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Cranial Nerve VIII v v Acoustic (Hearing and balance)
Cranial nerve IX v/ v Glossopharyngeal- swallowing and rise of the palate, gag reflex
Cranial Nerve XI v/ V' Spinal Accessory (upper trapezius)
Deep tendon reflex v'v Ankle- S1 primarily
Knee- Lumbar 2,3,4
Supinator(brachioradialis)-C5,6
BicepTriceps-C6,7
Stroke risk scale v'vCHADS?2
C-Congestive heart failure
H-Hypertension
A-Age >75 years
D- Diabetes
S-prior Stroke/TIA
In the majority of children, the first permanent teeth start to erupt at the age of 6 years. Which of
the following are the first permanent teeth to erupt in this time period?
A. First Molars
B. Second Molars
C. Lower or upper incisors
D. Canines vV A. First Molars
,All of the following are classified as activities of daily living (ADLs) except:
A. ability to feed self
B. Ability to manage bladder and bowel elimination
C. Personal hygiene and grooming
D. Grocery Shopping v v'D. Grocery shopping
You note the following result on a routine urinalysis of a 37-year old primigravida who is at 30
weeks gestation. Leukocyte=trace, nitrite=negative, protein=2+, blood=negative. Her weight has
increased by 5 1bs during the past week. Which of the following is most likely?
A.HELLP syndrome
B. Pregnancy-induced hypertension (pre-eclampsia)
C. Eclampsia of pregnancy
D. Primary hypertension v v'B. Pregnancy-induced hypertension (pre-eclampsia). Classic triad
of symptoms of preeclampsia include hypertension, edema (weight gain), and proteinuria.
The mother of a 12 month old infant reports to the nurse practitioner that her child had a high
fever for several days, which spontaneously resolved. After the fever resolved, the child
developed a maculopapular rash. Which of the following is the most likely diagnosis?
A. Fifth Disease (erythema infectiosum)
B. Roseola infantum (exanthema subitum)
C. Varicella
D. Infantile maculopapular rashes v'v'B. Roseola Infantum (Exanthema subitum)
A 70-year old male patient complains of a bright red-colored spot in his left eye for 2 days. He
denies eye pain, visual changes, or headaches. He has a new onset of cough from a recent viral
upper respiratory infection. The only medicine he is on Bayer aspirin, 1 tablet a day. Which of
the following is most likely?
A. Corneal abrasion
B. Acute bacterial conjunctivitis
C. Acute uveitis
,D. Subconjunctival hemorrhage v v'D. Subconjunctival hemorrhage. Bright red blood in a
sharply defined area surrounded by normal-appearing conjunctiva indicates subconjunctival
hemorrhage.
A woman is being evaluated by the nurse practitioner for complaints of dyspareunia. A
microscopy slide reveals a large number of atrophic squamous epithelial cells. The vaginal pH is
4.0. There are very few leukocytes and no RBCs are seen on the wet smear. Which of the
following is most likely?
A. Atrophic vaginitis
B. Bacterial Vaginosis
C. Trichomoniasis
D. This is a normal finding. v'v'A. Atrophic vaginitis. Symptoms of atrophic vaginitis include
painful intercourse, atrophic squamous epithelial cells, and a decrease in pH. Vaginal atrophy is
caused by lack of or imbalance of estrogen. Normal pH of the vagina is 4.0-5.0 (acidic)
The most common type of skin malignancy is:
A. Squamous cell cancer
B. Basal skin cancer
C. Melanoma
D. Dysplastic nevi v'v'B. Basal skin cancer. It is several times more common that squamous cell
skin cancer according to the NIH.
Koplik's spots are associated with:
A. Poxvirius infections
B. Measles
C. Kawasaki's disease
D. Reye's syndrome v/ v B. Measles. S/S include fever over 101, coryza, cough, conjunctivitis,
rash, and koplik's spots on buccal mucosa
At what level of prevention would you classify for lung cancer?
A. Primary prevention
, B. Secondary prevention
C. Tertiary prevention
D. Primordial prevention v'v'D. primordial prevention. Screening for lung cancer is not currently
recommended in the general population, but it is secondary prevention.
A test called the visual fields by confrontation is used to evaluate for:
A. Peripheral vision
B. Central vision
C. Visual acuity
D. Accomodation v'v/ A. Peripheral vision
What is the most common cause of Cushing's syndrome? v'v' Administration of a glucocorticoid
or ACTH.
ITatrogenic Cushing's syndrome is the most common type. Exogenous glucocorticoid
administration produces a Cushing's Syndrome that is reversible by discontinuation of the
medication.
A patient with no significant medical history has vericose veins. She complains of "aching legs".
The intervention that will provide the greatest relief for her complaint is to: v'v'Elevate her legs
periodically.
The intervention that will provide the greatest relief for this patient is elevating her legs
periodically. This will facilitate venous return. Use of support stockings will prolong the length
of time she is able to stand in place, but will not provide relief after her legs begin aching.
Support stockings should be applied prior to getting out of bed.
A 25-yo female patient presents for a routine well-women exam. On physical exam, the NP notes
a scant nipple discharge, absence of palpable mass, and absence of lymph node enlargement.
What is the most likely diagnosis? vV Itraductal papilloma.
Intraductal papilloma often presents as a non-tender mass with serous or bloody nipple discharge
located in the ductal system near the areola. Breast cancer, although usually non-tender, may
present with pain. Chest wall syndrome may present in some women as breast pain. Fibrocystic
breast disease often presents with bilateral breast pain.