DUNPHY CARE COMPREHENSIVE ANSWERS AND
QUESTIONS SET A+
✔✔You have a patient who presents with ankle pain. Which of the following facts or
observations does not belong in the physical exam portion of your note?
1.
The patient's pain started after a fall off his skateboard.
2.
The patient has a normal pulse and normal sensation of the foot.
3.
The patient has edema in his ankle.
4.
The patient has limited motion of his ankle. - ✔✔The patient's pain started after a fall off
his skateboard.
✔✔Joseph, a 55-year-old man with diabetes, is at your office for his diabetes follow-up.
On examining his feet with monofilament, you discover that he has developed
decreased sensation in both feet. There are no open areas or signs of infection on his
feet. What health teaching should Joseph receive today regarding the care of his feet?
1.
"Wash your feet with cold water only."
2.
"See a podiatrist every two years, inspect your own feet monthly, and apply lotion to
your feet daily."
3.
"Go to a spa and have a pedicure monthly."
4.
"See a podiatrist yearly; wash your feet daily with warm, soapy water and towel dry
between the toes; inspect your feet daily for any lesions; and apply lotion to any dry
areas." - ✔✔"See a podiatrist yearly; wash your feet daily with warm, soapy water and
towel dry between the toes; inspect your feet daily for any lesions; and apply lotion to
any dry areas."
✔✔How do you respond when Jill, age 42, asks you how long she should work out each
week?
,1.
Exercise for at least 30 minutes every day.
2.
Exercise a total of 2 hours per week.
3.
Exercise for at least 20 minutes 3 or more days per week.
4.
Exercise for at least 30 minutes 5 days per week. - ✔✔Exercise for at least 30 minutes
5 days per week.
✔✔Dennis, age 62, has benign prostatic hyperplasia (BPH). He tells you that he voids
at least 4 times per night and that he has read about a preventive drug called terazosin
hydrochloride (Hytrin) that might help him. What do you tell him?
1.
"It's not a preventive drug, but it relaxes smooth muscle in the prostate and bladder
neck."
2.
"It changes the pH of the urine and prevents infections caused by urinary stasis."
3.
"It relaxes the urethra."
4.
"It shrinks the prostate tissue." - ✔✔"It's not a preventive drug, but it relaxes smooth
muscle in the prostate and bladder neck."
✔✔Emily, a healthy 26-year-old woman, asks you how she can prevent bone loss as
she ages. She is concerned because both her maternal grandmother and now her
mother have severe osteoporosis. What guidance would you give to Emily?
1.
Drink all the soda you like—it has no effect on your bone density.
2.
It has not been proved that smoking affects bone loss.
3.
Replace estrogen when you reach menopause.
4.
Perform aerobic exercise at least 3 times a week. - ✔✔Perform aerobic exercise at least
3 times a week.
✔✔If a screening test used on 100 individuals known to be free of breast cancer
identified 80 individuals who did not have breast cancer while missing 20 of the
individuals, the specificity would be:
1.
80%.
2.
60%.
3.
40%.
,4.
20%. - ✔✔80%.
✔✔Mimi, age 52, asks why she should perform a monthly breast self-examination
(BSE) when she has her mammograms on schedule. You respond:
1.
"If you are faithful about your annual exams and mammograms, that is enough."
2.
"More breast abnormalities are picked up by mammograms than by clinical exams or
BSE."
3.
"More than 90% of all breast abnormalities are first detected by self-examination."
4.
"Self-examinations need to be performed only every other month." - ✔✔"More than 90%
of all breast abnormalities are first detected by self-examination."
✔✔Julia, age 18, asks you how many calories of fat she is eating when 1 serving has 3
g of fat. You tell her:
1.
12 cal.
2.
18 cal.
3.
27 cal.
4.
30 cal. - ✔✔27 cal.
✔✔What is the most common bacterial pathogen associated with acute otitis media?
1.
Streptococcus pneumoniae.
2.
Haemophilus influenzae.
3.
Streptococcus pyogenes.
4.
Moraxella (Branhamella) catarrhalis. - ✔✔Streptococcus pneumoniae.
✔✔You prescribe Levaquin (levofloxacin) for a severe sinus infection. What is not a
possible adverse reaction to this medication?
1.
Achilles tendon rupture.
2.
Peripheral neuropathy.
3.
Nephrotoxicity.
, 4.
Stevens-Johnson syndrome. - ✔✔Stevens-Johnson syndrome.
✔✔Which of the following is not a complication of untreated group A streptococcal
pharyngitis?
1.
Glomerulonephritis.
2.
Rheumatic heart disease.
3.
Scarlet fever.
4.
Hemolytic anemia. - ✔✔Hemolytic anemia.
✔✔What is the most common cause of epistaxis?
1.
Digital trauma.
2.
Warfarin.
3.
Vitamin C deficiency.
4.
Hemophilia A. - ✔✔Digital trauma.
✔✔You are the nurse practitioner caring for Martha, a 47-year-old accountant. You
have made a diagnosis of acute sinusitis based on Martha's history and the fact that she
complains of pain behind her eye. Which sinuses are affected?
1.
Maxillary.
2.
Ethmoid.
3.
Frontal.
4.
Sphenoid. - ✔✔Ethmoid.
✔✔Marlene, a 57-year-old cashier, comes to the clinic because she is unable to
differentiate between sharp and dull stimulation on both sides of her face. You suspect:
1.
Bell palsy.
2.
A lesion affecting the trigeminal nerve.
3.
A stroke—brain attack, cerebrovascular accident (CVA).
4.
QUESTIONS SET A+
✔✔You have a patient who presents with ankle pain. Which of the following facts or
observations does not belong in the physical exam portion of your note?
1.
The patient's pain started after a fall off his skateboard.
2.
The patient has a normal pulse and normal sensation of the foot.
3.
The patient has edema in his ankle.
4.
The patient has limited motion of his ankle. - ✔✔The patient's pain started after a fall off
his skateboard.
✔✔Joseph, a 55-year-old man with diabetes, is at your office for his diabetes follow-up.
On examining his feet with monofilament, you discover that he has developed
decreased sensation in both feet. There are no open areas or signs of infection on his
feet. What health teaching should Joseph receive today regarding the care of his feet?
1.
"Wash your feet with cold water only."
2.
"See a podiatrist every two years, inspect your own feet monthly, and apply lotion to
your feet daily."
3.
"Go to a spa and have a pedicure monthly."
4.
"See a podiatrist yearly; wash your feet daily with warm, soapy water and towel dry
between the toes; inspect your feet daily for any lesions; and apply lotion to any dry
areas." - ✔✔"See a podiatrist yearly; wash your feet daily with warm, soapy water and
towel dry between the toes; inspect your feet daily for any lesions; and apply lotion to
any dry areas."
✔✔How do you respond when Jill, age 42, asks you how long she should work out each
week?
,1.
Exercise for at least 30 minutes every day.
2.
Exercise a total of 2 hours per week.
3.
Exercise for at least 20 minutes 3 or more days per week.
4.
Exercise for at least 30 minutes 5 days per week. - ✔✔Exercise for at least 30 minutes
5 days per week.
✔✔Dennis, age 62, has benign prostatic hyperplasia (BPH). He tells you that he voids
at least 4 times per night and that he has read about a preventive drug called terazosin
hydrochloride (Hytrin) that might help him. What do you tell him?
1.
"It's not a preventive drug, but it relaxes smooth muscle in the prostate and bladder
neck."
2.
"It changes the pH of the urine and prevents infections caused by urinary stasis."
3.
"It relaxes the urethra."
4.
"It shrinks the prostate tissue." - ✔✔"It's not a preventive drug, but it relaxes smooth
muscle in the prostate and bladder neck."
✔✔Emily, a healthy 26-year-old woman, asks you how she can prevent bone loss as
she ages. She is concerned because both her maternal grandmother and now her
mother have severe osteoporosis. What guidance would you give to Emily?
1.
Drink all the soda you like—it has no effect on your bone density.
2.
It has not been proved that smoking affects bone loss.
3.
Replace estrogen when you reach menopause.
4.
Perform aerobic exercise at least 3 times a week. - ✔✔Perform aerobic exercise at least
3 times a week.
✔✔If a screening test used on 100 individuals known to be free of breast cancer
identified 80 individuals who did not have breast cancer while missing 20 of the
individuals, the specificity would be:
1.
80%.
2.
60%.
3.
40%.
,4.
20%. - ✔✔80%.
✔✔Mimi, age 52, asks why she should perform a monthly breast self-examination
(BSE) when she has her mammograms on schedule. You respond:
1.
"If you are faithful about your annual exams and mammograms, that is enough."
2.
"More breast abnormalities are picked up by mammograms than by clinical exams or
BSE."
3.
"More than 90% of all breast abnormalities are first detected by self-examination."
4.
"Self-examinations need to be performed only every other month." - ✔✔"More than 90%
of all breast abnormalities are first detected by self-examination."
✔✔Julia, age 18, asks you how many calories of fat she is eating when 1 serving has 3
g of fat. You tell her:
1.
12 cal.
2.
18 cal.
3.
27 cal.
4.
30 cal. - ✔✔27 cal.
✔✔What is the most common bacterial pathogen associated with acute otitis media?
1.
Streptococcus pneumoniae.
2.
Haemophilus influenzae.
3.
Streptococcus pyogenes.
4.
Moraxella (Branhamella) catarrhalis. - ✔✔Streptococcus pneumoniae.
✔✔You prescribe Levaquin (levofloxacin) for a severe sinus infection. What is not a
possible adverse reaction to this medication?
1.
Achilles tendon rupture.
2.
Peripheral neuropathy.
3.
Nephrotoxicity.
, 4.
Stevens-Johnson syndrome. - ✔✔Stevens-Johnson syndrome.
✔✔Which of the following is not a complication of untreated group A streptococcal
pharyngitis?
1.
Glomerulonephritis.
2.
Rheumatic heart disease.
3.
Scarlet fever.
4.
Hemolytic anemia. - ✔✔Hemolytic anemia.
✔✔What is the most common cause of epistaxis?
1.
Digital trauma.
2.
Warfarin.
3.
Vitamin C deficiency.
4.
Hemophilia A. - ✔✔Digital trauma.
✔✔You are the nurse practitioner caring for Martha, a 47-year-old accountant. You
have made a diagnosis of acute sinusitis based on Martha's history and the fact that she
complains of pain behind her eye. Which sinuses are affected?
1.
Maxillary.
2.
Ethmoid.
3.
Frontal.
4.
Sphenoid. - ✔✔Ethmoid.
✔✔Marlene, a 57-year-old cashier, comes to the clinic because she is unable to
differentiate between sharp and dull stimulation on both sides of her face. You suspect:
1.
Bell palsy.
2.
A lesion affecting the trigeminal nerve.
3.
A stroke—brain attack, cerebrovascular accident (CVA).
4.
