Exam 2 Neurological Problems, Psychosocial Problems, Renal Problems, Abdominal Problems, Respiratory Problems

Which of the following patients is most likely to have urge incontinence? A. Mary, a 35-year-old female with a history of four vaginal deliveries B. Devon, a 40-year-old male with a history of multiple sclerosis C. Dan, a 67-year-old male with a history of diabetes mellitus D. Cheryl, a 95-year-old female who takes Norpace daily

B. Devon, a 40-year-old male with a history of multiple sclerosis

Which of these sputum strains would one use to test for a viral respiratory culture? A. Gram stain B. Direct fluorescent antibody stain C. Wright-Giemsa stain D. Acid-fast stain

B. Direct fluorescent antibody stain

Which of the following Macrobid doses is appropriate to treat a lower UTI? A. 200 mg bid × 14 days B. 100 mg bid × 5 days C. 500 mg daily × 8 days D. 800 mg daily × 2 days

B. 100 mg bid × 5 days

IV thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset? A. 1 hour B. 3 hours C. 6 hours D. 12 hours

B. 3 hours

Fredericka is a 40-year-old Hispanic female with a history of diabetes mellitus, hypertension, and HIV. She has a tuberculosis (TB) skin test. What is the smallest diameter of induration that would indicate a positive result? A. 2 mm B. 5 mm C. 8 mm D. 10 mm

B. 5 mm

A chronic cough lasts longer than: A. 3 weeks B. 8 weeks C. 6 months D. 1 year

B. 8 weeks

Which patient is most likely to have myasthenia gravis (MG)? A. A 75-year-old Caucasian woman B. A 31-year-old Hispanic woman C. A 55-year-old African American male D. A 10-year-old Middle Eastern male

B. A 31-year-old Hispanic woman

The hallmark of an absence seizure is: A. No activity at all B. A blank stare C. Urine is usually voided involuntarily D. The attack usually lasts several minutes

B. A blank stare

What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster? A. A stabbing pain on one small area of the body B. A vesicular skin lesion on one side of the body C. A pain that is worse upon awakening D. A lesion on the exterior ear canal

B. A vesicular skin lesion on one side of the body

The patient is diagnosed with ARF. Which of the following conditions is the most common cause? A. Renal calculi B. Acute tubular necrosis C. Cardiac failure D. Acute glomerulonephritis

B. Acute tubular necrosis

Which is the most prevalent psychiatric condition in the United States? A. Depression B. Anxiety C. Substance-related addictions D. Gambling addiction

B. Anxiety

You are doing a cerumen extraction and touch the external meatus of your patient's ear. He winces and starts coughing. What is the name of this reflex? A. Baker phenomenon B. Arnold reflex C. Cough reflex D. Tragus reflex

B. Arnold reflex

It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period? A. Prior to the antidepressant reaching therapeutic levels B. As the mood lifts in response to antidepressant treatment C. During dosage or medication adjustments D. After the patient reveals suicidal thoughts or plans

B. As the mood lifts in response to antidepressant treatment

Which of the following examination findings should be expected in a patient with CKD? A. Weak, thready pulse B. Auscultatory crackles C. Hypotension D. Pleural friction rub

B. Auscultatory crackles

Which of the following patients is most likely to have squamous cell carcinoma? A. Janice, a 70-year-old female and is a nonsmoker B. Bill, a 65-year-old male with a 20-year history of smoking C. Sophie, a 30-year-old female with a family history of lung cancer D. David, a 90-year-old man whose brother passed away from lung cancer

B. Bill, a 65-year-old male with a 20-year history of smoking

What term describes random quick jerking movements that flow from joint to joint? A. Dystonia B. Chorea C. Myoclonus D. Compulsions

B. Chorea

Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer? A. Kidneys, ureter, bladder x-ray B. Cystoscopy with biopsy C. Magnetic resonance imaging D. Urine tumor marker (NMP22)

B. Cystoscopy with biopsy

Your patient is on theophylline for his asthma. You want to maintain his serum levels between: A. 0 to 5 mcg/mL B. 5 to 10 mcg/mL C. 5 to 15 mcg/mL D. 10 to 20 mcg/mL

C. 5 to 15 mcg/mL

The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least: A. 1 month B. 3 months C. 6 months D. 12 months

C. 6 months

Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)? A. A teenage male B. A 65-year-old male C. A 25-year-old female D. A 60-year-old female

C. A 25-year-old female

Which patient is most likely to be diagnosed with Guillain-Barré syndrome? A. A 6-month-old infant B. A 30-year-old man C. A 72-year-old woman D. A 50-year-old man

C. A 72-year-old woman

Which of the following may trigger migraines? A. Taking an ibuprofen for muscle pain B. A cup of coffee with regular sweetener C. A glass of merlot wine D. Drinking a cup of green tea

C. A glass of merlot wine

Emotional dysregulation is common in: A. Children with obsessive-compulsive disorder B. Adults with schizophrenia C. Adults with attention deficit-hyperactivity disorder D. Children with tic disorders

C. Adults with attention deficit-hyperactivity disorder

Which condition is characterized by the impaired ability to learn new information along with a cognitive disturbance in either language, function, or perception? A. Guillain-Barré syndrome B. Parkinson's disease C. Alzheimer's disease D. Delirium

C. Alzheimer's disease

A 21-year-old student presents with complaints of fatigue, headache, anorexia, and a runny nose, all of which began about 2 weeks ago. She started taking vitamins and over-the-counter cold preparations but feels worse. The smell of food makes her nauseated. Her boyfriend had mononucleosis about 1 month ago, and she wonders if she might have it also. Examination reveals cervical adenopathy and an enlarged liver and spleen. Which of the following labs would be most helpful in the differential diagnosis at this point? A. Stool culture B. Liver enzymes C. Antihepatitis D virus D. Thyroid-stimulating hormone test

C. Antihepatitis D virus

Lisa is a 25-year-old Hispanic female experiencing chest tightness, a feeling of suffocation, and feels like she "can't get air in." She has no current history of heart or lung disease and did not exercise leading up to this attack. Which of the following is the most likely cause for this dyspnea? A. Severe chronic anemia B. Congestive heart failure C. Anxiety-related dyspnea D. Chronic obstructive pulmonary disease (COPD)

C. Anxiety-related dyspnea

Which type of meningitis is more benign, self-limiting, and caused primarily by a virus? A. Purulent meningitis B. Chronic meningitis C. Aseptic meningitis D. Herpes meningitis

C. Aseptic meningitis

Which of the following activities is part of the functional activities questionnaire? A. Asking the patient to unravel a Rubik's cube B. Determining if the patient can drive on the highway C. Asking the patient about a news event from the current week D. Seeing if the patient can keep his or her home clean

C. Asking the patient about a news event from the current week

After typical groin hernia surgery, the patient should be instructed to: A. Avoid work for 3 weeks. B. Stay in the hospital for 2 weeks. C. Avoid heavy lifting for 4 to 6 weeks. D. Return to normal activities after 1 month.

C. Avoid heavy lifting for 4 to 6 weeks.

How much nicotine does an average cigarette contain? A. 5 to 10 mg B. 10 to 15 mg C. 15 to 20 mg D. 20 to 25 mg

C. 15 to 20 mg

About 90% of all headaches are: A. Tension B. Migraine C. Cluster D. Without pathological cause

D. Without pathological cause

A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria? A. NSAIDs B. Rhubarb C. Vitamin A D. Red meat

A. NSAIDs

Gabby, aged 22, has Bell's palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her? A. "Most patients have complete recovery in 3 to 6 months." B. "Unfortunately, you'll probably have a small amount of residual damage." C. "Don't worry, I'll take care of everything." D. "You may have a few more episodes over the course of your lifetime but no permanent damage."

A. "Most patients have complete recovery in 3 to 6 months."

Women are at the highest risk for developing peripartum depression for up to how long after childbirth? A. 1 to 3 weeks B. 1 month C. 3 to 6 months D. 7 months to 1 year

A. 1 to 3 weeks

34. What is the pressure needed for continuous positive air pressure (CPAP) to abolish apneas, snoring, and oxyhemoglobin desaturations in all positions and during REM sleep? A. 5 to 20 cm H2O B. 10 to 25 cm H2O C. 15 to 25 cm H2O D. 20 to 35 cm H2O

A. 5 to 20 cm H2O

Which of the following dietary instructions should be given to a patient with GERD? A. Eliminate coffee. B. Drink hot toddies to relieve stomach distress. C. Recline and rest after meals. D. Increase the amount of spicy foods.

A. Eliminate coffee.

Which ethnic group has the highest lung-cancer incidence and mortality rates? A. African American men B. Scandinavian men and women C. Caucasian women D. Asian men

A. African American men

A serious physical illness in any organ category is: A. An independent risk factor for geriatric suicide B. Likely to occur with body dysmorphic disorder C. Associated with mood disorders D. Likely to produce anxiety or panic disorders

A. An independent risk factor for geriatric suicide

On further questioning, the 21-year-old patient with complaints of fatigue, headache, anorexia, and a runny nose explains that she is sexually active only with her boyfriend, does not use injectable drugs, and works as an aide in a day-care center. Which of the following tests would be most helpful in confirming your diagnosis? A. Anti-HAV IgM B. HAV IgG C. Anti-HCV D. IgM anti-HBs

A. Anti-HAV IgM

Which obstructive lung disease is classified as reversible? A. Asthma B. Chronic bronchitis C. Emphysema D. COPD

A. Asthma

Echolalia is sometimes demonstrated by people with which disorder? A. Autism B. Alcoholism C. ADHD D. Asperger's

A. Autism

Which of the following diagnostic tests is ordered for a cecal volvulus bowel obstruction? A. Barium enema B. Colonoscopy C. Endoscopy D. Magnetic resonance imaging (MRI)

A. Barium enema

Which of the following scales is useful to assess the degree of dyspnea with a score of 6 to 20? A. Borg scale B. Patient Health Questionnaire-9 scale C. Visual analog scale D. Global assessment of functioning scale

A. Borg scale

Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing? A. CN V B. CN VII C. CN IX D. CN X

A. CN V

A patient has been diagnosed with meningitis caused by a Streptococcus pneumoniae infection. Which of the following treatments would be appropriate? A. Cefotaxime B. Isoniazid C. Acyclovir D. Amphotericin

A. Cefotaxime

Which drug for Alzheimer's disease should be administered beginning at the time of diagnosis? A. Cholinesterase inhibitors B. Anxiolytics C. Antidepressants D. Atypical antipsychotics

A. Cholinesterase inhibitors

A patient has just had a total nephrectomy for renal cell carcinoma. Which of the following follow-up strategies is appropriate? A. Computed tomography (CT) scan of abdomen and renal fossa in 3 to 6 months B. Magnetic resonance imaging (MRI) of abdomen and kidneys in 2 to 4 months C. X-ray of abdomen and renal fossa in 6 to 8 months D. No follow-up is necessary.

A. Computed tomography (CT) scan of abdomen and renal fossa in 3 to 6 months

Carol has CKD. Her creatinine levels are now 12 mg/dL. She would like to know what to expect next. What does the provider tell her? A. Due to her advanced renal failure, her survival time without intervention is 100 to 150 days. B. She does not require intervention and she will require dialysis once her creatinine levels reach 15 mg/dL. C. She requires dialysis and must have an arteriovenous graft this week to start dialysis in 1 week. D. She will be placed on the transplant list once her creatinine levels are greater than 16 mg /dL.

A. Due to her advanced renal failure, her survival time without intervention is 100 to 150 days.

A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her physical examination is remarkable for left lower quadrant tenderness. At this time, which of the following should be considered in the differential diagnosis? A. Endometriosis B. Yersinia enterocolitica infection C. Appendicitis D. GERD

A. Endometriosis

Eleanor would like to quit smoking, but she is unsure of the benefits, as she is 60 years old. Which of these is a benefit to quitting smoking that her provider should inform her of? A. Enhanced taste and smell B. Improved hearing C. Decreased risk of diabetes mellitus D. Decreased risk of sexually transmitted diseases

A. Enhanced taste and smell

Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery? A. Epidural hematoma B. Subdural hematoma C. Subarachnoid hematoma D. Intraparenchymal hemorrhage

A. Epidural hematoma

A patient is seen with complaints of diarrhea. Which of the following should be included in the patient's differential diagnosis? A. Gastroenteritis B. Recent use of Imodium C. Lack of dietary fiber D. Decreased physical activity

A. Gastroenteritis

Jeremy is a 27-year-old who comes to the clinic complaining of red-tinged urine. The clinician performs a urine dipstick and finds that the protein is 2+. Which of the following from Jeremy's history is related to this finding? A. He is training for a marathon. B. He recently broke a toe. C. He began taking Lexapro 2 weeks ago. D. He works in an office setting.

A. He is training for a marathon.

A 28-year-old patient is seen in the clinic with colicky abdominal pain, particularly after meals. She has frequent constipation, flatulence, and abdominal distension. Which of the data make a diagnosis of diverticulitis unlikely? A. Her age B. Frequent constipation C. Pain after meals D. Colicky abdominal pain

A. Her age

Which of the following is part of the treatment plan for the patient with IBS? A. High-fiber diet B. A discussion that the goal of treatment is to cure their disease C. Daily laxatives D. A conversation about their expected shorter life span

A. High-fiber diet

Which of the following is most effective in diagnosing acute appendicitis? A. History and physical B. Sedimentation rate C. Kidney, ureter, and bladder x-ray D. Complete blood count (CBC) with differentials

A. History and physical

Which of the following symptoms is NOT part of the diagnostic criteria for post-traumatic stress disorder (PTSD)? A. Hypersomnolence B. Blunted feelings C. Loss of interest in significant activities D. Intrusive recurrent recollections of the event

A. Hypersomnolence

A patient is seen in the office complaining of severe flank pain and hematuria. The clinician should assess this patient for which risk factor for poststreptococcal glomerulonephritis? A. Hypertension B. Constipation C. Tubal ligation D. Diabetes

A. Hypertension

Which of the following is a laboratory finding commonly found in patients with anorexia nervosa? A. Hypophosphatemia B. Hypermagnesmia C. Leukocytosis D. Decreased TRH

A. Hypophosphatemia

Joyce is taking a long-acting beta agonist for her asthma. What additional medication should she be taking? A. Inhaled corticosteroid B. Leukotriene-receptor antagonist C. Systemic corticosteroid D. Methylxanthines

A. Inhaled corticosteroid

Danielle presents to the clinic, saying "I do not feel like I want to eat." She also notes she is experiencing lethargy, nausea, headache, and muscle cramps. She "did not go to the bathroom a lot" yesterday. Which of the following stages of acute kidney injury (AKI) is Danielle in? A. Initiating stage B. Oliguric stage C. Diuretic stage D. Recovery stage

A. Initiating stage

Which of the following herbal supplements should be used cautiously in a patient with hypertension? A. Licorice B. Horehound C. Peppermint D. Jasmine

A. Licorice

Which of the following is a sign or symptom of a migraine? A. Light sensitivity B. Nonpulsatile pain C. Nasal stuffiness D. Bandlike pain

A. Light sensitivity

36. Tina is a 3-week-old who was recently diagnosed with influenza. Which of the following medications would be appropriate to treat her condition? A. Liquid oseltamivir B. Inhaled zanamivir C. Inhaled oseltamivir D. Liquid zanamivir

A. Liquid oseltamivir

A 30-year-old patient presents with pain on urination. The urine microscopy of clean-catch urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis? A. Lower urinary-tract infection B. Chlamydia infection C. Candidiasis D. Pyelonephritis

A. Lower urinary-tract infection

Which of the following is associated with celiac disease (celiac sprue)? A. Malabsorption B. Constipation C. Rectal bleeding D. Esophageal ulceration

A. Malabsorption

Which of the following patients has an increased risk of epigastric hernia? A. Mark, a 45-year-old African American male with chronic obstructive pulmonary disease B. Gladys, a 93-year-old Hispanic female with dyslipidemia C. Tony, a 33-year-old Asian male with hypertension D. Whitney, a 22-year-old Caucasian female with anemia

A. Mark, a 45-year-old African American male with chronic obstructive pulmonary disease

The clinician is educating a patient about the effects of marijuana. The patient stated that she has been smoking for years and believes the use does not interfere with her life. What is the potential long-term sequelae of marijuana use that the clinician should educate this patient about? A. Memory impairment B. Sexual dysfunction C. Dry mouth D. There are no long-term consequences of marijuana use

A. Memory impairment

Which of the following is an appropriate strategy to manage constipation? A. Mildly exercise after breakfast. B. Five timed minutes on the toilet in which to defecate. C. Drink at least 48 ounces of fluids daily. D. Immediately begin pharmacologic treatment.

A. Mildly exercise after breakfast.

A 25-year-old accountant is seen in the clinic complaining of crampy abdominal pain after meals. She is often constipated and takes laxatives, which are followed by a couple of days of diarrhea. She temporarily feels better after a bowel movement. She states she is embarrassed by flatulence and has abdominal distension. She has had no weight loss or blood in her stool. This problem has gone on for about 6 months. What should the next step be? A. Obtain a complete history. B. Order a barium enema. C. Schedule a Bernstein's test. D. Prescribe a trial of antispasmodics.

A. Obtain a complete history.

A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses? A. Pancreatitis B. Urinary tract infection C. Prostate tumor D. Gastroesophageal reflux disease

A. Pancreatitis

The "freezing phenomenon" is a cardinal feature of: A. Parkinson's disease B. Alzheimer's disease C. A cerebrovascular accident (CVA) D. Bell's palsy

A. Parkinson's disease

The stooped posture, motor slowness, and minor cognitive impairments of patients with major depressive disorders are similar to the signs of disorders of the basal ganglia, such as: A. Parkinson's disease B. Stevens-Johnson syndrome C. Neurological disease D. Huntington's disease

A. Parkinson's disease

Which of the following aspects of the patient history is a hallmark of delirium? A. Patient has chronic kidney disease. B. Patient has had aphasia for a year. C. Patient has diabetes mellitus. D. Patient has been getting lost driving home.

A. Patient has chronic kidney disease.

The patient is diagnosed with acute renal failure (ARF). Which of the following data obtained from the history should alert the provider that this is a case of prerenal azotemia? A. Patient is on lisinopril B. Nephrolithiasis C. Recent infection where gentamicin was used in treatment D. Ureteral obstruction

A. Patient is on lisinopril

Which of the following patients should be referred to a hepatologist? A. Patient with persistent elevation of HBsAg B. Patient with anti-HAV IgG C. Patient with IgG anti-HBs D. Patient with anti-HEV

A. Patient with persistent elevation of HBsAg

What is the first-line recommended treatment against Group A beta-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis? A. Penicillin B. Quinolone C. Cephalosporin D. Macrolide

A. Penicillin

All benzodiazepines are associated with: A. Potential anterograde amnesia B. Dopamine-related movement disorders C. Serotonin syndrome D. Xerostomia and agitation

A. Potential anterograde amnesia

Which of the following are predisposing factors for pyelonephritis? A. Pregnancy B. Dehydration C. Smoking D. Alkaline urine

A. Pregnancy

A patient presents with CVA tenderness and a several-day history of high fever, chills, and dysuria. Which of the following diagnoses is most likely given the above information? A. Pyelonephritis B. Cystitis C. Renal calculi D. Bladder tumor

A. Pyelonephritis

Marci has been started on a TB regimen. Because isoniazid (INH) may cause peripheral neuropathy, you consider ordering which of the following drugs prophylactically? A. Pyridoxine B. Thiamine C. Probiotic D. Phytonadione

A. Pyridoxine

Instead of reporting symptoms of body dysmorphic disorder (BDD) to the primary-care provider, patients often request which of the following? A. Referrals to plastic surgeons, orthodontists, or dermatologists B. Antidepressant medications C. Nutritional counseling services D. Unnecessary laboratory tests

A. Referrals to plastic surgeons, orthodontists, or dermatologists

The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is NOT true concerning SSRIs in comparison to tricyclic antidepressants? A. SSRIs are more effective than TCAs. B. SSRIs take less time to work than TCAs. C. SSRIs have a more favorable side-effect profile than TCAs. D. SSRIs are not lethal in overdose.

A. SSRIs are more effective than TCAs.

A 34-year-old patient was treated for a UTI and has not responded to antibiotic therapy. Which of the following actions should be taken next? A. Send a urine specimen for microscopy and evaluate for fungal colonies. B. Increase the dose of antibiotic. C. Order a cystoscopy. D. Order a different antibiotic.

A. Send a urine specimen for microscopy and evaluate for fungal colonies.

What is the presentation of a complex motor tic? A. Simultaneous shoulder shrugs and head turns B. Eye blinks and extension of extremities C. Throat clearing and finger raising D. Barking, screaming, and snorting

A. Simultaneous shoulder shrugs and head turns

What is a differential diagnosis of autism spectrum disorder? A. Speech sound disorder B. Duchenne muscular dystrophy C. Structural brain malformations D. Hypoxic ischemic brain injury

A. Speech sound disorder

George has COPD and an 80% forced expiratory volume in 1 second. How would you classify the severity of his COPD? A. Stage 1 mild COPD B. Stage 2 moderate COPD C. Stage 3 severe COPD D. Stage 5 very severe COPD

A. Stage 1 mild COPD

Gail, a 35-year-old female patient, is seen in the clinic in the morning. She complains of abrupt onset of nausea, vomiting, colicky abdominal cramps, and profuse watery diarrhea that began last night. Her vitals are BP: 110/70, HR: 110, temperature: 99°F, RR: 12. She recently came back from a vacation in Switzerland, ate leftovers for dinner last night, and had a cold 2 weeks ago. Which of the following is the most probable cause of her condition? A. Staphylococcus B. Shigella C. Rotavirus D. Entamoeba histolytica

A. Staphylococcus

What is the most common cause of CAP? A. Streptococcus pneumoniae B. Klebsiella pneumoniae C. Legionella pneumoniae D. Pseudomonas aeruginosa

A. Streptococcus pneumoniae

Which of the following instructions should be given to the patient with nephrolithiasis? A. Take ibuprofen, 600 mg every 8 hours. B. Take Tums for stomach upset. C. Drink more black tea. D. Increase intake of vegetables, like spinach.

A. Take ibuprofen, 600 mg every 8 hours.

Marta is taking TB drugs prophylactically. How do you instruct her to take them? A. Take them on an empty stomach to facilitate absorption. B. Take them with aspirin (ASA) to prevent flushing. C. Take them with ibuprofen to prevent a headache. D. Take them with food to prevent nausea.

A. Take them on an empty stomach to facilitate absorption.

Which information should be included when you are teaching your patient about the use of nicotine gum? A. The gum must be correctly chewed to a softened state and then placed in the buccal mucosa. B. Patients should not eat for 30 minutes prior to or during the use of the gum. C. Initially, 1 piece is chewed every 30 minutes while awake. D. Acidic foods and beverages should be encouraged during nicotine therapy.

A. The gum must be correctly chewed to a softened state and then placed in the buccal mucosa.

A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? A. Very early B. 3 to 4 hours after perforation C. Late in inflammation D. Appendicitis never presents with vague pain

A. Very early

Robin is a 57-year-old female presenting with diffuse abdominal pain. Which of the following statements from the provider to Robin is correct? A. "It does not matter that you feel pain not only in your stomach but also in your shoulder." B. "Does moving around change the nature of your pain?" C. "All causes of abdominal pain do not necessitate a surgical referral." D. "I noticed on examination that your stomach is rigid, and you stated your pain is quite severe. It is only necessary for a nurse to see you concerning this problem."

B. "Does moving around change the nature of your pain?"

A patient is diagnosed with overactive bladder. Which of the following instructions should be given to this woman? A. "Limit the amount of water that you drink." B. "Eliminate caffeine from your diet." C. "Wear panty liners." D. "You should not attempt pregnancy."

B. "Eliminate caffeine from your diet."

A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which of the following questions should be asked? A. "Do you have a history of liver disease?" B. "What medications are you currently taking?" C. "Have you noticed swelling in your ankles?" D. "Do you have an autoimmune condition?"

B. "What medications are you currently taking?"

What is the median reduction in life expectancy among those with mental illness? A. 15.4 years B. 10.1 years C. 5.7 years D. 9.2 years

B. 10.1 years

A patient is seen in the clinic with right upper quadrant pain that is radiating to the middle of the back. The NP suspects acute cholelithiasis. The NP should expect which of the following laboratory findings? A. Decreased alanine aminotransferase and decreased aspartate aminotransferase B. Elevated alkaline phosphatase C. Decreased indirect bilirubin D. Decreased white blood cells

B. Elevated alkaline phosphatase

Which of the following is the only drug used to treat bulimia that is approved by the U.S. Food and Drug Administration? A. Sertraline B. Fluoxetine C. Citalopram D. Imipramine

B. Fluoxetine

The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety? A. Acetylcholine B. Gamma-aminobutyric acid (GABA) C. Dopamine D. Serotonin

B. Gamma-aminobutyric acid (GABA)

Carotid endarterectomy should be considered only for symptomatic patients with greater than what percentage of stenosis? A. Greater than 25% B. Greater than 50% C. Greater than 75% D. Only for 100% occlusion

B. Greater than 50%

Ron has cirrhosis and now presents with altered mental status after increasing protein intake because he was trying to increase muscle mass. Which of the following diseases should the clinician be concerned about? A. Hepatopulmonary syndrome B. Hepatic encephalopathy C. Hepatorenal syndrome D. Spontaneous bacterial peritonitis

B. Hepatic encephalopathy

Jason, age 62, has obstructive sleep apnea. What do you think is one of his contributing factors? A. He is a recovering alcoholic of 6 years. B. His collar size is 17 inches. C. He is the only person in his family who has this. D. He is extremely thin.

B. His collar size is 17 inches.

When a patient has a carotid bruit, which of the following should the PCP gather from the patient history? A. History of hemophilia B. History of peripheral vascular occlusive disease C. History of seizure disorder D. History of sickle cell disease

B. History of peripheral vascular occlusive disease

A 42-year-old woman is seen in the clinic with fever, chills, vomiting, and severe dysuria. She is diagnosed with acute pyelonephritis. How should this patient be managed? A. 3-day course of oral antibiotics B. Hospitalization C. Encourage cranberry juice intake D. 6-week course of antibiotics

B. Hospitalization

HITS is a validated instrument used to identifying intimate partner violence. What does HITS stand for? A. Hit, Injured, Threatened, Scared B. Hurt, Insult, Threaten, Scream C. Humiliated, Isolated, Tortured, Scarred D. Harm, Injury, Terror, Shame

B. Hurt, Insult, Threaten, Scream

The barrel-chest characteristic of emphysema is a result of: A. Chronic coughing B. Hyperinflation C. Polycythemia D. Pulmonary hypertension

B. Hyperinflation

Which of the following neuroendocrine abnormalities is implicated in depression? A. Decrease in adrenal size B. Hypersecretion of cortisol C. An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing hormone D. Increased inhibitory response of glucocorticoids to dexamethasone

B. Hypersecretion of cortisol

Which of the following should be started promptly if viral encephalitis is suspected? A. Oral amoxicillin B. IV acyclovir C. IV ampicillin D. Oral acyclovir

B. IV acyclovir

Which of the following is true regarding the cause of isolated hematuria? A. It is usually caused by anemia. B. It can be due to bleeding in the urethra. C. It is can be due to hemoglobinopathies. D. It is usually due to sickle cell disease.

B. It can be due to bleeding in the urethra.

Which statement about adenocarcinoma of the lung is accurate? A. It is the least common type of lung cancer, representing approximately 5% to 10% of cases. B. It is the most prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35% to 40% of all tumors. C. It is more common in men than in women and occurs almost entirely in cigarette smokers. D. It is aggressive, with rapid growth in primarily the liver and brain.

B. It is the most prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35% to 40% of all tumors.

Which of these is one of the most common dietary triggers of IBS? A. Gluten-free items B. Lactose C. Honey D. Meat

B. Lactose

What is a procedure that can be performed in the outpatient setting for a patient with obstructive sleep apnea? A. Mandibular advancement B. Laser-assisted uvulopalatoplasty C. Retroglossal obstruction removal D. Uvulopalatopharyngoplasty

B. Laser-assisted uvulopalatoplasty

When proteinuria is detected in a low-risk patient, which laboratory testing should be ordered in addition to Bence Jones proteins? A. Serum glucose B. Lipid panel C. Hemoglobinopathy D. Cerebrospinal fluid (CSF) lumbar puncture

B. Lipid panel

African American patients seem to have a negative reaction to which of the following asthma medications? A. Inhaled corticosteroids B. Long-term beta-agonist bronchodilators C. Leukotriene-receptor agonists D. Oral corticosteroids

B. Long-term beta-agonist bronchodilators

What is the essential feature of bipolar-I? A. Hyperactivity B. Mania C. Depression D. Anxiety

B. Mania

What severity level of intellectual disability is demonstrated by a child whose language and academic skills markedly lagging behind peers, misperceive social cues, and have a simpler spoken language than their peers? A. Mild B. Moderate C. Severe D. Profound

B. Moderate

Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help given IV once a month? A. Glatiramer acetate B. Natalizumab C. Fingolimod D. Glucocorticoids

B. Natalizumab

A patient is seen in the clinic and diagnosed with Stage I renal cancer. The provider should refer the patient to a nephrologist for which of these treatments? A. Chemotherapy B. Nephrectomy C. Palliative treatment D. Radiation

B. Nephrectomy

What is the likely result of the over-prescription, over-supply, and over-production of opioids? A. Opioid use B. Opioid abuse C. Opioid dependence D. Opioid resistance

B. Opioid abuse

What is a common adverse reaction for children prescribed Risperdal for autism-associated irritability? A. Gynecomastia B. Parkinsonian-like syndrome C. Bradycardia D. Rebound hypertension

B. Parkinsonian-like syndrome

Which intervention has been shown to diminish feelings of isolation, improve coping skills, and decrease the need for hospitalization in schizophrenia? A. Cognitive behavioral therapy B. Peer-delivered services C. Family-based therapy D. Assertive community treatment (ACT) model of care

B. Peer-delivered services

Suicide plans are assessed on all of the following, EXCEPT: A. Specificity B. Possibility C. Availability D. Lethality

B. Possibility

Elaine is a 32-year-old Hispanic woman who is 33 weeks pregnant. She complains that when she wipes after defecation she noticed "a red streak on the toilet paper." Which of the following should be included in the differential diagnosis? A. Gastric ulcer B. Rectal prolapse C. Diverticulitis D. Irritable bowel syndrome

B. Rectal prolapse

The result of the patient's 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions? A. Repeat the test. B. Refer to a nephrologist. C. Measure the serum protein. D. Obtain a blood urea nitrogen (BUN) and creatinine.

B. Refer to a nephrologist.

Over the course of 3 years, a patient has had two MS flares. The patient's primary complaints during the episodes are bilateral tingling and pain in their legs, depression, and numbness in their right hand with complete recovery in between occurrences. Which MS classification fits their disease process? A. Clinically isolated syndrome B. Relapsing-remitting C. Primary progressive D. Secondary progressive

B. Relapsing-remitting

Which of these patients should be evaluated with serum alpha-antitrypsin levels? A. Jamie, a 70-year-old female with COPD with a history of smoking B. Ron, a 43-year-old male with COPD with a history of smoking C. Leslie, a 60-year-old female with clinical emphysema and no history of smoking D. Marshall, a 55-year-old male with clinical emphysema and no family history of early-onset COPD

B. Ron, a 43-year-old male with COPD with a history of smoking

Which of the following patients would you expect to have a decreased response to TST? A. Julie, a 50-year-old postal worker with hypertension B. Sandy, a 40-year-old patient who recently survived a fire that left 40% of her total body surface covered in burns C. Jill, a 16-year-old cheerleader with type 1 diabetes D. Mark, a 29-year-old tennis player who currently has a cold

B. Sandy, a 40-year-old patient who recently survived a fire that left 40% of her total body surface covered in burns

The health-care provider is treating a patient who was hit in the head with a frying pan. Which of the following should the provider suspect? A. Intraparenchymal hemorrhage B. Subdural hematoma C. Epidural hematoma D. Subarachnoid hematoma

B. Subdural hematoma

Which of the following patients is at risk for developing urinary-tract cancer? A. The 45-year-old woman who is 10 lbs underweight B. The 78-year-old man who smokes three packs of cigarettes a day C. The 84-year-old man who worked in an office setting D. The 25-year-old woman who has a lactose allergy

B. The 78-year-old man who smokes three packs of cigarettes a day

Which of the following statements regarding TST is true? A. Tests should be read 48 hours after the injection. B. The size of the TST reaction has nothing to do with erythema but is based solely on induration. C. It is a type V T-cell-mediated immune response. D. The diameter of the induration is measured in centimeters.

B. The size of the TST reaction has nothing to do with erythema but is based solely on induration.

Which of the following asthma medications should be used cautiously with geriatric patients? A. Atrovent B. Ventolin C. Singulair D. Asmanex

B. Ventolin

What prenatal factor could increase risk for ADHD? A. Exposure to lead B. Zinc deficiency C. Maternal allergies D. Central nervous system (CNS) infections

B. Zinc deficiency

A 78-year-old man says he has been diagnosed with Stage 0 bladder cancer and asks the provider what that means. Which is the best response? A. "There is no such thing as Stage 0 cancer." B. "You have cancer that has spread to the surrounding tissue." C. "Your cancer has spread to other organs." D. "Your cancer must be cured by removing your bladder."

C. "Your cancer has spread to other organs."

Hannah is a patient that just had an appendectomy after a diagnosis of appendicitis and had no complications. Which of the following patient education points is correct? A. "You will need to take laxatives to encourage defecation post-surgery." B. "You will need to stay in the hospital for 2 weeks to recover." C. "Your diet will be advanced when bowel sounds return." D. "I will put you on narcotics to manage your pain."

C. "Your diet will be advanced when bowel sounds return."

Which of the following are included in the Ranson's criteria for assessing the severity of pancreatitis at the time of diagnosis? A. Blood glucose 180 mg/dL B. Age 45 years old C. Base deficit greater than 4 mEq/L D. Serum LDH greater than 25 IU/L

C. Base deficit greater than 4 mEq/L

A patient is seen with dark-colored urine, and the urine dipstick reveals a high level of bilirubin. Which of the following could be a cause of this problem? A. Increased bilirubin uptake B. Increased bilirubin excretion C. Biliary obstruction D. A serum bilirubin level of 0.5 mg/dL

C. Biliary obstruction

41. Which of the following conditions is associated with cigarette smoking? A. Glaucoma B. Increased sperm quality C. Bladder cancer D. Eczema

C. Bladder cancer

A 27-year-old female presents with a chief complaint of burning and pain on urination. She has no previous history of urinary tract infection (UTI). What are some additional symptoms consistent with a diagnosis of lower UTI? A. Thick, green discharge B. Fever, chills, costovertebral angle (CVA) tenderness C. Blood in urine and frequency D. Foul-smelling discharge, perineal itch

C. Blood in urine and frequency

Which medication is used as a first-line treatment in the management of bipolar disorder? A. Gabapentin B. Lamotrigine C. Carbamazepine D. Topiramate

C. Carbamazepine

Sam, age 78, presents to the clinic with respiratory symptoms. His pulmonary function tests are as follows: a normal total lung capacity, a decreased PaO2, and an increased PaCO2. On assessment, you auscultate coarse crackles and forced expiratory wheezes. What is your diagnosis? A. Asthma B. Emphysema C. Chronic bronchitis D. Influenza

C. Chronic bronchitis

The nurse practitioner (NP) suspects a patient has a peptic ulcer. Which of the following items on the history would lead the NP to this conclusion? A. Use of fish oil vitamin B. Ethanol avoidance C. Cigarette smoking D. Prednisone use

C. Cigarette smoking

A patient is diagnosed with urge incontinence. Before prescribing Detrol LA, the provider should question the patient about which of these contraindications to this medication? A. Diarrhea B. Parkinson's disease C. Closed-angle glaucoma D. Breast cancer

C. Closed-angle glaucoma

When administered at the beginning of an attack, oxygen therapy may help this kind of headache? A. Tension B. Migraine C. Cluster D. Stress

C. Cluster

A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as: A. Spinothalamic dysfunction B. Ratcheting C. Cogwheeling D. Hand tremors

C. Cogwheeling

Which of these patients should be given a decongestant? A. Gerta, a 41-year-old female with GERD B. Christine, a 15-year-old female with pneumonia C. Dan, a 60-year-old male with allergic rhinitis D. Andy, a 26-year-old with cystic fibrosis

C. Dan, a 60-year-old male with allergic rhinitis

Sondra's peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear? A. Meclizine B. Diphenhydramine C. Diamox D. Promethazine

C. Diamox

Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter? A. GABA B. Acetylcholine C. Dopamine D. Serotonin

C. Dopamine

Which statement is true regarding driving and patients with a seizure disorder? A. Once diagnosed with a seizure disorder, patients must never drive again. B. After being seizure free for 6 months, patients may drive. C. Each state has different laws governing driving for individuals with a seizure disorder. D. These persons may drive but never alone.

C. Each state has different laws governing driving for individuals with a seizure disorder.

What is recorded as clinical category two of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision)? A. Clinical disorder or focus of clinical attention B. Personality or environmental problems C. Environmental and psychosocial stressors D. Global assessment of functioning

C. Environmental and psychosocial stressors

Rapid eye movement (REM) sleep occurs how frequently during non-REM sleep? A. Every 30 to 40 minutes B. Every 60 to 80 minutes C. Every 90 to 100 minutes D. Every 180 to 200 minutes

C. Every 90 to 100 minutes

Most nosocomial pneumonias are caused by: A. Fungi B. Viruses C. Gram-negative bacteria D. Pneumococcal pneumonia

C. Gram-negative bacteria

Which of the following would be important to monitor in a child receiving methylphenidate for treatment of attention deficit-hyperactivity disorder (ADHD)? A. Liver function B. Vision C. Growth parameters D. Renal function

C. Growth parameters

Cameron, 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had intermittent heartburn for several months and takes antacids with temporary relief. He has been waking during the night with a burning sensation in his chest. Which additional information would lead you to believe that gastroesophageal reflux disease (GERD) is the cause of his pain? A. The pain seems better when he smokes to relieve his nerves. B. Coffee and fried foods don't bother him. C. He wakes at night coughing with a bad taste in his mouth. D. He likes to wear loose clothing.

C. He wakes at night coughing with a bad taste in his mouth.

Which of the following must be completed prior to administering TPA (tissue plasminogen activator)? A. Full-body MRI B. Head x-ray C. Head CT D. Head MRI

C. Head CT

Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking? A. He should stop smoking today. B. He should stop smoking tomorrow. C. His quit date should be in 1 week. D. He will be ready to quit after the first 30 days.

C. His quit date should be in 1 week.

A 29-year-old is seen in the office with complaints of pain in his chest and belly. He quit smoking 6 months ago. He has been suffering the pain for 2 weeks and gets temporary relief from Alka-Seltzer® and Pepto-Bismol®. The burning pain wakes him at night and radiates up to his chest. Which factor favors a diagnosis of gastric ulcer? A. His use of Pepto-Bismol B. His age C. His use of Alka-Seltzer D. His smoking cessation

C. His use of Alka-Seltzer

Leslie is a 35-year-old Caucasian woman who presents with weakness, anorexia, weight loss, and fatigue. Her history is significant for inflammatory bowel disease, Hashimoto's thyroiditis, and cigarette smoking. Which of the following pieces of her history leads the clinician to believe she has primary sclerosing cholangitis? A. Age B. Gender C. Inflammatory bowel disease D. Smoker

C. Inflammatory bowel disease

Which of the following is a possible consequence of sleep apnea? A. Asthma B. Increased white blood cells C. Insulin resistance D. Hyperactivity

C. Insulin resistance

Carl has been diagnosed with Wilson's disease. Which of the following should be included in his dietary education? A. Avoid calcium-containing foods. B. Increase protein intake with peanut butter. C. Limit shrimp intake. D. Increase fat intake by eating liver.

C. Limit shrimp intake.

Which of the following causes of gastrointestinal bleeding is found in the lower gastrointestinal tract? A. Erosive esophagitis B. Duodenal ulcer C. Meckel's diverticulum D. Gastric ulcer

C. Meckel's diverticulum

A patient is diagnosed with Giardia lamblia after a backpacking trip in the mountains. Which of the following would be an appropriate treatment? A. Vancomycin B. Penicillin C. Metronidazole D. Bactrim

C. Metronidazole

Annie is a 30-year-old African American woman that complains of "coughing up blood." What is a likely cause of her condition? A. Bronchogenic carcinoma B. Pulmonary embolus with infarction C. Mitral stenosis D. Bronchitis

C. Mitral stenosis

Cydney presents with a history of asthma. She has not been treated for a while. She complains of daily but not continual symptoms, greater than 1 week and at nighttime. She has been using her rescue inhaler. Her FEV1 is 60% to 80% predicted. How would you classify her asthma severity? A. Mild intermittent B. Mild persistent C. Moderate persistent D. Severe persistent

C. Moderate persistent

Ryan has a UTI and has been prescribed Ceclor. Which of the following side effects should he be made aware of? A. Emesis B. Abdominal discomfort if taken without food C. Nausea D. Flatulence

C. Nausea

What is the most prevalent psychiatric comorbidity of ADHD? A. Antisocial personality disorder B. Generalized anxiety disorder C. Oppositional defiant disorder D. Social phobias

C. Oppositional defiant disorder

Which of the following is a risk factor for developing Alzheimer's disease? A. Having a master's or doctoral degree B. Patient is a physician C. Patient has Down's syndrome D. History of neurological disease

C. Patient has Down's syndrome

Which of the following medications may be linked to dysuria? A. Vitamin A B. Mirena C. Paxil D. Gabapentin

C. Paxil

A patient comes to the office complaining of constipation. The patient lists all of the following medications. Which drug could be responsible for the constipation? A. Multivitamin B. Magnesium hydroxide C. Pepto-Bismol® D. Ibuprofen

C. Pepto-Bismol®

Which of the following may be used to evaluate a person's suicide risk? A. CAGE B. SANE C. SAD PERSONAS D. DIGFAST

C. SAD PERSONAS

Why do you suspect that your patient may have a decreased response to the tuberculin skin test (TST)? A. She is on a high-protein diet. B. She is an adolescent. C. She has been on a long-term corticosteroid therapy. D. She just got over a cold.

C. She has been on a long-term corticosteroid therapy.

Laqueena has chronic kidney disease (CKD). Her glomerular filtration rate (GFR) is 33 mL/min per 1.73 m2 of body surface area. Which of the stages does her GFR fall under, as defined by the Third National Health and Nutrition Examination Survey? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4

C. Stage 3

Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean? A. The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the distant spread cannot be evaluated. B. The cancer is in situ; it is spreading into the lymph nodes but the spread cannot be evaluated otherwise. C. The cancer is less than 3 cm in size and has not spread to the lymph nodes or other parts of the body. D. The cancer is about 5 cm in size; nearby lymph nodes cannot be evaluated; and there is no evidence of distant spreading.

C. The cancer is less than 3 cm in size and has not spread to the lymph nodes or other parts of the body.

A patient is diagnosed with GERD, and his endoscopic report reveals the presence of Barrett's epithelium. Which of the following should the PCP include in the explanation of the pathology report? A. This is not premalignant tissue. B. This tissue is not resistant to gastric acid. C. This tissue supports healing of the esophagus. D. This tissue does not have an increased risk of developing esophageal adenocarcinoma.

C. This tissue supports healing of the esophagus.

What is the leading preventable cause of death and disability? A. Opioid addiction B. Obesity C. Tobacco use D. Stress

C. Tobacco use

A patient is experiencing extrapyramidal side effects from his antipsychotic medications. The clinician would most likely take which of the following approaches to treating these side effects? A. Give the patient a "drug holiday" until the symptoms resolve and then restart the medication. B. Switch the patient to a different antipsychotic. C. Treat the patient with anticholinergics. D. Treat the patient with anticonvulsants.

C. Treat the patient with anticholinergics.

A 40-year-old woman presents to the clinic with complaints of dull and achy flank pain and hematuria. She also notes, "I think I have a mass in my stomach." She works in a chemical plant and has a sedentary lifestyle. Which of the following parts of her history lead the clinician to believe she may have renal cell carcinoma? A. Age B. Gender C. Works in chemical plant D. Sedentary lifestyle

C. Works in chemical plant

What blood alcohol level corresponds with the signs of stupor and confusion? A. 0.05 B. 0.1 C. 0.2 D. 0.3

D. 0.3

Supplemental oxygen for how many hours per day has been shown to improve the mortality associated with COPD? A. 3 hours B. 6 hours C. 11 hours D. 15 hours

D. 15 hours

After discontinuing fluoxetine, how long must a person wait before starting a monoamine oxidase inhibitor? A. 2 weeks B. 3 weeks C. 4 weeks D. 5 weeks

D. 5 weeks

An 86-year-old woman is seen in the clinic for recurrent hematuria. The provider suspects bladder cancer. Which of the following data from the history is considered a risk factor for this type of cancer? A. History of alcoholism B. Sedentary lifestyle C. Obesity D. 65-year smoking history

D. 65-year smoking history

Which patient is more likely to have a cluster headache? A. A female in her reproductive years B. A 40-year-old African American male C. A 55-year-old female who drinks 10 cups of coffee daily D. A 45-year-old male awakened at night

D. A 45-year-old male awakened at night

Donna is a 36-year-old African American woman with chronic pancreatitis. Which of the following are necessary to manage her condition? A. One alcoholic drink a week maximum B. NSAIDs, which are the only analgesic appropriate for pain relief C. Treating serum glucose levels of 200 to 250 mg/dL D. A low-fat diet of less than 50 g of fat per day

D. A low-fat diet of less than 50 g of fat per day

Based on these patients' histories, which of the following should receive fungal serology testing for their chronic cough? A. A patient with a history of sickle cell disease B. A patient with a history of multiple sclerosis C. A patient with a history of celiac disease D. A patient with a history of AIDS

D. A patient with a history of AIDS

A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack? A. Pheochromocytoma B. Hyperthyroidism C. Cardiac arrhythmias D. All of the above

D. All of the above

If stimulant drugs are not tolerated or contraindicated for the treatment of ADHD, what medication may produce a therapeutic effect? A. Daytrana B. Vyvanse C. Warfarin D. Atomoxetine

D. Atomoxetine

Which of the following types of proteinuria is associated with Hodgkin's disease? A. Tamm-Horsfall proteinuria B. Tubulointerstitial area involvement C. Altered glomerular capillary permeability D. Bence Jones proteinuria

D. Bence Jones proteinuria

The clinician is speaking with Bernadette, who has recently been diagnosed with urinary incontinence. She has had this condition for a number of years, she is 5 feet 5 inches, and she weighs 140 pounds. Which of the following should the health-care provider be aware of? A. It is uncommon that Bernadette has this condition because she is female. B. Most patients should wait 3 months for follow-up after diagnosis. C. Since Bernadette has a regular body mass index, she probably has a positive body image. D. Bernadette may be suffering from depression and may need a psychiatric consult.

D. Bernadette may be suffering from depression and may need a psychiatric consult.

A patient with hypertension comes in and insists that one of his new medications is causing him to cough. When looking at his list of medications, you think the cough must be from: A. Metoprolol B. Clopidogrel C. Tadalafil D. Captopril

D. Captopril

Which of the following statements regarding pulmonary function and cigarette smoking is true? A. Cigarette smoking causes an increase in circulating immunoglobulin levels. B. Cigarette smoking has no increased risk of COPD. C. Cigarette smoking decreases mucus production. D. Cigarette smoking increases the risk of pneumothorax.

D. Cigarette smoking increases the risk of pneumothorax.

Which of the following is considered first-line treatment for panic disorders? A. Benzodiazepines B. Selective serotonin reuptake inhibitors (SSRIs) C. Tricyclic antidepressants D. Cognitive behavioral therapy

D. Cognitive behavioral therapy

Nathan, a 32-year-old policeman, has a 15-pack-a-year history of smoking and continues to smoke heavily. During every visit, he gets irate when you try to talk to him about quitting. What should you do? A. Hand him literature about smoking cessation at every visit. B. Wait until he is ready to talk to you about quitting. C. Document in the record that he is not ready to quit. D. Continue to ask him at every visit if he is ready to quit

D. Continue to ask him at every visit if he is ready to quit

Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of: A. Dementia B. Alzheimer's disease C. Parkinson's disease D. Delirium

D. Delirium

According to Kübler-Ross, the stages of grief occur in which order? A. Anger, denial, depression, bargaining, acceptance B. Anger, denial, bargaining, acceptance, depression C. Denial, anger, depression, bargaining, acceptance D. Denial, anger, bargaining, depression, acceptance

D. Denial, anger, bargaining, depression, acceptance

A patient with MS is complaining of new-onset "electric tingling" in both their arms. Which medication specifically treats these acute exacerbations? A. Lemtrada B. Aubagio C. Zanaflex D. Depo-Medrol

D. Depo-Medrol

Angela is a 30-year-old G0P0 biracial Asian and Caucasian woman. Her body mass index (BMI) is 22 and her history includes anemia, epilepsy, and bee-sting allergy. Which of the following parts of her patient history would increase her risk of cholelithiasis? A. Nulliparity B. Bee-sting allergy C. BMI 22 D. Female gender

D. Female gender

Which of the following strategies is useful when managing hypertension in a patient with CKD? A. Keep HbA1c of less than 7.5%. B. For a patient with proteinuria of more than 1 g/day, target BP is 135/85 mm Hg. C. Avoid systolic BP less than 100 mm Hgc. D. For a patient with proteinuria of less than 1 g/day, goal BP is no more than 130/80 mm Hg.

D. For a patient with proteinuria of less than 1 g/day, goal BP is no more than 130/80 mm Hg.

Which of the following is a condition that results in colicky abdominal pain? A. Peptic ulcers B. Glisson's capsule around the liver C. Peritoneum irritation D. Gallstones

D. Gallstones

Which of the following indicates a diagnosis of dementia? A. Onset after an infection B. Abrupt onset over a week C. Difficulty with long-term memory D. Hard time finding words

D. Hard time finding words

You are using the CURB-65 clinical prediction tool to decide whether Latisha, whom you have diagnosed with community-acquired pneumonia (CAP), should be hospitalized or treated at home. Which of the following risk factors would increase Latisha's chance of CAP-associated mortality and complications? A. Temperature of 100°F B. Respiratory rate 22 breaths per minute C. Hemoglobin 9.5 g/dL D. History of diabetes mellitus

D. History of diabetes mellitus

Amy has a history of lung cancer and is experiencing new-onset right side ptosis and miosis and says, "I'm so hot, but I'm not sweating." Which of the following conditions can be attributed to her new-onset symptoms? A. Bell's palsy B. Turner's syndrome C. Murphy's syndrome D. Horner's syndrome

D. Horner's syndrome

A patient is presenting with chorea (dance-like movements). Which of the following diseases might the patient have? A. Dementia B. Parkinson's disease C. Wilson's disease D. Huntington's disease

D. Huntington's disease

Which of the following medications will help reduce urinary excretion of nephrolithiasis-forming substances? A. Furosemide B. Triamterene C. Calcium supplement D. Hydrochlorothiazide

D. Hydrochlorothiazide

Which of the following physical examination manifestations are consistent with a patient in ARF? A. Weight gain B. Glycosuria C. Irritability D. Hypotension

D. Hypotension

Which of the following is true of appendicitis? A. Appendicitis is more common in Asian countries. B. Family history of appendicitis does not increase a patient's risk of having appendicitis. C. Appendicitis is most common between the ages of 40 and 60. D. If appendicitis occurs in infants, it is associated with higher morbidity.

D. If appendicitis occurs in infants, it is associated with higher morbidity.

What is the health impact of low-dose alcohol consumption? A. Increased risk of developing alcohol addiction B. Increased risk of coronary artery disease C. Increased excitation of critical ion channels D. Increased high-density lipoproteins

D. Increased high-density lipoproteins

What is the advantage of guanfacine (i.e., Tenex, Intuniv) over clonidine (i.e., Catapres, Kapvay) for the treatment of ADHD? A. Tapering off is not required on discontinuation B. Therapeutic effect is instantaneous C. Wider range of available dosages D. Less sedation and longer duration of action

D. Less sedation and longer duration of action

A score of 12 to 24 on this test indicates intermediate Alzheimer's disease: A. SLUMS B. MoCA C. FAST D. MMSE

D. MMSE

Which of the following is a potential adverse reaction to clozapine (Clozaril)? A. Prolonged QT interval B. Hyperprolactinemia C. Postural hypotension D. Myocarditis

D. Myocarditis

Bipolar disorder requires differential diagnosis from all of the following except? A. Substance abuse and medication effects B. Medical and neurological disorders C. Cluster B personality disorders and depression D. Obsessive-compulsive disorder

D. Obsessive-compulsive disorder

Each of the following antidepressants does NOT have significant liver CYP P450 interaction effects? A. Paroxetine B. Fluoxetine C. Fluvoxamine D. Olanzapine

D. Olanzapine

It is important for the clinician to discuss the long-term effects of sexual assault with survivors. Which of the following is the most common long-term effect of sexual assault? A. Depression B. Obsessive-compulsive disorder C. Substance abuse D. PTSD

D. PTSD

A 28-year-old patient is seen with complaints of diarrhea. Which of the following responses to the history questions would help the primary-care provider (PCP) establish the diagnosis of irritable bowel syndrome (IBS)? A. Feels relief after urination B. Pain wakes up patient from sleep C. Defecates in the middle of the night D. Pain is precipitated by eating

D. Pain is precipitated by eating

Which of the following has been linked to a delay in treatment for stroke? A. Patient has stroke symptoms at work. B. Patient experiences stroke during the day. C. Patient lives with a family member. D. Patient calls their primary-care provider (PCP) instead of 911 at sign of stroke.

D. Patient calls their primary-care provider (PCP) instead of 911 at sign of stroke.

A 35-year-old female patient is seen in the clinic complaining of abdominal pain. Which of the following should be included in the examination? A. Lumbar puncture B. Family history of cardiac problems C. Contrast venography D. Pelvic exam

D. Pelvic exam

Which statement about confusion is true? A. Confusion is a disease process. B. Confusion is always temporary. C. Age is a reliable predictor of confusion. D. Polypharmacy is a major contributor to confusion in older adults.

D. Polypharmacy is a major contributor to confusion in older adults.

Which of the following signs would a health-care provider expect to see in a patient with Parkinson-plus disorder? A. Resting tremor B. Bradykinesia C. Rigidity D. Postural instability

D. Postural instability

Madeline is a smoker in a primary-care visit with her provider. After her provider asks if she is willing to quit, she says she has decided to quit, has bought nicotine gum, and is interested in hearing about Chantix. Which of the following steps is Madeline in regarding behavioral changes and her attempts at cessation? A. Precontemplation B. Action C. Maintenance D. Preparation

D. Preparation

Talia has bladder cancer that has grown into the fatty tissue surrounding the bladder and to her vagina. The cancer has not spread to distant sites or lymph nodes. What is an appropriate treatment option? A. Palliative care only B. External beam radiation therapy C. Only chemotherapy is appropriate D. Radical cystectomy and lymph node resection

D. Radical cystectomy and lymph node resection

The forced vital capacity is decreased in: A. Asthma B. Chronic bronchitis C. Emphysema D. Restrictive disease

D. Restrictive disease

Which of the following is a specific test to MS? A. Magnetic resonance imaging (MRI) B. Computed tomography (CT) scan C. A lumbar puncture D. There is no specific test

D. There is no specific test

Which of the following information patients with a UTI can receive Bactrim DS? A. Mary, a 25-year-old who is 25 weeks pregnant B. Donna, a 55-year-old with an allergy to sulfa C. Lisa, a 33-year-old who is breastfeeding her 3-week-old daughter D. Tiffany, a 16-year-old with a hypersensitivity to penicillin

D. Tiffany, a 16-year-old with a hypersensitivity to penicillin