1) A 15 years old high school student with a mild sore throat andlow-grade fever that has persisted for about 3 weeks. She reports general malaise,
... [Show More] fatigue, and loss of appetite. The NP suspects mononucleosis. Which of the following is the LEAST appropriate intervention?
a. Palpate the lymph nodes and spleen
b. Examine the posterior oropharynx for petechiae
c. Obtain a CBC, throat culture, and heterophil antibody test.
d. Obtain an urinalyses and serum for LFTs and amylase
2) A 32 years old male patient complaint ofurinary frequency and burning on urination for 3 days. Urinalyses reveals bacteriuria and positive nitrites. He denies any past hx. Of urinary tract infections. The initial treatment should be:
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day
b. ciprofloxacin (Cipro) for 3-5 days
c. Trimethoprim-Sulfamethoxazole for 3 days
d. 750 mg ciprofloxacin as a one-time dose
3) Which agent is most effective for the treatment of nodulocystic acne?
a. Benzoyl peroxide (Benzac)
b. Retinoic acid (Retin A)
c. Topical tetracycline
d. Isotretinoin)
4) An 18 y/o woman is taking a combined hormonal oral contraceptive. She should be instructed to use a backup method for the prevention of pregnancy
a. Throughout the week of placebo pills
b. If prescribed topiramate (Topamax) for the treatment of migraines.
c. If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection
d. if she forgets to take a single dose of the contraceptive
5) A 44 years old female patient has diabetes. Her total cholesterol (TC) is 250 mg/dl (6.5 mmol/L), LDL= 190 mg/dL (4.94 mmol/L), HDL= 25 mg/dL (65 mmol/L), and triglycerides= 344 mg/dL (8.94 mmol/L). What agent have the greatest effect on improving her lipid profile and reducing morbidity and mortality associates with dyslipidemia?
a. Niacin (Niaspan)
b. Atorvastatin
c. Omega 3 fatty acids
d. Fenofibrates
6) A 30 years old female comes into a clinic with classic signs and symptoms of appendicitis. The NP fails to refer the patient to a surgeon. The appendix ruptures and the woman die. This is an example of
a. Failure of diligence
b. Professional liability
c. Negligence
d. Malpractice
7) A NP has recently been hired to work in a fast track facility. The NP employer asked if she has “a problem prescribing medications for emergency contraception.” The NP replies affirmatively. This is:
a. Grounds for dismissal
b. An ethical dilemma for the NP
c. Illegal according to the standards of nursing
d. Patient abandonment.
8) A patient presents with pruritic lesions on both knees. There are visible silver scales. How Should this condition be managed?
a. Topical antifungal cream or ointment
b. Oral antibiotics
c. Topical corticosteroids cream
d. Topical anti-fungal/ steroid cream
9) Antidepressant discontinuation syndrome is less likely if the patient
a. Is male
b. Is less than 35 y/o
c. Has taken an SSRI with a short half life
d. Gradually tapers SSRI use
10) Patient with benign prostatic hyperplasia (BPH) should be taught to avoid which one of the following drug classes?
a. Alpha adrenergic antagonist
b. Anti-androgen agents
c. Tricyclic antidepressant (TCA)
d. Sulfonamides
11) Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse?
a. What was if you did to make him angry?
b. You must seek refuge immediately
c. I am concerned about your safety
d. I am going to call a shelter for you
12) For which patient group does the US Preventive Services Task Force recommend routine screening for asymptomatic bacteriuria
a. pregnant woman
b. Children
c. Patients with diabetes
d. patients over the age of 70
13) What diabetic complications result from hyperglycemia?
1. Retinopathy
2. Hypertension resistant to treatment
3. Peripheral neuropathy
4. Accelerated atherosclerosis
a. 1,2,3
b. 2,3,4
c. 1,3,4
d. 1,2,4
14) A 6 y/o presents w/ complaints of sore throat and fever for 2 days. He has multiple vesiculated ulcerations on his tonsils and uvula. There are no other remarkable findings. What is the most likely diagnosis?
a. Viral pharyngitis
b. Herpangina
c. Epiglottitis
d. Tonsillitis
15) A patient has Kawasaki syndrome. Which characteristics would be UNUSUAL?
a. Age > 15 years
b. Fever > 101 F (38.3 C)
c. Exudative pharyngitis
d. Painful rash
16) According to the JNC 8 guideline hypertension in a 40 y/o can be diagnosed when blood pressure exceeds
a. 140/90
b. 130/90
c. 125/85
d. 150/100
17) A 48 y/o female complains of pain and stiffness in her right hip and knee that is mild on awakening in the morning, get worse as the day progresses and is relived with hot baths and ibuprofen. Crepitus is palpated on range of motion of the knee. Signs of inflammation are notably absent. What is the most likely diagnosis?
a. Rheumatoid arthritis (RA)
b. Gout
c. Osteoarthritis (OA)
d. Osteoporosis
18) A 7-year old female patient presents with severe injuries that are inconsistent with the explanation given for them. The nurse practitioner questions the mother about abuse. She admits that her husband, the child’s father, beat the child. How should the nurse practitioner proceed?
a. Inform the mother that the abuse must be reported to child protection authorities.
b. Counsel the mother that if it happens again it will be reported to child protection service.
c. Ask the child what she did to cause the punishment
d. Refer the family to the National Domestic Violence hotline.
19) A 1-month-old presents with reported recurrent diarrhea, screaming, and drawing up of the legs followed by periods of lethargy. On physical examination, a “sausage-like” mass in the upper right quadrant of the distended abdomen. Which of the following is the most likely diagnosis?
a. Intussusception
b. Volvulus
c. Crohn’s disease
d. Foreign body in the GI tract
20) A middle-aged female complains of insomnia, night sweats, feeling intensely hot, emotional lability, extreme nervousness and impatience. The LEAST likely cause of her symptoms is
a. Thyrotoxicosis
b. Menopausal vasomotor instability
c. Alcohol or another drug withdrawal
d. New onset type 2 diabetes mellitus
21) Which of the following indicated need for further evaluation?
a. A 7 y/o girl with vaginal bleeding
b. A 7years old girl with no true pubic hair
c. A 12 years old boy with sparse, slightly pigmented pubic hair
d. A 12-year-old girl with breast buds
22) A young couple is being seen by the NP for preconception counseling. They express a wish for pregnancy within the next 3 month and are very eager to know what they can do now to “make the baby as healthy as possible”. Which of the following should the NP encourage to decrease the chance of neural tube defect in the fetus?
a. Maternal alpha-fetoprotein level
b. Folic acid 0.4 mg daily
c. Rubella vaccine today
d. Vitamin E 400 IU daily
23) A patient with a past history of documented coronary arterial blockage less than 70% complains of chest pain several time p…. which is relived with nitroglycerin. Which is the most appropriate initial action for the NP?
a. Refer to a cardiologist as soon as possible
b. Prescribe long-acting nitroglycerin
c. Order treadmill stress test
d. Prescribe an ACE inhibitor and re-evaluate in 24 to 48 hours
24) A 3 y/o has enlarged, warm, tender cervical lymph nodes, indicating:
a. Infection proximal to the nodes
b. A possible cancer diagnosis
c. Shorty nodes, a common normal variant in children
d. An infectious process distal to the nodes
25) The NP examines a 2-month-old with unequal gluteal and thigh skin folds. What should the NP do next?
a. Send the infant for x-ray of the hips
b. Send the infant for ultrasound of the hips
c. Perform Ortolani and Barlow test
d. Examine the infant for unequal arm length
26) A very active 35 years old male has painful hemorrhoid, but he does not want hemorrhoidal surgery at this time. His diet has been indiscriminate as his job requires frequent travel. The most appropriate recommendation is for him to select food that are:
a. Low in fiber such as milk and other dairy products
b. High in simple carbohydrates such as white bread and mashed potatoes
c. High in fiber such as bran, complex carbohydrates and fresh fruit
d. High protein such a meat, poultry and fish
27) Correct instructions to give new parent who are transporting their newborn infant is
a. A rear-facing infant car seat secured in the backseat is required until the infant weight 20 lbs.
b. The infant car set may be secured in the back or front seat, but must rear-facing
c. The infant car seat may be front facing when the infant is 1 year old
d. A rear or front-facing infant car seat must be secured in the back seat until the infant weight 20 lbs.
28) A 13 y/o pt. complains that he fell while running during football practice. Now his knee hurts and sometimes “lucks”. The NP conducts McMurrays test. Which of the following is TRUE about this test?
a. An audible or palpated “click” is positive for a torn meniscus
b. A various stress is applied to the flexed knee
c. The straight leg is internally rotated with the patient supine and flat
d. The knee is grasped with the examiner’s fingers placed laterally.
29) A 20 y/o male patient complains of “scrotal swelling”. He states his scrotum feels heavy but denies pain. On examination, the NP notes transillumination of the scrotum. What is the most likely diagnosis?
a. Hydrocele
b. Orchitis
c. Testicular torsion
d. Indirect inguinal hernia
30) A 15 y/o male has a hx of cryptorchidism which was surgically repaired. Because of this information, it is essential for the NP to teach him about
a. Testicular self-examination
b. Protection of the testes during sports activities
c. Risk of testicular torsion
d. Practicing safer sex
.
31) A pt. present with classic symptoms of gastroesophageal reflux diseases’ (GERD). He is instructed in lifestyle modification, and drug initialed. Two month later, he returns and report that he still has symptoms. The next steps are to.
a) Refer for surgical interventions such as partial or complete fundoplication.
b) Refer for endoscopy, namometry, and/or PH testing
c) Repeat the 8*-week course of drug therapy while continuing lifestyles modifications.
d) Review proper proton pump inhibitor dosing time and adherence with the patient.
32) A 51 –year- old post-menopausal female, request guidance regarding osteoporosis risk. The NP would be correct to recommend all of the following EXCEPT
a. Moderate weight bearing exercise 3 times per week
b. 1200 – 1500 mg calcium daily
c. Avoidance of alcoholic beverages
d. Weight loss
33) According to Erickson, the developmental task of the elderly adult is:
a. Intimacy VS isolation
b. Ego integrity VS despair
c. Industry VS self-doubt
d. Trust Vs mistrust
34) Moderate weight loss, particularly of visceral adipose tissue in patients with type 2 diabetes mellitus may have all of the following beneficial effects EXCEPT:
a. Improved insulin sensitivity
b. Increased glucose uptake and utilization by the cells
c. Increase lean muscle mass’
d. Improved lipid profile
.
35) A 12 y/o presents with eat pain or 36 hours duration. The NP diagnoses acute otitis media because the
a. Tympanic membrane is bulging and glossy with tiny bubbles visible posteriorly
b. Tympanic membrane is retracted against boy landmarks
c. Bony landmarks are obscured, and the tympanic membrane is mildly erythematous, dulls and immobile.
d. Canal is narrowed, erythematous, and exquisitely tender with speculum contact.
36) The NP should instruct the mother of an infant with thrush to:
a. Take oral nystatin since she is breastfeeding
b. Stop breast feeding until the thrush has resolved
c. administer antifungal medication to the infant prior to feeding
d. sterilized pacifiers and bottle nipples
37) A 26 y/o patient, 18 weeks pregnant with twins, has been healthy and has followed recommendations of her nurse midwife. She is in the office to discuss results of her maternal serum alpha-fetoprotein (MSAFP) test. which show elevation in this particular pregnancy?
a. Elevated MSAFPO is an indicator of Down Syndrome
b. Low MSAFP is expected at 18 weeks’ gestation
c. Neural tube defects are highly probable
d. Elevated MSAFP is an expected finding
38) The hallmark of neurofibromatosis (von Recklinghousen disease) present in almost 100% of patients is:
a. Acoustic neuroma
b. Astrocytoma of the retina
c. Distinctive osseous lesion
d. Café au lait spots
39) The NP correctly teaches an elderly patient with pernicious anemia that food sources of B12 include
a. Red meat, poultry, fish, eggs, dairy products
b. Canned and frozen fruit
c. Whole grain breads, cereals and pastas
d. Fresh vegetables
40) An 18-year-old female applying for college admission present to the health clinic because evidence of rubella vaccination is required for admission. She says, “don’t remember ever getting that shot” She has negative serologic evidence of rubella antibody. The NP should:
a. Tell her that her serologic evidence demonstrates that she is immune to the rubella and that she probably has the disease as a child
b. Administer the vaccination after a negative pregnancy test and advise the patient that she must not get pregnant for 28 days
c. Tell her that she needs the immunization and can get today if her pregnancy test is negative
d. Administer the rubella vaccination after a negative pregnancy test and advise her not to get pregnant for at least 6 months.
41) A 45 y/o obese pre-menopausal female complains of indigestion, flatulence, RUQ pain and epigastric “crampy pain”. Symptoms are exacerbated by high-fat meal. What is the most likely diagnosis?
a. Hepatitis
b. Chronic cholecystitis
c. Acute pancreatitis
d. Myocarditis
42) A 16 y/o male presents w/ mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechia. With for this patient, what drug would be the LEAST appropriate to prescribe?
a. Ibuprofen
b. Erythromycin
c. Ampicillin
d. Doxycycline
43) A characteristic of delirium that is typically absent in dementia is
a. Acute onset of confusion in a previously alert and oriented patient
b. Gradual loss of short-term memory
c. Loss of language skills
d. Long term memory gaps filled in with confabulation
44) It is imperative that the NP teach patients taking oral contraceptives to report any of the danger signs of complications. Which of the following would be the LEAST concern to the NP?
a. Lower leg pain
b. Upper abdominal pain
c. Chest pain
d. Weight gain
45) Which of the following oral medications should be avoided in a child under 8 years of age?
a. Cephalexin (Keflex)
b. Tetracycline
c. Rifampin
d. Metronidazole (flaggyl)
46) Which of the following descriptions of Denver II Developmental Screening Test is most accurate?
a. Applicable to children from birth to 2 years; evaluates four major categories of development: motor, intellectual, emotional, and language to determine whether a child is within normal range for various behaviors or is developmentally delayed
b. Applicable to children from birth to 5 years; evaluates four major categories of development: motor, vision, hearing and psychosocial to determine whether a child is normal or developmentally compromised
c. Applicable to children from age 6 months to 6 years; evaluates 4 major categories of development: intellectual, verbal, social and memory to determine IQ and aptitude
d. Applicable to children from birth to 6 years; evaluates four major categories of development: gross motor, fine motor-adaptive, language, and personal social to determine whether a child is within normal range for behaviors or is developmentally delayed.
47) A 12-month-old has conjunctivitis in his right eye with a mucopurulent discharge. The mother asks if the child can forego for antibiotic eye drops because he does not’s like drops in his eyes. The NP replies that:
a. If untreated, conjunctivitis may permanently damage the cornea
b. Conjunctivitis is usually caused by a virus. Let’s wait a few days
c. If no one else at the daycare has it, we can wait a few days.
d. An oral antihistamine may be prescribed instead of eye drops.
48) which oral hypoglycemic agent would be safest for an elderly patient if hypoglycemia is a major concern?
a. Tolbutamide (orinase)
b. Glipizide (Glucotrol)
c. Metformin (Glucophage)
d. Chlorpropamide (diabinese)
.
49) the components of the Denver II Developmental screening test are:
a. Personal/social, fine motor, gross motor, language
b. Intelligence, motor performance, language development
c. Vocabulary, clarity of speech, abstract thinking
d. Problem-solving, speech, gross motor, fine motor
50) A patient has been taking fluoxetine (prozar) since being diagnosed with major depression 7 month ago. She reports considerable empowerment in her symptoms and her intention to discontinue the medication what should be the NP’s recommendation?
a. Advice the patient to stop the antidepressant medication
b. Question the patient to determine if the self-assessment is correct before advising her to discontinue the medication
c. Recommend that the patient continue the antidepressant medication for at least 4 more month
d. Discuss with the patient that need to take the antidepressant medication indefinitely
51) for the general adult population, total dietary fat intake should be no more than what percent of total calories?
a) 10%
b) 20%
c) 30%
d)40%
52) A 30 y/o female patient is being seen by the NP for the first time. She is seeking advice from the NP about becoming pregnant. She is currently taking an oral contraceptive. She gives a hx of having hydatidiform molar pregnancy 2 years ago. An appropriate plan of care for this
a. patient should include
b. Delaying pregnancy for 1 more year
c. Measuring serum chorionic gonadotropin level
d. Discontinuing oral contraceptive
e. Recommending permanent sterilization
.
53) which of the following is NOT a goal for treatment for the patient with cystic fibrosis?
a. Prevent intestinal obstruction
b. Provide adequate nutrition
c. Promote clearance of secretions
d. Replace water soluble vitamins
54) A 24 y/o female taking oral contraceptive has missed her last 2 pills. What should the NP advise her to do to minimize her risk of pregnancy?
a. Take today’s dose and do not miss any more during this month
b. Double today’s dose and use a barrier method for the rest of this month
c. Double today’s dose and tomorrow’s dose and use a barrier method for the rest of this month
d. Stop the pills and restart a new pill pack in one week.
55) Which red blood cell (RBC) index is most useful for differentiating types of anemias?
a. Mean corpuscular volume (MCV)
b. Mean corpuscular hemoglobin concentration (MCHC)
c. Hematocrit (HCT
d. Platelet count
56) what is a Tzanck test used to diagnosed?
a. Mastoiditis
b. Trichomoniasis
c. Hyphema
d. Herpes virus
57) a 40 y/o female with hx. Of frequent sun exposure present with multicolored lesion on her back it has irregular borders and is about 11 mm in diameter. What should the NP suspect?
a. Squamous cell carcinoma
b. Malignant melanoma
c. Common Nevis
d. Basal cell carcinoma
58) a 16 y/o sexually active female presents to the clinic. She has never had vaccinations for hepatitis A or B. She has had one MMR immunization, and her last tetanus vaccination was 4 years ago. which vaccination would be contraindicated without further testing?
a. Hepatitis B
b. Hepatitis A
c. MMR
d. Tetanus
59) following the finding of prostate gland abnormalities on DRE, The NP orders appropriate labs. When preparing to review with the patient, the NP knows all of the following are true EXCEPT
a. Normal PSA is 10 mg/ml or less
b. PSA is elevated in the presence of malignant prostate epithelium
c. PSA is elevated in the presence of BPH
d. Positive serum acid phosphatase reflects malignancy of the prostate gland with bone metastasis.
60) in which of the following presentations is further diagnostic testing NOT warranted?
a. Bilateral gynecomastia in a prepubertal male of average weight; Tanner stage 1
b. Bilateral gynecomastia in a 13 y/o male with normal testicular size and volume
c. Recent onset gynecomastia in a 20-year-old male with breast tenderness
d. Unilateral breast mass which is 5 centimeters in diameter
61) a 59 years old post-menopausal woman has atrophic vaginitis. She has a hx. Of breast cancer at age 40 years. What is the appropriate initial treatment for this patient?
a. Oran conjugated estrogens
b. Oral medroxyprogesterone aetate
c. Topical medroxyprogesterone aetate
d. Topical conjugate estrogen cream
62) Advances in obstetric and neonatal care have
a. Helped to identify the cause of cerebral palsy
b. Demonstrated the cerebral palsy is a direct result of birth asphyxia
c. Has no effect on the incident of cerebral palsy
d. Resulted in a dramatic decrease in the incidence of cerebral palsy
63) which of the following physical modalities recommended for treatment of rheumatic arthritis provides the most effective long-term pain relief?
a. Superficial and deep heat
b. Application of cold
c. Transcutaneous electrical nerve stimulation (TENS)
d. Exercise
64) The NP is counseling a 25 y/o sexually active male patient about condom use, which of the following statement is INCORRECT
a. Adequate lubrication is needed to prevent damage to the condom
b. Roll the condom over an erect penis before any sexual contact
c. Make sure the condom is tight against the head of the penis
d. Withdraw while the penis is erect, so that the condom stays in place
.
65) a patient with moderate persistent asthma will probably be most effectively managed with daily
a. Oral leukotriene blockers
b. Short and long acting bronchodilators
c. Inhaled steroids and long acting bronchodilators
d. Oral steroids and short acting bronchodilators
66) diagnosis of systemic lupus erythematosus (SLE) is made
a. On the basis of demonstrable anti-nuclear antibodies (ANA)
b. Consideringsymptom complex with confirmation by laboratory test
c. Using renal function studies and rheumatoid factor for confirmation
d. On the basis of renal or cutaneous biopsy
67) which of the following would not be considered a developmental red flag to a NP assessing a 4 y/o?
a. Persistent fear of going to sleep
b. Missing speech sounds
c. Fire-setting
d. An imaginary friend
68) A 44 y/o patient complains of stuffiness and soreness in his hands, hips and knees. There is noticeable PIP and DIP joint enlargement in his hands.. The NP suspects arthritis. All of the following questions are helpful in differentiation between rheumatoid arthritis (RA) and osteoarthritis (OA) EXCEPT
a. on the joint of your fingers never feel particularly warm or hot?
b. tell me about your usual energy level
c. does the soreness and stiffness get better or worse as the day progresses?
d. Have you noticed decreased joint movement or flexibility?
69) An adult presents w/ tinea corpus. What comment by the patient would be the LEAST likely explanation of how he acquired this disease?
a. "I trap animals"
b. "my wife has this also"
c. "I have diabetes"
d. "I live in the Northern US"
70) Acute rheumatic fever is diagnosed using the modified Jones criteria. Which is NOT a major criterion in the Jones System?
a. Jaundice
b. Carditis
c. Polyarthritis
d. Subcutaneous nodules
71) A pt is taking an ACE inhibitor for the blood pressure control. The NP decides to add a diuretic which of the following is the best choice?
a. a thiazide diuretic
b. a loop diuretic
c. a potassium-sparing diuretic
d. Fitness bar
70) Acute rheumatic fever is diagnosed using the modified Jones criteria. Which is NOT a major criterion in the Jones System?
e. Jaundice
f. Carditis
g. Polyarthritis
h. Subcutaneous nodules
71) A pt is taking an ACE inhibitor for the blood pressure control. The NP decides to add a diuretic which of the following is the best choice?
e. a thiazide diuretic
f. a loop diuretic
g. a potassium-sparing diuretic
h. Fitness bar
72) which of the following drugs classes would be most effective in decreasing elevated triglycerides levels (650 mg/dL)?
a. bile acid sequestrants
b. nicotinic acid
c. fibrates
d. statins
73) the mother of a 16 y/o high school student athlete is concerned that her daughter has not had a menstrual period yet. on physical examination, the NP finds normal growth and development including appropriate secondary sexual characteristics what is the most appropriate NP action?
a. refer to a endocrinolist
b. order a pelvic ultrasound
c. attempt progesterone challenge
d. prescribe oral contraceptive
74) factors known to be associated with early sexual activity include.
a. early development of secondary sex characteristics, living in an urban area, and easy access to contraceptives
b. legalized abortion, frequent viewing of adult television and movies, and lack of church affiliation
c. lower socioeconomic status, use of tobacco, alcohol or other drugs, and single parent household
d. exposure to sex education information at school
75) the finding which is most consistent with a diagnosis of benign prostatic hyperplasia is digital palpation of prostatic gland that is
a. enlarged, symmetrical, semi firm and non-tender
b. enlarged, symmetrical, boggy and exquisitely tender
c. asymmetrical and nodular
d. exquisitely tender with absence of median sulcus
76) The NP correctly diagnoses iron deficiency anemia in a female patient whose lab report reveals
a. an increase reticulocyte count
b. a mean corpuscular volume (MCV) > 100
c. hemoglobin (hgb) 140 mg/dL (140 g/L)
d. an increased total iron binding capacity (TIBC)
77) Strabismus is observed in a 13-month-old child. The most appropriate action for the NP to take
a. refer the patient to an ophthalmologist
b. patch the child affected eye
c. follow the child closely for 2 more month
d. teach the patient and parent, eye muscle exercises
78) giving appropriate patient education by the primary care provider, poor compliance with medical recommendations is most often due to:
a. willful disobedience
b. vision and/or hearing deficits
c. anxiety
d. limited cognitive ability
79) the physical exam findings in an infant are most effected by which item listed below?
a. what was the Apgar score at one minute?
b. is the child breast of bottle fed?
c. are the immunizations current?
d. what was the gestational age at birth?
e.
80) Babies should begin oral iron supplementation:
a. when they are able to eat iron enriched cereal
b. 2 months of age
c. 4-6 months
d. any time after their teeth have erupted
81) the most common cause of cerebral palsy is
a. unknown
b. intra-partial hypoxia
c. in utero infection
d. intraventricular hemorrhage
82) A patient with diabetes bring his glucose dairy from the past 7 days for the NP to review and evaluate what changes should be made? DAY 1234567 AM 67, 52, 61, 48, 39, 68, 70 PM138, 161, 148, 168, 171, 142, 176
a. increase the PM dose of NPH insulin
b. increase the PM dose of regular insulin
c. decrease the PM dose of NPH insulin
d. decrease the PM dose of regular insulin
83) which of the following patient is at highest risk of suicide?
a. 65 y/o female
b. 70 y/o male
c. 35 y/o white divorce male
d. 42 y/o single mother
84) a 17 y/o male is brought into the clinic by his mother who says that is there are no medical consequences or risk known, she will allow her son to get a possible. How should the NP respond?
a. tattoos distort one’s body image resulting in high possible of depression
b. tattoos and body piercing are possible sources of hepatitis C infection if there is a common use of contaminated needles.
c. the tattoo should be applied to an area that will not be exposed to sun to avoid increase risk of skin cancer
d. the only medical consequence of tattoos is the scarring associated with removal.
85) A diagnostic finding of Hodgkin’s lymphoma is the presence of:
a. granulocytopenia
b. reed Sternberg cells
c. lymphoblast
d. Howell -lolly bodies
86) A child with type 1 diabetes mellitus brings in a glucose dairy indicating consisted morning hyperglycemia. How you differentiate the Somogy effect from the dawn phenomenon?
a. experiment with a smaller insulin dose in the evening
b. increase the insulin dose and liberalize the child's diet
c. check HbA1C today and again in 3 months
d. instruct the parent to monitor the blood glucose at 3 am
87) practitioners working with physically active girls need to be aware of the "female athlete triad" in order to develop an effective pain for prevention, recognition and treatment. the components of the female athlete triad are:
a. distorted body image, low self-esteem, and generalized anxiety.
b. stress fractures, osteoarthritis and plantar fasciitis
c. eating disorders, amenorrhea and osteoporosis
d. iron deficiency anemia, steroid abuse and bradycardia.
88) palpable thyroid nodule is benign. How does it feel on palpation?
a. smooth
b. hard
c. non-tender
d. fixed
89) A 53 y/o postmenopausal female with a 38 BMI and gastric esophageal reflux disease, takes a daily calcium supplement for protection against osteoporosis. All of the following are appropriate teaching points for this patient, except
a. take the calcium supplement with milk to facilitate absorption
b. the addition of HRT may further decrease osteoporosis risk
c. take an OTC calcium containing antacid to increase calcium intake
d. avoid caffeine containing beverages.
90) A 65 y/o immunocompetent man with no underlying medical condition presents in mid-October and request the "flu and pneumonia shots" Records show he received the influenza and PCV13 ten month ago. The NP recommends that he
a. receive the PCV13 and influenza vaccine today, and return in Januaryfor the PPS23
b. should return in January to receive both the influenza and PPSV23
c. receive the influenza vaccine at this time and return in January for the PPSV23
d. receive the PPSV23 and the influenza vaccine today and again in January
91) when discussing treatment option with a patient. The NP would be correct to say that surgery can be curative for:
a. ulcerative colitis
b. irritable bowel syndrome
c. crohn's disease
d. inflammatory bowel disease
92) A patient has developed blood clot in his lower extremity and is receiving warfarin (Coumadin) therapy. Which outpatient laboratory measurement best measures the therapeutic effect of warfarin?
a. International normalized ratio
b. activated clotting time
c. PT
d. PTT
93) A female patient asks, "how do I calculate my ideal body weight?" The NP appropriately answers:
a. Starts with 100 pounds, and add 5 pounds for every inch in height over five feet
b. add 6 pounds to every inch over 5 feet, then add 100 pounds
c. start with 100 pounds, and add 10 pounds for every inch in height over five feet
d. multiply your height in inches times 2
94) which term most accurately describes the prostate gland of patient with prostate cancer?
a. hard
b. rubbery
c. boggy
d. spongy
95) Ideally, ante-partum care should begin:
a. as soon as the pregnancy is identified
b. at 6 weeks gestations
c. with preconception counselling
d. in the first trimester
96) which of the following must bepresent for the diagnosis of bacterial vaginosis?
a. presence of clue cells
b. vaginal pH <4.0
c. presence of pseudo hyphae on HPF
d. negative amine test
97) The patient Self Determination Act of 1991 requires all health care agencies receiving Medicare or Medicaid funds to give patients written information about their rights to make decisions regarding their medical care. A document which declares in advance what type of medical care a person wants ... he provided or withheld should he or she be unable to express his or her wishes is called:
a. an advance directive
b. a durable power of attorney
c. informed consent
d. a right to die statement
98) Thalassemia should be included in the differential diagnosis of an infant with microcytic anemia when the infant’s parents are of what ethnicity?
a. Italian
b. Swedish
c. Japanese
d. European
99) What is the earliest age that MMR immunization can be administered?
a. 2 months
b. 4 months
c. 6 months
d. 1 year
100) A male patient with chronic atrial fibrillation takes a genetic brand of Coumadin (Warfarin). He should report all of these to his health care provider EXCEPT
a. Brand name substitution for his genetic warfarin
b. On missed dose of warfarin
c. Chest pain or weakness
d. Blood in his urine
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