SM practice questions and answers
A 51-year-old man presents to the clinic for lab review. His history is significant
for diabetes mellitus, and he currently smokes. Labs reveal a total cholesterol of
240 mg/dL, LDL of 195 mg/dL, and HDL of 34 mg/dL. Which of the following is
the best next step in the management of his cholesterol? - ANSWER>>prescribe
crestor 20mg daily
Which of the following is the most important first step when evaluating a 15-
year-old girl with a 4-month history of secondary amenorrhea? -
ANSWER>>Measuring human chorionic gonadotropin levels
A 36-year-old G4P3 woman presents for a routine prenatal visit at 30 weeks
gestation. She was diagnosed with gestational diabetes mellitus at 26 weeks
gestation. The nurse practitioner reviews the patient's vital signs and blood
glucose log and orders lab work. Which of the following findings indicates
effective management of this condition? - ANSWER>>daily fasting glucose levels
< 95
A 58-year-old man presents to the clinic for a follow-up on his hypertension and
reports no issues. His additional medical history includes chronic kidney disease
stage IV, gout, and diabetes mellitus. His laboratory studies reveal hemoglobin
of 10 g/dL, hematocrit of 36%, total iron of 50 mcg/dL, and ferritin of 200
ng/mL. Which of the following should be included in the plan of care at this
time? - ANSWER>>routine iron studies and a CBC
A 61-year-old man presents to the clinic with reports of dysuria, fever, and
pelvic pain. A digital rectal exam reveals an edematous and tender prostate. The
nurse practitioner plans to prescribe ciprofloxacin (Cipro) for treatment of
suspected acute bacterial prostatitis. Which of the following, if included in the
patient's medical history, should indicate to the nurse practitioner to avoid
prescribing this medication? - ANSWER>>history of myasthenia gravis
,osteopenia - ANSWER>>defined as a T-score of −1 to −2.5 and correlates with
low bone density.
osteoporosis - ANSWER>>defined as a T-score ≤ −2.5
A 31-year-old patient presents with a history of anemia initially diagnosed
approximately 10 years ago, but the patient did not start treatment at that time
due to cost. The patient's mother is reported to be positive for the beta-
thalassemia trait, but the father's history is unknown. Currently, she reports no
symptoms but is concerned that she should be tested for thalassemia before
having children. Which of the following laboratory studies is often used to
confirm the diagnosis of beta-thalassemia? - ANSWER>>hemoglobin
electrophoresis
A nurse practitioner-owned and -run outpatient facility recently implemented
an electronic medical record and electronic prescribing program. The nurse
practitioner knows that the Medicare Modernization Act of 2003 supports this
technology and encourages more utilization within America's health-care
system. Which Medicare plan supports the use of electronic prescribing? -
ANSWER>>Part D
Medicare - ANSWER>>a government-based health insurance program for people
65 years old or older, people with disabilities, and people with end-stage kidney
disease who require dialysis.
Part D Medicare - ANSWER>>Medicare's prescription drug coverage plan. This
plan helps patients cover the cost of their prescription medications, but patients
have to pay premiums and copays. Medicare Part D is an additional plan in
which individuals may choose to enroll. In 2003, the Medicare Modernization
Act supported the use of electronic prescribing and gave health-care
professionals incentives to implement the technology in their practices.
,Part A Medicare - ANSWER>>insurance plan that covers the cost of
hospitalizations, skilled nursing facilities, and hospice care. Once one applies for
Medicare, the person is automatically enrolled in Part A. Medicare Part A does
not have a premium but has deductibles when services are rendered. Medicare
Part A will cover the cost of medications while the patient is hospitalized, but it
does not cover the cost after discharge.
Part B Medicare - ANSWER>>Medicare's health insurance plan that covers
outpatient care, certain medical services, medical equipment, and preventable
health services. There is a monthly premium that Medicare charges patients for
Part B coverage, but this premium does not cover medication costs
Part C Medicare - ANSWER>>Medicare's advantage plan that bundles both Parts
A and B into one package under a private insurer. This plan also allows for the
coverage of both dental and vision care, but it does not cover the cost of
medications.
Norethindrone (Aygestin) - ANSWER>>A woman who is breastfeeding may
begin a progestin-only oral contraceptive
Dunphy sign - ANSWER>>characterized by increased abdominal pain with
coughing, which may also reflect local peritoneal irritation.
Markle Sign - ANSWER>>characterized by abdominal pain when a patient
standing on their toes drops to their heels, which may also reflect local
peritoneal irritation.
Psoas Sign - ANSWER>>right lower quadrant pain elicited by right hip extension
and could be indicative of appendicitis.
Rovsing's sign - ANSWER>>elicitation of right lower quadrant pain when the left
lower quadrant is palpated. The cause is likely due to peritoneal irritation of the
, area localized to the inflamed appendix. The sign is a useful clinical diagnostic
indicator of appendicitis.
You are examining a 2-week-old female infant at a routine visit. Her mother
states that her child's eyes seemed to be tearing up frequently over the past
several days. The examination shows excessive tearing and some slight
discharge in the medial canthus bilaterally. There is no conjunctival injection or
discharge detected. Which of the following is the most appropriate next step in
management? - ANSWER>>educate the mother on how to massage the lacrimal
sac
Congenital nasolacrimal duct obstruction - ANSWER>>common in infants;
blocked tear duct
treat with lacrimal sac massage
A 22-year-old man presents to the clinic after sustaining a dog bite injury. He
has multiple bite wounds. After his wounds have been thoroughly cleaned and
irrigated, he asks whether he will need to have stitches. Which of the following
bite wounds would it be acceptable to offer primary wound closure for? -
ANSWER>>lip laceration that crosses the vermillion border (closure should only
be done for wounds in highly cosmetic areas)
The nurse practitioner is tasked with conducting research in the clinic to
determine the best course of action to improve compliance with prescribed
treatment plans in adult patients with diabetes. Which of the following studies
would offer the highest quality of evidence? - ANSWER>>RCT of using
smartphones to remind patients to check blood glucose levels (D).
A 26-year-old man presents to the clinic with a report of a human bite wound to
his right thumb, sustained while working as a nurse. Records indicate that a
primary childhood DTaP vaccination series was completed, and he received a
Tdap booster at age 19. The wound was cleaned and bandaged. Which
A 51-year-old man presents to the clinic for lab review. His history is significant
for diabetes mellitus, and he currently smokes. Labs reveal a total cholesterol of
240 mg/dL, LDL of 195 mg/dL, and HDL of 34 mg/dL. Which of the following is
the best next step in the management of his cholesterol? - ANSWER>>prescribe
crestor 20mg daily
Which of the following is the most important first step when evaluating a 15-
year-old girl with a 4-month history of secondary amenorrhea? -
ANSWER>>Measuring human chorionic gonadotropin levels
A 36-year-old G4P3 woman presents for a routine prenatal visit at 30 weeks
gestation. She was diagnosed with gestational diabetes mellitus at 26 weeks
gestation. The nurse practitioner reviews the patient's vital signs and blood
glucose log and orders lab work. Which of the following findings indicates
effective management of this condition? - ANSWER>>daily fasting glucose levels
< 95
A 58-year-old man presents to the clinic for a follow-up on his hypertension and
reports no issues. His additional medical history includes chronic kidney disease
stage IV, gout, and diabetes mellitus. His laboratory studies reveal hemoglobin
of 10 g/dL, hematocrit of 36%, total iron of 50 mcg/dL, and ferritin of 200
ng/mL. Which of the following should be included in the plan of care at this
time? - ANSWER>>routine iron studies and a CBC
A 61-year-old man presents to the clinic with reports of dysuria, fever, and
pelvic pain. A digital rectal exam reveals an edematous and tender prostate. The
nurse practitioner plans to prescribe ciprofloxacin (Cipro) for treatment of
suspected acute bacterial prostatitis. Which of the following, if included in the
patient's medical history, should indicate to the nurse practitioner to avoid
prescribing this medication? - ANSWER>>history of myasthenia gravis
,osteopenia - ANSWER>>defined as a T-score of −1 to −2.5 and correlates with
low bone density.
osteoporosis - ANSWER>>defined as a T-score ≤ −2.5
A 31-year-old patient presents with a history of anemia initially diagnosed
approximately 10 years ago, but the patient did not start treatment at that time
due to cost. The patient's mother is reported to be positive for the beta-
thalassemia trait, but the father's history is unknown. Currently, she reports no
symptoms but is concerned that she should be tested for thalassemia before
having children. Which of the following laboratory studies is often used to
confirm the diagnosis of beta-thalassemia? - ANSWER>>hemoglobin
electrophoresis
A nurse practitioner-owned and -run outpatient facility recently implemented
an electronic medical record and electronic prescribing program. The nurse
practitioner knows that the Medicare Modernization Act of 2003 supports this
technology and encourages more utilization within America's health-care
system. Which Medicare plan supports the use of electronic prescribing? -
ANSWER>>Part D
Medicare - ANSWER>>a government-based health insurance program for people
65 years old or older, people with disabilities, and people with end-stage kidney
disease who require dialysis.
Part D Medicare - ANSWER>>Medicare's prescription drug coverage plan. This
plan helps patients cover the cost of their prescription medications, but patients
have to pay premiums and copays. Medicare Part D is an additional plan in
which individuals may choose to enroll. In 2003, the Medicare Modernization
Act supported the use of electronic prescribing and gave health-care
professionals incentives to implement the technology in their practices.
,Part A Medicare - ANSWER>>insurance plan that covers the cost of
hospitalizations, skilled nursing facilities, and hospice care. Once one applies for
Medicare, the person is automatically enrolled in Part A. Medicare Part A does
not have a premium but has deductibles when services are rendered. Medicare
Part A will cover the cost of medications while the patient is hospitalized, but it
does not cover the cost after discharge.
Part B Medicare - ANSWER>>Medicare's health insurance plan that covers
outpatient care, certain medical services, medical equipment, and preventable
health services. There is a monthly premium that Medicare charges patients for
Part B coverage, but this premium does not cover medication costs
Part C Medicare - ANSWER>>Medicare's advantage plan that bundles both Parts
A and B into one package under a private insurer. This plan also allows for the
coverage of both dental and vision care, but it does not cover the cost of
medications.
Norethindrone (Aygestin) - ANSWER>>A woman who is breastfeeding may
begin a progestin-only oral contraceptive
Dunphy sign - ANSWER>>characterized by increased abdominal pain with
coughing, which may also reflect local peritoneal irritation.
Markle Sign - ANSWER>>characterized by abdominal pain when a patient
standing on their toes drops to their heels, which may also reflect local
peritoneal irritation.
Psoas Sign - ANSWER>>right lower quadrant pain elicited by right hip extension
and could be indicative of appendicitis.
Rovsing's sign - ANSWER>>elicitation of right lower quadrant pain when the left
lower quadrant is palpated. The cause is likely due to peritoneal irritation of the
, area localized to the inflamed appendix. The sign is a useful clinical diagnostic
indicator of appendicitis.
You are examining a 2-week-old female infant at a routine visit. Her mother
states that her child's eyes seemed to be tearing up frequently over the past
several days. The examination shows excessive tearing and some slight
discharge in the medial canthus bilaterally. There is no conjunctival injection or
discharge detected. Which of the following is the most appropriate next step in
management? - ANSWER>>educate the mother on how to massage the lacrimal
sac
Congenital nasolacrimal duct obstruction - ANSWER>>common in infants;
blocked tear duct
treat with lacrimal sac massage
A 22-year-old man presents to the clinic after sustaining a dog bite injury. He
has multiple bite wounds. After his wounds have been thoroughly cleaned and
irrigated, he asks whether he will need to have stitches. Which of the following
bite wounds would it be acceptable to offer primary wound closure for? -
ANSWER>>lip laceration that crosses the vermillion border (closure should only
be done for wounds in highly cosmetic areas)
The nurse practitioner is tasked with conducting research in the clinic to
determine the best course of action to improve compliance with prescribed
treatment plans in adult patients with diabetes. Which of the following studies
would offer the highest quality of evidence? - ANSWER>>RCT of using
smartphones to remind patients to check blood glucose levels (D).
A 26-year-old man presents to the clinic with a report of a human bite wound to
his right thumb, sustained while working as a nurse. Records indicate that a
primary childhood DTaP vaccination series was completed, and he received a
Tdap booster at age 19. The wound was cleaned and bandaged. Which
