Nonpharmacologic therapy for Raynaud's disease include:
Avoidance of cold
Use of hot soaks
Ginkgo biloba
Isometric exercise - Answers Avoidance of cold
Which of the following people groups represent the least risk of cardiac disease?
African Americans
American Indians
Native Hawaiians
Caucasians - Answers Caucasians
as a f/u from a hospitalization an adult patent presents with ankle edema. Which of the following
medications is the most likely cause of the edema?
Nebivolol
HCTZ
Metformin
Norvasc - Answers Norvasc
While working in a fast-track clinic as a NP in an emergency department, your patient complains of
shortness of breath with activity and near syncope with changing position from seated to standing on
multiple recent episodes. You examine them and notice a harsh systolic murmur heard best at the
right sternal border at the 2nd intercostal space rated 3/6, which has a bruit radiating to the right
carotid artery. Of the following examinations, which is most appropriate or you to order next to
evaluate this murmur?
12 Lead EKG
Carotid ultrasound
Transthoracic echocardiogram
CT non-contrast of chest, abdomen, pelvis - Answers Transthoracic echocardiogram
The inability to fully relax the myocardium during relaxation is a trademark of which of the following
diagnoses?
Systolic heart failure
The inability to fully relax the myocardium during relaxation is a trademark of which of the following
diagnoses?
Systolic heart failure
Diastolic dysfunction
Grade 2 systolic dysfunction
Grade 3 systolic dysfunction - Answers Diastolic dysfunction
Your patient with a diagnosis of peripheral arterial disease asks you what is considered a non-
modifiable risk factor. Which of the following represent the best answer for his question?
Smoking less cigarettes
Medication compliance
Family history of PAD
Tight glycemic control - Answers Family history of PAD
A 50-year-old woman with a history of hypertension presents with dyspnea on exertion and
orthopnea. On examination, she has jugular venous distention and bilateral crackles on lung
auscultation. What is the most likely diagnosis?
Pulmonary embolism
Chronic obstructive pulmonary disease
Congestive heart failure
Acute myocardial infarction - Answers Congestive heart failure
A 60-year-old man with a history of hypertension and diabetes presents with a new-onset headache
and visual disturbances. His blood pressure is 200/110 mmHg. What is the most appropriate
management?
Prescribe antihypertensive medication and follow up in a week
Advise dietary changes
Refer to the emergency department
,Start insulin therapy - Answers Refer to the emergency department
A 45-year-old man presents with chest pain radiating to the left arm, diaphoresis, and shortness of
breath. His ECG shows ST-segment elevation. What is the initial management response?
Start intravenous heparin
Administer nitroglycerin sublingually
Perform immediate coronary angiography
Administer aspirin and call for emergency medical services - Answers Administer aspirin and call for
emergency medical services
A 70-year-old man with a history of atrial fibrillation presents with sudden-onset left-sided weakness
and slurred speech. What is the most likely diagnosis?
Seizure
Transient ischemic attack (TIA)
Myocardial infarction (MI)
Stroke - Answers Stroke
A 60-year-old woman presents for a routine check-up. She has a history of hypertension, type 2
diabetes mellitus, and hyperlipidemia. She is currently on lisinopril, metformin, and atorvastatin. She
has no new complaints. On examination, her blood pressure is 135/80 mmHg, heart rate is 72 beats
per minute, and BMI is 32 kg/m². Recent laboratory tests reveal HbA1c of 7.5%, LDL cholesterol of 110
mg/dL, and creatinine of 1.1 mg/dL. What is the most appropriate management plan to optimize her
care?
Recommend lifestyle modifications including diet and exercise
Increase the dose of atorvastatin
Increase the dose of metformin
Increase the dose of lisinopril - Answers Recommend lifestyle modifications including diet and
exercise
Patients on levothyroxine should be monitored for signs of:
Memory deficits and hyperreflexia
Increased nausea and constipation
Ankle edema and discomfort
Angina pectoris and dysrhythmia - Answers Angina pectoris and dysrhythmia
A patient has a 3 cm pituitary mass noted on CT. What is your next step in evaluating the patient?
Screen for hormone deficiencies
Repeat MRI in 3 months
Start Cabergoline
Refer to surgery - Answers Screen for hormone deficiencies
Which of the following is the most common cause of Cushing's Syndrome?
Long term excessive glucocorticoid use
Adrenal adenoma
ACTH-producing pituitary adenoma
Ectopic ACTH secretion - Answers ACTH-producing pituitary adenoma
A 33-year-old woman presents with intermittent palpitations, anxiety, and heat intolerance. Her
thyroid function tests reveal low TSH and high free T4. What is the most likely diagnosis?
Hypothyroidism
Graves' disease
Hyperthyroidism
Thyroiditis - Answers Hyperthyroidism
An adult female who recently returned from a business trip to Japan presents for a recheck
appointment. The only remarkable laboratory result is for thyroid-stimulating hormone (TSH), at 0.3
microunits/mL (normal = 0.4-6 microunits/mL). The patient reports that her neck hurts; examination
reveals thyroid tenderness. Which of the following laboratory tests should the nurse practitioner
order now?
Triiodothyronine (T3) only
Triiodothyronine (T3) and free triiodothyronine (FT3)
Triiodothyronine (T3) and free thyroxine (FT4)
Triiodothyronine (T3) resin uptake assay - Answers Triiodothyronine (T3) and free thyroxine (FT4)
Pheochromocytoma is best diagnosed by which of the following tests:
Blood pressure values and adrenal CT/MRI
, 24-hour urine for catecholamines/metanephrines and plasma metanephrines
Adrenal CT/MRI
Plasma metanephrines with blood pressure values - Answers 24-hour urine for
catecholamines/metanephrines and plasma metanephrines
A 50-year-old man presents with fatigue, muscle weakness, and hyperpigmentation of the skin.
Laboratory tests show low sodium, high potassium, and low cortisol levels. What is the most likely
diagnosis?
Pheochromocytoma
Primary hyperaldosteronism
Addison's disease
Cushing's syndrome - Answers Addison's disease
A 18-year-old woman presents with increased thirst, frequent urination, and unexplained weight loss.
Her fasting plasma glucose level is 200 mg/dL. What is the most likely diagnosis?
Type 1 diabetes mellitus
Cushing's syndrome
Syndrome of inappropriate Anti Diuretic Hormone (SIADH)
Diabetes insipidus - Answers Type 1 diabetes mellitus
A 27-year-old woman presents with frequent headaches, galactorrhea, and amenorrhea. MRI of the
brain reveals a pituitary adenoma. What is the most appropriate initial treatment?
Surgery
Dopamine agonists
Corticosteroids
Radiation therapy - Answers Dopamine agonists
Which is best performed to assess the risk for fall in an 88-year old adult?
PHQ-2 questionnaire
Get up and go test
Clock-drawing test
Global screening assessment - Answers Get up and go test
How should a nurse practitioner evaluate if palliative care is effective?
Advanced directives have been discussed and signed.
The symptoms causing discomfort are lessened.
An out of hospital "Do not resuscitate" order is in place.
The illness or disease is in remission. - Answers The symptoms causing discomfort are lessened.
A 92-year-old presents with a decline in personal care and increasing forgetfulness. They had a CVA a
three years ago with mild cognitive changes then which has slowly progressed. The more likely
diagnosis in this case is?
Alzheimer's dementia
Mini-strokes
Progressive vascular dementia
Lewy-body dementia - Answers Progressive vascular dementia
Which of the following gastrointestinal changes is associated with normal aging?
Decreased production of gastric acid
Increased salivation
Increased esophageal emptying
Decreased incidence of gallstones - Answers Decreased production of gastric acid
he management of COPD in the elderly is best guided by:
radiologic imaging.
symptomatology.
arterial blood gases.
spirometry. - Answers symptomatology
During the past 24 hours, a 62-year-old has experienced abdominal pain that radiates to the back. The
patient also reports several episodes of nausea and vomiting, a low-grade temperature, and a history
of excessive drinking. Physical examination reveals a distended abdomen. Laboratory serum values
indicate elevated alkaline phosphatase, amylase, and serum lipase. The most likely diagnosis is:
acute mesenteric ischemia.
acute pancreatitis.
A alcoholic liver disease.