Comprehensive practice exam

Comprehensive practice exam Zina is a 34 y/o female who comes to the clinic with a chief complaint of 3 years of chronic heartburn. She states that she gets it after eating tacos and bacon. She has tried to self-medicate with OTC antacids with no improvement. In the exam, the NP notices a sour odor on Zina’s breath, thinning tooth enamel, and a chronic red throat. Medications to assist Zina would include all the following except: Zantac Pepcid NSAIDS Prevacid Martin is a 41 y/o male who comes to the clinic with the following symptoms: fever, chills, and malaise. On physical exam, the NP notes that he has a new murmur that was not present at his last visit and is aware that he has a prosthetic valve. He also has splinter hemorrhages on his nails, and petechiae on his palate. Treatment for Martin would include which of the following: IV antibiotics Debridement of prosthetic valve Dental evaluation and treatment All of the above A & B only People with darker skin require less sun exposure to produce Vitamin D. True False Serum creatinine is a better measure of renal function than BUN. True False If the TSH is decreased then the patient needs to be worked up for hypothyroidism. True False Agnes is a 26 y/o female who comes to the clinic with intermittent episodes of moderate to severe cramping in the LLQ. She has bloating that is relieved with defecation. Treatment of Agnes’s condition would include which of the following: Increased dietary fiber Avoid gas-producing foods Decrease stress in her life All of the above A & B only Carlos is a 64 y/o male who has previously been diagnosed as a Category A COPD patient based on Gold guidelines (2017). The Category A patient group includes which of the following? Minimally symptomatic (low risk of exacerbation) More symptomatic (low risk of exacerbation) Minimally symptomatic (high risk of exacerbation) High risk Bupropion (Wellbutrin) is contraindicated in patients with anorexia/bulimia because of the potential for increasing the seizure threshold. True False Osteoporosis is defined as having a T-score of or less than the standard deviation of a healthy individual. 1 -1.5 -2.5 -3.5 Andrew, a 41 y/o male resident of Oklahoma, presents to the clinic in July with the following symptoms: fever, chills, severe headache photophobia, and myalgia. He states that since his fever occurred 2 days ago, he now has this rash of petechiae on wrists, forearms, and ankles. The NP, based on these data, diagnoses Andrew with: Rocky Mountain Spotted Fever (RMSF) Atopic dermatitis Erythema migrans Brown recluse spider bite To perform the psoas sign, the NP would do which of the following? With patient supine, have pt. raise right leg against NPs hand. Positive if pain is elicited. With patient on left side, extend patients right leg at hip. Positive if pain is elicited. Pain during left-sided pressure in LLQ is positive sign. Flex patient’s right thigh at hip with knee bent and rotate leg internally at the hip. Positive if pain elicited. A & B only None of the above The preferred test for oral glucose tolerance test (OGTT) in a pregnant woman is: 100 g 75 g 50 g 25 g Andre is a 52 y/o construction worker who stayed home today because he was having severe chest pain. His wife calls the clinic and describes his symptoms as: squeezing chest tightness, with pain that radiates to the left side of his neck, jaw, and left arm. The NP’s immediate response should be to tell the wife: Begin CPR and then call 911. Call 911 immediately. Have the wife drive the patient to the ER. Call back if the intensity of the pain increases. The definition of a UTI is 100,000 CFU/mL of one organism. True False One of the most common side effects of SSRIs is: Nausea Ataxia Erectile dysfunction Seizures All of the following are characteristic of the S4 heart sound except Normal finding in some healthy elderly Occurs during systole Best heard at apex of the heart Best heard with bell of stethoscope Adam is a 10 y/o male who has Koplik’s spots inside the cheeks by the rear molars. The most likely diagnosis is: Measles Hand, foot, and mouth disease Scarlet fever Varicella Diabetes mellitus causes both microvascular and macrovascular damage. All of the following are indications of microvascular damage except: Retinopathy Nephropathy Neuropathy Atherosclerosis Martin is a 41 y/o male who comes to the clinic with the following symptoms: fever, chills, and malaise. On physical exam, the NP notes that he has a new murmur that was not present at his last visit and is aware that he has a prosthetic valve. He also has splinter hemorrhages on his nails, and petechiae on his palate. Additional diagnostic criteria for Martin’s presumed diagnosis would include which of the following: Blood cultures Echocardiography Transesophageal echocardiography All of the above A & B only