NR 511 midterm questions with correct answers 2024 Update

NR 511 midterm questions with correct answers 2024 Update NR 511 midterm questions with correct answers 2024 Update Question 2: Which drug for Alzheimer's disease should be administered beginning at the time of diagnosis? a. Cholinesterase inhibitors b. Anxiolytics c. Antidepressants d. Atypical antipsychotics a. cholinesterase inhibitors pg Question 3: Most adult poisonings are: a. intentional and self-inflicted. b. accidental. c. caused by someone wishing to do harm to the person. d. not attributed to any reason. b. accidental. Question 4: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate? a. "It is probably just a cyst, because that is the most common breast mass." b. "We will order a mammogram and ultrasound to help establish a diagnosis." c. "We will go ahead and schedule you for a biopsy because that is the only way to know for sure." d. "Because your lump is painful, it is most likely not cancer." "We will order a mammogram and ultrasound to help establish a diagnosis." Question 5: Which of the following is a specific test for multiple sclerosis (MS)? a. Magnetic resonance imaging (MRI) b. Computed tomography (CT) scan c. A lumbar puncture d. There is no specific test. d. There is no specific test. Question 7: Which characteristic of delirium helps to distinguish delirium from dementia? a. Abrupt onset b. Impaired attention c. Affective changes d. Delusions Abrupt onset Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)? a. Decrease in level of consciousness (LOC) b. Headache c. Nausea d. Widening pulse pressure Decrease in level of consciousness (LOC) Question 9: Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation? a. Posterior dislocations are more common than anterior dislocations. b. There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses. c. Recurrent dislocations are uncommon and would require a greater force to result in injury. d. Surgery is most commonly the treatment of choice. There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses. Question 10: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? a. Decreased C-reactive protein b. Hyperalbuminemia c. Morning stiffness d. Weight gain morning stiffness Question 11: The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient? a. Overweight b. Mild obesity c. Moderate obesity d. Morbid obesity Mild obesity Question 13: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam? a. Human papillomavirus (HPV) b. Endometrial hyperplasia c. Vagismus d. Polycystic ovarian syndrome Human papillomavirus (HPV) Question 14: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium? a. Benzodiazepines b. Antipsychotics c. Anticonvulsants d. Antidepressants Antipsychotic Question 15: What is the treatment of choice for a patient diagnosed with testicular cancer? a. Radical orchidectomy b. Lumpectomy c. Radiation implants d. All of the above treatment of choice for a patient diagnosed with testicular cancer? Radical orchidectomy Question 16: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to? a. Gonorrhea b. Human papillomavirus (HPV) c. Chlamydia d. Trichomonas Chlamydia Question 17: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment? a. Conjugated estrogen 0.625 mg/day oral b. Estradiol 7.5 mcg/24 hr vaginal ring c. Medroxyprogesterone 10 mg/day oral d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral Estradiol 7.5 mcg/24 hr vaginal ring Question 18: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are? a. Spores b. Leukocytes c. Pseudohyphae d. Epithelial cells spores Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point? a. 10% b. 20% c. 30% d. 50% 30% Question 20: John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear? a. Valgus stress test b. McMurray circumduction test c. Lachman test d. Varus stress test McMurray circumduction test Question 21: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? a. An enlarged rubbery gland b. A hard irregular gland c. A tender gland d. A boggy gland An enlarged rubbery gland Question 22: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? a. Gastrocnemius weakness b. A reduced or absent ankle reflex c. Numbness in the lateral foot d. Paresthesia of the perineum and buttocks Paresthesia of the perineum and buttocks Question 24: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease? a. Sinus bradycardia b. Atrial fibrillation c. Supraventricular tachycardia d. U waves Sinus bradycardia Question 25: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact? a. Superficial burns b. Superficial partial-thickness burns c. Deep partial-thickness burns d. Full-thickness burns Deep partial-thickness burns Question 26: Immunizations are an example of which type of prevention? a. Primary b. Secondary c. Tertiary a. Primary Question 27: If a previously frostbitten area becomes frostbitten again after it has healed, what might occur? a. Permanent tissue damage may occur, resulting in necrosis to that body part. b. The area will be super sensitive. c. The area is prone to a repeat frostbite. d. The area is as susceptible as any other area. Permanent tissue damage may occur, resulting in necrosis to that body part. Question 29: Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines? a. Propranolol c. Ergotamine b. Timolol d. Topiramate d. Topiramate Which of the following statements is true concerning the musculoskeletal pain? The uninvolved side should be examined initially and compared to the involved side. Question 1: In an outpatient setting, what is the most common reason for a malpractice suit? a. Failure to treat a condition b. Failure to diagnose correctly c. Ordering the wrong medication d. Failure to manage care Failure to diagnose correctly Question 2: How often should the clinician examine the feet of a person with diabetes? a. Once a year b. Every 6 months c. Every 3 months d. Every visit d. Every visit Question 4: Which of the following medications is the treatment of choice for trichomonas? a. Metranidazole b. Ceftriaxone c. Diflucan d. Doxycycline a. Metranidazole Question 16: S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician suspect in the initial test results for this patient? a. Elevated uric acid level b. Elevated blood urea nitrogen (BUN) c. Decreased urine pH d. Decreased C-reactive protein (CRP) Elevated uric acid level Question 17: Which of the following statements is true regarding the treatment of carpal tunnel syndrome? a. The goal of treatment is to prevent flexion and extension movements of the wrist. b. Splints are used in carpal tunnel syndrome because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position. c. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection. d. All of the above d. All of the above C) Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection. Question 21: A sunscreen with a sun-protection factor (SPF) of at least what number will block most harmful ultraviolet (UV) radiation? a. 4 b. 8 d c. 10 d. 15 15 Question 24: Sam, aged 65, is started on L-dopa for his Parkinson's disease (PD). He asks why this is necessary. You tell him: a. "L-dopa is neuroprotective." b. "The primary goal of therapy is to replace depleted stores of dopamine." c. "This is the only drug that can provide symptomatic benefit." d. "This is the initial monotherapy drug." "The primary goal of therapy is to replace depleted stores of dopamine." Question 25: A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find? a. The scrotum will be dark. b. The scrotum will appear light pink or yellow. c. The scrotum will appear milky white. d. The internal structures will be clearly visible. The scrotum will appear light pink or yellow. Question 29: A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnoses? a. Testicular cancer b. Inguinal hernia c. Varicocele d. All of the above Answer D Testicular cancer Inguinal hernia Varicocele Question 35: Which of the following laboratory findings should the clinician expect in a patient with untreated Graves' disease? a. Elevated thyroid-stimulating hormone (TSH) b. Elevated T4 c. Elevated TRH d. All of the above Answer D Elevated thyroid-stimulating hormone (TSH) b. Elevated T4 c. Elevated TRH Question 39: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least: a. 1 month. b. 3 months. c. 6 months. d. 12 months. 6 months Question 40: The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs to manage his pain? a. You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage. b. You should start with the lowest dose that is effective in managing your pain in order to avoid developing tolerance to the medication. c. You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain. d. It is important to take NSAIDs on an empty stomach in order to increase absorption. You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage. Question 46: In the United States, what is the second most common connective tissue disease and the most destructive to the joints? a. Osteoarthritis b. Systemic lupus erythematosus (SLE) c. Rheumatoid arthritis (RA) d. Sjogren's syndrome ... Question 42: Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? a. Morning stiffness and limited mobility of the lumbar spine b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain c. Fever, chills, and elevated erythrocyte sedimentation rate d. Pathologic fractures, severe night pain, weight loss, and fatigue Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain Question 48: A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding? a. Trichomonas b. Bacterial vaginosis c. Human papillomavirus (HPV) d. Herpes simplex virus (HSV) Bacterial vaginosis A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of "my feet feel like they are on fire." He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment? a. Tricyclic antidepressants b. Capsacin cream c. Vitamin B12 injections d. Insulin a. Tricyclic antidepressants Which of the following is a crucial element of developing a guideline? a. Creating a physician expert panel b. Reviewing the literature with ratings of available evidence c. Conducting an external review of a guideline d. Developing evidence-based tables B. Reviewing the literature with ratings of available evidence Question 2: African American patients seem to have a negative reaction to which of the following asthma medications? a. Inhaled corticosteroids b. Long-term beta-agonist bronchodilators c. Leukotriene receptor agonist d. Oral corticosteroid b. Long-term beta-agonist bronchodilators Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean? a. The tumor size cannot be evaluated, the cancer has not spread to the lymph nodes, and the distant spread cannot be evaluated. b. The cancer is in situ, it is spreading into the lymph nodes, but the spread otherwise cannot be evaluated. c. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body. d. The cancer is about 5 cm in size, nearby lymph nodes cannot be evaluated, and there is no evidence of distant spreading c. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body Sondra's peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear? a. Meclizine b. Diphenhydramine c. Diamox d. Promethazine c. Diamox Mandy presents with a cauliflower-like wart that is in her anogenital region. You suspect it was sexually transmitted and document this as a: a. Filiform/digitate wart. b. Dysplastic cervical lesion. c. Condyloma accuminata. d. Koilocytosis. Condyloma accuminata Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of? a. Dementia b. Alzheimer's disease c. Parkinson's disease d. Delirium d. Delirium You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her? a. "Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow." b. "Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow." c. "Drive to the emergency room (ER) now." d. "Call 911." b. "Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow." A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria? a. NSAIDs b. Beets c. Vitamin A d. Red meat a. NSAIDs Which of the following is an example of tertiary prevention in a patient with chronic renal failure? a. Fluid restriction b. Hemodialysis 4 days a week c. High-protein diet d. Maintain blood pressure at 120/80 Hemodialysis 4 days per week Which of the following conditions is associated with cigarette smoking? a. Glaucoma b. Increased sperm quality c. Bladder cancer d. Eczema c. Bladder cancer A chronic cough lasts longer than: a. 3 weeks b. 1 month c. 6 months d. 1 year a. 3 weeks The 'freezing phenomenon' is a cardinal feature of? a.Parkinson's disease b. Alzheimer's disease c. A CVA d. Bell's palsy a.Parkinson's disease When administered at the beginning of an attack, oxygen therapy may help this kind of headache? a. Tension b. Migraine c. Cluster d. Stress c. Cluster Which ethnic group has the highest lung cancer incidence and mortality rates? a. African American men b. Scandinavian men and women c. Caucasian women d. Asian men ######### a. African American men The most significant precipitating event leading to otitis media with effusion is: a. Pharyngitis b. Allergies c. Viral upper respiratory infection (URI) d. Perforation of the eardrum c. Viral URI Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of: a. Severe asthma. b. A common valvular lesion. c. Severe hypertension. d. A previous coronary artery bypass graft (CABG). d. A previous coronary artery bypass graft (CABG). A 34-year-old patient was treated for a urinary tract infection (UTI) and has not responded to antibiotic therapy. Which of the following actions should be taken next? a. Send a urine specimen for microscopy looking for fungal colonies. b. Increase the dose of antibiotic. c. Order a cytoscopy. d. Order a different antibiotic. a. Send a urine specimen for microscopy looking for fungal colonies. Which statement best describes a carotid bruit? a. It is felt with the middle three fingers over the carotid artery. b. A bruit becomes audible when the lumen is narrowed to 1 mm or less. c. A low-pitched bruit is a medical emergency. D. The higher the pitch of the bruit, the higher the degree of stenosis D. The higher the pitch of the bruit, the higher the degree of stenosis Which statement is true regarding chloasma, the 'mask of pregnancy'? a. It is caused by a decrease in the melanocyte-stimulating hormone duringpregnancy. b. This condition only occurs on the face. c. Exposure to sunlight will even out the discoloration. d. It is caused by increased levels of estrogen and progesterone. d. It is caused by increased levels of estrogen and progesterone Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause? a. "You must be under a lot of stress lately." b. "It is hereditary. Did your father experience this also?" c. "The cause is unknown, but we suspect it is due to an immunologic mechanism." d. "We'll have to do some tests." c. "The cause is unknown, but we suspect it is due to an immunologic mechanism." A blood pressure (BP) of 150/90 is considered: a. Stage 2 hypertension b. Hypertensive c. Normal in healthy older adults d. Acceptable if the patient has DM a. Stage 2 hypertension When teaching post MI patients about their NTG tablets, theclinician should stress that the tablets should remain in thelight-resistant bottle in which they are packaged and shouldnot be put in another pill box or remain in areas that are orcould become warm and humid. Once opened, the bottlemust be dated and discarded after how many months? a. 1 month b. 3 months c. 6 months d. As long as the tablets are kept in this special bottle, they will last forever c. 6 months Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking? a. He should stop smoking today. b. He should stop smoking tomorrow. c. His quit date should be in 1 week. d. He will be ready to quit after the Frst 30 days c. His quit date should be in 1 week. The hallmark of an absence seizure is: a. No activity at all. b. A blank stare. c. Urine is usually voided involuntarily. d. The attack usually lasts several minutes. b. A blank stare. Which medication used for scabies is safe for children 2 months and older? a. Permethrin cream b. Lindane c. Crotamiton lotion and cream d. Ivermectin a. Permethrin cream The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis? a. Viral conjunctivitis b. Keratoconjunctivitis c. Bacterial conjunctivitis d. Allergic conjunctivitis c. Bacterial conjunctivitis Gabby, aged 22, has Bell's palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her? a."Most pt's have complete recovery in 3-6mo." b. "Unfortunately, you'll probably have a small amount of residual damage." c. "Don't worry, I'll take care of everything." d. "You may have a few more episodes over the course of your lifetime but no permanent damage." "Most pt's have complete recovery in 3-6mo." How often should drug levels be monitored when a seizure medication has controlled the seizures and the drug level is adequate a. Every 3 months b. Every 6 months c. Annually d. Whenever there is a problem b. Every 6 months The result of the patient's 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions? a. Repeat the test. b. Refer to a nephrologist. c. Measure the serum protein. d. Obtain a blood urea nitrogen (BUN) and creatinine. b. Refer to a nephrologist. Which cranial nerve is afected in a patient with acerebrovascular accident who has difficulty chewing? a. CN V b. CN VII c. CN IX d. CN X a. CN V trigenminal Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer? a. KUB (kidneys, ureter, bladder) x-ray b. Cystoscopy with biopsy c. Magnetic resonance imaging (MRI) d. Urine tumor marker (NMP22) b. Cystoscopy with biopsy The "B" in the ABCDEs of assessing skin cancer represents: a. Biopsy. b. Best practice. c. Boundary. d. Border irregularity. d. Border irregularity. Which statement is true regarding driving and patients with a seizure disorder? a. Once diagnosed with a seizure disorder, patients mustnever drive again. b. After being seizure free for 6 months, patients may drive. c. Each state has diferent laws governing driving forindividuals with a seizure disorder. d. These persons may drive but never alone. c. Each state has diferent laws governing driving forindividuals with a seizure disorder. Which high-density lipoprotein (HDL) level is considered cardioprotective? a. Greater than 30 b. Greater than 40 c. Greater than 50 d. Greater than 60 d. Greater than 60 The most common etiologic organism for community-acquired pneumonia is: A. Streptococcus pneumoniae B. Beta hemolytic streptococcus C. Mycoplasma D. Methicillin resistant staphylococcus A. Streptococcus pneumoniae Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause? a. Serum calcium b. Electrocardiogram (ECG) c. Thyroid-stimulating hormone test d. Complete blood cell count a. Serum calcium A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be? a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment. b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen. c. A throat culture should be performed to confirm the results of the rapid strep test. d. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive. c. A throat culture should be performed to confirm the results of the rapid strep test. Patients with acute otitis media should be referred to a specialist in which of the following situations? a. Concurrent vertigo or ataxia b. Failed closure of a ruptured tympanic membrane c. If symptoms worsen after 3 or 4 days of treatment d. All of the above d. All of the above Concurrent vertigo or ataxia Failed closure of a ruptured tympanic membrane If symptoms worsen after 3 or 4 days of treatment Which of the following tests is most useful in determining renal function in a patient suspected of chronic renal failure (CRF)? a. Blood urea nitrogen (BUN) and creatinine b. Electrolytes c. Creatinine clearance d. Urinalysis c. Creatinine clearance Marci has a wart on her hand. She says she heard something about "silver duct tape therapy." What do you tell her about his? a. It is an old wives' tale. b. It is used as a last resort. c. Salicylic acid is more effective. d. It is a simple treatment that should be tried first. d. It is a simple treatment that should be tried first. What is the first-line recommended treatment against Group A b-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis? a. Penicillin b. Quinolone c. Cephalosporin d. Macrolide a. Penicillin Which of the following is an example of sensorineural hearing loss? a. Perforation of the tympanic membrane b. Otosclerosis c. Cholesteatoma d. Presbycusis b. Otosclerosis Which of the following is "a linear crack extending from the epidermis to the dermis?" a. An ulcer b. A fissure c. Lichenification d. An excoriation b. A fissure A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma? a. The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma. b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient. c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist. d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve. c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist. The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection? a. IgA b. IgE c. IgG d. IgM c. IgG A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses? a. Pancreatitis b. Peptic ulcer disease c. Diverticulitis d. All of the above d. All of the above Pancreatitis Peptic ulcer disease Diverticulitis Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test? a. B-type natriuretic peptide b. C-reactive protein c. Serum albumin d. Erythrocyte sedimentation rate a. B-type natriuretic peptide You are doing a cerumen extraction and touch the external meatus of your patient's ear. He winces and starts coughing. What is the name of this reflex? a. Baker phenomenon b. Arnold reflex c. cough reflex d. Tragus reflex b. Arnold reflex Women are at the highest risk for developing postpartum depression for up to how long after childbirth? 2 weeks 1 month 3 months 6 months 6 months CPT coding offers the uniformed language used for reporting medical services and procedures performed by physician and nonphysician practitioners. Clinicians are paid based on calculated resource costs that are calculated based on practice components. a. Clinician education loans b. Clinician practice liability and malpractice expense c. Clinician reported cost reduction efforts d. Clinician volume of patients treated Clinician practice liability and malpractice expense What is the normal number for the Glasgow Coma Scale? a. 7 b. 9 c. 10 d. 15 d. 15 Best Eye Response. (4) 1No eye opening. 2Eye opening to pain. 3Eye opening to verbal 4command. 5Eyes open spontaneously. Best Verbal Response. (5) 1No verbal response 2Incomprehensible sounds. 3Inappropriate words. 4Confused 5Orientated Best Motor Response. (6) 1No motor response. 2Extension to pain. 3Flexion to pain. 4Withdrawal from pain. 5Localising pain. 6Obeys Commands. Which solution should be used when irrigating lacerated tissue over a wound on the arm? a. Dilute povidone-iodine solution b. Hydrogen peroxide (H2O2) c. Saline solution infused with an antibiotic d. Saline irrigation or soapy water d. Saline irrigation or soapy water Which ethical principle reflects respect for all persons and their self-determination? a. Autonomy b. Beneficence c. Justice d. Veracity a. Autonomy George, aged 59, complains of a flulike illness, including fever, chills, and myalgia after returning from visiting his grandchildren in New England. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering? a. A viral syndromes b. Lyme disease c. Rocky Mountain spotted fever d. Relapsing fever b. Lyme disease What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster? a. A stabbing type of pain on one small area of the body b. A vesicular skin lesion on one side of the body c. A pain that is worse upon awakening d. A lesion on the exterior ear canal A vesicular skin lesion on one side of the body Which drug commonly prescribed for burns is active against a wide spectrum of microbial pathogens and is the most frequently used agent for partial- and full-thickness thermal injuries? a. Clotrimazole cream (Lotrimen) b. Mafenide acetate (Sulfamylon) c. Silver nitrate d. Silver sulfadiazine (Silvadene) d. Silver sulfadiazine (Silvadene) Which of the following is a role of the advanced practice nurse in palliative cancer care? a. Detecting cancer in asymptomatic patients or those with specific symptoms b. Arranging for follow-up care, including psychosocial and spiritual support c. Identifying and managing complications of care d. All of the above d. All of the above a. Detecting cancer in asymptomatic patients or those with specific symptoms b. Arranging for follow-up care, including psychosocial and spiritual support c. Identifying and managing complications of care The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety? a. Acetylcholine b. Gamma-aminobutyric acid (GABA) c. Dopamine d. Serotonin Gamma-aminobutyric acid (GABA) A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority? a. Pregnancy test b. Pelvic ultrasound c. Endometrial biopsy d. Platelet count a. Pregnancy test A bulla is: a. A vesicle larger than 1 cm in diameter. b. An elevated solid mass with a hard texture, and the shape and borders can be regular or irregular. c. A superficial elevated lesion filled with purulent fluid. d. Thinning of the skin (epidermis and dermis) that appears white or translucent. a. A vesicle larger than 1 cm in diameter. Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? a. Morning stiffness and limited mobility of the lumbar spine b. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain c. Fever, chills, and elevated erythrocyte sedimentation rate d. Pathologic fractures, severe night pain, weight loss, and fatigue Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain Which of the following statements is true concerning the musculoskeletal exam? a. The uninvolved side should be examined initially and compared to the involved side. b. The part of the body that is causing the patient pain should be examined first. c. The patient should not be asked to perform active range-of-motion (ROM) exercises whenever possible to avoid causing pain. d. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient. The uninvolved side should be examined initially and compared to the involved side The current goal of treatment for a patient with HIV infection is which of the following? a. Viral suppression of HIV to undetectable levels in the peripheral blood b. Compete eradication of the virus c. Encouraging the person to have no contact with uninfected individuals d. Complete abstinence Viral suppression of HIV to undetectable levels in the peripheral blood After removing a tack from a type 2 diabetic's heel and evaluating the site for infection, what is the best plan for this patient? a. Suggest she use a heating pad to improve circulation b. Refer to a podiatrist for a foot care treatment plan c. Send her for acupuncture treatments d. All of the above b. Refer to a podiatrist for a foot care treatment plan Which of the following statements is true concerning the management of the client with a herniated disc? a. Muscle relaxants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use. b. An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred. c. Intolerable pain for more than a 3-month period is an indication for surgical intervention. d. All of the above intolerable pain for more than a 3-month period is an indication for surgical intervention. Which patient is more likely to have a cluster headache? a. A female in her reproductive years b. A 40-year-old African American male c. A 55-year-old female who drinks 10 cups of coffee daily d. A 45-year-old male awakened at night A 45-year-old male awakened at night The main mechanism for avoiding a lawsuit involves: a. Good liability insurance b. A collaborating physician c. Good documentation d. Open communication skills Open communication skills When may confidentiality be overridden? a. When personal information is available on the computer b. When a clinician needs to share information with a billing company c. When an insurance company wants to know the results of a breast cancer gene test d. When a patient has a communicable disease When a patient has a communicable disease The most cost-effective screening test to determine HIV status is which of the following? a. Western Blot b. Enzyme-linked immunosorbent assay (ELISA) c. Venereal Disease Research Laboratory (VDRL) test d. Viral load Enzyme-linked immunosorbent assay (ELISA) After 6 months of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? a. Elevated thyroid-stimulating hormone (TSH) b. Normal TSH c. Low TSH d. Undetectable TSH Normal TSH In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the "C" of LACE represents? a. Commitment b. Consensus c. Certification d. Collaboration certification which percentage of burns is involved using the nines if both front legs are burned? 18% The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods? a. Rice b. Carrots c. Spinach d. Potatoes spinach The clinician should question the patient with suspected gout about use of which of these medications that may be a risk factor? a. Low-dose aspirin b. Thiazide diuretics c. Ethambutol d. All of the above Answer D Low-dose aspirin Thiazide diuretics Ethambutol Clinicians who learn how to code and document Evaluation and Management and clinician services will be more successful in gaining timely payment for care delivery. Which of the following CMS practices is designed to financially penalize clinicians who do not bill according to CMS guidelines? Audits and probes In the United States, what is the second most common connective tissue disease and the most destructive to the joints? Rheumatoid Arthritis If you suspect diverticulitis in a patient, you can treat with antibiotics alone, no imaging is necessary. True False False It is safe to use laxatives long term for the treatment of constipation. T F T According to the American Cancer Society guidelines, African Americans with no other risk factors for colon cancer should begin routine colon cancer screening at age 45. T F T In ulcerative colitis, typical symptoms include abdominal cramping, fever, anorexia, weight loss, spasm, flatulence, and RLQ pain or mass. Stools may contain blood, mucus, and/or pus. T F F In diverticulitis, typical symptoms include bleeding, cramping pain, and the urge to defecate. Stools are characteristically watery diarrhea with blood and mucus. T F F In diverticulitis, typical symptoms include LLQ pain and tenderness, fever, change in bowel habits (usually diarrhea), and sometimes nausea/vomiting. T F T Acute gastroenteritis is the most common cause of nausea and vomiting. T F T Nausea, vomiting, and diarrhea do not usually occur together in acute gastroenteritis. T F F The most common pathogen responsible for acute gastroenteritis is bacterial. T F F Norovirus is the most common virus responsible for acute gastroenteritis T F T If a person presents to the office with nausea, vomiting, and diarrhea, which of the following would prompt you to order stool studies? Symptoms that have been ongoing for 6 days Antibiotic use in the past month More than four bowel movements per day Abdominal pain Antibiotic use in the past month Which of the following would be an appropriate treatment for prophylaxis or treatment of traveler's diarrhea? Amoxicillin Keflex Ciprofloxin Flagyl Ciprofloxin The history is a critical part of the visit for a patient with complaint of a hearing disorder. T F t The majority of TM ruptures will heal themselves. T F T Meniere's disease is diagnoses of exclusion. T F T Age-related hearing loss (presbycusis) is classified as which type of hearing loss? Conductive Relative Sensorineural Unfortunate Sensorineural The triad of symptoms associated with Meniere's disease include _____. vertigo, pain, and tinnitus tinnitus, pain, and hearing loss vertigo, hearing loss, and pain hearing loss, vertigo, and tinnitus hearing loss, vertigo, and tinnitus The most common bacterial cause of pharyngitis or tonsillitis is from Group _____ Hemolytic Streptococcus. A B C D A Which are not findings associated with mononucleosis? Exudative tonsillitis Palatal petechiae and exantham Splenic enlargement Cough Cough Name the four clinical features suggestive of bacterial pharyngitis (Centor criteria) Fever, cervical adenopathy, pharyngeal/tonsillar exudate, no cough Fever, fatigue, submandibular adenopathy, cough Submandibular adenopathy, pharyngeal/tonsillar exudate, cough, fever Pharyngeal/tonsillar exudate, cough, fever, fatigue Fever, cervical adenopathy, pharyngeal/tonsillar exudate, no cough A red tongue with enlarged papillae, sometimes seen with strep throat is called a _____ tongue Raspberry Sandpaper Strawberry Blackberry Strawberry Patients with > 3 Centor criteria can be empirically diagnosed with GABHS and treated without further testing. T F T Empiric treatment of asymptomatic household contacts of patients with acute GABHS pharyngitis is recommended. T F F Doxycycline is an alternative for patients with GABHS pharyngitis who are allergic to PCN. T F F Patients with mononucleosis who develop an erythematous, macular rash after taking amoxicillin for pharyngitis should be identified as having a PCN allergy. T F ... The most common cause of viral laryngitis is _____. HPV Coxsackie H. Influenza Pasturella H. Influenza Which is (are) a symptom(s) of peritonsillar abscess? (select all that apply) severe, unilateral sore throat Fever Asymetric cervical adenopathy Exudate Severe, bilateral sore throat ... Dyspnea is one of the more common complaints in primary care that can be caused by diverse health problems. In the majority of cases, dyspnea is a results of a cardiac or pulmonary decompensation. Which etiology is not associated with cardiac or pulmonary decompensation? Spinal cord lesions affecting the innervation to the diaphragm Congestive heart failure Interstitial lung disease Pneumona Spinal cord lesions affecting the innervation to the diaphragm Dyspnea can be classified into flow or volume disorders, and the underlying cause can be from an intrathorax or an extrathorax problem. Which of the following is an example of a flow extrathorax problem? Diphtheria Asthma Epiglottis Diphtheria Epiglottis The following are all essential in gathering your history of a patient with a chief complaint of dyspnea, except _____. timing of dyspnea ordering diagnostic test onset and timing of episode of dyspnea acute, chronic, or recurrent symptoms ordering diagnostic test Which of the following is not a test that can be used in the evaluation of the patient who is dyspenic? Sleep apnea or sleep hypoxia testing Rhinoscopy, laryngoscopy, bronchoscopy Arterial blood gas (ABG) None of the above None of the above Rubeola Reddish, purple, generalized macular/popular rash Varicella Urticarial, erythemic, papules that turn to vesicles