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CMN 577 UNIT 5 STUDENT
QUESTION BANK
A 55 year-old male presents to the office with his wife for evaluation of the patient's left arm
tremors. The symptoms are increased when he gets upset. The wife has noticed that the patient's
movements are slowed, "It seems as if he's shuffling his feet when he walks". The Nurse Practitioner
knows these are signs of:
a. Huntington Disease
b. Parkinson's Disease
c. Dementia
d. Bell's Palsy - CORRECT ANSWER -* b. Parkinson's Disease
Rationale: According to Papadakis and McPhee (2015), In Parkinson's Disease, tremor is commonly
confined to one limb and is exacerbated by emotional stress. The disease is also manifested by
slowed voluntary movements and gait is characterized by shuffling steps. Page 988
A twenty-five year old college student presents to the outpatient clinic today with complaints of a
"bug in my ear." The FNP is able to visualize the insect with an otoscope. The next best action is to:
a. Use a cotton tipped applicator to remove the insect.
b. Use an aqueous solution to irrigate the ear
c. Fill the ear with lidocaine prior to removing.
d. Apply heat to the ear to make the bug crawl out. - CORRECT ANSWER -*c. Fill the ear with
lidocaine prior to removing.
Rationale: Lidocaine helps to immobilize insect for easier removal.
A 46 year old male presents to the office with complaints of the room "spinning", noting that these
symptoms last several seconds after he rolls over to get out of bed in the mornings. He denies
symptoms of the 'spinning' otherwise. Which of the following would be the best initial treatment?
a. Prescribe steroid dose pack
b. Valsalva maneuver
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c. Hall Pike
d. Epley Maneuver - CORRECT ANSWER -*d. Epley Maneuver
Rationale: Benign Paroxysmal Positioning Vertigo (BPPV) is recognized by positional changes, most
often described as spinning or dizziness that occurs with head position changes such as rolling over
in bed. This is caused by loose, freely moving otoconia located in the semicircular canal. Treatment
includes the Epley maneuver which can cause the otoliths to settle back into place.
Source: (Lustig & Schindler, 2015) (page 211 in McPhee 2015)
A mom brings her 6 year old who is complaining with headache and sore throat for 2 days.
Temperature on arrival is 102.1 F orally. Examination reveals tonsillar erythema and edema and soft
palate petechiae. What is your first best action?
a. Start Amoxicillin immediately
b. Perform rapid strep throat culture
c. Have patient gargle with warm salty water
d. Refer to ENT specialist - CORRECT ANSWER -*b. Perform rapid strep throat culture
Rationale: None listed
Which of the following statements is true regarding the treatment of patients with HIV-associated
nephropathy?
a. A patient with ESRD, who is otherwise in good health, is a potential candidate for renal transplant.
b. Calcium channel blockers are the best choice to control blood pressure
c. HAART has not been shown to slow progression in these patients
d. Serum blood values can be used for diagnosis - CORRECT ANSWER -* a. A patient with ESRD, who
is otherwise in good health, is a potential candidate for renal transplant.
Rationale: In McPhee & Papadakis (2015), Watnick and Dirkx note several key points for the
treatment of patients with HIV-associated nephropathy. Kidney biopsy is needed to locate a focal
segment of glomerulosclerosis pattern of injury with glomerular collapse. Studies have shown that
HAART slows progression of disease. ACE inhibitors and ARBs can be used to control blood pressure
and slow disease progression. Patients who progress to ESRD and are otherwise healthy are good
candidates for renal transplantation (Watnick & Dirkx, 2015).
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,CLASSROOM CLASSROOM CLASSROOM
A 65-year-old man has a 10-month history of dysphagia, noted primarily with solid foods. The
dysphagia has progressed and he has noted a 20 lb. weight loss over that same period of time. His
wife states he now eats very slowly and throws his shoulders back when he swallows. Barium
esophagography shows a "bird's beak" tapering of the distal esophagus. The most likely diagnosis is:
a. Esophageal Cancer
b. Achalasia
c. Esophageal Stricture
d. Zencker's Diverticulum - CORRECT ANSWER -* b. Achalasia
Rationale: Rationale: Achalasia is an idiopathic motility disorder in which peristalsis is absent or
diminished in the distal 2/3 of the esophagus. Incidence of the disorder steadily increases with age.
Most patients complain of dysphagia for solid foods, which gradually includes liquids also. Symptoms
are often present for months to years before the patient seeks treatment. Patients with achalasia
typically eat more slowly and use certain maneuvers, such as lifting the neck or throwing the
shoulders back to increase esophageal emptying. Weight loss is common. (McPhee & Papadakis,
2015, pp. 601-602).
An 11-year-old female develops gross hematuria approximately 10 days after a sore throat. Her blood
pressure is 160/100 and she has 2+ pedal and pre-tibial edema. Which of the following is the most
likely diagnosis?
a. Post-streptococcal Glomerulonephritis
b. Hemolytic Uremic Syndrome
c. Minimal Change Disease
d. Urinary Tract Infection - CORRECT ANSWER -*a. Post-streptococcal Glomerulonephritis
Rationale: Rationale: The post-streptococcal GN diagnosis is supported by a recent history (usually 7-
14 days prior) of a group A beta-hemolytic streptococcal infection of the skin or throat. This infection
causes acute kidney injury. The typical clinical presentation includes gross hematuria, which may
appear as coffee or tea-colored urine, edema, and hypertension. (Hay, Levin, Deterding, & Abzug,
2014, pp. 757-758).
Mammogram screenings used to detect a disease process or identify a lesion is what method of
prevention?
a. Primary Prevention
b. Secondary Prevention
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c. Tertiary Prevention
d. Quinary Prevention - CORRECT ANSWER -*b. Secondary Prevention
Rationale: According to Pigone and Salazar (2015), the primary goal of screening is to promote early
detection of a disease, disease precursor, or disease process. A screening tool utilized to detect
breast cancer is a mammogram thus would be recognized as a method of secondary prevention
(p.2). It is secondary and not primary because it is a tool used for screening, primary prevention aims
to remove or reduce risk factors.
A mother brings her infant into your clinic and states she needs her second Rotavirus vaccine. What
is the maximum age limit for administration for the first vaccination?
a. 17 weeks 6 days
b. 14 weeks 6 days
c. 6 weeks 2 days
d. Can be administered anytime - CORRECT ANSWER -* b. 14 weeks 6 days
Rationale: According to Daley, O'Leary, and Nyquist (2014), the lack of safety data around
administering the initial dose of the rotavirus is the reason for the maximum age for administration is
14w 6d.
A 22-year-old female presents to the office with a diffuse, oval, fawn-colored, scaly, mildly pruritic
rash present on her abdomen. Upon examination, the center of the
lesions have a crinkled, "cigarette paper" appearance. This skin disorder is most likely:
a. Plaque psoriasis
b. Pityriasis rosea
c. Impetigo
d. Seborrheic dermatitis - CORRECT ANSWER -* b. Pityriasis rosea
Rationale: The correct answer is (b). Pityriasis rosea is a common, mild, inflammatory disease, more
common in females. Itching is common. The lesions are oval, fawn colored plaques with a center that
has a crinkled appearance. It often resembles a Christmas tree. Seborrheic dermatitis consists of dry
scales and underlying erythema commonly found on the face. Impetigo presents with
superficial blisters filled with purulent material that crust over when ruptured.
Plaque psoriasis are red, sharply defined margins with silvery scales.
CLASSROOM CLASSROOM CLASSROOM
CMN 577 UNIT 5 STUDENT
QUESTION BANK
A 55 year-old male presents to the office with his wife for evaluation of the patient's left arm
tremors. The symptoms are increased when he gets upset. The wife has noticed that the patient's
movements are slowed, "It seems as if he's shuffling his feet when he walks". The Nurse Practitioner
knows these are signs of:
a. Huntington Disease
b. Parkinson's Disease
c. Dementia
d. Bell's Palsy - CORRECT ANSWER -* b. Parkinson's Disease
Rationale: According to Papadakis and McPhee (2015), In Parkinson's Disease, tremor is commonly
confined to one limb and is exacerbated by emotional stress. The disease is also manifested by
slowed voluntary movements and gait is characterized by shuffling steps. Page 988
A twenty-five year old college student presents to the outpatient clinic today with complaints of a
"bug in my ear." The FNP is able to visualize the insect with an otoscope. The next best action is to:
a. Use a cotton tipped applicator to remove the insect.
b. Use an aqueous solution to irrigate the ear
c. Fill the ear with lidocaine prior to removing.
d. Apply heat to the ear to make the bug crawl out. - CORRECT ANSWER -*c. Fill the ear with
lidocaine prior to removing.
Rationale: Lidocaine helps to immobilize insect for easier removal.
A 46 year old male presents to the office with complaints of the room "spinning", noting that these
symptoms last several seconds after he rolls over to get out of bed in the mornings. He denies
symptoms of the 'spinning' otherwise. Which of the following would be the best initial treatment?
a. Prescribe steroid dose pack
b. Valsalva maneuver
CLASSROOM CLASSROOM CLASSROOM
,CLASSROOM CLASSROOM CLASSROOM
c. Hall Pike
d. Epley Maneuver - CORRECT ANSWER -*d. Epley Maneuver
Rationale: Benign Paroxysmal Positioning Vertigo (BPPV) is recognized by positional changes, most
often described as spinning or dizziness that occurs with head position changes such as rolling over
in bed. This is caused by loose, freely moving otoconia located in the semicircular canal. Treatment
includes the Epley maneuver which can cause the otoliths to settle back into place.
Source: (Lustig & Schindler, 2015) (page 211 in McPhee 2015)
A mom brings her 6 year old who is complaining with headache and sore throat for 2 days.
Temperature on arrival is 102.1 F orally. Examination reveals tonsillar erythema and edema and soft
palate petechiae. What is your first best action?
a. Start Amoxicillin immediately
b. Perform rapid strep throat culture
c. Have patient gargle with warm salty water
d. Refer to ENT specialist - CORRECT ANSWER -*b. Perform rapid strep throat culture
Rationale: None listed
Which of the following statements is true regarding the treatment of patients with HIV-associated
nephropathy?
a. A patient with ESRD, who is otherwise in good health, is a potential candidate for renal transplant.
b. Calcium channel blockers are the best choice to control blood pressure
c. HAART has not been shown to slow progression in these patients
d. Serum blood values can be used for diagnosis - CORRECT ANSWER -* a. A patient with ESRD, who
is otherwise in good health, is a potential candidate for renal transplant.
Rationale: In McPhee & Papadakis (2015), Watnick and Dirkx note several key points for the
treatment of patients with HIV-associated nephropathy. Kidney biopsy is needed to locate a focal
segment of glomerulosclerosis pattern of injury with glomerular collapse. Studies have shown that
HAART slows progression of disease. ACE inhibitors and ARBs can be used to control blood pressure
and slow disease progression. Patients who progress to ESRD and are otherwise healthy are good
candidates for renal transplantation (Watnick & Dirkx, 2015).
CLASSROOM CLASSROOM CLASSROOM
,CLASSROOM CLASSROOM CLASSROOM
A 65-year-old man has a 10-month history of dysphagia, noted primarily with solid foods. The
dysphagia has progressed and he has noted a 20 lb. weight loss over that same period of time. His
wife states he now eats very slowly and throws his shoulders back when he swallows. Barium
esophagography shows a "bird's beak" tapering of the distal esophagus. The most likely diagnosis is:
a. Esophageal Cancer
b. Achalasia
c. Esophageal Stricture
d. Zencker's Diverticulum - CORRECT ANSWER -* b. Achalasia
Rationale: Rationale: Achalasia is an idiopathic motility disorder in which peristalsis is absent or
diminished in the distal 2/3 of the esophagus. Incidence of the disorder steadily increases with age.
Most patients complain of dysphagia for solid foods, which gradually includes liquids also. Symptoms
are often present for months to years before the patient seeks treatment. Patients with achalasia
typically eat more slowly and use certain maneuvers, such as lifting the neck or throwing the
shoulders back to increase esophageal emptying. Weight loss is common. (McPhee & Papadakis,
2015, pp. 601-602).
An 11-year-old female develops gross hematuria approximately 10 days after a sore throat. Her blood
pressure is 160/100 and she has 2+ pedal and pre-tibial edema. Which of the following is the most
likely diagnosis?
a. Post-streptococcal Glomerulonephritis
b. Hemolytic Uremic Syndrome
c. Minimal Change Disease
d. Urinary Tract Infection - CORRECT ANSWER -*a. Post-streptococcal Glomerulonephritis
Rationale: Rationale: The post-streptococcal GN diagnosis is supported by a recent history (usually 7-
14 days prior) of a group A beta-hemolytic streptococcal infection of the skin or throat. This infection
causes acute kidney injury. The typical clinical presentation includes gross hematuria, which may
appear as coffee or tea-colored urine, edema, and hypertension. (Hay, Levin, Deterding, & Abzug,
2014, pp. 757-758).
Mammogram screenings used to detect a disease process or identify a lesion is what method of
prevention?
a. Primary Prevention
b. Secondary Prevention
CLASSROOM CLASSROOM CLASSROOM
, CLASSROOM CLASSROOM CLASSROOM
c. Tertiary Prevention
d. Quinary Prevention - CORRECT ANSWER -*b. Secondary Prevention
Rationale: According to Pigone and Salazar (2015), the primary goal of screening is to promote early
detection of a disease, disease precursor, or disease process. A screening tool utilized to detect
breast cancer is a mammogram thus would be recognized as a method of secondary prevention
(p.2). It is secondary and not primary because it is a tool used for screening, primary prevention aims
to remove or reduce risk factors.
A mother brings her infant into your clinic and states she needs her second Rotavirus vaccine. What
is the maximum age limit for administration for the first vaccination?
a. 17 weeks 6 days
b. 14 weeks 6 days
c. 6 weeks 2 days
d. Can be administered anytime - CORRECT ANSWER -* b. 14 weeks 6 days
Rationale: According to Daley, O'Leary, and Nyquist (2014), the lack of safety data around
administering the initial dose of the rotavirus is the reason for the maximum age for administration is
14w 6d.
A 22-year-old female presents to the office with a diffuse, oval, fawn-colored, scaly, mildly pruritic
rash present on her abdomen. Upon examination, the center of the
lesions have a crinkled, "cigarette paper" appearance. This skin disorder is most likely:
a. Plaque psoriasis
b. Pityriasis rosea
c. Impetigo
d. Seborrheic dermatitis - CORRECT ANSWER -* b. Pityriasis rosea
Rationale: The correct answer is (b). Pityriasis rosea is a common, mild, inflammatory disease, more
common in females. Itching is common. The lesions are oval, fawn colored plaques with a center that
has a crinkled appearance. It often resembles a Christmas tree. Seborrheic dermatitis consists of dry
scales and underlying erythema commonly found on the face. Impetigo presents with
superficial blisters filled with purulent material that crust over when ruptured.
Plaque psoriasis are red, sharply defined margins with silvery scales.
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