman presents with moderate depression. She refuses to take a medication but is willing to try psychotherapy. Select all examples of psychotherapy.

  1. Cognitive behavioral therapy
  2. Social skills training
  3. Interpersonal psychotherapy
  4. Behavioral activation
  5. Problem-solving therapy
A

ALL:

  1. Cognitive behavioral therapy
  2. Social skills training
  3. Interpersonal psychotherapy
  4. Behavioral activation
  5. Problem-solving therapy
163
Q

A 40 year-old woman is diagnosed with a first episode of moderate depression. What medication would be a good initial choice for her?

  1. Aripiprazole (Abilify)
  2. Bupropion XR (Wellbutrin) 150 mg once daily
  3. Sertraline (Zoloft)
  4. Duloxetine (Cymbalta)
A
  1. Sertraline (Zoloft)
164
Q

A patient has taken 100 mg sertraline for the past 7 months. She abruptly stopped taking it 5 days ago. What symptoms today may be attributed to abrupt discontinuation of this SSRI? Select all that apply.

  1. Chills
  2. Dizziness
  3. Fatigue
  4. Myalgias
  5. Dysphoria
A

ALL:

  1. Chills
  2. Dizziness
  3. Fatigue
  4. Myalgias
  5. Dysphoria
165
Q

What history finding contraindicates the use of bupropion in a patient who has depressive disorder?

  1. Intolerance of SSRIs
  2. History of seizures
  3. Hypothyroidism
  4. Cholecystectomy
A
  1. History of seizures
166
Q

An 85 year-old patient has been diagnosed with moderate depressive disorder. Which medication would be a good initial choice to treat her?

  1. Aripiprazole (Abilify)
  2. Desipramine
  3. Escitalopram (Lexapro)
  4. Duloxetine (Cymbalta)
A
  1. Escitalopram (Lexapro)
167
Q

A 75 year-old woman was diagnosed with depression and started on sertraline (usual dose 50 mg - 200 mg daily). Which dosage would be a good starting dose for her?

  1. 25 mg once daily
  2. 25 mg twice daily
  3. 50 mg once daily
  4. 100 mg once daily
A
  1. 25 mg once daily

(due to her age)

168
Q

Which statements are true about depression in adolescents?

  1. They attempt suicide more often than older adults
  2. Impulsivity is a common finding in these patients
  3. Depressed mood is a predominant symptom
  4. Patients should be screened for substance abuse as a potential co-occurring disease
  5. These patients may experience difficulty thinking or concentrating
A

ALL:

  1. They attempt suicide more often than older adults
  2. Impulsivity is a common finding in these patients
  3. Depressed mood is a predominant symptom
  4. Patients should be screened for substance abuse as a potential co-occurring disease
  5. These patients may experience difficulty thinking or concentrating
169
Q

A patient has been diagnosed with generalized anxiety disorder (GAD). What symptoms might be helpful relieving long-term symptoms?

  1. Propanolol (Inderal)
  2. Alprazolam (Xanax)
  3. Bupropion (Wellbutrin)
  4. Escitalopram (Lexapro)
A
  1. Escitalopram (Lexapro)
170
Q

A patient has been diagnosed with generalized anxiety disorder (GAD). What medication might be helpful in relieving acute symptoms?

  1. Propanolol (Inderal)
  2. Alprazolam (Xanax)
  3. Bupropion (Wellbutrin)
  4. Escitalopram (Lexapro)
A
  1. Alprazolam (Xanax)
171
Q

A 22 year-old patient witnessed the brutal murder of her friend. She has been diagnosed with PTSD. Select all medications that could be tried initially to manage her symptoms.

  1. Escitalopram
  2. Bupropion
  3. Lorazepam
  4. Hydroxyzine
  5. Sertraline
A
  1. Escitalopram
  2. Sertraline
172
Q

A 24 year-old woman tells the NP that, since she began treatment with escitalopram, she has been experiencing episodes of racing thoughts and inability to sleep. This patient should be screened for:

  1. Anxiety
  2. Bipolar disorder
  3. PTSD
  4. Suicide potential
A
  1. Bipolar disorder
173
Q

Which antidepressant is most lethal if consumed in quantity?

  1. Escitalopram
  2. Sertraline
  3. Amitriptyline
  4. Fluoxetine
A
  1. Amitriptyline
174
Q

A man who is being treated with sertraline for depression has complaints of erectile dysfunction. Which medication could be tried in lieu of sertraline?

  1. Paroxetine (Paxil)
  2. Bupropion (Wellbutrin)
  3. Duloxetine (Cymbalta)
  4. Venlafaxine (Effexor)
A
  1. Bupropion (Wellbutrin)
175
Q

A 70 year-old woman has daily complaints of fatigue and pain for the past few months. The NP suspects depression. How should she be evaluated initially?

  1. With a geriatric-specific depression screen
  2. With TSH and B12/folate levels
  3. With a screen for anxiety
  4. CBC, CMP, TSH today
A
  1. With a geriatric-specific depression screen
176
Q

Which neurological assessment/s will evaluate cerebellar function in a patient who reports experiencing left facial numbness that occurred for 10 minutes, then subsided? Select all that apply.

  1. Balance
  2. Coordination
  3. Movement
  4. Cerebral reflexes
  5. Sensation
A

ALL:

  1. Balance
  2. Coordination
  3. Movement
  4. Cerebral reflexes
  5. Sensation
177
Q

Select all conditions that can mimic a stroke.

  1. Migraine headache
  2. Atrial fibrillation
  3. Seizure
  4. Hypoglycemia
  5. Dementia
A
  1. Migraine headache
  2. Seizure
  3. Hypoglycemia
178
Q

Based on his clinical complaints, you suspect that a patient has gastroesophageal reflux disease (GERD). What is the first step in diagnosis and treatment?

  1. Prescribe a proton pump inhibitor
  2. Order a CT of the abdomen
  3. Advise the patient to avoid recumbence after meals
  4. Refer the patient to a gastroenterologist
A
  1. Prescribe a proton pump inhibitor
179
Q

Which of the following symptoms of irritable bowel syndrome is considered a red flag?

  1. Abdominal cramping in the lower quadrants
  2. Mucus in stool
  3. Rectal bleeding
  4. Constipation or diarrhea
A
  1. Rectal bleeding
180
Q

A 70 year-old woman complains of restless sleep and insomnia. After ruling out potential common physiologic causes, the NP recommends a sleep aid. Which is most appropriate?

  1. Diphenhydramine
  2. Melatonin
  3. Zolpidem
  4. Chamomile tea
A
  1. Melatonin
181
Q

A 62 year-old patient takes 36 units of basal insulin. the NP has added once-daily mealtime insulin. What is the most likely reason?

  1. A1C goal is within 1% of being met
  2. AM fasting goals were not met
  3. AM hypoglycemia is a problem
  4. PPG (post-prandial glucose) elevations are occurring
A
  1. PPG (post-prandial glucose) elevations are occurring
182
Q

A 66 year-old woman reports seeing blood in the toilet after a bowel movement. She has a normal colonoscopy at age 50. What should be done first?

  1. Abdominal CT
  2. CBC with ferritin level
  3. Stool for occult blood
  4. Referral to GI for repeat colonoscopy
A
  1. CBC with ferritin level
183
Q

Which diagnosis cannot be determined by chest x-ray?

  1. Pneumonia
  2. Heart failure
  3. Pulmonary embolism
  4. Pulmonary edema
A
  1. Pulmonary embolism
184
Q

Quinolones are not recommended for patients with community-acquired pneumonia who have a comorbidity of:

  1. Epilepsy
  2. Diabetes
  3. Heart failure
  4. Depression
A
  1. Epilepsy
185
Q

Select all of the following that are common asthma triggers.

  1. Exercise
  2. Changes in weather
  3. Respiratory infection
  4. Irritant exposure
A

ALL:

  1. Exercise
  2. Changes in weather
  3. Respiratory infection
  4. Irritant exposure
186
Q

Iron deficiency anemia is:

  1. Macrocytic, normochromic
  2. Microcytic, hypochromic
  3. Microcytic, normochromic
  4. Macrocytic, hypochromic
A
  1. Microcytic, hypochromic
187
Q

B12 deficiency is a side effect of all the following except:

  1. Proton pump inhibitors
  2. Metformin (Glucophage)
  3. Colchicine
  4. Aspirin
A
  1. Aspirin
188
Q

Which medication is associated with Reye’s Syndrome?

  1. Acetaminophen
  2. Aspirin
  3. Guaifenesin
  4. Ibuprofen
A
  1. Aspirin
189
Q

Migraine with aura is characterized by:

  1. Bilateral frontal head pain caused by fatigue
  2. Headache lasting < 2 hours with nausea
  3. Onset within 60 minutes and subsides after rest
  4. Unilateral pain lasting 4 - 72 hours
A
  1. Unilateral pain lasting 4 - 72 hours
190
Q

According to the CC, HIV screening should be:

  1. Routine in patients ages 13 - 64
  2. Recommended for pregnant women in the 3rd trimester
  3. Performed after a blood transfusion
  4. Only advised if the patient is seeking STI treatment
A
  1. Routine in patients ages 13 - 64

Various: Multiple Choice & Other Questions (1 decks)

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