Miami Regional University Florida: MSN6400 (MSN 6400) Final Final Blueprint Fall 2025 Updated | Answered Correctly.

Final Blueprint Fall 2025 Updated. Final Examen 4/20/2025 1. Lymonogranuloma venereum A 25-year-old male presents with a bubo in the right groin, as well as stiffness and aching near his genitals. You note that there is swelling in his right inguinal area. You aspirate the bubo and prescribe doxycycline. For what condition would this be the proper treatment? Molluscum contagiosum Herpes simplex virus type 2 Lymonogranuloma venereum Genital warts An examination of Andrew, a 28-year-old male, reveals a non-indurated ulcer on his prepuce that he claims appeared 3 days ago. He states that he did some research online and believes it may be either chancroid or lymphogranuloma venereum (LGV). While you examine him, which finding would you tell him best distinguishes chancroid from LGV? a. Only LGV typically starts as a small papule. b. LGV is asymptomatic in men. c. Tender inguinal lymphadenopathy is generally indicative of LGV. d. Only LGV may present with buboes. Identify the following picture? a. Genital warts b. Lymonogranuloma venereum c. Herpes simplex virus type 2 d. Molluscum contagiosum An examination of a patient diagnosed with an advanced case of lymphogranuloma venereum reveals buboes in the vulvovaginal area. Which treatment is recommended to prevent ulcerations? a. Drying agents b. Electrocautery c. Aspiration d. Cryotherapy. 2. CRF Stages Chronic Renal Failure Stage 3b is characterized by: GFR: 45-59 GFR: 90 or above GFR: 60-89 GFR: 30-44 Which of the following laboratory tests is a sensitive test for evaluating renal function? a. Estimated glomerular filtration rate (eGFR) b. Creatinine c. Blood urea nitrogen (BUN) d. Electrolyte panel Which of the following laboratory tests is a sensitive test for evaluating renal function, Stage 3a? GFR= 45-59 mL/min GFR= 60-89 mL/min GFR= 15-29 mL/min GFR= 30-44 mL/min 3. Mammography (44, 75) What are the ACS guidelines for mammography screening include? a. ended at 65 years of age b. Start at 40 years of age c. Ended at 55 years of age d. Start at 45 years of age When Maria was 49-years old, she had a scare when she discovered a lump in her breast. It was eventually determined to be benign, but, since then, she has been diligent about monitoring hersett for other lumps. She has also made sure to receive mammograms annually. Now. at 65, she is asking when these examinations will end. What should you tell her? Ten years from now This year Fifteen years from now Five years from now American Cancer Society / ACS recommend Mammography Annually for ages 40-74 years Annually for ages 80-85 years Annually for ages 40-81 years Annually for ages 65-74 years Note By Ferrer: When to begin?: Beginning at age 40; if family history of breast cancer, MRI in addition to a mammogram How often?: Annually for ages 40 to 74 When to end?: No recommendation for age to stop; "continue as long as the woman is in good health” Clinical Breast Exam?: For ages 20 to 39, every 3 years; Annually starting at age 40 Self-Breast Exam?: Optional beginning at age 21; women should be informed of potential benefits and harms 4. Osteoporosis Risk factors The diagnosis of osteoporosis involves the dual-energy x-ray absorptiometry (DEXA) test to measure bone mineral density in four different parts of the skeletal system. The practitioner knows that all of the following types of bone tissue are typically measured by a DEXA except: Hip Tibia Spine Ankle Your patient's dual-energy x-ray absorptiometry scan reveals a value of -2.7. Based on this finding, your best course of action at this time would be to recommend which of these therapies? Alendronate / Prolia sq injection every 6 month (Cualquiera de las 2) Increase in dietary calcium Coumadin therapy once daily Calcium supplements daily You are treating a 67-year-old Latina. Based on her profile and family history, you decide to order a est to check for osteoporosis. Which of the following is not a typical risk factor that would lead you to suspect osteoporosis in this patient? Excessive alcohol use Obesity Smoking Hyperthyroidism A new patient is extremely concerned about developing osteoporosis. She asks you if there are any effective ways to increase calcium in her diet. Which of the following options would be the most helpful suggestion regarding her request? Canned Salmon. Which patient has the most substantial signs for developing osteoporosis? A. A 5'2" African American female weighing 115 lb B. A 5'9" Caucasian male weighing 155 lb C. A 5'4" Asian female weighing 90 lb D. A 5'1 0" Latin female weighing 200 lb You are treating four female patients who each exhibit predisposing factors for osteoporosis. Which patient is least likely to be at risk for osteoporosis? An overweight African American female with a family history of uterine cancer A Hispanic woman living a predominantly sedentary lifestyle An underweight Asian woman with a history of tobacco use A Caucasian woman experiencing early onset of menopause Which of the following statements describes the best guidelines to prevent osteoporosis? the following statements describes the best guidelines to prevent osteoporosis.? a. The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older. b. The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 75 years and older. c. The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 81 years and older. d. The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 50 years and older. Your post-menopausal patient’s dual energy X-ray absorptiometry scan reveals a value of -2.7. Based on this finding your best course of action at this time would be to recommend which of these therapies? Coumadin therapy once daily Increase in dietary calcium Calcium supplement daily Denosumab inyection Which of the following individuals would be at highest risk for Osteoporosis? A 51 years old Chinese American female taking anticonvulsants for bipolar disorder 5. Apley's grind test For swollen, painful knees, what is the easiest, most sensitive test to assess for anterior and posterior cruciate ligament tears? Straight leg raise test Lachman's test McMurray's test Apley's grind test A patient comes to your practice with a knee that keeps "locking," making it difficult for him to walk. You perform the Apley's grind test on the patient to determine the presence of soft tissue damage. What would be the best method for carrying out this test? a. Applying pressure to the heel while rotating the lower leg, and then flexing the knee 70° b. Applying pressure to the heel while rotating the lower leg, and then flexing the knee 70°. c. Applying pressure to the heel while rotating the lower leg, and then flexing the knee 30°. d. Applying pressure to the heel while rotating the lower leg, and then flexing the knee 90°. 6. Migraine 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? Get enough sleep Avoid foods with high potassium content Avoid fermented foods Avoid foods with high tyramine content Hannah, a 23-year-old female, comes to the clinic after having multiple episodes of headaches. She complains that the headaches throb and usually manifest on one side of her head, build "to a slow crescendo," and last for several hours. She also experiences visual disturbances and nausea. Which of the following foods would most likely be contributing to her complaints? Smoked salmon Cane sugar Chocolate Bananas 7. Murmur Classification Which of the following best describes a II/VI heart murmur? a. Soft murmur that is readily detectable b. Loud; associated with a thrill c. Barely audible d. Moderately loud; easily heard Which of the following best describes a II/VI heart murmur? Loud; associated with a thrill Moderately loud; easily heard Audible but faint Barely audible You hear a low-pitched diastolic rumble at the fifth intercostal space with the patient in the left lateral position. The murmur does not radiate. You refer the patient to cardiology to "rule out " Aortic stenosis Mitral regurgitation Mitral stenosis Aortic regurgitation During a routine physical for Leonard, age 56, you note a diastolic murmur. The murmur presents with a blowing at the second left intercostal space. He most likely has which valvular disease? Mitral stenosis Mitral regurgitation Aortic stenosis Aortic regurgitation A 40 years old woman comes to the medical office complaining of palpitations and some light headaches for the past 6 months. These are random episodes. The nurse practitioner noticed a mid-systolic click with a late systolic murmur that is best heard in the apical area during auscultation of the chest. You would suspect Atrial Fibrillation Mitral Valve prolapses Mitral stenosis Sinus Arrhythmia You are examining Victor, age 67, and identify aheart murmur. This murmur is fairly loud and can be heard with one corner of the stethoscope offthe chest wall. You are most likely listening to which of the following murmurs? Grade II/VI Grade III/VI Grade IV/VI Grade V/VI Which of the following statements is not typical ofthe heart murmur with which it is associated? a. A grade I/VI murmur is barely audible. b. A grade II/VI murmur is associated with a thrill. c. A grade III/VI murmur can easily be heard. d. A grade V/VI murmur can be heard off the chest wall with one corner of the stethoscope. A physical examination of a patient reveals a heart murmur near the second intercostal space (ICS). You suspect the patient may have aortic stenosis and you auscultate again for more details. Which details of the murmur would most likely confirm your diagnosis? Low-pitched, mid-diastolic, builds to crescendo Musical, blowing, radiates to left axilla Blowing, rough, radiates to neck Diastolic, blowing, at second left ICS You hear a loud pansystolic murmur that is "blowing" at the apex of the heart. You refer the patient to a cardiology service to rule out which of these? Mitral regurgitation Aortic stenosis Mitral stenosis Aortic regurgitation 8. Pap smear guidelines and Diagnosis interpretation According to the American Cancer Association cervical cancer screening is performed to patients between 30-65 years every: a. one year b. 3 years c. Every two years d. every 6 months American' Cancer Society (ACS), American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology (ASCP): (2012) Every 4 Years Every 3 Years Every Year Every 2 Years The results of a patient's cervical cytology test indicate "atypical squamous cell of undetermined significance." Which test would you least likely order as a follow- up? a) Human papillomavirus testing b) A second Pap smear (por Internet) c) Ultrasound (respuesta del libro) mal en el examen d) Colposcopy Respuesta del libro C: An ultrasound is generally not recommended as a follow-up for a Papanicolaou test indicating atypical squamous cells of undetermined significance (ASCUS). An ultrasound is more likely to be used to scan for ovarian cysts in cases of pelvic inflammatory disease. A proper follow-up for ASCUS may include testing for human papillomavirus, repeating the Pap smear, and performing a colposcopy. Which of the following is a risk factor for abnormal results on a Pap Smear? Cigarette Smoking Active gonorrhea infection IUD use Being nulliparus 9. Colon Rectal Cancer diet, Guidelines for Colonoscopy Which of the following patients has the lowest risk of developing colon cancer? a. A female whose aunt and grandmother both developed ovarian cancer b. A Hispanic male with a history of peptic ulcer disease c. A female with a high-fat diet that includes red meat and refined carbohydrates d. A male with a history of recurrent inflammatory bowel disease 10. Skin Eczema A 19-year-old female presents with the following rash and describes the itchy sensation as intense. Additionally, she says that she has been experiencing occasional itchy flare-ups since childhood, yet her symptoms last no more than a few days. Which condition do her complaints most likely indicate? Eczema Allergic contact dermatitis Psoriasis Pityriasis rosea 11. Metabolic Syndrome The metabolic syndrome, also known as syndrome X, is associated with the risk of type 2 diabetes mellitus. It is characterized by a group of predisposing factors that include obesity and hypertension. What additional risk factors are associated with syndrome X? a. High total cholesterol and high LDL levels b. BP:160/100 and Impaired fasting glucose c. High total cholesterol and low HDL levels d. High triglyceride levels and high LDL levels The metabolic syndrome, also known as syndrome X, is associated with the risk of type 2 diabetes mellitus. It is characterized by a group of predisposing factors that include obesity and hypertension. What additional risk factors are associated with syndrome X? High triglyceride levels and low HDL levels High total cholesterol and low HDL levels High triglyceride levels and high LDL levels High total cholesterol and high LDL levels Which of the following statements is incorrect about criteria for metabolic syndrome? Select one. HDL <50 mg/dL in men Fasting blood sugar > 100 mg/dL. Waist circumference >40 inches in men. Blood pressure >135/90 mm Hg. All of these findings are components of metabolic syndrome except: Waist circumference > 40 inches in men Blood pressure > 130/85 mmHg Fasting blood glucose> 100 mg/di High-density lipoprotein < 50 mg/di in men 12. Varicella Zoster Rash Identify the following picture? a. Urticaria b. Herpes Vitus II c. Herpes virus I d. Varicella Zoster A 24-year-old male presents with the following skin rash on the torso. This presentation is most indicative of which condition Atopic dermatitis Herpes zoster Molluscum contagiosum 13. HTN risk factors A 54-year-old former professional athlete Is being screened for hypertension, a condition that runs In his family. Which of the following findings is not consistent with a diagnosis of significant hypertension? Blurred vision A S4 heart sound A sub-parietal headache Epistaxis Which statement is false regarding hypertension? A classic presentation of hypertension includesa subparietal, "pulsating" headache, usually in the morning, which resolves throughout the day. Approximately 95% of all cases of hypertension are "primary" in nature. Hypertension related to contraceptive estrogentherapy would be classified as "secondary." Hypertension affects approximately 20%-30%of the African American population. While performing a fundoscopic exam on your patient, you notice several arterioles that cross a venule, producing bulging on either side. Your patient, a 57-year-old African American male, is slightly overweight and admits to smoking approximately one pack of cigarettes a day. Which of the following is the most likely cause of the findings? a) Diabetes b) Hypertension c) Cataract d) Previous trauma A 65-year-old man with a body mass index (BMI) of 30 and a history of asthma has hypertension that has been well controlled with hydrochlorothiazide 12.5 mg PO daily. His total cholesterol is 230 g/dL. How many risk factors for coronary artery disease (CAD) does he have? Two risk factors Four risk factors One risk factor d. Three risk factors 14. Pneumonia TX A 75-year-old diabetic male requires treatment for pneumonia. Which of the following drugs is not recommended for this patient? Moxifloxacin Gemifloxacin A respiratory fluoroquinolone A macrolide antibiotic Iris, a 32-year-old patient, presents with fever, shaking chills, and malaise. A physical examination reveals lung consolidation, purulent sputum, and an increased fremitus. Further diagnostic evaluation shows a low white blood cell count and infiltrates on the chest x-ray. Given the most likely diagnosis, which medication would be best suited for treating Iris's condition? Doxycycline Gemifloxacin Gnseofulvin Moxifloxacin Ethel, a 90-year-old female, presents to the clinic with fever, headache, excessive sweating, and soreness in the throat and chest. Results from a complete blood count reveal a low white blood cell count, and a chest x-ray shows infiltrates. Based on the most likely diagnosis, which antibiotic should Ethel be treated with? Doxycycline Azithromycin Clarithromycin Levofloxacin An HIV- positive male who is in your care has been complaining of shortness of breath and a serious cough. Given this information, which condition should you be most cautious to monitor for in this patient? а. Pneumocystis Jiroveci pneumonia Cytomegalovirus Acute bronchitis Mycoplasma pneumonias An otherwise healthy 45-year-old patient with atypical pneumonia would best be treated with which medication? Macrolide Antileukotriene Short-acting beta-2 adrenergic agonist Fluoroquinolone Andre, an 89-year-old male, enters the hospital with pneumonia. Of the choices below, which details the best way and time to deal with an advanced directive? a. Advise his attorney when symptoms look like they will lead to a coma b. Advise him when it seems his symptoms will lead to a coma c. Advise his family as soon as he enters the hospital d. Advise him as soon as he enters the hospital 15. TIA s/s A 73-year-old patient complains of recent episodes of acute-onset left-sided facial asymmetry, slurred speech, weakness, and dizziness, accompanied by weakness of the left arm and left leg. She reports that the episodes occur at random and last from 30 minutes to about 2 hours. Each episode was resolved completely. The patient has type 2 diabetes with hyperlipidemia, peripheral arterial disease, hypertension, and osteoporosis. Her symptoms suggest: Meniere’s Disease Bening Paroximal Positional vertigo Cerebrovascular accident (CVA) Transient ischemic attack (TIA) You have just transferred a patient showing classical findings of a transient ischemic attack to emergency care. You know that, in the course of imaging the condition, your patient will likely first undergo a computed tomography scan. Why would this diagnosti be performed? a. To identify the need for urgent surgical intervention b. To determine whether antihypertensive therapy is warranted c. To evaluate for a cardioembolic source d. To rule out the possibility of hemorrhage TIA Vertebrobasilar is characterized by vertigo, ataxia, dizziness, visual defficit, weakness and confusion. True False Your patient is admitted to the hospital with slurred speech and tingling in his right arm and leg. An hour later, he appears to have fully recovered. However, he is alarmed to learn that about one-third of patients who have such attacks will experience which of the following within the next 5 years? Brain tumor Intraventricular hemorrhage Increased intracranial pressure Cerebral infarction A 62-year-old male presents to urgent care saying that he has been experiencing Trouble maintaining balance and coordinating his movement since early this morning. As he puts it, "every once in a while, I feel lightheaded and dizzy." Suddenly, he appears to lose his balance and states that "it feels as though the room is spinning." You notify the ER physician that you are transferring the patient based on which most likely diagnosis? Vertebrobasilar transient ischemic attack Trigeminal neuralgia Partial seizure Carotid transient ischemic attack 16. Cluster and tension headache A 30-year-old female presents to your office with frequent and debilitating headaches that are particularly intense about her neck. She says that her neck and shoulders feel extremely tight and tense during these headaches. However, she denies any neurologic deficits. Based upon her complaints, what type of headaches is this patient most likely experiencing? Cluster headache Tension headaches Vascular Headache MigraigneHeadache You are treating four patients who experience recurring headaches. Which of the following patients is most likely to be experiencing cluster headaches? ???a. A 70-year-old man whose headache lasts for several hours and is most intense at the back of the neck. b. A 30-year-old woman whose headache lasts for several hours and often comes after she skips breakfast. c. A 45-year-old man whose headache lasts for 1 hour and usually returns a month later. (RESPUESTA POR EL LIBRO) d. A 22-year-old woman whose headache lasts for a couple hours and coincides with her menstrual cycle. ANS: C- Cluster headaches, which usually last less than 2 hours, are most common in middle-aged men. Patients can go several weeks or months between episodes. Tension headaches, on the other hand, can last for several hours. Tension headaches are more intense at the neck or back of the head. Migraine headaches are more common in women and can be triggered by stress, missed meals, and specific foods, among other factors. Menstrual cycles can also trigger migraine headaches. Doug, a 58-year-old male, has recently been diagnosed with cluster headaches. He had previously assumed that he was experiencing migraines and wants to know what the two types of headaches have in common. You tell him that cluster headaches and migraines may share which precipitating factor? Nitrate containing foods Changes in weather Genetic predisposition Alcohol ingestion Which of these patients would be most likely to be affected by a cluster headache? a. A 17-year-old male b. A 23-year-old female c. A 55-year-old male d. 60-year-old All of the following are expected findings with cluster headaches, except: Nasal congestion, rhinorreha, eye redness. Daily peroiorbital pain. Alcohol causes the headcahe. Vice-like pain, apathy, and inability to concentrate. Sally, a 27-year-old female, reports to your clinic with complaints of recurring headaches. When you ask her to describe the nature of the pain, she says: "I don't know, it just hurts." You decide to ask her about signs and symptoms that accompany the headaches. All of these statements would suggest Sally is experiencing cluster headaches except: "It feels like my nostrils just close up." "I keep crying and I don't know why." "My nose just starts running like a waterfall." "I feel like the light starts stabbing at my eyes." Diference s between Migraine Headache and Tension headache is given by the presence(s) of: Neurological Symptoms. Time of onset. Type of pain. Triggers factors Which of these patient statements would most warrant a diagnosis of tension headaches? "I've been experiencing throbbing in my temples that is consistently dull." "The pain only occurs on one side of my head." "I feel pressure around my eyes." "It feels like something is squeezing my head." Your 57-year-old male patient has awakened nightly for the last three weeks to severe throbbing pain around his left eye, particularly after drinking alcohol. The pain usually subsides within an hour. A physical exam reveals nothing too unusual, other than eye redness and rhinorrhea. Of the following, which would be the best way to manage the patient's condition? Sumatriptan Ticiopidine Over-the-counter analgesics Clopidogrel Your 57-year-old male patient has awakened nightly for the last three weeks to severe throbbing pain around his left eye, particularly after drinking alcohol. The pain usually subsides within an hour. A physical exam reveals nothing too unusual, other than eye redness and rhinorrhea. Of the following, which would be the best way to manage the patient's condition? a. Over-the-counter analgesics b. Imitrex c. Ticlopidine d. Clopidogrel Which of these patients would be most likely to be affected by a cluster headache? a. A 17-year-old male b. A 23-year-old female c. A 55-year-old male d. A 60-year-old female Cluster headaches are most often seen in: Adolescent girls Middle-aged men Elderly men Postmenopausal women A 40-year-old man complains to the nurse practitioner of severe stabbing pains behind his left eye for the past 2 days. They are accompanied by some nasal congestion and rhinorrhea, which is clear in color. The patient denies pharyngitis and fever. Which of the following conditions is most likely? Migraine headache with aura Cluster headache Tic douloureux Cranial neuralgia All of the following are expected findings with cluster headaches, except: Select one: Nasal congestion, rhinorreha, eye redness. Daily peroiorbital pain. Alcohol causes the headcahe. Vice-like pain, apathy, and inability to concentrate. Which of these headaches occurs as a result of vasodilation and excessive pulsation of the external carotid artery branches but does not typically present with an aura? a. Common migraine b. Tension headache c. Cluster headaches d. Classic migraine 17. Tanner stages Which Tanner stage of breast development is characterized by the projection of the areola and nipple as a secondary mound? Tanner stage 1 (presents with preadolescent breasts.) Tanner stage 2 (presents with breast buds with areolar enlargement.) Tanner stage 3 ( presents with breast enlargement without separate nipple contour.) Tanner stage 4 During an annual physical exam, you notice that 12-year-old Lisa has breast enlargement without separate nipple contour. You tell her she can expect which of the following in the next stage of her development: Breast buds with areolar enlargement Sparse, pale, fine pubic hair Receding areolas and retracting nipples Onset of menses After which Tanner stage do males usually begin spermarche or nocturnal emissions? Stage 1 Stage 2 Stage 3 Stage 4 A Tanner sexual maturity rating of 3 in a male indicates which of the following? a. A penis that is adult in shape and appearance with adult pattern pubic hair A rough, red scrotum with sparse, fine pubic hair An elongated penis with darker, curlier pubic hair Development of glans and rugae on the penis and curly, sparse pubic hair 18. Pulmonary Function test Your patient has severe restrictive lung disease. The nurse practitioner would expect that all of the following pulmonary function test results should be significantly lower than normal except: Functional residual capacity Forced vital capacity Forced expiratory volume in one second Residual volume A patient presents to you with a productive cough and headache. The patient displays no other signs or symptoms and is afebrile. Upon physical examination, you note that his lungs are clear upon auscultation and resonant upon percussion. You suspect acute bronchitis; as the indications are far from definitive, however, you wish to rule out other conditions. Which of the following diagnostics would be least helpful in confirming or excluding probable conditions at this time? Sputum culture Chest x-ray Sputum sensitivity Pulmonary function test The NP is examining a school-age child who has had several hospitalizations for bronchitis and wheezing. The parent reports that the child has several coughing episodes associated with chest tightness each week and gets relief with an albuterol metered-dose inhaler. What will the NP order? Allergy testing Chest radiography Spirometry testing Sweat chloride test 19. Hearing loss classification Of the following causes of conductive hearing loss, which is the most common? Perforated tympanic membrane Hematoma Foreign body Otosclerosis Of the following causes of conductive hearing loss, which is the most common? a. Impactation of Cerumen b. Otosclerosis c. Perforated tympanic membrane d. Hematoma A patient states that she is unable to hear well with her left ear. The Weber test shows lateralization to the right ear. The Rinne test shows AC>BC with a ratio of 2:1 in both ears, left AC 4 sec. and BC 2 sec., right AC 20 sec. and BC 1 O sec. What would be the best interpretation of these results? The test results are reflective of normal hearing. Conduction of sound through bones is impaired. The patient may have sensorineural hearing loss. Further testing should be done. You are treating Peter, a 47-year-old male, who exhibits symptoms of sensorineural hearing loss. In order to determine the cause of his condition, you obtain the patient's history. You know that the following factors may usually contribute to this type of hearing loss except: Close range to an explosion Acoustic neuroma Perforated tympanic membrane Long-term exposure to loud music. A patient presents with hearing loss and painless otorrhea. Upon physical exam, you note the canal is filled with mucopus and granulation tissue. Tympanic perforation and ossicular damage are also noted. As a nurse practitioner, how would you best treat this patient's condition? Prescribe antibiotics and recommend hydration Refer the patient for surgery Refer the patient for a general neurological exam Prescribe prednisone. 20. Prostate Cancer Prevalence and DX What is a Normal standard for a PSA value? a. 0-4 b. 8-10 c. 4-6 d. 6-8 A 64-year-old male presents to your practice with complaints regarding urination. He says that he has trouble "getting started" when he wishes to void, and that the stream "keeps leaking" when he tries to terminate it. He also wakes frequently with the urge to urinate. Upon further discussion, he mentions with some embarrassment that he "let go" while celebrating a victory for his sports team. Which diagnostic test should the nurse practitioner order initially? Prostate-specific antigen Gram stain Urinalysis 24-hour urine collection PSA screening is recommended to patients older than: 60 years 65 years 50 years 45 years A 79-year-old male presents to your practice stating, "I'm back today because I forgot to tell you last week that I'm having trouble with my urine. I go several times a night, feel like I have to go all of the time, and when I pee, it starts, stops and even dribbles sometimes." At his physical exam 1 week ago, his complete blood count, urinalysis, and vital signs, including temperature, were all normal. His prostate specific antigen was noted to be 6.0 ng/ml. The nurse practitioner considers a referral for which of the following tests at this time? Magnetic resonance imaging Transrectal ultrasound Computed tomography of the pelvis X-ray of the kidney, ureters, and bladder 21. Types otitis media and TX For a patient diagnosed with bacterial acute otitis media, which of these medications is usually recommended for first-line treatment? Amoxicillin Miconazole Ceftriaxone Clotrimazole. Nonviral otitis media is most commonly caused by what pathogenic bacteria? Staphylococcus aureus Streptococcus pneumoniae Haemophilus influenzae Moraxella catarrhalis. A 31-year-old patient comes to your office complaining of hearing loss but only in the right ear. When examining her, you notice some erosion on her eardrum in the middle ear. Which of the following is the most likely diagnosis and treatment? Serous Otitis media; antibiotics Cholesteatoma; surgery Otitis externa; surgery Cholesteatoma; antibiotics 22. Iron deficiency anemia A 23-year-old woman, Jamie, comes to your office. Jamie has been experiencing food cravings. including a desire to consume ice. You suspect a specific type of anemia. Which of the following findings would you most expect as result? Low hemoglobin/Normal ferritn Low hemoglobin/high total iron binding capacity Low hemoglobin/high serum ferritin High hemoglobin/high total iron binding capacity Which of the following lab findings is most likely to be indicative of iron deficiency anemia? Low mean corpuscular volume High mean corpuscular hemoglobin concentration Low red cell distribution width High serum ferritin You would like to recommend oral ferrous sulfate to your 36-year-old patient with iron deficiency anemia, but you want to make sure the treatment is effective and that nothing inhibits the absorption of the medicine. Which of the following should you most strongly recommend the patient avoid for optimal absorption of the oral ferrous sulfate? Antacids Vitamin C Folate Analgesics Joey, an 11-month-old infant, is brought in by his mother because he's been sleeping more than usual. A physical examination indicates pallor, palpitations, and tachycardia. In discussing recent events with the mother, she says that she has been alternating between breast milk and formula for Joey; when pressed for time and lacking formula, she gives him whole milk instead. After he responded well to the taste, she replaced breast milk with whole cow's milk. Joey most likely has which of these dietary insufficiencies? Insufficient iron Insufficient folic acid Insufficient fiber Insufficient vitamin D Iron deficiency anemia results in a decrease in the amount of iron available for which process? Hemoglobin production Red blood cell formation Transportation of oxygen in the body Absorption of vitamin B12 23. Fibroadenoma Which of the following is an appropriate intervention for a newly patient diagnosed with left breast fibroadenoma? Continue to monitor/ left Breast Ultrasound in 6 month. Olan for Mastectomy Mandatory excisional Biopsy Bilateral Breast US in 2 years 24. Chlamydia TX A patient presents with lower abdominal pain and vomiting. Her temperature is 40°C. You perform a cervical exam, and your patient tests positive for cervical motion tenderness. Upon further testing, you identify Chlamydia trachomatis. Based on the likely diagnosis, which regimen would you most likely prescribe? Levofloxacin and probenecid Ofloxacin and ceftriaxone Cefoxitin and probenecid with or without ceftriaxone Ceftriaxone and doxycycline with or without metronidazole A patient presents with lower abdominal pain and vomiting. Her temperature is 40 °C. You perform a cervical exam, and your patient tests positive for cervical motion tenderness. Upon further testing, you identify Chlamydia trachomatis. Based on the likely diagnosis, which regimen would you most likely prescribe? a. Ofloxacin and ceftriaxone b. Levofloxacin and probenecid c. Azithromycin 1000 mg as a single dose d. Cefoxitin and probenecid with or without ceftriaxone 25. Chancroid Identify the following picture? a. Folliculitis b. Erisipela c. Carbuncle d. Chancroid A male presents to the clinic complaining of a painful ulcer on his genitals. A close examination reveals that the ulcer is surrounded by an erythematous halo. Given the most likely condition, which of the following antibiotics would not be prescribed? Doxycycline Ceftriaxone Azithromycin Ciprofloxacin 26. BMI classification A 65-year-old man with a body mass index (BMI) of 30 and a history of asthma has hypertension that has been well controlled with hydrochlorothiazide 12.5 mg PO daily. His total cholesterol is 230 g/dL. How many risk factors for coronary artery disease (CAD) does he have? Two risk factors Four risk factors One risk factor d. Three risk factors BMI: Below 18.5 Underweight 18.5 – 24.9 Healthy Weight 25.0 – 29.9 Overweight 30.0 and Above Obesity 27. Diverticulitis diet Diet for acute diverticulitis include? broccoli, thus veggie can get pigeonholed as fiber vegetable? baked good made with refined wheat or rye flour , such as breads , biscuit , pancakes , waffles, bagel…. beans, lentils and other beans are an easy way to sneak fiber into your diet in soups , stews and salad Doris. 77 years old. reports abdominal pain in the lower left side of her abdomen. For the last several weeks, Doris experienced frequent constipation and has taken laxatives for relief. However, her abdominal pain has become increasingly severe. Her lab work shows an erythrocyte sedimentation rate of 45 millimeters per hour and leukocytosis, Additionally, a sigmoidoscopy reveals inflamed mucosa. Based on her findings and lab results, which of the following is the most likely diagnosis? a. Diverticulitis b. Irritable bowel syndrome c. Bowel obstruction d. Ulcerative conns 28. Glaucoma screening The American Academy of Ophthalmology recommends that all patients receive a complete screening for glaucoma by at least what age? By age 25 By age 30 By age 35 By age 40 29. Carpal Tunnel Syndrome Which of these tests would provide an accurate assessment for carpal tunnel syndrome? Varus test Tinel's test Valgus test MacMurray All of the following musculoskeletal disorders affect women at a higher rate than men. Except: a. Carpal tunnel syndrome b. Plantar fasciitis c. Rheumatoid arthritis d. Morton's neuroma Which of these tests would provide the best assessment for carpal tunnel syndrome? a. Allen's test b. Tinel test c. McMurray's test d. Hirschberg's test A 42-year-old secretary is diagnosed with carpal tunnel syndrome, and you are advising her on proper forms of management. Which of the following medications would be best for early treatment of her symptoms? Celecoxib Betamethasone Hydroxychloroquine Methotrexate 30. Trigeminal Neuralgia What is trigeminal neuralgia characterized by? a. affects the 12 cranial nerve b. recurrent brief episodes of electric shock-like pains affecting the fifth cranial nerve c. recurrent brief episodes of electric shock-like pains affecting the seventh cranial nerve d. affecting Mid Brain Trigeminal Neuralgia is characterized by: a. Prednisone 60 mg divided in 4 to 5 doses daily and tapered over 7 to 10 days b. Nerve disorder that causes a stabbing or electric-shock-like pain in parts of the face c. sudden weakness in your facial muscles d. Ipsilateral monocular blindness Josephine, age 63, experiences severe pain in her face, claiming that it feels like "an electric shock." In discussing her history, she mentions that her gait has become stiff and unpredictable as of late, and reports experiencing blurred vision. Which of the following Is the most likely diagnosis? Parkinson's disease Trigeminal neuralgia Bell's palsy Myasthenia gravis A 56-year-old man complains of several episodes of severe lacerating pain that shoots up his right cheek and is precipitated by drinking cold drinks or chewing. The episodes start suddenly and end spontaneously after a few seconds with several episodes per day. He denies any trauma, facial weakness, or difficulty swallowing. He has stopped drinking cold drinks because of the pain. Which of the following is most likely? Trigeminal neuralgia Cluster headache Acute sinusitis Sinus headache Treatment for Trigeminal Neuralgia includes all the following medications, except: Ibuprofen (NSAID). Carbamazepine (Anticonvulsant). Cyclobenzaprine/Flexeril (Muscle Relaxant). Amitriptyline (Tricyclic Antidepressant). For Trigeminal Neuralgia diagnostic test you have to do: All of the choice , regardless the patient. Neurological Examination Trigeminal reflex testing. MRI 31. Molluscum Contagiosum Rash How would you describe molluscum contagiosum? a. Clusters of small bumps or pimples around hair follicles b. blisters (cold sores) or open sores (ulcers) in or around the mouth or lips. c. dome-shaped, round, and pinkish-purple in color. d. rough, red, or reddish brown spots both on the palms of the hands and the bottoms of the feet Joseph, 31, complains of a few painless, smooth, raised bumps on his penis. He says that the bumps are fairly fITT11 and match the color of his skin but do not hurt at all. Without further examining the patient, with what condition can you diagnose the patient? Gonorrhea Genital warts Herpes simplex virus type 2 Molluscum contagiosum You have just diagnosed your male patient with chancroid. You order a second battery of tests, knowing that other conditions are commonly associated with the presentation of chancroid. Which of the following conditions would you least expect to find? a. Syphilis b. Molluscum contagiosum c. Gonorrhea d. HIV You have just diagnosed your male patient with chancroid. You order a second battery of tests, knowing that other conditions are commonly associated with the presentation of chancroid. Which of the following conditions would you least expect to find? a. HIV b. Gonorrhea c. Syphilis d. Infection caused by a poxvirus Identify the following picture? Molluscum contagiosum Gonorrhea Syphilis Monkeypox Upon examining a 23-year-old patient, you identify pearly-white papules around her anogenital region. the papules are about 2 mm wide and are round, smooth, and firm. The patient does not exhibit any other signs or symptoms. You would most strongly suspect which of the following conditions? Genital warts Molluscum contagiosum Chancroid Herpes What are the two most common methods for diagnosing molluscum contagiosum? Serologic tests and complete blood count (CBC) Inspection and microscopic exam CBC and inspection Microscopic exam and serologic tests Robin, a 45-year-old female, presents to the clinic with rounded, firm, painless bumps along her lower abdomen and genital region. You note that the papules are about 3 mm and pearly-white. Which is the most common form of treatment for the most likely condition? Aspiration Antipruritic agents Laser therapy Cryoanesthesia with liquid nitrogen 32. COPD S/S and TX A 52-year-old female patient comes to your practice with complaints of breathlessness and cough accompanied by excessive phlegm. She produces a sputum sample, which appears clear upon inspection. You order a pulmonary function test; in reviewing the results, you find evidence indicating both an increased functional residual capacity and an increased total lung capacity. Which of the following respiratory diseases would be the most likely diagnosis? Emphysema Acute bronchitis Pneumonia Tuberculosis A 67-year-old woman with a 30-pack-year history of smoking presents for a routine annual examination. She complains of easily short of breath and is frequently fatigued. Physical examination reveals breath sounds and hyperresonance. Her completed blood count (CBC) results reveal that her hematocrit is high. Which diagnostic is most likely? Bronchogenic carcinoma Chronic obstructive pulmonary disease (COPD) Chronic bronchitis Congestive heart failure Which of the following medications is considered to be the mainstay of treatment for chronic obstructive pulmonary disease? a. Salmeterol b. Budesorude c. Ipratropium bromide d. Triamcinolone Which of the following findings would be least indicative of chronic obstructive pulmonary disease? Hyperinflated lungs Elevated diaphragm Reduced FEV, Increased residual volume A thin patient with a slight build presents with constant difficulty breathing and clear mucus. A physical exam also indicates an increased chest anteroposterior diameter and hyperresonance on percussion. Given the most likely diagnosis, which class of medications is best suited for long-term treatment? Antibiotics Anticholinergics Antileukotrienes Short-acting beta-2 adrenergic agonists Victor, a stocky 40-year-old male, presents to the clinic with complaints of difficulty breathing and "endless amounts of gunk whenever [he] cough[s]." During the visit, he coughs up a substantial amount of yellow phlegm. A blood test reveals an increased hematocrit level, and a physical examination detects lungs that are normal upon percussion. You order a pulmonary lab for the patient. Given the most likely condition, which of the following findings would you ~ expect? Increased forced expiratory volume in 1 second Increased total lung capacity Increased functional residual capacity Increased residual volume A thin, 70-year-old patient with a wasted appearance comes to the clinic complaining of difficulty breathing and a cough. She states that she had to stop taking her senior water aerobics class because she couldn't make it through the 30 minutes without tiring out. Which of these characteristics would lead you to believe she has emphysema and not chronic bronchitis? Thin and wasted habitus Cough Exercise intolerance Dyspnea 33. Psoriasis DX Which of the following best describes the appearance of Auspitz sign when psoriasis scales are removed? Erythematous, warm, indurated areas Rough skin that is either flesh-colored, pink, or hyperpigmented Droplets of blood Honey-colored crusts at the edges Otra: Small bleeding point after successive layers of scale have been removed A 25-year-old female presents with the following lesions. Which of these would most effectively treat the patient's condition? a. Miconazole b. Betamethasone c. Clindamycin d. Doxycycline A 25-year-old female presents with the following lesions. Which of these would most effectively treat the patient's condition? a. Clindamycin b. Doxycycline c. Triamcinolone d. Miconazole 34. Hematuria differential DX Your 35-year-old patient is being worked up for microscopic hematuria. All of the following are differential diagnoses of microscopic hematuria except: Bladder cancer Kidney Stones Acute Pyelonephrytis Renal artery stenosis 35. Condyloma Acuminata How would you describe condyloma acuminata? a. A single chancre marks the onset of the primary (first) stage of syphilis, but there may be multiple sores b. skin-colored, fleshy papules in the anogenital region. c. Cluster lesions in the back area d. skin-colored, purples papules in the facial area All of the following findings are associated with the secondary stage of an infection by the organism Treponema pallidum except: a. Condyloma acuminata b. Maculopapular rash of the palms and soles c. Lymphadenopathy d. Condyloma lata All of the following keratolytic agents are routinely used to treat condyloma acuminata except: Podophyllin 5-Fluorouracil Trichloroacetic acid Biochloroacetic acid All of the following sexually transmitted diseases are paired with a pathogen commonly responsible for the condition except: Pelvic inflammatory disease-Neisseria gonorrhoeae Lymphogranuloma venereum-Chlamydia trachomatis Chancroid-Haemophilus ducreyi Condyloma acuminata-Treponema pallidum Which finding from a patient's cervical cytology results would best confirm condyloma acuminata? Squamous intraepithelial lesions Multinucleated giant cells Infection Parabasal cells 36. Cellulitis Type of Rash (74) As a nurse practitioner, you know that the most common cause of cellulitis in outpatients is which of the following? Escherichia coli Klebsiella Staphylococcus aureus Streptococcus pyogenes Risk factor for cellulitis include: Non healthy food habits Diabetes, Obesity, and Alcoholism Increase physical activity Cold like symptoms Identify the following picture? Lymphangitis MRSA skin infection DVT Cellulitis Identify the following picture? a. DVT b. Atopic Dermatitis c. Cellulitis d. Eczema Note: Cellulitis, which can be caused by MRSA, is a generalized classification of a breach in the skin from inflammation of the surrounding skin and tissues. 37. Shingles Post s/s TX Dori, 64, has experienced recurring bouts of shingles. Although you note during today’s appointment that her skin eruptions have disappeared, she complains of pain and burning sensations that remain in the areas of outbreak. These sensations, she adds. have been severe enough to interfere with her sleep. Which of the following do you prescribe to alleviate the patient s complaints? Acyclovir Gabapentin Famciclovir Zostavax If a patient experiences a painful, blistering eruption in a dermatomal distribution that resembles the following, which is the most likely diagnosis? Erysipelas Eczema Xanthelasma Herpes zoster. Differential Diagnosis for Tinea Corporis include all of the following, except: Pityriasis Rosea. Vitiligo Parapsoriasis. Herpes Zoster. 38. DMI Criteria for DX A 27-Year-old patient complained about the following findings: polydipsia and polyphagia, and a fasting glucose on 126. What other criteria may need to diagnose the patient with Diabetes Mellitus? a. Hba1c: 6.5.7.0 O b. Hba1c: 5.9.6.0 c. Fasting glucose: 90 d. Randon Blood sugar: 86 Which of the following are useful tool criteria to diagnostic a diabetes mellitus Select one or more Hba1C: 6.5 Random blood sugar fasting; Greater than 200 mg/dl Self blood glucose fasting monitoring: 126 mg/dl S/S of Polydipsia and Polyuria ANS: A, B,C,D A female presents to the urgent care unit with complaints of constant nausea, weakness, and fatigue. She reports that she has been feeling extremely thirsty since her symptoms began 2 days ago, and she also has been "urinating a lot," which she attributes to constantly drinking water. The physical exam reveals that the patient has a normal blood pressure and heart rate. A urine test indicates ketones. For which condition should the patient be further evaluated? Diabetic ketoacidosis Type 2 diabetes Hyperosmolar hyperglycemic non-ketosis Type 1 diabetes 39. Colon screening During his check-up, Gary, a 66-year-old male, reports thin stools and recurring bouts of both constipation and diarrhea. He has also experienced rapid, unexplained weight loss in the last month (around 5% of his body weight). Gary is concerned because he has a family history of cancer. Of the following, which procedure would you order to best rule out colon cancer? A Sigmoidoscopy Barium Studies Colonoscopy E. Complete blood count Colon Screening is recommended to patients older than: 50 years 45 years 60 years 65 years To screen for colorectal cancer, low-risk adults > 40 years of age should undergo a fecal occult blood test at which interval? Every 5 years Annually Biannually Every 10 years Colon cancer (2016) Baseline screening at age 45 years Use high-sensitivity fecal occult blood test (yearly) or sigmoidoscopy (every 5 years) or colonoscopy (every 10 years) from age 45–75 years ??? 40. Thyroid Levels Which of the following lab values would most likely confirm a diagnosis of hyperthyroidism? Low TSH, low free T3, low free T4 Normal TSH, increased free T3, increased free T4 Elevated TSH, normal free T3, normal free T4 Low TSH, increased free T3, normal free T4 Your patient, Franklin, age 64, has the following lab values: elevated TSH, low T4, and decreased T3. Which of the following drugs should be prescribed to treat his condition? Propranolol Levothyroxine Propylthiouracil Methimazole A patient diagnosed with hyperthyroidism is about to undergo thyroid surgery. Which of the following factors would be most reliable as an indicator of a euthyroid state? T4 is normal T3 is normal Thyroid stimulating hormone is normal Thyroid resin uptake is normal 41. Bells Palsy Identify the following picture? a. Myasthenia Gravis b. Temporal Arteritis c. Bells Palsy d. Trigeminal Neuralgia Bell's palsy is characterized: a. Ipsilateral monocular blindness b. cerebral insufficiency lasting less than 24 hours without any residual deficits c. Pain behind the ear and weakness d. The exact cause is unknown. It's believed to be the result of swelling and inflammation of the nerve that controls the muscles enervated by trigeminus. What is Bell’s palsy The exact cause is unknown. It's believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face You are examining a patient who has just been diagnosed with Bell’s palsy. Bell’s palsy is characterized by all of the following except: Drooling Inability to swallow Inability to close the eye on the affected side Drooping of the corner of the mouth on the affected side As a Family Nurse Practitioner, you are taking care of a patient with Bell’s Palsy, you know you need to refer this patient to neurology at what moment: a. Immediately after diagnosis. b After 3 months of diagnosis. c. After 6 months of diagnosis. d. Never referred to neurology. A patient presents with an inability to move the left side of his face. The nurse b practitioner identifies the cause as an inflammatory reaction involving the facial nerve. Which of the following medications would be best suited for treating the condition most evidenced by the patient's findings and the known cause? Sumatriptan Chlordiazepoxide Oxazepam Prednison You are treating a patient who is unable to move the right side of her face. As a nurse practitioner, you know that while this condition may resolve without treatment, some patients may benefit from treatment. Which of the following treatment options is least likely to be beneficial? Prednisone Artificial tears Pyridostigmine Acyclovir Dysfunction in Cranial nerve VII is most strongly involved inm the diagnosis of following? Miller-Fisher Syndrome Bell’s palsy Acute motor axonal neuropathy Multiple Sclerosis 42. Urea Breath test Use of Urea breath test (UBT) is often considered as the gold standard test in the diagnosis of H. pylori infection. The patient should fast for at least one hour prior to testing. The patient should not take antimicrobials, proton pump inhibitors, or bismuth preparations within two weeks prior to testing. Do not eat or drink for one hour before the test Do not chew gum or tobacco for one hour before your test Do not smoke for one hour before the test Repeat testing for H. pylori at least four weeks after your treatment is recommended. If the tests show the treatment didn't get rid of the infection, you may need more treatment with a different combination of antibiotics. 43. Herpes Zoster Based on the image below, which of the following is the most likely diagnosis? a. Herpes Zoster b. Actinic keratosis c. Squamous cell carcinoma d. Seborrheic keratosis Jordan, 24, presents with complaints of painful, itchy lesions around her labia majora region. She adds, I think I‘ve had the chills a few times, and I ve really felt sluggish for the past few days. Upon physical examination of the affected area, you note small, painful, fluid-filled blisters. Given her presentation and your assessment. which of the following tests should be ordered to confirm the most likely sexually transmitted disease? Viral culture An elderly patient is diagnosed with herpes zoster ophthalmic.: Which cranial nerve is infected with this disorder? Cranial nerve V Dori, 64, has experienced recurring bouts of shingles. Although you note during today s appointment that her skin eruptions have disappeared, she complains of pain and burning sensations that remain in the areas of outbreak. These sensations, she adds. have been severe enough to interfere with her sleep. Which of the following do you prescribe to alleviate the patient s complaints? Acyclovir Gabapentin Famciclovir Zostavax If a patient experiences a painful, blistering eruption in a dermatomal distribution that resembles the following, which is the most likely diagnosis? Erysipelas Eczema Xanthelasma Herpes zoster. Differential Diagnosis for Tinea Corporis include all of the following, except: Pityriasis Rosea. Vitiligo Parapsoriasis. Herpes Zoster. Which of the following lesions cause a painful rash that may appear as a stripe of blisters on the trunk of the body. (Select one) Contact dermatitis Herpes Zoster Scabies Erythema Annulare Centrifugum 44. Mammography (3,75) When Maria was 49-years old, she had a scare when she discovered a lump in her breast. It was eventually determined to be benign, but, since then, she has been diligent about monitoring hersett for other lumps. She has also made sure to receive mammograms annually. Now. at 65, she is asking when these examinations will end. What should you tell her? Ten years from now This year Fifteen years from now Five years from now American Cancer Society / ACS recommend Mammography Annually for ages 40-74 years Annually for ages 80-85 years Annually for ages 40-81 years Annually for ages 65-74 years Note By Ferrer: When to begin?: Beginning at age 40; if family history of breast cancer, MRI in addition to a mammogram How often?: Annually for ages 40 to 74 When to end?: No recommendation for age to stop; "continue as long as the woman is in good health” Clinical Breast Exam?: For ages 20 to 39, every 3 years; Annually starting at age 40 Self-Breast Exam?: Optional beginning at age 21; women should be informed of potential benefits and harms 45. Lumbar disc compression physical assessment Jerry, age 64, has a history of a herniated disk. He comes to your practice complaining of pain that radiates from his lower back down through the left side of his calf. He is also experiencing numbness in his back and left foot. During the examination, he has difficulty dorsiflexing his great toe. Given his most likely injury, which of the following would be best to have Jerry perform for a proper assessment? a. Squatting and rising b. Walking on heels c. Standing on toes for 5 seconds d. Walking on toes Peter comes to you after having stood for four straight days working his company s booth at a convention. He complains of intermittent numbness and tingling on his right foot up into his calf, as well as pain in the calf. During the examination, you have Peter walk on the heels of his feet and you note pain and weakness of the dorsiflexion mechanism of the great toe and fool. Which of the following is your most likely suspicion? L5 - S1 Disk Pathology T5- T6 Pathology L3-L4 disk pathology L4-L5 disk pathology A 50-year-old male has weakness in his quadriceps, pain radiating into the medial malleolus, along with numbness and a diminished patellar reflex. You suspect an L-3-4 disk herniation. Which screening exam is appropriate to confirm this diagnosis? Walk on heels of feet L4-L5 Have the patient reach upward, keeping head forward Have the patient squat and rise L3-L4 Have the patient walk on heels of feet L4-L5 Have the patient walk on toes L5-S1 46. HTN classification According to the American Heart Association normal reading for blood pressure include Understand Systolic mm Hg (first number) and Diastolic BP mm Hg (second number) a. BP: 120-129 / less than 80 b. BP: 130-139 / 80-89 c. less than 120 and less than 80 d. Bp: 140 or higher and 90 or higher A 56-ysar-old marketing executive has various past blood pressure (BP) readings of between 140 to 150 (systolic) and 80 to 100 (diastolic) over the last few months. During an office visit, you find his currant BP is 142/88. This collective data confirms a diagnosis of hypertension. Based on national guidelines and the patient s current blood pressure, how would you classify his hypertension today? Elevated Stage I Stage II Normal A 56-ysar-old marketing executive has various past blood pressure (BP) readings of between 140 to 150 (systolic) and 80 to 100 (diastolic) over the last few months. During an office visit, you find his currant BP is 120/85. This collective data confirms a diagnosis of hypertension. Based on national guidelines and the patient's current blood pressure, how would you classify his hypertension today? a. Stage l b. Normal c. Stage II d. Pre-hypertension/ Elevated blood pressure 47. Sjogren Syndrome VS rheumatoid Arthritis What is Sjogren Severe xerosis in plantar soles Autoimmune disorder That happens when the immune system attacks the glands that make moisture in the eyes, mouth, and other parts of the body. What blood tests diagnose rheumatoid arthritis? a. ANA, CRP, ESR, Rheumatoid factor b. CBC, CRP, VDRL c. CBC, UA, ANA d. RPR, UA, CRP Which of the following statements best described Sjogren Syndrome? a. Severe xerosis in the sole of the feet b. The body's immune system attacks heart system leading the patient to a heart failure c. The body's immune system attacks its own healthy cells that produce saliva and tears. d. The body's immune system attacks thyroid gland itself 48. B12 deficiency Anemia (70) 49. Temporal Arteritis What is the best diagnostic test for temporal arteritis? a. Have people annoyed you by criticizing your drinking?" b. Superficial temporal artery biopsy c. Brain MRI d. XR of temporal area Temporal Arteritis is characterized by: a. Sumatriptan (Imitrex) 6 mg, SQ may be effective b. A Unilateral headache c. Symptoms include headaches, jaw pain, vision loss, fever, and fatigue d. Characterized by severe, unilateral, periorbital pain occurring daily for several 50. Valgus and Varus Stress test (69) Which of the following best described Valgus test? The examiner places one hand at the outside of the knee, acting as a pivot point, while the other hand is placed at the foot. The medial joint line is palpated while the examiner simultaneously applies an abducting force at the foot, and a valgus force through the knee joint. The examiner places one hand at the inside of the knee, acting as a pivot point, while the other hand is placed at the foot. The medial joint line is palpated while the examiner simultaneously applies an abducting force at the foot, and a valgus force through the knee joint. The examiner places one hand at the anterior position of the knee, acting as a pivot point, while the other hand is placed at the foot. The medial joint line is palpated while the examiner simultaneously applies an abducting force at the the foot, and a valgus force through the knee joint. The examiner places one hand at the lateral of the knee, acting as a pivot point, while the other hand is placed at the foot. The medial joint line is palpated while the examiner simultaneously applies an abducting force at the foot, and a valgus force through the knee joint. Which of these test would provide the best assessment for a rupture of lateral collateral ligament Varus Stress test Phalen’s test Hirshberg’s test McMurray’s test Which of these tests would provide the best assessment for a rupture of lateral collateral ligament? a. Varus Stress test b. Phalen's test c. McMurray's test d. Tinnel test Which is the main purpose of Valgus stress test Identify a ACL/PCL ligament injury Identify anterior / posterior cruciate ligament injury Identify a medial meniscal injuries Identify a rupture of median lateral collateral ligament 51. Latchman test (66) Which of the following choices best describes the proper order of steps for performing the Lachman's test? a. Place knee in 20-30 degree flexion, grasp leg with one hand with anterior force to proximal tibia (stresses the ACL/PCL) while the opposite hand stabilizes the thigh; graded 1+ to 3+ grade of displacement b. Apply pressure to the proximal tibia, stabilize the thigh, and bend the knee 20°. c. Bend the knee 60°, apply pressure to proximal tibia, and stabilize the thigh d. Bend the knee 20°, stabilize the thigh, and apply pressure to the proximal tibia. Which of the following choices best describes the proper order of steps for performing the Lachman's test? Bend the knee 20°, apply pressure to proximal tibia, and stabilize the thigh. Stabilize the thigh, bend the knee 20°, and apply pressure to the proximal tibia. Apply pressure to the proximal tibia, stabilize the thigh, and bend the knee 20°. Bend the knee 20°, stabilize the thigh, and apply pressure to the proximal tibia. 52. Thalassemia The practitioner knows that conditions associated with an MCV = 124 u3 include all of the following except: Alcoholism B12 deficiency anemia Folate deficiency anemia Thalassemia Julie, a 44-year-old female of Middle Eastern descent, comes in for routine bloodwork. You note that she has a low hemoglobin level and a mean corpuscular volume of 75 fL/red cell. Her mean corpuscular hemoglobin concentration is 30%. She denies experiencing any changes in general well-being and assures you that she has been feeling normal. Which condition does Julie most likely have? Anemia of chronic disease Thalassemia Pernicious anemia Folic acid deficiency 53. Syphilis Diagnosis Which of the following test is a confirmatory test to diagnose a patient with Syphilis? Elisa testing TPR antibody Treponema (specific) test (e.g., FTA-ABS, TPPA) RPR A patient with