A). Right lower lobe crackles
13 yo male diagnosed as bronchitis was treated with fluids and expectant. He returns with fever 102.8, R. pleuretic pain,
... [Show More] and green sputum. which of the following would be an expected finding?
a) Right lower lobe crackles
B) decreased fremitus
c)bilateral wheezing
d)normal percussion
c) The child quickly begins using arm to pick up toy
3yo diagnosed with radial head subluxation (nursemaid elbow). After closed manipulation the best indicator of successful procedure is:
a) swelling decreases immediately
b) pulses return
c) the child quickly begins using arm to pick up toy
d) a click is felt while the child is attempting to pick up toy
D)Measles
a 11mo old presents with a rash, runny clear nose, and cough. During assessment you note tiny white papules with erythema on the buccal mucousa. What is this suggestive of?
a)Scarletina
b)Rubella
c)hand, foot, mouth
d) Measles
A)Augmentin
A 17yo complains of 14 day onset of facial pain in maxillary region with yellow nasal drainage. what is an appropriate initial pharmacological intervention?
a)Augmentin
b)Ceftriaxone(rocephin)
c)Levaquin
d)Erythromycin
d)Lung
Leading cause of cancer-related death in women?
a)cervical
b)ovarian
c)breast
d)lung
b) No obvious signs/symptoms
a 27yo male uncomplicated chlamydia infection may exhibit:
a)urticaria
b)no obvious signs or symptoms
c) green mucoid penile drainage
d)penile shaft ulcer
b)start lower dose then taper up
common practice rule to follow with initiating medications in the elderly is:
a)prescribe meds to take in am
b)start lower dose then taper up
c)obtain creatinine clearance for baseline data for those over 70
d)give meds with a full glass of water
b) lower the seizure threshold
12 yo with PMI of seizure is reported by mother that cold symptoms are present. Denies fever. The NP should advise that a fever may:
a)make seizure medication less effective
b)lower the seizure threshold
c)increase the seizure threshold
d) have no effect on the seizure threshold
c. doxycyline
According to the American Thoracic Society/Infectious Disease Society of American (ATS/IDSA) Consensus guidelines on the Management of Community-Acquired Pneumonia in Adults, which of the following is the most appropriate antimicrobial for tx of CAP in a:
46 y/o well female with a hx of a bilateral tubal ligation who is macrolide intolerant?
a. clarithromycin
b. amoxicillin
c. doxycyline
d. fosfomycin
c) Doxycycline
after a 3 wk camping trip, a 11yo presents with a target lesion with central clearing on the inner left thigh. Chief complaints of headache, fatigue,and generalized muscle pain for several days. What should NP prescribe?
a)bactrim
b)azithromycin
c) doxycycline
d) metronidazole
b. osteoporosis
During development of a treatment plan for a 78 yo with dx hypothyroidism, the NP needs to be concerned with?
a)renal insufficiency
b)osteoporosis
c)dementia
d)anemia
d)provide reassurance
16 yo currently taking ortho-novum 7/7/7 comes to clinic to report midcycle spotting. Denies missing doses and is currently not on any other medications. Which is appropriate?
a)modify usage
b)double her dose x 2 days
c) change to a different medication
d) provide reassurance
d)prednisone
Polymyalgia Rheumatica (PMR) should be managed by:
a)whirlpool tub
b)celebrex
c) analgesic
d)prednisone
c) Paxil (paroxetine)
54yo male c/o malaise as well as delayed ejaculation. Current medications: atenolol, paxil, hctz, claritin. Which med is most likely to cause ED?
a)HCTZ
b)atenolol
c)paxil
d) claritin
a) palpate structures around shoulder
25yo presents with chief complaint of decreased mobility and pain of the right shoulder exacerbated with movement. The patient occupation is painting houses. He reports he recently painted for 24 hours prior to onset of pain. Denies trauma. Passive ROM intact. No visible signs of injury. What should NP do next?
a) Palpate structures around shoulder
b)obtain MRI
c) Order Xray
d) Order EMG
C. Primary amenorrhea
17 yo has never had menses. She is at tanner stage III Physical exam normal with weight appropriate. What is likely diagnosis?
a) ovarian dysfunction
b) dysmenorrhea
c) primary amenorrhea
d)secondary amenorrhea
a)hemoglobin electrophoresis
12 yo patient has a family history of thalessemia and anemia is stage II presentation and a HCT of 330. What should NP order in addition to CBC?
a) hemoglobin electrophoresis
b) vitamin b12 level
c) 25 hr creatinine clearance
d) serum folic acid
c)strep pneumo
Common bacteria responsible for pneumonia in older patients residing in the community is:
a) staph aureus
b)pseudomonas
c)strep pneumo
d)tuberculi
d) prescribe bulk forming agents & hydrocortisone suppositories
43yo c/o 14 day rectal itch &pain. PMI of constipation. Also reports bright red blood on toilet paper several times a week. Rectal exam positive for a single tender, blue, swollen ovoid mass. Guaiac stools negative. What should NP prescribe?
a) lomotil
b)colonoscopy to r/o cancer
c) repeat guaiac test three times and a CBC
d) Prescribe bulk forming agents& hydrocortisone suppositories.
d) FSH , LH, prolactin &TSH
16yo is suspected of having PCOS. In addition to testosterone, the most appropriate diagnostic tests to order:
a) BUN,Creatinine,electrolytes &Dhea
b) CBC,BUN,creatinine & estrogen
c)FBS,CBC,BUN & sex hormone
d) FSH,LH,prolactin & TSH
b) Metronidazole
Which is an example of the typical management of trichomoniasis
a)miconazole
b)metronidazole
c) clindamycin
d)azithromycin
b)Tamiflu
High risk population such as elderly, COPD, or immunocompromised. What should NP prescribe?
a) Rest & fluids
b) Tamiflu
c) amoxicillin
d) watch & wait
c) 7(VII)
Which CN is affected in Bell's palsy?
a) 5
b)3
c)7
d)4
b)3,4,6
Which CN function together for oculomotor function?
a)3,4,5
b)3,4,6
c)3&5
d)4&5
c) cold compress
Treatment of "viral" conjunctivitis includes the use of:
a) antihistamine/decongestant drops
b) antihistamine/mast cell stabilizer drops
c) cold compresses
d) steroid eyedrop
B. Cocaine
A 42-year-old patient with epistaxis, dilated pupils, tachycardia, and mild euphoria shows symptoms associated with the use of:
a) benzodiazepine (Alprazolam)
b) cocaine
c) morphine (MS Contin)
d) oxycodone (OxyContin)
a)blindness in the affected eye
Temporal arteritis requires immediate treatment in order to prevent:
a) blindness in the affected eye
b) facial nerve palsy
c) transient ischemic attack
d) trigeminal neuralgia
d) tertiary prevention
A patient who sustained a myocardial infarction comes to the clinic for a refill of atorvastatin (Lipitor). The family nurse practitioner explains that the medication is prescribed for:
a) cancer prevention
b) primary prevention
c) secondary prevention
d) tertiary prevention [Show Less]