NUR 6531 FINAL EXAM 1 LATEST UPDATE

NUR 6531 FINAL EXAM 1 Central obesity, “moon” face, and dorsocervical fat pad are associated with: An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days later, he returns to the office complaining of left great toe pain. On exam, the nurse practitioner notes an edematous, erythematous tender left great toe. The likely precipitant of this patient’s pain is: The most effective treatment of non-infectious bursitis includes: Conservative treatment drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare? Selected Answer: The physician must be on-site and engaged in patient care Answers: You must initiate the plan of care for the patient The physician must be on-site and engaged in patient care You must be employed as an independent contractor You must be the main health care provider who sees the patient Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus? The metabolic syndrome refers to the co-occurrence of several known cardiovascular risk factors, including insulin resistance, obesity, atherogenic dyslipidemia and hypertension. Which of the following is not a common early sign of benign prostatic hyperplasia (BPH)? A. Nocturia B. Urgency incontinence C. Strong urinary stream flow D. Straining to void Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid? Food that is very hot or very cold Fatty or fried foods Peppermint or spearmint, including flavoring Coffee, tea, and soft drinks that contain caffeine Spicy, highly seasoned foods Fried food DT caffeine, chocolate and anticholinergics Which drug category contains the drugs that are the first line Gold standard therapy for COPD? Beta antagonist The most commonly recommended pharmacological treatment regimen for low back pain (LBP) is: Nsaid Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis? Erythromycin A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness, anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take? .A Obtain a thorough history and physical, and check serum cortisol and ACTH levels. B. Perform a diet history and check CBC and FBS. C. Provide nutritional guidance and have the patient return in one month. D. Consult home health for intravenous administration You are assessing a patient after a sports injury to his right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to the: he A. lateral meniscus B. cruciate ligament C. medial meniscus D. collateral ligament. A 32 year old female patient presents with fever, chills, right flank pain, right costovertebral angle tenderness, and hematuria. Her urinalysis is positive for leukocytes and red blood cells. The nurse practitioner diagnoses pyelonephritis. The most appropriate management is: Include 500 mg of oral ciprofloxacin (Cipro) twice per day for seven days; 1,000 mg of extended-release ciprofloxacin once per day for seven days; or 750 mg of levofloxacin (Levaquin) once per day for five days. A middle-aged man presents to urgent care complaining of pain of the medial condyle of the lower humerus. The man works as a carpenter and describes a gradual onset of pain. On exam, the medial epicondyle is tender and pain is increased with flexion and pronation. Range of motion is full The most likely cause of this patient’s pain is: epicondylitis The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy s to measure albumin in a spot urine sample, collected either as the first urine in the morning or at random, for example, at the medical visit. This method is accurate,:Early morning What is the first symptom seen in the majority of patients with Parkinson’s disease? Tremor at rest The most commonly recommended method for prostate cancer screening in a 55 year old male is: digital rectal exams, Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect? Otitis externa/ swimmer’s ear Which of the following symptoms suggests a more serious cause of back pain? Pain associated with lying down at night A patient taking levothyroxine is being over-replaced. What condition is he at risk for? osteoporosis Which of the following is the most common cause of low back pain? Which is the most common cause of end-stage renal disease in the United States? Diabetes A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects: A 60 year old female patient complains of sudden onset unilateral, stabbing, surface pain in the lower part of her face lasting a few minutes, subsiding, and then returning. The pain is triggered by touch or temperature extremes. Physical examination is normal. Which of the following is the most likely diagnosis? A. fibromyligia or neuro something Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within normal limits. Which of the following diagnoses do you explore further? Arthritis, C • Question 34 • D 1 out of 1 points A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the following symptoms would lead you to look for another diagnosis? high fever (102 to 104 degrees F), irregular pulse, accelerated heartbeat (tachycardia), increased rate of respiration (tachypnea), muscle rigidity, altered mental status, autonomic nervous system dysfunction resulting in high or low blood pressure, profuse perspiration, and excessive sweating. called Malignant Hyperthermia” OR Neuroleptic malignant syndrome hallucinations. Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of: carpal tunnel syndrome The most common cause of elevated liver function tests is: alcohol Reed-Sternberg B lymphocytes are associated with which of the following disorders: A Aplastic anemia . B Hodgkin’s lymphoma . C Non Hodgkin’s . lymphoma D Myelodysplastic . syndromes Which of the following is a potential acquired cause of thrombophilia? A Homocysteinuria . B Protein C deficiency . C Factor V Leiden . D Antiphospholipid . antibodies A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains: A 25 year old overweight patient presents with a complaint of dull achiness in his groin and history of a palpable lump in his scrotum that “comes and goes”. On physical examination, the nurse practitioner does not detect a scrotal mass. There is no tenderness, edema, or erythema of the scrotum, the scrotum does not transilluminate. What is the most likely diagnosis? A. Testicular torsion B. Epididymitis C. Inguinal hernia D. Varicocele Dave, age 38, states that he thinks he has an ear infection because he just flew back from a business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next action? A. Prescribe nasal steroids and oral decongestants B. Prescribe antibiotic eardrops C. Prescribe systemic eardrops D. Refer David to an ear, nose, and throat specialist A. Prescribe The physiological explanation of syncope is: Syncope is a transient loss of consciousness (TLOC) due to global cerebral hypoperfusion characterized by rapid onset, short duration and spontaneous complete recovery. A 20 year old male patient complains of “scrotal swelling.” He states his scrotum feels heavy, but denies pain. On examination, the nurse practitioner notes transillumination of the scrotum. What is the most likely diagnosis? hydrocele A 32 year old male patient complains of urinary frequency and burning on urination for 3 days. Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial treatment should be: nclude nitrofurantoin monohydrate/macrocrystals, trimethoprim-sulfamethoxazole (TMP-SMX), or fosfomycin. trimethoprim and sulfamethoxazole Diagnostic radiological studies are indicated for low back pain: Diagnostic imaging is indicated for patients with low back pain only if they have severe progressive neurologic deficits or signs or symptoms that suggest a serious or specific underlying condition. In other patients, evidence indicates that routine imaging is not associated with clinically meaningful benefits but can lead to harms. An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects? The diagnosis of human papilloma virus (HPV) infection in males is usually made by: The diagnosis of HPV in men is made when external genital warts are seen. The diagnosis of genital warts is made by examination of the lesions Which history is commonly found in a patient with glomerulonephritis? upper respiratory tract infection or a skin infection that was caused by those bacteria A patient complains of generalized joint pain and stiffness associated with activity and relieved with rest. This patient history is consistent with which of the following disorders? Osteoarthritis The most common presentation of thyroid cancer is: is an asymptomatic thyroid mass or a nodule that can be felt in the neck. The obligatory criteria for diagnosis of muscular dystrophy (MD) are: Genetic testing to evaluate missing or repeated mutations in the dystrophin gene. A The case for genetic diagnosis. Accurate diagnosis of the muscular dystrophies is important for patients, their families, and efficient and cost-effective use of medical resources. (EEG.) The diagnosis which must be considered in a patient who presents with a severe headache of sudden onset, with neck stiffness and fever, is: viral meningitis A 60 year old male patient with multiple health problems presents with a complaint of erectile dysfunction (ED). Of the following, which medication is most likely to be causing the problem? Hypertensive medication such as hydrochlorothiazides, and other DM2 medications A 72 year old patient exhibits sudden onset of fluctuating restlessness, agitation, confusion, and impaired attention. This is accompanied by visual hallucinations and sleep disturbance. What is the most likely cause of this behavior? A. Dementia B. Delirium C. Parkinson's disease D. Depression Which of the following set of symptoms should raise suspicion of a brain tumor? Holocranial headaches present in the morning and accompanied by projectile vomiting without nausea The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is: relative rest-that being the cessation of the offending activity for a period of time until the irritation is eliminated, pain is gone and the bone is given a chance to heal. Rest the affected part of the body - Once pain free, the person can gradually begin the sporting activity again - Air splinting can reduce pain and decrease the time until return to full participation or intensity of exercise. - NSAIDs to reduce pain and inflammation Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to: a. refer her to a hand surgeon b. take a more complete hx c. try neutral position wrist splinting and order an oral NSAID d. order a nerve conduction study such as an electromyography (EMG) Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? A. Musculosckeletal pain B. Difficulty sleeping C. Depression D. Fatigue The cardinal sign of infectious arthritis is: Affected joint is painful at rest, with movement and weight bearing Diagnostic evaluation for urinary calculi includes: Diagnosis is based on urinalysis and radiologic imaging, usually noncontrast helical CT. A 15 year-old female patient is 5 feet tall and weighs 85 pounds. You suspect anorexia and know that the best initial approach is to: Having the client in view of staff for 90 minutes after each meal Provide the client with a feeling of responsibility and control over her behavior A 63-year-old man presents to the office with hematuria, hesitancy, and dribbling. Digital rectal exam (DRE) reveals a moderately enlarged prostate that is smooth. The PSA is 1.2. What is the most appropriate management strategy for you to follow at this time? A. Prescribe an alpha adrenergic blocker. B. Recommend saw palmetto. C. Prescribe an antibiotic D. Refer the client to urology. A positive drawer sign supports a diagnosis of: Posterior cruciate ligament injury A 14 year old female cheerleader reports gradual and progressive dull anterior knee pain, exacerbated by kneeling. The nurse practitioner notes swelling and point tenderness at the tibial tuberosity. X-ray is negative. What is the most likely diagnosis? prepatellar bursitis? Jack, age 55, comes to the office with a blood pressure of 144/98 mm Hg. He states that he did not know if it was ever elevated before. When you retake his blood pressure at the end of the exam, it remains at 144/98. What should your next action be? Answer: stage 2 hypertension (lifestyle change, and medication Martin is complaining of erectile dysfunction. He also has a condition that has reduced arterial blood flow to his penis. The most common cause of this condition is: diabetes mellitus Successful management of a patient with attention deficit hyperactivity disorder (ADHD) may be achieved with: Ritalin and diet What diabetic complications result from hyperglycemia? Retinopathy Hypertension resistant to treatment 3. Peripheral neuropathy 4. Accelerated atherogenesis In which of the following presentations is further diagnostic testing not warranted? The most common symptoms of transient ischemic attack (TIA) include: Common symptoms are sudden and transient, and include unilateral paresis, speech disturbance, and monocular blindness. clinical symptoms typically lasting less than one hour, and without evidence of i nfarction on Establishment of a definitive diagnosis of osteomyelitis requires: Bone biopsy leads to a definitive diagnosis . Which of the following is the most common causative organism of nongonococcal urethritis? A 30 year old female patient presents to the clinic with heat intolerance, tremors, nervousness, and weight loss inconsistent with increased appetite. Which test would be most likely to confirm the suspected diagnosis? TSH. We also assess free thyroid hormone (FT4) and at times T3 Potential causes of hypocalcemia include which of the following? Hypoalbuminemia is the most common cause of hypocalcemia. Causes include cirrhosis, nephrosis . hypoparathyroidism, vitamin D deficiency, and renal disease. Which of the following is a contraindication for metformin therapy? hypersensitity metabolic acidiosis, dehydration, sepsis, hypoxemia, hepatic impairment, renal dysfunction The organism most often associated with prostatitis is: The most effective intervention(s) to prevent stroke is (are): Aspirin is one of the most common, most effective/or life style changes What is the most commonly abused substance? alcohol is the #1 abused substance in America. An estimated 135.5 million people drink alcohol, but of those people, 86 million are considered to be abusers, An obese hyperlipidemic patient, newly diagnosed with type 2 diabetes mellitus, has fasting glucose values 180 to 250 mg/Dl. What is the most appropriate initial treatment to consider? A. A low-calorie diet and exercise B. Sliding-scale NPH insulin every 12 hours C. A sulfonylurea and/or metformin (Glucophage® -XR) D. Sliding-scale regular insulin every 6 hours • Question 100 Prolonged PT suggests: A Platelet abnormality . B Abnormality in intrinsic coagulation . pathway C Abnormality in extrinsic coagulation . pathway D None of the above . Deficiency of FII, FV, FX, or fibrinogen abnormalities A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as: Overweight • Question 2 1 out of 1 points A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness, anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take? Answer: Obtain a thorough history and physical, and check serum cortisol and ACTH levels. Question 5 1 out of 1 points Which of the following is a potential acquired cause of thrombophilia? Antiphospholipid antibodies Question 8 1 out of 1 points Differential diagnosis of proteinuria includes which of the following? • Question 10 1 out of 1 points Question 35 The nurse practitioner diagnoses epididymitis in a 24 year old sexually active male patient. The drug of choice for treatment of this patient is: Ceftriaxone 250 mg IM in a single dose plus. Doxycycline 100 mg orally twice a day for 10 days • Question 11 1 out of 1 points How do you respond when Jessica, age 42, asks you what constitutes a good minimum cardiovascular workout? 20 3x per week • Question 12 1 out of 1 points The intervention known to be most effective in the treatment of severe depression, with or without psychosis, is: electroconvulsive therapy (ECT). • Question 21 1 out of 1 points Which of the following accounts for half of the bladder tumors among men and one- third in women? Cigarette smoke, both active and passive inhalation • Question 23 1 out of 1 points A 21-year-old female presents to the office complaining of urinary frequency and urinary burning. The nurse practitioner suspects a urinary tract infection when the urinalysis reveals Answer: 10WBC/HPF • Question 26 1 out of 1 points The initial clinical sign of Dupuytren’s contracture is: Answer: Painless nodule on palmer fascia • Question 33 1 out of 1 points A nurse practitioner diagnoses a 60 year old male with balanitis. Which disease is commonly associated with balanitis? ( • Question 34 Josh, age 22, is a stock boy and has an acute episode of low back pain. You order and NSAID and tell him which of the following? Begin lower back strengthening exercises depending on pain tolerance. • Question 35 1 out of 1 points A 72 year old female patient reports a 6 month history of gradually progressive swollen and painful distal interphalangeal (DIP) joints of one hand. She has no systemic symptoms but the erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), and rheumatoid factor (RF) are all minimally elevated. What is the most likely diagnosis? Osteoarthritis • Question 40 1 out of 1 points Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond? "A high caffeine intake has a diuretic effect that may cause calcium to be excreted more rapidly." • Question 41 1 out of 1 points Which of the following set of symptoms should raise suspicion of a brain tumor? Holocranial headaches present in the morning and accompanied by projectile vomiting without nausea • Question 43 1 out of 1 points Diagnostic confirmation of acute leukemia is based on: Bone marrow aspiration and biopsy • Question 44 1 out of 1 points Which of the following antibiotics should not be prescribed for a pregnant woman in the 3rd trimester? Trimethoprim-sulfamethoxazole • Question 46 1 out of 1 points Who is at a higher risk for developing nephrolithiasis? Bill, who runs every day and takes excessive amounts of vitamin C • Question 53 1 out of 1 points A 28-year-old female presents to the office requesting testing for diagnosis of hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her risk factors. The nurse practitioner explains that: B and D (does not always require anticoagulation therapy and genetic and risk management counseling are recommended • Question 54 1 out of 1 points Martin, a 58 year old male with diabetes, is at your office for his diabetes follow up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Martin receive today regarding the care if his feet? See a podiatrist yearly; wash your feet daily with warm, soapy water and towel dry between the toes; inspect your feet daily for any lesions; and apply lotion to any dry areas. • Question 57 1 out of 1 points Potential causes of septic arthritis include which of the following? Lyme disease and prosthetic joint infection • Question 58 1 out of 1 points Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse? "I am concerned about your safety." • Question 62 1 out of 1 points A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder? benzodiazepines include Xanax, Librium, Valium, and Ativan • Question 64 1 out of 1 points Sam, age 67, is a diabetic with worsening renal function. He has frequent hypoglycemic episodes, which he believes means that his diabetes is getting “better.” How do you respond? Because your kidneys are not functioning well, your insuling is not being metabolized and excreted as it should, so you need less of it • Question 67 1 out of 1 points A 35 year old male presents with a complaint of low pelvic pain, dysuria, hesitancy, urgency, and reduced force of stream. The nurse practitioner suspects acute bacterial prostatitis. Which of the following specimens would be least helpful for diagnosis? Midstream urine specimens for culture and sensitivity CBC and differential Blood urea nitrogen Creatinine • Question 69 1 out of 1 points A patient has just been diagnosed with Bell’s palsy. He is understandably upset and has questions about the prognosis. You response should be: the condition is self-limiting, and most likely complete recovery will occur • Question 70 1 out of 1 points What is the first step in the treatment of uric acid kidney stones? Encouraging hydration • Question 71 1 out of 1 points Urine cultures should be obtained for which of the following patients? All of the above All of the above (pregnant females, males, and febrile patients) • Question 73 1 out of 1 points A patient has been diagnosed with hypothyroidism and thyroid hormone replacement therapy is prescribed. How long should the nurse practitioner wait before checking the patient’s TSH? Answer: 6 – 8 weeks • Question 76 1 out of 1 points Which of the following patients most warrants screening for hypothyroidism? An elderly female with recent onset of mental dysfunction • Question 77 1 out of 1 points The hallmark of neurofibromatosis (von Recklinghausen’s disease) present in almost 100% of patients is: cafe au lait spots. • Question 82 1 out of 1 points A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as: Overweight • Question 84 1 out of 1 points Diagnostic evaluation of hypothyroidism reveals: Elevated TSH and decrease T4 • Question 85 1 out of 1 points Diagnostic radiological studies are indicated for low back pain: Pain lasting more than 1 month - Objective radiculopathy - Cauda equina syndrome - Considering "red flag": systemic arthritis, infx, malignancy, trauma, congenital/developmental abnormalities • Question 88 1 out of 1 points The correct treatment for ankle sprain during the first 48 hours after injury includes: a cold compress to help reduce swelling (Rest, ice, compression, elevation) • Question 89 1 out of 1 points The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are): decreased reflexes, strength, and sensation in the lower extremities • Question 91 1 out of 1 points Risk factors for Addison’s disease include which of the following? Tuberculosis, Autoimmune disease, AIDS (all of the above) • Question 92 1 out of 1 points Major depression occurs most often in which of the following conditions? stroke • Question 93 1 out of 1 points Which of the following medications increase the risk for metabolic syndrome? Answer: antihistamines and proton pump inhibitors, diuretics, beta-blockers • Question 97 1 out of 1 points A 27 year old female patient with epilepsy is well controlled with phenytoin (Dilantin). She requests information about contraception. The nurse practitioner should instruct her that while taking phenytoin: the effective of an oral contraceptive may be reduced • Question 98 1 out of 1 points Risk factors for prostate cancer include all of the following except: BPH • Question 101 1 out of 1 points Maria, age 17, was raped when she was 13 year old. She is now experiencing sleeping problems, flashbacks, and depression. What is your initial diagnosis? Post-traumatic stress disorder Diabetes screening recommendations for asymptomatic adults age 45 and over include which of the following: (HbA1C and 2-hour 75gram oral glucose tolerance test) A child with type 1 diabetes mellitus has experienced excessive hunger, weight gain and increasing hyperglycemia. The Somogyi effect is suspected. What steps should be taken to diagnose and treat this condition? -------------------------------------------- Potential side effects of levofloxacin include which of the following? Confusion, Hypoglycemia, Achilles tendon rupture, All of the above. Which of the following is the most common complication of the myelodysplastic syndromes? Bleeding Which of the following is characteristic of a manic episode? Grandiosity or grandiose delusions Which of the following characteristics are associated with prepatellar bursitis? Repetitive knee trauma A middle-aged female presents complaining of recent weight loss. The physical exam reveals an enlarged painless cervical lymph node. The differential diagnosis for this patient’s problem includes: Answer: infection What is the most common cause of Cushing’s syndrome? the long-term, high-dose use of the cortisol-like glucocorticoids A diabetic patient is taking low-dose enalapril for hypertension. A record of the patient’s blood pressure over 4 weeks ranges from 130 to 142 mmHg systolic and 75 to 85 mmHg diastolic. How should the nurse practitioner respond? Answer: Current guidelines recommend lowering BP to 135/80 mmHg Your patient has an elevated mean cell volume (MCV). What should you be considering in terms of diagnosis? Anemia (pernicious or folic acid anemia) macrocytic Liver disease What information should patients with diabetes and their families receive about hypoglycemia? …………………. At what age is screening most likely to detect scoliosis? Adolescent (age 11 and older, or from onset of puberty until skeletal maturity). A patient has been taking fluoxetine (Prozac) since being diagnosed with major depression, first episode, 2 months ago. She reports considerable improvement in her symptoms and her intention to discontinue the medication. What should be the nurse practitioner’s recommendation? Answer: Recommend that the patient continue the antidepressant medication for at least 4 more months A typical description of a tension headache is: mild to moderate intensity, bilateral, nonthrobbing Which of the following is not a characteristic of type 2 diabetes mellitus? ----------------------------------- Which of the following is not a characteristic of type 1 diabetes mellitus? It is generally controlled by diet and/or oral medication. The most accurate measure of diabetes control is: hemoglobin A1c considered the most accurate measurement or Glycosylated hemoglobin level Microalbuminuria is a measure of: Answer: Urinary excretion of 30-299mg/24 hours of albumin, Expressing albumin and creatinine ratio (ACR) takes the variability into account and normalizes the albumin in a spot specime A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is: Cryptosporidiosis The nurse practitioner is following a child with juvenile rheumatoid arthritis (JRA) who has been previously diagnosed and is being managed for the disease by a pediatric rheumatologist. The mother asks for information about the child’s long term prognosis. What is the most appropriate reply? prevent disease progression and destruction of joints, bones, cartilage and soft tissues such as muscles, tendons and joint capsules Which factors are associated with high risk for foot complications in a patient with diabetes mellitus? Obesity Abnormal nails Abnormal gait Poorly controlled lipids Obesity 2.Abnormal nails 3.Abnormal gait 4.Poorly controlled lipids Which of the following is the most common causative organism of nongonococcal urethritis? Chlamydia trachomatis A 65 year old patient complains of recurrent bilateral temporal headaches, malaise, muscle aches, and low grade fever. The headache is described as superficial tenderness rather than deep pain. Giant cell arteritis is suspected. Appropriate treatment is: refer for temporal artery biopsy and initiation of oral prednisone The most reliable diagnostic indicator of gout is: Elevated serum uric acid levels A patient with HIV infection has a fever of unknown origin (FUO). Which of the following is a possible cause of FUO in a patient with HIV? drug fever After treating a patient for Helicobacter pylori infection, what test do you order to see if it has been cured? A urea breath test Which of the following physical modalities recommended for treatment of rheumatoid arthritis provides the most effective long term pain relief? Your physical therapist may use modalities, such as gentle heat and electrical stimulation to help manage your RA symptoms. Other than smoking cessation, which of the following slows the progression of COPD in smokers? oxygen What intervention does the American College of Rheumatology recommend as first line therapy for osteoarthritis? Acetaminophen should be used as first-line therapy for mild osteoarthritis. Nonsteroidal anti-inflammatory drugs are superior to acetaminophen for treating moderate to severe osteoarthritis The best test to determine microalbuminuria to assist in the diagnosis of diabetic neuropathy: Answer: measure albumin (microalbuminuria A 26 year old female presents with elbow pain that is described as aching and burning. There is point tenderness along the lateral aspect of the elbow and painful passive flexion and extension. She reports she has been playing tennis almost daily for the past month. The most likely diagnosis is: lateral epicondylitis (tennis elbow)