Exam Flashcards
(146 cards)
1
Q
A patient with mitral regurgitation (MR) has developed the most common arrhythmia associated with MR. The intervention most likely to prevent complications from this arrhythmia is:
A
anticoagulation.
2
Q
AV nicking may be identified in a patient who has what disease?
A
Hypertension
3
Q
Which infant feeding behavior is least likely related to congenital heart disease (CHD)?
A
Infants that burp frequently when feeding
4
Q
The most common cause of acute pharyngitis in children is:
A
respiratory viruses.
5
Q
A 71-year-old female presents with a vesicular rash that burns and itches. Shingles is diagnosed. An oral antiviral:
A
should be started within 72 hours of the onset of symptoms.
6
Q
Certification:
A
validates competence.
7
Q
A female patient with a complaint of dysuria has the following urinalysis results. The most appropriate diagnosis is:
A
UTI with hematuria.
8
Q
A 6-year-old is brought to your clinic because of behavior problems at school. DSM V criteria are used to diagnose attention deficit disorder (ADD). Which finding is likely present?
A
Inattention
9
Q
A 72-year-old patient with a history of coronary artery disease and hypertension reports an episode of slurred speech and right-sided facial droop. What is the most likely explanation for these symptoms?
A
Transient ischemic attack
10
Q
An NP examines a screaming 2-year-old. A common finding is:
A
pink tympanic membranes.
11
Q
In a patient with end-of-life physical pain, constipation commonly occurs. What is the most common cause of this?
A
Opioid use
12
Q
A pregnant patient is 30 weeks’ gestation and will fly to Colorado for a hiking trip. The nurse practitioner knows:
A
travel to a city of high altitude can precipitate preterm labor.
13
Q
Depression is diagnosed on clinical presentation. What time frame is important for distinguishing between depressed mood and clinical depression?
A
2 weeks
14
Q
A patient who wrote a living will has changed his mind about life-sustaining measures. Which statement is true?
A
He can only change the content if he is of sound mind.
15
Q
In order to reduce lipid levels, statins are most beneficial when taken:
A
in conjunction with diet and exercise.
16
Q
A 75-year-old patient has asymptomatic bacteriuria. How should she be managed?
A
Monitor for symptoms of a urinary tract infection.
17
Q
A patient with a dirty puncture wound and no insurance presents to a clinic. The NP should:
A
prescribe a tetanus shot and medications for HIV exposure even if he can’t afford them.
18
Q
A 55-year-old patient has persistent proteinuria. What is the most likely diagnosis?
A
diabetes.
19
Q
Which study would be most helpful in evaluating the degree of hypertrophy of the atrium or ventricle?
A
Echocardiography
20
Q
A patient calls about a tick bite. What should he be advised?
A
No treatment is needed.
21
Q
Which lab test will be elevated in pancreatitis?
A
Serum amylase
22
Q
Which medication is NOT associated with weight gain?
A
Metoprolol
23
Q
What is the most prevalent skeletal problem in the United States?
A
Osteoarthritis
24
Q
A skin scraping shows hyphae. What kind of infection is this?
A
Fungal
25
Tricyclic antidepressants may be used in older patients who have:
hypothyroidism.
26
Best form of birth control for a lactating mother?
Injectable progestin
27
A diabetic elderly male has gait difficulty and urinary incontinence. What is a likely diagnosis?
Normal pressure hydrocephalus
28
A college student with anorexia is bradycardic and has orthostatic hypotension. What is likely?
Amenorrhea
29
A 2-cm breast mass in a 51-year-old female should be evaluated with:
Ultrasound
30
A 35-year-old finds a small, discrete breast mass. Initial step?
Ask whether the mass changes at the time of menses.
31
What is true regarding overweight older adults?
Mortality related to overweight states declines over time.
32
A 65-year-old received pneumonia immunization at age 60. He should:
receive another one today.
33
Malodorous discharge with maceration under pendulous breasts is likely:
Intertrigo
34
A woman has mildly elevated TSH and normal free T4. Diagnosis?
Subclinical hypothyroidism
35
The relationship between duodenal ulcer disease and H. pylori infection is:
very likely.
36
The most common presenting sign of Parkinson’s disease is:
tremor.
37
A patient is 86 years old and functions independently. He has hypertension, hyperlipidemia, BPH, and flare-ups of gout. His last colonoscopy was at age 76 years. What should he be advised about having a colonoscopy?
It is not advised in this patient at this time
38
A sexually active adolescent male has a warty growth on the shaft of his penis. It is painless. This is likely:
human papilloma virus.
39
A 32-year-old female was exposed to HIV after sexual intercourse. When do the majority of patients seroconvert if they are going to do so?
Within 3 months
40
A liability policy that pays claims even after the policy is no longer active is termed:
tail coverage.
41
A 35-year-old patient has the following laboratory values. How should they be interpreted?
The patient should consider Hepatitis B immunization.
42
Which statement about attention deficit disorder (ADD) is correct?
DSM V is used to diagnose a child with ADD.
43
What is the usual age of onset of symptoms for patients with bipolar disorder?
Between 15 and 30 years
44
Cranial nerve II could be evaluated in a young infant by assessing:
squinting response to bright light.
45
The incidence of pyelonephritis is:
less common than urinary tract infections.
46
A patient is taking a generic SSRI and reports intermittent nausea and mild headache since starting 5 days ago. How should the nurse respond?
These are typical complaints of patients who take SSRIs.
47
A patient has two fasting glucose values that were measured on two separate days in the same week. This patient:
has impaired fasting glucose.
48
A patient presents with sudden decreased visual acuity. Pupil is fixed and about 4mm. The affected eye is red. Etiology?
Glaucoma
49
The NP suspects that a pregnant patient may have been physically abused. The NP knows that:
abuse can worsen during pregnancy.
50
The first step in evaluating a breast lump is:
history and physical exam.
51
A patient taking candesartan for hypertension should avoid:
potassium supplements.
52
Babies up to one year of age are called:
infants.
53
The most common cause of pneumonia in an otherwise healthy 3-year-old child is:
a viral infection.
54
A patient with tick bite and red circle presents with myalgias and arthralgias. Best test for Lyme disease?
ELISA
55
Which statement below is true of infants with developmental dysplasia of the hip?
A palpable clunk is considered diagnostic.
56
A nurse practitioner is participating in Medicare. Medicare paid 80% of the charges. What about the other 20%?
The NP can bill the patient for a percentage of the remainder.
57
An older adult calls asking about a safe agent for runny nose and congestion. What is safe?
Guaifenesin
58
Which medication could potentially exacerbate heart failure (HF)?
Naproxen
59
Which medication used to treat diabetes is associated with diarrhea and flatulence?
Metformin
60
A patient may benefit from a tricyclic antidepressant (TCA) if they experience depression and:
chronic pain.
61
A 4-year-old diagnosed with measles has Koplik’s spots. These are:
found on the inside of the cheek and are granular.
62
A patient with diarrhea is tested for C. difficile. How soon should the enzyme immunoassay (EIA) yield results?
About 24 hours
63
Which findings suggest that a patient may be abusing alcohol?
Macrocytosis, tremulousness, hypertension
64
Impetigo is characterized by:
honey-colored crusts.
65
Medications considered first line to treat attention deficit disorder and attention deficit hyperactivity disorder are Schedule:
II.
66
A 2-year-old has a high fever and apparent seizure. Otitis media is diagnosed. How should the NP manage this?
Treat the otitis media and give education about fever management
67
The three most common causes of bacterial diarrhea in the US are Salmonella, Campylobacter, and:
Shigella.
68
Choose the number on the image that most closely approximates the location of a direct inguinal hernia.
1
69
The classic presentation of placenta previa is:
painless vaginal bleeding after the 20th week.
70
A patient has a urinary tract infection. What findings on urine dipstick best describe a typical urinary tract infection?
Positive leukocytes, positive nitrites
71
Serotonin is thought to play a role in the etiology of:
depression.
72
Which symptom can be used to rule out a fracture?
No symptom can rule out a fracture
73
An infant is brought to the NP because his gaze is asymmetrical. Which finding indicates a need for referral to ophthalmology?
He has persistent strabismus.
74
Which antibiotic should be used with caution if an older patient has cardiac conduction issues?
Ciprofloxacin
75
In a patient who is diagnosed with mastoiditis, which of the following is most likely?
Displaced pinna
76
Which statement is true about vitamin B12?
Inadequate amounts can produce cognitive changes.
77
A person with 20/60 vision:
has better vision than someone with 20/80 vision.
78
A 17-year-old presents with complaints of dysmenorrhea. Which finding suggests that this is secondary dysmenorrhea?
Dysmenorrhea is not limited to menses
79
What is true regarding the Shingrix herpes zoster vaccine given to adults at or after age 50?
It is an inactivated form of the virus.
80
The 'get up and go' test in an older adult patient is used to evaluate:
risk for falls.
81
A 24-year-old presents with fever, rhinorrhea, and paroxysmal, high-pitched cough. This is:
pertussis.
82
A 70-year-old presents for a well exam. What medication probably has no effect on screening for occult blood in the stool?
Acetaminophen
83
A patient has a positive hepatitis B surface antibody. This means he:
is immune to hepatitis B.
84
A 44-year-old nonsmoker is diagnosed with pneumonia. What antibiotic can be used for empirical treatment according to IDSA/ATS guidelines?
Amoxicillin
85
A common strategy used to minimize the incidence of side effects when giving an older adult a selective serotonin reuptake inhibitor (SSRI) is:
prescribe a low dose initially.
86
An example of a premalignant lesion that develops on sun-damaged skin is:
actinic keratosis.
87
What is the relationship between Hgb A1C and a diabetic patient’s lipid values?
As Hgb A1C decreases, triglycerides decrease.
88
Many older adults have cachexia. What characterizes this?
Illness and loss of muscle mass
89
Which of the following is NOT a risk factor for developing hepatitis B?
Consuming contaminated water
90
A 52 year old female presents with a palpable mass in her right breast. Last normal mammogram was 6 months ago. What is true?
It is probably a benign lesion.
91
Purulent discharge from puncta of the eye suggests:
dacryocystitis.
92
Lab values supporting suspicion of alcohol abuse include:
Elevated ALT, AST, and GGT
93
At what age would it be unusual to see thrush?
At birth
94
Asymptomatic pregnant patient with positive leukocytes and nitrites should be prescribed:
Nitrofurantoin (Macrobid).
95
What would benefit a 76-year-old on oral steroids for COPD and aspirin for MI prevention?
Daily proton pump inhibitor (PPI)
96
Chest circumference of a 12-month-old is:
equal to head circumference.
97
Most common cause of influenza in older adults is:
pneumonia.
98
Drug class used to treat BPH and provide immediate relief:
Alpha-1 blockers
99
Hypertension drug that may cause exercise intolerance:
metoprolol.
100
Earliest age to copy triangle, know colors, count fingers:
5 years
101
Test to confirm DDH in infant with positive Barlow and Ortolani:
Ultrasound of the hip
102
How should a college student with TB symptoms be screened?
A TB skin test
103
Symptom of pneumonia in asthmatic patient with upper right lobe findings:
Fever
104
Framingham cardiovascular study is an example of:
cohort study.
105
Test NOT suitable for diagnosing shingles when presentation is questionable:
Complete blood count (CBC)
106
Type of incontinence NOT helped by pelvic floor training:
Overflow
107
Medication that may have caused acute angioedema:
Fosinopril
108
Most characteristic finding of shingles:
Single dermatome affected
109
First sign of male puberty:
increase in testicular size.
110
Inguinal hernia in children history includes:
have a history of an intermittent bulge in the groin.
111
Asthma patient should avoid which medication?
Long-acting bronchodilator
112
Fasting instructions before hyperlipidemia screening:
to fast for 12-14 hours.
113
Thrush microscopy finding:
Budding yeasts, pseudohyphae
114
Age to receive rounded scissors and construction paper:
4 years
115
Tanner stage for 8-year-old female:
Stage 1
116
Most common skin cancer:
basal cell carcinoma.
117
Initial assessment for anhedonia in 86-year-old male:
Suicidal ideations
118
Symptom suggesting something other than gout:
Fever
119
What should be limited in diet for thalassemia minor patient?
Multivitamin with iron
120
Stage 4 breast development includes:
projection of areola and nipple to form a secondary mound above the level of the breast.
121
Albuterol inhaler education for COPD patient:
This may cause tachycardia
122
Naegle’s rule is calculated by:
adding 7 days and subtracting 3 months.
123
ACS recommendation for prostate cancer screening:
screening starting at 50 years of age.
124
Common side effect of diphenhydramine in older adults:
Next day sleepiness
125
Man fell and has medial malleolus tenderness. Next step?
X-ray of the foot and ankle
126
Best antihypertensive for 35-year-old Caucasian male:
Lisinopril in a 35-year-old Caucasian male
127
Diagnosis for child with 8–10 café au lait spots >1 cm:
neurofibromatosis.
128
Whiplash injury true statement:
Is identifiable on MRI or CT, but not X-ray.
129
Emphysema patient on inhaled steroids should:
should be screened for osteoporosis.
130
Swimmer’s ear symptom besides tragal tenderness:
Otic itching
131
Lab value most indicative of B12 deficiency:
Macrocytosis
132
Choice with no precautions for oral contraceptive use:
Varicose veins
133
Elderly male with urethral irritation after ruling out STD and UTI. Next likely cause?
Chronic prostatitis
134
Bell’s palsy typical finding:
Unilateral numbness of the cheek
135
NOT a cause of erythematous tympanic membrane:
Coughing
136
137
A child has 8-10 medium brown café au lait spots > 1 cm in diameter. The differential diagnosis should include:
neurofibromatosis.
138
A 4-year-old was diagnosed and treated for acute otitis media in the left ear 4 weeks ago. She is here today for a well-child visit. There is an effusion in the left ear. She denies complaints. How should this be managed?
This should be monitored.
139
According to the National Heart, Lung and Blood Institute, which characteristic listed below is a coronary heart disease (CHD) risk equivalent; that is, which risk factor places the patient at a CHD risk similar to a history of CHD?
Diabetes mellitus
140
A child’s resting heart rate is expected to be between 60 and 100 beats per minute once he reaches:
10 years of age.
141
The correlation between blood pressure and age greater than 60 years is that as age increases:
diastolic blood pressure decreases.
142
Most hypertension in preadolescents and children is:
secondary hypertension.
143
Which class of medications is NOT used for migraine prophylaxis?
Triptans
144
Which medication used to treat diabetes is associated with diarrhea and flatulence?
Metformin
145
Which laboratory abnormality commonly accompanies hypothyroidism?
Dyslipidemia
146
Which of the following increases the risk of cryptorchidism?
Premature birth
