The National Cholesterol Education Program’s Adult Treatment Panel III recommends that the goal for low density lipoproteins in high risk patients be less than:

Question 1The National Cholesterol Education Program’s Adult Treatment Panel III recommends that the goal for low density lipoproteins in high risk patients be less than:

 

Question 2An AST that is more than twice the level of ALT is suggestive of:

 

Question 3The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The least likely diagnosis for this patient is:

 

 Question 4A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough?

 

Question 5Mort is hypertensive. Which of the following factors influenced your choice of using an alpha blocker as the antihypertensive medication?

 

Question 6Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication?

 

Question 7A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him:

 

Question 8Of the following, the patient who should be referred for periodic colonoscopy is the patient with:

 

Question 9A patient with elevated lipids has been started on lovastatin. After 3 weeks of therapy, he calls to report generalized muscle aches. The nurse practitioner should suspect:

 

Question 10Of the following choices, the least likely cause of cough is:

 

Question 11 An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3–4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has:

 

Question 12An adult presents with tinea corporis. Which item below is a risk factor for its development?

 

Question 13Risk factors for acute arterial insufficiency include which of the following?

 

Question 14Which of the following dermatologic vehicles are the most effective in absorbing moisture and decreasing friction?

 

Question 15Which type of lung cancer has the poorest prognosis?

 

Question 16An active 65-year-old man under your care has known acquired valvular aortic stenosis and mitral regurgitation. He also has a history of infectious endocarditis. He has recently been told he needs elective replacement of his aortic valve. When he comes into the office you discover that he has 10 remaining teeth in poor repair. Your recommendation would be to:

 

Question 17John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia?

 

Question 18A 70 year old man who walks 2 miles every day complains of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 2 mile walk. What question asked during the history, if answered affirmatively, would suggest a diagnosis of arteriosclerosis obliterans?

 

Question 19Which of the following is the most appropriate therapeutic regimen for an adult patient with no known allergies diagnosed with group A B-hemolytic strep?

 

Question 20Which of the following heart murmurs warrants the greatest concern?

 

Question 21A 55 year old patient has a work-up for hypertension and is noted to have elevated BUN and creatinine. Which of the following should the nurse practitioner suspect?

 

Question 22Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to:

 

Question 23Which of the following statements about malignant melanomas is true?

 

Question 24Sarah has allergic rhinitis and is currently being bothered by nasal congestion. Which of the following meds ordered for allergic rhinitis would be most appropriate?

 

Question 25What condition is associated with mucus production greater than 3 months per year for at least 2 consecutive years?

 

Question 26Amaurosis fugax is described as a:

 

Question 27Which of the following patient characteristics are associated with chronic bronchitis?

 

Question 28Marvin has sudden eye redness that occurred after a strenuous coughing episode. You diagnose a subconjunctival hemorrhage. Your next step is to:

 

Question 29Medicare is a federal program administered by the Centers for Medicare and Medicaid Services (CMS). The CMS has developed guidelines for Evaluation and Management coding, which all providers are expected to follow when coding patient visits for reimbursement. Which of the following is an important consideration regarding billing practices?

 

Question 30A 70 year old patient presents with a slightly raised, scaly, erythematous patch on her forehead. She admits to having been a “sun worshiper.” The nurse practitioner suspects actinic keratosis. This lesion is a precursor to:

 

Question 31Which of the following color changes in a pigmented lesion suggests malignant transformation?

 

Question 32A 58-year-old man is diagnosed with Barrett’s esophagus after an endoscopy. He has no known allergies. Which of the following medications is MOST appropriate to treat this patient’s disorder?

 

Question 33Risk factors for acute otitis media (AOM) include all of the following except:

 

Question 34Alan, age 54, notices a bulge in his midline every time he rises from bed in the morning. You tell him it is a ventral hernia, also known as:

 

Question 35What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery?

 

Question 36A patient has experienced nausea and vomiting, headache, malaise, low grade fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is elevated with a shift to the left. He is requesting medication for diarrhea. What is the most appropriate response?

 

Question 37A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is:

 

Question 38Impetigo and folliculitis are usually successfully treated with:

 

Question 39Which of the following is not a risk factor for coronary arterial insufficiency?

 

Question 40Which of the following is a predisposing condition for furunculosis?

 

Question 41An 18 year old complains that his “throat hurts” with swallowing. His voice is very “throaty” and he is hyperextending his neck to talk. Examination reveals asymmetrical swelling of his tonsils. His uvula is deviated to the left. What is the most likely diagnosis?

 

Question 42 A 76-year-old male complains of weight loss, nausea, vomiting, abdominal cramping and pain. Physical findings include an abdominal mass and stool positive for occult blood. The nurse practitioner pain suspects a tumor in the small intestine. The best diagnostic test for this patient is:

 

Question 43In order to decrease deaths from lung cancer:

 

Question 44Your 31-year-old patient, whose varicella rash just erupted yesterday, asks you when she can go back to work. What do you tell her?

 

Question 45Jennifer, age 49, who has a history of hyperlipidemia, has symptoms that lead you to suspect unstable angina. Your next action would be to:

 

Question 46Expected spirometry readings when the patient has chronic emphysema include:

 

Question 47Sandra has celiac disease. You place her on which diet?

 

Question 48Appropriate therapy for peptic ulcer disease (PUD) is:

 

Question 49A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most effective in keeping him symptom-free?

 

Question 50Your well-nourished 75-year-old patient has come into the office for a physical exam and states that she recently had two nosebleeds. She does not take any anticoagulants, and you have ruled out any coagulopathies. The most likely cause of these nosebleeds is:

 

Question 51A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe?

 

Question 52Which of the following are classic features of ulcerative colitis?

 

Question 53A 60 year old male diabetic patient presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which “is better.” His temperature is 100°F and pulse is 102 bpm. The most appropriate initial action is to:

 

Question 54An 18 year old patient is afebrile and complains of severe left ear pain. On examination, the TM is gray and intact and there is a green discharge in the external canal. What action by the nurse practitioner is most appropriate?

 

Question 55When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action?

 

 

 

Question 56 A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 different thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect:

 

Question 57The nurse practitioner is reviewing a patient’s lab report who completed the hepatitis B series 3 months ago. Which of the following lab results would you expect to see in this patient?   

 

Question 58A patient presents with periorbital erythema and edema, fever, and nasal drainage. The nurse practitioner should:

 

Question 59Treatment of H.pylori includes which of the following?

 

Question 60A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory?

 

Question 61Which of the following can result from chronic inflammation of a meibomian gland?

 

Question 62After thorough history, physical examination, and laboratory tests, a patient is diagnosed with irritable bowel syndrome (IBS). Which of the following initial treatment plans is currently considered most effective?

 

Question 63Marian, age 52, is obese. She complains of a rapid onset of severe right upper quadrant abdominal cramping pain, nausea, and vomiting. Your differential diagnosis might be:

 

Question 64A 58 year old complains of tightness in his chest while cutting firewood. It disappears quickly if he stops chopping. He denies shortness of breath, his total cholesterol level is less than 200 mg/dL, and he is a non-smoker. What is the most appropriate action for the nurse practitioner to take with this patient?

 

Question 65 A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent care with new onset left lower quadrant pain. Her current medications include omeprazole 20 milligrams po daily, lisinopril 20 milligrams po daily, simvastatin 20 milligrams po daily, and prednisone 12 milligrams po daily. The nurse practitioner suspects acute diverticulitis and possibly an abscess. The most appropriate diagnostic test for this patient at this time is:

 

Question 66A cashier complains of dull ache and pressure sensation in her lower legs. It is relieved by leg elevation. She occasionally has edema in her lower legs at the end of the day. What is the most likely cause of these problems?

 

Question 67A middle-aged male presents to urgent care complaining of fever, dysphagia, and shortness of breath. The nurse practitioner notes the patient leaning forward in a tripod position and drooling. The clinical presentation of this patient suggests:

 

Question 68Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect?

 

Question 69A 40 year old female with history of frequent sun exposure presents with a multicolored lesion on her back. It has irregular borders and is about 11mm in diameter. What should the nurse practitioner suspect?

 

Question 70Your patient Jerry has gout. What do you suggest?

 

Question 71An 18-year-old female presents to the urgent care center complaining of severe pruritus in both eyes that started 2 days ago. Associated symptoms include a headache and fatigue. On examination, the nurse practitioner notes some clear discharge from both eyes and some erythema of the eyelids and surrounding skin. Which of the following is the most likely cause of this patient’s symptoms?

 

Question 72Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?

 

Question 73A 15 year old male presents with abdominal pain that began in the peri-umbilical area then localized to the right lower quadrant (RLQ). He complains of anorexia, and low grade fever. A complete blood count (CBC) reveals moderate leukocytosis. What is the most likely diagnosis?

 

Question 74The nurse practitioner is performing a physical exam on a middle-aged African-American man. Which of the following areas is a common site for melanomas in African-Americans and other dark-skinned individuals?

 

Question 75Which of the following best describes hypertrophic cardiomyopathy?

 

Question 76Martha had a less than 7% value on her Schilling test. What medication do you anticipate she might need?

 

Question 77A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with:

 

Question 78The most common correlate(s) with chronic bronchitis and emphysema is(are):

 

Question 79If a patient presents with a deep aching, red eye and there is no discharge, you should suspect:

 

Question 80The American Cancer Society recommends a flexible sigmoidoscopy for colorectal cancer screening in persons at average risk every:

 

Question 81Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?

 

Question 82 A patient presents with classic symptoms of gastroesophageal reflux disease (GERD). He is instructed on life style modifications and drug therapy for 8 weeks. Three months later he returns, reporting that he was “fine” as long as he took the medication. The most appropriate next step is:

 

Question 83The differential diagnosis for a patient complaining of a sore throat includes which of the following?

 

Question 84Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg daily, and Calcium 1500 mg daily. At today’s visit. Her blood pressure is 170/89. According to JNC VIII guidelines, what should you do next to control Harriet’s blood pressure?

 

Question 85A 40 year old presents with a hordeolum. The nurse practitioner teaches the patient to:

 

Question 86Which of the following is not a symptom of irritable bowel syndrome?

 

Question 87In the initial evaluation of a patient with new onset hypertension, the nurse practitioner should:

 

Question 88Before initiating an HMG CoA-reductase inhibitor for hyperlipidemia, the nurse practitioner orders liver function studies. The patient’s aminotransferase (ALT) is elevated. What laboratory test(s) should be ordered?

 

 

 

Question 89A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect:

 

Question 90 What prophylactic medication is commonly recommended for the patient under 35 years of age with a positive PPD?

 

Question 91Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect?

 

Question 92 An 80-year-old male admits to difficulty swallowing during the review of systems. The nurse practitioner recognizes the differential diagnosis for this patient’s dysphagia is:

 

Question 93A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed?

 

Question 94A 47 year old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On examination, external hemorrhoids are noted. How should the nurse practitioner proceed?

 

Question 95A patient reports “something flew in my eye” about an hour ago while he was splitting logs. If there were a foreign body in his eye, the nurse practitioner would expect to find all except:

 

Question 96Which of the following is a secondary cause of hyperlipidemia?

 

Question 97Mark has just been given a diagnosis of congestive heart failure. Which of his medications should be discontinued?

 

Question 98Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis?

 

Question 99Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by:

 

Question 100 Which Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is:

 

Question 101When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

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