LEIK FNP Practice Questions With Complete Solutions

LEIK FNP Practice Questions With Complete Solutions .124. Which of the following viral infections is associated with occasional abnormal forms of lymphocytes during an acute infection? A) Cytomegalovirus (CMV) B) Epstein-Barr virus (EBV) C) Human papilloma virus (HPV) D) Coxsackie virus - ANSWER-B) Epstein-Barr virus (EBV) A test for an acute infection of the Epstein-Barr virus will show abnormal forms of lymphocytes. .2. All of the following are infections that affect mostly the labia and vagina except: A) Bacterialvaginosis B) Candidiasis C) Trichomoniasis D) Chlamydia trachomatis - ANSWER-D) Chlamydia trachomatis Infections that commonly affect the labia and vagina include bacterial vaginosis, candidiasis, and trichomoniasis. Chlamydia trachomatis commonly affects the cervix, endometrial lining , fallopian tubes, and pelvic cavity. .411. Which of the following is the most common cause of nongonococcal urethritis? A) Escherichia coli B) Chlamydia trachomatis C) Neisseria gonorrhoeae D) Mycoplasma - ANSWER-B) Chlamydia trachomatis The most common cause of nongonococcal urethritis is Chlamydia trachomatis. .A 10-year-old boy complains of a sudden onset of scrotal pain when he woke up that morning. He is also complaining of severe nausea and vomiting. During the physical examination, the nurse practitioner finds a tender, warm, and swollen left scrotum. The cremasteric reflex is negative and the urine dipstick is negative for leukocytes, nitrites, and blood. The most likely diagnosis is: A) Acute epididymitis B) A severe salmonella infection C) Testicular torsion D) Acute orchitis - ANSWER-C) Testicular torsion Testicular torsion signs and symptoms include sudden onset of unilateral scrotal pain, nausea, vomiting, and abdominal pain. Acute epididymitis causes fever, chills, nausea, and unilateral pain and is most com- monly seen in sexually active men. Unilateral scrotal pain does not occur with Salmonella infection. Acute orchitis is often based on having a recent mumps infec- tion or parotitis with testicular edema. .A 10-year-old male who was recently accepted into his school's soccer team has a history of exercise-induced asthma. The child wants to know when he should take his albuterol inhaler. The nurse practitioner would advise the patient: A) Premedicate himself 20 minutes prior to starting exercise B) Wait until he starts to exercise before using the inhaler C) Premedicate 60 minutes before starting exercise D) Wait until he finishes his exercise before using his inhaler - ANSWER-A) Premedicate himself 20 minutes prior to starting exercise Exercise-induced asthma is best controlled by using the Proventil inhaler (bronchodilator) approximately 20 minutes prior to exercise, to prevent vasospasm of the bronchioles and shortness of breath with exercise. These bronchodilators usually last approximately 4 hours. They also work quickly to open up the bronchioles if an acute attack/shortness of breath occurs .A 12-year-old girl is complaining of a 2-week history of facial pressure that worsens when she bends over. She complains of tooth pain in her upper molars on the right side of her face. On physical exam, her lung and heart sounds are normal. Which of the following is the most likely diagnosis? A) An acute dental abscess B) Chronic sinusitis C) Acute sinusitis D) Severe allergic rhinitis - ANSWER-C) Acute sinusitis Signs/symptoms of acute sinusitis includes headache, facial pain that worsens with bending over, eye/ear pressure and pain, aching in upper jaw/teeth, reduced smell and taste, cough (especially at night due to the nasal drainage), sore throat, bad breath, and fatigue. .A 12-year-old male's peak expiratory flow results indicate 60 to 80% of the predicted range. How would you classify his asthma? A) Mild intermittent asthma B) Mild persistent asthma C) Moderate persistent asthma D) Severe asthma - ANSWER-C) Moderate persistent asthma Asthma classifications: Intermittent: normal FEV between exacerbations, FEV 80%; mild persistent, FEV 80%; moderate persistent, FEV 60-80%; severe persistent, FEV 60%. .A 13-year-old adolescent female is brought in by her mother for a sports physical. The mother reports that the teen's last vaccines were given at the age of 6 years. Which of the following vaccines is recommended by the CDC for this patient? A) Td and HPV vaccines B) Tdap, MCV4, and the HPV vaccines C) DTap and the flu vaccine D) DT and MCV4 vaccines - ANSWER-B) Tdap, MCV4, and the HPV vaccines Vaccine questions usually are not this complicated, but there are several lessons that can be learned with this question. The 2012 CDC recommendations for the ages 13 to 18 years are the Tdap catch-up (if did not receive at age 11-12 years), HPV or Gardasil catch-up (if did not receive at age 11-12 years), and the MCV4 or meningococcal conjugate vaccine (Menactra). Only one dose of Tdap is recommended (lifetime). Thereafter, the Td form of the vaccine is indicated every 10 years. .A 13-year-old boy wants to be treated for his acne. He has a large number of closed and open comedones on his face. The patient has been treating himself with OTC benzoyl peroxide and salicylic acid topical products. Which of the following would be recommended next? A) Retinoic acid (Accutane) B) Tetracycline C) Retin A 0.25% gel D) Wash face carefully with medicated soap at bedtime - ANSWER-C) Retin A 0.25% gel Topical agents are the first-line treatment for acne vulgaris. Retin A 0.25% gel would be the next step. Oral preparations would then be offered for the next step (tetracycline), and Accutane would be the final step of therapy. .A 13-year-old male is brought in by his mother for a physical exam. During the genital exam, the nurse practitioner notices that the patient is at Tanner Stage II. Which of the following is the best description of this Tanner stage? A) The penis is growing more in length than in width and the testicles become larger with darker scrotal skin and the pubic hair is starting to curl B) The penis is growing more in width than in length with darker scrotal skin and more numerous pubic hairs that are darker, curly, and coarser C) The testicles become larger and the skin of the scrotum starts to become darker with straight, fine, countable hairs on the genitals and the axilla D) The testicles, penile width and length are all developing quickly - ANSWER-C) The testicles become larger and the skin of the scrotum starts to become darker with straight, fine, countable hairs on the genitals and the axilla Tanner Stage II is when the testicles start to grow. The scrotal skin becomes thicker and starts to get darker (hyperpigmentation). The pubic hair is of a fine texture and straight and there are few countable hairs on the genitals and the axilla. .A 13-year-old patient has a throat culture that is positive for strep throat. She reports that her younger brother was recently diagnosed with strep throat and treated. The patient has a severe allergy to penicillin and reports that erythromycin makes her very nauseated. Which of the following antibiotics is the best choice? A) Azithromycin (Zithromax) B) Cephalexin (Keflex) C) Cefuroxime axetil (Ceftin) D) Levofloxacin (Levaquin) - ANSWER-A) Azithromycin (Zithromax) If the patient has a severe penicillin allergy, there is a 10% chance of cross-reactivity to cephalosporins (especially first generation). Because the patient is a child, the levofloxacin is contraindicated. Nausea is a com- mon adverse reaction to erythromycin (it is not an allergic reaction). The best option is to use azithromycin because of its minimal GI adverse effects. Azithromycin has fewer drug interactions compared with other macrolides. .A 14-year-old female who is sexually active is brought in by her mother for an immunization update. According to the mother, her daughter had 1 dose of hepatitis B vaccine. Which of the following vaccines would you administer at this visit? A) Td and hepatitis B