Answers Latest Update 2025/2026
GRADED A+
A 50-year-old woman presents to the clinic for follow-up on her type 2 diabetes mellitus.
She is currently taking metformin (Glumetza) at her maximum tolerated dose, and her
HbA1C at the current appointment is 8.6%. The patient is not open to insulin and wants
to try alternative medications to reduce her HbA1C. Which of the following medications
will directly stimulate the release of insulin from pancreatic beta cells, thereby lowering
blood glucose concentrations?
A.
Acarbose (Precose)
Incorrect
B.
Dulaglutide (Trulicity)
Incorrect
C.
Empagliflozin (Jardiance)
Incorrect
D.
Glipizide (Glucotrol) - correct answerGlipizide (Glucotrol)
An 18-year-old patient presents with unilateral ear pain for 2 days. On an otoscopic
exam, the tympanic membrane is bulging and appears inflamed. The posterior
landmarks are obscured, and the light reflex is distorted. Which of the following is the
most likely diagnosis?
A.
Mastoiditis
Incorrect
B.
Otitis externa
Incorrect
C.
Otitis media
Correct
D.
Presbycusis - correct answerOtitis media
A 7-year-old boy with a past medical history of atopic dermatitis presents to the clinic
with his father for concern about an allergic reaction. The boy states that 2 hours ago,
,after eating lunch, he developed an itchy throat and eye swelling. He reports no
wheezing or shortness of breath. The physical exam does not show urticaria, and his
airway is patent. Which of the following would be responsible for oral allergy syndrome?
A.
Cow milk
Incorrect
B.
Eggs
Incorrect
C.
Peaches
Correct
D.
Salmon - correct answerPeaches
An 8-year-old boy presents to the office with an erythematous, nonpruritic,
maculopapular rash in a lacy pattern on his trunk and arms. His cheeks are also
noticeably red. His mother reports that he had a fever 1 week ago that resolved within 2
days without any other symptoms until now. He is afebrile at the current visit. Which of
the following is the most likely diagnosis?
A.
Erythema infectiosum
Correct
B.
Hand, foot, and mouth disease
Incorrect
C.
Roseola
Incorrect
D.
Rubella - correct answerErythema infectiosum
An 85-year-old man with recently diagnosed hypertension presents to the clinic for a BP
check. Two weeks ago, his BP was 168/74 mm Hg, and he started taking lisinopril
(Zestril) 10 mg daily. He reports no missed doses. His BP at the current visit is 128/78
mm Hg. What is the best next step in his BP management?
A.
Add hydrochlorothiazide and reassess in 1 month
Incorrect
B.
Continue his lisinopril (Zestril) at the current dose
Correct
C.
Increase his lisinopril (Zestril) dose to 20 mg
Incorrect
D.
,Stop lisinopril (Zestril) and start hydrochlorothiazide - correct answerContinue his
lisinopril (Zestril) at the current dose
A 66-year-old man presents to the clinic with a tremor for 6 months. He reports that it is
mainly on the left side of his body and is significantly worse when he is at rest. He
states that it has also been more difficult recently to use utensils and tools and that it
takes him a long time to get out of chairs and bed. The physical examination reveals a
resting tremor, mild hyperreflexia on the left, and lead-pipe rigidity in his joints. Which of
the following is the best next step in confirming the suspected diagnosis?
A.
A levodopa or apomorphine challenge test
Incorrect
B.
Brain parenchyma sonography
Incorrect
C.
MRI
Incorrect
D.
Referral to a neurologist - correct answerReferral to a neurologist
A 45-year-old man with a BMI of 32 kg/m2 is following up at the clinic for weight loss.
He explains to the nurse practitioner that, for the past month, he has been trying to
follow the recommended diet and a 30-minute daily exercise routine but has only lost 2
pounds. Which of the following is the most appropriate next step in the management of
this patient's condition?
A.
Increase moderate exercise activity to 60 minutes/day
Incorrect
B.
Prescribe phentermine (Lomaira)
Incorrect
C.
Recommend stress management
Correct
D.
Refer patient for bariatric surgery - correct answerRecommend stress management
A nurse practitioner is lecturing students on the importance of sleep and how it can
affect the overall health of an older patient. The nurse practitioner explains that a
comprehensive history and physical examination may help to identify differential
diagnoses that negatively impact the sleep cycle. Which of the following diagnoses is a
sleep-related movement disorder characterized by uncontrollable urges to move the
extremities?
A.
Essential tremor
, Incorrect
B.
Parkinsonian tremor
Incorrect
C.
Peripheral artery disease
Incorrect
D.
Restless leg syndrome - correct answerRestless leg syndrome
A 27-year-old woman presents to the clinic for a well-woman visit. She reports to the
nurse practitioner that she has noticed more vaginal discharge than usual, and it stings
when she urinates. The pelvic exam reveals mucopurulent discharge from the cervical
os, and blood is noted when the cervix is swabbed. She has a history of sexually
transmitted infections, and there is concern that she will not be compliant with
medications. Which of the following is the most appropriate therapy?
A.
Acyclovir (Zovirax) 400 mg orally three times daily for 10 days
Incorrect
B.
Ceftriaxone 500 mg intramuscularly and azithromycin (Zithromax) 1 g orally both in a
single dose
Correct
C.
Doxycycline (Vibramycin) 100 mg orally twice daily for 7 days
Incorrect
D.
Nitrofurantoin (Macrobid) 100 mg orally twice daily for 5 days - correct
answerCeftriaxone 500 mg intramuscularly and azithromycin (Zithromax) 1 g orally both
in a single dose
A 5-year-old boy presents to the clinic for a well-child checkup. He has no medical
history and is developmentally appropriate for his age. During the physical examination,
the nurse practitioner notes that when the child stands up straight, his knees touch, but
his ankles do not. Which of the following is the most likely diagnosis?
A.
Genu valgum
Correct
B.
Genu varum
Incorrect
C.
Osgood-Schlatter disease
Incorrect
D.
Slipped capital femoral epiphysis - correct answerGenu valgum