NR 511 Differential Diagnosis and Primary Care- Final Exam Review. 280 Actual exam Questions with Correct and Verified Answers

NR 511 Differential Diagnosis and Primary Care- Final Exam Review. 280 Actual exam Questions with Correct and Verified Answers "A 38-year-old male patient has recently had an ileostomy for ulcerative colitis. Which self-care measures should the clinician teach him about to relieve food blockage? - Correct Answer massage the peristomal area" "Diverticulitis - Correct Answer " "a 51 year old diabetic male presents to the clinic after sustaining a deep scalp laceration at a construction site 1 hour ago. The dr cleans and irrigates and sutures. Prophylactic antibiotics are ordered... which antibiotics in addition to Cephtriaxone - Correct Answer Cephlexin" "in which of the following situations would wound closure be appropriate? - Correct Answer 6cm superficial laceration" "Wounds and bites - Correct Answer " "Cleaning a Lac - Correct Answer " "Punc Wounds - Correct Answer " "A 60 year old male presents to the clinic after stepping on a nail. What is the next step after assessing his vaccination status? - Correct Answer If it's been more than 5 years" "Flexor Tendon Injury - Correct Answer " "Abscess care - Correct Answer " "Musculoskeletal - Correct Answer " "What is the most common risk factor for adhesive capsulitis? - Correct Answer Diabetes mellitus (especially type 1)" "Who is most likely to be affected by adhesive capsulitis - Correct Answer Patient's aged 40 to 60 years" "Occurs when the strong connective tissue surrounding the shoulder joint (called the shoulder joint capsule) becomes thick, stiff, and inflamed - Correct Answer Adhesive Capsulitis" "What is Adhesive Capsulitis also known as - Correct Answer Adhesive Capsulitis" "What is the treatment for Meralgia Paresthetica? - Correct Answer Analgesics and avoiding tight clothing around the waist and weight loss" "Symptoms include pain or paresthesias over the anterior superior iliac spine and the anterolateral thigh, with decreased touch and pinprick sensation - Correct Answer Meralgia Paresthetica" "Who is Meralgia Paresthetica commonly seen in? - Correct Answer Overweight middle aged men" "Caused by compression of the lateral femoral cutaneous nerve - Correct Answer Meralgia Paresthetica" "Elbow pain that is aggravated with movement, especially with gripping objects or shaking hands - Correct Answer Lateral epicondylitis" "Caused by rupture or avulsion of the extensor digitorum tendon - Correct Answer Mallet finger" "One of the inital steps in assessing patents with musculoskeletal complaints is to determine whether the complaint is artcular or nonartcular in origin. Which of the following is an example of an artcular structure? - Correct Answer Synovium" "Which of the following medications is appropriate during an exacerbation of gout? - Correct Answer indomethacin" "Which of the following is true regarding diverticula - Correct Answer obesity is correlated" "Left lower quadrant abdominal pain for 2 days, the pain started suddenly and then fever, chills, anorexia, nausea and painless bloody stools. - Correct Answer Acute diverticulitis" "An 82-year-old female has been diagnosed with irritable bowel, chronic constipation, and diverticulosis following a colonoscopy. Which pharmacological agent should the clinician recommend? - Correct Answer bulk laxative" "Which of the following is part of the treatment plan for the patient with irritable bowel syndrome? - Correct Answer High fiber diet" "A 35-year-old female patent is seen in the clinic complaining of abdominal pain. Which of the following should be included in the history and physical exam? - Correct Answer digital rectal exam, Sexual history, Pelvic exam" "A 28-year-old patent is seen in the clinic with colicky abdominal pain, particularly with meals. She has frequent constipation, flatulence, and abdominal distension. Which of the data make a diagnosis of diverticulitis unlikely? - Correct Answer Her age" "C. diff Definition and Risk factors - Correct Answer " "C. diff Symptoms - Correct Answer " "C. diff Diagnosis - Correct Answer " "C. diff Treatment - Correct Answer " "GERD pathophysiology - Correct Answer " " - Correct Answer " "A 54-year-old female presents to your primary care office for routine reevaluation for gastroesophageal reflux disease (GERD). She has been treated with diet modifications and 6 weeks of omeprazole without improvement of her symptoms. What is the next step in the management of this patient's GERD? - Correct Answer Order an endoscopy (This is the next step in treatment in order to evaluate the etiology of the patient's GERD and consider biopsy if necessary)" "A 67-year-old female on multiple medications for chronic conditions was just diagnosed with gastroesophageal reflux disease (GERD). In teaching the patient about the disease, what medication should the clinician recommend that the patient refrain from using? - Correct Answer nonsteroidal anti-inflammatory drugs" "The patient with gastro esophageal reflux disease (GERD) should be instructed to eliminate which of these activities? - Correct Answer Weight lifting" "A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis, in addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses? - Correct Answer Pancreatitis, peptic ulcer disease, diverticulitis, All of the above" "A patient is diagnosed with Giardia after a backpacking trip in the mountains. Which of the following would be the appropriate treatment? - Correct Answer Metrinidazole" "A patient is seen in the clinic with right upper quadrant (RUQ) pain that is radiating to the middle of the back. The clinician suspects acute cholelithiasis. The clinician should expect which of the following laboratory findings? - Correct Answer Elevated alkaline phosphatase" "A patient is diagnosed with gastroesophageal reflux disease (GERD), and his endoscopic report reveals the presence of Barretts epithelium. Which of the following information should the clinician include in the explanation of the pathology - Correct Answer This is a premalignant tissue, This tissue is resistant to gastric acid, This tissue supports healing of the esophagus: All of the above" "which of the following dietary information should be given to a patient with gastroesophageal reflux disease (GERD) - Correct Answer Eliminate coffee" "Mark has necrotizing fasciitis of his left lower extremity. Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria? - Correct Answer Clostridium perfringens" "A patient is diagnosed with GERD, the clinician knows that she misunderstands the teaching when she says: - Correct Answer stop smoking eat smaller meals -have a snack before retiring for bed." "a patient presents to the clinic with a dry cough, non smoker, for 5 weeks. the cough increases at night, he reports episodes of heartburn after meals. what should the differential include? - Correct Answer GERD" "A 64-year-old obese woman comes in complaining of difficulty swallowing for the past 3 weeks. She states that "some foods get stuck" and she has been having "heartburn" at night when she lies down, especially if she has had a heavy meal. Occasionally, she awakes at night coughing. She denies weight gain and/or weight loss, vomiting, or change in bowel movements or color of stools. She denies alcohol and tobacco use. There is no pertinent family history or findings on review of systems (ROS). Physical examination is normal, with no abdominal tenderness, and the stool is occult blood (OB) negative. What is the most likely diagnosis? - Correct Answer GERD" "Mr. J. K., 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had intermittent heartburn for several months for which he takes Tums with temporary relief. He has been waking during the night with a burning sensation in his chest. Which additional information's would lead you to believe that gastro esophageal reflux disease (GERD) is the cause of his pain? - Correct Answer He awakens at night coughing with a bad taste in his mouth" "Which of the following dietary information's should be given to a patent with gastroesophageal reflux disease (GERD) - Correct Answer Stop coffee" "PUD - Correct Answer " "A 29-year-old Englishman is seen in the office with complaints of pain in his chest and belly for 2 weeks. He gets temporary relief from Alka Seltzer. The burning pain wakes him at night and radiates up into his chest. Which factor favors a diagnosis of gastric ulcer? - Correct Answer His use of Alka Seltzer" "You suspect that Harry has a peptic ulcer and tell him that it has been found to be strongly associated with: - Correct Answer Infection by Helicobacter pylori (About 90% of cases of pepti c ulcers have been found to be caused by infection with the bacteria H pylori)" "Peptic ulcer disease symptom Question of symptoms - Correct Answer Burning/nawing" "PUD Treatement - Correct Answer " "PUD V GERD 1 - Correct Answer " "PUD V GERD - Correct Answer " "A 52-year-old female is suspected of having a gastric ulcer and will undergo an Esophagogastroduodenoscopy (EGD). She is concerned because she heard that gastric ulcers can be malignant. How should the clinician respond? - Correct Answer About 95% of gastric ulcers are benign" "A 72-year-old male patient presents to the clinic for his annual physical. He states that he is worried because he only has a bowel movement every three days. How should the clinician respond? - Correct Answer There is no such thing as a normal pattern of defecation" "Rotavirus - Correct Answer " "Appendicitis - Correct Answer " "A 16 year old male presents to urgent care clinic with abdominal pain. The pain is constant and located in the periumbilical region shifting to the RLQ. N/V/D. Elevation in wbc and wbc in urine - Correct Answer Appendicitis" "Rovsing's sign is associated with which of the following? - Correct Answer An acute abdomen, such as during a ruptured appendix" "A 7-year-old male presents with his mother to the urgent care clinic complaining of abdominal pain. He started to complain of pain prior to going to bed; however, it has gotten progressively worse and is now preventing him from sleeping. He is nauseous but hasn't vomited and didn't eat dinner due to the pain. The patient appears pale and is complaining of right-sided abdominal pain. His vitals are as follows: blood pressure 130/85, pulse 120, temperature 100.5°F, pulse oximetry 98% on room air. On physical exam he is tender in the right lower quadrant. His complete blood count (CBC) shows a white blood cell count (WBC) of 17.0. What is the patient's likely diagnosis? - Correct Answer Appendicitis (This is the clinical scenario typical for appendicitis)" "gastroenteritis - Correct Answer " "A 26-year-old male recently returned from a camping trip with symptoms of acute gastroenteritis. He reports that he only ate vegetables from his garden that he canned prior to his outing. Which of the following pathogens might be causing his symptoms? - Correct Answer Clostridium botulinum" "A 39 year old female reports a 10 year history of crohns disease. which of the following is true of crohns disease? - Correct Answer obstructions, fissures are seen with disease progression" "Initial laboratory testing for IBS may include: - Correct Answer abdominal imaging" "A 25-year-old accountant is seen in the clinic complaining of crampy abdominal pain after meals. She is often constipated and takes laxatives. Following this, she has diarrhea for a couple of days. She temporarily feels better after a bowel movement. She states she is embarrassed by flatulence and has abdominal distension. She has had no weight loss or blood in her stool. This problem has gone on for about 6 months. What should the next step be? - Correct Answer Obtain a complete history" "H. Pylori - Correct Answer " "A 42 year old male has been diagnosed with h pylori gastritis which was confirmed by urea breath test. The clinician has given the patient a prescription for a standard 14 day triple therapy regimen. Which is correct regarding treatment? - Correct Answer Repeat test 4 weeks after therapy completion" "What is the recommended treatment to eradicate h pylori - Correct Answer amox, clarythro and omeprazole" "A clinician expects the patient to have gastroduodenal ulcer dt HPYLORI and plans to treat empirically - Correct Answer PPI" "A patent is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses? - Correct Answer Pancreatitis b. Peptic ulcer disease Diverticulitis d. All of the above" "Diarrhea - Correct Answer " "A patent with complaints of diarrhea is seen. Which of the following should be included on the differential diagnosis list for a patent with diarrhea? - Correct Answer gastroenteritis, Lactase deficiency, Inflammatory bowel disease" "Most common cause of travelers diarrhea - Correct Answer " "a 25-year old male presents with abdominal cramping and diarrhea for 7 days. The clinician knows that stool samples are warranted in which of the following situations: - Correct Answer Consuming sushi" "Which of the following is the least likely diagnosis for a patient with diarrhea? - Correct Answer GERD" "A 30-year-old male presents to the clinic with intermittent diarrhea. He states the loose stools always occur within 30 minutes after taking antacids. How should the clinician respond? - Correct Answer Antacids may contain magnesium, which may cause diarrhea" "A 29-year-old female just returned from Central America with traveler's diarrhea and presents to the clinic for evaluation. Which of the following is the best treatment? - Correct Answer supportive care" "Giardia - Correct Answer " "Salmonella - Correct Answer " "Giardia vs Salmonella - Correct Answer " "splenic sequestration - Correct Answer " "Nausea is difficult to discern in a young child. What question should the clinician ask to determine if a child has nausea? - Correct Answer Are you hungry" "To differentiate among the different diagnosis of inflammatory bowel disease, you look at the clients histological and radiologic images that show: - Correct Answer Crohns-Focal involvement of the colon with some skipped areas and sparing rectal mucosa." "Which of the following is the appropriate treatment for giardia - Correct Answer ." "Anemia - Correct Answer " "Anemia Cont - Correct Answer " "What is the most common cause of anemia - Correct Answer c. iron deficiency anemia" "Diagnostic tests Anemia results - Correct Answer " "Which of the following reflects the sickle cell anemia heritary? - Correct Answer Sickle cell is autosomal recessive" "Gold standard for definitive diagnosis of sickle cell? - Correct Answer Hemoglobin electophoresis" "Stu, age 49, has slightly reduced hemoglobin and hematocrit readings. What is your next action after you ask him about his diet? - Correct Answer Perform a fecal occult blood test" "iron deficiency anemia1 - Correct Answer " "iron deficiency anemia - Correct Answer " "Caroline, 65, is homeless and has iron deficiency anemia. She smokes and drinks when she can and has a stomach ulcer. Which of the following is not one of her risk factors for iron deficiency anemia? - Correct Answer Smoking" "Lorie, age 29, appears with the following signs: pale conjunctivae and nail beds, tachycardia, heart murmur, cheilosis, stomatitis, splenomegaly, koilonychia, and glossitis. What do you suspect? - Correct Answer iron deficiency anemia" "a 19 year old female was diagnosed with iron deficiency d/t menorrhia. What education should you give? - Correct Answer Take on an empty stomach" "A woman presents to your primary care office for an annual physical. She denies any complaints other than having heavy menstrual bleeding which is something she has experienced her whole life. On routing CBC evaluation, her hemoglobin is 11. Other values; dec ferritin, elevated total iron binding compacity. mcv is 75. Which is the most likely cause of her anemia - Correct Answer iron deficiency anemia" "Caroline, an older adult, is homeless and has iron deficiency anemia. She smokes and drinks when she can and has an ulcer. Which of the following is not one of the risk factors of iron deficiency anemia? - Correct Answer Smoking" "Which is the best test to perform to spot an iron-deficiency anemia early before it progresses to full-blown anemia? - Correct Answer Ferritin" "A 68-year-old man complains of lower abdominal pain, anorexia, extreme fatigue, an unintentional weight loss of 15 pounds in last 3 weeks, and you find a positive hemoccult on digital rectal examination. Laboratory tests show iron deficiency anemia. Which diagnosis should the NP consider? - Correct Answer Colon cancer" "Retic Count - Correct Answer " "In which of the following circumstances is the reticulocyte count elevated? - Correct Answer Acute blood loss" "MCV - Correct Answer " "Sherri's blood work returns with a decreased mean corpuscular volume (MCV) and a decreased mean corpuscular hemoglobin concentration (MCHC). What should you do next? - Correct Answer Order a serum iron level, a total iron-binding capacity level, and a serum ferritin level" "Your client Shirley has an elevated mean corpuscular volume (MCV). What should you be considering in terms of diagnosis? - Correct Answer Liver disease" "normocytic anemia is defend as anemia associated with normally sized RBCs, what is the MCV - Correct Answer MCV=81-99 (macrocytic equal or greater than 100fL)" "megaloblastic anemia - Correct Answer " "Macrocytic normochromic anemias are caused by - Correct Answer A defciency of folic acid" "Sideroblastic anemia - Correct Answer " "Which of the following diagnostic tests confirms sideroblastic anemia? - Correct Answer perusian blue stain" "what will a cbc with differential reveal with pernicious anemia? - Correct Answer macrocytic and normochromic" "microcytic anemia - Correct Answer " "What type of anemia is beta thalacemia minor - Correct Answer Micro" "Macrocytic normochromic anemia are caused by - Correct Answer Deficiency of folic acid" "Tina, age 2, had a complete blood count (CBC) drawn at her last visit. It indicates that she has a microcytic hypochromic anemia. What should you do now at this visit? - Correct Answer Obtain a lead level" "What is the most common cause of microcytic anemia? - Correct Answer Iron-deficiency anemia" "how severe is the anemia in patents with beta-thalassemia major? - Correct Answer severe" "ALL - Correct Answer " "ALL Chart - Correct Answer " "Which of the following is the most common kind of cancer in kids and adults? - Correct Answer ALL in kids and AML in adults" "Most common cancer in young kids? - Correct Answer ALL" "a boy is receiving radiation for ALL. What cancer is he more at risk for when hes an adult? - Correct Answer Brain Tumor" "CLL - Correct Answer " "CLL Chart - Correct Answer " "A patient has just been diagnosed with chronic CLL. According to the REI classification system, which of the following is stage 3? - Correct Answer Thrombocytopenia" "x-linked recessive disorder commonly seen in AA males? - Correct Answer g6p deficiency" "a 4 year old boy is brought to the office by his mother. His symptoms include pallor, fatigue, fever, bone pain, adenopathy, arthralgia and hepatosplenomegaly. A cbc with differential diagnosis him with leukemia. Which of the following is the next best step to take? - Correct Answer Bone Marrow Smear; elsa test" "Which of the following is true regarding polycythemia? - Correct Answer increases with age" "Sandra is 42 years old and has just been diagnosed with leukemia. She is complaining of bone and joint pain. Which type of leukemia is most likely the culprit? - Correct Answer Acute myelogenous leukemia" "Mr. Reynolds is on the antithyroid drug (ATD) methimazole (Tapazole), so you make it a point to check his: - Correct Answer Complete blood count (CBC) and liver transaminases" "Hashimotos occurs most commonly in what population? - Correct Answer Middle aged women" "Genitourinary - Correct Answer " "a 32 Year old male is brought to the clinic with a gout attack. He had 1 other within last 6 months. Upon examination they note the joint on the right great toe is swollen. Indomethacin and colchicine. What to teach the patient about colchicine? - Correct Answer 1 tablet every 1-2 hours until relief is obtained, or until abdominal pain" "To reduce the incidence of flares, foods High in what amino acid needs to be limited in the diets of patients with gout? - Correct Answer Purine" "Incontinence - Correct Answer " "A 63-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? - Correct Answer BPH" "A 76-year-old man is seen in the office for complaints of urinary incontinence. The clinician should explore which of these causes of incontinence in men? - Correct Answer UTI" "Overactive bladder + Incontinence - Correct Answer " "Over Active Bladder medications include? - Correct Answer Anticholinergic/Antimuscarinic medications Oxybutynin- Ditropan and XL PO or patch Tolterodine (Detrol and Detrol LA) Side effects: dry mouth, constipation, blurred vision" "A patent is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patent about which of these contraindications to this medication? - Correct Answer Closed-angle glaucoma" "A patent is diagnosed with overactive bladder. Which of the following instructions should be given to this woman? - Correct Answer Eliminate caffeine from your diet" "An 82-year-old man 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 diagnoses? - Correct Answer Benign prostatic hyperplasia (BPH) Parkinson's disease Prostate cancer All of the above" "UTI - Correct Answer " "a 35 YEAR OLD sexually active man has pain over left scrotum, with urinary frequency and dysuria. The scrotum is edematous and tender to touch. - Correct Answer Acute epidymitis" "What antibiotics would be prescribed for an uncomplicated UTI? - Correct Answer Bactrim (TMP-SMP) 160/800 mg BID for 3 days" "What diagnostic tests would one use for UTI? - Correct Answer Clean catch urine sample showing presence of bacteria **>100 organisms/ml with presence of clinical symptoms" "Most common pathogen of UTI includes? - Correct Answer E.coli" "A 34-year-old patent was treated for a UTI and has not responded to antibiotic therapy. Which of the following actions should be taken next? - Correct Answer Send a urine specimen for microscopy and evaluate for fungal colonies" "A 27-year-old female presents with a chief complaint of burning and pain on urination. She has no previous history of urinary tract infection (UTI). What are some additional symptoms consistent with a diagnosis of lower UTI? - Correct Answer Blood in urine and frequency" "A 30-year-old patent presents with pain on urination. The urine microscopy of unspun urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis? - Correct Answer Lower urinary tract infection" "A patent presents with CVA tenderness and a several-day history of high fever, chills, and dysuria. Which of the following diagnoses is most likely given the above information's? - Correct Answer Pyelonephritis" "Priapism - Correct Answer " "A 59 year old presents to the er with a diagnosis of priaprism. Despite application of pain meds, what medication should be given as well? - Correct Answer Phenylephrine" "Phimosis - Correct Answer " "You are performing a school physical examination on a 5 year old boy. You are unable to pull the skin back on the penis. what is this called? - Correct Answer Phimosis" "Hypospadias - Correct Answer " "A new mother wants her son to be circumcised, but has hypospadius - Correct Answer The foreskin is needed for repair.A child's foreskin is not removed since it is needed to help repair a hypospadias. Once the hypospadias is repaired, a circumcision can be performed at the same time." "Hypospadias is a congenital defect in which the urethra meatus is located on the ventral surface of the glans penis. This is thought to occur embryologically during urethral development during which stage of gestation? - Correct Answer 8 to 20 week" "varicele - Correct Answer " "A boy comes in and complains that his testicles feels like a bag of worms, what can this be? - Correct Answer Varicecole" "A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnoses? - Correct Answer Testcular cancer Inguinal hernia Varicocele All of the above" "32-year-old male presents with complaints of a scrotal mass; however, the scrotum is so edematous that it is difficult to assess. How would the nurse practitioner (NP) best determine whether the condition is a hernia or a hydrocele? - Correct Answer bowel sounds may be heard over a hernia" "Which of the following data is indicative of testicular torsion? - Correct Answer Absent cremasteric reflex" "A 15-year-old male comes to the clinic in acute distress with belly pain. When obtaining his history, the nurse practitioner (NP) finds that he fell off his bike this morning and has vomited. Upon closer examination, the NP determines the belly pain to be left-sided groin pain or pain in his left testicle. He is afebrile and reports no dysuria. Which of the following diagnoses is most likely? - Correct Answer testicular torsion" "which test is used to confirm a diagnosis of epididymitis? - Correct Answer Ultrasound of the scrotum Treatments: Scrotal elevation" "A 32-year-old male appears with a rapid onset of unilateral scrotal pain radiating up to the groin and flank. The nurse practitioner is trying to differentiate between epididymitis and testicular torsion. Which test should be the provider's first choice? - Correct Answer ultrasound" "A patient's chief complaint is pain and heaviness in the scrotum. The nurse practitioner notes swelling of the testes, along with warm scrotal skin. Which of the following diagnoses is most probable? - Correct Answer orchitis" "Undescended Testes - Correct Answer " "BPH - Correct Answer " "Which of the following drugs used in the treatment of BPH is considered a 5-alpha-reductase inhibitor? - Correct Answer Proscar" "Which of the following is true regarding bph? - Correct Answer the prostate is smooth and enlarged." "What is the expected objective finding in BPH? - Correct Answer Enlarged rubbery gland" "A 72-year-old unmarried, sexually active man, presents to the clinic with complaints of hesitancy, urgency, and occasional uncontrolled dribbling. Although the nurse practitioner suspects benign prostatic hyperplasia, what else should the differential diagnosis include? - Correct Answer urethral stricture" "A 63-year-old man presents to your office with hematuria, hesitancy, and dribbling. Digital rectal examination (DRE) reveals a smooth, moderately enlarged prostate. The client's prostate-specific antigen (PSA) is 1.2. What is the most appropriate management strategy at this time? - Correct Answer prescribing an alpha-adrenergic blocker" "The patent with benign prostatic hyperplasia (BPH) is seen for follow-up. He has been taking finasteride Proscar for 6 months. The clinician should assess this patent for which of these side effects of the medication? - Correct Answer ED" "Male Reproductive Disorders - Correct Answer " "ED - Correct Answer " "Which of the following can cause ED in patients? - Correct Answer Reserpine" "Which of the following medication classes can be associated with erectile dysfunction? - Correct Answer Beta blockers" "A 58-year-old male has been diagnosed with erectile dysfunction and says that a friend told him about a method that uses a constricting ring around the base of the penis. What is he referring to? - Correct Answer an external vacuum device" "A patient is being treated for erectile dysfunction. The patient is morbidly obese and is also being treated for a coagulopathy. Which of the following medications would be contraindicated? - Correct Answer alprostadil" "A 51-year-old male requests a prescription for sildenafil (Viagra). He says that the only medication he takes is isosorbide mononitrate (Monoket) oral tablets and that he has diabetes which is controlled with diet alone. What should the nurse practitioner tell him? - Correct Answer Viagra is contraindicated with isosorbide mononitrate; let's discuss other options" "Bacterial Prostatitis - Correct Answer " "Jeff, age 20, presents to the college health clinic with complaints of difficulty passing his urine and a discharge from his penis. Upon further investigation, you note that the discharge is urethral in origin. The most common cause of these symptoms in the young adult male population is: - Correct Answer Acute prostatitis" "Which of the following is contraindicated with acute prostitis? - Correct Answer Prostate message" "The clinician should prescribe an antibiotic that covers which of these organisms for a patent with acute prostatitis? - Correct Answer Gram-negatve bacillus" "The 56-year-old man with chronic prostatitis should be treated with trimethoprim 80 mg- sulfamethoxazole 400 mg (TMP-SMX, Bactrim) for how long? - Correct Answer 6 to 12 weeks" "Prostate Cancer - Correct Answer " "Which of the following is not a Prostate cancer risk factor? - Correct Answer circumcision" "You are referring a 73-year-old client for management of his prostate cancer with hormonal therapy. It is understood that goserelin acetate (Zoladex) acts as a method of androgen ablation by: - Correct Answer blocking the release of lH and FSH" "Prostate cancer is associated with what virus? - Correct Answer HPV" "a 63 year old male has been on bph medications, and a decrease in his PSA has not decreased by 50%. What is the expected outcome? - Correct Answer A significant to PSA should occur by 50%" "During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? - Correct Answer An enlarged rubbery gland" "In teaching a patient how to do a testicular self-examination, which of the following should the clinician advise? - Correct Answer Make an appointment if you note any hard lumps directly on the testicle, regardless of whether they are tender" "Upper and Lower Extremity disorders - Correct Answer " "Adhesive capsulitis risk factors - Correct Answer diabetes" "A 36 year old male presents to the office with complaints of right arm and elbow pain for two weeks. Works at amazon handling packages. Has pain at elbow; what do you think it could be - Correct Answer Lateral epicondylitis" "Carpel Tunnel - Correct Answer " "Sandra, a computer programmer, has just been given a new diagnosis of carpal tunnel syndrome. Your next step is to - Correct Answer C. try neutral position wrist splinting and order anoral NSAID." "Phalen's test Positive result? - Correct Answer tingling, numbness, burning, or pain over first three digitis" "Certain patterns of pain, numbness, and tingling are associated with carpal tunnel syndrome. - Correct Answer Tinel sign Median nerve integrity Katz hand diagram Tinel sign is tested by striking the patient's wrist with your index or middle finger where the median the nerve passes under the flexor retinaculum and volar carpal ligament." "To perform the Phalen test, ask the patient to hold both wrists in a fully palmar-flexed position with the dorsal surfaces pressed together for 1 minute - Correct Answer Phalen test" "In assessing the skeletal muscles, the clinician turns the client's forearm so that the palm is face up. This is called: - Correct Answer supination" "A 55-year-old female presents to the clinic with complaints of left hand and wrist pain and swelling after a slip and fall on the ice yesterday. On examination, the clinician notes tenderness at the anatomical snuffbox.This finding most likely indicates which of the following? - Correct Answer scaphoid fracture" "A 28-year-old male presents to the clinic for follow-up from the emergency department, where he was seen for right forearm pain 3 days ago. He works as a carpenter and is right hand dominant. He states he was diagnosed with right forearm tendinitis and is not sure what this means. As part of teaching, the clinician explains that the condition is caused by inflammation of one or more of the tendons. Which of the following describes tendons? - Correct Answer collagen fibers that connect muscle to bone" "Carpal tunnel syndrome is due to inflammation of which nerve? - Correct Answer Median nerve" "The articulaton of the radius and carpal bones is the: - Correct Answer wrist" "Carpal tunnel syndrome would result in - Correct Answer Median nerve compression, as in carpal tunnel syndrome, results in a positive Tinel sign, positive Phalen test, reduced abduction of the thumb, and sparing of palm tingling." "Shoulder Pain - Correct Answer " "The Hawkins test is performed by abducting the shoulder to 90 degrees, flexing the elbow to 90 degrees, and then internally rotating the arm to its limit. Increased shoulder pain is associated with rotator cuff inflammation or a tear - Correct Answer Hawkins test" "Shoulder Dislocation - Correct Answer " "Jill, age 49, has recently begun a rigorous weightlifting regimen. She presents to the primary care office with a shoulder dislocation. Which of the following clinical manifestations leads the nurse practitioner to suspect an anterior shoulder dislocation over a posterior dislocation? - Correct Answer inability to shrug the shoulder" "Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explained that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation - Correct Answer There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses." "Mrs. Gray is also experiencing tenderness with moton and pain at the deltoid inserton. Her medical history is signifcant for type 1 diabetes mellitus and hypertension. Hersocial history reveals that she is a secretary and that she is right-handed. Based on her exam and medicalhistory, you suspect adhesive capulits or "frozen shoulder." Which clue in Mrs. Gray's history supports this diagnosis - Correct Answer Her history of diabetes mellitus" "Test performed to assess shoulder rotator cuff impingement or tear - Correct Answer Neer test Harkins test" "A nurse practitioner is trying to distinguish between an articular and a nonarticular musculoskeletal complaint in a 26-year-old patient complaining of pain in the elbow area. Which of the following would characterize nonarticular bursitis? - Correct Answer Point or focal tendernes" "Anne, age 67, sustained a fall on an outstretched hand. She presents holding her arm against her chest with her elbow flexed. Based on the specific location of her pain, you suspect a radial head fracture. The best initial strategy to assess for a radial head fracture would be: - Correct Answer To palpate for tenderness, swelling, and crepitus just distal to the lateral epicondyle" "Herniated Disc - Correct Answer " "The nurse practitioner (NP) suspects a herniated disk in a 72-year-old patient. The NP elevates the patient's affected leg when she is in the supine position, and it elicits back and sciatic nerve pain, which indicates a positive test. This is known as which test or sign? - Correct Answer Straight leg raise" "Disc herniation occurs most commonly at which level of the spine? - Correct Answer L4-L5" "Which of the following are expected findings with a A lumbar disc herniation compressing the L5 ribs. - Correct Answer Weakness in the ankle flexion" "Which of the following statements is true concerning the management of the client with a herniated disc? - Correct Answer intolerable pain for more than a 3-month period is an indication for surgical intervention" "Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? - Correct Answer Paresthesia of the perineum and buttocks" "A positive straight leg raise test usually indicates - Correct Answer lumbar nerve root irritation" "When performing the McMurray test, the examiner should place the patent in a supine position with a hand on the patent's completely flexed knee and the foot fat on the table at the buttocks, and then: - Correct Answer grasp and evert" "Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? - Correct Answer Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain" "Knee Px - Correct Answer " "Which treatment should the clinician recommend to the patient with patella-femoral dysfunction due to over use? - Correct Answer quadricept strengthening excercises" "10 year old boy presents to the clinic following a soccer injury. The clinician says this is a positive mcmurray sign. What does this finding mean? - Correct Answer Tear of meniscus" "Mr. McKinsey, age 69, was recently given a diagnosis of degenerative joint disease. Which assessment should the nurse practitioner use to check for effusion of the patient's knee? - Correct Answer Bulge test" "A 20 year old male presents to the clinic complaining of right knee pain from a soccer injury today. He felt his right ankle twist. He cannot bear weight. He now reports the knee locks up when he tries to straighten it. What could this be? - Correct Answer Meniscus, tested by mcmurray" "McMurray test - Correct Answer Have the patient lie supine and flex one knee. Position your thumb and fingers on either side of the joint space. Hold the heel with your other hand, fully flexing the knee, and rotate the foot and knee outward (VALGUS stress) to a lateral position. Extend and then flex the patient's knee. Any palpable or audible click, grinding, pain, or limited extension of the knee is a positive sign of a torn medial meniscus." "Musckuloskeletal Assessment techni - Correct Answer " "The lachman manuever is used to detect which of the following? - Correct Answer ACL" "The ____ and ____ are used to identify instability of the lateral and medial collateral ligaments. - Correct Answer Varus (abduction) and valgus (adduction) stress test" "Anterior cruciate ligament integrity is assessed via the - Correct Answer Lachman test" "During a football game, a player was struck on the lateral side of the left leg while his feet were firmly planted. He is complaining of left knee pain. To examine the left knee, you should initially perform the - Correct Answer valgus stress test" "Mrs. Thomas was seen complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tenniselbow)is: - Correct Answer Pain at the elbow with resisted movements at the wrist and forearm" "A 16-year-old male client presents to the clinic after sustaining a football injury to his right knee. The clinician elicits a positive anterior/posterior drawer sign. What area of the knee is likely injured? - Correct Answer cruciate ligament" "The valgus stress test, varus stress test, Lachman test, and thumb sign are all considered standard tests to check the integrity of the ligaments of the knee. Which of the following would the clinician choose to assess the anterior cruciate ligament (ACL)? - Correct Answer Lachman test" "You have a patient who presents with ankle pain. Which of the following observations does not belong in physical exam clinicians' note? - Correct Answer That the pain started after the fall off a skateboard" "Neck and Back Disorders - Correct Answer " "Lower back px - Correct Answer " "a 22 year old man is diagnosed with acute low back strains and is given nsaids. what educated is needed? - Correct Answer lower back strengthening exercises" "Lumbar Spinal Stenosis - Correct Answer " "a 74 year old male presents with bilateral back and leg pain for 6 months. The leg pain is greater than the back pain and describes it as a shooting down her legs? What in the history makes you think it is lumbar spinal stenosis? - Correct Answer Leaning on grocery cart" "Which diagnostc used for acute lumbar radiculopathy? - Correct Answer MRI" "Spinal Fx - Correct Answer " "Hilda, age 73, presents with a complaint of low back pain. Red flags in her history of a minor fall, osteopenia, and prolonged steroid use for systemic lupus erythematosus suggest the possibility of which of the following serious underlying conditions as the cause of her low back pain? - Correct Answer spinal fracture" "Cervical spondylosis & Cervical Myelopathy - Correct Answer " "What is the first line treatment for a patient with cervical spondylosis without myelopathy symptoms? - Correct Answer Physical therapy" "a 79 year old male reports neck stiffness and aching discomfort on his right. The pain is aggravated with activity and has been progressing over the last year. full strength of the others and the DTRs are 2+, slightly limited of neck towards the right. Plain radiograph shows degeneration. - Correct Answer Cervical spondylosis" "A 55-year-old female client presents with complaints of pain and paresthesias in the left ulnar aspect of the forearm, thumb, and middle finger following a C6 & C7 nerve root dermatomal pattern. What is the most likely diagnosis? - Correct Answer cervical radiculopathy" "Nerve Root - Correct Answer " "A 49 year old female presents with pain on soul of her foot between 3-4 toe, feels like a pebble in her shoe. what is this? - Correct Answer morton's neuroma" "Vertebral Fx - Correct Answer " "which of the following is the most commonly associated with vertebral fractures? - Correct Answer osteoporosis" "peripheral neuropathy - Correct Answer " "A 52 year old OBESE male presents to the clinic with complaints of numbness and tingling in the right leg for a month. He denies pains but feels pins and needles in the anterior right thigh. He cannot recall a trigger. Nothing relieves or aggravates. Physical exam shows negative straight leg raise. Dull sensation on needle prick to left thigh. DTR are 3+. The clinician looks back and sees theres been no changes, except that the patient has gained 25 lbs. Based on these findings, which should be included in the differential diagnosis? - Correct Answer Neuralgia Paresthesia" "Which tests are used for numbness in hand, finger's, or wrist? - Correct Answer Phalen and Tinel" "Muscle strains and sprains - Correct Answer " "A 12 YEAR old presents with another sprain. The NP thinks she may have never been taught on injury management. What could she teach him? - Correct Answer Stretching is important" "67 yr old female presents with low back pain, pain above lower back pain and spine without sciatica. What can this be? - Correct Answer Musculosketal sprain" "A 15-year-old boy presents to the clinic after sustaining an ankle injury. He jumped for a rebound and landed and felt immediate pain and heard a pop. EXAM: Mod swelling and ecchymosis over right lateral ankle extending to the fifth metatarsal. Bearing minimal weight. Based on H&P, what injury is most likely? - Correct Answer Grade 3" "Which of the following is not a recommended treatment option for myofacial pain? - Correct Answer Cortico steroids and heat therapy" "a 26 year old male complains of painful contraction in his calf muscles after running a marathon, what is the problem? - Correct Answer hyponatremia" "A 10-year-old male presents to the clinic after jumping off a 2-foot wall, twisting his foot and ankle upon landing. His ankle x-ray demonstrates a fracture of the distal tibia, over the articular surface, through the epiphysis and physis. Based on the Salter-Harris classification of growth plate injuries, the clinician knows that this is what type of fracture? - Correct Answer Salter-Harris III fracture" "A 55-year-old client is able to complete range of motion (ROM) against gravity with some resistance. The nurse practitioner would assign which of the following numerical grades to this manual muscle testing description? - Correct Answer 4" "A 13-year-old obese (body mass index [BMI] above the 95th percentile) boy reports low-grade left knee pain for the past 2 months. He denies antecedent trauma but admits to frequent “horseplay†with his friends. The pain has progressively worsened, and he is now unable to bear weight at all on his left leg. His current complaints include left groin, thigh, and medial knee pain and tenderness. His examination demonstrates negative drawer, Lachman, and McMurray tests; left hip with decreased internal rotation and abduction; and external hip rotation with knee flexion. Based on the above scenario, the clinician should suspect which of the following? - Correct Answer Slipped capital femoral epiphysis" "Muscle sprain/strain - Correct Answer " "Which of the following statements is true concerning the musculoskeletal exam? - Correct Answer The uninvolved side should be examined initially and compared to the involved side" "Animal Bites - Correct Answer " "15 year old bitten by neighbors dog. The mother asks the clinician whether or not her son will need the rabies vaccine. The clinician knows that when a domestic dog is suspected of being infected,...what is the minimum number of days a dog suspected should be under quarantine? - Correct Answer 10 days" "a 16 year old male presents to the clinic following a domestic cat bite on his hands. On exam two small puncture wounds are noted without discharge, no evidence of foreign body, and does not require treatment. What to do? - Correct Answer Give antibiotic" "Bites and Lacerations - Correct Answer " "Which causes the greatest percentage of mammalian bites? - Correct Answer Dogs" "Wounds and Lacs - Correct Answer " "An 18 year old male fell while running and has a 5 cm simple linear cut on the face and uses a 3.0 nylon. When should the patient return to get them removed? - Correct Answer 4-6 days" "How soon after a facial laceration should sutures be removed? - Correct Answer 4 to 6 days"