B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic.
NSAIDs and ASA inhibit the vasodilatory effects of prostaglandins, which predisposes the
kidney to ischemia. NSAIDs and diuretics can cause acute prerenal failure by decreasing renal
blood flow.
A 72-year-old woman has been on
hydrochlorothiazide 12.5 mg for many years to
control her Stage II hypertension. Her blood
pressure (BP) at this visit is 168/96. She is
currently complaining of pain on her right hip and
on both knees. She has increased her dose of
ibuprofen (Motrin) from 400 mg 3 times day
(TID) to 800 mg TID. She is still in pain and
would like something stronger. Which of the
following statements is the best explanation of
the effects of ibuprofen (Motrin) on her disease?
A) It increases the chances of adverse effects to
her health
B) It inhibits the effect of renal prostaglandins
and blunts the effectiveness of the diuretic
C) It prolongs the therapeutic effects of
hydrochlorothiazide and other diuretics
D) None of the statements are true
D) Chlamydia trachomatis
2. All of the following are infections that affect
Infections that commonly affect the labia and vagina include bacterial vaginosis, candidiasis,
mostly the labia and vagina except: and trichomoniasis. Chlamydia trachomatis commonly affects the cervix, endometrial lining ,
fallopian tubes, and pelvic cavity.
A) Bacterialvaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis
B) Acute appendicitis.
The nurse practitioner would test the obturator Signs and symptoms of an acute abdomen include invol- untary guarding, rebound
and iliopsoas muscle to evaluate for: tenderness, boardlike abdomen, and a positive obtu- rator and psoas sign. A positive obturator
sign occurs when pain is elicted by internal rotation of the right hip from 90 degrees hip/knee
A) Cholecystitis flexion. The psoas sign is positive when pain occurs with passive extension of the thigh while
B) Acute appendicitis the patient is lying on his/her side with knees extended, or when pain occurs with active flexion
C) Inguinal hernia of his/her thigh at the hip.
D) Gastriculcer
We have an expert-written solution to this problem!
D) A prescription of methyldopa (Aldomet) to control blood pressure
Treatment for mild preeclampsia includes all of Recommended care for women diagnosed with preeclampsia includes bed rest with bath-
the following except: room privileges, weight and BP monitoring, and closely following urine protein and serum
protein, creatinine, and platelet counts. Oral medications are not used as first-line treatment.
A) Bed rest except for bathroom privileges
B) Close monitoring of weight and blood
pressure
C) Close follow-up of urinary protein, serum
creatinine, and platelet count
D) A prescription of methyldopa (Aldomet) to
control blood pressure
C) Nursing home care
All of the following services are covered under Medicare A coverage includes inpatient hospitalization and skilled care given in a certified
Medicare Part A except: skilled nursing facility. Most nursing home care is custodial care (help with bathing, dressing,
using a bathroom, and eating). This care is not covered by Medicare A.
A) Inpatienthospitalizations
, C) 10 mm
A 39-year-old migrant worker presents to the
clinic 2.5 days after a purified protein derivative The PPD is administered on the volar aspect of the lower arm and read 48 hours after the test
(PPD) test. What minimum size of induration is given. The PPD result must have induration and measure 10 mm or greater to be positive in
would be considered posi- tive for this patient? a low-risk patient. Induration (firmness with palpation) must be present. If the site has
erythema but no induration, result would be negative. Color is not important.
A) 3 mm B) 5 mm C) 10 mm D) 15 mm
We have an expert-written solution to this problem!
D) The patient's spouse has a right to override the agent's decisions
The person named in a durable power of attorney (the agent) is designated by the patient to
All of the following are correct statements make all medical decisions, as well as any decisions regarding the patient's private affairs in
regarding the role of the person named in a the event that the patient becomes incompetent and unable to make his/her own decisions. No
durable power of attorney except: one has the ability to override the agent's decision.
A) The agent's decisions are legally binding
B) The agent can make decisions in other areas
of the patient's life such as financial
issues
C) The agent can decide for the patient who is
on life support when that life support
can be terminated
D) The patient's spouse has a right to override
the agent's decisions
B) The patient has a medical illness that causes an anxiety reaction and denial
All of the following are true statements regarding Munchausen syndrome is a psychiatric disorder in which the patient fakes a medical illness or
Munchausen syndrome except: disorder to gain attention from health care provid- ers. These patients commonly use the
emergency department frequently to gain attention.
A) It is considered a mental illness
B) The patient has a medical illness that causes
an anxiety reaction and denial
C) The patient fakes an illness in order to gain
attention from health care providers
D) The patient has an inconsistent medical
history along with a past history of
frequent hospitalizations
C) Beta-blockers
Which of the following antihypertensive Beta-blockers should be avoided in patients with a history of emphysema. Studies have shown
medications should the nurse practitioner avoid evidence of a reduction in forced expiratory volume in 1 second (FEV1), increased airway
when treating patients with emphysema? hyperresponsiveness, and inhibition of bronchodilator response to beta agonists in patients
receiving non-selective beta- blockers and high doses of cardioselective beta-blockers.
A) Calcium channel blockers
B) Angiotensin-converting enzyme (ACE)
inhibitors
C) Beta-blockers
D) Diuretics
We have an expert-written solution to this problem!
A) Perform a complete and thorough history
Prior to prescribing medications, a complete and thorough history must be performed to
A 30-year-old chef complains of pruritic hives determine possible causes of hives. The patient denied difficulty with swallowing and
over her chest and arms but denies difficulty breathing, so there was no medical emergency to require calling 911.
swallowing or breathing. She reports a family
history of allergic rhinitis and asthma. Which of
the following interventions is most appropriate?
A) Perform a complete and thorough history
, D) Tingling and numbness of both feet
Which of the following symptoms is associated Vitamin B12 deficiency anemia can cause nerve cell damage if not treated. Symptoms of B12
with B12 deficiency anemia? deficiency anemia may include tingling or numbness in fingers and toes, difficulty walking,
mood changes or depression, memory loss, disorientation, and dementia.
A) Spoon-shaped nails and pica
B) An abnormal neurological exam
C) A vegan diet
D) Tingling and numbness of both feet
We have an expert-written solution to this problem!
A) Order an ultrasound
Abnormally low levels of alpha fetoprotein and estriol and high levels of human chorionic
A second triple screen on a 35-year-old gonadotropin are abnormal during pregnancy. An ultrasound should be ordered to further
primigravida reveals abnormally low lev- els of evaluate the fetus for characteristics of Down syndrome and/or fetal demise.
the alpha fetoprotein and estriol and high levels
of human chorionic gonad- otropin. Which of the
following interventions is the best choice for this
patient?
A) Order an ultrasound
B) Order a computed tomography (CT) scan of
the abdomen
C) Order a 24-hour urine for protein clearance
D) Assess for a history of illicit drug or alcohol
use
C) Most diverticula in the colon are infected with gram-negative bacte-
ria
All of the following are true statements about
Diverticuli in the colon can be infected with both gram-negative and gram- positive bacteria.
diverticula except:
A) Diverticula are located in the colon
B) A low-fiber diet is associated with the
condition
C) Most diverticula in the colon are infected with
gram-negative bacteria
D)
Supplementingwithfibersuchaspsyllium(Metamuc
il)isrecommended
B) Chlamydia trachomatis
Patients who are diagnosed with gonorrhea When diagnosed with gonorrhea, the patient should also be treated for Chlamydia
should also be treated for which of the following trachomatis.
infections?
A) Chancroid
B) Chlamydia trachomatis
C) Herpes genitalis
D) PID (pelvic inflammatory disease)
C) Osteoporosis
Kyphosis is a late sign of:
Kyphosis is a curvature of the spine that causes a rounding of the back, which leads to a
A) Old age slouching posture. Severe thinning of the bones (osteoporosis) contributes to this curvature in
B) Osteopenia the spine. Symptoms that may occur with severe cases of kyphosis include difficulty breathing,
C) Osteoporosis fatigue, and back pain.
D) Osteoarthritis
B) Higher than normal
A 35-year-old primigravida who is at 28 weeks of Alpha fetoprotein is produced in the fetal and maternal liver. Higher levels of alpha fetoprotein
gestation is expecting twins. What would you are commonly seen in multiple gestations due to the growing fetuses and enlargement of the
would expect her alpha fetoprotein (AFP) values livers.
to be?
A) Normal
B) Higher than normal
C) Lower than normal
D) None of the above
, B) Tanner Stage III
When an adolescent male's penis grows more in Tanner Stage III in males consists of penis lengthening and darker, coarse pubic hair, which
length than width, at which of the following begins to curl
Tanner stages is he classified?
A) Tanner Stage II
B) Tanner Stage III
C) Tanner Stage IV
D) Tanner Stage V
A) Toxoplasmagondii, other infections, rubella, cytomegalovirus, and herpes
The acronym TORCH stands for Toxoplasma gondii, other infections, rubella, cytomegalovirus,
Fetal TORCH infections can cause and herpes. Although several of the conditions listed in the other answer options can also
microcephaly, mental retardation, hepatospleno- cause fetal problems, they are not included in the TORCH acronym.
megaly, and intrauterine growth retardation. The
acronym TORCH stands for:
A) Toxoplasma gondii, other infections, rubella,
cytomegalovirus, and herpes
B) Toxic shock syndrome, ocular infections,
rubella, cytomegalovirus, and herpes
zoster
C) Tetanus, ophthalmic infections, roseola,
cancer, and head abnormalities
D) Toxins, other infections, roseola, candidiasis,
and head abnormalities
A) Laryngeal neoplasia
Human papilloma virus (HPV) infection of the
HPV infection of the larynx has been associated with laryngeal neoplasia; HPV infection of the
larynx has been associated with:
cervix is associated with cervical cancer.
A) Laryngeal neoplasia
B) Esophageal stricture
C) Cervical cancer
D) Metaplasia of esophageal squamous cells
C) Degenerative joint disease
Heberden's nodes are commonly seen in degenerative joint disease. Heberden's nodes are
Mr. Brown is a 65-year-old carpenter bony nodules located on the distal interphalangeal joints (DIPs).
complaining of morning stiffness and pain in both
his hands and right knee upon awakening. He
feels some relief after warming up. On exam, the
nurse notices the presence of Heberden's
nodes. Which of the fol- lowing is most likely?
A) Osteoporosis
B) Rheumatoid arthritis
C) Degenerative joint disease
D) Reiter's syndrome
B) Instability of the knee
What does a positive posterior drawer sign in a The drawer sign is performed on the knee or ankle to assess for knee instability. The affected
10-year-old soccer player signify?
knee will have more laxity when compared to the unaffected knee.
A) An abnormal knee
B) Instability of the knee
C) A large amount of swelling on the knee
D) An injury of the meniscus
We have an expert-written solution to this problem!
A) Advise the mother that her pregnancy is progressing well
NSAIDs and ASA inhibit the vasodilatory effects of prostaglandins, which predisposes the
kidney to ischemia. NSAIDs and diuretics can cause acute prerenal failure by decreasing renal
blood flow.
A 72-year-old woman has been on
hydrochlorothiazide 12.5 mg for many years to
control her Stage II hypertension. Her blood
pressure (BP) at this visit is 168/96. She is
currently complaining of pain on her right hip and
on both knees. She has increased her dose of
ibuprofen (Motrin) from 400 mg 3 times day
(TID) to 800 mg TID. She is still in pain and
would like something stronger. Which of the
following statements is the best explanation of
the effects of ibuprofen (Motrin) on her disease?
A) It increases the chances of adverse effects to
her health
B) It inhibits the effect of renal prostaglandins
and blunts the effectiveness of the diuretic
C) It prolongs the therapeutic effects of
hydrochlorothiazide and other diuretics
D) None of the statements are true
D) Chlamydia trachomatis
2. All of the following are infections that affect
Infections that commonly affect the labia and vagina include bacterial vaginosis, candidiasis,
mostly the labia and vagina except: and trichomoniasis. Chlamydia trachomatis commonly affects the cervix, endometrial lining ,
fallopian tubes, and pelvic cavity.
A) Bacterialvaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis
B) Acute appendicitis.
The nurse practitioner would test the obturator Signs and symptoms of an acute abdomen include invol- untary guarding, rebound
and iliopsoas muscle to evaluate for: tenderness, boardlike abdomen, and a positive obtu- rator and psoas sign. A positive obturator
sign occurs when pain is elicted by internal rotation of the right hip from 90 degrees hip/knee
A) Cholecystitis flexion. The psoas sign is positive when pain occurs with passive extension of the thigh while
B) Acute appendicitis the patient is lying on his/her side with knees extended, or when pain occurs with active flexion
C) Inguinal hernia of his/her thigh at the hip.
D) Gastriculcer
We have an expert-written solution to this problem!
D) A prescription of methyldopa (Aldomet) to control blood pressure
Treatment for mild preeclampsia includes all of Recommended care for women diagnosed with preeclampsia includes bed rest with bath-
the following except: room privileges, weight and BP monitoring, and closely following urine protein and serum
protein, creatinine, and platelet counts. Oral medications are not used as first-line treatment.
A) Bed rest except for bathroom privileges
B) Close monitoring of weight and blood
pressure
C) Close follow-up of urinary protein, serum
creatinine, and platelet count
D) A prescription of methyldopa (Aldomet) to
control blood pressure
C) Nursing home care
All of the following services are covered under Medicare A coverage includes inpatient hospitalization and skilled care given in a certified
Medicare Part A except: skilled nursing facility. Most nursing home care is custodial care (help with bathing, dressing,
using a bathroom, and eating). This care is not covered by Medicare A.
A) Inpatienthospitalizations
, C) 10 mm
A 39-year-old migrant worker presents to the
clinic 2.5 days after a purified protein derivative The PPD is administered on the volar aspect of the lower arm and read 48 hours after the test
(PPD) test. What minimum size of induration is given. The PPD result must have induration and measure 10 mm or greater to be positive in
would be considered posi- tive for this patient? a low-risk patient. Induration (firmness with palpation) must be present. If the site has
erythema but no induration, result would be negative. Color is not important.
A) 3 mm B) 5 mm C) 10 mm D) 15 mm
We have an expert-written solution to this problem!
D) The patient's spouse has a right to override the agent's decisions
The person named in a durable power of attorney (the agent) is designated by the patient to
All of the following are correct statements make all medical decisions, as well as any decisions regarding the patient's private affairs in
regarding the role of the person named in a the event that the patient becomes incompetent and unable to make his/her own decisions. No
durable power of attorney except: one has the ability to override the agent's decision.
A) The agent's decisions are legally binding
B) The agent can make decisions in other areas
of the patient's life such as financial
issues
C) The agent can decide for the patient who is
on life support when that life support
can be terminated
D) The patient's spouse has a right to override
the agent's decisions
B) The patient has a medical illness that causes an anxiety reaction and denial
All of the following are true statements regarding Munchausen syndrome is a psychiatric disorder in which the patient fakes a medical illness or
Munchausen syndrome except: disorder to gain attention from health care provid- ers. These patients commonly use the
emergency department frequently to gain attention.
A) It is considered a mental illness
B) The patient has a medical illness that causes
an anxiety reaction and denial
C) The patient fakes an illness in order to gain
attention from health care providers
D) The patient has an inconsistent medical
history along with a past history of
frequent hospitalizations
C) Beta-blockers
Which of the following antihypertensive Beta-blockers should be avoided in patients with a history of emphysema. Studies have shown
medications should the nurse practitioner avoid evidence of a reduction in forced expiratory volume in 1 second (FEV1), increased airway
when treating patients with emphysema? hyperresponsiveness, and inhibition of bronchodilator response to beta agonists in patients
receiving non-selective beta- blockers and high doses of cardioselective beta-blockers.
A) Calcium channel blockers
B) Angiotensin-converting enzyme (ACE)
inhibitors
C) Beta-blockers
D) Diuretics
We have an expert-written solution to this problem!
A) Perform a complete and thorough history
Prior to prescribing medications, a complete and thorough history must be performed to
A 30-year-old chef complains of pruritic hives determine possible causes of hives. The patient denied difficulty with swallowing and
over her chest and arms but denies difficulty breathing, so there was no medical emergency to require calling 911.
swallowing or breathing. She reports a family
history of allergic rhinitis and asthma. Which of
the following interventions is most appropriate?
A) Perform a complete and thorough history
, D) Tingling and numbness of both feet
Which of the following symptoms is associated Vitamin B12 deficiency anemia can cause nerve cell damage if not treated. Symptoms of B12
with B12 deficiency anemia? deficiency anemia may include tingling or numbness in fingers and toes, difficulty walking,
mood changes or depression, memory loss, disorientation, and dementia.
A) Spoon-shaped nails and pica
B) An abnormal neurological exam
C) A vegan diet
D) Tingling and numbness of both feet
We have an expert-written solution to this problem!
A) Order an ultrasound
Abnormally low levels of alpha fetoprotein and estriol and high levels of human chorionic
A second triple screen on a 35-year-old gonadotropin are abnormal during pregnancy. An ultrasound should be ordered to further
primigravida reveals abnormally low lev- els of evaluate the fetus for characteristics of Down syndrome and/or fetal demise.
the alpha fetoprotein and estriol and high levels
of human chorionic gonad- otropin. Which of the
following interventions is the best choice for this
patient?
A) Order an ultrasound
B) Order a computed tomography (CT) scan of
the abdomen
C) Order a 24-hour urine for protein clearance
D) Assess for a history of illicit drug or alcohol
use
C) Most diverticula in the colon are infected with gram-negative bacte-
ria
All of the following are true statements about
Diverticuli in the colon can be infected with both gram-negative and gram- positive bacteria.
diverticula except:
A) Diverticula are located in the colon
B) A low-fiber diet is associated with the
condition
C) Most diverticula in the colon are infected with
gram-negative bacteria
D)
Supplementingwithfibersuchaspsyllium(Metamuc
il)isrecommended
B) Chlamydia trachomatis
Patients who are diagnosed with gonorrhea When diagnosed with gonorrhea, the patient should also be treated for Chlamydia
should also be treated for which of the following trachomatis.
infections?
A) Chancroid
B) Chlamydia trachomatis
C) Herpes genitalis
D) PID (pelvic inflammatory disease)
C) Osteoporosis
Kyphosis is a late sign of:
Kyphosis is a curvature of the spine that causes a rounding of the back, which leads to a
A) Old age slouching posture. Severe thinning of the bones (osteoporosis) contributes to this curvature in
B) Osteopenia the spine. Symptoms that may occur with severe cases of kyphosis include difficulty breathing,
C) Osteoporosis fatigue, and back pain.
D) Osteoarthritis
B) Higher than normal
A 35-year-old primigravida who is at 28 weeks of Alpha fetoprotein is produced in the fetal and maternal liver. Higher levels of alpha fetoprotein
gestation is expecting twins. What would you are commonly seen in multiple gestations due to the growing fetuses and enlargement of the
would expect her alpha fetoprotein (AFP) values livers.
to be?
A) Normal
B) Higher than normal
C) Lower than normal
D) None of the above
, B) Tanner Stage III
When an adolescent male's penis grows more in Tanner Stage III in males consists of penis lengthening and darker, coarse pubic hair, which
length than width, at which of the following begins to curl
Tanner stages is he classified?
A) Tanner Stage II
B) Tanner Stage III
C) Tanner Stage IV
D) Tanner Stage V
A) Toxoplasmagondii, other infections, rubella, cytomegalovirus, and herpes
The acronym TORCH stands for Toxoplasma gondii, other infections, rubella, cytomegalovirus,
Fetal TORCH infections can cause and herpes. Although several of the conditions listed in the other answer options can also
microcephaly, mental retardation, hepatospleno- cause fetal problems, they are not included in the TORCH acronym.
megaly, and intrauterine growth retardation. The
acronym TORCH stands for:
A) Toxoplasma gondii, other infections, rubella,
cytomegalovirus, and herpes
B) Toxic shock syndrome, ocular infections,
rubella, cytomegalovirus, and herpes
zoster
C) Tetanus, ophthalmic infections, roseola,
cancer, and head abnormalities
D) Toxins, other infections, roseola, candidiasis,
and head abnormalities
A) Laryngeal neoplasia
Human papilloma virus (HPV) infection of the
HPV infection of the larynx has been associated with laryngeal neoplasia; HPV infection of the
larynx has been associated with:
cervix is associated with cervical cancer.
A) Laryngeal neoplasia
B) Esophageal stricture
C) Cervical cancer
D) Metaplasia of esophageal squamous cells
C) Degenerative joint disease
Heberden's nodes are commonly seen in degenerative joint disease. Heberden's nodes are
Mr. Brown is a 65-year-old carpenter bony nodules located on the distal interphalangeal joints (DIPs).
complaining of morning stiffness and pain in both
his hands and right knee upon awakening. He
feels some relief after warming up. On exam, the
nurse notices the presence of Heberden's
nodes. Which of the fol- lowing is most likely?
A) Osteoporosis
B) Rheumatoid arthritis
C) Degenerative joint disease
D) Reiter's syndrome
B) Instability of the knee
What does a positive posterior drawer sign in a The drawer sign is performed on the knee or ankle to assess for knee instability. The affected
10-year-old soccer player signify?
knee will have more laxity when compared to the unaffected knee.
A) An abnormal knee
B) Instability of the knee
C) A large amount of swelling on the knee
D) An injury of the meniscus
We have an expert-written solution to this problem!
A) Advise the mother that her pregnancy is progressing well
