Leik questions

Question 1

17. A 39 year old migrant worker presents to the clinic 2 days after a mantoux test.  What minimum size of induration would be considered positive for this patient?
A. 3 mm
B. 5 mm
C. 10 mm
D. 15 mm

Answer 1

C. 10mm

Question 2

40. Signs and symptoms of depression include all of the following except:
A. anhedonia
B. low self esteem
C. apathy
D. apraxia

Answer 2

D. apraxia

Question 3

53. All of the following patients are at higher risk of suicide except
    A. a 66 year old white man whose wife of 40 years recently died
    B. a high school student with a history of bipolar disorder
    C. a depressed 45 year old woman with family history of suicide
    D. a 17 year old teen who has only one close friend in school

Answer 3

D. a 17 year old teen who has only one close friend in school

Question 4

67. A middle aged woman who works in the housekeeping department of a hospital presents to the employee health clinic with a c/o a needlestick to her left thumb. The needle was in one of the garbage bags from the ED. The patient had a little bleeding that stopped spontaneously. Which of the following is the next step
    A. order an ELISA as soon as possible
    B. recommend a tetanus booster in 1 week
    C. offer the patient hepatitis B immunoglobulin
    D. order a chest x ray

Answer 4

A. order an ELISA as soon as possible

Question 5

71. A nursing home resident reports to his physician that his previous roommate was recently started on TB treatment.  A mantoux test and chest x ray are ordered for the patient.  What is the minimum size of induration considered positive for this patient
A. 3 mm
B. 5 mm
C. 10 mm
D. 15 mm

Answer 5

B. 5 mm

Question 6

72. In small children with AIDS, which of the following vaccines is contraindicated?
A. diphtheria and tetanus (Td)
B. hepatitis B and mumps
C. varicella
D. Td and oral polio

Answer 6

C. varicella

Question 7

A 40 year old female bank teller has recently been diagnosed with OCD by her therapist

95. Which of the following characterize this disorder:
    A. ritualistic behavior that the patient feels compelled to repeat
    B. increased anxiety when attempting to ignore or suppress the repetitive behaviors
    C. frequent intrusive and repetitive thoughts and impulses
    D. all of the above

96. Which of the following medications is indicated for the treatment of OCD
A. paroxetine (paxil CR)
B. haloperidol (Haldol)
C. lorazepam (Ativan)
D. imipramine (Elavil)

Answer 7

95. D… all of the above

96. A…. paroxetine (paxil)

Question 8

109. A patient is positive for anti-HCV (hepatitis C virus antibody). What is the next step to further evaluate this patient?
     A. refer the patient to GI doctor
     B. order a hepatitis C RNA test
     C. order a hepatitis B comprehensive panel
     D. the patient is immune to hepatitis C and no further testing is indicated

Answer 8

B. order a hepatitis C RNA test

Question 9

122. NPs and clinical nurse specialists derive their legal right to practice from
     A. the nurse practice act in the state where they practice
     B. the laws of the state where they practice
     C. the medicare statute
     D. the board of nursing in the state where they practice

Answer 9

A. the nurse practice act in the state where they practice

Question 10

124. The following children are considered at higher risk for TB except
     A. a child who has recently been diagnosed with leukemia
     b. an infant whose family is homeless
     C. a child who was born in Japan
     D. a Hispanic child with asthma who is using a steroid inhaler

Answer 10

C. a child who was born in Japan

Question 11

142. All of the following are considered SSRIs except
A. imipramine (tofranil)
B. fluoxetine (Prozac)
C. sertraline (Zoloft)
D. paroxetine (paxil)

Answer 11

A. imipramine (tofranil)

Question 12

154. The anti-HCV test of a 60 year old female patient is positive.  Which test is appropriate for follow up
A. HCV RNA
B. HCV antibody
C. HCV core antibody
D. HCV surface antigen

Answer 12

A. HCV-RNA

Question 13

205. A newborns mother is discovered to be HBsAg (hepatitis B surface antigen) positive. Which of the following would you recommend for this infant?
     A. give the infant hepatitis B immunoglobulin
     B. give the infant both hepatitis B vaccine and hepatitis B immunoglobulin
     C. give the infant hepatitis B vaccine only
     D. send the infant home because he is not infected

Answer 13

B. give the infant both hepatitis B vaccine and hepatitis B immunoglobulin

Question 14

227. A NPs right to practice is regulated under
A. medicare regulations
B. the board of medicine
C. the federal government
D. the board of nursing

Answer 14

D. the board of nursing

Question 15

235. Which type of hepatitis virus infection is more likely to result in chronic hepatitis and increased risk of developing hepatocellular carcinoma
A. hepatitis A virus
B. hepatitis B virus
C. hepatitis C virus
D. both hepatitis B and C virus

Answer 15

D. both hepatitis B and C virus

Question 16

237. A 19 year old woman has recently been diagnosed with acute hepatitis B.  She is sexually active and is monogamous.  She reports that her sexual partner uses condoms inconsistently.  What would you recommend for her partner who has also tested for hepatitis with the following results: 
HBsAg (-)
anti-HBs (-)
anti-HCV (-)
anti-HAV (+)
A. hepatitis B vaccination
B. hepatitis B immunoglobulin
C. hepatitis B vaccination and hepatitis B immunoglobulin
D. no vaccination is needed at this time

Answer 16

C. hepatitis B vaccination and hepatitis B immunoglobulin

Question 17

299. All of the following are included in the criteria used to diagnose patients with AIDS except:
A. profound fatigue
B. thrush
C. Kaposi's sarcoma
D. hairy leukoplakia of the tongue

Answer 17

A. profound fatigue

Question 18

330. a 30 year old male patient with bipolar disorder refuses to take his afternoon dose of pills. The nurse tells him of the possible consequences of his action, but the patient still refuses to cooperate. Which of the following is the best course for the nurse to follow
     A. document the patients behavior in his record and the action taken by the nurse
     B. reassure the patient that he will be fine after taking the medicine
     C. document only the patient behavior
     D. document only the nurse’s action

Answer 18

A. document the patients behavior in his record and the action taken by the nurse

Question 19

332. While reviewing some lab reports, the NP notes that one of the results for her teenage male patient is abnormal. The LFTs are all normal except for a slight elevation in the alkaline phosphatase level. The patient is a member of a soccer team and denies any recent injury. Which of the following statements is true:
     A. it is an indication of possible liver damage from alcohol; order a liver ultrasound to rule out fatty liver
     B. this is a normal finding due to skeletal growth spurt in this age group
     C. the patient needs to be evaluated further for pancreatic disease
     D. the patient needs an ultrasound of the liver to rule out fatty liver and referral to a pediatric rheumatologist

Answer 19

B. this is a normal finding due to skeletal growth spurt in this age group

Question 20

336. All of the following statements are correct regarding licensure for NPs except
     A. it ensures a minimum level of professional competency
     B. it grants permission for an individual to practice in a profession
     C. it requires verification of educational training from an accredited graduate program
     D. it reviews information via a non governmental agency

Answer 20

D. it reviews information via a non governmental agency

Question 21

370. The treatment plan of patients with AIDS who have CD4 counts of less than 200 cells/mm3 should emphasize?
A. administer the MMR vaccine
B. preventive therapy for toxoplasmosis
C. preventive therapy for PCP
D. evaluation of the home environment

Answer 21

C. preventive therapy for PCP

Question 22

393. Prophylaxis for pneumocystis jirovecii pneumonia includes all of the following drugs except
     A. Bactrim
     B. dapsone
     C. aerosolize penatmidine
     D. aerosolized albuterol sulfate (Ventolin)

Answer 22

D. aerosolized albuterol sulfate (Ventolin)

Question 23

404. Which of the following factors is associated with increased risk of osteopenia in teenage girls
     A. drinking one glass of low fat milk daily
     B. anorexia nervosa
     C. participation in sports
     D. a normal BMI

Answer 23

B. anorexia nervosa

Question 24

419. Sources of legal risk for the NP would include all of the following except
A. invasive procedures
B. electronic medical record entries
C. prescribing medication
D. in-service training

Answer 24

D. in-service training

Question 25

467. A sexually active 22 year old man is asking to be screened for hepatitis B because his new girlfriend has recently been diagnosed with hepatitis B infection. His lab results are the following
     anti-HBV is negative
     HBsAg is positive
     HBeAg is positive
     Which of the following is true
     A. the patient is immune to the hepatitis B virus
     B. the patient is not infected with hepatitis B virus
     C. the patient needs hepatitis B vaccine and immunoglobulin
     D. the patient needs only hepatitis B immunoglobulin

Answer 25

C. the patient needs hepatitis B vaccine and immunoglobulin

Question 26

501. The atypical antipsychotic drugs have many adverse effects.  Which of the following side effects are most likely to be seen with this drug class?
A. orthostatic hypotension and sedation
B. malignant hypertension and headache
C. skin hyperpigmentation and alopecia
D. severe anxiety and increased appetite

Answer 26

A. orthostatic hypotension and sedation

Question 27

525. a 25 year old man with schizophrenia comes in for a routine annual PE. He is a heavy smoker and has a BMI of 28. The patient has been on olanzapine (Zyprexa) for 10 years. Regarding the patients prescription, which of the following lab tests is recommended for monitoring the adverse effects of atypical antipsychotics?
     A. fasting blood glucose, fasting lipid profile and weight
     B. urinalysis, serum creatinine, 24 hour urine protein and creatinine clearance.
     C. liver function tests only
     D. CBC with diff, LFTs and weight

Answer 27

A. fasting blood glucose, fasting lipid profile and weight

Question 28

528. A middle aged man who is homeless reports to the local pubic health clinic c/o a painless and shallow ulcer on the penile shaft for the past 2 weeks. He is sexually active and had unprotected intercourse with 2 male partners over the past few months. The patient is tested for HIV, syphilis, gonorrhea, hepatitis B and herpes type 1 and 2. The syphilis and HIV are both positive. The gonorrhea, hepatitis B, and herpes tests are negative. The NP is aware of the nationally notifiable infectious conditions. Which of the following is true regarding reporting of any of these sexually transmitted infections
     A. health care providers must obtain the patients permission before reporting the positive HIV and syphilis test results to the local public health department
     B. the NP should obtain the patients and sexual partners permission before reporting the positive test results to the local health department.
     C. health care providers are mandated by law to report certain types of diseases to the local health department even if the patient does not give permission
     D. the NP should consult with the supervising physician about this issue

Answer 28

C. health care providers are mandated by law to report certain types of diseases to the local health department even if the patient does not give permission