1. An older adult presents with severe abdominal pain. The husband reports that earlier in the afternoon, the patient's abdominal hernia had been firm and
... [Show More] bulged out 4 inches (10.2 cm). The patient had him press on the hernia and immediately felt burning pain throughout the abdomen. Which of the following is the nurse practitioners' NEXT action?
1. Abdominal CT scan
2. Complete blood count with differential
3. Abdominal ultrasound
4. Referral to the ED
4. Referral to the ED
2. A young adult female who is 34 weeks pregnant presents with the complaint of urinary frequency every 1 to 2 hours. The patient has no fever and denies back pain. A urine dipstick test is positive for leukocyte esterase and nitrites. Microscopic analysis reveals 15-20 WBCs/hpf and a few bacteria. The BEST choice for treatment of this patient's urinary tract infection would be:
1. trimethoprim-sulfamethoxazole (Bactrim), 160 mg/800 mg twice daily for 3 days.
2. cephalexin (Keflex), 500 mg four times daily for 7 days.
3. ciprofloxacin (Cipro), 500 mg twice daily for 7 days.
4. erythromycin, 250 mg three times daily for 5 days.
2. cephalexin (Keflex), 500 mg four times daily for 7 days.
3. An adult male presents with new-onset pain and tenderness in the low back and pain in the right great toe after a weekend of golf. He denies experiencing numbness and tingling. Which of the following would the nurse practitioner expect to find an investigation of this patient's low back pain?
1. Exacerbation of extremity symptoms with straight-leg raising
2. Loss of bowel and bladder function
3. Increased ankle jerk on evaluation of deep tendon reflexes
4. Increased lumbar lordosis
1. Exacerbation of extremity symptoms with straight-leg raising
4. A true statement about essential tremors is that they:
1. often begin with "pill-rolling" of one hand and may affect the legs, feet, and toes.
2. are often barely visible, rapid tremors.
3. are a characteristic of Parkinson's disease.
4. are slow tremors that are absent or minimal at rest and usually involve the hands.
4. are slow tremors that are absent or minimal at rest and usually involve the hands.
5. Which opioid medication is the MOST potent?
1. Codeine
2. Morphine
3. Oxycodone
4. Hydromorphone
4. Hydromorphone
6. Which symptom documented in a menstrual diary is diagnostic of PMS?
1. Irritability
2. Decreased libido
3. Menstrual cramps
4. Dyspareunia
1. Irritability
7. Which of the following is the medication of choice for monotherapy of an older adult with hypertension and
no related comorbid conditions?
1.Alpha-blocker
2.Vasodilator
3.Thiazide diuretic
4.Beta-blocker
3.Thiazide diuretic
8. An elderly, obese female presents for evaluation of a painful rash, first noticed 2 weeks ago, located under both breasts. The rash is visible as an area of confluent, beefy-red, excoriated lesions with smaller satellite lesions extending beyond the borders of the main lesions. The KOH prep reveals pseudohyphae. The nurse practitioner
would recommend a/an:
1. course of oral steroids and air drying of skin after showers.
2. topical antifungal and order a fasting blood glucose.
3. oral antibiotic and order a hemoglobin A1c.
4. high-potency topical corticosteroid and use of dry dressings.
2. topical antifungal and order a fasting blood glucose.
9. An older adult female complains of problems with urination. She reports that whenever she feels the need to urinate, she is unable to "make it to the bathroom in time," and wets herself. Which type of incontinence is MOST likely?
1. Urge
2. Overflow
3. Transient
4. Stress
1. Urge
10. A young adult female presents with painful swelling of the right cheek anterior to the TMJ. The diagnosis is sialadenitis. In addition to antibiotics, treatment for this patient should include:
1. hot soaks and lemon drops.
2. alternating heat and cold.
3. cold compresses and massage.
4. hot soaks and mucolytics.
1. hot soaks and lemon drops.
11. Initial therapy for older adult patients with arthritic joints is:
1. naproxen, 1000 mg twice daily.
2. ibuprofen, 600 mg four times daily.
3. glucosamine, 750 mg twice daily.
4. acetaminophen, 1000 mg four times daily.
4. acetaminophen, 1000 mg four times daily.
12. Which of the following is an example of gross negligence?
1. Prescription of a drug that causes a fatal allergic reaction
2. Misdiagnosis of appendicitis, resulting in peritonitis and a prolonged hospital stay
3. Refusal to return the emergency phone call of a patient who has chest pain evolving into an MI
4. Failure to diagnose a problem at an unrelated routine visit
3. Refusal to return the emergency phone call of a patient who has chest pain evolving into an MI [Show Less]