EXAM2- SU23 Exam with Questions and Answers (Recent Exam)

Which of the following best describes asthma? Intermittent airway inflammation with occasional bronchospasm A disease of bronchospasm that leads to airway inflammation Chronic airway inflammation with superimposed bronchospasm Relatively fixed airway constriction - Chronic airway inflammation with superimposed bronchospasm The patient you are evaluating is having an asthma flare. You have assessed that his condition is appropriate for office treatment. You expect to find the following on physical examination: Tripod posture Inspiratory crackles Increased vocal fremitus Hyperresonance on thoracic percussion - Hyperresonance on thoracic percussion Which of the following is most accurate regarding the use of ca chest x-ray during an acute asthma flare? Chest radiograph should be performed with each asthma flare Chest radiograph should be performed during and following resolution of the flare Chest radiograph should be avoided as it can further exacerbate a flare Chest radiograph should be limited to those with signs or respiratory tract infection (e.g. fever, congested cough). - Chest radiograph should be limited to those with signs or respiratory tract infection (e.g. fever, congested cough). In the treatment of asthma, an LTM should be used as a: controller to prevent bronchspasm Controller to inhibit inflammatory responses Reliever to treat acute bronchspasm Reliever to treat inflammation - Controller to inhibit inflammatory responses The cornerstone of moderate persistent asthma controller drug therapy is the use of: Oral theophyline Inhaled mast cell stabilizers Inhaled SABAs EXAM2- SU23 Exam with Questions and Answers (Recent Exam) ICSs - ICSs Which is a possible reason for delayed onset of puberty in a 13-year-old girl? A. history of abdominal irradiation B. obesity C. report of asthma since age 6 years D. Turner's syndrome - D. Turner's syndrome The most common reason for precocious puberty in boys is: A. excessive physical activity. B. a select number of relatively uncommon health problems. C. exogenous testosterone. D. early onset of normal puberty. - B. a select number of relatively uncommon health problems. The onset of puberty in girls is marked by: A. breast budding. B. menarche. C. peak of growth spurt. D. presence of axillary hair. - A. breast budding. Which of the following is noted in a child with premature thelarche? A. breast enlargement B. accelerated linear growth C. pubic hair D. body odor - A. breast enlargement Girls typically grow to their adult height by: A. menarche. B. 1 year before menarche. C. 1 year after the onset of menstruation. D. their 16th birthday. - C. 1 year after the onset of menstruation. You examine a 29 year old woman, who reports a sudden onset of right-sided facial asymmetry. She is unable to close her right eyelid tightly, frown, or smile on the affected side. She states, "I was fine last night when I went to bed and woke up like this." Her health history and physical examination are otherwise unremarkable. Her medications include a multivitamin daily and a progestin implant for contraception. She is not a smoker. This presentation likely represents paralysis of CN: III IV VII VIII - VII In prescribing a systemic corticosteroid for a patient with Bell's palsy, the nurse practitioner considers that its use: Has not been shown to be helpful in improving outcomes in this condition Should be initiated as soon as possible after the onset of facial paralysis Is likely to help minimize ocular symptoms May prolong the course of the disease - Should be initiated as soon as possible after the onset of facial paralysis A 46-year-old man diagnosed with Bell's palsy and being treated with a systemic corticosteroid asks the NP about the use of an antiviral medication as he read online that an antiviral can help to "cure the disease." The NP correctly responds: An antiviral can be considered though the benefit has not been established in clinical studies The toxicity associated with antivirals will outweigh any benefits of treatment Antivirals can be considered if symptoms do not improve after 4 weeks Antiviral treatment is contraindicated when taking a systemic corticosteroid - Antivirals can be considered if symptoms do not improve after 4 weeks A 27 year old man presents with a 5 week history of recurrent headaches that awaken him during the night. The pain is severe, lasts about 1 hour, and is located behind the left eye. Additional symptoms include lacrimation and nasal discharge. His physical examination is within normal limits, and he is currently headache- free. This clinical presentation is most consistent with: Migraine without aura Migraine with aura Cluster headache Increased ICP - Cluster headache Indicators that a headache can be the presenting symptom of a serious underlying illness and consideration for neuroimaging include all of the following except: Similar headaches that occur periodically in clusters Increasing frequency and severity of headaches Headache causing confusion, dizziness, and/or lack of coordination Sudden, abrupt onset - Similar headaches that occur periodically in clusters A 45-year-old female with a BMI of 28 complains of intermittent burning epigastric pain over the past few months. It is worse at night, especially after a heavy or spicy meal. She goes to sleep about 2 hours after eating. The pain is partially relieved by antacids or not at all. She is not a smoker and denies radiation of pain to neck, arms, or jaw; diaphoresis; and dyspnea. What is the next step? A. Order a 12-lead EKG B. Prescribe a proton-pump inhibitor C. Instruct the patient to stop eating at least 4 hours before bedtime, avoid spicy and heavy meals at night, and lose weight D. Schedule a fasting lipid profile, including cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides - C. Instruct the patient to stop eating at least 4 hours before bedtime, avoid spicy and heavy meals at night, and lose weight A patient with irritable bowel syndrome (IBS) tells the nurse practitioner that over the past few months, she has been experiencing frequent bouts of constipation. Which prescription will the nurse practitioner add to the treatment plan? A. Amitriptyline (Elavil) 50 mg PO once daily B. Lubiprostone (Amitiza) 8 mcg PO BID C. Alosetron (Lotronex) 0.5mg PO BID x 4 weeks D. Dicyclomine (Bentyl) 20 mg PO every 6 hours, 30 to 60 minutes before meals - B. Lubiprostone (Amitiza) 8 mcg PO BID All of the following assessment findings are associated with Chron's disease, except: A. Mass palpated in abdomen B. Weight loss and dehydration C. Fistula formation D. Inflammation limited to mucosal layer of colon - D. Inflammation limited to mucosal layer of colon A 54-year-old man presents with recurrent abdominal cramping and pain associated with diarrhea that occurs for four to five times per day. The patient reports that he has lost weight, is always fatigued, and that his stools are bloody with mucus and pus. The patient denies recent travel and outdoor camping. Which of the following conditions is most likely? A. Giardiasis B. Irritable bowel syndrome (IBS) C. Diverticulitis D. Ulcerative colitis - D. Ulcerative colitis A male patient presents with lower right-sided abdominal pain, an elevated temperature, and a white blood cell count of 17,000. He complains of nausea and vomiting over several days. The nurse practitioner flexes his right leg at his hip and knee, which results in moderate discomfort. Which diagnosis is most likely? A. Hepatitis B. Appendicitis C. Cholecystitis D. Nephrolithiasis - B. Appendicitis . An older adult male with alcohol use disorder is scheduled for a physical exam and laboratory testing. The patient's laboratory blood test results may show: A. Increased serum creatinine levels and eGFR. B. Decreased number of platelets and increased MCV. C. Increased serum potassium and increased triglycerides. D. Decreased AST and ALT levels - B. Decreased number of platelets and increased MCV. 1. Which of the following individuals is at higher risk for suicide? A. Obese teenager who fails am exam in high school. B. Black middle-aged female who is newly diagnosed with DM2. C. Elderly white male whose wife of 40 years recently died. D. Asian adult whose mother has a chronic illness - C. Elderly white male whose wife of 40 years recently died. An elderly diabetic female with peripheral neuropathy and CAD is recently diagnosed with major depression. The patient refuses psychotherapy and wants medication. She denies suicidal and homicidal ideation. Which of the following medications is the best choice for this patient? A. Seroquel B. Cymbalta C. Lexapro D. Elavil - B. Cymbalta 3. Which of the following drug classes is indicated as the first line treatment of both major depression and OCD? A. SSRIs B. TCAs C. Mood stabliziers D. Benzodiazepines - A. SSRIs Which of the following individuals is least likely to have an alcohol abuse problem? A. A woman who gets annoyed if her best friend talks to her about her drinking habit. B. A carpenter who drinks two cans of beer nightly when playing cards with friends. C. A nurse who feels shaky when she wakes up and drinks one glass of wine to feel better. D. A college student who tells his friend that he drinks only on weekends but feels that he should be drinking less. - B. A carpenter who drinks two cans of beer nightly when playing cards with friends. 4. Signs and symptoms of depression include all of the following, except: A. Anhedonia B. Low self esteem C. Apathy D. Apraxia - D. Apraxia The NP is evaluating a 16-year-old female with fatigue and headaches. The patient is wearing multiple layers of clothing and her hair is limp and dry. Upon examination, the NP finds the patient's skin to have a yellow cast and downy hair on her body. Which diagnosis is most likely? A. Alopecia B. Anorexia Nervosa C. Bulimia D. Amenorrhea - B. Anorexia Nervosa 5. All of the following are at higher risk of suicide, except: A. A 66-year-old white man whose wife of 40 years just recently died B. A high school student with a history of bipolar disorder C. A depressed 45-year-old woman with a family history of suicide D. A 17-year-old teen who has only one close friend in school - D. A 17-year-old teen who has only one close friend in school The nurse practitioner is assessing a 63-year-old male who has a history of IV drug use as a young adult. He presents with fatigue and nausea. Which screening will the NP recommend for this patient? A. CXR B. Urine Specimen C. Hepatitis C D. Electroencephalogram - C. Hepatitis C Which lifestyle factor is associated with secondary polycythemia vera? A. Obesity B. Smoking C. Alcohol abuse D. Sedentary lifestyle - B. Smoking What is the first-line treatment for asthma? A.Inhaled corticosteroids (ICS) B.Long-acting beta2-agonists (LABAs) C.Leukotriene inhibitors D.Short-acting beta2-agonists (SABAs) - A. Inhaled corticosteroids (ICS) Which of the following is a major risk factor for fatal asthma? A.Exercising in cold weather B.Smoking and vaping C.Hospital admission in past year D.Allergy to pet dander and dust mites - C.Hospital admission in past year What is the preferred reliever medication for asthmatics according to the Global Initiative for Asthma (GINA, 2020) treatment guideline? A.Low-dose ICS with formoterol B.SABA C.LABA D.Leukotriene receptor antagonist - A.Low-dose ICS with formoterol Pulsus paradoxus is more likely to be associated with: A.Sarcoidosis B.Acute bronchitis C.Status asthmaticus D.Bacterial pneumonia - C.Status asthmaticus A young adult presents for reassessment of uncontrolled asthma symptoms. The patient is currently taking an inhaled short-acting beta2-agonist (SABA) as needed and reports daytime symptoms more than 3 days/week, but not daily, and nighttime awakenings 4 to 5 times/week. The patient's forced expiratory volume (FEV1) is 80% of predicted. The nurse practitioner upgrades the patient to the next stage of treatment, which includes: A.Budesonide with formoterol B.Budesonide with montelukast C.Cromolyn or nedocromil DFluticasone with salmeterol - A.Budesonide with formoterol A 23-year-old woman is seen in the office by the nurse practitioner for complaints of weakness, poor balance, and problems with walking. She states, "I am so clumsy. Sometimes I fall when I walk." She reports new-onset vision loss and bladder incontinence. Each episode lasts a few days; she has had several in the past 6 months. When she bends her head forward to tie her shoes, she reports a sharp shooting sensation from the upper to lower back. She is anxious and crying at the office. What is the most likely diagnosis for this patient? A.Vitamin B12 deficiency B.Tertiary syphilis C.Multiple sclerosis D.Lou Gehrig's disease - C.Multiple sclerosis Which cranial nerve is responsible for tongue movement? A.CN VIII B.CN IX and CN X C.CN XI D.CN XII - D.CN XII A 54-year-old woman complains of "being stressed out" at her new job. She complains about daily headaches for several months and takes acetaminophen (Tylenol) to self-treat twice a day. She describes the headache as being band-like and dull accompanied by tight neck muscles bilaterally. She denies nausea, vomiting, visual changes, and photophobia. Which of the following is appropriate management of this patient? A. Stop the acetaminophen (Tylenol) and start her on ketorolac (Toradol) B.Discontinue the acetaminophen (Tylenol) and encourage stress reduction measures such as exercise and yoga C. Advise patient to start taking ibuprofen one to two tablets daily D. Start patient on butalbital and discontinue acetaminophen (Tylenol) - B.Discontinue the acetaminophen (Tylenol) and encourage stress reduction measures such as exercise and yoga middle-aged male patient with a history of cluster headaches arrives at the primary care clinic for treatment. Which of the following interventions is included in the acute treatment plan? A. Ice pack on forehead B. Acetaminophen B.Intranasal 4% lidocaine C. Phenytoin (Dilantin) - B.Intranasal 4% lidocaine A 20-year-old patient has recently been diagnosed with migraines. The nurse practitioner is educating the patient about factors that are known to trigger migraine headaches. Which of the following is incorrect advice? A.Avoid foods with high tyramine content B.Avoid foods with high potassium content C.Get enough sleep C.Avoid fermented foods - B.Avoid foods with high potassium content You are seeing a 14-year-old patient in your office being evaluated for a concussion. Which of the following symptoms is NOT a symptom you would expect? Sensitivity to light Irritability and behavioral changes Impaired gait Nuchal rigidity - Nuchal rigidity You are speaking to a parent of a 16-year-old who has suffered a mild concussion. The parent asked how long it will take until the child is back to normal. Your answer should be? "He should be fully recovered in a few hours." "He should be recovered in 24-48 hours." "Most recoveries from concussions take 7-10 days, though it takes longer in some people." "Most recoveries from concussions takes 1-2 months." - "Most recoveries from concussions take 7-10 days, though it takes longer in some people." You are reevaluating and counseling a 21-year-old college football player in your office who suffered a concussion 4 days ago. Which of the following statements is important to tell him as to why you are continuing to hold him out of practices and competitions? "You are more likely to become depressed if you practice too early." "There is a very serious and potentially fatal complication of concussions called 'Second Impact Syndrome' that can occur if you don't allow yourself to heal completely from a concussion." "You are not tough enough to play with a concussion." "You will not be able to sleep if you return too quickly from a concussion." - A 40-year-old patient was in a car crash yesterday, was seen in the ER, and diagnosed with a concussion. On the follow-up today, you observe many severe cranial nerve deficits, slurred speech, drowsiness, and a severe headache, rated 10/10, that is much worse than yesterday. Her husband states she is doing much worse than yesterday. What do you do? Send the patient to the ER as you suspect a vaulting intracranial hematoma Tell the patient the avoid contact and to rest as you suspect second impact syndrome Tell the patient to take Tylenol as you suspect migraines Prescribe an SSRI as you suspect severe depression - Send the patient to the ER as you suspect a vaulting intracranial hematoma A 13-year-old Caucasian male comes into your office for a yearly checkup. As a part of the exam, you are doing Tanner staging. He has recently started a rapid growth spurt; he also has dense, dark, curly pubic hair over the pubic region but none on his thighs. On what Tanner Stage do you place him? Stage 2 Stage 3 Stage 4 Stage 5 - Stage 4 The Nurse Practitioner is evaluating a 17 y/o female who presents with acute knee pain. The patient states she was competing in a tennis match when she felt a "pop" in her knee, associated with swelling and acute pain rated as 6/10. During inspection, the Nurse Practitioner notes a positive Lachman's test. Which action is appropriate following evaluation? A) Encourage partial weight bearing for the patient until the knee heals. -The patient should be non-weight bearing. B) Advise the patient to apply heat to the area- Patient should apply ice to decrease swelling and inflammation C) Refer to an orthopedic surgeon- the patient with an ACL injury should be referred to orthopedics to determine if surgical management is appropriate. In the meantime, the patient should be non weight bearing. D) Apply an ace wrap and educate the patient on knee sprains. - while compression may be appropriate for initial inflammatory management, this patients clinical presentation is consistent with a tear of their ACL, and should be referred to orthopedics to determine if surgical management is appropriate. - C) Refer to an orthopedic surgeon- the patient with an ACL injury should be referred to orthopedics to determine if surgical management is appropriate. In the meantime, the patient should be non weight bearing. All of the following are causes of bursitis except: A) Direct injury or trauma B) Prolonged pressure C) Overuse or strenuous activity D) Hypertension E) Infection - D) Hypertension Mandatory services defined by federal law for inclusion in Medicaid include all of the following except: Laboratory and x-ray services Select family planning services Rehabilitation therapy Nurse practitioner (NP) services - Rehabilitation therapy n a malpractice case involving the family NP care of a 4-year-old previously well boy with acute Otis media who is seen in a family practice primary care setting, the most appropriate expert plaintiff may use to establish standard of care would be: A pediatrician A family NP An infectious disease (ID) physician assistant An NP specializing in ethical and legal dilemmas - A family NP When billing commercial insurance, NPs' authority to bill for their services comes from: State law only Federal law only State law and/or the commercial payers Federal law and/or the commercial payers - State law and/or the commercial payers Nurse practitioners with the ability to fully utilize the knowledge, skills, and judgement to pactice consistently with their education, training, and certification have ? State licensure National certification Full practice authority Collaborative practice - Full practice authority A nurse practitioner is writing a referral for a middle-aged diabetic who has an A1C of 8.5% despite being on three antidiabetic medications. She is referring the patient to an endocrinologist. What type of relationship exists between the nurse practitioner and the endocrinologist? Consultive relationship Collaborative relationship Referral relationships Formal relationship - Collaborative relationship The Lachman maneuver is used to detect which of the following? A) Instability of the knee B) Nerve damage of the knee due to past knee injuries C) Integrity of the patellar tendon D) Tears on the meniscus of the knee - A) Instability of the knee Carpal tunnel syndrome is due to inflammation of the: A) Ulnar nerve B) Radial nerve C) Brachial nerve D) Median nerve - D) Median nerve A fracture on the navicular area of the wrist is usually caused by falling forward and landing on the hands. The affected wrist is hyperextended to break the fall. The nurse practitioner is aware that all of the following statements are true regarding a fracture of the scaphoid bone of the wrist except: A) It has a higher rate of nonunion compared with the other bones in the wrist when it is fractured B) The fracture frequently does not show up on an x-ray film when it is taken immediately after the injury C) The x-ray film will show the fracture if the film is repeated in 2 weeks D) These fractures always require surgical intervention to stabilize the joint - D) These fractures always require surgical intervention to stabilize the joint Which of the following tests would be the initial choice for evaluating for possible fractures on the right lower leg? A) Plain radiographs of the right lower leg, ankle, and foot B) Ultrasound of the right lower leg C) MRI of the right ankle D) Radiograph of the right ankle and knee with special view of the hip - A) Plain radiographs of the right lower leg, ankle, and foot In addition to surgical repair of a compound fracture that has broken through the skin, which of the following treatment plans is important to consider in this patient? A) Application of a topical antibiotic BID until the wound is healed B) Wound irrigation C) Use cold packs three times per day D) Tetanus vaccine and systemic antibiotics - D) Tetanus vaccine and systemic antibiotics A middle-aged woman has been experiencing low-back pain that recently started to radiate to both buttocks and down her legs. She complains of leg weakness and problems with walking. Along with these symptoms she reports new onset of urinary incontinence, in which she leaks a small amount of urine at random. She also reports numbness on her perineal area, which is new. She denies trauma but reports that she recently moved to a new apartment and has been lifting and moving furniture. Which of the following is best described? A) Sciatica B) Acute muscle spasm C) Cauda equina syndrome D) Acute muscle strain - C) Cauda equina syndrome A 40-year-old nurse complains of new-onset back pain secondary to her job on the medical-surgical floor of a hospital. She reports lifting some obese patients while working the previous night shift. She reports to the worker's compensation clinic where she was referred. She describes the pain as starting in her right buttocks area and radiating down the back of her thigh. It becomes worse when she sits down for long periods. You would suspect: A) Sciatica B) Acute muscle spasm C) Cauda equina syndrome D) Acute muscle strain - A) Sciatica A 53-year-old crossing guard complains of twisting his right knee while working that morning. The knee is swollen and tender to palpation. The nurse practitioner diagnoses a grade II sprain. The initial treatment plan includes which of the following? A) Intermittent application of cold packs the first 24 hours followed by applications of low heat at bedtime B) Elevation of the affected limb and intermittent applications of cold packs for the next 48 hours C) Rechecking the knee in 24 hours and encouraging isometric exercises D) Application of an elastic bandage wrap to the affected knee - B) Elevation of the affected limb and intermittent applications of cold packs for the next 48 hours A neighbor's 14-year-old son, who is active in basketball, complains of pain and swelling on both knees. On physical exam, there is tenderness over the tibial tuberosity of both knees. Which of the following is most likely? A) Chondromalacia patella B) Left knee sprain C) Osgood-Schlatter disease D) Tear of the medial ligament to prevent frostbite and further damage to tissue. - C) Osgood-Schlatter disease If planter fasciitis is suspected in a patient, how is this diagnosed? A) X-ray of the foot B) CT scan C) Physical Exam D) Bone scan - C) Physical Exam An 18-year old man with a BMI = 40 kg/m presents with periumbilical pain, vomiting, and abdominal cramping over the past 48 hours. Physical examination revels rebound tenderness, and laboratory analysis shows the presence of bandemia and a total WBC of 28,000/mm. To support the diagnosis o acute appendicitis with the suspected appendiceal rupture, you consider obtaining the following abdominal imaging study: MRI CT scan Ultrasound Flat plate - CT scan Commonly encountered diagnoses other than acute appendicitis can include which of the following in a 28-year-old woman with a 2-day history of lower abdominal pain and with right-sided pain slightly worse than left? (Select all that apply) Constipation PID Ectopic pregnancy Splenic infarct - Constipation PID Ectopic pregnancy In a 28-year-old man who presents with a 6-month history of involuntary weight loss, recurrent abdominal cramping, loose stools, and anterior and posterior anal fissure, which of the following diagnoses should be considered? UC Crohn's disease C difficile colitis Condyloma acuminata - Crohn's disease Diagnostic criteria for IBS include abdominal pain that is associated with all of the following except: Improvement with defecation A change in frequency of stool A change in stool form Unexplained weight loss - Unexplained weight loss An example of medication with prokinetic activity is: Dicyclomine (Bentyl) Metoclopramide (Reglan) Loperamide (Immodium) Psyllium (Metamucil) - Metoclopramide (Reglan) Which of the following assessment findings would help confirm a diagnosis of asthma in a client suspected of having the disorder? a. Circumoral cyanosis b. Increased forced expiratory volume c. Inspiratory and expiratory wheezing d. Normal breath sounds - c. Inspiratory and expiratory wheezing A client with acute asthma showing inspiratory and expiratory wheezes and a decreased expiratory volume should be treated with which of the following classes of medication right away? a. Beta-adrenergic blockers b. Bronchodilators c. Inhaled steroids d. Oral steroids - b. Bronchodilators A 19-year-old comes into the emergency department with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should be taken first? a. Take a full medication history b. Give a bronchodilator by nebulizer c. Apply a cardiac monitor to the client d. Provide emotional support to the client - b. Give a bronchodilator by nebulizer Which of the following types of asthma involves an acute asthma attack brought on by an upper respiratory infection? a. Emotional b. Extrinsic c. Intrinsic d. Mediated - c. Intrinsic Emergency treatment of a client in status asthmaticus includes which of the following medications? a. Inhaled beta-adrenergic agents b. Inhaled corticosteroids c. IV beta-adrenergic agents d. Oral corticosteroids - a. Inhaled beta-adrenergic agents Peak expiratory flow meters: A. should only be used in the presence of a medical professional. B. provide a convenient method to check lung function at home. C. are as accurate as spirometry. D. should not be used more than once daily. - B. provide a convenient method to check lung function at home. Which of the following is most likely to appear on a chest radiograph of a person during an acute severe asthma attack? A. hyperinflation B. atelectasis C. consolidation D. Kerley B signs - A. hyperinflation Which of the following best describes the mechanism of action of short-acting beta2-agonists? A. reducer of inflammation B. inhibition of secretions C. modification of leukotrienes D. smooth muscle relaxation - D. smooth muscle relaxation Compared with albuterol, levalbuterol (Xopenex) has: A. a different mechanism of action. B. the ability potentially to provide greater bronchodilation with a lower dose. C. an anti-inflammatory effect similar to that of an inhaled corticosteroid. D. a contraindication to use in elderly patients. - B. the ability potentially to provide greater bronchodilation with a lower dose. A potential adverse effect from inhaled corticosteroid use is: A. oral candidiasis B. tachycardia C. gastrointestinal upset D. insomnia - A. oral candidiasis A patient with an eating disorder might exhibit evidence of: Thyroid disease Sleep disorders Anxiety disorders Sexual abuse - Anxiety disorders According to the DSM-5 criteria, which criterion is NOT part of the diagnostic criteria for anorexia nervosa? Intense fear of weight gain Significantly low weight Distorted perception of body weight Muscle wasting - Muscle wasting Which of the following characterizes bulimia nervosa? Binge eating Purging Food restriction Concern over body weight - Binge eating A person who abuses alcohol will probably exhibit: Elevated alkaline phosphatase Decreased TSH Elevated ALT, AST, and GGT Elevated AST only - Elevated ALT, AST, and GGT Which findings suggest that a person may be abusing alcohol? Microcytosis, tremulousness, hypertension Rhinophyma, hypotension, peripheral neuropathy Telangiectasias, flat affect, thyroid dysfunction Hepatosplenomegaly, murmur, osteoarthritis - Microcytosis, tremulousness, hypertension A 19 year old college student is at least 15% below her ideal body weight. She reports doing well in classes but drinks alcohol nightly, and several cups of coffee throughout the day. She is bradycardic and gets dizzy when stands. What may also be observed in this patient? HTN OSA Amenorrhea Mitral regurgitation - Amenorrhea n adolescent patient presents with complaints of palpitations and low energy. Her BMI is 16.5 and she is amenorrheic. She has a history of anxiety. The nurse practitioner suspects anorexia nervosa. Which laboratory studies should the NP initially order? TSH, glucose, EKG, and Sedimentation rate Echocardiogram, CBC, serum ferritin Glucose sedimentation rate, BUN, Cr, EKG CBC, glucose, electrolytes, BUN, Cr, urine HcG - CBC, glucose, electrolytes, BUN, Cr, urine HcG How should a NP approach a patient who consumes excessive amounts of alcohol but denies that he has a problem? Order a liver function study to show the patient that his liver has damage Order a blood alcohol and discuss the results Tell him to find another provider Tell him you are concerned for his health - Tell him you are concerned for his health What assessment tool is utilized for detecting alcoholism? SNAP PROMIS MMSE CAGE - CAGE Binge eating disorder includes all the following EXCEPT Binge eating on average once a week for 3 consecutive months Eating more rapidly than normal Severe limitation of food as primary means to lose weight Eating larger amounts and then feeling disgusted with oneself - Severe limitation of food as primary means to lose weight The nurse is aware that Bells Palsy affects which cranial nerve? a. 2nd CN (optic) b. 3rd CN (oculomotor) c. 4th CN (trochlear) d. 7th CN (facial) - d. 7th CN (facial) The nurse has given the male client with bells palsy instructions on preserving muscle tone in the face and preventing denervation. The nurse determines that the client needs additional information if the client states that he or she will: a. Exposure to cold and drafts b. Massage the face with a gentle upward motion c. Perform facial exercises d. Wrinkle the forehead, blow out the cheeks, and whistle - a. Exposure to cold and drafts Which of the following diseases has not been directly linked with Bell's palsy? a. AIDS b. Diabetes c. Lyme disease d. Alzheimer's disease - d. Alzheimer's disease Trigeminal neuralgia is most commonly caused by which of the following? a. Aneurysm b. Arteriovenous malformation c. Compression of the trigeminal nerve by an intracranial artery d. Multiple sclerosis plaque at the root entry zone of the trigeminal nerve - c. Compression of the trigeminal nerve by an intracranial artery Multiple Sclerosis tends to affect men more than women and occurs during the ages of 50-70 years. a. True b. False - b. False Prophylactic treatment for migraine headaches includes: A. amitriptyline B. ergot derivative C. naproxen sodium D. clonidine - A. amitriptyline Risk factors for cluster headaches include all of the following except: A. being older than 65 years of age. B. heavy alcohol use. C. heavy tobacco use. D. male gender. - A. being older than 65 years of age. The mechanism of action of triptans is as: A. a selective serotonin receptor agonist. B. a dopamine agonist. C. a vasoconstrictor. D. an inhibitor of leukotriene synthesis. - A. a selective serotonin receptor agonist. The cause of multiple sclerosis (MS) is best described as: A. a destructive process of the nerve fiber protecting myelin. B. an intracranial viral infection. C. inflammation of the brain and/or spinal cord. D. an autoimmune disorder that destroys muscle fibers. - A. a destructive process of the nerve fiber protecting myelin. Treatment options in MS to attenuate disease progression include: A. interferon beta-1b B. methylprednisolone C. ribavirin D. phenytoin - A. interferon beta-1b A patient with acute anxiety will experience the fastest relief of symptoms when he is treated with: An SSRI A TCA A benzodiazepine A beta blocker - A benzodiazepine A patient had been diagnosed with anxiety. What sleep disturbance might she have? Early morning wakening Difficulty remaining asleep Difficulty falling asleep Never feeling tired - Difficulty falling asleep Serotonin syndrome may result from taking an SSRI and: Dextromethorphan Loratadine Pravastatin Niacin - Dextromethorphan A depressed patient is started on an SSRI. When should another antidepressant be tried if there is no response? 3-7 days 2-3 weeks 4-6 weeks 8-12 weeks - 8-12 weeks A common side effect of trazodone may be alleviated by: Taking this medication with food Taking this medication at bedtime Drinking a big glass of water with each dose. Eating increased fiber while taking this medication - Taking this medication at bedtime A male patient reports feelings of anhedonia for the last month. What should be part of the NPs initial assessment? Libido Suicidal ideations Mania Depression - Suicidal ideations The preferred medication class to treat patients with an initial episode of minor depressive disorder is: Tricyclic antidepressants Monoamine oxidase inhibitors SSRI Any class, there is no preferred class - SSRI A patient reports that she is takes kava kava regularly for anxiety with good results. What should the NP evaluate? Liver function studies Risk of bleeding Thyroid function Colon polyps - Liver function studies Which patient is most likely to exhibit depression related to his illness? A patient with: Femur fracture Parkinson's disease Diabetes Loss of a finger - Parkinson's disease A patient presents to the NP's clinic and states that she feels sad and thinks she's depressed. What information is important to elicit in order to diagnose her with depression? How long have you felt like this? Does anyone in your family have depression? Are you thinking about harming yourself? Do you have a plan to harm yourself? - How long have you felt like this? Sources of legal risk for the nurse practitioner include all the following except: Invasive procedures Electronic medical record entries Prescribing medication In-service training - In-service training The NP assesses health status by all the following except: Obtaining a comprehensive relevant health, social and medical history. Performing a thorough physical examination based on age and history. Performing or ordering preventive and diagnostic procedures based on the patient's age and history. Ignoring health risk factors - Ignoring health risk factors The NP makes a diagnosis by: Relying solely on diagnostic reasoning Formulating a differential diagnosis based on the history, physical examination and diagnostic test results and information. Synthesizing and analyzing the collected data from health history, physical exam, and ignoring any subjective patient input - Formulating a differential diagnosis based on the history, physical examination and diagnostic test results and information. The scope of practice for nurse practitioners includes, but are not limited to: Professionalism, Education, Accountability and Responsibility. Professionalism and Education. Independently practice in all states NP scope of practice is setting-specific and is based on the needs of the patient. - Professionalism, Education, Accountability and Responsibility. What is the difference between RN and NP scope of practice? NPs can prescribe medications, RNs cannot. NPs focus on patient observation; RNs focus on patient care. Both RNs and NPs are permitted to diagnose patients NPs have a scope of practice in which RNs do not. - NPs can prescribe medications, RNs cannot. What is the primary treatment for a patient who is present with asthma Exacerbation? Prescribe albuterol PRN. Teach patient how to properly use a spacer. Assess Asthma Triggers Apply nebulizer Treatment. - Apply nebulizer Treatment. The nurse practitioner orders a pulmonary function test for a patient exhibiting signs of obstructive lung disease. All the following are differential diagnosis except: A. Asthma B. Bronchiectasis C. Pulmonary Fibrosis D. Emphysema - C. Pulmonary Fibrosis A patient with a history of asthma is presenting with acute respiratory distress. During assessment of the patient, the nurse practitioner would be most concerned about which finding? a. a pulse oximetry reading of 90%. b. a peak expiratory flow rate of 240 ml/min. c. decreased breath sounds and wheezing. d. a respiratory rate of 26 breaths/min. - c. decreased breath sounds and wheezing. All of the following agents are used to control the inflammatory changes seen in the lungs of asthmatics except: A) Albuterol inhaler (Proventil) B) Triamcinolone (Azmacort) C) Montelukast (Singulair) D) Cromolyn sodium inhaler (Intal) - A) Albuterol inhaler (Proventil) Asthmatics may have all the following symptoms during an exacerbation except: A) Rapid pulse B) Wheezing C) Chronic coughing D) Tachypnea - C) Chronic coughing According to the CDC, the leading cause of TBI-related deaths for youth and young adults is: Falls MVA Unintentional blunt trauma Homicide - MVA A 14-year-old boy falls and hits hit head on the ground while riding his bicycle. He is complaining of having trouble seeing and that his vision is blurry. What part of the brain is affected due to this fall? Frontal lobe Occipital lobe Temporal lobe Parietal lobe - Occipital lobe An adolescent is playing soccer and collides into another player with his head. After the collision, the adolescent is experiencing nausea and dizziness. There symptoms are known as what type of injury? Concussion Moderate bring injury Severe brain injury Vertigo - Concussion Question 4: What is the long-term impact of repeated concussions on cognitive function in adolescent athletes? Repeated concussions have no significant impact on cognitive function in adolescent athletes. Repeated concussions may lead to short-term cognitive impairment, but there is no evidence of long-term effects. Repeated concussions have been associated with long-term cognitive deficits in some adolescent athletes. Repeated concussions only affect physical function and do not have any impact on cognitive abilities in adolescent athletes. - Repeated concussions have been associated with long-term cognitive deficits in some adolescent athletes. A concussion is: a type of traumatic brain injury (or TBI) caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. a type of injury that only affects the bones in the skull a temporary loss of consciousness due to a lack of oxygen to the brain. a psychological condition characterized by memory loss and confusion - a type of traumatic brain injury (or TBI) caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. What physical changes are typically observed during adolescent growth and development? Decreased height due to growth plate closure Decreased muscle mass and strength Development of primary sexual characteristics Decreased bone density and increased risk of osteoporosis - Development of primary sexual characteristics What psychological changes are typically observed during adolescent development? Increase emotional stability and maturity Decreased risk-taking behavior and impulsivity Decreased self-awareness and self-identity exploration Development of abstract thinking and reasoning skills - Development of abstract thinking and reasoning skills Which of the following is a primary sexual characteristic that develops during female adolescence? Breast development Increased height Growth of pubic hair Broadening of the shoulders - Breast development Which of the following is a secondary sexual characteristic that develops during female adolescence? Menstruation Breast development Increased height Development of the uterus - Menstruation During male adolescence, which of the following physical changes occurs due to hormonal influences? Development of breasts Increased height Widening of the hips Deepening of the voice - Deepening of the voice