When performing a visual acuity test the nurse practitioner notes 20/30 in the left eye and 20/40 in the right eye using the Snellen eye chart.
When performing a visual acuity test the nurse practitioner notes 20/30 in the left eye and 20/40 in the right eye using the Snellen eye chart. This means:
a) have the patient returning in two weeks for a follow up vision screen
b) dilated the eye and retest
c) refer the patient to an ophthalmologist
d) document this as a normal finding
2. The American psychiatric association’s diagnostic and statistical manual of mental disorder defines Munchausen Syndrome By Proxy
a) a self-inflicted injury to gain attention
b) a caregiver making up or causing an illness or injury in a person under his or her care
c) an abusive behavior that does not involve the caregiver
d) a situation in which the abuser is often inattentive and uncaring toward the victim
3. Symptoms of depression are a side effect of which neurotransmitter medication?
a) dopamine serotonin, norepinephrine
b) gabapentin
c) mil
d) cortisol
4. Which lesion is dark raised and asymmetric with irregular border? Quizlet Bates Chapter 20
a) Nevus
b) Actinic keratosis
c) Keratoacanthoma
d) Melanoma
5. A 32 years old woman presents with dull puffiness of the ayes pronounced not pitting periorbital edema this finding is suggestive of this condition? APEA
a) Nephrotic syndrome
b) Myxedema
c) Cushing syndrome
d) Sinusitis
6. A 42 years old woman with a past medical history of migraine headaches is requesting prophylactic medication treatment. Which medication should the Nurse practitioner prescribe?
a) Sumatriptan (Imitrex)
b) Amitriptyline (Elavil)
c) Verapamil (verelan)
d) Metoprolol (Lopressor)
7. A pediatric patient has areas of scaling on the scalp with round patches of alopecia. This clinical finding is consistent with:
a) Tinea capitis
b) Seborrheic dermatitis
c) Trichotillomania
d) Alopecia areata
8. What is the appropriate prophylactic medication for an 18 years old woman with a past medical history of migraine headaches?
a) Sumatriptan (Imitrex)
b) Propanolol (Inderal)
c) Ibuprofeno (motrin)
d) Dihydroergotamine (DHE)
9. Why would a combined hormonal contraceptive be contraindicated in a 36 year old patient with a past medical history of type 2 diabetes, obesity, chronic smoking and sedentary life
a) She is obese
b) She has type 2 diabetes mellitus
c) Her age and tobacco use
d) She leads a sedentary lifestyle
10. During the breast examination of a perimenopausal woman the NP detects a bloody spontaneous discharge from the right nipple. This indicates further evaluation.
a) Fibroadenoma
b) Polycystic breast disease Generalized breast pain or tenderness. Green or dark brown nonbloody nipple discharge that tends to leak without pressure or squeezing
c) An intraductal papilloma
d) Pituitary prolactinoma
11. Rh negative women should receive Rho (D) immunoglobulin at what gestational time?
a) 6 weeks
b) 12 weeks
c) 28 weeks
d) 35 weeks
What happens is the client is Rh negative and has a negative antibody screen?
12. When interpreting a complete blood count (CBC) lab report which of the following results describes the size of the RBCs?
a) Hemoglobin
b) Mean corpuscular volume (MCV)
c) Red cell distribution width (RDw)
d) Hematocrit
13. What medication should be avoided when prescribe prophylactic therapy for headache
a) Verapamil
b) Propranolol
c) Venlataxin (Effexor)
d) Nimodipine
14. What is the mechanism of action of prostaglandin E1 (PG1) in a patient with transposition of the great arteries
a) To maintain equal pressure in the ventricles
b) To maintain patency of the great arteries
c) To produce vasodilation on …………….
d) To prevent cyanotic episodes by trapping blood in the lower …………
15. Which of the following complaints best describes lower extremity calf pain associated with peripheral artery disease
a) A sharp stabbing pains
b) A dull pain or cramp
c) An electric shock
d) A pulsating pain
16. Which of the following conditions is NOT a typical finding of hyperprolactinemia in a 47- year-old premenopausal woman?
a) Hirsutism
b) Gynecomastia
c) Oligomenorrhea
d) Acne
17. When treating a patient with asthma who is experiencing acute wheezing which medication should be given to relieve the symptom?
a) Short acting bronchodilator
b) Long acting bronchodilator
c) Inhaled corticosteroid
d) Combination of methylxanthine and long acting bronchodilator
18. Which immunization reduces a patient’s risk for infection with the virus that causes painful localized blistering rash?
a) Smallpox vaccine
b) Varicella vaccine (chicken Pox)
c) Shingles (herpes zoster) vaccine
d) Meningococcal vaccine
19. Headache warning signs that need prompt investigation include all of the following EXCEPT:
a) new onset after age 50
b) aggravated or relieved by change of position
c) precipitated by Valsalva maneuver
d) Headache relieved with mild infrequent use of analgesics
20. The client with iron deficiency anemia should be advised to take the iron supplement
a) With milk to avoid stomach upset
b) With milk of magnesia at bedtime to avoid constipation
c) On an empty stomach between meals
d) For 30 days to 5 weeks
21. Which one of the following statements is true of Munchausen syndrome by proxy?
a) The injury is self-inflicted as the patient is seeking attention from others
b) Under the supervision of adults other than the abuser, the patient does not exhibit symptoms
c) The caregiver is usually not involver in the abusive behavior
d) The abuser is often inattentive and uncaring towards the victim
22. Which of the following is the most common presenting sign of substance abuse in adolescents?
a) Poor school performance
b) change in sleep habits
c) increased blood pressure
d) changes in behavior
23. A woman is 11 weeks pregnant and has a maternity history of one full term vaginal delivery, a set of premature triplets delivered vaginally, and a first trimester abortion. Using her TPAL system to document her maternal status
a) Gravida 4 para 1114
b) Gravida 4, para 1314 4 is the number of living children GTPAL
c. Gravida 3, para 1114
d) Gravida 3, para 1112
24. The nurse practitioner palpates an enlarged right epitrochlear lymph node in a 30 years old patient. The Nurse Practitioner should asses the patents
a) Throat, face, and right ear
b) Neck and supraclavicular region
c) Right forearm and hand
d) Right groin and abdomen
25. Anticholinergics are indicated for the treatment of
a) Asymptomatic bacteriuria
b) Renal insufficiency
c) Urge incontinence
d) Overflow incontinence
26. A patient presents with signs of chest pain, the nurse practitioner observes jugular venous distention. Their finding is consistent with
a) Hypertension
b) Heart failure
c) Asthma
d) Pneumonia
27. On examination of the neck, a dome shaped lesion in the dermis forming a benign closed firm sac attached to the epidermis is noted on the right lateral side of the neck. The type of lesion is known as
a) Keloid
b) Tophi
c) A cutaneous cyst
d) Chondrodermatitis
28. Symptoms of heartburn and regurgitation are associated with:
a) Hiatal hernia
b) Gastroesophageal reflux
c) Peptic ulcer disease
d) Esophageal cancer
29. A 70 years old man walks 20 minutes most days of the week. He has begun to complain of pain of his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 20 minutes walks without stopping to rest. What choice best describes the pain associated with peripheral artery disease?
a) A sharp, stabbing pain
b) A dull pain and cramp
c) An electric shock
d) A pulsating pain
30. Papilledema is a cause for concern because it is suggestive of
a) Optic atrophy
b) Microaneurysms
c) Increased intracranial pressure
d) Retinal hemorrhage
31. A 38-year-old patient with a history of abdominal pain presents to the nurse practitioner. Findings reveal superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. Hemorrhagic pancreatic is suspected because of which finding?
a) A positive Gray Turner’s sign
b) A positive Cullen’s sign
c) Kaposi’s sarcoma
d) Petechiae
32. A 57 years old post-menopausal female presents with a complaint of vaginal burning, pruritus and painful intercourse. On examination, the nurse practitioner would be most concern with the findings
a) A thin, pale, dry vaginal mucosa
b) Absence of rugae
c) A friable cervix
d) Raised yellowish cervical lesion
33. What intervention does the American College of Rheumatology recommend as first line therapy for Osteoarthritis, rheumatoid arthritis or something else
a) Diagnostic workup to rule out rheumatic arthritis
b) NSAID use at lowest effective dose
c) Acetaminophen use up to 4 grams/day
d) Exercise and weight loss
34. Which of the following drugs is not contraindicated for concurrent use with warfarin (Coumadin)?
a) Amoxicillin (Amoxil)
b) Trimethroprim/sulfamethaxazole (Bactrim)
c) Cirpofloxacin (Cipro)
d) Clarithromycin (Biaxin)
35. The lymphatic ducts drain into the (APEA)
a) arterial system
b) venous system
c) vertebral bodies of the spine
d) shoulder
36. Which of the following is the most appropriate treatment for trichomoniasis in a non- pregnant woman?
a) Metronidazole (flagyl)
b) Doxycycline (Vibramycin)
c) Clindamycin (Cleocin)
d) Clotrimazole (lotrimin)
37. Osteosarcoma in a pediatric patient is most often diagnosed when there is:
a) Pain in the affected bone
b) Pathologic fracture
c) Repeat fracture
d) Apophyseal avulsion
38. In a patient who has a history of migraine headaches, which characteristics is most common?
a) Focal deficits
b) Family history
c) Weakness
d) Initial onset after age 35
39. Symptoms associated with small bowel obstruction usually include:
a) Nausea and diarrhea
b) Vomiting and pain
c) Hematemesis and bloody stool
d) Indigestion and anorexia
40. Unilateral rhinitis could be caused by all of the following except
a) A foreign body in the nasal canal
b) A nasal polyp
c) Drug induced rhinitis
d) A deviated sputum
41. A 7 years old child has been diagnosed with acute sinusitis. The drug class that should be avoided is:
a) Antihistamines
b) Expectorants
c) Decongestants
d) Nasal steroids
42. A patient present with an elongated head with bony prominence of the forehead, nose and lower jaw. These facial features could be suggestive of:
a) Nephrotic syndrome
b) Acromegaly
c) Cushing’s syndrome
d) Parkinson’s disease
43. Why would a child diagnosed with beta thalassemia and hemosiderosis receive deferoxamine (desferal)?
a) To prevent blood transfusion reactions
b) To simulate red blood cell production
c) To improve the oxygen carrying capacity of RBCs
d) To eliminate excessive iron and prevent organ damage
44. A patient has newly diagnosed hypothyroidism. What are the patients TSH level expected to be?
a) Higher than normal
b) Lower than normal
c) Within normal range
d) TSH is not used to diagnose hypothyroidism Suggest that the provider lower the dose.
45. Which of the following symptoms would be a clinical manifestation noted during the secondary stage of syphilis?
a) Absence of symptoms
b) Single painless lesion, chancre on the genital area.
c) Rash marked by red or reddish-brown, penny-sized lesions over the palms and soles
d) Poor muscle coordination
46. An 84-year-old male with prostatic hypertrophy is at increased risk of:
a) Constipation
b) Fecal incontinence
c) Urinary tract infections
d) Prostate cancer
47. A characteristic lesion observed in a male with primary syphilis is a:
A) Group of small scattered vesicles
B) Chancre
C) Papule of many shapes
D) Non-tender penile indurated nodule
48. During an acute attack of gout, the nurse practitioner knows NOT to prescribe
a) Colchicine (Colcrys)
b) Allopurinol (zyloprim)
c) Steroids
d) NSAIDS
49. What two vitamins and minerals should be included in oral multivitamins in women
a) Folic Acid and Vitamin C
b) Iron and Vitamin B12
c) Vitamin D and Iron
d) Folic Acid and Iron
50. In a patient with bacterial meningitis, the most common reason for finding of headaches:
a) Meningeal erythema
b) Increased intracranial pressure
c) Meningeal irritation
d) Swelling of the spinal cord
51. Janeway lesions, petechiae and Oster nodes are associated with:
a) Gonococcemia
b) Infective endocarditis
c) Hyperthyroidism
d) Peripheral vascular disease
52. A patient present with decreased hearing related to antibiotic use. Which class of antibiotics is this?
a) Aminoglycosides
b) Beta-lactams
c) Cephalosporins
d) Macrolides
53. Which antihypertensive would be appropriate to prescribe for a hypertensive patient (B/P 150/95) that is in her third trimester?
a) Candesartan
b) Lisinopril
c) Methyldopa
d) Furosemide
54. A 40-year-old admits to multiple sex partners presents with several lesions over his body. Finding reveals hemorrhagic vesiculopustular lesions over the hands and feet. These lesions are most likely associated with:
a) Gonococcemia
b) Infective endocarditis
c) Hyperthyroidism
d) Peripheral vascular disease
55. Which agent is NOT useful in prophylactic treatment of migraine headaches?
a) Sumatriptan (Imitrex)
b) Amitriptyline (elavil)
c) Verapamil (verelant)
d) Metropolol (lopresor)
56. The right lymph duct drains lymphatic fluid from all the following expect the (APEA)
a) Right side of the heard
b) Right upper thorax
c) Right arm
d) Right leg
57. Acute lymphocytic leukemia is usually diagnosed by:
a) A completed blood count
b) Magnetic resonance imaging
c) A nuclear bone scans
d) A bone marrow examination
58. The medication that blocks the transportation of glucose across the intestines into the blood stream to target prandial blood glucose is:
a) Metformin (Glucophage XR)
b) Acarbose (Precose)
c) Rosiglitazone (Avandia)
d) Glipizide (Glucotrol XL)
59. Prostate pain is usually located in the:
a) Supra pubic area
b) Back
c) Perineum
d) In the glans penis
60. A nurse practitioner examines the skin of an elderly patient which finding below is NOT benign lesion associated with the aging process?
a) Xerosis
b) Cherry angiomas and senile purpura
c) Senile keratosis and senile lentigines
d) Dermatophytosis
61. A 65-year-old male presents with findings of symmetric thorax with moderate kyphosis and anterior diameter. Chest expansion is decreased and the diaphragm descending 2 cm bilaterally. These findings relate to:
a) Pneumothorax
b) Plural effusion
c) A fractured rib
d) Chronic obstructive pulmonary disease
62. Phenazopyridine (Pyridium) is recommended for very short-term use in patients with urinary tract infections (UTIs) because:
a) Possible resistance
b) Occurrence of hemolytic anemia
c) Gastritis
d) Cost
63. Estrogen-progestin contraceptives should be avoided in women with:
a) Tension headaches
b) Migraines with aura
c) Unilateral headaches
d) Cluster headaches
64. The addition of benzoyl peroxide to erythromycin for the topical treatment of acne:
a) Improve the efficacy of erythromycin
b) Decrease the risk of desquamation
c) Decreases the risk of resistance to erythromycin
d) Increases the time patient can be exposed to sunlight
65. An elderly male with benign prostate hyperplasia (BPH) should be advised to avoid antihistamines. What is the reason for this?
a) Urinary incontinence
b) Constipation
c) Orthostatic hypotension
d) Urinary retention
66. Examination of the hair reveals a fine silky appearance. This finding may be seen in patients that have:
a) Hypothyroidism
b) Hyperthyroidism
c) Type 2 diabetes
d) Celiac disease
67. A patient develops a cough secondary to an angiotensin-converting-enzyme (ACE). The most appropriate statement related to ACE-I cough is that the cough typically:
a) Resolves within a week after stopping the ACE inhibitor
b) Resolves with splitting the daily dose to twice daily dosing
c) Occurs with an angiotensin- II receptor blocker (ARB)
d) Affects men more than women
68. A patient with a diagnosis of giardiasis is being treated with metronidazole (flagyl). What information would be important to obtain before prescribing this medication?
a) If the patient allergic to sulfa
b) If the patient has peptic ulcer disease
c) If the patient is at least 18 year of age
d) If the patient drinks alcohol
69. A 20 years old male living in the college dorm, complains of a dry cough for the past month. Assessment finding associated with an atypical, community acquired pneumonia would include:
a) A low-grade fever, malaise, and clear lung fields on auscultation
b) A low-grade fever, malaise, and crackles audible throughout the lung fields
c) Temperature of 1010 F, sore throat, and diminished breath sounds on auscultation
d) Temperature of 1020 F, dyspnea, and diminished lung sounds on auscultation
70. The most appropriate medication indicated for reversing the anticoagulated effects of dabigatran etexilate (Pradaxa)
a) Idarucizumab (Praxbind)
b) Vitamin K
c) Protamine sulfate
d) Fondaparinux (Arixtra)
71. A common pathological finding in patient with asthma
a) Necrosis of small airway
b) Absence of goblet cells
c) Absence of ciliary regeneration
d) Hypertrophy of smooth muscle
72. Which cranial nerves are responsible for eye movement?
a) CN II, III, IV
b) CN III, IV, VI
c) CN II, IV, VI
d) CN III, IV, VII
73. The typical presentation of severe acute aortic regurgitation (AR) includes sudden severe shortness of breath rapidly developing heart failure, and:
a) Dry cough
b) Chest pain
c) Decreased blood pressure
d) Systolic murmur
74. Disorders in the kidneys and the ureters may cause pain in all of the following areas except the:
a) Flank
b) Abdomen
c) Back
d) Suprapubic
75. When palpating the prostate gland during the rectal exam, the prostate feels tender, swollen, boggy and warm. This finding is consistent with:
a) A normal prostate gland
b) Acute bacterial prostatitis
c) Benign prostatic hyperplasia
d) Carcinoma of the prostate.
76. This contagious disease causes fever, headache, stiff neck, photophobia, nausea, vomiting, and altered mental status. What immunization prevents this?
a) Meningococcal vaccine
b) Pneumococcal vaccine
c) Measles, Mumps, and Rubella (MMR) vaccine
d) Varicella vaccine
77. Headache warning signs that need prompt investigation include all of the following
a) New onset after 50
b) Aggravated or relieved by change or position
c) Precipitated by Valsalva maneuver
d) Headaches relieved with mild recurrent use of analgesics
78. Serotonin Syndrome is a potentially life-threatening condition associated with:
a) Depression
b) Anxiety
c) Increased levels of serotonin
d) Chlylothorax
79. Which one of the following statements about treating scabies with lindane (Kewell) is correct? Know that Nix is the treatment.
a) Lindane is safe to use in pregnant women, babies, children, and the elderly
b) Lindane lotion and/or shampoo in not considered first-line therapy
c) Repeated applications of lindane can be used if there has been a twelve-hour interval
d) Lindane can be used in patient with a history of seizures.
80. Symptoms consistent with later stage human deficiency disease (HIV) typically include all of the following except,
a) Night sweats
b) Lymphadenopathy for more than 3 months
c) Persistent vomiting
d) Persistent, unexplained fatigue
81. The earliest clinical manifestation of diabetic nephropathy is:
a) An elevation in blood urea nitrogen (BUN)
b) An elevation in blood urea nitrogen (BUN) and creatinine (CR)
c) A decreased glomerular filtration rate
d) Microalbuminuria
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