1. A patient with systemic lupus erythematosus (SLE) is diagnosed with idiopathic thrombo-
cytopenic purpura (ITP).Which statement should the provider give the patient regarding the
pathophysiology of SLE and its relation to thrombocytopenia?
a. SLE disrupts immune homeostasis and promotes development of self-reactive antibodies.
b. SLE causes a cross-reaction of antibodies with normal platelet antigens.
c. SLE causes a defect in the number and function of regulatory B cells.
d. SLE increases megakaryocyte maturation. - ANSWER SLE disrupts immune homeostasis
and promotes development of self-reactive antibodies.
1. A 44-year-old woman has recently been diagnosed with advanced metastatic non-small-
cell lung cancer. Genetic testing is ordered to determine if the patient's tumor has any ge-
nomic alterations and to guide treatment decisions. A few weeks later, the patient's test re-
sults come back positive for a genetic mutation. The APN starts osimertinib (Tagrisso).Based
on this information, what types of genetic mutation does this patient have? Choose 2 an-
swers.
a. ALK mutation
b. EGFR mutation
c. BRCA mutation
d. MET amplification mutation - ANSWER ALK mutation and EGFR mutation
1. A 20-year-old male meets with an advanced professional nurse (APN) to discuss symptoms
that have been slowly progressing over the past several years. He is mainly concerned be-
cause he has been falling frequently. Since childhood, his gait has consisted of walking on his
toes. During middle school, he was able to participate in sports but was unable to participate
in high school sports due to difficulty with running and jumping. Lately, he has noticed it
takes longer and is more difficult to change positions from sitting to standing than it used to
in the past. He has also been waking up with muscle and joint stiffness. The APRN notes that
his family history is not significant for any chronic or genetic diseases.Which condition is
likely to be the cause of these symptoms?
1
,a. Becker muscular dystrophy
b. Myotonic dystrophy
c. Facioscapulohumeral muscular dystrophy (FSHD)
d. Limb-girdle muscular dystrophy - ANSWER Becker muscular dystrophy
1. A 26-year-old female presents to urgent care with complaints of extreme fatigue, muscle
aches, abdominal pain, numbness and tingling in her extremities, and bloating. She explains
that she has been experiencing gastrointestinal upset after meals and has not had a bowel
movement for the past four days. She reports using over-the-counter, anti-diarrheal prod-
ucts last week to combat diarrhea. She denies having any chronic diseases. The assessment
findings include a blood pressure of 108/71 mm Hg, pulse of 82 beats per minute, and respi-
rations of 20 breaths per minute. The abdomen is distended and firm. Bowel sounds are pre-
sent in all four quadrants. The patient has a steady gait, though verbally complains of feeling
weak and off balance upon ambulation. Following antibody testing, Celiac disease is sus-
pected.Which follow-up tissue test, the gold standard for this suspected diagnosis, should be
ordered?
aa. Endoscopy - ANSWER Colonoscopy with rectal biopsy
1. A female patient presents to an office to establish care. Her previous primary care pro-
vider told her to follow up regarding an elevated ferritin level. She has no previous medical
history and is currently asymptomatic. She is concerned about the elevated ferritin and
would like to know if she should be worried.What should the provider do next for this pa-
tient?
a. Order a liver function test
b. Order a renal ultrasound
c. Refer her for a bone marrow biopsy
d. Order a thyroid panel - ANSWER Order a liver function test
1. A 75-year-old female presents to the emergency department with an irregular heart rate
of 130.What can be ascertained about this patient's findings given the limited information?
a. She has a normal sinus rhythm and needs her heart rate controlled with metoprolol (Lo-
pressor).
2
, b. She is diagnosed with atrial fibrillation and needs her heart rate controlled with metopro-
lol (Lopressor).
c. She is diagnosed with ventricular tachycardia and needs her heart rhythm controlled with
metoprolol (Lopressor).
d. She is diagnosed with torsades de pointes and needs her heart rate controlled with mag-
nesium. - ANSWER She is diagnosed with atrial fibrillation and needs her heart rate con-
trolled with metoprolol (Lopressor).
1. A 75-year-old male presents with a history of transient ischemic attack, acute myocardial
infarction, angina, and atrial fibrillation. The patient's echocardiogram shows low cardiac
output and loss of contractility.Which condition from this patient's medical history is contrib-
uting to the loss of contractility?
a. Atrial fibrillation
b. Acute myocardial infarction
c. Angina
d. Transient ischemic attack - ANSWER Acute myocardial infarction
1. A patient presents to an emergency room with blurred vision, fatigue, shortness of breath,
and disorientation. Some of the preliminary lab results reveal the following: glucose >400
mg/dL, sodium 150 mEq/L, potassium 7 mEq/L, serum bicarbonate 12 mEq/L, serum creati-
nine 3 mg/dL.Which condition is this patient suffering from?
a. Diabetic ketoacidosis
b. Retinopathy
c. Nephropathy
d. Peripheral neuropathy - ANSWER Diabetic ketoacidosis
1. A 45-year-old female fears that she is having a stroke and takes herself to an emergency
room. After several diagnostic and laboratory tests, the patient is diagnosed with Cushing
disease.Which lab abnormality would be present in this patient?
a. Decreased adrenocorticotropic hormone (ACTH)
b. Increased adrenocorticotropic hormone (ACTH)
3
cytopenic purpura (ITP).Which statement should the provider give the patient regarding the
pathophysiology of SLE and its relation to thrombocytopenia?
a. SLE disrupts immune homeostasis and promotes development of self-reactive antibodies.
b. SLE causes a cross-reaction of antibodies with normal platelet antigens.
c. SLE causes a defect in the number and function of regulatory B cells.
d. SLE increases megakaryocyte maturation. - ANSWER SLE disrupts immune homeostasis
and promotes development of self-reactive antibodies.
1. A 44-year-old woman has recently been diagnosed with advanced metastatic non-small-
cell lung cancer. Genetic testing is ordered to determine if the patient's tumor has any ge-
nomic alterations and to guide treatment decisions. A few weeks later, the patient's test re-
sults come back positive for a genetic mutation. The APN starts osimertinib (Tagrisso).Based
on this information, what types of genetic mutation does this patient have? Choose 2 an-
swers.
a. ALK mutation
b. EGFR mutation
c. BRCA mutation
d. MET amplification mutation - ANSWER ALK mutation and EGFR mutation
1. A 20-year-old male meets with an advanced professional nurse (APN) to discuss symptoms
that have been slowly progressing over the past several years. He is mainly concerned be-
cause he has been falling frequently. Since childhood, his gait has consisted of walking on his
toes. During middle school, he was able to participate in sports but was unable to participate
in high school sports due to difficulty with running and jumping. Lately, he has noticed it
takes longer and is more difficult to change positions from sitting to standing than it used to
in the past. He has also been waking up with muscle and joint stiffness. The APRN notes that
his family history is not significant for any chronic or genetic diseases.Which condition is
likely to be the cause of these symptoms?
1
,a. Becker muscular dystrophy
b. Myotonic dystrophy
c. Facioscapulohumeral muscular dystrophy (FSHD)
d. Limb-girdle muscular dystrophy - ANSWER Becker muscular dystrophy
1. A 26-year-old female presents to urgent care with complaints of extreme fatigue, muscle
aches, abdominal pain, numbness and tingling in her extremities, and bloating. She explains
that she has been experiencing gastrointestinal upset after meals and has not had a bowel
movement for the past four days. She reports using over-the-counter, anti-diarrheal prod-
ucts last week to combat diarrhea. She denies having any chronic diseases. The assessment
findings include a blood pressure of 108/71 mm Hg, pulse of 82 beats per minute, and respi-
rations of 20 breaths per minute. The abdomen is distended and firm. Bowel sounds are pre-
sent in all four quadrants. The patient has a steady gait, though verbally complains of feeling
weak and off balance upon ambulation. Following antibody testing, Celiac disease is sus-
pected.Which follow-up tissue test, the gold standard for this suspected diagnosis, should be
ordered?
aa. Endoscopy - ANSWER Colonoscopy with rectal biopsy
1. A female patient presents to an office to establish care. Her previous primary care pro-
vider told her to follow up regarding an elevated ferritin level. She has no previous medical
history and is currently asymptomatic. She is concerned about the elevated ferritin and
would like to know if she should be worried.What should the provider do next for this pa-
tient?
a. Order a liver function test
b. Order a renal ultrasound
c. Refer her for a bone marrow biopsy
d. Order a thyroid panel - ANSWER Order a liver function test
1. A 75-year-old female presents to the emergency department with an irregular heart rate
of 130.What can be ascertained about this patient's findings given the limited information?
a. She has a normal sinus rhythm and needs her heart rate controlled with metoprolol (Lo-
pressor).
2
, b. She is diagnosed with atrial fibrillation and needs her heart rate controlled with metopro-
lol (Lopressor).
c. She is diagnosed with ventricular tachycardia and needs her heart rhythm controlled with
metoprolol (Lopressor).
d. She is diagnosed with torsades de pointes and needs her heart rate controlled with mag-
nesium. - ANSWER She is diagnosed with atrial fibrillation and needs her heart rate con-
trolled with metoprolol (Lopressor).
1. A 75-year-old male presents with a history of transient ischemic attack, acute myocardial
infarction, angina, and atrial fibrillation. The patient's echocardiogram shows low cardiac
output and loss of contractility.Which condition from this patient's medical history is contrib-
uting to the loss of contractility?
a. Atrial fibrillation
b. Acute myocardial infarction
c. Angina
d. Transient ischemic attack - ANSWER Acute myocardial infarction
1. A patient presents to an emergency room with blurred vision, fatigue, shortness of breath,
and disorientation. Some of the preliminary lab results reveal the following: glucose >400
mg/dL, sodium 150 mEq/L, potassium 7 mEq/L, serum bicarbonate 12 mEq/L, serum creati-
nine 3 mg/dL.Which condition is this patient suffering from?
a. Diabetic ketoacidosis
b. Retinopathy
c. Nephropathy
d. Peripheral neuropathy - ANSWER Diabetic ketoacidosis
1. A 45-year-old female fears that she is having a stroke and takes herself to an emergency
room. After several diagnostic and laboratory tests, the patient is diagnosed with Cushing
disease.Which lab abnormality would be present in this patient?
a. Decreased adrenocorticotropic hormone (ACTH)
b. Increased adrenocorticotropic hormone (ACTH)
3
