NSGm6440mPredictormtestmQuestionmandmcorrectedmAnswersm100%msure.
TypedmPre-Predictor
1) Am15myearsmold mhighmschoolmstudent mwithmammild msoremthroat mand mlow-
grademfevermthat mhasmpersisted mformabout m3mweeks.mShemreportsmgeneralmmalaise,mfatigue,mand ml
ossmof mappetite.mThemNPmsuspectsmmononucleosis.mWhichmof mthemfollowingmismthemLEASTmappr
opriatemintervention?
a. Palpatemthemlymphmnodesmand mspleen
b. Examinemthemposteriormoropharynxmformpetechiae
c. ObtainmamCBC,mthroat mculture,mand mheterophilmantibodymtes
t.md. Obtainmanmurinalysesmand mserummformLFTsmand mamylase
Explanation:mmononucleosismismamsymptomaticminfectionmcaused mbymthemEpstein-
Barmvirus.mCommonmismpeoplem15-
24myearsmof mage.m Commonmsignsmand msymptomsmfollowingmincubationmperiod m(1-
2mmonths)mincludemfatigue,mchills,mmalaise,manorexia,mwhitemtonsillarm exudatesmand mlymphadenopa
thymormposteriormcervicalmregion.mSplenomegaly mcanmbempresent.mAmmaculopapularmor moccasionally
mampetechialmrashmoccursminmlessmthanm15%mof mpatients.mA mdiagnosism ismusually mmademusingmthemM
onospot.mInmaddition,mneutropeniamand mlymphocytosismaremusuallymdetected minmthemCBC.
2) Am32myearsmold mmalempatient mcomplaint mof murinarymfrequencymand mburningmonmurinationmfo
rm3mdays.mUrinalysesmrevealsmbacteriuriamand mpositivemnitrites.mHemdeniesmanympast mhx.mOf murinar
ymtract minfections.mTheminitialmtreatment mshould mbe:
a. trimethoprim-sulfamethoxazolem(Bactrim,mSulfatrim)mform7-10mday
b. ciprofloxacinm(Cipro)mform3-5mdays
c. Trimethoprim-Sulfamethoxazolemform3mdays
d. 750mmgmciprofloxacinmasmamone-timemdose
Explanation:mtrimethoprim-
sulfamethoxazolem(TMPS)mismusuallymnmappropriatemmedicationmtomtreat murinarymtract minfectionsmin
mmost mpatients.m Inmthemcasemof mcommunitymresistancemtomTMPS
>20%^,manothermmedicationmshould mbemsubstituted.mInmmen,mthemappropriatemlengthmof mtimemism7-
10mdays.mWomenmmaymbemtreated mform3mdaysmformuncomplicated mUTI
3) Whichmagent mismmost meffectivemformthemtreatment mof mnodulocysticmacne?
a. Benzoylmperoxidem(Benzac)
b. Retinoicmacid m(RetinmA)
c. Topicalmtetracyclinem
d. Isotretinoin)
Explanation:mIsotretinoinm(Accutane)mismamsystemicmagent mindicated mformtreatment mwithmseveremi
nflammatorymacne.mGuidelinesmformitsmusemmust mbemclearlymunderstood mbymthempatient.mAmwomanm
of mchildbearingmagemmust musemanmeffectivemmethod mof mcontraceptionmbecausemisotretinoinmismterato
genic.mTheremaremmanymrestrictionsmin mprescribingmthismmedicationmbecausemof mthemteratogenicmeffe
ctsmismgivenmduringmpregnancy.mTherefore,mit mismampregnancymcategorymX.
4) Anm18my/omwomanmismtakingmamcombined mhormonalmoralmcontraceptive. mShemshould
mbem
instructed mtomusemambackupmmethod mformthempreventionmof mpregnancy
1
,NSGm6440mPredictormtestmQuestionmandmcorrectedmAnswersm100%msure.
a. Throughout mthemweekmof mplacebompills
b. If mprescribed mtopiramatem(Topamax)mformthemtreatment mof mmigraines.
2
,NSGm6440mPredictormtestmQuestionmandmcorrectedmAnswersm100%msure.
c. If mprescribed mamoxicillin/clavulanatem(Augmentin)mformamsinusminfection
d. if mshemforgetsmtomtakemamsinglemdosemof mthemcontraceptive
Explanation:mAnticonvulsant mincludingmphenytoinm(Dilantin),mcarbamazepinem(Tegretol),mprimid
onem(Mysoline),mtopiramatem(Topamax) mand moxcarbazepinem (Trileptal) mreducemthemeffectivenessmo
f mcontraceptives.mDepo-medroxyprogesteronemacetatem injectionsmormlevonorgestrel-
releasingmintrauterinemdevicesmwould mbemambettermmethod mof mcontraceptivemformpatientsmtakingmant
m
iconvulsants.mMost mcommonlymused mantibioticsmhavemnot mbeenmprovenmtomreducemthemeffectivenes
smof mcontraceptives.mRifampinmismanmexception,mand madditionalm….mBemused mbymwomenmtakingmthis
mdrugmand musingmoralmcontraceptives,mtransdermal,mormvaginalmringmpreparations.
Additionalmbackupmcontraceptionmshould mbemused mif mtakingmantifungalmagents.mNomadditionalmpro
tectionmismneeded mthought mthemweekmof mplacebompills.mMissingmonemsinglemdosemof mcontraceptivem
doesmnot mrequiremadditionalmprotection,mmissingmmoremthanmonemdosesmdoes.
5) Am44myearsmold mfemalempatient mhasmdiabetes.mHermtotalmcholesterolm(TC)mism250mmg/dlm(6.5m
mmol/L),mLDL=m190mmg/dLm(4.94mmmol/L),mHDL=m25mmg/dLm(65mmmol/L),mand mtriglycerides=
m344mmg/dL m(8.94mmmol/L).mWhat magent mhavemthemgreatest meffect monmimprovingmhermlipid mprofilem
and mreducingmmorbiditymand mmortalitymassociatesmwithmdyslipidemia?
a.
Niacinm(Niaspan)m
b. Atorvastatin
c. Omegam3mfattymacids
d. Fenofibrates
Explanation:mFirst mand mforemost,mit mismessentialmtomeducatemindividualsmonmamheart-
healthymlifestyle.mLDL-
Cmismonemof mthemmajormculpritsminmthemdevelopment mof matheroscleroticmheart mdisease.mThemtarget ml
evelmof mLDL-
Cmismbetweenm50mtom70mg/dlmtomprevent mplaquemformationminmthemblood mvessels.mGuidelinesmstro
nglymrecommend mstatinmtherapymbecausemtheymprimarilymlowermLDL-
Cmlevels,mbut mtheymalsomhavemthemsecondarymeffectsmof mloweringmtriglyceridemand mincreasingmHD
L-Cmlevels.
6) Am30myearsmold mfemalemcomesmintomamclinicmwithmclassicmsignsmand msymptomsmof mappendici
tis.mThemNPmfailsmtomrefermthempatient mtomamsurgeon.mThemappendixmrupturesmand mthemwomanmdie.m
Thismismanmexamplemof
a. Failuremof mdiligence
b. Professionalmliability
c. Negligencem
d. Malpractice
Explanation:mmalpractice,mamnegligencemtort,moccursmwhenmamhealthmcaremprofessional’smactionsmfal
l
bellow mthemappropriatemstandard mof mcaremand mhurtsmthempatient.mInmthismcasemthempatient mcamemwit
hmsingsmand msymptomsmindicatingmappendicitismand mthemNPmfailed mtomrefermthempatient..
7) AmNPmhasmrecentlymbeenmhired mtomworkminmamfast mtrackmfacility.mThemNPmemployermaske
d mif mshemhasm“amproblemmprescribingmmedicationsmformemergencymcontraception.”m ThemNPmre
3
, NSGm6440mPredictormtestmQuestionmandmcorrectedmAnswersm100%msure.
pliesmaffirmatively.mThismis:
a. Groundsmformdismissal
b. AnmethicalmdilemmamformthemNP
4
TypedmPre-Predictor
1) Am15myearsmold mhighmschoolmstudent mwithmammild msoremthroat mand mlow-
grademfevermthat mhasmpersisted mformabout m3mweeks.mShemreportsmgeneralmmalaise,mfatigue,mand ml
ossmof mappetite.mThemNPmsuspectsmmononucleosis.mWhichmof mthemfollowingmismthemLEASTmappr
opriatemintervention?
a. Palpatemthemlymphmnodesmand mspleen
b. Examinemthemposteriormoropharynxmformpetechiae
c. ObtainmamCBC,mthroat mculture,mand mheterophilmantibodymtes
t.md. Obtainmanmurinalysesmand mserummformLFTsmand mamylase
Explanation:mmononucleosismismamsymptomaticminfectionmcaused mbymthemEpstein-
Barmvirus.mCommonmismpeoplem15-
24myearsmof mage.m Commonmsignsmand msymptomsmfollowingmincubationmperiod m(1-
2mmonths)mincludemfatigue,mchills,mmalaise,manorexia,mwhitemtonsillarm exudatesmand mlymphadenopa
thymormposteriormcervicalmregion.mSplenomegaly mcanmbempresent.mAmmaculopapularmor moccasionally
mampetechialmrashmoccursminmlessmthanm15%mof mpatients.mA mdiagnosism ismusually mmademusingmthemM
onospot.mInmaddition,mneutropeniamand mlymphocytosismaremusuallymdetected minmthemCBC.
2) Am32myearsmold mmalempatient mcomplaint mof murinarymfrequencymand mburningmonmurinationmfo
rm3mdays.mUrinalysesmrevealsmbacteriuriamand mpositivemnitrites.mHemdeniesmanympast mhx.mOf murinar
ymtract minfections.mTheminitialmtreatment mshould mbe:
a. trimethoprim-sulfamethoxazolem(Bactrim,mSulfatrim)mform7-10mday
b. ciprofloxacinm(Cipro)mform3-5mdays
c. Trimethoprim-Sulfamethoxazolemform3mdays
d. 750mmgmciprofloxacinmasmamone-timemdose
Explanation:mtrimethoprim-
sulfamethoxazolem(TMPS)mismusuallymnmappropriatemmedicationmtomtreat murinarymtract minfectionsmin
mmost mpatients.m Inmthemcasemof mcommunitymresistancemtomTMPS
>20%^,manothermmedicationmshould mbemsubstituted.mInmmen,mthemappropriatemlengthmof mtimemism7-
10mdays.mWomenmmaymbemtreated mform3mdaysmformuncomplicated mUTI
3) Whichmagent mismmost meffectivemformthemtreatment mof mnodulocysticmacne?
a. Benzoylmperoxidem(Benzac)
b. Retinoicmacid m(RetinmA)
c. Topicalmtetracyclinem
d. Isotretinoin)
Explanation:mIsotretinoinm(Accutane)mismamsystemicmagent mindicated mformtreatment mwithmseveremi
nflammatorymacne.mGuidelinesmformitsmusemmust mbemclearlymunderstood mbymthempatient.mAmwomanm
of mchildbearingmagemmust musemanmeffectivemmethod mof mcontraceptionmbecausemisotretinoinmismterato
genic.mTheremaremmanymrestrictionsmin mprescribingmthismmedicationmbecausemof mthemteratogenicmeffe
ctsmismgivenmduringmpregnancy.mTherefore,mit mismampregnancymcategorymX.
4) Anm18my/omwomanmismtakingmamcombined mhormonalmoralmcontraceptive. mShemshould
mbem
instructed mtomusemambackupmmethod mformthempreventionmof mpregnancy
1
,NSGm6440mPredictormtestmQuestionmandmcorrectedmAnswersm100%msure.
a. Throughout mthemweekmof mplacebompills
b. If mprescribed mtopiramatem(Topamax)mformthemtreatment mof mmigraines.
2
,NSGm6440mPredictormtestmQuestionmandmcorrectedmAnswersm100%msure.
c. If mprescribed mamoxicillin/clavulanatem(Augmentin)mformamsinusminfection
d. if mshemforgetsmtomtakemamsinglemdosemof mthemcontraceptive
Explanation:mAnticonvulsant mincludingmphenytoinm(Dilantin),mcarbamazepinem(Tegretol),mprimid
onem(Mysoline),mtopiramatem(Topamax) mand moxcarbazepinem (Trileptal) mreducemthemeffectivenessmo
f mcontraceptives.mDepo-medroxyprogesteronemacetatem injectionsmormlevonorgestrel-
releasingmintrauterinemdevicesmwould mbemambettermmethod mof mcontraceptivemformpatientsmtakingmant
m
iconvulsants.mMost mcommonlymused mantibioticsmhavemnot mbeenmprovenmtomreducemthemeffectivenes
smof mcontraceptives.mRifampinmismanmexception,mand madditionalm….mBemused mbymwomenmtakingmthis
mdrugmand musingmoralmcontraceptives,mtransdermal,mormvaginalmringmpreparations.
Additionalmbackupmcontraceptionmshould mbemused mif mtakingmantifungalmagents.mNomadditionalmpro
tectionmismneeded mthought mthemweekmof mplacebompills.mMissingmonemsinglemdosemof mcontraceptivem
doesmnot mrequiremadditionalmprotection,mmissingmmoremthanmonemdosesmdoes.
5) Am44myearsmold mfemalempatient mhasmdiabetes.mHermtotalmcholesterolm(TC)mism250mmg/dlm(6.5m
mmol/L),mLDL=m190mmg/dLm(4.94mmmol/L),mHDL=m25mmg/dLm(65mmmol/L),mand mtriglycerides=
m344mmg/dL m(8.94mmmol/L).mWhat magent mhavemthemgreatest meffect monmimprovingmhermlipid mprofilem
and mreducingmmorbiditymand mmortalitymassociatesmwithmdyslipidemia?
a.
Niacinm(Niaspan)m
b. Atorvastatin
c. Omegam3mfattymacids
d. Fenofibrates
Explanation:mFirst mand mforemost,mit mismessentialmtomeducatemindividualsmonmamheart-
healthymlifestyle.mLDL-
Cmismonemof mthemmajormculpritsminmthemdevelopment mof matheroscleroticmheart mdisease.mThemtarget ml
evelmof mLDL-
Cmismbetweenm50mtom70mg/dlmtomprevent mplaquemformationminmthemblood mvessels.mGuidelinesmstro
nglymrecommend mstatinmtherapymbecausemtheymprimarilymlowermLDL-
Cmlevels,mbut mtheymalsomhavemthemsecondarymeffectsmof mloweringmtriglyceridemand mincreasingmHD
L-Cmlevels.
6) Am30myearsmold mfemalemcomesmintomamclinicmwithmclassicmsignsmand msymptomsmof mappendici
tis.mThemNPmfailsmtomrefermthempatient mtomamsurgeon.mThemappendixmrupturesmand mthemwomanmdie.m
Thismismanmexamplemof
a. Failuremof mdiligence
b. Professionalmliability
c. Negligencem
d. Malpractice
Explanation:mmalpractice,mamnegligencemtort,moccursmwhenmamhealthmcaremprofessional’smactionsmfal
l
bellow mthemappropriatemstandard mof mcaremand mhurtsmthempatient.mInmthismcasemthempatient mcamemwit
hmsingsmand msymptomsmindicatingmappendicitismand mthemNPmfailed mtomrefermthempatient..
7) AmNPmhasmrecentlymbeenmhired mtomworkminmamfast mtrackmfacility.mThemNPmemployermaske
d mif mshemhasm“amproblemmprescribingmmedicationsmformemergencymcontraception.”m ThemNPmre
3
, NSGm6440mPredictormtestmQuestionmandmcorrectedmAnswersm100%msure.
pliesmaffirmatively.mThismis:
a. Groundsmformdismissal
b. AnmethicalmdilemmamformthemNP
4
