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A BUNDLE OF APEAS EXAM 2023/2024
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APEAS
When patients administer regular insulin (Humulin R U-500), they should be taught: - answers10 units of Humulin R U-500 is equal to 10 units on a U-500 ins... [Show More] ulin syringe. Radioiodine therapy is safe to administer to: - answersA 30-year-old man who desires natural fatherhood-used to tx hyperthyroidism and does not cause infantility or birth defects in the offspring of tx'd pts A pt who has Addison's disease has received a prescription for fludrocortisone. Fludrocortisone acts by: - answersRegulating salt and water balance-mineralocorticoid indicated as partial replacement therapy for pts with primary or 2ndary adrenocortical insufficiency Methimazole for the tx of Graves' disease is contraindicated in pts: - answersWho are pregnant-can cause fetal harm when administered, can readily cross the placental membranes Which of the following medications may cause gynecomastia? - answersEnalapril (Vasotec)-ACE inhibitors may cause gynecomastia A pt is started on a sulfonylurea (i.e. glyburide). The NP informs the pt that sulfonylureas are likely to: - answersReduce microvascular events-also low in cost Disadvantages-produce hypoglycemia and cause weight gain Thiazolidinedione (TZD) medications: - answersIncrease insulin sensitivity-by acting on adipose, muscle & liver to increase glucose utilization and decrease glucose production Pts taking dipeptidyl-peptidase-4 (DDP-IV) inhibitors for the tx of T2DM do NOT routinely need to be monitored for: - answersWeight loss-Januvia, Onglyza, Tradjenta not likely to cause weight loss or weight gain The expected hemoglobin A1V reduction for pts who are started on dipeptidyl-peptidase-4 (DDP-IV) inhibitors such as sitagliptin (Januvia) is: - answers0.6% DDP-IV inhibitors such as alogliptin (Nesina): - answersSuppress glucagon secretion and increase insulin secretion Sulfonylurea-stimulate the release of insulin from functioning beta cells Biguanides-decrease hepatic glucose production, decrease intestinal absorption of glucose, and improve insulin sensitivity Prior to the admin of methimazole (Tapazole) the NP should obtain a baseline: - answersCBC-tx for hyperthyroidism, CBC & liver profile should be obtained A pt is started on exenatide (Byetta) for T2DM. Byetta should be d/c'd if the pt exhibits: - answersPersistent abd pain, radiating to the back-monitored for sx of acute pancreatitis Sulfonylureas such as glyburide (Micronase) are extensively metabolized: - answersIn the liver-primarily by CYP 450 A 48-year-old pt is started on metformin (Glucophage) for T2DM. The maximum expected hemoglobin A1C reduction after initiation of this medication is: - answers2%- usual expected decrease in A1C is 1-2% Insulins recommended for use in insulin pump delivery systems include: - answersApidra & Humalog-only rapid acting insulins are safe for continuous IV use The generic name for Victoza is: - answersLiraglutide-GLP-1 agonists A pt who is started on a glucagon-like peptide (GLP-1), such as Victoza, should be informed that this class of medications may: - answersIncrease satiety-delay gastric emptying & promote weight loss Pts who are receiving radioiodine therapy for hyperthyroidism should be advised to: - answersAvoid contact with young children for several days-radiation emits from the body avoid kids & pregnant women Pts taking thiazolidinedione (TZD) medications should be monitored for: - answersFluid retention & weight gain-may precipitate or exacerbate HF in some pts by causing dose-related fluid retention Levothyroxine use in the 1st trimester of pregnancy: - answersMay require an increase in dose-due to alterations of endogenous maternal thyroid hormones Exenatide (Byetta) is classified as: - answersGLP-1 Gynecomastia is NOT likely to be caused by: - answersClonazepam Ketoconazole, finasteride, spiro, lavender/tea tree oil may cause this Pt receiving insulin detemir (Levemir) are at higher risk for developing: - answersHypokalemia-causes a shift in K+ from the extracellular space to the intracellular space The mechanism of action by which metformin (Glucophage) improves glucose tolerance is: - answersDecreased intestinal absorption of glucose-also improves insulin sensitivity by increasing peripheral glucose uptake and utilization Due to the mechanism of action of meglitinides used in the tx of T2DM, they should by administered: - answersat meal time-should be admin within 30 mins of a meal or at meal time 2-4 times daily Victoza (liraglutide), a GLP-1 for the tx of T2DM, may potentially decrease effectiveness of: - answersOral contraceptives-delay absorption of orally absorbed medications Metformin (Glucophage) is a: - answersBiguanide The combination of metformin (Glucophage) and glyburide (Diabeta) for the tx of T2DM is: - answershighly efficacious with a moderate risk of hypoglycemia A pt is receiving a fast-acting insulin to decrease post-prandial blood sugars. If the bedtime blood sugar is elevated, the pt should be advised to increase the fast-acting insulin dose at: - answersDinner-onset of rapid acting is 15 mins Which of the following is a rapid-acting insulin? - answersAspart (Novolog) Pts should be advised to take glimepiride (Amaryl): - answersIn the morning with breakfast-or 1st meal of the day, long acting sulfonylurea Which statement about metformin (Glucophage) is correct? - answersIt should be temporarily discontinued for radiologic studies with iodinated contrast-may result in acute alteration of kidney function Insulin glargine (Lantus) is NOT indicated in the tx of: - answersPediatric pts with T2DM Sodium-glucose co-transporter 2 (SGLT2) inhibitors reduce blood glucose by: - answersIncreasing urinary glucose excretion Pioglitazone hydrochloride (Actos) is contraindicated in pts with: - answersheart failure-can cause dose-related fluid retention Alpha-glucosidase inhibitors such as acarbose (Precose) are contraindicated in pts with: - answersInflammatory bowel disorders-delays absorption of carbs following a meal In addition to hemoglobin A1C, pts receiving metformin (Glucophage) should be monitored for: - answersRenal function, liver function, and vit B12 levels The mechanism of action of methimazole (Tapazole) is to: - answersBlock synthesis of thyroxine and triiodothyronine (T3)-readily absorbed in the GI tract, metabolized in the liver, and excreted in the urine Insulin detemir (Levemir): - answersMay be administered once or twice daily-subq Signs and symptoms of hypoglycemia may be blunted by: - answersbeta-blockers-masks signs by inhibiting these sx Aspart (Novolog) should be administered: - answers10 mins prior to a meal-rapid acting In addition to hypoglycemia, rapid-acting insulins may cause: - answersHypokalemia Maximum plasma concentrations of glucagon, after intramuscular injection, are observed in approximately: - answers15 minutes Which of the following is an intermediate-acting insulin? - answersInsulin NPH (Humulin N), 1-2hr onset, 6-12 hour peak and 18-24 hours duration Levothyroxine (Synthroid) is indicated in the tx of: - answersHypothyroidism The most commonly reported s/e of the GLP-1 medication class is? - answersNausea-n/v/d Which of the following side effects may be caused by methimazole (Tapazole)? - answersHypothyroidism-routine measuring of TSH and free T4 levels The onset of action of short-acting insulins is: - answers30 mins-regular insulin, Humulin R Patients who use insulin glargine (Lantus) should be advised: - answersto inspect for visable particles or color change before admin-should be colorless, never frozen, never mixed with other insulins Thiazolidinedione (TZDs) such as pioglitazone (Actos) reduce A1C levels by: - answers0.7% The most common serious s/e associated with glimepiride (Amaryl) is: - answersHypoglycemia Levothyroxine (Synthroid) is best administered: - answersOn an empty stomach, first thing in the morning-at least 30-60 mins before food for optimal absorption Undertreatment of hypothyroidism in pediatric patients may lead to: - answersCretinism-congenital disease due to absence or deficiency of normal thyroid secretion The most frequent s/e of metformin (Glucophage) is: - answersDiarrhea-dose-dependent, may be alleviated by decreasing dose Because the mechanism of action, patients should be instructed to administer exenatide (Byetta): - answerstwice daily, within 1 hr prior to morning and evening meals, should NOT be taken AFTER meals Sx of Graves' disease include: - answersProptosis-bulging of eyes (hyperthyroidism) Hypo-weight gain, bradycardia, and anemia When a patient presents with myxedema coma, which one of the following groups of symptoms may be present? - answersHypothermia, thickening of the tongue, and disorientation-due to longstanding low level of thyroid hormone Which of the following is NOT associated with Hashimoto's thyroiditis? - answersWeight loss-this is usually noted in hyperthyroidism Striae, skin atrophy, and purpura may be associated with: - answersCushing's Disease-also moon facies & buffalo hump A 20-year-old with acanthosis nigricans should be evaluated for: - answersDiabetes mellitus-skin condition characterized by dark velvety patches in the body folds or creases Thyrotoxicosis is most commonly associated with: - answersHyperthyroidism [Show Less]
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APEAS
changes that occur in the second trimester of pregnancy - ANSWERSblood pressure decreases, heart rate increases effect of DRE on PSA value if it is meas... [Show More] ure the same day as DRE - ANSWERSchange in PSA is insignificant chancroid is cofactor for transmission of ? - ANSWERSHIV initial recommended treatment for uncomplicated acute bronchitis in adults - ANSWERSantitussives most common cause of R sided heart failure - ANSWERSleft ventricular HF lab test that best assesses for early renal insufficiency - ANSWERSGFR headaches, eye pain, and seeing halos around lights - ANSWERSangle closure glaucoma notice yellowish plaque on upper eyelid- what labs to assess - ANSWERSlipid levels minimum target outcomes to evaluate the effectiveness of the stimulant medications for ADHD - ANSWERS3- relationships with parents, disruptive behaviors, grades prolonged use of corticosteroids in children does not lead to - ANSWERSSIADH trulicity is best indicated for which patient - ANSWERS35 year old with type 2 and morbid obesity suspicion of cushings disease in which patient - ANSWERS34 year old woman with hypertension gluten restricted diet includes - ANSWERScorn functional rehab timing for knee or ankle sprain - ANSWERSthe day of the injury thickened, hyperpigmented skin in flexural areas with velvet like texture - ANSWERSacanthosis nigricans patient with peripheral neuropathy- which is NOT a differential - ANSWERShyperthyroidism drug related rash likelihood increases when augementin is given to a patient with... - ANSWERSmono treatment of chronic paronychia - ANSWERStopical steroid 60 year old COPD patient wants to be immunized for flu, but has not had pneumonia vaccine- what should the NP do - ANSWERSreceive the flu and pneumococcal today butalbital - ANSWERSis a barbiturate that acts on the cns lesion on trunk (herald patch) associated with what - ANSWERSpityriasis rosea recommended therapy for reduction of elevated LDL in primary prevention of CVD is - ANSWERSstatin therapy patient with photophobia, HA, febrile and unable to fully extend leg when the hip is flexed - ANSWERSmeningitis side effect of doxycycline - ANSWERSphotosensitivity which cranial nerve is not associated with the loss of extraocular muscle control that may cause strabismus - ANSWERSVII topical corticosteroids used to treat skin conditions - ANSWERSpossess anti inflammatory properties most common side effect of calcium - ANSWERSconstipation joint swelling in inflammatory arthritis is associated with - ANSWERSsynovial hypertrophy, synovial effusion, or inflammation of periarticular structures asymptomatic male with UTI treatment - ANSWERS14 day course of cipro immunoglobulins activated in response to allergic rhinitis - ANSWERSigE 54 year old woman postmenopausal with moderate vaginal bleeding- dx least likely? - ANSWERSovarian cancer severe right sided facial pain over the last 48 hours- what is not a differential? - ANSWERSbells palsy oral prednisone for COPD exacerbation should last how long - ANSWERS5 days srojens syndrome characteristic of what - ANSWERSdry mouth/eyes side effect of sildenafil - ANSWERSnasal congestion true statement about missed doses of oral contraception - ANSWERSif a patient misses two consecutive pills she should take two pills per day for the next two days baseline levels prior to initiating treatment for osteoporosis includes baseline serum - ANSWERScalcium and vit D levels silvadene - ANSWERSoculotoxic and should not be placed near the eyes patient who takes atorvastatin complains of fatigue, weakness, and muscle aches in lower back arms and legs. next step by provider: - ANSWERSstop the atorvastatin immediately. frequent cause of arrhythmia is - ANSWERScoronary artery disease recommended patient delivered expedited therapy for treatment of gonorrhea is - ANSWERSazithromycin 1g orally plus doxycyline 100mg BID for 7 days correct answer is: azithromycin 1g orally plus cefixime 400mg orally? test to differentiate between infectious colitis and ulcerative colitis - ANSWERSstool culture peak flow meter measures - ANSWERSexpiratory flow patient with comedonal noninflammatory acne should be treated with topical - ANSWERSretinoid treatment of hiristuism associated with PCOS - ANSWERSnorethidrone/ethinyl estradiol (lo loestrin) pregnant patient complains of edema and asks for fluid pill: best NP response - ANSWERSbest treated with elevation and rest patient with GAS has PCN allergy and there is a high community resistence to macrolides- what is the best treatment for this patient - ANSWERSoral clindamycin?? normal assessment finding of 3 day old infant who is crying - ANSWERSpalpable pulsations over the anterior fontanel man presents with erythema migrans after a hunting trip one week ago, appropriate pharmacotherapy would be? - ANSWERSdoxycycline first generation cephalosporins for the treatment of bacterial skin infections have - ANSWERSprimarily gram positive sumatriptan drug class - ANSWERSSerotonin 5-HT1 receptor agonist side effect of beta blockers in children - ANSWERSa cough that produces mucous inhaled glucocorticoid medication - ANSWERSbudesonide partial or complete loss of pigmentation producing melanocytes within the epidermis - ANSWERSvitiligo prostatitis dosing at least - ANSWERS30 days (4 weeks) effect of alpha reductase inhibitor on PSA - ANSWERSdecrease treatment of syphilis in a pregnant woman - ANSWERSparenteral pen G not a deficiency directly related to development of osteoporosis in older adults - ANSWERSmagnesium patient takes atenolol for angina; caution when using what other agent to help control blood pressure - ANSWERSverapamil [Show Less]
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APEAS
A gray or white ring present around the peripheral iris - ANSWERSarcus senilis A loss of the central sulcus of the prostate on DRE is a sign of what? - ... [Show More] ANSWERSBPH A male patient presents to your clinic with a lump in his breast. How should we work this up? - ANSWERSclinical breast exam, mammogram, AND ultrasound A positive "drop arm" test is a sign of what? - ANSWERStorn rotator cuff A woman who gets the MMR vaccine should wait at least __________ before getting pregnant. - ANSWERS4 weeks ACEIs can cause what electrolyte abnormality? - ANSWERShyperkalemia After exposure to HIV, when will the patient seroconvert and become positive? - ANSWERS3 months An herbal supplement thought to help BPH - ANSWERSsaw palmetto an inflammation in the hip joint that causes pain, limp and sometimes refusal to bear weight. This occurs in pre-pubescent children and is the most common cause of hip pain. It occurs when a viral infection, such as an upper respiratory infection, moves to and settles in the hip joint. - ANSWERStransient synovitis Ankle inversion is a common complaint from a patient with what? - ANSWERSa lateral ankle sprain Are saturated or unsaturated fatty acids better for you? - ANSWERSunsaturated Children can start to ride a tricycle around age _____ - ANSWERS3 Diphenhydramine has __________ properties and is contraindicated in which patient populations? - ANSWERSanticholinergic; elderly and those with glaucoma Dix Hallpike maneuver is the standard clinical test for _______ - ANSWERSBPPV For a patient on warfarin who needs to receive a tetracycline antibiotic, how will we adjust their warfarin? - ANSWERStetracyclines depress prothrombin activity, same as warfarin, so we need to decrease the warfarin to avoid an increase in INR and significant bleeding Growing pains often start in what age group? - ANSWERS3-5 HCTZ can cause _________, whereas ACEI can cause _________ - ANSWERShypokalemia; hyperkalemia hey - ANSWERSstopped at top of page 7 HMO and PPOs are called what? - ANSWERSmanaged care plans How can we best diagnose coarctation of the aorta? - ANSWERSby comparing the upper and lower extremity blood pressures How do we manage rubella immunity in pregnant women? - ANSWERSwe screen all pregnant women with a rubella titer. If they had a protective rubella titer in a previous pregnancy, then they do not need to be checked again. If they are found to not be immune when pregnant, then she should be vaccinated AFTER delivery How do we test cerebellar function? - ANSWERSrapid alternating movements, finger to nose test, balance (romberg), gait How do we treat thrush in infants? - ANSWERSapplication of nystatin to inside of the mouth, sterilize all pacifiers and bottle nipples; a topical antifungal may be applied to the nipples How does plantar fasciitis usually present? - ANSWERSas pain in the morning with resolution after several steps, but as it worsens the patient will start to complain of heel pain throughout the day and with walking How is a diagnosis of neuroblastoma confirmed? - ANSWERSvia serum catecholamine testing and a biopsy How is influenza diagnosed? - ANSWERSa nasal swab How is permethrin applied to the skin for scabies? - ANSWERSa one time application to all skin below the neck and then left on for 8-12 hours is sufficient How long must a tick be attached to the skin in order for Lyme disease to be transferred? - ANSWERS48 hours Hyperparathyroidism can cause what? - ANSWERShypercalcemia and thus, osteoporosis If a patient with strep comes back after 48 hours with no improvement on antibiotics, what should you then prescribe? - ANSWERSa penicillin or cephalosporin with beta lactamase coverage Immunizations are considered to be what level of prevention? - ANSWERSprimary In the presence of an elevated serum TSH, what is the next step in management? - ANSWERSrepeat TSH plus free T4 Is age less than 18 years a risk factor for an ectopic pregnancy? - ANSWERSno; but personal history of PID, an IUD, previous ectopic pregnancy, previous tubal surgery, pathology, or ligation all are risk factors Is Meniere's disease most often unilateral or bilateral? - ANSWERSunilateral Koilonychia is a sign of what? - ANSWERSiron deficiency anemia Normal weight people should gain how much weight during pregnancy? - ANSWERS25-35 pounds Obese women should gain how much weight during pregnancy? - ANSWERS11-20 pounds Oral contraceptive regimen in which both the estrogen and progesterone concentrations vary throughout the cycle - ANSWERSquadriphasic Oral contraceptive regimen in which in the estrogen dose remains the same for the first 21 days of the cycle, while progestin is lower in the first half and higher in the second half - ANSWERSbiphasic Oral contraceptive regimen in which the estrogen and progestin doses are fixed throughout the cycle - ANSWERSmonophasic Oral contraceptive regimen in which the estrogen remains consistent and the progestin dose varies - ANSWERStriphasic Overweight women should gain how much weight during pregnancy? - ANSWERS15-25 pounds Patients who are receiving beta blockers may find what treatment for allergies ineffective? - ANSWERStreatments containing epinephrine Patients with a history of UC or Crohn's should have a colonoscopy how often? - ANSWERSevery 1-5 years due to the increased risk of colorectal cancer PID should improve after ____ of the antibiotic course. - ANSWERS3 days Pregnant women should increase their daily caloric intake by how many calories per day? - ANSWERS300 Prostate infection or inflammation can cause a sharp rise in PSA values. When should this value go back down to normal levels and be checked after an acute infection? - ANSWERS4 weeks Scope of practice for NPs is not influenced by which entity? - ANSWERSa court of law Signs of a ruptured ovarian cyst - ANSWERSnausea, vomiting, shoulder pain, fever TCAs can cause what worsened problem in a patient with BPH? - ANSWERSurinary retention The antibiotic of choice for a dog bite - ANSWERSaugmentin; doxy if there is a penicillin allergy The first sign of puberty in girls - ANSWERSthelarche (breast budding) The medical term for flat feet - ANSWERSpes planus The medical term for spoon shaped nails - ANSWERSkoilonychia The most common cause of atypical pneumonia in adults - ANSWERSmycoplasma pneumoniae The most effective treatments for acne related to increased sebum production are what? - ANSWERSoral contraceptives and isotretinoin Treatment of choice for pyelonephritis - ANSWERSciprofloxacin Treatment of subclinical hypothyroidism is generally not indicated unless the TSH is ___________. - ANSWERSgreater than 10 Underweight people should gain how much weight during pregnancy? - ANSWERS28-40 pounds Used to establish a designated level of professional competence - ANSWERSlicensure Vitamin B12 deficiency anemia is a type of ____________ anemia. - ANSWERSpernicious; macrocytic What antibiotics are considered safe in pregnancy? - ANSWERSbeta lactams (cephalosporins, amox, augmentin), nitrofurantoin, vancomycin, metronidazole, clindamycin, and fosfomycin What are the 4 components of Tetralogy of Fallot? - ANSWERSVSD, pulmonic stenosis, overriding aorta, right ventricular hypertrophy What are the intrauterine transplacental infections that can be passed from mother to infant? - ANSWERSthink TORCH; toxoplasmosis, Other (syphilis, varicella zoster, parvovirus) Rubella, Cytomegalovirus and Herpes simplex, as well as tuberculosis. Note that chlamydia is NOT transplacental, but rather transvaginal during childbirth What are two common classes of drugs that interact with grapefruit juice? - ANSWERSstatins and CCBs What causes arcus senilis? - ANSWERSit is a normal, benign condition with aging, but can also occur in younger people as a result of high cholesterol and triglycerides What class of drug is dabigatran (pradaxa)? - ANSWERSdirect thrombin inhibitor What does the murmur of Tet of Fallot sound like? - ANSWERSharsh systolic murmur at the left upper sternal border What finding would be most likely to differentiate gout from septic arthritis? - ANSWERSfever would be indicative of septic arthritis [Show Less]
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APEAS
CN Ii in a young infant is evaluated by: - ANSWERSsquinting response to bright light Older adults who are treated for depression w/ TCAs often exhibit -... [Show More] ANSWERSDepression A pregnant pt is 30 weeks gestation and wants to fly in an airplane to Colorado. The NP knows: - ANSWERSTravel to a city of high altitude can precipitate preterm labor Ankle inversion is a common complaint from a patient with a: - ANSWERSLateral ankle sprain How often should bp be measured in a child who is 3 yo? - ANSWERSIt should be measured annually What is the relatioship btwn A1c and pt's lipid values? - ANSWERSAs A1c decreases, TGCs will also decrease In order to establish a pregnancy, a pregnancy test of the urine or blood is routinely performed. How early can this be done with reliable results? - ANSWERS6-8 days after conception A pt presents to clinic with a complaint of a red eye. Which assessment below rules out the most worrisome diagnosis? - ANSWERSUsual visual acuity The primary risk factor for development of breast canfer in women of average risk is? - ANSWERSage Which infant feeding behavior is likely related to CHD - ANSWERS1. Feeding interrupted by choking, gagging or vomiting 2. Rapid breathing w/ feedings 3. Persistent cough or wheeze What advice should be given to a parent who a child w/ Fifth Disease? - ANSWERSA parent may experience joint aches and pains The 3 most common causes of bacterial diarreha in the US are? - ANSWERS1: Salmonella 2. Campylobacter 3. Shigella What is an abnormal growth found int he middle or mastoid? - ANSWERSCholesteatoma [Show Less]
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APEAS
Cranial Nerve VIII - ANSWERSAcoustic (Hearing and balance) Cranial nerve IX - ANSWERSGlossopharyngeal- swallowing and rise of the palate, gag reflex ... [Show More] Cranial Nerve XI - ANSWERSSpinal Accessory (upper trapezius) Deep tendon reflex - ANSWERSAnkle- S1 primarily Knee- Lumbar 2,3,4 Supinator(brachioradialis)-C5,6 BicepTriceps-C6,7 Stroke risk scale - ANSWERSCHADS2 C-Congestive heart failure H-Hypertension A-Age >75 years D- Diabetes S-prior Stroke/TIA In the majority of children, the first permanent teeth start to erupt at the age of 6 years. Which of the following are the first permanent teeth to erupt in this time period? A. First Molars B. Second Molars C. Lower or upper incisors D. Canines - ANSWERSA. First Molars All of the following are classified as activities of daily living (ADLs) except: A. ability to feed self B. Ability to manage bladder and bowel elimination C. Personal hygiene and grooming D. Grocery Shopping - ANSWERSD. Grocery shopping You note the following result on a routine urinalysis of a 37-year old primigravida who is at 30 weeks gestation. Leukocyte=trace, nitrite=negative, protein=2+, blood=negative. Her weight has increased by 5 lbs during the past week. Which of the following is most likely? A.HELLP syndrome B. Pregnancy-induced hypertension (pre-eclampsia) C. Eclampsia of pregnancy D. Primary hypertension - ANSWERSB. Pregnancy-induced hypertension (pre-eclampsia). Classic triad of symptoms of preeclampsia include hypertension, edema (weight gain), and proteinuria. The mother of a 12 month old infant reports to the nurse practitioner that her child had a high fever for several days, which spontaneously resolved. After the fever resolved, the child developed a maculopapular rash. Which of the following is the most likely diagnosis? A. Fifth Disease (erythema infectiosum) B. Roseola infantum (exanthema subitum) C. Varicella D. Infantile maculopapular rashes - ANSWERSB. Roseola Infantum (Exanthema subitum) A 70-year old male patient complains of a bright red-colored spot in his left eye for 2 days. He denies eye pain, visual changes, or headaches. He has a new onset of cough from a recent viral upper respiratory infection. The only medicine he is on Bayer aspirin, 1 tablet a day. Which of the following is most likely? A. Corneal abrasion B. Acute bacterial conjunctivitis C. Acute uveitis D. Subconjunctival hemorrhage - ANSWERSD. Subconjunctival hemorrhage. Bright red blood in a sharply defined area surrounded by normal-appearing conjunctiva indicates subconjunctival hemorrhage. A woman is being evaluated by the nurse practitioner for complaints of dyspareunia. A microscopy slide reveals a large number of atrophic squamous epithelial cells. The vaginal pH is 4.0. There are very few leukocytes and no RBCs are seen on the wet smear. Which of the following is most likely? A. Atrophic vaginitis B. Bacterial Vaginosis C. Trichomoniasis D. This is a normal finding. - ANSWERSA. Atrophic vaginitis. Symptoms of atrophic vaginitis include painful intercourse, atrophic squamous epithelial cells, and a decrease in pH. Vaginal atrophy is caused by lack of or imbalance of estrogen. Normal pH of the vagina is 4.0-5.0 (acidic) The most common type of skin malignancy is: A. Squamous cell cancer B. Basal skin cancer C. Melanoma D. Dysplastic nevi - ANSWERSB. Basal skin cancer. It is several times more common that squamous cell skin cancer according to the NIH. Koplik's spots are associated with: A. Poxvirius infections B. Measles C. Kawasaki's disease D. Reye's syndrome - ANSWERSB. Measles. S/S include fever over 101, coryza, cough, conjunctivitis, rash, and koplik's spots on buccal mucosa At what level of prevention would you classify for lung cancer? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Primordial prevention - ANSWERSD. primordial prevention. Screening for lung cancer is not currently recommended in the general population, but it is secondary prevention. A test called the visual fields by confrontation is used to evaluate for: A. Peripheral vision B. Central vision C. Visual acuity D. Accomodation - ANSWERSA. Peripheral vision What is the most common cause of Cushing's syndrome? - ANSWERSAdministration of a glucocorticoid or ACTH. Iatrogenic Cushing's syndrome is the most common type. Exogenous glucocorticoid administration produces a Cushing's Syndrome that is reversible by discontinuation of the medication. A patient with no significant medical history has vericose veins. She complains of '"aching legs". The intervention that will provide the greatest relief for her complaint is to: - ANSWERSElevate her legs periodically. The intervention that will provide the greatest relief for this patient is elevating her legs periodically. This will facilitate venous return. Use of support stockings will prolong the length of time she is able to stand in place, but will not provide relief after her legs begin aching. Support stockings should be applied prior to getting out of bed. A 25-yo female patient presents for a routine well-women exam. On physical exam, the NP notes a scant nipple discharge, absence of palpable mass, and absence of lymph node enlargement. What is the most likely diagnosis? - ANSWERSItraductal papilloma. Intraductal papilloma often presents as a non-tender mass with serous or bloody nipple discharge located in the ductal system near the areola. Breast cancer, although usually non-tender, may present with pain. Chest wall syndrome may present in some women as breast pain. Fibrocystic breast disease often presents with bilateral breast pain. According to the ANA, the role of the NP who provides primary health care is the: - ANSWERSDirect nursing care role. The NP with a traditional nursing care role is a primary health care provider. Increasing numbers of nurse practitioners are assuming indirect roles such as educator, administrator, researcher, and consultant. An 8-mo male presents with hemarthrosis of both knees and hematuria. The parents give no history of trauma, but say " he has always bruised easily" The most likely diagnosis is: - ANSWERSA type of hemophilia. Hemophilia is usually diagnosed within the first year of life. It commonly presents with hemarthrosis, bleeding into soft tissue, hematuria, and prolonged bleeding times. The nurse practitioner is following a child with juvemile rheumatoid arthritis (JRA) who has been previously diagnosed and is being managed for the disease by a pediatric rheumatologist. The mother asks for information about the child's long-term prognosis. The appropriate reply is that: - ANSWERSmost children with JRA achieve complete remission by adulthood, but its effects might cause lifelong limitations. Although the active disease does not continue into adulthood, the contractures, growth retardation, bone deformities, and visual impairment associated with JRA may lead to lifelong functional impairments. A comprehensive treatment program involving physical therapy, occupational therapy, nutrition, education, and regular opthalmologic care can limit residual functional limitations. Approximately 70% of the organisms found in canine oral and nasal fluids, and consequently in fresh dog bite wounds, are: - ANSWERSStaphylococcus and Pasteurella multocida. All of these organisms are found in canine oral and nasal fluids, and cultured from fresh dog bite wounds, but the most common (70%) are Staph and Pasteurella multocida. Education of women with fibrocystic breast disease should include which of the following statements? - ANSWERSCaffeine may trigger breast pain. Avoidance of all methylxanthines (eg coffee, tea, chocolate) has been shown to reduce breast pain in women with fibrocystic breast disease. It is usually a benign condition, not a precursor of malignancy. Mammography is recommended once at age 35 years, at least every 1-2 years after age 40, and then annually beginning at age 50 years. Oral contraceptives may help reduce cyclical pain and swelling. Congenital heart disorders present with symptoms at: - ANSWERSbirth, infancy, or in childhood. A common misconception is that congenital disorders always present symptomatically at birth. They can present at various times throughout childhood and are classified as cyanotic or acyanotic. Cardiac disorders in infants and children may be acquired from rheumatic fever or kawasaki syndrome. A 21-yo patient presents with abdominal guarding, rigid abdominal musculature, rebound tenderness at McBurney's point, and leukocytosis. What is the most likely diagnosis? - ANSWERSAppendicitis. McBurney's point is the RLQ abdominal landmark for the appendix. Rigid abdominal musculature, rebound tenderness, and positive psoas sign (inflamed psoas muscle), indicates inflammation of the peritoneum. Cholecystitis presents with RUQ pain and positive Murphy's inspriatory arrest. Ilcerative colitis presents with LLQ pain. Pain associated with pancreatitis is typically in the epigastric region. Atenolol (Tenormin) should be avoided in: - ANSWERSa 43-yo female with asthma. Atenolol is a beta blocker. It should be avoided in pateints with asthma or other bronchospastic conditions. These patients often require beta stimulation, not beta blockade. Although atenolol is a beta 1-selective agent, at higher doses beta 2 receptors (bronchial and vascular) are blocked. Beta blockers, specifically atenolol, are beneficial post-myocardial infarction because they have demonstrated a reduction in morbidity and mortality. All of the following interventions with pediatric patients are appropriate EXCEPT: - ANSWERSPre-medicate the patient prior to all painful interventions. Pre-medication is not warranted prior to all painful interventions. For example, premedication is not warranted prior to routine immunizations but it certainly is prior to suturing. Pain management should be an integral part of patient management. Infants with veliac disease (gluten eneteropathy) are at risk for multiple complications. The most urgen complication of this disease is: - ANSWERSIntususseption or volvulus. [Show Less]
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APEAS
An enlarged liver with a smooth tender edge may suggest: - ANSWERSright sided heart failure An enlarged liver with a firm, non tender edge may suggest: ... [Show More] - ANSWERSCirrhosis, hematochromotosis (increase iron intake in the blood and lymphoma An enlarged liver that is firm or hard and has an irregular edge or surface - ANSWERSHepatocellular carcinoma S/S associated with diabetic gastroparesis may include: - ANSWERSVomiting of undigested food Weight loss Erratic glucose levels GERD What is sarcopenia and what causes it? - ANSWERSSarcopenia = age related loss of skeletal muscle mass Causes: -inactivity -protein imbalance -mitochondrial dysfunction -insulin resistance -oxidative stress -increased inflammatory factors -loss of motor units as muscle ages Psoas sign - ANSWERSRLQ pain with extension of right thigh indicative of appendicitis Rovsing's sign - ANSWERSPain in RLQ with palpation of LLQ indicative of appendicitis Obturator's sign - ANSWERSRLQ on internal rotation of right thigh indicative of appendicitis Murphy's sign - ANSWERSpain with palpation of the RUQ during inspiration, indicative of cholecystitis acute pancreatitis - ANSWERSinflammation of the pancreas secondary to the leakage of pancreatic enzymes from the acinar cells into the parenchyma of the organ Pain is localized in the abdomen, can be epigastric and may radiate to the posterior trunk biliary colic - ANSWERSpain in the gallbladder caused by gallstones obstructing bile flow [Show Less]
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