6531 midterm review part II Exam Questions with Verified Answers

Marvin has sudden eye redness that occurred after a strenuous coughing episode. You diagnose a subconjunctival hemorrhage. Your next step is to: - Answer- Do nothing other than provide reassurance Which of the following color changes in a pigmented lesion suggests malignant transformation? - Answer- ALL COLORS The Centor criteria for diagnosis of Group A B-hemolytic streptococcus includes which of the following? - Answer- A and B only Mark has just been given a diagnosis of congestive heart failure. Which of his medications should be discontinued? - Answer- Nifedipine (Procardia XL) for long-term management of his chronic stable angina. Treatment of acute vertigo includes: - Answer- bedrest and an antihistamine Diagnosis of Crohn's disease is made considering signs, symptoms and: - Answer- Intestinal obstruction demonstrated by plain x-ray of the abdomen Which of the following is a predisposing condition for furunculosis? - Answer- Diabetes mellitus A middle-aged male presents to urgent care complaining of fever, dysphagia, and shortness of breath. The nurse practitioner notes the patient leaning forward in a tripod position and drooling. The clinical presentation of this patient suggests: - Answer- Epiglottitis The differential diagnosis for a patient complaining of a sore throat includes which of the following? - Answer- Thrush The American Cancer Society recommends a flexible sigmoidoscopy for colorectal cancer screening in persons at average risk every: - Answer- flexible sigmoidoscopy (FS) every 5 years Jennifer, age 49, who has a history of hyperlipidemia, has symptoms that lead you to suspect unstable angina. Your next action would be to: - Answer- Hospitalize the client in a monitored setting with pharmacological control of ischemia, arrhythmias, and thrombosis as appropriate. John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia? - Answer- OFTEN A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him: - Answer- Basal cell carcinoma (BCC) is the most common type of skin cancer. It's also the most commonly diagnosed cancer in the United States. Every year, millions of people learn that they have BCC. Your patient Jerry has gout. What do you suggest? - Answer- treating the acute attack of inflammation when one or more joints are very inflamed and painful ongoing treatment to reduce the level of urate in your blood and to get rid of urate crystals.The two most commonly used drug treatments for acute attacks of gout are non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine.Acute attacks of gout are often treated with oral non-steroidal anti-inflammatory drugs (NSAIDs), which can ease pain and possibly reduce some of the inflammation. Examples include ibuprofen, naproxen and etoricoxib. Your well-nourished 75-year-old patient has come into the office for a physical exam and states that she recently had two nosebleeds. She does not take any anticoagulants, and you have ruled out any coagulopathies. The most likely cause of these nosebleeds is: - Answer- Trauma or inflammation Management of a patient with hypertension and an abdominal aortic aneurysm would include: - Answer- The goals of pharmacotherapy are to reduce morbidity and to prevent complications. Antihypertensive agents are used to reduce tension on the vessel wall in patients with abdominal aortic aneurysms (AAAs) who have elevated blood pressure (BP). Esmolol (Brevibloc) View full drug information An ultrashort-acting beta1 blocker, esmolol is particularly useful in patients with elevated arterial pressure, especially if surgery is planned. It can be discontinued abruptly if necessary. This agent is normally used in conjunction with nitroprusside. It may be useful as a means of testing beta-blocker safety and tolerance in patients with a history of obstructive pulmonary disease who are at uncertain risk for bronchospasm from beta blockade. The elimination half-life of esmolol is 9 minutes. An AST that is more than twice the level of ALT is suggestive of - Answer- alcoholic liver disease A 45 year old with diabetes has had itching and burning lesions between her toes for 2 months. Scrapings of the lesions confirm the diagnosis tinea pedis. What is the best initial treatment option for this patient? - Answer- Prescribe an anti-fungal powder for application between her toes and in her shoes and a topical prescription strength anti-fungal cream for other affected areas. Monitor for a secondary bacterial infection. Which of the following is a secondary cause of hyperlipidemia? - Answer- Diabetes mellitus An employee picnic menu includes grilled hamburgers, potato salad, and homemade ice cream sundaes. Within an hour after the meal, several children and parents begin to have nausea, vomiting and stomach cramps. None of those affected have fever. What is the most likely etiologic agent? - Answer- Staphylococcus aureus A patient presents to the office with a blood pressure 142/80. This patient is classified as having: - Answer- HB stage 1 A patient reports to the nurse practitioner that he was diagnosed with hepatitis B a year ago and has not seen a health care provider since then. What information should this patient be given? - Answer- About 10% of affected persons become carriers and are at increased risk for hepatocellular carcinoma. The most common correlate(s) with chronic bronchitis and emphysema is(are): - Answer- Smoking Which of the following best describes hypertrophic cardiomyopathy? - Answer- of heart disease that affects the heart muscle. It causes thickening of the heart muscle (especially the ventricles, or lower heart chambers), left ventricular stiffness, mitral valve changes and cellular changes. Amaurosis fugax is described as a: - Answer- is a painless temporary loss of vision in one or both eyes. Transient and periodic Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg daily, and Calcium 1500 mg daily. At today's visit. Her blood pressure is 170/89. According to JNC VIII guidelines, what should you do next to control Harriet's blood pressure? (HTN stage 2) - Answer- Add a thiazide diuretic to the Lisinopril 5mg daily Dana has ischemic arterial ulcers. What is your first priority when counseling her? - Answer- Tell her to reduce risk factors to improve tissue perfusion After thorough history, physical examination, and laboratory tests, a patient is diagnosed with irritable bowel syndrome (IBS). Which of the following initial treatment plans is currently considered most effective? - Answer- A low fat, tyramine-free, caffeine-free, high fiber diet, along with a daily diary, and attention to psychosocial factors. An 8 year old presents to the health clinic with history of acute onset severe sore throat and respiratory distress with stridor in the last 2 hours. The child's history is positive for fever and pharyngitis for 2 days. What is the most likely diagnosis? - Answer- croup The nurse practitioner is reviewing a patient's lab report who completed the hepatitis B series 3 months ago. Which of the following lab results would you expect to see in this patient? - Answer- Positive hepatitis B surface antibody and negative core antibody A 15 year old male presents with abdominal pain that began in the peri-umbilical area then localized to the right lower quadrant (RLQ). He complains of anorexia, and low grade fever. A complete blood count (CBC) reveals moderate leukocytosis. What is the most likely diagnosis? - Answer- Acute appendicitis A 55 year old patient has a work-up for hypertension and is noted to have elevated BUN and creatinine. Which of the following should the nurse practitioner suspect? - Answer- Diabetes A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe? - Answer- Ibuprofen* A 58 year old complains of tightness in his chest while cutting firewood. It disappears quickly if he stops chopping. He denies shortness of breath, his total cholesterol level is less than 200 mg/dL, and he is a non-smoker. What is the most appropriate action for the nurse practitioner to take with this patient? - Answer- Treat the complaints as "cardiac" in origin until proven otherwise. A patient has experienced nausea and vomiting, headache, malaise, low grade fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is elevated with a shift to the left. He is requesting medication for diarrhea. What is the most appropriate response? - Answer- Prescribe a broad-spectrum antibiotic such as ciprofloxacin (Cipro), and symptom management. The differential diagnosis for a patient complaining of a sore throat includes which of the following? - Answer- Gonococcal infection, Thrush, Leukoplakia Before initiating an HMG CoA-reductase inhibitor for hyperlipidemia, the nurse practitioner orders liver function studies. The patient's aminotransferase (ALT) is elevated. What laboratory test(s) should be ordered? - Answer- Serologic markers for hepatitis Acute rheumatic fever is an inflammatory disease which can follow infection with: - Answer- Group A Streptococcus A patient complains of "an aggravating cough for the past 6 weeks." There is no physiological cause for the cough. Which medication is most likely causing the cough? - Answer- Enalapril