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NURP 503 - Ex 2' COPY > Leik questions for weeks 4-7 > Flashcards

Leik questions for weeks 4-7 Flashcards

1
Q 
31. When an adolescent's penis grows more in length than width, in which of the following Tanner stages is he classified?
A. Tanner stage II
B. Tanner stage III
C. Tanner stage IV
D. Tanner stage V
A

B. Tanner stage III

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2
Q 
33. HPV infection of the laryngx has been associated with
A. laryngeal cancer
B. esophageal stricture
C. cervical cancer
D. metaplasia of the squamous cells
A

A. laryngeal cancer

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3
Q 
34. A 65 year old carpenter c/o morning stiffness and pain in both his hands and right knee upon awakening.  He feels some relief after warming up.  On exam, the NP notices the presence of Heberden nodes.  Which of the following is most likely.
A. osteoporosis
B. rheumatoid arthritis
C. osteoarthritis
D. reiter's syndrome
A

C. osteoarthritis

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4
Q 
41. a mother brings her 4 year old daughter, who just started attending preschool, to the health clinic.  She tells the NP that her child has been c/o burning and itching that started in her left eye.  Within 2 days it involved both eyes and the child developed a runny nose and sore throat.  During the PE, the child's eyes appear bilaterally injected with no purulent discharge.  The throat is red, the inferior nasal turbinates are swollen, and shotty nodes are palpated in front of each ear.  Which of the following is most likely
A. herpes keratitis
B. corneal ulcer
C. viral conjunctivitis
D. bacterial conjunctivitis.
A

C. viral conjunctivitis

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5
Q 
54. a 70 year old male patient c/o a bright red colored spot that has been present in his left eye for 2 days.  He denies eye pain, visual changes or headaches.  He has a new onset cough from a recent URI.  the only medicine he is taking is bayer aspirin 1 tab a day.
Which of the following is most likely
A. corneal abrasion
B. acute bacterial conjunctivitis
C. acute uveitis
D. subconjunctival hemorrhage
  1. which of the following actions is appropriate f/u for this patient?
    A. Refer patient to optometrist
    B. refer the patient to the ophthalmologist
    C. advise the patient that the condition is benign and will resolve spontaneously
    D. prescribe an ophthalmic antibiotic solution
A
  1. D. subconjunctival hemorrhage

55. C. advise the patient that the condition is benign and will resolve spontaneously

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6
Q 
58. The best test for diagnosing glaucoma is which of the following
A. fluorescein staining
B. tonometry
C. Snellen vision exam
D. the refractive index
A

B. tonometry

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7
Q
  1. A patient with a history of MVP is requesting prophylaxis before her dental surgery. Which of the following would you prescribe this patient
    A. amoxicilling a half hour before and 2 hours after procedure
    B. amoxicillin 1 hour before the procedure
    C. amoxicillin 1 hour before and 3 hours after the procedure
    D. prophylaxis is not recommended for this patient
A

D. prophylaxis is not recommended for this patient

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8
Q 
91. The first teeth to erupt during infancy are which of the following
A. first molars
B. second molars
C. incisors
D. canines
A

C. incisors

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9
Q
  1. a 14 year old female is worried that she has not started to menstruate like most of her friends. During the GYN exam, the NP tells the mother, who is in the room with the patient, that her daughter is starting Tanner stage II. What are the PE findings during this stage?
    A. breast buds and some straight pubic hair
    B. fully developed breasts and curly pubic hair
    C. breast tissue with the areola on a separate mound with curly pubic hair
    D. no breast tissue and no pubic hair
A

A. breast buds and some straight pubic hair

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10
Q
  1. a 28 y.o. male nurse of Hispanic descent reports a history of a cold that resolved 2 weeks ago except for a dry cough and pain over his right cheek that worsens when he bends down. The patient denies fever. He tells the employee health NP that he is very allergic to both Keflex (cephalexin) and erythromycin. The patients vital signs are temperature of 99.2 , pulse of 72 and respirations of 12. Which of the following conditions is most likely
    A. acute sinusitis
    B. acute bronchitis
    C. fever secondary to the previous viral URI
    D. hay fever
A

A. acute sinusitis

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11
Q 
119. During a routine PE of an elderly woman, a triangular thickening of the bulbar conjunctiva on the temporal side is noted to be encroaching on the cornea.  She denies any eye pain or visual changes.  Which of the following is most likely
A. corneal arcus
B. pterygium
C. pinguecula
D. chalazion
A

B. pterygium

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12
Q 
132. Which of the following viral infections is associated with occasional abnormal forms of lymphocytes during an acute infection
A. cytomegalovirus
B. Epstein barr virus
C. HPV
D. coxsackivirus
A

B. Epstein barr virus (mono)

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13
Q 
136. During the eye exam of a 50 year old hypertensive patient who is c/o an onset of a severe headache, you find that the borders of the disc margins on both eyes are blurred.  What is the name of this clinical finding
A. normal optic disc
B. optic neuropathy
C. papilledema
D. hypertensive retinopathy
A

C. papilledema

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14
Q 
138. The red reflex exam is used to screen for
A. cataracts
B. strabismus
C. blindness
D. blinking response
A

A. cataracts

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15
Q 
140. Which of the following findings is associated with the chronic use of chewing toabacco
A. cheilosis and xerostomia
B. glossitis
C. geographic tongue
D. leukoplakia and oral cancer
A

D. leukoplakia and oral cancer

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16
Q
  1. A NP is doing a fundoscopic exam on a 35 year old woman during a routine PE. He notices that she has sharp disc margins and a yellowish-orange color in the macular area. The ratio of veins to arteries 3:2. What is the next most appropriate action
    A. advise the patient that she had a normal exam
    B. advise the patient that she an abnormal exam
    C. refer the patient to the ER
    D. refer the patient to the ophthalmologist
A

A. advise the patient that she had a normal exam

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17
Q 
165. Which of the following lab tests is positive in a large number of patients with lupus (SLE)
A. Antinuclear antibody ANA
B. rheumatoid factor
C. antiparietal antibody
D. immunologlobulin
A

A. Antinuclear antibody ANA

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18
Q 
168. Which of the following would you recommend on an annual basis for an elderly patient with type 2 diabetes?
A. eye exam with ophthalmologist
B. follow up visit with a urologist
C. periodic visits to an optometrist
D. colonoscopy
A

A. eye exam with ophthalmologist

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19
Q 
171. Heberden's nodes are commonly found in which of the following diseases?
A. rheumatoid arthritis
B. degenerative joint disease
C. psoriatric arthritis
D. septic arthritis
A

B. degenerative joint disease (osteoarthritis)

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20
Q 
177. A test called the visual fields by confrontation is used to evaluate for:
A. peripheral vision
B. central distance vision
C. narrow angle glaucoma
D. accomodation
A

A. peripheral vision

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21
Q 
181. An elderly woman with a history of rheumatoid arthritis reports to the NP that she has been taking ibuprofen twice daily for many years.  All of the following organ systems are at risk of damage from chronic NSAIDs use except:
A. cardiovascular system
B. pulmonary system
C. gastrointestinal system
D. renal system
A

B. pulmonary system

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22
Q 
192. A small abscess on a hair follicle on the eyelid is called
A. a hordeolum
B. pterygium
C. pinguecula
D. ptosis
A

A. a hordeolum

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23
Q 
211. When evaluating a case of temporal arteritis, the ESR is expected to be
A. normal
B. lower than normal
C. elevated
D. indeterminate
A

C. elevated

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24
Q
  1. Atrophic macular degeneration of the aged is the leading cause of blindness in the elderly in the United States. Which of the following statements is correct?
    A. it is a slow or sudden painless loss of central vision
    B. it is a slow or sudden painless loss of peripheral vision
    C. it is an occlusion of the central retinal vein causing degeneration of the macular area
    D. it is commonly caused by diabetic retinopathy.
A

A. it is a slow or sudden painless loss of central vision

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25
Q 
252. What is the best procedure for evaluating a corneal abrasion?
A. tonometry
B. fluorescein stain
C. visual field test
D. funduscopy
A

B. fluorescein stain

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26
Q
  1. Which of the following is considered an objective finding in patients who have a case of suppurative otitis media?
    A. erythema of the tympanic membrane
    B. decreased mobility of the tympanic membrane measured by tympanogram
    C. displacement of the light reflex
    D. bulging of the TM
A

B. decreased mobility of the tympanic membrane measured by tympanogram

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27
Q 
279. All of the following abnormal lab results may be seen in patients with infectious mononucleosis except:
A. lymphocytosis
B. positive EBV
C. abnormal liver function tests
D. elevated creatinine level
A

D. elevated creatinine level

28
Q
  1. Which of the following is considered an abnormal result on a Weber test?
    A. lateralization to one ear
    B. no lateralization to either ear
    C. air conduction lasts longer than bone conduction
    D. bone conduction lasts longer than air conduction
A

A. lateralization to one ear

29
Q
  1. A woman at 32 weeks gestation has a positive throat culture for Streptococcus pyogenes (strep throat). She denies allergies but becomes very nauseated with erythromycin. Which of the following is the best choice for this pregnant patient.
    A. clarithromycin (biaxin)
    B. trimethoprim-sulfamethoxazole (Bactrim)
    C. ofloxacin
    D. penicillin (pen VK)
A

D. penicillin (pen VK)

30
Q 
289. A new patient who is a 40 year old female postal worker is being evaluated for c/o a new onset erythematous rash on both cheeks and the bridge of the nose, accompanied by fatigue.  She reports a history of Hashimoto's thyroiditis and is currently being treated with synthroid 1.25 mg daily.  Which of the following conditions is most likely?
A. atopic dermatitis
B. thyroid disease
C. lupus erythematosus
D. rosacea
A

C. lupus erythematosus

31
Q
  1. The following statements are all true regarding herpes zoster except:
    A. it is due to reactivation of latent varicella virus
    B. the typical lesions are bullae
    C. it is usually more in immunocompromised individuals
    D. infection of the trigeminal nerve ophthalmic branch can cause corneal blindness
A

B. the typical lesions are bullae

32
Q 
312. The NP notices a gray ring on the edge of both irises of an 80 year old woman. The patient denies visual changes or pain.  She reports that she has had the "ring" for many years.
Which of the following is most likely:
A. arcus senilis
b. pinguecula
C. peripheral cataracts
D. macular degeneration
  1. What is the clinical significance of this finding in a 35 year old patient?
    A. the patient has a higher risk of blindness
    B. the patient should be evaluated for hyperlipidemia
    C. the patient should be evaluated by an ophthalmologist
    D. The patient should be evaluated for acute glaucoma
A
  1. A. arcus senilis

313. B. the patient should be evaluated for hyperlipidemia

33
Q 
314. The cones in the retina of the eye are responsible for:
A. central vision
B. peripheral vision
C. night vision
D. color vision
A

D. color vision

34
Q
  1. The mother of a 16 year old boy is concerned that her son is not developing normally. On PE, the patient is noted to have small testes with no pubic hair or facial hair. What is the most appropriate statement to the mother:
    A. Her son is developing normally
    B. Her sons physical development is delayed and should be evaluated by a pediatric endocrinologist
    C. Her son should be rechecked in 3 months; if he still does not have secondary sex characteristics, a thorough hormonal workup should be initiatied
    D. Her son physiological development is slower than normal but is within the normal limit for his age group.
A

B. Her sons physical development is delayed and should be evaluated by a pediatric endocrinologist

35
Q 
331. All of the following are clinical eye findings found in some patients with chronic uncontrolled hypertension.  Which is not associated with this disorder?
A. AV nicking
B. copper wire arterioles
C. flame-shaped hemorrhages
D. microaneurysms
A

D. microaneurysms

36
Q
  1. Which of the following is the correct statement regarding the size of the arterioles and veins on the fundus of the eye
    A. the veins are larger than the arterioles
    B. the arterioles are larger than the veins
    C. the arterioles are half the size of the veins
    D. the veins and the arterioles are equal in size
A

A. the veins are larger than the arterioles

37
Q
  1. A woman who has recently been diagnosed with lupus complains that her hands and feet are always cold even in the summertime. Sometimes her fingertips become numb and turn a blue color. The fingertips eventually turn dark red in color. Which of the following is most likely:
    A. chronic arterial insufficiency
    B. this is a normal reaction when one feels very cold
    C. peripheral vascular disease
    D. Raynaud’s phenomenon
A

D. Raynaud’s phenomenon

38
Q
  1. A cauliflower-like growth with foul-smelling discharge is seen during the otoscopic exam of the left ear of an 8 year old boy with a history of chronic otitis media. The tympanic membrane and ossicles are not visible, and the patient seems to have difficulty hearing the NP’s instructions. Which of the following conditions is best described?
    A. chronic perforation of the TM with secondary bacterial infection
    B. chronic mastoiditis
    C. choleasteatoma
    D. cancer of the middle ear
A

C. choleasteatoma

39
Q
  1. You note that your 11 year old female patient is at Tanner stage II. You would advise her mother that menarche will probably start in
    A. 2 to 3 years
    B. 3 to 4 years
    C. 5 years
    D. it is dependent on the girls genetic makeup
A

A. 2 to 3 years

40
Q
  1. The NP does not need to obtain parental consent from all of the following patients except:
    A. a 17 year old who wants to be treated for a sexually transmitted infection
    B. A 12 year old who wants a serum pregnancy test
    C. A 15 year old who wants birth control pills
    D. a 14 year old who wants to be treated for dysmenorrhea
A

D. a 14 year old who wants to be treated for dysmenorrhea

41
Q 
456. An adolescent female's areola, nipples, and breast tissue develop and become elevated as one mound.  Which of the following is the correct Tanner stage for this phase of breast development?
A. Tanner stage I
B. Tanner stage II
C. Tanner stage III
D. Tanner stage IV
A

C. Tanner stage III

42
Q 
463. A 16 year old c/o a severe sore throat for 3 days along with a generalized rash and fever.  The skin has the texture of fine sandpaper.  This constellation of findings best describes
A. Kawasaki's disease
B. scarlatina
C. german measles
D. rubeola
A

B. scarlatina

43
Q 
468. Three of the following are eye findings associated with chronic uncontrolled hypertension.  Which of the following is associated with diabetic retinopathy
A. AV nicking
B. copper wire arterioles
C. flame-shaped hemorrhages
D. microaneurysms
A

D. microaneurysms

44
Q 
480. The Romberg test is done to check for problems with balance.  Which area of the brain is responsible for balance
A. frontal lobe
B. temporal lobe
C. midbrain
D. cerebellum
A

D. cerebellum

45
Q 
486. Systemic lupus erythematosus (SLE) is more common among patients from all of the following ethnic and racial backgrounds except:
A. African American
B. Asian
C. Hispanic
D. caucasian
A

D. caucasian

46
Q
  1. What type of testing is recommended before starting a patient ona prescription of hydroxychloroquine (plaquenil)
    A. CBC
    B. serum creatinine and urine for microalbumin
    C. Liver function tests
    D. Comprehensive eye exam
A

D. Comprehensive eye exam

47
Q
  1. An older man is diagnosed with conductive hearing loss in the left ear by the NP. Which of the following is the expected result when performing a Rinne test on this patient
    A. AC (air conduction) > BC (bone conduction)
    B. lateralization to the bad ear
    C. BC > AC
    D. lateralization to the good ear
A

C. BC > AC

48
Q 
562. A college student is seen as a walk in appointment in a college health clinic.  She c/o the abrupt onset of sore throat, nasal congestion, runny nose and malaise.  Vital signs are a temp of 99.8 F, pulse of 84, and repirations of 14.  The PE reveals an erythematous throat, swollen nasal turbinates, and rhinitis.  The NP suspects viral upper respiratory infection.  All of the following treatments are appropriate except
A. saline nasal spray 
B. Pseudoephedrine (Sudafed)
C. ibuprofen
D. oral prednisone (Medrol dose pack)
A

D. oral prednisone (Medrol dose pack)

49
Q 
511. Which of the following anatomic areas is involved with sensorineural hearing loss
A. outer ear
B. middle ear
C. inner ear
D. Cranial nerve VIII
A

C. inner ear

50
Q 
577. The NP suspects that a middle aged woman may have lupus (SLE).  Which of the following lab tests is most specific for the disease?
A. ESR
B. CRP
C. anti-nuclear antibody (ANA)
D. IgG antibody
A

C. anti-nuclear antibody (ANA)

51
Q 
579. A 68 year old woman has recently been diagnosed with polymyalgia rheumatica.  The NP is discussing the treatment options with the patient.  Which of the following medications is the first line treatment for this medication
A. etanercept (Enbrel)
B. oral prednisone
C. indomethacin
D. methotrexate
A

B. oral prednisone

52
Q 
582. Glucosamine sulfate is a natural supplement that is used for which of the following conditions
A. rheumatoid arthritis
B. osteoarthritis
C. osteoporosis
D. metabolic syndrome
A

B. osteoarthritis

53
Q 
587. Which of the following structures of the eyes is responsible for color vision
A. rods
b. macula
C. cones
D. pupils
A

C. cones

54
Q 
593. Which structure of the eye is responsible for 20/20 vision
A. rods
B. cones
C. optic disc
D. fovea of the macula
A

D. fovea of the macula

55
Q 
613. Which bacterium is the most common pathogen seen in otitis externa infections?
A. pseudomonas aeruginosa
B. streptococcus pyogenes
C. haemophilus influenza
D. Moraxella catarrhalis
A

A. pseudomonas aeruginosa

56
Q 
627. According to the US Preventative Services Task Force, which of the following tests should be used to screen for lung cancer
A. chest radiograph
B. bronchoscopy with biopsy
C. low dose computed tomography (LDCT)
D. sputum for cytology
A

C. low dose computed tomography (LDCT)

57
Q 
636. According to Erik Erikson, adolescents are at what psychosocial developmental stage
A. autonomy verus shame
B. industry versus inferiority
C. identity versus role confusion
D. intimacy versus isolation
A

C. identity versus role confusion

58
Q
  1. A 6 year old who attends preschool part time is brought to the clinic by her mother as a walk in patient. The mother reports that her daughter has recently begun swim lessons. The symptoms began on the left eye and spread to the second eye within 2 days. The child’s eyes are watery and crusted in the morning when she wakes up. Her vital signs are temp of 98.8, HR 90, respirations 16. The eye exam reveals bilateral injected conjunctiva. When the lower eyelid is examined, the NP notes that it is pink with a cobblestone appearance. There is ipsilateral preauricular adenopathy. All of the following treatment options are appropriate except
    A. prescribe a topical ophthalmic vasoconstrictor to be used 2x/day as need for up to 3 days to reduce redness
    B. Write a note excusing the child from school because she should not attend until the symptoms resolve
    C. prescribe ophthalmic topical antibiotic eye drops, two to three drops to be applied in each eye QID for 7 days
    D. Advise use of cool compress over closed eyes as needed for comfort, washing hands often with soap and water, and to avoid rubbing eyes or sharing towels
A

C. prescribe ophthalmic topical antibiotic eye drops, two to three drops to be applied in each eye QID for 7 days

59
Q 
663. A 36 year old woman c/o fatigue and headaches accompanied by widespread muscle and joint pain that started 6 months ago.  She reports insomnia and feeling tired even with adequate sleep.  She was diagnosed with major depression 1 year ago and is currently on escitalopram (Lexapro) 20mg po daily.  She is also taking a B complex vitamin and melatonin at bedtime for sleep.  During the PE, the NP notes bilateral areas of tender points on the neck, jaw, shoulders, chest, upper back, and greater trochanter.  The symptoms and physical exam findings are highly suggestive of which condition
A. rheumatoid arthritis
B. osteoarthritis
C. fatigue syndrome
D. fibromyalgia
A

D. fibromyalgia

60
Q 
668. A 4 year old boy diagnosed with acute otitis media returns in 48 hours with a possible rupture of the TM of the right ear.  The mother reports seeing pus and a small amount of blood on the pillow that morning.  The child states that his ear is no longer painful.  During the ear exam, the otoscope is used to visualize the TM, which has a perforation on the lower edge that is draining a small amount of purulent discharge.  All of the following topical ear medications should be avoided in patients with perforation of the TM except
A. gentamycin ear drops
B. ofloxacin ear drops
C. tobramycin ear drops
D. neomycin sulfate ear drops
A

B. ofloxacin ear drops

61
Q
  1. While performing a fundoscopic exam, the NP notices arteriovenous (AV) nicking on the patient’s retina. What causes AV nicking
    A. it is caused by an arteriole crossing a venule, which compresses the venule and causes it to bulge on each side
    B. it is associated with diabetic retinopathy
    C. it is caused by copper wire arteriole that becomes distended
    D. it occurs when the optic disc becomes ischemic
A

A. it is caused by an arteriole crossing a venule, which compresses the venule and causes it to bulge on each side

62
Q
  1. Bouchard’s nodes are associated with which of the following conditions
    A. osteoarthritis and rheumatoid arthritis
    B. osteoporosis and osteopenia
    C. degenerative joint disease
    D. autoimmune disorders
A

C. degenerative joint disease

63
Q
  1. A 17 year old high school student is diagnosed by the NP with serous otitis media of the left ear. He states that his nose is always congested because of dust mite allergy. His medical history includes allergic rhinitis and asthma.
    What is the expected result of the Rinne test in patients who have serous otitis media of the left ear
    A. Air conduction (AC) > Bone conduction (BC)
    B. BC > AC
    C. lateralization to the left ear
    D. sound is heard by both ears
  2. The student reports a history of chronic nasal congestion. He occasionally has fits of sneezing when he is in a dusty room. The NP is using an otoscope to examine his nasal tissue. The inferior nasal turbinates appear swollen and pale. Which of the following medications is considered first line treatment for allergic rhinitis
    A. azelastine (astelin) 1-2 sprays in each nostril twice a day
    B. saline nasal spray 1-2 sprays 4x/day as needed
    C. cetirizine (Zyrtec) one 5-mg tablet at bedtime
    D. budesonide (rhinocort) 1-2 sprays in each nostril twice a day
A
  1. B. BC > AC

677. D. budesonide (rhinocort) 1-2 sprays in each nostril twice a day

64
Q
  1. Bouchard’s nodes are associated with which of the following conditions
    A. osteoarthritis and rheumatoid arthritis
    B. osteoporosis and osteopenia
    C. degenerative joint disease
    D. autoimmune disorders
A

A. osteoarthritis and rheumatoid arthritis

65
Q 
713. The 2013 American College of Cardiology (ACC)/American Heart Association (AHA)/Arteriosclerotic Cardiovascular Disease (ASCVD) risk calculator measures the risk of a cardiovascular event within 10 years after measurement.  What is the cutoff value when treatment for hyperlipidemia is recommended
A. 6.5% or higher
B. 7.5% or higher
C. 8% or higher
D. 10% or higher
A

B. 7.5% or higher
The estimated 10 year ASCVD risk score is 7.5
% or higher. The 2013 ACC/AHA guidelines recommend treatment with high intensity statins for patients aged 40-75 years with very high low density lipoprotein (LDL) values who have a score of 7.5% or higher.

NURP 503 - Ex 2' COPY (23 decks)

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