ANSWERS
Jean, a 47 year old presents to the clinic with complaints of dysuria, frequency and strong odor of
her urine for 5 days. This is the second occurrence this year. The first occurrence was 3 months ago.
Today, UA reveals positive leukocyte esterase, positive nitrates, 18 WBC's, few RBC's, no protein, no
casts. What is the appropriate next step for this patient
a. order a urine culture and sensitivity and hold treatment until you receive results
b. prescribe a 7 day course of antibiotics and order a urine culture and sensitivity
c. treat the patient with a stronger antibiotic, ofloxin, for 10 days
d. treat the patient with antibiotics today ✅✅ANSW-d. treat the patient with antibiotics today
Delirium is typically characterized by all of the following except:
a. altered level of consciousness
b. insidious onset
c. inattention ✅✅ANSW-b. insidious onset
Not sure of the question but
a. dominant personality
b. obesity
c. cardiovascular disease
d. diabetes ✅✅ANSW-a. dominant personality
Mrs. G has returned to your office for a follow up visit for urinary incontinence (UI). Mrs G has
followed your 1st line recommendations. She has quit smoking, drinks plenty of fluids, and has
eliminated caffeine and spicy foods. Despite all these changes, she still experiences UI. You decide to
initiate second line treatement. You recommend:
a. bladder control training
,b. keagels
c. antimuscarinic medications
d. alpha 1 adrenergic receptor antagonists ✅✅ANSW-c. antimuscarinic medications
Which of the following diagnoses should be considered in a patient presenting with erectile
dysfunction?
a. diabetes mellitus
b. artherosclerosis
c. depression
d. all options are appropriate ✅✅ANSW-d. all options are appropriate
urinary incontinence is defined as:
a. unintentional voiding, loss or leakage of urine
b. urination occurs more frequently during the day
c. continous loss of urine or leakage of urine
d. sudden, compelling desire to pass urine that is difficult to prevent ✅✅ANSW-a. unintentional
voiding, loss or leakage of urine
A patient has been prescribed metformin (Glucophage). One week later he returns with complaints
of some loose stools during the week. How should the nurse practitioner respond?
a. double the dosage of medication and have patient return in one week
b. order a chem. 7 to check for lactic acidosis
c. discontinue the medication immediately
d. reassure the patient that this is an anticipated side effect ✅✅ANSW-d. reassure the patient
that this is an anticipated side effect
An 82 year old mamn is seen in the primary care office with complaints of dribbling urine and
difficulty starting his stream. Which of the following should be included in the list of differential
diagnosis.
, a. parkinson's disease
b. prostate cancer
c. all options are appropriate
d. benign prostatic hyperplasia (BPH) ✅✅ANSW-c. all options are appropriate
A 67 year old man is seen in the clinic with a chief complaint of nocturia. Which of the following
should be included in the differential diagnosis?
a. psychogenic nocturia
b. benign prostatic hypertrophy
c. drug induced impotence
d. irritative posterior urethral lesion ✅✅ANSW-b. benign prostatic hypertrophy
Which of the following maneuvers is contraindicated in acute prostatitis
a. palpation of the epididymis
b. massaging the infected prostate
c. serial urine samples
d. rectal exams ✅✅ANSW-b. massaging the infected prostate
You are working up a 52 year old patient for microscopic hematuria. Your differential diagnosis list
includes all of the following except
a. nephrocalcinosis
b. acute pyelonephritis
c. renal stenosis
d. bladder cancer ✅✅ANSW-c. renal stenosis
A 48 year old male patient screened for diabetes has a fasting plasma glucose level of 120mg/dl
(6.7mmol/L). The nurse practitioner plan includes:
a. prescribe metformin 500mg po BID