PRACTICE TEST 2 - PART A

Question 1

75 YO FEMALE C/O HEART KEEPS SKIPPING BEATS AND GOES VERY FAST. PT ALSO REPORTS DIZZINESS AND SOB, ESPECIALLY WITH ACTIVITY. PUSLE 120 AND IRREGULAR. NP ORDERS A 12-LEAD EKG AND CONSIDERS ECHOCARDIOGRAM. NP WILL LIKELY PRESCRIBE WHAT MEDICATION?

Answer 1

WARAFIN

Question 2

WARFARIN IS AKA

Answer 2

COUMADIN

Question 3

75 YO FEMALE C/O HEART KEEPS SKIPPING BEATS AND GOES VERY FAST. PT ALSO REPORTS DIZZINESS AND SOB, ESPECIALLY WITH ACTIVITY. PUSLE 120 AND IRREGULAR. NP ORDERS A 12-LEAD EKG AND CONSIDERS ECHOCARDIOGRAM. NP WILL LIKELY PRESCRIBE WHAT DOSAGE?

Answer 3

2.5 MG DAILY CUMADIN

Question 4

YOUNG ADULT MALE VISITS CLINIC AFTER FALLING ON BUTTOCKS. C/O FEELING ELECTRICAL IMPULSES TRAVELING DOWN BOTH LEGS AND INABILITY TO URINATE. NP NOTES DECREASED LOWER EXTREMITY STRENGTH/REFLEXES. LIKELY DX?

Answer 4

CAUDA EQUINA SYNDROME. THIS IS ACUTE ONSET SADDLE ANESTHESIA THAT AFFECTS NERVE ROOTS FROM L1 TO L5 AND S1 TO S5. SYMPTOMS MAY INCLUDE BLADDER INCONTINENCE OR RETENTION, FECAL INCONTINENCE, WEAKNESS AND BILATERAL LEG NUMBNESS.

Question 5

35 YO PT IS BEING WORKED UP FOR MICROSCOPIC HEMATURIA. WHICH IS NOT A DX OF MICROCOPIC HEMATURIA: KIDNEY STONES, BLADDER CANCER, ACUTE PYELONEPHRITIS, RENTAL ARTERY STENOSIS

Answer 5

RENAL ARTERY STENOSIS.

Question 6

35 YO PT IS BEING WORKED UP FOR MICROSCOPIC HEMATURIA. WHICH IS NOT A DX OF MICROCOPIC HEMATURIA: KIDNEY STONES, BLADDER CANCER, ACUTE PYELONEPHRITIS, RENAL ARTERY STENOSIS

Answer 6

RENAL ARTERY STENOSIS.

Question 7

WHAT IS RENAL ARTERY STENOSIS?

Answer 7

NARROWING OF THE KIDNEY ARTERIES.

Question 8

RENAL ARTERY STENOSIS COMMONLY NOTED IN PT OF WHAT AGE?

Answer 8

OLDER THAN 50

Question 9

RENAL ARTERY STENOSIS ASSOCIATED WITH WHAT 2 CONDITIONS?

Answer 9

HTN, ATHEROSCLEROSIS

Question 10

22 YO FEMALE WITH SIGNS OF BROKEN ARM STATING SHE FELL AT HOME. NP OBSERVES NUMEROUS BRUISES IN VARIOUS STAGES OF HEALING. PTS BOYFRIEND RESPONDS AGGRESSIVELY TO ALL QUESTIONS POSED TO PT. WHAT IS APPROPRIATE INTERVENTION?

Answer 10

INFORM BOYFRIEND REMAINDER OF EXAM MUST BE PRIVATE, SHOW HIM TO WAITING AREA AND TELL HIM HE WILL BE RETRIEVED WHEN EXAM COMPLETED.

Question 11

13 YO MALE PRESENTS WITH BACK PAIN AND N/V FOR PAST 24 HOURS. PT REPORTS FEELING A DULL PAIN AND MUSCLE SPASM IN BACK AFTER A DIRECT HIT TO THE SIDE DURING FOOTBALL. VITAL SIGNS ARE 140/84, 99.1F, P 98, RR 26. WHAT IS DX?

Answer 11

BRUISED KIDNEY. DIRECT HIT TO SIDE OF BODY INDICATES POTENTIAL BRUISED KIDNEY.

Question 12

1ST LINE MEDICATION FOR TINEA UNGUIUM

Answer 12

ORAL TERBINAFINE.

Question 13

ORAL TERBINAFINE IS AKA

Answer 13

LAMISIL.

Question 14

WHAT IS TINEA UNGUIUM

Answer 14

FUNGAL INFECTION OF THE NAILS, USUALLY THE GREAT TOE. THE TOENAIL BECOMES YELLOW AND THICKENED. MAY SEPARATE FROM THE NAIL BED.

Question 15

ELDERLY PT BURNED WHEN POT OF BOILING WATER FELL OFF THE STOVE. ACCORDING TO LUND-BROWDER CHART, PT HAS REDDENED SKIN AND SEVERAL BULLAE ON 4% OF ABD AREA. PT IS ALLERGIC TO SULFA. WHAT IS MOST APPROPRIATE INTERVENTION?

Answer 15

TREAT WITH BACITRAIN ZINC. PT HAS 2ND DEG BURN BECAUSE PT IS OLDER THAN 50 AND TOTAL BODY SURFACE BURNED WAS < 5%.

Question 16

ELDERLY PT BURNED WHEN POT OF BOILING WATER FELL OFF THE STOVE. ACCORDING TO LUND-BROWDER CHART, PT HAS REDDENED SKIN AND SEVERAL BULLAE ON 4% OF THE ABD AREA. WHAT DEGREE BURN IS THIS?

Answer 16

PT HAS 2ND DEG BURN BECAUSE PT IS OLDER THAN 50 AND TOTAL BODY SURFACE BURNED WAS < 5%.

Question 17

ELDERLY PT BURNED WHEN POT OF BOILING WATER FELL OFF THE STOVE. ACCORDING TO LUND-BROWDER CHART, PT HAS REDDENED SKIN AND SEVERAL BULLAE ON 4% OF ABD AREA. PT IS ALLERGIC TO SULFA. WHAT IS THE MOST APPROPRIATE INTERVENTION?

Answer 17

TREAT WITH BACITRAIN ZINC.

Question 18

ASIAN MOTHER WITH NEWBORN PRESENTS TO CLINIC. NP NOTES BLACK COLORED PATCHES ON NEWBORNS LUMBOSACRAL AREA. HOW WILL THE NP DOCUMENT THESE FINDINGS?

Answer 18

MONGOLIAN SPOTS.

Question 19

MONGOLIAN SPOTS MOST COMMON TYPE OF SKIN LESION IN NEONATES OF WHAT RACE?

Answer 19

ASIAN

Question 20

WHICH ANTIPSYCHOTIC MED IS MOST LIKELY TO PRODUCE EXTRAPYRAMIDAL EFFECTS

Answer 20

HALOPERIDOL (HALDOL). FIRST GENERATION ANTIPSYCHOTIC DRUGS (HALOPERIDOL/HALDOL) ARE POTENT ANTAGONISTS OF D2, D3 AND D4 RECEPTORS. MAY PRODUCE EXTRAPYRAMIDAL SIDE EFFECTS BECAUSE OF THE BLOCKING OF THE D2 RECEPTORS.

Question 21

TODDLER WITH CONGENITAL HEART DZ SEEN FOR A 1 WEEK HISTORY OF FACIAL AND LOWER EXTREMITY EDEMA ACCOMPANIED BY SOB. CHILD APPETITE POOR. CXR REVEALS CHILD HAS CHF. WHICH HEART SOUNDS ARE FOUND IN PATIENTS WITH CHF?

Answer 21

S1, S2 AND S3

Question 22

14 YO MALE PT ACUTE PAIN IN LEFT TESTICLE RADIATING TO THE LOWER ABD LASTING FOR 2 HOURS. BEST INTERVENTION?

Answer 22

COLOR DOPPLER ULTRASONOGRAPHY

Question 23

TESTICULAR TORSION IS A MEDICAL EMERGENCY. T/F

Answer 23

TRUE

Question 24

ALL BLOOD FOR THE TESTICLE COMES THROUGH THE SPERMATIC CORD. T/F

Answer 24

TRUE

Question 25

IF A PT HAS TESTICULAR TORSION, BLOOD SUPPLY MUST BE RESTORED TO TESTICLE WITHIN 6 HOURS. WHAT HAPPENS IF IT IS NOT RESTORED?

Answer 25

THE TESTICLE WILL SHRINK (ATROPHY)

Question 26

67 YO FEMALE PT C/O DYSPNEA, MINIMAL COUGH, 10LB WEIGHT LOSS OVER PAST 3 MONTHS. NP NOTES DECREASED POSTERIOR BREATH SOUNDS, THE USE OF ACCESSORY MUSCLES TO BREATHE, TEMP 98.8, RR 24. NP SUSPECTS?

Answer 26

EMPHYSEMA.

Question 27

WHAT 3 SYMPTOMS DOES EMPHYSEMA PRESENT?

Answer 27

SOB, MINIMAL COUGH, DECREASED HEART/LUNG SOUNDS

Question 28

WHAT 3 SYMPTOMS DOES CHRONIC BRONCHITIS PRESENT?

Answer 28

PRODUCTIVE COUGH, WHEEZING, COURSE CRACKLES.

Question 29

MIDDLE AGE MALE PT WITH HX OF CLUSTER HA ARRIVES FOR TX. WHAT 2 INTERVENTIONS ARE INCLUDED IN ACUTE TX PLAN?

Answer 29

FINTRANASAL 4% LIDOCAINE AND 100 OXYGEN VIA MASK.

Question 30

CLUSTER HA ARE MOST PREVALENT IN MIDDLE AGED MEN BETWEEN WHAT AGES?

Answer 30

30-40

Question 31

PT WITH MIGRAINE HA CAN BE TREATED WITH ICE PACK TO FOREHEAD AND DARK ROOM THEREAPY. T/F.

Answer 31

TRUE

Question 32

WHAT DRUG IS HELPFUL FOR MUSCLE TENSION HA?

Answer 32

ACETAMINOPHEN OR NSAIDs

Question 33

MIDDLE AGE FEMALE PRESENTS WITH COMPLAINTS OF WEIGHT GAIN, CONSTIPATION, AND ALOPECIA OF THE EYEBROWS. SERUM CHOLESTEROL IS 247 MG/DL AND THYROID PEROXIDASE TPO IS 161 IU/ML. WHAT IS LIKELY DX?

Answer 33

HASHIMOTO THYROIDITIS.

Question 34

HASHIMOTO THYROIDITIS IS AN AUTOIMMUNE DISORDER. T/F

Answer 34

TRUE

Question 35

WHAT IS GOLD STANDARD FOR DX HASHIMOTO THYROIDITIS?

Answer 35

THYROID PEROXIDASE (TPO) LEVELS

Question 36

THROID CANCER PRESENTS WITH HOARSENESS AND PROBLEMS SWALLOWING (DYSPHAGIA, DYSPNEA, COUGH) T/F.

Answer 36

TRUE

Question 37

OVERWEIGHT MALE TEENAGER PRESENTS WITH C/O FATIGE / LETHARGY. HE HAS BEEN FALLING ASLEEP IN SCHOOL. UPON EXAM, HE IS FOUND TO BE HYPERTENSIVE WITH AVG BLOOD PRESSURE OF 164/92. NP SUSPECTS SECONDARY HTN. WHAT 3 CONX CAN CAUSE SECONDARY HTN?

Answer 37

RENAL DISORDER (POLYCYSTIC KIDNEY, CHRONIC KIDNEY DZ), ENDOCRINE DISORDER (HYPERTHROIDISM, HYPERALDOSTERONISM, PHEOCHOMOCYTOMA), AND RESPIRATORY (SLEEP APNEA).

Question 38

DO MUSCULOSKELETAL DISORDERS CAUSE HTN?

Answer 38

NO

Question 39

ADULT PT STEPPED ON NAIL WHICH PUNCTURED SNEAKER. SHE NOW HAS A SWOLLEN DIFFUSE PINKISH-RED WARM FOOT. WHAT GRAM NEGATIVE PATHOGEN IS MOST LIKELY THE CAUSE OF THIS INFECTION?

Answer 39

PSEUDOMONAS AERUGINOSA. PUNCTURE WOUNDS OF THE FOOT MAY BECOME INFECTED WITH P. AERUGINOSA (GRAM NEGATIVE) BY THE FOAM MATERIAL FROM SNEAKERS, ULTIMATELY CAUSING CELLULITIS.

Question 40

P. MULTOCIDA IS A GRAM-NEGATIVE PATHOGEN THAT IS PRESENT IN DOG/CAT BITES. T/F

Answer 40

TRUE

Question 41

PT WITH PICKS DZ FELL OUT OF BED AND HIT HEAD ON TABLE. PT NOT ON ANTICOAGULANT THERAPY AND IS ALERT AND ORIENTED. PT VITALS: BP 188/90, P 43, RR 7. WHAT IS DX?

Answer 41

INCREASED INTRACRANIAL PRESSURE. PT VITALS REVEAL INCREASED ICP. WITH INCREASED ICP, SYSTOLIC BP INCREASES, AND RESPIRATIONS DECREASE.

Question 42

INCREASED INTRACRANIAL PRESSURE (ICP) IS KNOWN AS __________ TRIAD.

Answer 42

CUSHINGS TRIAD

Question 43

A CVA OR STROKE IS CAUSED BY AN EMBOLUS/TROMBUS OR A HEMORRHAGE. T/F

Answer 43

TRUE

Question 44

PIOGLITAZONE (ACTOS) IS CONTRAINDICATED IN PTS WITH WHAT CONDITION?

Answer 44

CLASS III OR CLASS IV HEART DISEASE. PIOGLITAZONE (ACTOS) IS CONTRAINDICATED BECAUSE IT CAUSES WATER RETENTION.

Question 45

82 YR OLD PT IN CLINIC FOR ANNUAL EXAM. PT REQUESTS COLONOSCOPY TO SCREEN FOR COLON CANCER. WHAT IS AN APPROPRIATE THERAPEUTIC RESPONSE OF NP?

Answer 45

TELL ME WHAT YOU KNOW ABOUT COLONOSCOPY AND WHY YOU FEEL IT IS IMPORTANT. SCREENINGS SHOULD BE BASED ON EVIDENCE-BASED GUIDELINES BUT THE NP MUST ALSO INVOLVE THE PT IN THE DECISION MAKING PROCESS TO ENSURE THEIR AUTONOMY IS MAINTAINED.

Question 46

MIDDLE-AGED MALE HAS RIGHT EYELID PAIN X 24 HOURS. DENIES VISION CHANGE OR DISCHARGE FROM THE EYE. UPON EXAMINATION, NP NOTES A PAINFUL SWOLLEN RED ABSCESS ON THE UPPER RIGHT EYELID. WHAT SHOULD NP DO NEXT?

Answer 46

INITIATE HOT COMPRESSES TID.

Question 47

MIDDLE-AGED MALE HAS RIGHT EYELID PAIN X 24 HOURS. DENIES VISION CHANGE OR DISCHARGE FROM THE EYE. UPON EXAMINATION, NP NOTES A PAINFUL SWOLLEN RED ABSCESS ON THE UPPER RIGHT EYELID. WHAT IS DX?

Answer 47

PT HAS A HORDEOLUM OR STYE.

Question 48

INITIAL TX FOR PT WITH MILD ALLERGIC CONJUNCTIVITIS?

Answer 48

TOPICAL ANTIHISTAMINES/MAST CELL STABILIZERS

Question 49

WHAT CAUSES MILD ALLERGIC CONJUNCTIVITIS

Answer 49

MILD ALLERGIC CONJUNCTIVITIS OCCURS BECAUSE OF MAST CELL RESPONSE TO AN ALLERGEN.

Question 50

NSAIDS ARE THE FIRST LINE OF TX FOR MILD ALLERGIC CONJUNCTIVITIS. T/F

Answer 50

FALSE. TOPICAL ANTIHISTAMINES/MAST CELL STABILIZERS ARE THE INITIAL TREATMENT FOR SIGNS OF MILD ALLERGIC CONJUNCTIVITISF.

Question 51

FIRST LINE TX FOR PT WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) - CATEGORY B AND C?

Answer 51

LONG-ACTING MUSCARINIC AGONIST (LAMA).

Question 52

FIRST LINE TX FOR PT WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) - CATEGORY A?

Answer 52

SABA IS RECOMMENDED

Question 53

RESULTS OF A PAP TEST ON 21 YO WOMAN STATE "ATYPICAL SQUAMOUS EPITHELIAL CELLS PRESENT. NO ENDOCERVICAL CELLS PRESENT." WHAT IS NP'S NEXT STEP?

Answer 53

REPEAT TEST ASAP. THE SPECIMEN IS UNSATISFACTORY. A SPECIMEN IS SATISFACTORY ONLY WHEN BOTH SQUAMOUS EPITHELIAL CELLS AND ENDOCERVICAL CELLS ARE PRESENT.

Question 54

NP ASSESSING CEREBELLAR SYSTEM OF OLDER ADULT WITH ATAXIA. DURING EXAM, PT HAS POSITIVE ROMBERG'S TEST. WHAT DOES THIS INDICATE?

Answer 54

PT UNABLE TO STAND WITH EYES CLOSED AND ARMS BY SIDE WITHOUT SWAYING OR FALLING.

Question 55

WHAT 3 SENSES ARE NEEDED TO MAINTAIN BALANCE WHILE STANDING?

Answer 55

PROPRIOCEPTION, VESTIBULAR FUNCTION, VISION

Question 56

CHILD WITH ECZEMA WAS TREATED WITH OTC 1% HYDROCORTISONE OINTMENT. RASH DOES NOT SEEM TO BE IMPROVING. WHAT LEVEL STEROID SHOULD THE NP PRESCRIBE NEXT?

Answer 56

GROUP 6. PT IS CURRENTLY USING POTENCY GROUP 7 (OTC TOPICAL HYDROCORTISONE)

Question 57

GROUP 7 POTENCY OF OTC TOPICL HYDROCORTISONE IS WHAT PERCENTAGE CONCENTRATION?

Answer 57

0.5 - 1.0%

Question 58

INFANT WITH FAUN TAIL NEVUS AT THE LUMBOSACRAL AREA. WHAT PROCEDURE SHOULD BE ORDERED FIRST?

Answer 58

ULTRASOUND TO ASSESS FOR NEURAL TUBE DEFECTS (SPINA BIFIDA)

Question 59

DURING THE BREAST EXAM OF 30 YO NULLIPAROUS WOMAN, NP PALPATES SEVERAL RUBBERY MOBILE AREAS OF BREAST TISSUE. SLIGHTLY TENDER TO PALPATION. BOTH BREASTS HAVE SYMMETRIC FINDINGS. NO SKIN CHANGES OR NIPPLE DISCHARGE. PT IS EXPECTING A MENSTRUAL PERIOD IN 5 DAYS. NP WILL:

Answer 59

ADVISE PT TO RETURN 1 WEEK AFTER HER PERIOD SO BREASTS CAN BE RECHECKED. SYMPTOMS OF FIBROCYSTIC BREAST DZ INCLUDE CYCLIC TENDERNESS WITH PROMINENT BREAST TISSUE THAT IS PRESENT IN BOTH BREASTS. SYMPTOMS ARE WORSE ABOUT 1 WEEK BEFORE MENSES. SYMPTOMS RESOLVE AFTER MENSES STARTS.

Question 60

35 YO SMOKER EVALUATED FOR BIRTH CONTROL CHOICES. PT HAS HX OF PELVIC INFLAMMATORY DISEASE (PID) AND EMNBOLIC EPISODE AFTER THE LAST PREGNANCY. NP WILL RECOMMEND:

Answer 60

CONDOMS AND VAGINAL SPONGE.

Question 61

NAME 3 CONTRAINDICATIONS OF HORMONAL CONTRACEPTION (BIRTH CONTROL PILLS)

Answer 61

MIGRAINE HA, SMOKING, OBESITY IN WOMEN OLDER THAN 35

Question 62

WHAT DOES A POTASSIUM HYDROXIDE (KOH) PREP HELP THE NP DX?

Answer 62

FUNGAL INFECTIONS. KOH PREP TEST IS PERFORMED TO EVALUATE FOR TINEA OR CANDIDA (YEAST) INFECTION OF SKIN.

Question 63

10 YO PT PRESENTS WITH EXTERNAL PAIN, SWELLING, AND DECREASED HEARING IN THE LEFT EAR. CHILD ON THE SWIM TEAM AND PRACTICES DAILY. UPON EXAM, THE CHILD FLINCHES WHEN THE AFFECTED EAR IS TOUCHED. NO OTHER ABNORMAL FINDINGS. DX?

Answer 63

OTITIS EXTERNA (SWIMMERS EAR)

Question 64

AUSCULTATION OF NORMAL BREATH SOUNDS OF THE CHEST WILL REVEAL WHAT?

Answer 64

VESICULAR BREATH SOUNDS IN THE LOWER LOBE.

Question 65

WHERE ARE BRONCHIAL BREATH SOUNDS BEST HEARD?

Answer 65

SECOND AND THIRD INTERCOSTAL SPACES.

Question 66

WHERE ARE TRACHEAL BREATH SOUNDS BEST HEARD?

Answer 66

OVER THE TRACHEA.

Question 67

MOST COMMON SIGN OF ALLERGIC RHINITIS?

Answer 67

TRANSVERSE NASAL CREASE.

Question 68

WHAT CAUSES TRANSVERSE NASAL CREASE?

Answer 68

FREQUENT RUBBING AND WIPING AWAY OF NASAL DISCHARGE.

Question 69

ALLERGIC RHINITIS GENERALLY PRODUCES CLEAR NASAL DISCHARGE. T/F

Answer 69

TRUE (UNLESS THERE IS ALSO SINUSITIS)

Question 70

TX FOR PARTNER OF 22 YO PT WHO HAS A POSITIVE NUCLEIC ACID AMPLIFICATION TEST?

Answer 70

AZITHROMYCIN 1G PO -ONE TIME DOSE.

Question 71

WHAT DOES A POSITIVE NUCLEIC ACID AMPLIFICATION TEST INDICATE?

Answer 71

CHLAMYDIA TRACHOMATIS

Question 72

PT RECEIVING THYROID REPLACEMENT THERAPY CONTRACTS THE FLU AND FORGETS TO TAKE HER THYROID REPLACEMENT MEDICINE. PT IS AT RISK FOR WHAT LIFE-THREATENING COMPLICATION?

Answer 72

MYXEDEMA COMA.

Question 73

WHAT MAY DEVELOP WITH THE ABRUPT CESSATION OF THYROID REPLACEMENT THERAPY?

Answer 73

MYXEDEMA COMA

Question 74

WHAT PROCEDURE WILL NP DO TO PERFORM SCREENINGS FOR SCOLIOSIS?

Answer 74

ASK PT TO STAND FIRMLY ON BOTH FEET AND BEND FORWARD AT HPS WHILE ARMS HANG FREE. NP EXAMINES ADOLESCENT FROM BEHIND, CHECKING FOR ASYMMETRY OF SHOULDERS, SCAPULAE AND HIPS.

Question 75

10 YO FEMALE PT CONCERNED ABOUT DX OF ACTINIC KERATOSIS. WHAT IS EXPLANATION OF THIS CONDX?

Answer 75

IT IS A PRECANCEROUS LESION AND NEEDS TO BE FOLLOWED UP WITH HER DERMATOLOGIST.

Question 76

HOW DOES ACTINIC KERATOSES PRESENT?

Answer 76

SMALL, RAISED SKIN LESIONS, THAT RESULT FROM EXTENDED SUN EXPLOSURE. CAN DEVELOP INTO SKIN CANCER.

Question 77

4 YO PT PRESENTS WITH HIGH FEVER AND ENLARGED LYMPH NODES IN NECK AREA. NP NOTES DRY, CRACKED LIPS AND STRAWBERRY TONGUE. WHAT IS LIKELY DX?

Answer 77

KAWASAKI DZ.

Question 78

KAWASAKI DZ OCCURS IN CHILDREN UNDER WHAT AGE?

Answer 78

UNDER 5 YRS OF AGE.

Question 79

DURING THE RECTAL EXAM OF 55 YO MALE, A FIXED NODULE IS DETECTED ON THE PROSTATE GLAND. PT HAS A PSA OF 4.1. WHAT SHOULD NP ORDER?

Answer 79

TRANSRECTAL ULTRASOUND GUIDED NEEDLE BIOPSY.

Question 80

PSA OF > OR = TO 4 INDICATES FOR BIOPSY IN MEN OVER WHAT AGE?

Answer 80

50 YRS OLD

Question 81

LAB RESULTS OF FEMALE PT WHO STATES SHE HAS HAD ONE MENSTUAL PERIOD OVER THE LAST YEAR AND IS EXPERIENCING PROBLEMS SLEEPING. PT LAB RESULTS INCLUDE ESTRADIOL LEVEL OF 200 PG/ML, FOLLICLE STIMULATING HORMONE (FSH) OF 35, AND ANTI MULLERIAN HORMONE (AMH) LEVEL OF .2. WHAT DO THESE FINDINGS INDICATE?

Answer 81

LAB RESULTS INDICATE PT IS PERIMENOPAUSAL. THE ESTRADIOL LEVEL REFLECTS A PERIMENOPAUSAL STATE.

Question 82

MENOPAUSE IS DX AFTER THE MENSTRUAL PERIOD HAS BEEN ABSENT FOR HOW MANY MONTHS?

Answer 82

12 MONTHS

Question 83

PARENT OF 5 YR OLD STATES CHILD HAS HAD A RASH FOR THE PAST WEEK AND CANNOT STOP SCRATCHING IT. PHYSICAL ASSESSMENT REVEALS 1MM PAPULES AND PUSTULES, GRAYISH WHICH BURROWS ON CHILD'S PALMS AND SOLES OF FEET, AND EXCORIATED SKIN WITH HONEY COLORED CRUSTING ON THE FACE AND NECK. THE NP WILL PRESCRIBE WHAT MED?

Answer 83

TOPICAL PERMETHRIN (ELIMITE). ASSESSMENT FINDINGS ARE CONSISTENT WITH SCABIES. THIS REQUIRES APPLICATION OF A SCABICIDE SUCH AS TOPICAL PERMETHRIN.

Question 84

WHAT MED IS USED TO TREAT CANDIDAL INFECTIONS?

Answer 84

TOPICAL NYSTATIIN

Question 85

PT DIAGNOSED WITH IBS tells NP THAT OVER PAST FEW MONTHS SHE HAS EXPERIENCED FREQUENT BOUTS OF CONSTIPATION. WHAT PRESCRIPTION SHOULD BE ADDED TO TX PLAN?

Answer 85

LUBIPROSTONE (AMITIZA). LUBIPROSTONE IS A CHLORIDE CHANNEL ACTIVATOR APPROVED FOR THE TX OF IBS WITH CONSTIPATION IN ADULTS.

Question 86

22 YO MALE PT PRESENTS WITH KNEE PAIN. NP PERFORMS MCMURRAYS TEST. A POSITIVE SIGN INDICATES WHAT CONDX?

Answer 86

MENISCAL TEAR.

Question 87

WHAT TEST IS USED FOR ANTERIOR CRUCIATE LIGAMENT TEAR?

Answer 87

THE LACHMANS TEST OR ANTERIOR DRAWER TEST.

Question 88

68 YO FEMALE RECENTLY DIAGNOSED WITH POLYMALGIA RHEUMATICA (PMR). NP IS DISCUSSING TX OPTIONS. WHAT IS FIRST LINE TREATMENT FOR PMR?

Answer 88

ORAL PREDNISONE.

Question 89

WHAT TYPE OF STEROID IS ORAL PREDNISONE?

Answer 89

ORAL CORTICOSTERIOD

Question 90

WHAT LAB TEST IS A SENSITIVE TEST FOR RENAL FUNCTION?

Answer 90

ESTIMATED GLOMERULAR FILTRATION RATE (EFGR). GFR CAN BE ESTIMATED FROM SERUM CREATININE.

Question 91

WHAT TEST IS USED TO MEASURE AND MONITOR KIDNEY FUNCTION AND EVALUATE CHRONIC KIDNEY DISEASE?

Answer 91

(GLOMERULAR FILTRATION RATE (GFR) TEST

Question 92

4 YR OLD UNABLE TO ATTEND PRESCHOOL DUE TO LACK OF MOTOR SKILLS. WHAT 3 TACTICS CAN BE USED TO DETERMINE APPROPRIATE GROWTH AND DEVELOPMENT OF PT?

Answer 92

TRACE SIMPLE OBJECTS (CIRCLE), RUN, CLIMB STEPS, THROW A BALL.

Question 93

4 YR OLD UNABLE TO ATTEND PRESCHOOL DUE TO LACK OF MOTOR SKILLS. WHAT TACTICS CANNOT BE USED TO DETERMINE APPROPRIATE GROWTH AND DEVELOPMENT OF PT?

Answer 93

CATCH A BALL

Question 94

82 YO MALE PENILE GLAND AND FORESKIN ARE INFLAMED. REDDENED, MOIST MACULAR LESION IS PRESENT ON THE PREPUCE. PT IS BEING TREATED FOR A UTI WITH AMOXICILLIN. NEXT STEP?

Answer 94

OBTAIN SWAB OF THE LESION FOR POTASSIUM HYDROXIDE (KOH) PREP. NOTE: PT HAS SYMPTOMS ASSOCIATED WITH BALANOPOSTHTIIS. FUNGAL INFECTIONS ARE COMMON WHEN ANTIBIOTICS ARE USED.

Question 95

PT PRESENTS WITH PAINFUL URINATION, LOWER ABD PAIN, INCOMPLETE BLADDER ELIMINATION, AND CLOUDY URINE. NP WILL ...

Answer 95

ORDER URINE CULTURE AND SENSITIVITY FOR ESCHERICHIA COLI.

Question 96

THE MAJORITY (75-90%) OF UTIs ARE CAUSED BY WHAT BACTERIA?

Answer 96

E. COLI.

Question 97

WHAT IS THE CAUSE OF MANY DIGESTION-RELATED INFECTIONS?

Answer 97

C. DIFFICILE

Question 98

WHAT MED IS USED TO TREAT PT WITH A POSITIVE FINKELSTEIN TEST?

Answer 98

IBUPROFEN.

Question 99

FINKELSTEIN TEST USED TO DX WHAT CONDITION?

Answer 99

QUERVAINS TENOSYNOVITIS.

Question 100

FINKELSTEIN TEST USED TO DX WHAT CONDITION?

Answer 100

QUERVAINS TENOSYNOVITIS

Question 101

WHAT CAUSES QUERVAINS TENOSYNOVITIS?

Answer 101

REPETITIVE MOVEMENT OF WRIST AND THUMB

Question 102

45 YO PT REPORTS STEPPING ON A NAIL. LAST TETANUS VACCINE WAS 7 YEARS AGO. WHAT VACCINES ARE RECOMMENDED?

Answer 102

TETANUS, DIPHTHERIA, ACELLULAR, PERTUSSIS (TDAP)

Question 103

WHAT IS RECOMMENDED TX FOR ERYTHEMA MIGRANS OR EARLY LYME DZ?

Answer 103

DOXYCYCLINE 100MG PO BID X 21 DAYS.

Question 104

ERYTHEMA MIGRANS IS THE RASH CHARACTERISTIC OF LYME DZ. THE RASH USUALLY APPEARS ___ DAYS AFTER A TICK BITE.

Answer 104

7 TO 10 DAYS

Question 105

INFANT BORN WITH MICROCEPHALY, NARROW EYES, A FLAT NASAL BRIDGE, A THIN UPPER LIP, AND UNDER-DEVELOPED EARS. WHAT IS DX?

Answer 105

FETAL ALCOHOL SYNDROME.

Question 106

WHAT TEST SHOULD BE ORDERED FOR PT WITH SYMPTOMS OF CHRONIC PROSTATITIS?

Answer 106

MEARES STAMEY 2 GLASS TEST. THIS TEST IS USED TO ASSESS FOR INFLAMMATION AND THE PRESENCE OF BACTERIA IN THE LOWER URINARY TRACT.

Question 107

FEMALE PT WITH C/O FATIGUE, COLD INTOLERANCE, AND UNEXPLAINED WEIGHT GAIN. DX?

Answer 107

HYPOTHYROIDISM.

Question 108

WHAT IS A POSITIVE KERNIGS SIGN?

Answer 108

PT WITH POSITIVE KERNIGS SIGN WILL RESIST LEG STRAIGHTENING WHEN HIP IS FLEXED BECAUSE OF PAINFUL HAMSTRINGS FROM LUMBAR NERVE ROOT INFLAMATION.

Question 109

ELDERLY MALE WITH C/O SEVERE PAIN ON LEFT BACK AND A CONCENTRATED SWATH OF VESICLES. DX?

Answer 109

HERPES ZOSTER (SHINGLES). SHINGLES CAUSE SEVERE DEEP PAIN ALONG A PRERIPHERAL NERVE ON THE TRUNK OF THE BODY AND RED, NODULAR SKIN LESIONS.

Question 110

HERPES ZOSTER IS AKA?

Answer 110

SHINGLES