Nsg5003 Final Exam (2 Versions, Latest- 2022) / Nsg 5003 Final Exam: Advanced Pathophysiology: South University |100% Correct Answers, Download To Score Highgrade|

NSG5003 FINAL EXAM (2 VERSIONS, LATEST- 2022) / NSG 5003 FINAL EXAM: ADVANCED PATHOPHYSIOLOGY: SOUTH UNIVERSITY |100% CORRECT ANSWERS, DOWNLOAD TO SCORE HIGHGRADE| SOUTH UNIVERSITY NSG 5003 PATHOPHYSIOLOGY FINAL EXAM 2022 (2 VERSIONS, LATEST- 2022) / NSG5003 FINAL EXAM: ADVANCED PATHOPHYSIOLOGY |100% CORRECT ANSWERS, DOWNLOAD TO SCORE HIGHGRADE| NSG5003 Final Exam / NSG 5003 Final Exam: Advanced pathophysiology: South University South University NSG5003 Final Exam / South University NSG 5003 Final Exam Question 1 (5 points) Which component of the cell produces hydrogen peroxide (H2O2) by using oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction? Question 1 options: Lysosomes Peroxisomes Ribosomes Oxyhydrosomes Question 2 (5 points) What is a consequence of plasma membrane damage to the mitochondria? Question 2 options: Enzymatic digestion halts deoxyribonucleic acid (DNA) synthesis. Influx of calcium ions halts adenosine triphosphate (ATP) production. Edema from an influx in sodium causes a reduction in ATP production. Potassium shifts out of the mitochondria, which destroys the infrastructure. Question 3 (5 points) Which statement is a description of one of the characteristics of apoptosis? Question 3 options: Apoptosis involves programmed cell death of scattered single cells. Apoptosis is characterized by the swelling of the nucleus and the cytoplasm. Apoptosis involves unpredictable patterns of cell death. Apoptosis results in benign malignancies. Question 4 (5 points) During cell injury caused by hypoxia, sodium and water move into the cell because: Question 4 options: During cell injury caused by hypoxia, sodium and water move into the cell because: The pump that transports sodium out of the cell cannot function because of a decrease in adenosine triphosphate (ATP) levels. The osmotic pressure is increased, which pulls additional sodium across the cell membrane Oxygen is not available to bind with sodium to maintain it outside of the cell. Question 5 (5 points) What is an effect of ionizing radiation exposure? Question 5 options: Respiratory distress Sun intolerance Deoxyribonucleic acid (DNA) aberrations Death Question 6 (5 points) Obesity creates a greater risk for dehydration in people because: Question 6 options: chapter 3 q.2 ?Adipose cells contain little water because fat is water repelling. The metabolic rates of obese adults are slower than those of lean adults. The rates of urine output of obese adults are higher than those of lean adults. The thirst receptors of the hypothalamus do not function effectively. Question 7 (5 points) In addition to osmosis, what force is involved in the movement of water between the plasma and interstitial fluid spaces? Question 7 options: a) Oncotic pressure b) Buffering c) Net filtration d) Hydrostatic pressure Question 8 (5 points) Venous obstruction is a cause of edema because of an increase in which pressure? Question 8 options: a) Capillary hydrostatic b) Interstitial hydrostatic c) Capillary oncotic d) Interstitial oncotic Question 9 (5 points) At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because: Question 9 options: a) The interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure. b) The capillary hydrostatic pressure is higher than the capillary oncotic pressure. c) The interstitial oncotic pressure is higher than the interstitial hydrostatic pressure. d) The capillary oncotic pressure is lower than the interstitial hydrostatic pressure. Question 10 (5 points) It is true that natriuretic peptides: Question 10 options: a) Decrease blood pressure and increase sodium and water excretion. b) Increase blood pressure and decrease sodium and water excretion. c) Increase the heart rate and decrease potassium excretion. d) Decrease the heart rate and increase potassium excretion. Question 11 (5 points) What causes the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma in hypernatremia? Question 11 options: a) High sodium in the blood vessels pulls water out of the brain cells into the blood vessels, causing brain cells to shrink. b) High sodium in the brain cells pulls water out of the blood vessels into the brain cells, causing them to swell. c) High sodium in the blood vessels pulls potassium out of the brain cells, which slows the synapses in the brain. d) High sodium in the blood vessels draws chloride into the brain cells followed by water, causing the brain cells to swell. Question 12 (5 points) A major determinant of the resting membrane potential necessary for the transmission of nerve impulses is the ratio between: Question 12 options: a) Intracellular and extracellular Na+ b) . Intracellular and extracellular K+ c) Intracellular Na+ and extracellular K+ d) Intracellular K+ and extracellular Na+ Question 13 (5 points) In hyperkalemia, what change occurs to the cells’ resting membrane potential? Question 13 options: a) Hypopolarization b) Hyperexcitability c) Depolarization d) Repolarization Question 14 (5 points) Physiologic pH is maintained at approximately 7.4 because bicarbonate (HCO3) and carbonic acid (H2CO3) exist in a ratio of: Question 14 options: a) 20:1 b) 1:20 c) 10:2 d) 10:5 Question 15 (5 points) Increased capillary hydrostatic pressure results in edema because of: Question 15 options: a) Losses or diminished production of plasma albumin b) Inflammation resulting from an immune response c) Blockage within the lymphatic channel system d) Sodium and water retention Question 16 (5 points) Hypomethylation and the resulting effect on oncogenes result in: Question 16 options: a) A decrease in the activity of the oncogene, thus suppressing cancer development b) Deactivation of MLH1 to halt deoxyribonucleic acid (DNA) repair c) An increase in tumor progression from benign to malignant d) Overexpression of micro-ribonucleic acid (miRNA), resulting in tumorigenesis Question 17 (5 points) The functions of the major histocompatibility complex (MHC) and CD1 molecules are alike because both: Question 17 options: a) Are antigen-presenting molecules b) Bind antigens to antibodies c) Secrete interleukins (ILs) during the immune process d) Are capable of activating cytotoxic T lymphocytes Question 18 (5 points) The B-cell receptor (BCR) complex functions uniquely by: Question 18 options: a) Communicating information about the antigen to the helper T (Th) cell b) Secreting chemical signals to help cells communicate c) Recognizing the antigen on the surface of the B lymphocyte d) Communicating information about the antigen to the cell nucleus Question 19 (5 points) The generation of clonal diversity includes a process that: Question 19 options: a) Involves antigens that select lymphocytes with compatible receptors b) Allows the differentiation of cells into antibody-secreting plasma cells or mature T cells c) Takes place in the primary (central) lymphoid organs d) Causes antigens to expand and diversify their populations Save Question 20 (5 points) Vaccinations are able to provide protection against certain microorganisms because of the: Question 20 options: a) Strong response from immunoglobulin M (IgM) b) Level of protection provided by immunoglobulin G (IgG) c) Memory cells for immunoglobulin E (IgE) d) Rapid response from immunoglobulin A (IgA) Question 21 (5 points) What is the mechanism that results in type II hypersensitivity reactions? Question 21 options: a) Antibodies coat mast cells by binding to receptors that signal its degranulation, followed by a discharge of preformed mediators. b) Antibodies bind to soluble antigens that were released into body fluids, and the immune complexes are then deposited in the tissues. c) Cytotoxic T (Tc) lymphocytes or lymphokine-producing helper T 1 (Th1) cells directly attack and destroy cellular targets. d) Antibodies bind to the antigens on the cell surface. Question 22 (5 points) When soluble antigens from infectious agents enter circulation, tissue damage is a result of: Question 22 options: a) Complement-mediated cell lysis b) Phagocytosis by macrophages c) Phagocytosis in the spleen d) Neutrophil granules and toxic oxygen products Save Question 23 (5 points) ? Considering the hypothalamus, a fever is produced by: Question 23 options: a) Endogenous pyrogens acting directly on the hypothalamus b) Exogenous pyrogens acting directly on the hypothalamus c) Immune complexes acting indirectly on the hypothalamus d) Cytokines acting indirectly on the hypothalamus Question 24 (5 points) Vaccines against viruses are created from: Question 24 options: a) Killed organisms or extracts of antigens b) Live organisms weakened to produce antigens c) Purified toxins that have been chemically detoxified d) Recombinant pathogenic protein Question 25 (5 points) Carcinoma in situ is characterized by which changes? Question 25 options: a) Cells have broken through the local basement membrane. b) Cells have invaded immediate surrounding tissue. c) Cells remain localized in the glandular or squamous cells d) Cellular and tissue alterations indicate dysplasia. Question 26 (5 points) Two “hits” are required to inactivate tumor-suppressor genes because: Question 26 options: a) Each allele must be altered and each person has two copies, or alleles, of each gene, one from each parent. b) The first hit stops tissue growth and the second hit is needed to cause abnormal tissue growth. c) Tumor-suppressor genes are larger than proto-oncogenes, requiring two hits to effect carcinogenesis. d) The first hit is insufficient to cause enough damage to cause a mutation. Question 27 (5 points) What is the skin-related health risk induced by some types of chemotherapy? Question 27 options: a) Infection b) Ultraviolet damage c) Pain d) Erythema Question 28 (5 points) When a child is diagnosed with cancer, which intervention has the greatest influence on the child’s mortality rate? Question 28 options: a) Age at the time of diagnosis b) Participation in clinical trials c) Proximity to a major cancer treatment center d) Parental involvement in the treatment planning Question 29 (5 points) Reflex activities concerned with the heart rate, blood pressure, respirations, sneezing, swallowing, and coughing are controlled by which area of the brain? Question 29 options: a) Pons b) Midbrain c) Cerebellum d) Medulla oblongata Question 30 (5 points) The edema of the upper cervical cord after a spinal cord injury is considered life threatening because of which possible outcome? Question 30 options: a) Hypovolemic shock from blood lost during the injury b) Breathing difficulties from an impairment to the diaphragm c) Head injury that likely occurred during the injury d) Spinal shock immediately after the injury Question 31 (5 points) What term is used to describe the complication that can result from a spinal cord injury above T6 that is producing paroxysmal hypertension, as well as piloerection and sweating above the spinal cord lesion? Question 31 options: a) Craniosacral dysreflexia b) Parasympathetic dysreflexia c) Autonomic hyperreflexia d) Retrograde hyperreflexia Save Question 32 (5 points) Atheromatous plaques are most commonly found: Question 32 options: a) . In larger veins b) Near capillary sphincters c) At branches of arteries d) On the venous sinuses Question 33 (5 points) Multiple sclerosis is best described as: Question 33 options: a) A CNS demyelination, possibly from an immunogenetic virus b) Inadequate supply of acetylcholine at the neurotransmitter junction as a result of an autoimmune disorder c) The depletion of dopamine in the CNS as a result of a virus d) A degenerative disorder of lower and upper motor neurons caused by viral-immune factors Question 34 (5 points) Graves disease develops from: Question 34 options: a) A viral infection of the thyroid gland that causes overproduction of thyroid hormone b) An autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue c) Thyroid-stimulating immunoglobulin, which causes overproduction of thyroid hormones d) Ingestion of goitrogens, which inhibits the synthesis of the thyroid hormones, causing goiter Question 35 (5 points) Pathologic changes associated with Graves disease include: Question 35 options: a) High levels of circulating thyroid-stimulating immunoglobulins b) Diminished levels of TRH c) High levels of TSH d) Diminished levels of thyroid-binding globulin Question 36 (5 points) A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20, serum glucose 500 mg/dl, positive urine glucose and ketones, serum potassium (K+) 2 mEq/L, and serum sodium (Na+) 130 mEq/L. The patient reports that he has been sick with the “flu” for a week. What relationship do these values have to his insulin deficiency? Question 36 options: a) Increased glucose use causes the shift of fluid from the intravascular to the intracellular space. b) . Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresi c) Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis. d) Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss. Question 37 (5 points) Type 2 diabetes mellitus is best described as: Question 37 options: a) Resistance to insulin by insulin-sensitive tissues b) The need for lispro instead of regular insulin c) An increase in glucagon secretion from α cells of the pancreas d) The presence of insulin autoantibodies that destroy β cells in the pancreas Question 38 (5 points) The common hay fever allergy is expressed through a reaction that is mediated by which class of immunoglobulins? Question 38 options: a) Immunoglobulin E (IgE) b) Immunoglobulin G (IgG) c) Immunoglobulin M (IgM) d) T cells Question 39 (5 points) A person diagnosed with type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The most probable cause of these symptoms is: Question 39 options: a) Hyperglycemia caused by incorrect insulin administration b) The dawn phenomenon from eating a snack before bedtime c) Hypoglycemia caused by increased exercise d) Somogyi effect from insulin sensitivity Question 40 (5 points) Hypoglycemia, followed by rebound hyperglycemia, is observed in those with: Question 40 options: a) The Somogyi effect b) The dawn phenomenon c) Diabetic ketoacidosis (DKA) d) Hyperosmolar hyperglycemic nonketotic syndrome Question 41 (5 points) Which structure is lined with columnar epithelial cells Question 41 options: a) Perimetrium b) Endocervical canal c) Myometrium d) Vagina Question 42 (5 points) Where is the usual site of cervical dysplasia or cancer in situ? Question 42 options: a) Where the squamous epithelium of the cervix meets the cuboidal epithelium of the vagina b) Where the columnar epithelium of the cervix meets the squamous epithelium of the uterus c) Where the squamous epithelium of the cervix meets the columnar epithelium of the uterus d) Where the columnar epithelium of the cervix meets the squamous epithelium of the vagina Question 43 (5 points) Which statement best describes a Schilling test? Question 43 options: a) Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency b) Measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia c) Measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia d) Administration of folate and measurement in two hours of its level in a blood sample to test for folic acid deficiency anemia Question 44 (5 points) In aplastic anemia (AA), pancytopenia develops as a result of which of the following? Question 44 options: a) Suppression of erythropoietin to produce adequate amounts of erythrocytes b) Suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes c) Lack of deoxyribonucleic acid (DNA) to form sufficient quantities of erythrocytes, leukocytes, and thrombocytes d) Lack of stem cells to form sufficient quantities of leukocytes Question 45 (5 points) Which statement is true regarding warm autoimmune hemolytic anemia? Question 45 options: a) Warm autoimmune hemolytic anemia occurs primarily in men. b) It is self-limiting and rarely produces hemolysis. c) Erythrocytes are bound to macrophages and sequestered in the spleen. d) Immunoglobulin M (IgM) coats erythrocytes and binds them to receptors on monocytes. Question 46 (5 points) Hemolytic disease of the newborn (HDN) can occur if the mother: Question 46 options: a) Is Rh-positive and the fetus is Rh-negative b) Is Rh-negative and the fetus is Rh-positive c) Has type A blood and the fetus has type O blood d) Has type AB blood and the fetus has type B blood Question 47 (5 points) When diagnosed with hemolytic disease of the newborn (HDN), why does the newborn develop hyperbilirubinemia after birth but not in utero? Question 47 options: a) Excretion of unconjugated bilirubin through the placenta into the mother’s circulation is no longer possible. b) Hemoglobin does not break down into bilirubin in the intrauterine environment. c) The liver of the fetus is too immature to conjugate bilirubin from a lipid-soluble form to a water-soluble form. d) The destruction of erythrocytes producing bilirubin is greater after birth. Question 48 (5 points) How does angiotensin II increase the workload of the heart after a myocardial infarction (MI)? Question 48 options: a) By increasing the peripheral vasoconstriction b) By causing dysrhythmias as a result of hyperkalemia c) By reducing the contractility of the myocardium Question 49 (5 points) What event is a characteristic of the function in Zone I of the lung? Question 49 options: a) Blood flow through the pulmonary capillary bed increases in regular increments. b) Alveolar pressure is greater than venous pressure but not greater than arterial pressure. c) The capillary bed collapses, and normal blood flow ceases. d) Blood flows through Zone I, but it is impeded to a certain extent by alveolar pressure. Question 50 (5 points) What factor associated with gluten-sensitive enteropathy (celiac sprue) causes an infant to bruise and bleed easily? Question 50 options: a) Vitamin K deficiency from fat malabsorption b) Bone marrow function depression c) Iron, folate, and B12 deficiency anemias ________________________________________ NSG5003 Final Exam / NSG 5003 Final Exam: Advanced pathophysiology: South University South University NSG5003 Final Exam / South University NSG 5003 Final Exam 1. It is important to not dilate the eye if ____ is suspected. Cataract Macular degeneration Acute closed-angle glaucoma Chronic open-angle glaucoma Question 2. 2. An 18-year-old female patient presents with repeated urinary tract infections. She has no risk factors in her history, and her physical examination is unremarkable. She also has a normal pelvic exam. Which of the following should be obtained if anatomic abnormalities are suspected? Ultrasound of the kidneys Intravenous pyelogram Cystoscopy Transvaginal ultrasound of the bladder Question 3. 3. The pathophysiological hallmark of ACD is: Depleted iron stores Impaired ability to use iron stores Chronic uncorrectable bleeding Reduced intestinal absorption of iron Question 4. 4. Which of the following is the most important question to ask during cardiovascular health history? Number of offspring Last physical exam Sudden death of a family member Use of caffeine Question 5. 5. A 26-year-old, non-smoker, male presented to your clinic with SOB with exertion. This could be due to: Exercise-induced cough Bronchiectasis Alpha-1 deficiency Pericarditis Question 6. 6. Which of the following dermatological conditionsresults from reactivation of the dormant varicella virus? Tineaversicolor Seborrheic keratosis Verruca Herpes zoster Question 7. 7. Mr. Jones is a 68-year-old retired Air Force pilot that has been diagnosed with prostate cancer in the past week. He has never had a surgical procedure in his life and seeks clarification on the availability of treatments for prostate cancer. He asks the nurse practitioner to tell him the side effects of a radical prostatectomy. Which of the following is not a potential side effect of this procedure? Urinary incontinence Impotence Dribbling urine Selected low back pain Question 8. 8. Presbycusis is the hearing impairment that is associated with: Physiologic aging Ménière’s disease Cerumen impaction Herpes zoster Question 9. 9. Asymptomatic 1+ bacteriuria is found in a nursing home resident with an indwelling catheter. The nurse practitioner’s initial intervention includes: Assessing resident’s cognitive status and last change of the catheter/bag Prescribing prophylactic Bactrim 1 tablet at bedtime Ordering a urine culture and sensitivity and prescribing empiric treatment until results obtained Ordering an X-ray of the kidney, urine, and bladder Question 10. 10. A 64-year-old male presents with erythema of the sclera, tearing, and bilateral pruritus of the eyes. The symptoms occur intermittently throughout the year and he has associated clear nasal discharge. Which of the following is most likely because of the inflammation? Bacterium Allergen Virus Fungi Question 11. 11. The nurse practitioner is examining a 62-year-old female who has been complaining of lower abdominal pain. Upon auscultation, bowel sounds are high pitched and tinkling. Which of the following terms describes this finding? Succession splash Borborygmi Tenesmus Puddle sign Question 12. 12. Which ethnic group has the highest incidence of prostate cancer? Asians Hispanics African Americans American Indians Question 13. 13. A key symptom of ischemic heart disease is chest pain. However, angina equivalents may include exertional dyspnea. Angina equivalents are important because: Women with ischemic heart disease many times do not present with chest pain Some patients may have no symptoms or atypical symptoms; diagnosis may only be made at the time of an actual myocardial infarction Elderly patients have the most severe symptoms A & B only Question 14. 14. The nurse practitioner is discussing lifestyle changes with a patient diagnosed with gastroesophageal reflux. What are the nonpharmacological management interventions that should be included? Weight reduction and rest 30 minutes after each meal in the supine position Elevation of head of the bed 4-6 inches on blocks and weight reduction Encouraged to wear restrictive clothing to add support for diaphragmatic breathing Using oral mints to relieve gastric distress Question 15. 15. Which lesions are typically located along the distribution of dermatome? Scabies Herpes zoster Tinea Dyshidrosis Question 16. 16. Which of the following medications are commonly associated with the side effect of cough? Beta blocker Diuretic ACE inhibitor Calcium antagonist Question 17. 17. On DRE, you note that a 45-year-old patient has a firm, smooth, non-tender but asymmetrically shaped prostate. The patient has no symptoms and has a normal urinalysis. The patient’s PSA is within normal limits for the patient’s age. The clinician should: Refer the patient for transrectal ultrasound guided prostate biopsy Obtain an abdominal X-ray of kidneys, ureter, and bladder Recognize this as a normal finding that requires periodic follow up Obtain urine culture and sensitivity for prostatitis Question 18. 18. Your patient complains of a feeling of heaviness in the lower legs daily. You note varicosities, edema, and dusky color of both ankles and feet. Which of the following is the most likely cause for these symptoms? Femoral vein thrombosis Femoral artery thrombus Venous insufficiency Musculoskeletal injury Question 19. 19. The most common cause of eye redness is: Conjunctivitis Acute glaucoma Head trauma Corneal abrasion Question 20. 20. The aging process causes what normal physiological changes in the heart? The heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis Cardiology occurs along with prolapse of the mitral valve and regurgitation Dilation of the right ventricle occurs with sclerosis of pulmonic and tricuspid valves Hypertrophy of the right ventricle Question 21. 21. Ms. Smith, 37-year-old, comes to the clinic today complaining of dull, throbbing bilateral headaches almost every evening. You suspect she is experiencing: cluster headaches migraine headaches tension headaches benign intracranial hypertension Question 22. 22. A 59-year-old patient with history of alcohol abuse comes to your office because of ‘throwing up blood”. On physical examination, you note ascites and caput medusa. A likely cause for the hematemesis is: Peptic ulcer disease Barrett’s esophagus Esophageal varices Pancreatitis Question 23. 23. Which of the following is considered a “red flag” when diagnosing a patient with pneumonia? Fever of 102 Infiltrates on chest X-ray Pleural effusion on chest X-ray Elevated white blood cell count Question 24. 24. Your patient complains of lower abdominal pain, anorexia, extreme fatigue, unintentional weight loss of 10 pounds in last 3 weeks, and you find a positive hemoccult on digital rectal examination. Laboratory tests show iron deficiency anemia. The clinician needs to consider: Diverticulitis Colon cancer Appendicitis Peptic ulcer disease Question 25. 25. You have a patient complaining of vertigo and want to know what could be the cause. Knowing there are many causes for vertigo, you question the length of time the sensation lasts. She tells you several hours to days and is accompanied by tinnitus and hearing loss. You suspect which of the following conditions? Ménière’s disease Benign paroxysmal positional vertigo Transient ischemic attack (TIA) Migraine Question 26. 26. In examining the mouth of an older adult with a history of smoking, the nurse practitioner finds a suspicious oral lesion. The patient has been referred for a biopsy to be sent for pathology. Which is the most common oral precancerous lesion? Fictional keratosis Keratoacanthoma Lichen planus Leukoplakia Question 27. 27. A cough is described as chronic if it has been present for: 2 weeks or more 8 weeks or more 3 months or more 6 months or more Question 28. 28. The first assessment to complete related to the eyes is: Eye lids Visual acuity Extraocular movements Peripheral vision Question 29. 29. The Mini-Cog is a short screening tool used to assess cognition. Which of the following statements pertaining to the test is a true statement? The patient will be asked to repeat five words immediately following the directions by the practitioner. The patient is asked to draw the hour and minute hands on a picture of an analog clock. A score of 0-2 is a positive screen for dementia. The patient is asked to recall five images from picture cards following the drawing of the clock hands. Question 30. 30. A woman with an X-linked dominant disorder will: Not be affected by the disorder herself Transmit the disorder to 50% of her offspring (male or female) Not transmit the disorder to her daughters Transmit the disorder to only her daughters Question 31. 31. Your patient has just returned from a 6-month missionary trip to Southeast Asia. He reports unremitting cough, hemoptysis, and an unintentional weight loss of 10 pounds over the last month. These symptoms should prompt the clinician to suspect: Legionnaires' disease Malaria Tuberculosis Pneumonia Question 32. 32. In assessing the eyes, which of the following is considered a “red flag” finding when associated with eye redness? History of prior red-eye episodes Grossly visible corneal defect Exophthalmos Photophobia Question 33. 33. The best evidence rating drugs to consider in a post myocardial infarction patient include: ASA, ACE/ARB, beta-blocker, aldosterone blockade ACE, ARB, Calcium channel blocker, ASA Long-acting nitrates, warfarin, ACE, and ARB ASA, clopidogrel, nitrates Question 34. 34. In examination of the nose, the clinician observes gray, pale mucous membranes with clear, serous discharge. This is most likely indicative of: Bacterial sinusitis Allergic rhinitis Drug abuse Skull fracture Question 35. 35. Which of the following findings should trigger an urgent referral to a cardiologist or neurologist? History of bright flash of light followed by significantly blurred vision History of transient and painless monocular loss of vision History of monocular severe eye pain, blurred vision, and ciliary flush All of the above Question 36. 36. Which symptom is more characteristic of Non-Cardiac chest pain? Pain often radiates to the neck, jaw, epigastrium, shoulder, or arm Pain tends to occur with movement, stretching or palpation Pain usually lasts less than 10 minutes and is relieved by nitroglycerine Pain is aggravated by exertion or stress Question 37. 37. Aortic regurgitation requires medical treatment for early signs of CHF with: Beta blockers ACE inhibitors Surgery Hospitalization Question 38. 38. What test is used to confirm the diagnosis of appendicitis? CBC Flat plate of abdomen Rectal exam CT of abdomen with attention to appendix Question 39. 39. The major impact of the physiological changes that occur with aging is: Reduced physiological reserve Reduced homeostatic mechanisms Impaired immunological response All of the above Question 40. 40. A smooth round nodule with a pearly gray border and central induration best describes which skin lesion? Seborrheic keratosis Malignant melanoma Herpes zoster Basal cell carcinoma Question 41. 41. A 20-year-old engineering student complains of episodes of abdominal discomfort, bloating, and episodes of diarrhea. The symptoms usually occur after eating, and pain is frequently relieved with bowel movement. She is on a “celiac diet” and the episodic symptoms persist. Physical examination and diagnostic tests are negative. Colonoscopy is negative for any abnormalities. This is a history and physical consistent with: Inflammatory bowel disease Irritable bowel syndrome Giardiasis Norovirus gastroenteritis Question 42. 42. Which of the following disorders can cause urinary incontinence? Cystocele Overactive bladder Uterine prolapse All of the above Question 43. 43. Which of the following drugs would be useful for the nurse practitioner to prescribe for an older adult to prevent gastric ulcers when a nonsteroidal anti-inflammatory drug is used for chronic pain management? Misoprostol (Cytotec) Cimetidine (Tagamet) Metronidazole (Flagyl) Bismuth subsalicylate (Peptobismol) Question 44. 44. Which of the following details are NOT considered while staging asthma? Nighttime awakenings Long-acting beta agonist usage Frequency of symptoms Spirometry findings Question 45. 45. A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The patient reports a smoking history of 2 packs of cigarettes per day since age 16. This would be recorded in the chart as: 50 x 2-pack years 100-pack years 50-year, 2-pack history 100-pack history Question 46. 46. A clinical clue for suspected renal artery stenosis would be: Decreased urine output Development of resistant hypertension in a previously well-controlled patient Retroperitoneal pain on the affected side Rising BUN level with normal creatinine level Question 47. 47. What is the most common valvular heart disease in the older adult? Aortic regurgitation Aortic stenosis Mitral regurgitation Mitral stenosis Question 48. 48. The cytochrome p system involves enzymes that are generally: Inhibited by drugs Induced by drugs Inhibited or induced by drugs Associated with decreased liver perfusion Question 49. 49. Which of the following is the most common cause of heartburn-type epigastric pain? Decreased lower esophageal sphincter tone Helicobacter pylori infection of stomach Esophageal spasm Peptic ulcer disease Question 50. 50. A nurse practitioner reports that your patient’s abdominal X-ray demonstrates multiple air-fluid levels in the bowel. This is a diagnostic finding found in: Appendicitis Cholecystitis Bowel Obstruction Diverticulitis Question 51. 51. A patient suffered a laceration of the shin three days ago, and today presents with a painful, warm, red swollen region around the area. The laceration has a purulent exudate. The clinician should recognize that the infected region is called: Contact dermatitis Folliculitis Hidradenitis suppurativa Cellulitis Question 52. 52. A 62-year-old client presents with a complaint of fever, pain, and burning on urination. Difficulty urinating with dribbling has been increasing in the past few days. He has a feeling of pressure in his groin. On examination, his prostate is tender, boggy, and warm. A stat urinalysis reveals the presence of leukocytes and bacteria. He is allergic to sulfa drugs. His weight is 70 kg and his last serum creatinine was 1.0. While awaiting the culture and sensitivity, the nurse practitioner begins empiric treatment with which of the following? Trimethoprim/sulfamethoxazole DS bid x 2 weeks Ampicillin 250 mg PO Q day for 10 days Nitrofurantoin 100 mg Q 12 hours for 7 days Ciprofloxacin 500 mg Q 12 hours for 14 days Question 53. 53. In teaching an older adult female client with end-stage renal disease her medication regimen, the nurse practitioner must include which of the following pieces of information in the treatment plan? Report any changes in the color of her stool Take iron supplement and elemental calcium with each meal Take iron supplement before meals and the calcium after meals Take calcium with a high phosphorus meal Question 54. 54. A 46-year-old female complains of fatigue, general malaise, and pain and swelling in her hands that has gradually worsened over the last few weeks. She reports that pain, stiffness, and swelling of her hands are most severe in the morning. On physical examination, you note swelling of the metacarpophalangeal joints bilaterally. These are common signs of: Osteoarthritis Rheumatoid arthritis Scleroderma Sarcoidosis Question 55. 55. Whenever a patient presents with acute non-traumatic shoulder pain, the clinician should make sure to exclude a: Cardiac origin of symptoms Gastrointestinal condition Cervical spine disorder All of the above Question 56. 56. A female patient presents to the clinic with complaints of a severe, throbbing, unilateral headache. She complains of seeing flashes of light prior to the headache. She complains of sound and light sensitivity as well as nausea. The clinician should recognize these as symptoms of: Epilepsy with aura Cluster headache Migraine headache Normal pressure hydrocephalus Question 57. 57. The main focus of treatment of patients with ACD is: Replenishing iron stores Providing for adequate nutrition high in iron Management of the underlying disorder Administration of monthly vitamin B12 injections Question 58. 58. The most common neurological cause of seizures in an older adult is: Alzheimer’s disease Multiple sclerosis Stroke Peripheral neuropathy Question 59. 59. Your 63-year-old Caucasian woman with polymyalgia rheumatica (PMR) will begin treatment with corticosteroids until the condition has resolved. You look over her records and it has been 2 years since her last physical examination and any laboratory or diagnostic tests as she relocated and had not yet identified a health-care provider. In prioritizing your management plan, your first orders should include: Recommending she increase her dietary intake of Calcium and Vitamin D Ordering once a year bisphosphonate and a proton pump inhibitor Participate in a fall prevention program Dual-energy X-ray (DEXA) scan and updating immunizations Question 60. 60. Your patient is a 78-year-old female with a smoking history of 120-pack years. She complains of hoarseness that has developed over the last few months. It is important to exclude the possibility of: Thrush Laryngeal cancer Carotidynia Thyroiditis Question 61. 61. A 43-year-old female was in a bicycling accident and complains of severe pain of the right foot. The patient limps into the emergency room. On physical examination, there is no point tenderness over the medial or lateral ankle malleolus. There is no foot tenderness except at the base of the fifth metatarsal bone. According to the Ottawa foot rules, should an X-ray of the feet be ordered? Yes, there is tenderness over the fifth metatarsal No, there is not tenderness over the navicular bone Yes, the patient cannot bear weight on the foot A and C Question 62. 62. When assessing a patient who complains of a tremor, the nurse practitioner must differentiate essential tremor from the tremor of Parkinson’s disease. Which of the following findings are consistent with essential tremor? The handwriting is not affected by the tremor The tremor occurs with purposeful movements The tremor occurs at rest The tremor gets worse with alcohol ingestion Question 63. 63. Folliculitis is most commonly due to: Contact dermatitis Varicella zoster Dermatophytes Staphylococcal infection Question 64. 64. What kind of lesions are caused by the herpes simplex virus? Scales Vesicles Plaques Urticaria Question 65. 65. A 65-year-old male complains of a headache that feels “like a knife is cutting into his head.” He also reports feeling right-sided scalp and facial pain and “seeing double” at times. He has a history of hypertension and hyperlipidemia. His medications include beta blocker, statin drug, and an ACE inhibitor. On physical examination, you note palpable tenderness over the right side of the forehead. There are no neurological deficits. Vision is 20/20 with lenses. No weakness of extremities. CN II to XII are intact. The history corresponds to which of the following disorders? Drug toxicity Giant cell arteritis Cluster headache Migraine headache Question 66. 66. Which of the following conditions is the most common cause of nausea, vomiting, and diarrhea? Viral gastroenteritis Staphylococcal food poisoning Acute hepatitis A E coli gastroenteritis Question 67. 67. The nurse practitioner orders bilateral wrist X-rays on a 69-year-old gentleman complaining of pain in both wrists for the past 6 weeks not related to any known trauma. The nurse practitioner suspects elderly onset rheumatoid arthritis. The initial radiographic finding in a patient with elderly onset rheumatoid arthritis would be: Symmetric joint space narrowing Soft tissue swelling Subluxations of the joints Joint erosions Question 68. 68. A common auscultatory finding in advanced CHF is: Systolic ejection murmur S3 gallop rhythm Friction rub Bradycardia Question 69. 69. The three cardinal features of Parkinson’s disease are: Essential tremor, postural rigidity, and infarcts of the basal ganglion Bradykinesia, rigidity, and tremor Shuffling gait, constipation, positional freezing. Dementia, incontinence, and infarcts of the basal ganglion Question 70. 70. In AR disorders, carriers have: Two mutated genes; one from each parent that cause disease A mutation on a sex chromosome that causes a disease A single gene mutation that causes the disease One copy of a gene mutation but not the disease Question 71. 71. A 75-year-old patient complains of pain and paresthesias in the right foot that worsens with exercise and is relieved by rest. On physical examination you note pallor of the right foot, capillary refill of 4 seconds in the right foot, +1 dorsalis pedis pulse in the right foot, and +2 pulse in left foot. Which of the following is a likely cause of the signs and symptoms? Arterial insufficiency Femoral vein thrombus Venous insufficiency Peripheral neuropathy Question 72. 72. Which of the following statements is true concerning anti-arrhythmic drugs? Amiodarone is the only one not associated with increased mortality and it has a very favorable side effect profile. Both long-acting and short-acting calcium channel blockers are associated with an increased risk of cardiovascular morbidity and mortality. Most anti-arrhythmics have a low toxic/therapeutic ratio and some are exceedingly toxic. Anti-arrhythmic therapy should be initiated in the hospital for all patients. Question 73. 73. A 23-year-old patient who has had bronchiectasis since childhood is likely to have which of the following: Barrel-shaped chest Clubbing Pectusexcavatum Prolonged capillary refill Question 74. 74. Which of the following is a common trigger of migraine headache? Missed meals Menses Alcohol All of the above Question 75. 75. A 55-year-old patient complains of lower back pain due to heavy lifting at work yesterday. He reports weakness of the left leg and paresthesias in the left foot. On physical examination, the patient has diminished ability to dorsiflex the left ankle. Which of the following symptoms should prompt the clinician to make immediate referral to a neurosurgeon? Straight leg raising sign Lumbar herniated disc on X-ray Loss of left sided patellar reflex Urinary incontinence Question 76. 76. The appearance of a 2-10 cm. herald patch with subsequent development of parallel oval lesions on the trunk in a christmas tree distribution involving the upper arms and upper legs are common in: PityriasisRosea Shingles Psoriasis Lymes Disease Question 77. 77. When interpreting laboratory data, you would expect to see the following in a patient with Anemia of Chronic Disease (ACD): Hemoglobin 12 g/dl, MCV decreased, MCH decreased Hemoglobin 12 g/dl, MCV increased, MCH increased Hemoglobin 12 g/dl, MCV normal, MCH normal Hemoglobin 12 g/dl, MCV decreased, MCH increased Question 78. 78. In differentiating a gastric ulcer from a duodenal ulcer, you know that each type of ulcer can present with distinct signs and symptoms. Which of the following pieces of information from the patient’s history is the least useful for you to determine that the patient has a duodenal ulcer? Pain occurs on an empty stomach Diffuse epigastric pain Rarely associated with non-steroidal use Occurs in patients under 40 years of age Question 79. 79. A 43-year-old male patient complains of right-sided abdominal and pain in the back in the right costovertebral angle region, fever, chills, dysuria, and nausea. On physical examination, there is 102 degree fever, tachycardia, and right costovertebral angle tenderness to percussion. The most likely condition is: Lower urinary tract infection Nephrolithiasis Hydronephrosis Pyelonephritis Question 80. 80. A careful history of a female client with a chief complaint of intermittent diarrhea reveals that she also experiences bouts of constipation. She has no known allergies and experienced no unintentional weight loss. What is the most likely condition? Inflammatory bowel disease Irritable bowel syndrome Giardiasis Lactose intolerance Question 81. 81. A 33-year-old female reports general malaise, fatigue, stiffness, and pain in multiple joints of the body. There is no history of systemic disease and no history of trauma. On physical examination, the patient has no swelling or decreased range of motion in any of the joints. She indicates specific points on the neck and shoulders that are particularly affected. She complains of tenderness upon palpation of the neck, both shoulders, hips, and medial regions of the knees. The clinician should include the following disorder in the list of potential diagnoses: Osteoarthritis Rheumatoid arthritis Fibromyalgia Polymyalgia rheumatica Question 82. 82. A 60-year-old female patient complains of pain in both hands that is worse in the morning. On physical examination, the thumb metacarpophalangeal joint is swollen on both hands. There is swelling of the proximal and distal interphalangeal joints bilaterally. These are typical signs of: Osteoarthritis Rheumatoid arthritis Normal aging Gouty arthritis Question 83. 83. A 68-year-old male reports painless rectal bleeding occasionally noted with thin pencil-like stools, but no pain with defection. He has a history of colon polyp removal 10 years ago but was lost to follow-up. The nurse practitioner’s appropriate intervention is: Digital rectal exam and send home with 3 hemoccult to return Immediate referral to gastroenterologist and colonoscopy Order a screening sigmoidoscopy Order a colonoscopy and barium enema and refer based on results Question 84. 84. During physical examination of a patient, you note resonance on percussion in the upper lung fields. This is consistent with: COPD Pneumothorax A normal finding Pleural effusion Question 85. 85. Your 70-year-old patient has gastroesophageal reflux disease (GERD). After a trial of lifestyle modifications and antacids, the patient continues to have occasional mild heartburn after occasional meals and at night. The most appropriate next action is: Prokinetic agents H2 antagonists Proton pump inhibitors Sucralfate Question 86. 86. In order to provide a comprehensive genetic history of a patient, the NP should: Ask patients to complete a family history worksheet Seek out pathology reports related to the patient’s disorder Interview family members regarding genetic disorders All of the above Question 87. 87. An 86-year-old patient who wears a hearing aid complains of poor hearing in the affected ear. In addition to possible hearing aid malfunction, this condition is often due to: Acoustic neuroma Cerumen impaction Otitis media Ménière’s disease Question 88. 88. A 62-year-old woman presents with a recurrent urinary tract infection. She now has a fever of 104°F and severe costovertebral tenderness with pyuria. What is the appropriate diagnosis and intervention for this patient? Septic arthritis and oral prednisolone is indicated Pyelonephritis and hospitalization is required Recurrent cystitis and 10 days of antibiotics are needed Pelvic inflammatory disease and 7 days of antibiotics are indicated Question 89. 89. When counseling clients regarding the use of antidiarrheal drugs such as Imodium anti-diarrheal and Kaopectate, the nurse practitioner advises patients to: Use all the medication Do not use for possible infectious diarrhea Use should exceed one week for effectiveness These drugs provide exactly the same pharmaceutical effects Question 90. 90. What is the most common cause of hip pain in older adults? Osteoporosis Osteoarthritis Trauma due to fall Trochanteric bursitis Question 91. 91. A 65-year-old woman is accompanied by her daughter for a physical examination. She has mild heart failure and takes digitalis and an ACE inhibitor. As you examine the patient, you note flat affect, hand tremor, and slowed movements. The tremor is worsened at rest. There are no neurologic deficits. Hand grip, sensation of face and extremities, and lower extremity muscle strength are within normal limits and bilaterally equal. DTRs are equal bilaterally. CN II to XII are intact. The mental status exam is normal. These are key signs of: Chiari malformation Normal pressure hydrocephalus Parkinson’s disease Drug toxicity Question 92. 92. An older patient reports burning pain after ingestion of many foods and large meals. What assessment would assist the nurse practitioner in making a diagnosis of GERD? Identification of a fluid wave Positive Murphy’s sign Palpable spleen Midepigastric pain that is not reproducible with palpation Question 93. 93. An 82-year-old female presents to the emergency department with epigastric pain and weakness. She admits to having dark, tarry stools for the last few days. She reports a long history of pain due to osteoarthritis. She self-medicates daily with ibuprofen, naprosyn, and aspirin for joint pain. On physical examination, she has orthostatic hypotension and pallor. Fecal occult blood test is positive. A likely etiology of the patient’s problem is: Mallory-Weiss tear Esophageal varices Gastric ulcer Colon cancer Question 94. 94. Your 2-year-old patient shows facial features, such as epicanthal folds, up-slanted palpebral fissures, single transverse palmar crease, and a low nasal bridge. These are referred to as: Variable expressivity related to inherited disease Dysmorphic features related to genetic disease De novo mutations of genetic disease Different penetrant signs of genetic disease Question 95. 95. The first step in the genomic assessment of a patient is obtaining information regarding: Family history Environmental exposures Lifestyle and behaviors Current medications Question 96. 96. Your patient is a 43-year-old female golfer who complains of arm pain. On physical examination, there is point tenderness on the elbow and pain when the patient is asked to flex the wrist against the clinician’s resistance. These are typical signs of: Carpal tunnel syndrome Osteoarthritis of the wrist Epicondylitis Cervical osteoarthritis Question 97. 97. Upon assessment of respiratory excursion, the clinician notes asymmetric expansion of the chest. One side expands greater than the other. This could be due to: Pneumothorax Pleural effusion Pneumonia Pulmonary embolism Question 98. 98. Which of the following symptoms is common with acute otitis media? Bulging tympanic membrane Bright light reflex of tympanic membrane Increased tympanic membrane mobility All of the above Question 99. 99. A 75-year-old patient with community-acquired pneumonia presents with temperature of 102.1, chills, productive cough, BP 90/5062, WBC 12,000, and blood urea nitrogen (BUN) 20 mg/dl. He has a history of mild dementia and his mental status is unchanged from his last visit. These findings indicate that the patient: Can be treated as an outpatient Requires hospitalization for treatment Requires a high dose of parenteral antibiotic Can be treated with oral antibiotics Question 100. 100. A 34-year-old female presents with fever, general malaise, fatigue, arthralgias and rash for the last 2 weeks. On physical examination, you note facial erythema across the nose and cheeks. Serum diagnostic tests reveal positive antinuclear antibodies, anti-DNA antibodies, elevated C-reactive protein and erythrocyte sedimentation rate. The clinician should include the following disorder in the list of potential problems: Fibromyalgia Sarcoidosis Systemic lupus erythematosus Rheumatoid arthritis Question 101. 101. A pneumatic otoscopic examination is used to assess: Inner ear conditions Otitis externa Cerumen impaction Tympanic membrane mobility Question 102. 102. An elderly patient has had a CVA in the anterior cerebral circulatory system (frontal lobe). What symptoms are most likely expressed? Neglect of body and difficulty organizing space Wernicke’s aphasia (difficulty understanding speech) Disorders of behavior and cognition Bilateral motor and sensory problem Question 103. 103. Asymmetrical bi-color lesion with irregular border measuring 8 mm is found on the right lower arm of an adult patient. This assessment finding is consistent with: Melanoma Basal cell carcinoma Leukoplakia Senile lentigines Question 104. 104. Iron Deficiency Anemia (IDA) is classified as a microcytic, hypochromic anemia. This classification refers to which of the following laboratory data? Hemoglobin and Hematocrit Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH) Serum ferritin and Serum iron Total iron binding capacity and transferrin saturation Question 105. 105. On a physical examination for employment, a 45-year-old male shows no significant findings and takes no medications. Past medical history and surgery are unremarkable. On urinalysis, hematuria is present. The urinalysis is repeated on another day and still reveals microscopic hematuria. It is important to recognize that painless hematuria can be diagnostic of: Urinary tract infection Bladder cancer Nephrolithiasis Pyelonephritis Question 106. 106. A 17-year-old male complains of severe right knee pain. He was playing football when he heard a “pop” at the moment of being tackled and his knee “gave away” from under him. On physical examination, there is right knee swelling and decreased range of motion. There is a positive anterior drawer sign. These findings indicate: Knee ligament injury Osgood-Schlatter disease Prepatellar bursitis Chondromalacia patella Question 107. 107. In addition to the complete blood count (CBC) with differential, which of the following laboratory tests is considered to be most useful in diagnosing ACD and IDA? Serum iron Total iron binding capacity Transferrin saturation Serum ferritin Question 108. 108. Dan G., a 65-year-old man, presents to your primary care office for the evaluation of chest pain and left-sided shoulder pain. Pain begins after strenuous activity, including walking. Pain is characterized as dull, aching; 8/10 during activity, otherwise 0/10. Began a few months ago, intermittent, aggravated by exercise, and relieved by rest. Has occasional nausea. Pain is retrosternal, radiating to left shoulder, definitely affects quality of life by limiting activity. Pain is worse today; did not go away after he stopped walking. BP 120/80.Pulse 72 and regular. Normal heart sounds, S1 and S2, no murmurs. Which of the following differential diagnoses would be most likely? Musculoskeletal chest wall syndrome with radiation Esophageal motor disorder with radiation Acute cholecystitis with cholelithiasis Coronary artery disease with angina pectoris Question 109. 109. A middle-aged patient has been diagnosed with Parkinson’s disease. What influences the nurse practitioner’s decision to begin pharmacological treatment for this patient? Intentional tremors Gait instability requiring use of a cane Symptoms interfering with functional ability Medications initiated at first sign of unilateral involvement Question 110. 110. Essential parts of a health history include all of the following except: Chief complaint History of the present illness Current vital signs All of the above are essential history components Question 111. 111. When palpating the posterior chest, the clinician notes increased tactile fremitus over the left lower lobe. This can be indicative of pneumonia. Areas of increased fremitus should raise the suspicion of conditions resulting in increased solidity or consolidation in the underlying lung tissue, such as in pneumonia, tumor, or pulmonary fibrosis. In the instance of an extensive bronchial obstruction: No palpable vibration is felt Decreased fremitus is felt Increased fremitus is felt Vibration is referred to the non-obstructed lobe Question 112. 112. Which of the following would be considered a “red flag” that requires more investigation in a patient assessment? Colon cancer in family member at age 70 Breast cancer in family member at age 75 Myocardial infarction in family member at age 35 All of the above Question 113. 113. Your 66-year-old male patient has recently started treatment for metabolic syndrome and is currently taking the following medications: an ACE inhibitor and beta blocker for treatment of hypertension. He is also taking a statin medication, simvastatin for hyperlipidemia, and a biguanide, metformin, for type 2 diabetes. The patient complains of myalgias of the legs bilaterally and blood work shows elevated serum creatine kinase. Which of the medications can cause such a side effect? Beta blocker ACE inhibitor Statin medication Metformin Question 114. 114. Symptoms in the initial human immunodeficiency virus (HIV) infection include all of the following except: Sore throat Fever Weight loss Headache Question 115. 115. The most appropriate first-line treatment for an acute gout flare is (assuming no kidney disease or elevated bleeding risk): Indomethacin 50 mg thrice daily for 2 days; then 25 mg thrice daily for 3 days Doxycycline 100 mg twice daily for 5 days Prednisolone 35 mg four times a day for 5 days Ice therapy Question 116. 116. According to the Genetic Information Nondiscrimination Act (GINA): Nurse Practitioners (NPs) should keep all genetic information of patients confidential NPs must obtain informed consent prior to genetic testing of all patients Employers cannot inquire about an employee’s genetic information All of the above Question 117. 117. A 55-year-old post-menopausal woman with a history of hypertension complains of jaw pain on heavy exertion. There were no complaints of chest pain. Her ECG indicates normal sinus rhythm without ST segment abnormalities. Your plan may include: Echocardiogram Exercise stress test Cardiac catheterization Myocardial perfusion imaging Question 118. 118. A 27-year-old male comes in to the clinic for symptoms of dysuria, urinary frequency, as well as urgency and perineal pain. Transrectal palpation of the prostate reveals a very tender, boggy, swollen prostate. The clinician should recognize these as signs of: Prostatitis Prostate cancer Urethritis Benign prostatic hyperplasia Question 119. 119. Patient presents with complaint of a “swollen node” under his arm. The area is tender and the node has progressed in size over the past few days. Which of the following should be included in your differential diagnosis? Hidradenitis suppurativa Epidermoid cyst Furuncle Both A and C Question 120. 120. The most common complication of an untreated urinary obstruction due to a ureteral calculus is: Ureteral rupture Hydronephrosis Kidney mass Renal artery stenosis Question 121. 121. A woman complains of malaise and arthralgias. You note a butterfly-shaped, macular, erythematous rash across her cheeks and nose. These conditions are common in: Psoriasis Lichen planus Systemic lupus erythematosus Erythema nodosum Question 122. 122. Your patient has been treated for glaucoma for 5 years. Which of the following will provide indication of the level of progression during the funduscopic examination for this patient? Checking the macula Estimating cup-to-disk ratio Verifying a red reflex Extraocular movements Question 123. 123. Age-related changes in the bladder, urethra, and ureters include all of the following in older women except: Increased estrogen production’s influence on the bladder and ureter Decline in bladder outlet function Decline in ureteral resistance pressure Laxity of the pelvic muscle Question 124. 124. A 33-year-old female patient visits the clinic multiple times over the last year complaining of dysuria, frequency, urgency, suprapubic pain, and dyspareunia. Her physical examination, including a pelvic exam, is normal. Urinalysis and urine culture is repeatedly negative. Her intravenous pyelogram is also normal. The clinician should recognize that this presentation is consistent with symptoms of: Interstitial cystitis Polycystic kidneys Upper urinary tract infection Asymptomatic bacteriuria Question 125. 125. An older adult male presents with pain in his right chest wall for the past 48 hours. Upon examination, the nurse practitioner notices a vesicular eruption along the dermatome and identifies this as herpes zoster. The NP informs the gentleman that: All symptoms should disappear within three days Oral medications can dramatically reduce the duration and intensity of his symptoms He has chickenpox and can be contagious to his grandchildren He has a sexually transmitted disease Question 126. 126. Functional abilities are best assessed by: Self-report of function Observed assessment of function A comprehensive head-to-toe examination Family report of function Question 127. 127. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or patients? Clinical practice guideline Clinical decision rule Clinical algorithm Clinical recommendation Question 128. 128. Jenny is a 24 year old graduate student that presents to the clinic today with complaints of fever, midsternal chest pain and generalized fatigue for the past two days. She denies any cough or sputum production. She states that when she takes Ibuprofen and rest that the chest pain does seem to ease off. Upon examination the patient presents looking very ill. She is leaning forward and states that this is the most comfortable position fo