1. 60yo obese male has T2DM and lipid panel of TC = 250, HDL = 32, LDL = 165. You
teach him about his modifiable cardiac risk factors, which include:
a.
... [Show More] DM, obesity, hyperlipidemia
2. Diabetic pt presents w/R foot pain but denies any recent known injury. He states it
has gotten progressively worse over past few months. On exam, vibratory sense, as
well as sensation tested w/monofilament, was abnormal. Pt's foot is warm,
edematous, misshapen. You suspect Charcot foot. What intervention is indicated?
a. Referral to orthopedist
3. What is a s/s of insulin resistance that can present in African Americans?
a. Acanthosis Nigricans
4. During routine exam of 62yo female, you ID xanthelasma around both eyes. What is
the significance of this?
a. Abnormal lipid metabolism requiring medical management
5. Mr. White is 62yo, had CKD that has been relatively stable. He also has h/o
hyperlipidemia, OA, HTN. He is compliant w/meds, BP has been well controlled on
CCB. Last lipids showed: TC = 201, HDL = 40, TG = 180, LDL = 98. He currently
takes Crestor 20mg daily. Today his BP is 188/90 and urine dip shows significant
proteinuria. He denies changes in dietary habits or med regimen. What would be
the best med change at this point?
a. Change CCB to ACEi
6. You are working as NP in Fast Track of ER. 76yo male presents w/LUQ pain. There
can be many conditions that present as LUQ pain, but which of the following is least
likely to cause pain here?
a. Acute pancreatitis
7. Which is cardinal feature of failure to thrive?
a. Poor nutritional status
8. Feeding gastrostomy tubes at end-of-life Alzheimer's pt's have been associated with:
a. Aspiration pna
9. Which of the following nutritional indicators is not an indication of poor nutritional
status in elderly?
a. BMI 25
10. OA of cervical and lumbar spine causes pain related to all of the following except:
2
a. Crystal deposition
11. In differentiating OA from chronic gout, pseudogout, or septic arthritis, the most
valuable diagnostic study would be:
a. Synovial fluid analysis
12. Pt's w/OA of hip and knee often have distinguishable gait described as:
a. Antalgic
13. Which of the following best describes pain associated w/OA?
a. Begins upon arising and after prolonged wt bearing and/or use of the
joint
14. Joint effusions typically occur later in the course of OA, especially in the:
15. Knee
16. You ordered CBC for your pt you suspect has polymyalgia rheumatica (PMR).
Which 2 clinical findings are common in pt's w/PMR?
a. Normochromic, normocytic anemia and thrombocytosis
17. You suspect your pt has PMR and now are concerned that they may have Giant Cell
Arteritis (GCA) too. Which of the following 2 symptoms are most indicative of GCA
and PMR?
a. Scalp tenderness and aching in shoulder and pelvic girdle
18. 63yo Caucasian pt w/PMR will begin Tx w/corticosteroids until the condition has
resolved. You look over her records and it has been 2yrs since her last physical exam
and any labs or diagnostic tests as she relocated and had not yet ID'd a provider. In
prioritizing your management plan, your first orders should include:
a. Duel-energy x-ray (DEXA) scan and updating immunizations
19. Which of the following DD for pt's presenting w/PMR can be ruled out w/a muscle
biopsy?
a. Polymyositis
20. In reviewing lab results for pt's w/suspected PMR, you realize there is no definitive
test to dx PMR, rather clinical response to Tx. Results you would expect to see
include:
a. Elevated erythrocyte sed rate (ESR) >50
21. Which of the following is the most appropriate lab test for monitoring gout therapy
over the long-term?
a. Serum urate level
3
22. In providing health teaching related to dietary restrictions, you should advise a pt
w/gout to avoid which of the following dietary items:
a. Beer, sausage, fried seafood
23. The best method of verifying gout dx in a joint is which of the following:
24. Joint aspiration and polarized-light microscopy
25. The most appropriate first-line Tx for acute gout flare is (assuming no kidney dz or
elevated bleeding risk):
a. Indomethacin 50mg TID x2 days, then 25mg TID x3 days
26. You order bilat wrist XR on 69yo man c/o pain both wrists x6 wks no related to any
known trauma. You suspect early onset RA. The initial XR finding in a pt w/elderly
onset RA would be:
a. Soft tissue swelling
27. A 72yo female has been dx'd w/gout. She [Show Less]