Predictor Study Guide {336 Questions +Answers } Rated A+
Predictor Study Guide {336 Questions +Answers } Rated A+
Predictor Study Guide A+
... [Show More] Predictor_Study_Guide_2 1. A 37-year-old female patient with a history of a single episode of depression and frequent complaints of PMS is being treated for hypothyroidism. Today she complains of poor concentration and fatigue. Initially, the NP should: a. Question her further 3. Which of the following is an example of secondary prevention? a. Annual influenza vaccination 7. A 35-year old female with a history of mitral valve prolapse is scheduled for routine dental cleaning. According to the 2007 American Association’s guideline for endocarditis prophylaxis, what would you advise this patient? a. She does not need prophylaxis for any dental procedure b. 8. A patient recovering from a recent stroke is starting anticoagulant therapy. The nurse practitioner should teach the patient to avoid all of the following EXCEPT: a. b. milk and milk products 9. A patient presents with periorbital erythema and edema, fever, and nasal drainage. The nurse practitioner should a. start aggressive antibiotic therapy 10. A positive drawer sign support a diagnosis of b. cruciate ligament injury 11. A 50-year-old patient with diabetes complains of pain bilaterally in her lower legs while walking. The pain disappears at rest. What else would you expect to identify on her lower extremities. b. peripheral artery insufficiency 12. A 16-year-old athlete complains of pain underneath his heel every time he walks. There is a verrucous surface level with the skin of the heel. What pharmacologic interventions should the nurse practitioner prescribe for this patient? a. salicylic acid plasters 13. A -year-old with Type I diabetes has had itching and burning lesions between her toes for 6 months. Scrapings of the lesion confirm the diagnosis of tinea pedis. What is the best treatment option for this patient? a. prescribe an anti-fungal powder for application between her toes and in her shoes and a topical prescription strength anti-fungal cream for other affected areas. Monitor for a secondary bacterial infection. c. Prescribe an oral anti-fungal for 4 to 12 weeks. Monitor liver enzymes, BUN and creatinine at one week, 2 weeks, and every month thereafter. d. Prescribe a prescription strength antifungal/steroid combination cream. Monitor for a secondary bacterial infection. 14. What is an appropriate drug for prophylactic treatment of migraine headaches in a 21-year-old female? a. Sumatriptan (Imitrex) b. propranolol (Inderal) c. ibuprofen (Motrin) d. dihydroergotamine (DHE) 15. Which of the following are the classic features of ulcerative colitis? a. RLQ pain, frequently accompanied by a palpable mass, fever, and leukopenia b. Massive painful hematemesis, occasionally accompanied by melena c. Rapidly progressive dysphagia to solid foods, anoriexia, and weight loss out of proportion to the dysphagia d. Remission and exacerbations of bloody diarrhea, tenesmus, fecal incontinence, abdominal pain, and . 16. Which drugs below would be expected to produce the least amount of hypokalemia? a. Furosemide (Lasix) b. hydrochlorothiazide (HCTZ) and spironolactone (Aldactone) c. Spironolactone (Aldactone) d. hydrochlorothiazide (HCTZ) 17. What information should patients with diabetes and their families receive about hypoglycemia? a. Hypoglycemia is very rare b. Hypoglycemia requires professional medical treatment c. Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly d. Hypoglycemia occurs only as a result of overdose of insulin 18. A 60-year-old male patient with a past history of glaucoma and frequent sinusitis presents today with hypertension. On his last 2 visits to the clinic his blood pressures were 150-160/90-98. The nurse practitioner decides to treat the hypertension with long-acting propranolol (Inderal). Before prescribing it, the nurse practitioner should ask: a. whether he smokes or consumes alcohol on a daily basis b. what other medications have been prescribed for him c. if he takes a daily antihistamine d. if other family members are hypertensive 19. Which of the following is NOT associated with Type 2 diabetes mellitus? a. Gestational diabetes, birth of a macrosomic infant b. Hispanic, African-American, or Native American descent c. Alcohol or other drug abuse d. Obesity, hypertension, hypertriglyceridemia 20. A 35-year-old male presents with a severe unilateral headache over his left eye. He says it started about one hour ago and has rapidly gotten worse. He gives a history of similar headaches over the past 2 years. Physical examination is negative except for left eye lacrimation. What is the most likely diagnosis? c. Cluster headache d. Classic migraine headache 21. A 16-year-old sexually active female present to the clinic. She has never had vaccination 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? c. MMR 22. A 15-year-old male presents with abdominal pain that began in the peri-umbilical area then localized to the right lower quadrant. He complains of nausea, vomiting, anorexia, and low-grade fever. A complete blood count (CBC) reveals moderate leukocytosis. What is the most likely diagnosis? d. Acute appendicitis 23. A 25-year-old hypertensive patient has a BMI of 16. His blood pressure is 165/100. There is an audible bruit in his left upper abdominal quadrant. He probably has: a. Essential hypertension b. Secondary hypertension 24. Which of the following is the most common presenting sign of substance abuse in adolescents? d. changes in behavior 25. Therapeutic international normalized ratio (INR) for a patient takein warfarin (Coumadin) for chronic atrial fibrillation is expected to be a. increased 26. A 199-year-old female reports that she is having “panic attacks.” The NP knows that panic attacks are characterized by d. sudden onset of intense fear or terror 27. A 25-year-old complains of fever and throat pain. The tonsils have exudate bilaterally. The patient describes having an anaphylactic reaction to penicillin in the past. What antibiotic should the NP prescribe if she believes the causative agent is bacterial? a. amoxicillin (Amoxil) b. erythromycin 28. A diagnostic finding of Hodgkin’s lymphoma is the presence of b. Reed-Sternberg cells 29. With a history of ankle sprain, the nurse practitioner would most likely elicit a history of d. ankle inversion 30. Certification for nurse practitioners is offered through: c. national certifying organizations 31. Simple cases of impetigo and folliculitis are usually successfully treated with: a. systemic antibiotics b. topical antibiotics 32. A 43-year-old has chronic gout. He comes to the clinic for the 3rd time in as many months for treatment of an exacerbation. Dietary counseling should include avoidance of all of the following EXCEPT: c. green, leafy vegetables 33. A 57-year-old patient presents for an annual physical exam. He reports having 3 attacks of acute gout during the past year. He does not take any medication except NSAIDs during the attacks which help “a little bit.” The NP would appropriately recommend c. avoidance of dietary purine sources 34. A 43-year-old male presents with a large and painful furuncle, the 3rd one in the past 6 months. The NP should _?_ all of the following EXCEPT: b. prescription of a prophylactic antibiotic 37. A 64-year-old female has sudden onset of right eye pain, blurred vision, and dilated pupil. The most likely diagnosis is acute: b. angle-closure glaucoma 38. A 25-year-old patient presents with complaints of pain and burning in the vulvar area. Upon examination, the NP notices vesicles with an erythematous base arranged ina group on the patient’s labia major. The most likely diagnosis is: d. herpes simplex II 39. An 85 – year-old is diagnosed with shingles. The patient states that she became “miserable” yesterday when the symptoms started. What pharmacologic interventions should the nurse practitioner offer this patient? c. Oral acyclovir (Zovirax) for 7-10 days, NSAIDs, and topical capsaicin cream after resolution of the lesions 40. A 16-year-old presents to the clinic for a scheduled immunization. The patient is unaccompanied by an adult. The NPs action is based on the knowledge that: a. a minor must have the informed consent of a parent or guardian to receive an immunization 41. The mechanism by which nurses are held accountable for practice, based on the quality of nursing car ein a given situation inaccordance with established standards of practice, is: c. peer review 42. A 52- year-old female has a firm, non-tneder, one centimeter mass in the RLQ of her breast. There are no palpable axillary lymph nodes. A mammogram the month before her examination was netative. The most appropriate nurse practitioner action today is to: c. schedule an ultrasound of the breast 43. Which of the following is NOT a characteristic of the S3 heart sound? d. An S3 is fairly common in children, young adults, and females in the last trimester of pregnancy 44. A characteristic of elders which affects the pharmacotherapeutics of drug therapy in that population is an increase in: d. percent of body fat 45. The AUDIT questionnaire is useful to assess: a. alcohol use disorders 46. A 32- year-old mother and her 10-year-old child each have a 10 cm round, reddened patch on the trunk. There is central clearing in the lesion. Different lesions run parallel to each other in a Christmas tree pattern. The mother has been treating the “ringworm” with an anti-fungal cream for 7 days without success. The NP best response is: b. No medication will help this to clear. It must clear on its own and may take 4-8 weeks . 47. For the general adult population, total dietary fat intake should be no more than what percent of total calories? c. 30% 48. A 23-year-old female college student is being evaluated by the nurse practitioner for immunization status. She has documentation of completion of IPV, DTaP, and MMR series. She states “I got a shot when I was 12 years old, but none since.” Which vaccine(s) should she receive today? d. Td and HBV 49. Which of the following patients is most likely to have a diagnosis of Type 2 diabetes mellitus? b. A 49-year-old male with impotence and HbAIC 10.0% 50. Which of the following findings is consistent with otitis externa? d. pain 51. The most effective primary prevention of skin cancer is to educate the public about: d. limiting exposure to natural solar radiation 52. Which of the following is NOT a symptom of irritable bowel syndrome? d. Weight loss 53. An 18-year-old woman is taking a combined hormonal oral contraceptive. She should be instructed to use a backup method for the prevention of pregnancy: b. if prescribed topiramate (Topamax) for the treatment of migraines 54. A 50-year old patient has abnormal vaginal bleeding with heavy periods and intermenstrual watery discharge with a small amount of blood. What is the most likely diagnosis? a. uterine fibroids b. normal peri-menopause c. endometrial cancer d. cervical cancer 55. Which agent is most effective for the treatment of nodulocystic acne? d. isotretinoin (Accutane) 56. Which of the following signs and symptoms is typical of hyperthyroidism? a. heat intolerance 57. An 83-year-old man has a resting hand tremor. What disease process is this type of tremor is most commonly associated with? a. Multiple sclerosis (MS) b. Parkinson’s disease c. diabetic neuropathy 58. A young female reports onset of right flank pain 2 days ago that is now severe. Last night she discovered a “burning rash” in the same area. The NP identifies popular fluid-filled lesions that are confluent and follow a linear distribution along the T-8 dermatome. The NP would appropriately order: c. an oral antiviral d. a topical steroid cream 59. Expected spirometry redings when the patient has chronic emphysema include: d. increased total lung capacity (TLC) 60. Right-sided heart failure is characterized by all of the following clinical findings EXCEPT: Answer: a 4th heart sound 61. Moderate weight loss, particularly of visceral adipose tissue, in patients with Type 2 diabetes mellitus may have all of the following beneficial effects EXCEPT: c. increased lean muscle mass d 62. Nurse practitioner services are filed with Medicare for reimbursement a. and paid by Medicare Part B 63. Which of the following drugs has a beneficial effect on benign prostatic hyperplasia? a. doxazosin (Cardura) 64. A 46-year-old female has hypertension and is well managed with propranolol (Inderal). Which of the following is a beneficial secondary effect of this drug? d. migraine prophylaxis 65. The finding which is most consistent with a diagnosis of benign prostatic hyperplasia is digital palpation of a prostate gland that is: a. enlarged, symmetrical, semi-firm, and non-tender b. enlarged, symmetrical, boggy, and exquisitely tender 66. A 20-year-old male complains of a “skin rash” on his knees and elbows. The lesions have silvery scales and are pruritic. A positive Auspitz sign is present. What is the most likely diagnosis? d. psoriasis 67. The daughter of a 75-year-old patient reports that her mother roams the house at night saying she cannot fall asleep. She has fallen twice. Of the following choices, which would be the most appropriate to treat her insomnia? a. doxepin (Sinequan) 68. A 65-year-old African American patient was screened at his local church for “high cholesterol.” His total cholesterol (no-fasting) was 215 mg/dL (5.6 mmol/L). What action below is most appropriate for the NP? a. Recommend a fasting lipid profile 69. Swan neck and boutonniere deformities are typical clinical findings in the later presentation of: a. gouty arthritis b. rheumatoid arthritis 70. A 13- year-old patient complains the he fell while running during football practice. Now his knee hurts and sometimes “locks.” The NP conducts McMurray’s test. Which of the following is TRUE about this test? a. an audible or palpable click is positive for a torn meniscus 71. A hemoglobin AIC level is 7.2 in a patient with Type 2 diabetes mellitus. The patient is currently taking a sulfonylurea medication. Which of the following drug should be added next to the medication regime? d. Metformin (Glucophage) 72. A patient with a diagnosis of giardiasis is being treated with metronidazole (Flagyl). What information would be important to obtain before prescribing this medication? c. if the patient drinks alcohol 73. The nurse practitioner is performing a routine assessment of a 47-year-old female who wants to lose weight She has truncal obesity with relatively slender forearm and lower legs. Her BMI is 38. Upon review of her history, physical examination, and laboratory reports, the nurse practitioner diagnoses “Syndrome X.” This diagnosis is based on the previous findings plus all of the following EXCEPT: d. cardiac arrhythmias 74. A 59-year-old postmenopausal woman has atrophic vaginitis. She has a history of breast cancer at age 40 years. What is the appropriate initial treatment for this patient? d. Topical conjugate estrogen cream 75. The process by which a profession association cofers recognition that a licensed profession has demonstrated mastery of a specialist body of knowledge and skills is termed: c. certification 76. A nurse practitioner has just diagnosed a patient as having acute hepatitis B. The principle which prohibits the nurse practitioner from notifying the patient’s spouse without permission is: d. confidentiality 77. A 43-year-old female patient complains of dull ache around both ankles after a day’s work as a cashier. Her symptoms are relieved by sitting and elevating her legs. She reports ankle edema at the end of the day. What is the most likely cause of these problems? a. varicose veins 78. Which of the following are characteristic of patients with Type 2 diabetes mellitus? 1. Beta cell destruction 2. High body mass 3. Central obesity 4. Unexplained weight loss a. 1,2,3 b. 2,3 c. 1,4 79. The sexual partner of a symptomatic male patient with gonorrhea should be empirically treated: c. with ceftriaxone and doxycycline (Vibramycin) 80. A patient on oral contraceptives complains of breast fullness, tenderness, and some nausea. The patient is concerned. How should the NP manage this? b. change the pill to one containing less estrogen 81. A 62-year-old with Type 2 diabetes mellitus complains of increased nocturia, fatigue, and weakness. His fasting blood glucose is 110 mg/dL (6.2 mmol/L), he is slightly anemic and his serum creatinine level is slightly elevated. All other laboratory tests and physical examination are within normal limits. What is the most likely diagnosis? d. renal insufficiency 82. A 23-year-old female presents with scaly hypo-pigmented macular lesions on her trunk, shoulders, and upper arms. The lesions fluoresce under Wood’s lamp. Appropriate treatment for this condition is: a. Apply selenium sulfide (Versel) lotion and allow to dry for 10 minutes, then rinse off 83. The goals of treatment for patients with alcohol abuse disorder are: c. abstinence or reduction in sue, relapse prevention and rehabilitation d. marital satisfaction, improvement in family functioning, and reduction in psychiatric impairment 84. Which of the following drug classes may potentiate hyperkalemia in a patient taking a potassium- sparing supplement? a. thiazide diuretic b. angiotensin-converting enzyme inhibitor 85. A patient has laboratory studies performed which demonstrate increased TSH, decreased free T4, and T3. Which symptoms might she complain of? d. hair loss 86. The anatomical site currently believed to be the best location for subcutaneous insulin administration is the c. abdomen 87. Following the finding of prostate gland abnormalities on DRE, the nurse practitioner orders appropriate labs. When preparing to review lab reports with the patient, the NP know all of the following are true EXCEPT: a. normal PSA is 10 mg/ml or less 88. An obese 43-year-old has recurrent superficial fungal skin infections over the past 2 years. Today, she presents with intertriginous candida. Her skin is macerated from frequent rubbing and scratching. The plan of care for this patient should include: a. recommended screening for diabetes mellitus and HIV infection 89. Which statement is true regarding dental health? a. a diet high in sugar has no effect on dental caries b. individuals with dentures should visit the dentist every 2 years 90. A 51-year-old post-menopausal female, requests guidance regarding osteoporosis risk. The NP would be correct to recommend all of the following EXCEPT: d. weight loss 91. When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action? a. order abdominal x-rays b. order abdominal ultrasound 92. Which of the following is NOT an appropriate treatment for chronic bacterial prostatitis (CBP) d. nitrofurantoin (Macrobid) 93. The first step when taking a patient history is the c. introductory information 94. Characteristics of prescription and OTC drug use in the elder population include all of the following EXCEPT: a. high incidence of drug reactions b. multiple prescribers and polypharmacy 95. The nurse practitioner wants to assess intactness of a patient’s cerebellar function. Which of the following clinical tests will provide information relative to cerebellar function? a. kinesthesia b. stereognosis c. Romberg 96. A 57-year-old patient with known diverticulosis presents with fever, leukocytosis, and bright red rectal bleeding. The nurse practitioner’s least appropriate action at this time is: d. education regarding low fiber diet 97. A 41-year-old woman presents with multiple painful vesicular lesions in the vulvar area She has been with the sexual partner for 21 years. Which of the following is the MOST likely diagnosis? c. herpes simplex d. chlamydia 98. The differential diagnoses for transient episodes of dizziness would appropriately include all of the following EXCEPT: c. allergic rhinitis 99. Which of the following is NOT a common early sign of benign prostatic hyperplasia (BPH)? d. increased force of urine flow 100. The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The LEAST likely diagnosis is: a. acute otitis media (AOM) 101. A 16-year-old presents for a sports physical for football. The nurse practitioner auscultates a diastolic murmur. It is a grade II/IV. He has no history of a murmur. The patient denies symptoms. What is the most appropriate action for the NP? a. refer this patient to a cardiologist 102. What is the most common causative pathogen found in cystitis, pyelonephritis, and prostatitis? a. Escherichia coli 103. The most common symptoms of a transient ischemic attack (TIA) include: a. nausea, vomiting, syncope, incontinence, dizziness, and seizure b. weakness in an extremity, abruptly slurred speech or partial loss of vision, and sudden gait changes 104. 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 105. A 48-year-old female presents with a chief complaint of insomnia. On further investigation, she reports fatigue, nervousness and agitation during the daytime, and feeling hot most of the time. Which of the following would NOT be included in the differential diagnosis? d. Parkinson’s disease 106. The nurse practitioner correctly diagnoses iron deficiency anemia in a female patient whose lab report reveals a. an increased reticulocyte count b. a mean corpuscular volume (MCV >100) c. hemoglobin (Hgb) 14.0 d. an increase total iron binding capacity (TIBC) 107. A 16-year-old sexually active student presents with complaints of a greenish-gray frothy vaginal discharge and vaginal itching. The nurse practitioner should suspect: a. bacterial vaginosis (BV) b. trichomoniasis c. syphilis d. gonorrhea 108. A 37-year-old female is found to have a negative rubella titer. How long after immunization should she avoid pregnancy? a. 28 days 109. A 60-year-old male diabetic presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which has resolved. His temperature is 102 degrees F and pulse is 100 bpm. The nurse practitioner’s most appropriate initial action is to: a. start an oral antibiotic, refer the patient to a dentist immediately, and follow up within 3 days b. order mandibular x-rays and question the patient about physical abuse c. start an oral antibiotic, mouth swishes with an oral anti-infectives, and an analgesic d. initiate an IM/IV antibiotic and consider hospital admission 110. A 44-year-old male Caucasian patient’s blood pressures are consistently 170 mm Hg systolic and 100-119 mm Hg diastolic. He has no significant medical history and is of normal weight. His lab tests and EKG are normal. What is the most appropriate action at this time? d. Prescribe and ACE inhibitor and a low dose thiazide diuretic 111. A 65-year old diabetic patient has periorbital cellulitis secondary to a sinus infections, What course of action should the nurse practitioner take? d. Consider collaboration with a physician regarding antibiotic treatment, culture and subsequent action 112. A 15- year-old swim team member presents with mild “swimmer’s ear.” Vital signs are normal. What is the most appropriate therapy for this patient? a. Oral amoxicillin-clavulanate (Augmentin) b. Oral cefaclor (Ceclor) c. Keep the ear canals dry at all times until the condition resolves on its own d. hydrocortisone-bacitracin-polymyxin B (Corisporin) otic suspension 113. Which of the following is true concerning sensitivity and specificity? a. Assessment techniques must be highly sensitive and highly specific to be useful b. Sensitivity relates to the reliability of a technique to give a positive result when the finding is present. Specificity relates to the reliability of a technique to successfully rule out a finding. 114. A nurse practitioner has recently been hired to work in a fast track facility. The NP’s employer asks 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 115. According to the American Diabetes Association, what is the lowest fasting plasma glucose level which warrants a diagnosis of diabetes mellitus if confirmed on a subsequent day? a. 121 mg/dL b. 126 mg/dL c. 130 mg/dL d. 140 mg/dL 116. A 23-year-old female patient of Italian descent has been diagnosed with anemia secondary to glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. It is important to teach this patient to avoid: a. beef or pork liver b. fava beans c. phenylalanine d. milk and mild products 117. A 14- year-old develops otitis externa with swelling erythema, and pain,. To facilitate antibiotic deliver to the canal, the NP should: a. use a cotton tipped swab to apply medication b. insert a wick by gently twisting it into the canal c. prescribe an oral antibiotic prescribe an oil-based otic antibiotic to seep into the canal 118. A patient taking levothyroxine is being over-replaced. What condition is he at risk for? a. Osteoporosis b. diarrhea c. bipolar disorder d. periorbital puffiness 119. A nurse practitioner plan to open a private clinic. Each patient will be expected pay $45 immediately following the visit. This is a example of: a. utilitarianism b. fee-for-service c. case management d. preferred providership 120. Along with helping to prevent osteoporosis, hormone replacement therapy (HRT) in the post- menopausal woman has been shown to: a. raise high density lipoprotein (HDL) b. raise low density lipoprotein (LDL) c. lower triglyceride d. prevent coronary heart disease (CAD) 121. An elderly patient presents with a gray-white ring around the periphery of the iris. This is probably a. indicative of underlying atherosclerotic disease b. a normal variant associated with the aging process 122. A patient complains of “stomach pains” on and off for the past month. In distinguishing between a gastric and duodenal ulcer, what question is least important to ask? a. Have you been out of the country in the past several months? b. Have you had dark, tarry or bloody stools? 123. Which of the following is a microcytic hypochromic anemia? a. Folic acid deficiency anemia b. Iron deficiency anemia 124. What information should a 42- year old patient with newly diagnosed diabetes receive about exercise? c. Snack before exercise 125. A 14-year-old female cheerleader reports gradual and progressive dull anterior knee pain, exacerbated by kneeling. She also complains of a “sore lump on my knee.” The nurse practitioner notes swelling and point tenderness at the tibial tuberositiy X-ray is negative. What is the most likely diagnosis? c. Osgood-Schlatter disease 126. The obesity associated with Type 2 diabetes mellitus is: d. a truncal (android distribution) 127. Which of the following patients would appropriately be diagnosed with isolated systolic hypertension (ISH)? a. a 69-year old male with BP 156/86 128. An adolescent goes to Colorado for a ski trip. He is unaccustomed to the high altitude and very dry air. He develops nose bleeds and visits the nurse practitioner. What intervention is LEAST effective? d. Drink adequate water to promote hydration of the nares 129. The intervention known to be most effective in the treatment of severe depression, with or without psychosis, is a. psychotherapy b. electroconvulsive therapy (ECT) 131. A person with 20/80 vision: d. has poorer vision than someone with 20/40 vision 132. Which of the following is considered a non-inflammatory disease process? a. Osteoarthritis (OA) 133. A 49 – year-old Hispanic female has a blood pressure of 145/95. mmHg during a routine annual evaluation. She no history of hypertension. She takes a statin for dyslipidemia. How should the NP proceed with this patient? a. The patient’s blood pressure should be checked in about 2-4 weeks 134. With a diagnosis of syphilis, which of the following tests remains positive for the patient’s lifetime? b. RPR c. FTA-Abs or MHA-TP 135. Stress urinary incontinence is: a. associated with the normal aging process b. may be caused by anticholinergic or antidepressant medication c. due to detrusor muscle instability d. may be aggravated by caffeine or alcohol 136. Which of the following accurately describes the appropriate use of influenza vaccine? a. Influenza vaccine is recommended on a one-time only basis for all 65 yrs. or older and to persons 6 months or older who are in chronic care facilities or who suffer cardiopulmonary disorders, metabolic diseases, hemoglobinopathies, or immunosuppression. a. Influenza vaccine should be given annually to all persons 65 yrs. or older and to persons 6 months or older who are in chronic care facilities or who suffer cardiopulmonary disorders, metabolic diseases, hemoglobinopathies, or immunosuppression. a. Influenza vaccine should be administered to all persons born after 1956 who lack evidence of immunity to influenza. a. Influenza vaccine should be administered to all young adults not previously immunized and also to susceptible adults in high risk groups including homosexual men, injecting drug users, and persons in health-related job with frequent exposure to influenza 137. Ideal weight for 5’7” female is 135# 138. A 65-year-old diabetic patient has newly diagnosed peripheral artery disease in her lower extremities. She is exhibiting symptoms of this disease. In assessing this patient, theNP would expect to find: a. decreased pulses proximal to theblockage b. pain in affected leg at rest c. diminished pedal pulses d. dependent rubor 139. A 75-year-old female complains that she awakens 3 to 4 times each night sensing bladder fullness, but is unable to “hold it” until she can get seated on thebathroom toilet. This type of urinary incontinence is termed: a. overflow incontinence b. stress incontinence c. functional incontinence d. urge incontinence 140. The nurse practitioner strongly suspects hyperthyroidism in a 62-year-old patient. Which of thefollowing would NOT be an appropriate initial intervention? d. Start levothyroxine (Synthroid) 0.025 mg (25 mcg) daily and re-assess in 2 weeks 141. 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 declare in advance what type of medical care a person wants to be provided or withheld should he or she be unable to express his or her wishes is called: a. an advanced directive 142. A 2-year-old male complains of severe headaches localized to theleft frontal and parietal area with blurred vision. thenurse practitioner identifies vesicular lesions on his forehead. themost appropriate intervention is to start: a. acyclovir, and referral to an ophthalmologist 143. A patient has experienced nausea and vomiting, headache, malaise, low-grade fever, abdominal cramps, and diarrhea for 32 hours. thewhite count is slightly elevated with a shift to theleft. He is requesting medication for diarrhea. What is themost appropriate response? c. Offer an anti-emetic medication such as prochlorperazine (Compazine) and provide oral fluid and electrolyte replacement instruction 144. The nurse practitioner is evaluating a 35-year-old female nurse. She has a history of hospitalization for hepatitis-B infection 2 years ago. Her laboratory tests demonstrate positive HBsAg. thenurse practitioner would most likely diagnose: a. chronic hepatitis B infection 145. What medication would be best to relieve symptomatic wheezing in a patient who has asthma? a. Short-acting bronchodilator 146. Tricyclic antidepressants should be avoided in elderly patients because they have potentially disabling side effects. Which of thefollowing is least likely to be a side effect of TCAs? d. potentiation of seizures 147. Of thefollowing, thepatient who should be referred for periodic colonoscopy is thepatient with: a. diverticulitis resistant to traditional medical management b. extensive ulcerative colitis of long duration c. irritable bowel syndrome (IBS) complicated by psychiatric illness d. lactose intolerance 148. What is themost frequent cause of death in patients with anorexia nervosa? d. cardiac arrest 149. All patients with renal calculi should be taught that thebest prevention is: a. increased fluid intake 150. In order to decrease deaths from lung cancer: d. patients should be counseled to quit smoking OTHER PRE-TEST QUESTIONS 2. Which of thefollowing physical findings is consistent with a diagnosis of beta-thalassemia major? a. Bronze skin color 4. Weber test with lateralization to right ear Conduction problem in theright ear 5. Yesterday, a patient got sand in his eye during a volleyball game at thebeach. Today, he presents with an exquisitely painful left eye, photophobia, and constant tearing. thenurse practitioner removes a tiny spec of sand from under thelid and notes vertical corneal abrasion. thetreatment of choice is: a. patching theinjured eye only; no medication is needed b. an ophthalmic steroid to reduce swelling, inflammation, and pain c. an ophthalmic antibiotic ointment, eye patch, and ibuprofen d. normal saline drops only, eye-patching is not necessary 6. A critically ill patient states “my family is well provided for. thenurse practitioner must interpret this as meaning thepatient a. is suicidal b. wishes to discuss thetopic of death 7. The patient who has iron deficiency anemia should be advised that food high in iron content include: a. bananas, apples, and oranges b. yellow vegetables c. organ meats, and dark, leafy vegetables 8. Microalbuminuria is a measure of: d. protein lost into theurine 9. Appropriate therapy for peptic ulcer disease (PUD) is: a. primarily by eradication of infection b. based on etiology 10. All of thefollowing are medical emergencies which may be attributed to acute cocaine intoxication EXCEPT: d. decreased heart rate and vasodilation leading to hypersomnia 11. The treatment of choice for chronic bacterial prostatitis (CBP) is: c. a flouroquinolone twice daily for 3 weeks to 4 months 12. Before initiating a HMG-CoA-reductase inhibitor for hyperlipidemia, thenurse practitioner orders liver function studies. thepatient’s aminotransferase (ALT) is elevated. What lavoratory test(s) should be ordered? a. serologic markers for hepatitis 13. Subsequent to successful completion of thenurse practitioner certification exam, thecandidate is considered to be: b. certified 14. Which of thefollowing patient characteristics are associated with chronic bronchitis? a. Overweight, cyanosis, and normal or slightly increased respiratory rate 15. The nurse practitioner would be correct to include all of thefollowing points in theeducation of patients with folic acid deficiency anemia EXCEPT: c. oral folate replacement therapy is 0.4 mg per day 17. On examination, a 67-year-old patient is noted to have high-tone hearing loss. This finding is consistent with what diagnosis. c. presbycusis 18. Which of thefollowing is appropriate to teach a patient who is using a daily nitrate agent for treatment of chronic angina? a. continuous 24-hour coverage is necessary for maximum protection b. A daily 12-hour nitrate free period is important to prevent tolerance 19. An 83-year-old has heart failure (HF). He takes Prinivil (Lisinopril), metoprolol (Lopressor), ASA, and low dose furosemide every morning. After assessing thepatient today, theNP determines that he is having a mild exacerbation of HF. theLEAST likely cause of this is: d. consumption of an antacid calcium carbonate, 3x yesterday 22. Upon ophthalmic examination of a 78-year-old patient, thenurse practitioner observes dark spots against a red retina. What diagnosis is this finding most consistent with? d. macular degeneration 24. Which immunization(s) is (are) contraindicated in an immunodeficient individual? 1. Varicella 2. IPV 3. MMR 4. HBV b. 1,3 25. Which of thefollowing may predispose thepatient to hyperglycemia? a. glucocorticosteroids 26. An 18-year-old college student lives in thedormitory. He has been treated for scabies infestation with permethrin (Nix). He was asymptomatic for two weeks, but now complain again of itching and skin bumps. How should thenurse practitioner proceed? d. Retreat him with permethrin and have him launder all of his bedding and clothing. 27. Pre-diabetes is: a. the result of insulin resistance and hyperinsulinemia 29. The nurse practitioner suspects a TMJ disorder. As thepatient slowly opens and closes thelower jaw, thenurse practitioner palpates thetemporomandibular joint (TMJ) bilaterally: a. anterior to themastoid process b. anterior to thetragus 30. A patient newly diagnosed with Type 2 diabetes referred to a diabetes nurse educator and complete theinitial educational program. theneed for further education is indicated when thepatient says which of thefollowing? b. “I may notice some weight loss as my diabetes gets under better control” 31. A 44-year-old patient complains of stiffness and soreness in his hands, hips, and knees. There is noticeable PIP and DIP joint enlargement in his hands. thenurse practitioner suspects arthritis. All of thefollowing questions are helpful in differentiation between rheumatoid arthritis (RA) and osteoarthritis(OA) EXCEPT: d. Have you notice decreased joint movement or flexibility? 32. Changes in pulmonary air flow associated with asthma exacerbations and remissions is best assessed by monitoring: c. peak expiratory flow rate (PEFR) as measured by a peak flowmeter 33. The most effective intervention to prevent stroke is (are): d. smoking cessation and treatment of hypertension 35. A patient recovering from a recent stroke is starting anticoagulant therapy. thenurse practitioner should teach thepatient to avoid all of thefollowing EXCEPT: b. milk and milk products 36. What is themost common chronic condition in theelder population in theUnited States? b. arthritis 38. It is imperative that thenurse practitioner teach patients taking oral contraceptives to report any of thedanger signs of complications. Which of thefollowing, would be of LEAST concern to thenurse practitioner? d. weight gain 41. A patient reports to thenurse practitioner that he was diagnosed with hepatitis B one year ago and has not seen a health care provider since then. What information should this patient be given? b. About 10% of affected persons become carriers, and are at increased risk for hepatocellular carcinoma 42. An active 82-year-old male in good health complains “I don’t see as well as I used to and my eyes are very sensitive to glare.” His near-distant visual acuity is diminished, and he has a bilateral white pupillary reflex. themost likely diagnosis is: c. cataracts 43. A female patient asks “How do I calculate my ideal body weight?” thenurse practitioner appropriately answers: a. Start with 100 pounds, and add 5 pounds for every inch in height over five feet 44. What assessment findings are NOT typical of thepatient with psoriasis? d. Satellite lesions 45. A patient presents to thenurse practitioner with complaints of diarrhea and malaise which started at 2:00 am themorning of thevisit. After history and examination, thenurse practitioner advises thepatient that theproblem should be self-limiting. If thediarrhea does not resolve, when should thenurse practitioner advise thepatient to return? c. 3 days 46. The nurse practitioner diagnoses epididymitis in a 24-year-old sexually active male patient. thedrug of choice for treatment of this patient is: b. oral doxycycline (Vibramycin) plus intramuscular ceftriaxone 47. A 75-year-old patient is well controlled on timolol maleate (Timoptic) for chronic open-angle glaucoma. Prescribing propranolol (Inderal) for this patient may precipitate: c. bradycardia 48. What intervention does theAmerican College of Rheumatology recommend as first-line therapy for osteoarthritis? d. Exercise and weight loss 50. Electrocardiogram markers of hypokalemia include all of thefollowing EXCEPT: c. peaked T waves 52. Which of thefollowing drugs classes would be most effective in decreasing elevated triglyceride levels (650 md/dL)? c. fibrates 53. The most effective treatment for anemia of chronic disease is: b. treatment of theunderlying disease 54. A 17-year-old presents with a wound receive while building a fence. He has completed a primary vaccination series and he had a Td booster 3 years ago. Does he need a Td booster today? a. No, expert o[pinion supports vaccination after a contaminated wound when more than 5 years have elapsed since thelast Td vaccine 56. Phalen’s test, 90 degress wrist flexion for 60 seconds, reproduces symptoms of: b. carpal tunnel syndrome 58. Health People 2020 published by theU.S. Department of Health and Human Service: a. is a set of national health objectives designed to improve theoverall health of people and communities 61. A 16-year-old received stitches in his arm after an accident. He tells thenurse practitioner that his last tetanus shot was “on time.” Should he receive another one? b. Yes, because there is no documentation of theprevious immunization 63. Which of thefollowing is themost important diagnosis to rule out in theadult patient with acute bronchitis? a. pneumonia 65. A 72-year-old patient reports a 6-month history of progressively more swollen and painful distal interphalangeal (DIP) joints of one hand. There are no systemic symptoms but theerythrocyte sedimentation rate (ESR), antinuclear antibody (ANA) and rheumatoid factor (RF) are all minimally elevated. What is themost likely diagnosis? b. osteoarthritis 66. Persons with thalassemia should avoid: d. iron replacement therapy 67. Of thefollowing characteristics, which are most closely associated with risk for becoming an abusive parent? b. Young, isolated, with unreasonable expectations of thechild 68. The nurse practitioner must increase a patient’s dosage of theophylline to achieve a therapeutic level. After thedosage has been increased, a serum theophylline level should be checked: c. just prior to thefifth dose 70. Education of women with fibrocystic breast disease should include which of thefollowing statements? c. Caffeine may trigger breast pain 71. An adult patient has an S4 heart sound and thePMI is located at the5th left ICS, left of theMCL. What are these findings associated with? c. hypertension 72. Which of thefollowing is an appropriate drug for initial treatment of gastroesophageal reflux disease (GERD) in adults? a. famotidine (Pepcid) 73. The cornerstone of treatment for stress fracture of thefemur or metatarsal stress fracture is: a. absolute rest from activities which may further stress thebone 75. What diabetic complications result from hyperglycemia? 1. Retinopathy 2. Hypertension resistant to treatment 3. Peripheral neuropathy 4. Accelerated atherogenesis c. 1,3,4 76. A 66-year-old patient exhibits sudden onset of fluctuating restlessness, agitation, confusion, and impaired attention. This is accompanied by visual hallucinations and sleep disturbance. What is themost likely cause of this behavior? b. delirium 77. The preferred therapeutic regimen for an 18-year-old pregnant patient diagnosed with Chlamydia trachomatis infection is: d. a single dose of azithromycin (Zithromax) one gram orally 78. An 80-year-old Caucasian female has heart failure (HF). Which symptom below is an early indication of failure? a. Weight gain 79. What is themost common cause of Cushing’s syndrome? b. Administration of a glucocorticoid or ACTH 81. A 45-year-old male is diagnosed with hypertension. theblood pressures have been gradually increasing over time, with a reading today of 152/98. Diagnostic studies are normal. themost likely diagnosis for this patient is: b. essential hypertension 82. A patient with hepatic cirrhosis presents with pedal edema. He reports that his iwfe prepares thesame lunch for him every day: a ham and cheese sandwich on white bread with mustard, a bowl of fresh vegetable soup, a fresh orange, banana or grapes, and sweetened iced tea. He denies adding salt to his food. thefood that is most likely causing his edema is the: b. ham and cheese 83. A depressed patient has been treated and has had relief of symptoms while on medication for depression. Which patient statements is a correct understanding of depression? b. I must remain on medication for about 6 months since this is my first episode of depression 84. A 16-year-old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be theLEAST appropriate to prescribe? d. doxycycline 85. An 87-year-old patient was placed on low dose amlodipine (Norvasc) for treatment of hypertensionadn angina. She takes no other medications. What side effects might be expected from amlodipine? b. orthostatic hypotension 86. Patients diagnosed with polycystic ovarian disease are at increased risk of developing: a. diabetes mellitus 87. A patient present with an inflamed upper eyelid margin. theconjunctiva is red and there is particulate matter along theupper eyelid. thepatient complains of a sensation that “there is something in my eye.” What is thediagnosis and how should it be treated? c. Blepharitis, treat with warm compresses and gentle debridement with a cotton swab 88. What disease process are Bouchard’s nodes most commonly associated with? c. osteoarthritis (OA) 89. An adult female presents with a hordeolum. A topical antibiotic is prescribed. Which of thefollowing instructions is NOT appropriate advice for thenurse practitioner to give thepatient? a. Apply warm, moist compresses several times per day b. Do not use soap near theaffected eyelid c. Do not wear eye makeup and discard all use eye makeup d. Do not rub your eyes 90. A 43-year-old patient complains of dull ache around both ankles after a day’s work as a cashier. Her symptoms are relieved by sitting and elevating her legs. She reports ankle edema at theend of theday. What is themost likely cause of these problems? a. Varicose veins 91. A patient reports, “something flew in my eye” about an hour ago while he was splitting logs. If there was a foreign body in his eye, thenurse practitioner would expect to find all EXCEPT: a. a purulent discharge 92. Which of thefollowing is NOT a symptom of irritable bowel syndrome? d. weight loss 93. A 76-year-old female patient with chronic atrial fibrillation is taking warfarin (Coumadin) and being managed on an outpatient basis. What is thepreferred laboratory test to evaluate this patient’s coagulation status? c. International normalization ratio (INR) 95. Which drug(s) below would be expected to produce theleast amount of hypokalemia? c. Spironolactone (Aldactone) 97. Which choice below is NOT a symptom of COPD? d. fully reversible airflow 98. A 21-year-old patient presents with abdominal guarding, rigid abdominal musculature, rebound tenderness at McBurney’s point, and leukocytosis. What is themost likely diagnosis? c. appendicitis 99. What is themarker for asthma in theWBC differential? c. elevated eosinophils 100. The most appropriate first-line drug treatment for African American patients diagnosed with hypertension is: a. a calcium channel blocker (CCB) demonstrated by research to be themost effective anti- hypertensive drug class for this population 102. A 25-year-old female complains that she never had a bladder infection before she became sexually active, but now she has had 3 in thepast year. What intervention is especially important for thenurse practitioner to teach this patient to help prevent recurrence of bladder infections? a. Drink a glass of water before sexual intercourse and urinate within 15 minutes after 103. An obese patient presents with intertrigo under her breasts. thenurse practitioner prescribes an anti- fungal cream and encourages her to: c. expose theintertriginous areas to light and air 3 times a day 104. The long-term prognosis for a patient with a diagnosis of dementia is: d. poor, because gradual deterioration of cognitive function, memory, judgment, and emotional stability is progressive [Show Less]