Pre-Predictor exam review with Questions
and Correct Answers 2025
Prescriptive,.authority:,.-,.CORRECT,.ANSWER-
may,.be,.exercised,.by,.giving,.a,.verbal,.medication,.order,.to,.a,.pharmacist.
An,.example,.of,.exercising,.prescriptive,.authority,.is,.giving,.a,.verbal,.order,.to,.a,.pharmaci
st,.or,.writing,.an,.order,.for,.a,.prescription,.medication.,.Prescriptive,.authority,.rules,.and,.re
gulations,.vary,.from,.state,.to,.state.,.Prescriptive,.authority,.is,.granted,.only,.to,.those,.APR
Ns,.who,.meet,.the,.requirements,.of,.the,.governing,.body,.for,.the,.state,.in,.which,.the,.APR
N,.practices.
When,.examining,.a,.pregnant,.patient,,.where,.should,.the,.fundal,.height,.be,.at,.22,.weeks?,
.-,.CORRECT,.ANSWER-Above,.the,.umbilicus
Between,.18,.and,.32,.weeks,,.there,.is,.good,.correlation,.between,.fundal,.height,.and,.gesta
tional,.age,.of,.the,.fetus.,.The,.expected,.heights,.are:,.10-
12,.weeks:,.fundus,.slightly,.above,.the,.symphysis,.pubis,.16,.weeks:,.fundus,.midway,.betw
een,.the,.symphysis,.pubis,.and,.umbilicus,.20,.weeks:,.fundus,.at,.the,.level,.of,.umbilicus,.28,
.weeks:,.fundus,.3,.fingerbreadths,.above,.the,.umbilicus,.36,.weeks:,.fundus,.just,.below,.the,
.xiphoid,.process
What,.intervention,.does,.the,.American,.College,.of,.Rheumatology,.recommend,.as,.first-
line,.therapy,.for,.osteoarthritis?,.-,.CORRECT,.ANSWER-Exercise,.and,.weight,.loss
Exercise,,.weight,.loss,,.and,.rest,.are,.recommended,.by,.the,.American,.College,.of,.Rheum
atology,.guidelines,.for,.the,.initial,.management,.of,.osteoarthritis,.(OA).,.Given,.the,.adverse
,.effects,.of,.medications,.used,.to,.treat,.OA,,.it,.is,.best,.to,.minimize,.dosage,.and,.delay,.use,.
as,.long,.as,.possible.,.An,.extensive,.diagnostic,.workup,.is,.not,.recommended,.unless,.the,.
presentation,.is,.in,.question.,.Patients,.who,.have,.severe,.degenerative,.joint,.disease,.(DJ
D),,.joint,.fusion,,.or,.whose,.pain,.severity,.is,.not,.relieved,.by,.more,.conservative,.therapies,
.may,.be,.candidates,.for,.joint,.replacement.,.Acetaminophen,.is,.recommended,.as,.a,.first-
line,.medication.
,A,.63-year-
old,.male,.retired,.accountant,.complains,.of,.pain,.and,.stiffness,.in,.his,.feet,.and,.hands,.of,.s
everal,.years,.duration.,.He,.reports,.that,.the,.pain,.and,.stiffness,.become,.worse,.with,.activi
ty.,.On,.examination,,.he,.is,.noted,.to,.have,.Heberden's,.nodes,.but,.no,.other,.bony,.deformit
ies.,.Which,.of,.the,.following,.is,.the,.most,.probable,.diagnosis?,.-,.CORRECT,.ANSWER-
Osteoarthritis,.(OA)
Although,.his,.vocation,.involved,.sedentary,.activity,,.this,.patient,.is,.not,.at,.great,.risk,.for,.o
steoarthritis.,.Rheumatoid,.arthritis,.is,.characterized,.by,.several,.joint,.deformities,,.usually,.
bilaterally,.symmetrical.,.RA,.is,.characterized,.by,.inflammatory,.processes,,.while,.OA,.is,.n
ot.,.RA,.and,.OA,.are,.chronic,.conditions.,.Gout,.is,.characterized,.by,.acute,.exacerbations,.r
elated,.to,.a,.defect,.in,.purine,.metabolism,,.increased,.uric,.acid,.production,,.or,.decreased,.
uric,.acid,.excretion.
The,.family,.of,.a,.78-year-
old,.man,.moved,.him,.into,.an,.assisted,.living,.center,.because,.he,.can,.no,.longer,.be,.left,.at
,.home,.alone.,.He,.is,.unable,.to,.toilet,.when,.asked,.to,.do,.so,.and,.he,.has,.had,.several ,.epi
sodes,.of,.incontinence.,.He,.has,.walked,.out,.of,.the,.facility,.twice,.and,.been,.unable,.to,.find
,.his,.way,.back,.from,.3,.blocks,.away.,.On,.examination,,.he,.is,.pleasant,.but,.mildly,.confuse
d.,.Which,.of,.his,.medications,.is,.LEAST,.likely,.contributing,.to,.his,.behavior?,.-
,.CORRECT,.ANSWER-ramipril,.(Altace®)
Tricyclic,.antidepressants,,.like,.amitriptyline,,.have,.anticholinergic,.side,.effects,.which,.are,
.especially,.problematic,.in,.the,.elderly,.because,.they,.contribute,.to,.urinary,.retention.,.Hyd
rochlorothiazide,.is,.a,.diuretic,.and,.may,.contribute,.to,.his,.incontinence.,.Cimetidine,.is,.wel
l,.known,.to,.produce,.adverse,.reactions,.such,.as,.confusion,.in,.elders.,.Ramipril,,.an,.ACE,.i
nhibitor,,.is,.unlikely,.to,.contribute,.to,.this,.patient's,.incontinence,.or,.confusion.,.Toileting,.
may,.be,.a,.complicated,.by,.the,.anticholinergic,.medication,.and/or,.the,.diuretic,.causing,.di
uresis,,.urge,.incontinence,,.and,.inability,.to,.void,.at,.will.
A,.patient,.with,.no,.significant,.medical,.history,.has,.varicose,.veins.,.She,.complains,.of,."ac
hing,.legs".,.The,.intervention,.that,.will,.provide,.the,.greatest,.relief,.for,.her,.complaint,.is,.to:,
.-,.CORRECT,.ANSWER-elevate,.her,.legs,.periodically.
The,.intervention,.that,.will,.provide,.the,.greatest,.relief,.for,.this,.patient,.is,.elevating,.her,.leg
s,.periodically.,.This,.will,.facilitate,.venous,.return.,.Use,.of,.support,.stockings,.will,.prolong,.t
he,.length,.of,.time,.she,.is,.able,.to,.stand,.in,.place,,.but,.will,.not,.provide,.relief,.after,.her,.leg
s,.begin,.aching.,.Support,.stockings,.should,.be,.applied,.prior,.to,.getting,.out,.of,.bed.
Stress,.urinary,.incontinence,.is:,.-,.CORRECT,.ANSWER-
may,.be,.aggravated,.by,.caffeine,.or,.alcohol.
Stress,.urinary,.incontinence,.is,.not,.expected,.as,.a,.result,.of,.the,.normal,.aging,.process.,.
The,.primary,.problem,.is,.sphincter,.incompetence.,.The,.ingestion,.of,.caffeine,.or,.alcohol,.
decreases,.sphincter,.control.,.Anticholinergic,.and,.antidepressant,.medications,.are,.caus
,ative,.factors,.related,.to,.overflow,.incontinence.,.Detrusor,.muscle,.instability,.is,.the,.primar
y,.underlying,.problem,.causing,.urge,.incontinence.
Which,.commonly,.used,.herbal,.remedy,.is,.NOT,.associated,.with,.anxiety,.and/or,.depressi
ve,.symptom,.relief?,.-,.CORRECT,.ANSWER-Ginkgo,.biloba
Ginkgo,.biloba,.is,.a,.common,.herbal,.remedy,.associated,.with,.enhancement,.of,.vascular,.
and,.cerebral,.perfusion,.and,.memory.,.The,.nurse,.practitioner,.should,.be,.aware,.when,.th
e,.patient,.is,.taking,.any,.herbal,.supplement,.to,.avoid,.risk,.of,.drug,.interactions.
Upon,.ophthalmoscopic,.examination,.of,.a,.78-year-
old,.patient,,.the,.nurse,.practitioner,.observes,.dark,.spots,.against,.a,.red,.retina.,.What,.diag
nosis,.is,.this,.finding,.most,.consistent,.with?,.-,.CORRECT,.ANSWER-Cataract
A,.cataract,.opacity,.is,.seen,.as,.a,.dark,.disruption,.of,.the,.red,.reflex,.on,.ophthalmoscopic,.
exam.
A,.72,.year,.old,.female,.patient,.reports,.a,.6,.month,.history,.of,.progressively,.more,.swollen,.
and,.painful,.distal,.interphalangeal,.(DIP),.joints,.of,.one,.hand.,.There,.are,.no,.systemic,.sy
mptoms,.but,.the,.erythrocyte,.sedimentation,.rate,.(ESR),,.antinuclear,.antibody,.(ANA),,.an
d,.rheumatoid,.factor,.(RF),.are,.all,.minimally,.elevated.,.What,.is,.the,.most,.likely,.diagnosis
?,.-,.CORRECT,.ANSWER-Osteoarthritis
When,.osteoarthritis,.affects,.the,.hands,,.the,.distal,.interphalangeal,.(DIP),.joints,.are,.usual
ly,.involved.,.Rheumatoid,.arthritis,.is,.usually,.symmetrical,,.and,.the,.proximal,.interphalang
eal,.(PIP),.joints,.are,.more,.often,.affected.,.Inflammation,.often,.develops,.quickly,,.not,.grad
ually.,.This,.patient,.is,.elderly;,.therefore,,.it,.is,.expected,.that,.the,.ESR,,.ANA,,.and,.RF,.will,.
be,.only,.somewhat,.elevated.,.Over-
interpretation,.of,.laboratory,.tests,.without,.evidence,.of,.systemic,.inflammation,.can,.lead,.t
o,.misdiagnosis.
The,.nurse,.practitioner,.is,.evaluating,.a,.35-year-
old,.female,.nurse.,.She,.has,.a,.history,.of,.hospitalization,.for,.hepatitis,.B,.infection,.2,.years,
.ago.,.Her,.laboratory,.tests,.demonstrate,.positive,.HBsAg.,.The,.nurse,.practitioner,.would,.
most,.likely,.diagnose:,.-,.CORRECT,.ANSWER-chronic,.hepatitis,.B,.infection.
Presence,.of,.hepatitis,.B,.surface,.antigen,.at,.this,.time,.indicates,.chronic,.infection,.with,.he
patitis,.B.,.Lab,.studies,.indicating,.a,.positive,.surface,.antigen,.on,.2,.separate,.occasions,.at,
.least,.6,.months,.apart,.indicate,.chronic,.infection.,.Immunization,.produces,.positive,.hepati
tis,.B,.antibodies,.in,.most,.instances.,.Hepatitis,.B,.surface,.antigen,.would,.not,.be,.present,.i
n,.a,.person,.who,.has,.recovered,.from,.hepatitis,.B,.infection.,.This,.case,.would,.not,.be,.an,.
acute,.episode,.because,.of,.the,.history,.of,.hepatitis,.B,.infection,.2,.years,.prior.
One,.exception,.to,.the,.recommendation,.to,.limit,.dietary,.fat,.intake,.is:,.-
,.CORRECT,.ANSWER-children,.under,.2,.years-of-age.
, In,.order,.for,.myelinization,.of,.the,.nervous,.system,.to,.occur,,.children,.under,.2,.years-of-
age,.require,.>,.30%,.daily,.dietary,.fat.
The,.most,.effective,.primary,.prevention,.of,.skin,.cancer,.is,.to,.educate,.the,.public,.about:,.-
,.CORRECT,.ANSWER-limiting,.exposure,.to,.natural ,.solar,.radiation.
Primary,.prevention,.of,.skin,.cancer,.includes,.limiting,.sun,.exposure,,.avoiding,.tanning,.fac
ilities,,.and,.applying,.sunscreen.,.Examining,.the,.skin,.and,.recognizing,.melanoma,.are,.bot
h,.secondary,.prevention,.measures.
A,.patient,.has,.experienced,.nausea,.and,.vomiting,,.headache,,.malaise,,.low-
grade,.fever,,.abdominal,.cramps,,.and,.diarrhea,.for,.32,.hours.,.The,.white,.count,.is,.slightly,
.elevated,.with,.a,.shift,.to,.the,.left.,.He,.is,.requesting,.medication,.for,.diarrhea.,.What,.is,.the,.
most,.appropriate,.response?,.-,.CORRECT,.ANSWER-Offer,.an,.anti-
emetic,.medication,.such,.as,.prochlorperazine,.(Compazine®),.and,.provide,.oral,.fluid,.and,
.electrolyte,.replacement,.instruction.
Enterocolitis,.is,.the,.most,.common,.clinical,.presentation,.of,.salmonellosis.,.Diagnosis,.is,.
made,.by,.clinical,.presentation,,.and,.can,.be,.confirmed,.only,.with,.stool,.or,.blood,.cultures.,
.Most,.healthy,.adults,.have,.a,.course,.that,.is,.self-
limiting,.to,.72,.hours.,.Antibiotics,.should,.be,.used,.very,.discriminantly,.as,.resistance,.appr
oaches,.50%.,.Anti-
diarrheal,.agents,.potentially,.increase,.complications,.and,.predispose,.the,.patient,.to,.bact
eremia.
A,.child,.with,.Type,.1,.diabetes,.mellitus,.brings,.in,.a,.glucose,.diary,.indicating,.consistent,.m
orning,.hyperglycemia.,.How,.can,.the,.nurse,.practitioner,.differentiate,.the,.Somogyi,.effect,.
from,.dawn,.phenomenon?,.-,.CORRECT,.ANSWER-
Instruct,.the,.parent,.to,.monitor,.the,.blood,.glucose,.at,.3:00,.am.
Dawn,.phenomenon,.is,.an,.early,.morning,.rise,.in,.plasma,.glucose.,.It,.indicates,.a,.need,.for
,.increased,.insulin.,.The,.Somogyi ,.effect,.is,.a,.rise,.in,.plasma,.glucose,.in,.response,.to,.hyp
oglycemia.,.It,.is,.usually,.accompanied,.by,.weight,.gain,.and,.hunger,.and,.is,.corrected,.by,.
decreasing,.the,.evening,.insulin,.dose.,.A,.series,.of,.3,.early,.morning,.measurements,.of,.bl
ood,.glucose,.will,.help,.differentiate,.between,.the,.2,.conditions.
Of,.the,.following,.signs,.and,.symptoms,.of,.heart,.failure,.(HF),,.the,.earliest,.clinical,.manifes
tation,.is:,.-,.CORRECT,.ANSWER-weight,.gain.
The,.earliest,.and,.most,.sensitive,.clinical,.indicator,.of,.HF,.is,.weight,.gain.,.A,.patient,.with,.
HF,.should,.be,.instructed,.to,.weigh,.himself,.daily,.to,.note,.changes,.in,.his,.weight.,.The,.be
st,.time,.of,.day,.to,.weigh,.is,.early,.morning.,.The,.other,.clinical,.manifestations,.listed,.will,.pr
esent,.after,.the,.weight,.gain.,.Another,.early,,.clinical,.manifestation,.of,.CHF,.not,.listed,.abo
ve,.is,.fatigue.
and Correct Answers 2025
Prescriptive,.authority:,.-,.CORRECT,.ANSWER-
may,.be,.exercised,.by,.giving,.a,.verbal,.medication,.order,.to,.a,.pharmacist.
An,.example,.of,.exercising,.prescriptive,.authority,.is,.giving,.a,.verbal,.order,.to,.a,.pharmaci
st,.or,.writing,.an,.order,.for,.a,.prescription,.medication.,.Prescriptive,.authority,.rules,.and,.re
gulations,.vary,.from,.state,.to,.state.,.Prescriptive,.authority,.is,.granted,.only,.to,.those,.APR
Ns,.who,.meet,.the,.requirements,.of,.the,.governing,.body,.for,.the,.state,.in,.which,.the,.APR
N,.practices.
When,.examining,.a,.pregnant,.patient,,.where,.should,.the,.fundal,.height,.be,.at,.22,.weeks?,
.-,.CORRECT,.ANSWER-Above,.the,.umbilicus
Between,.18,.and,.32,.weeks,,.there,.is,.good,.correlation,.between,.fundal,.height,.and,.gesta
tional,.age,.of,.the,.fetus.,.The,.expected,.heights,.are:,.10-
12,.weeks:,.fundus,.slightly,.above,.the,.symphysis,.pubis,.16,.weeks:,.fundus,.midway,.betw
een,.the,.symphysis,.pubis,.and,.umbilicus,.20,.weeks:,.fundus,.at,.the,.level,.of,.umbilicus,.28,
.weeks:,.fundus,.3,.fingerbreadths,.above,.the,.umbilicus,.36,.weeks:,.fundus,.just,.below,.the,
.xiphoid,.process
What,.intervention,.does,.the,.American,.College,.of,.Rheumatology,.recommend,.as,.first-
line,.therapy,.for,.osteoarthritis?,.-,.CORRECT,.ANSWER-Exercise,.and,.weight,.loss
Exercise,,.weight,.loss,,.and,.rest,.are,.recommended,.by,.the,.American,.College,.of,.Rheum
atology,.guidelines,.for,.the,.initial,.management,.of,.osteoarthritis,.(OA).,.Given,.the,.adverse
,.effects,.of,.medications,.used,.to,.treat,.OA,,.it,.is,.best,.to,.minimize,.dosage,.and,.delay,.use,.
as,.long,.as,.possible.,.An,.extensive,.diagnostic,.workup,.is,.not,.recommended,.unless,.the,.
presentation,.is,.in,.question.,.Patients,.who,.have,.severe,.degenerative,.joint,.disease,.(DJ
D),,.joint,.fusion,,.or,.whose,.pain,.severity,.is,.not,.relieved,.by,.more,.conservative,.therapies,
.may,.be,.candidates,.for,.joint,.replacement.,.Acetaminophen,.is,.recommended,.as,.a,.first-
line,.medication.
,A,.63-year-
old,.male,.retired,.accountant,.complains,.of,.pain,.and,.stiffness,.in,.his,.feet,.and,.hands,.of,.s
everal,.years,.duration.,.He,.reports,.that,.the,.pain,.and,.stiffness,.become,.worse,.with,.activi
ty.,.On,.examination,,.he,.is,.noted,.to,.have,.Heberden's,.nodes,.but,.no,.other,.bony,.deformit
ies.,.Which,.of,.the,.following,.is,.the,.most,.probable,.diagnosis?,.-,.CORRECT,.ANSWER-
Osteoarthritis,.(OA)
Although,.his,.vocation,.involved,.sedentary,.activity,,.this,.patient,.is,.not,.at,.great,.risk,.for,.o
steoarthritis.,.Rheumatoid,.arthritis,.is,.characterized,.by,.several,.joint,.deformities,,.usually,.
bilaterally,.symmetrical.,.RA,.is,.characterized,.by,.inflammatory,.processes,,.while,.OA,.is,.n
ot.,.RA,.and,.OA,.are,.chronic,.conditions.,.Gout,.is,.characterized,.by,.acute,.exacerbations,.r
elated,.to,.a,.defect,.in,.purine,.metabolism,,.increased,.uric,.acid,.production,,.or,.decreased,.
uric,.acid,.excretion.
The,.family,.of,.a,.78-year-
old,.man,.moved,.him,.into,.an,.assisted,.living,.center,.because,.he,.can,.no,.longer,.be,.left,.at
,.home,.alone.,.He,.is,.unable,.to,.toilet,.when,.asked,.to,.do,.so,.and,.he,.has,.had,.several ,.epi
sodes,.of,.incontinence.,.He,.has,.walked,.out,.of,.the,.facility,.twice,.and,.been,.unable,.to,.find
,.his,.way,.back,.from,.3,.blocks,.away.,.On,.examination,,.he,.is,.pleasant,.but,.mildly,.confuse
d.,.Which,.of,.his,.medications,.is,.LEAST,.likely,.contributing,.to,.his,.behavior?,.-
,.CORRECT,.ANSWER-ramipril,.(Altace®)
Tricyclic,.antidepressants,,.like,.amitriptyline,,.have,.anticholinergic,.side,.effects,.which,.are,
.especially,.problematic,.in,.the,.elderly,.because,.they,.contribute,.to,.urinary,.retention.,.Hyd
rochlorothiazide,.is,.a,.diuretic,.and,.may,.contribute,.to,.his,.incontinence.,.Cimetidine,.is,.wel
l,.known,.to,.produce,.adverse,.reactions,.such,.as,.confusion,.in,.elders.,.Ramipril,,.an,.ACE,.i
nhibitor,,.is,.unlikely,.to,.contribute,.to,.this,.patient's,.incontinence,.or,.confusion.,.Toileting,.
may,.be,.a,.complicated,.by,.the,.anticholinergic,.medication,.and/or,.the,.diuretic,.causing,.di
uresis,,.urge,.incontinence,,.and,.inability,.to,.void,.at,.will.
A,.patient,.with,.no,.significant,.medical,.history,.has,.varicose,.veins.,.She,.complains,.of,."ac
hing,.legs".,.The,.intervention,.that,.will,.provide,.the,.greatest,.relief,.for,.her,.complaint,.is,.to:,
.-,.CORRECT,.ANSWER-elevate,.her,.legs,.periodically.
The,.intervention,.that,.will,.provide,.the,.greatest,.relief,.for,.this,.patient,.is,.elevating,.her,.leg
s,.periodically.,.This,.will,.facilitate,.venous,.return.,.Use,.of,.support,.stockings,.will,.prolong,.t
he,.length,.of,.time,.she,.is,.able,.to,.stand,.in,.place,,.but,.will,.not,.provide,.relief,.after,.her,.leg
s,.begin,.aching.,.Support,.stockings,.should,.be,.applied,.prior,.to,.getting,.out,.of,.bed.
Stress,.urinary,.incontinence,.is:,.-,.CORRECT,.ANSWER-
may,.be,.aggravated,.by,.caffeine,.or,.alcohol.
Stress,.urinary,.incontinence,.is,.not,.expected,.as,.a,.result,.of,.the,.normal,.aging,.process.,.
The,.primary,.problem,.is,.sphincter,.incompetence.,.The,.ingestion,.of,.caffeine,.or,.alcohol,.
decreases,.sphincter,.control.,.Anticholinergic,.and,.antidepressant,.medications,.are,.caus
,ative,.factors,.related,.to,.overflow,.incontinence.,.Detrusor,.muscle,.instability,.is,.the,.primar
y,.underlying,.problem,.causing,.urge,.incontinence.
Which,.commonly,.used,.herbal,.remedy,.is,.NOT,.associated,.with,.anxiety,.and/or,.depressi
ve,.symptom,.relief?,.-,.CORRECT,.ANSWER-Ginkgo,.biloba
Ginkgo,.biloba,.is,.a,.common,.herbal,.remedy,.associated,.with,.enhancement,.of,.vascular,.
and,.cerebral,.perfusion,.and,.memory.,.The,.nurse,.practitioner,.should,.be,.aware,.when,.th
e,.patient,.is,.taking,.any,.herbal,.supplement,.to,.avoid,.risk,.of,.drug,.interactions.
Upon,.ophthalmoscopic,.examination,.of,.a,.78-year-
old,.patient,,.the,.nurse,.practitioner,.observes,.dark,.spots,.against,.a,.red,.retina.,.What,.diag
nosis,.is,.this,.finding,.most,.consistent,.with?,.-,.CORRECT,.ANSWER-Cataract
A,.cataract,.opacity,.is,.seen,.as,.a,.dark,.disruption,.of,.the,.red,.reflex,.on,.ophthalmoscopic,.
exam.
A,.72,.year,.old,.female,.patient,.reports,.a,.6,.month,.history,.of,.progressively,.more,.swollen,.
and,.painful,.distal,.interphalangeal,.(DIP),.joints,.of,.one,.hand.,.There,.are,.no,.systemic,.sy
mptoms,.but,.the,.erythrocyte,.sedimentation,.rate,.(ESR),,.antinuclear,.antibody,.(ANA),,.an
d,.rheumatoid,.factor,.(RF),.are,.all,.minimally,.elevated.,.What,.is,.the,.most,.likely,.diagnosis
?,.-,.CORRECT,.ANSWER-Osteoarthritis
When,.osteoarthritis,.affects,.the,.hands,,.the,.distal,.interphalangeal,.(DIP),.joints,.are,.usual
ly,.involved.,.Rheumatoid,.arthritis,.is,.usually,.symmetrical,,.and,.the,.proximal,.interphalang
eal,.(PIP),.joints,.are,.more,.often,.affected.,.Inflammation,.often,.develops,.quickly,,.not,.grad
ually.,.This,.patient,.is,.elderly;,.therefore,,.it,.is,.expected,.that,.the,.ESR,,.ANA,,.and,.RF,.will,.
be,.only,.somewhat,.elevated.,.Over-
interpretation,.of,.laboratory,.tests,.without,.evidence,.of,.systemic,.inflammation,.can,.lead,.t
o,.misdiagnosis.
The,.nurse,.practitioner,.is,.evaluating,.a,.35-year-
old,.female,.nurse.,.She,.has,.a,.history,.of,.hospitalization,.for,.hepatitis,.B,.infection,.2,.years,
.ago.,.Her,.laboratory,.tests,.demonstrate,.positive,.HBsAg.,.The,.nurse,.practitioner,.would,.
most,.likely,.diagnose:,.-,.CORRECT,.ANSWER-chronic,.hepatitis,.B,.infection.
Presence,.of,.hepatitis,.B,.surface,.antigen,.at,.this,.time,.indicates,.chronic,.infection,.with,.he
patitis,.B.,.Lab,.studies,.indicating,.a,.positive,.surface,.antigen,.on,.2,.separate,.occasions,.at,
.least,.6,.months,.apart,.indicate,.chronic,.infection.,.Immunization,.produces,.positive,.hepati
tis,.B,.antibodies,.in,.most,.instances.,.Hepatitis,.B,.surface,.antigen,.would,.not,.be,.present,.i
n,.a,.person,.who,.has,.recovered,.from,.hepatitis,.B,.infection.,.This,.case,.would,.not,.be,.an,.
acute,.episode,.because,.of,.the,.history,.of,.hepatitis,.B,.infection,.2,.years,.prior.
One,.exception,.to,.the,.recommendation,.to,.limit,.dietary,.fat,.intake,.is:,.-
,.CORRECT,.ANSWER-children,.under,.2,.years-of-age.
, In,.order,.for,.myelinization,.of,.the,.nervous,.system,.to,.occur,,.children,.under,.2,.years-of-
age,.require,.>,.30%,.daily,.dietary,.fat.
The,.most,.effective,.primary,.prevention,.of,.skin,.cancer,.is,.to,.educate,.the,.public,.about:,.-
,.CORRECT,.ANSWER-limiting,.exposure,.to,.natural ,.solar,.radiation.
Primary,.prevention,.of,.skin,.cancer,.includes,.limiting,.sun,.exposure,,.avoiding,.tanning,.fac
ilities,,.and,.applying,.sunscreen.,.Examining,.the,.skin,.and,.recognizing,.melanoma,.are,.bot
h,.secondary,.prevention,.measures.
A,.patient,.has,.experienced,.nausea,.and,.vomiting,,.headache,,.malaise,,.low-
grade,.fever,,.abdominal,.cramps,,.and,.diarrhea,.for,.32,.hours.,.The,.white,.count,.is,.slightly,
.elevated,.with,.a,.shift,.to,.the,.left.,.He,.is,.requesting,.medication,.for,.diarrhea.,.What,.is,.the,.
most,.appropriate,.response?,.-,.CORRECT,.ANSWER-Offer,.an,.anti-
emetic,.medication,.such,.as,.prochlorperazine,.(Compazine®),.and,.provide,.oral,.fluid,.and,
.electrolyte,.replacement,.instruction.
Enterocolitis,.is,.the,.most,.common,.clinical,.presentation,.of,.salmonellosis.,.Diagnosis,.is,.
made,.by,.clinical,.presentation,,.and,.can,.be,.confirmed,.only,.with,.stool,.or,.blood,.cultures.,
.Most,.healthy,.adults,.have,.a,.course,.that,.is,.self-
limiting,.to,.72,.hours.,.Antibiotics,.should,.be,.used,.very,.discriminantly,.as,.resistance,.appr
oaches,.50%.,.Anti-
diarrheal,.agents,.potentially,.increase,.complications,.and,.predispose,.the,.patient,.to,.bact
eremia.
A,.child,.with,.Type,.1,.diabetes,.mellitus,.brings,.in,.a,.glucose,.diary,.indicating,.consistent,.m
orning,.hyperglycemia.,.How,.can,.the,.nurse,.practitioner,.differentiate,.the,.Somogyi,.effect,.
from,.dawn,.phenomenon?,.-,.CORRECT,.ANSWER-
Instruct,.the,.parent,.to,.monitor,.the,.blood,.glucose,.at,.3:00,.am.
Dawn,.phenomenon,.is,.an,.early,.morning,.rise,.in,.plasma,.glucose.,.It,.indicates,.a,.need,.for
,.increased,.insulin.,.The,.Somogyi ,.effect,.is,.a,.rise,.in,.plasma,.glucose,.in,.response,.to,.hyp
oglycemia.,.It,.is,.usually,.accompanied,.by,.weight,.gain,.and,.hunger,.and,.is,.corrected,.by,.
decreasing,.the,.evening,.insulin,.dose.,.A,.series,.of,.3,.early,.morning,.measurements,.of,.bl
ood,.glucose,.will,.help,.differentiate,.between,.the,.2,.conditions.
Of,.the,.following,.signs,.and,.symptoms,.of,.heart,.failure,.(HF),,.the,.earliest,.clinical,.manifes
tation,.is:,.-,.CORRECT,.ANSWER-weight,.gain.
The,.earliest,.and,.most,.sensitive,.clinical,.indicator,.of,.HF,.is,.weight,.gain.,.A,.patient,.with,.
HF,.should,.be,.instructed,.to,.weigh,.himself,.daily,.to,.note,.changes,.in,.his,.weight.,.The,.be
st,.time,.of,.day,.to,.weigh,.is,.early,.morning.,.The,.other,.clinical,.manifestations,.listed,.will,.pr
esent,.after,.the,.weight,.gain.,.Another,.early,,.clinical,.manifestation,.of,.CHF,.not,.listed,.abo
ve,.is,.fatigue.
