NR509 Final Exam Practice Test

NR509 Final Exam Practice Test A 6-year-old female presents to the clinic with sore throat. The point of care test for Group A Streptococcal infection is positive. Which of the following indicates the expected lymphadenopathy presentation in this case? Bilateral, tender, mobile anterior cervical lymphadenopathy Which of the following changes are expected in vision as part of the normal aging process? Blurring of near vision Identify the anatomical structure in this image between both of the examiner's hands and fingertips. Cricoid cartilage A 19-year-old African-American female presents to the clinic with moderate to severe right lower quadrant abdominal pain for the last 2 days. She has been experiencing nausea and vomiting but unsure if she has had fever. Which of the following is a possible differential diagnosis? Appendicitis A 15-day old infant girl is brought to the outpatient clinic by her mother on a Monday morning. The mother is concerned about a rash that seems to have appeared suddenly after she and her infant daughter spent the previous weekend in Florida visiting family. The time of year is August and the house did not have air conditioning. The infant is afebrile, eating and drinking well, and does not appear to be in distress. You note scattered vesicles on an erythematous base involving the infant's face and trunk. Based on the history and physical examination findings, what is the likely diagnosis? Erythema Toxicum A 48-year-old high school librarian comes to your clinic, complaining of 1 week of heavy discharge causing severe itching. She is not presently sexually active and has had no burning with urination. The symptoms started several days after her last period. She just finished a course of antibiotics for a sinus infection. Her past medical history consists of type 2 diabetes and high blood pressure. She is widowed and has three children. She denies tobacco, alcohol, or drug use. Her mother has high blood pressure and her father died of diabetes complications. On examination you see a healthy appearing woman. Her blood pressure is 130/80 and her pulse is 70. Her head, eyes, ears, nose, throat, cardiac, lung, and abdominal examinations are unremarkable. Palpation of the inguinal lymph nodes is unremarkable. On visualization of the vulva, a thick, white, curdy discharge is seen at the introitus. On speculum examination there is a copious amount of this discharge. The pH of the discharge is 4.1 and the KOH whiff test is negative, with no unusual smell. Wet prep shows budding hyphae. What vaginitis does this patient most likely have? Candida vaginitis A 32-year-old female presents with a complaint of a singular breast mass. The nurse practitioner collects a thorough history and physical examination of the client's breast and related systems. Based on the characteristics of a soft, round, mobile, and tender mass, as well at the client's age, select the most likely cause of the breast mass. Cyst A 16-year-old female presents with the complaint of acne as represented in this image. When documenting the assessment findings, what is the morphology of the predominant skin lesions? Papules and pustules You are observing an infant born at 42-weeks gestation who is able to pull to a stand, uses "mama" and "dada" specifically, and indicates his wants by vocalization and pointing. Where would you place this child's developmental age? 8 months Which of the following vaccinations are safe during pregnancy? Hep B A 50- year-old Caucasian male presents to the clinic with left leg pain that increases with rest and a feeling of warmth in the calf area. During your physical examination, you note erythema and increased warm involving the left posterior lower leg as well as a palpable cord. What diagnosis do you suspect? Thrombophlebitis Upon physical examination of an 11-month-old infant, you note the skin findings represented in this image. What is your initial assessment? Atopic dermatitis Jim is a 60-year-old man who presents with vomiting. He denies seeing any blood with emesis, which has been occurring for 2 days. He does note a dark, granular substance resembling the coffee left in the filter after brewing. What do you suspect? Bleeding from a peptic ulcer A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He has smoked two packs per day since the age of 16, but he is otherwise healthy. You are concerned that he may have peripheral vascular disease. Which of the following is part of common or concerning symptoms for the peripheral vascular system? Intermittent claudication You note a painful ulcerative lesion near the medial malleolus, with accompanying hyperpigmentation. Which of the following etiologies is most likely? Venous insufficiency Which is the proper sequence of examination for the abdomen? Inspection, auscultation, percussion, palpation An elderly woman with dementia is brought in by her daughter for a "rectal mass." On examination you notice a moist pink mass protruding from the anus, which is non-tender. It is soft and does not have any associated bleeding. Which of the following is most likely? Rectal prolapse Which of the following is true of the human papilloma virus (HPV) vaccine? It can protect against anogenital lesions. Susanne is a 27-year-old who has had headaches, muscle aches, and fatigue for the last 2 months. You have completed a thorough history, examination, and laboratory workup but have not found a cause. What would be your appropriate next action? Screen for depression A 24-year-old graduate student presents to the clinic with a chief complaint of abdominal pain, nausea, and diarrhea that has been occurring intermittently over the last 2 months. The patient states that symptoms often occur before taking course examinations and writing term papers. After performing a health history interview, physical examination, and reviewing lab and diagnostic test results, you determine that this patient has a diagnosis of irritable bowel syndrome (IBS). A mental health assessment would classify IBS as which of the following? Medically Unexplained Symptom Otoscopic examination of the patient's ear reveals the findings represented in this image. What are your assessment findings of the TM and external auditory canal? Retracted TM. Effusion with amber fluid. Non-erythematous external canal without exudate Which of the following is worrisome in Melissa, a woman in her 26th week of pregnancy? Facial Edema A 68-year-old retired truck driver comes to your office for evaluation of swelling in his legs. He is a smoker and has been taking medications to control his hypertension for the past 25 years. You are concerned about his risk for peripheral vascular disease. Which of the following tests are appropriate to order to initially evaluate for this condition? Ankle-brachial index (ABI) A pregnant woman is concerned by the recent onset of mid-line abdominal swelling. It is soft and non-tender. What does this represent? Diastasis recti A 60-year-old African-American male presents to the office with nail changes. He denies pain or history of injury, trauma, or chronic, systemic, inflammatory disease. What is the most likely etiology for the nail changes in this image? Onychomycosis Jim is a 47-year-old man who is having difficulties with sexual function. He is recently separated from his wife of 20 years. He notes that he has early morning erections but otherwise cannot function. Which of the following is the most likely cause for his problem? Psychological issues Dawn is a 55-year-old woman who comes in today for her yearly wellness examination. You carefully perform the rectal examination in the lithotomy position and feel an irregular mass against the bowel wall which is firm and immobile. Which of the following is most likely? Colon Cancer A 29-year-old woman comes to your office. As you take the history, you notice that she is speaking very quickly, and jumping from topic to topic so rapidly that