gka STUDY QUESTIONS
The above picture would be considered a patient having a mammography. If the patient's tissue measures 4.2 cm, the mean radiation should not exceed which of the following?
0.3 rad per image The above picture would be considered an example of a practitioner assisting a female patient with a mammography. The radiation dose should be kept as low as possible for all patients. If the patient's tissue measures 4.2 cm, then the mean radiation should not exceed 0.3 rad per image. Report a problem with this question
Serum creatinine is an indirect measure of renal function. The reference range for serum creatinine in males is:
0.7 - 1.3 mg/dL The serum creatinine for males should be between 0.7 - 1.3 mg/dL. The serum creatinine level for females should be between 0.6 - 1.1 mg/dL.
The Romberg test is used to evaluate which of the following?
cerebellar system The Romberg test is used to evaluate the cerebellar system. Tandem gait is also used for testing the cerebellar system.
You are testing a client suspected of having Parkinson's disease. You support the client's elbow with his forearm extended in your hand and grasp his wrist, flexing the forearm. You find rigid resistance to this motion. This is considered which of the following?
cogwheeling Cogwheeling is resistance to passive movement. It is best felt in the elbow, wrist, and neck.
A patient has recently been diagnosed with Addison's disease. How often should this patient's electrolytes be monitored?
every 3-4 months for the first year of therapy This is the typical schedule for monitoring electrolytes in a newly diagnosed case of Addison's disease. The client should be educated about the lifelong need for therapy to control the disease.
You suspect that your patient is experiencing an ectopic pregnancy. If this diagnosis is correct you would expect to find all of the following in an examination EXCEPT:
fever Hypotension and tachycardia may be evident with blood loss. Fever is not expected. Abdominal tenderness is present in 80% to 90% of cases. Report a problem with this question
Which of the following diagnostic studies would you use to diagnose a corneal abrasion?
fluorescein staining Fluorescein staining will reveal epithelial disruption on the cornea. A corneal abrasion may arise from a scratch, foreign body, or an object hitting the eye.The Amsler grid test looks for changes in the retina. IOP measures intraocular pressure and a gonioscopy looks at the drainage angle.
An FNP is preparing a campaign for teachers in an inner city middle school. The purpose is to decrease and eventually eliminate aggressive behavior. Which of the following would be the best method for presenting the information to the teachers?
panel presentation and small discussion groups Adult learning theory says that the older the learner, the more self-direction is needed. Since adults are "doers" an interactive session is most effective.
Of the following patients who suffer from inflammatory bowel disease (IBD) which one are you least likely to refer to an internist or gastroenterologist?
patient with familial tendency This patient is the least likely to be referred of the choices given. You would also refer a patient with acute exacerbation of symptoms.
The most common chest x-ray view is which of the following?
posterior-anterior view The most common chest x-ray view is the posterior-anterior (PA) view. Critically ill patients, however, are rarely able to tolerate the positioning requirements of a PA chest x-ray and so most chest x-rays in critical care are obtained with an anterior-posterior (AP) view.
Basic laboratory screening for hyperparathyroidism is indicated for which of the following individuals?
postmenopausal women with low bone mineral density Basic laboratory screening for hyperparathyroidism is indicated for postmenopausal women with low bone mineral density. Bone demineralization, weakness, and joint complaints may be ascribed to aging when they may actually indicate parathyroid disease. Report a problem with this question
Which of the following would be the least significant risk factor for ectopic pregnancy?
progestin use Progestin use is a significant but less potent risk factor for ectopic pregnancy. Other less potent risk factors include: current IUD use, vaginal douching, and tubal ligation failure. Other potent factors besides the ones mentioned in the other three choices are: assisted reproduction and a history of prior ectopic pregnancy.
The most common cause of secondary hypertension is which of the following?
renal conditions The most common causes of secondary hypertension are renal conditions, e.g., renal artery stenosis and renal failure. The other choices are factors in primary hypertension.
The nurse practitioner knows that red flags of important healthcare issues are all of the following EXCEPT:
School based programs School based programs do not represent as a red flag for important healthcare issues. Other red flags are the disadvantaged and vulnerability.
Your patient has "swimmer's ear." She has no other associated conditions. Your management of this patient will include which of the following?
application of local heat to outer ear for pain relief "Swimmer's ear" or otitis externa is an inflammation of the external auditory canal. Management includes application of local heat to outer ear for pain relief. Oral antibiotics are indicated only if there is associated otitis media or cellulitis of the outer ear is present. The Valsalva maneuver and decongestants are things that might be used to manage otitis media, not otitis externa.
The United States Preventive Services Task Force recommends screening older patients for depression:
at each primary care visit Depression is very common among older adults. Recommendations are to screen every adult patient in the primary care setting. Untreated depression often leads to higher rates of mortality when other co-morbid conditions exist, especially heart disease.
Which of the following is most likely when there is no p wave present on an electrocardiogram?
atrial fibrillation Atrial fibrillation is indicated by no p wave being present on an electrocardiogram. Myocardial ischemia is indicated by inverted T wave with T wave depression. Myocardial infarction is indicated by a pathologic "Q" wave. Myocardial injury is indicated by ST segment elevation with tall peaked T wave.
In which of the following cases should you refer a patient to a specialist for lower back pain?
bowel dysfunction If the patient has a bowel dysfunction, or a limb or bladder dysfunction, prompt referral to a specialist is needed. Suspicion of aortic aneurysm is also a reason for referral.
An injury to one of the ligamentous structures of the body is termed a(n):
sprain A sprain is an injury to one of the ligamentous structures of the body. A strain is trauma to a muscle or musculoskeletal unit of the body from an excessive forcible stress.
The American Academy of Pediatrics recommends infants to be fed whole cow's milk at what age?
12 months of age Since cow's milk has a low iron content, it is recommended that infants are not started on it until around age one. Additionally, formula and breast milk is fortified with protein, linoleic acid, and vitamin E whereas whole cow's milk does not contain adequate amounts of these substances.
he FNP has a pregnant patient whose uterus is grapefruit size. At what stage of pregnancy is this patient most likely to be?
12 weeks At 12 weeks the uterus is softball or grapefruit size. It rises above the symphysis pubis and the uterine fundus is palpable through the abdominal wall.
In patients with depression, the maximum recommended dose of Cymbalta is which of the following?
120 mg/day The maximum recommended dose of Cymbalta for depression is 120 mg/day.
You have a postmenopausal female patient who is 65 years of age. You would recommend which of the following as the optimal daily intake of calcium for her?
1200 mg The optimal daily intake of calcium for a woman older than 50 years of age who is postmenopausal is 1200 mg. For women 19 to 50 years of age the optimal daily intake of calcium is 1000 mg.
Lispro insulin has an onset which starts at which of the following?
15 minutes Lispro insulin has an onset which starts at 15 minutes and is considered a rapid-acting insulin. This insulin peaks in 30 minutes to 2.5 hours with a duration of 3-6.5 hours
The child of 1 - 10 years requires 80 kcal/kg/day. If a child weighs 44 lb, how many calories are needed per day?
1600 To arrive at this answer, you must first convert the child's weight to kg. 1 kg = 2.2 lb; therefore this child weighs 20 kg (44 lb ÷ 2.2). Multiply this by 80 and the result is 1600 calories.
At what stage of pregnancy is the uterine fundus at the level of the umbilicus?
20 weeks At 20 weeks (5 months) of pregnancy the uterine fundus is at the level of the umbilicus. Also the fetal heart tones are heard with a fetoscope or stethoscope. Report a problem with this question
Pulmonary hypertension is a progressive, life-threatening disorder of the pulmonary circulation characterized by high pulmonary artery pressure. Pulmonary artery pressure is considered high at which of the following levels?
> 25 mm Hg Pulmonary hypertension is a progressive, life-threatening disorder of the pulmonary circulation characterized by high pulmonary artery pressure of > 25 mm Hg leading from the right side of the heart to the lungs. This persistent high pulmonary artery pressure ultimately leads to right ventricular failure.
Bactrim should NOT be prescribed to which of the following patients?
A 1-month old child. Bactrim's safety and effectiveness has not been confirmed in children less than 2 months old. Bactrim may be prescribed with caution to pregnant women before the 38th week and to the elderly, though these patients should be watched for increased side effects.
Paul is a 67-year-old male patient with type 2 diabetes. In managing this patient's care which of the following lab tests would you have done for Paul every 3 - 6 months?
A1c The A1c test should be done every 3 - 6 months. The goal for this test is a result of ≤ 6.9% (ADA) or ≤ 6.5% (AACE).
According to Prochaska and DiClemente, the 5 stages of preparation for patient change would include which of the following?
Action This is considered the TTM (Stages of Change Model/Transtheoretical Model).These 5 stages of preparation for patient change would include: Precontemplation Contemplation Preparation Action Maintenance/relapse
bowel dysfunctionIf the patient has a bowel dysfunction, or a limb or bladder dysfunction, prompt referral to a specialist is needed. Suspicion of aortic aneurysm is also a reason for referral.
All of the above In addition to colchicine, aminoglycosides and potassium supplements, ascorbic acid may destroy the vitamin B12 supplement within one hour of ingestion. Therefore, these drugs should not be taken concomitantly with oral vitamin B12.
What reflex should not be present in a three month old at an assessment?
Stepping reflex. The stepping reflex usually disappears around 6 weeks of age. The plantar grasp and the moro reflex can last until about 4 - 6 months. The blinking response lasts into adulthood.
Which of the following would be considered a medication that would be one of the leading causes of patients having allergic reactions?
B&C Cephalosporins and penicillins would be considered the first most frequent cause of allergic reactions. Sulfonamides would be considered the second most frequent cause of allergic reactions.
A 38-year-old man is in the emergency department with acute onset of abdominal pain and low-grade fever. The pain started at the umbilicus two hours ago and is now localized to the right lower quadrant. He has mild nausea, and blood work reveals an elevated white blood cell count. The laboratory tests are remarkable for WBC: 18400 cells/mm3 and polymorphonuclear (PMN): 89%. The abdominal sonography is remarkable for abnormally increased echogenicity of peri-appendiceal fat. The appropriate surgical management is undertaken, and the perforated appendix is removed. A few days later, the patient develops a red, inflamed surgical site wound with a purulent discharge. What is the likely organism?
Bacteroides Because it is perforated, had it been an uncomplicated non perforated the germ would be Staphylococcus aureus
In treating a patient with eczema, which of the following would you use if the patient has acute, weeping lesions?
Burow's solution Burow's solution is best used for acute, weeping lesions in a patient with eczema. It should be applied 4 - 6 times a day for 10 minutes using wet compresses.
Which of the following is a normal physiologic change during pregnancy?
Cardiac output increases by 1/3 by the last two trimesters. Decreased systolic and diastolic pressure occurs in the first trimester. There is decreased peristalsis from progesterone effects. These are all normal physiologic changes during pregnancy. Plasma volume increases by 50% by the end of the third trimester. Hemoglobin and hematocrit are decreased because of the hemodilution from increased plasma volume. And the heart is displaced upward and to the left in the late second to third trimester. And hemorrhoids are more common.
During the process of implantation, the fetus in the above picture (4 weeks) would have finger-shaped growths that grow to help anchor the embryo to the uterine lining. Which of the following would be considered the correct name for these growths?
Chorionic villi The above picture would be considered a medical illustration of an embryo at week 4. At this time, the fertilized egg has attached to the uterine lining by finger-shaped growths called chorionic villi. These help to anchor the embryo. Shortly after this time, the umbilical cord and the placenta will start to provide the embryo with oxygen and nourishment.
Which of the following would be considered one of the stages of Pertussis?
Convalescent There are 3 stages of Pertussis: Catarrhal Paroxysmal Convalescent
A patient with sensitive skin had a TB skin test but has no symptoms. He returns with redness and swelling that appears positive. What is the next step?
Correct answer: Schedule a chest x-ray A chest x-ray shows signs of TB and is more accurate than the skin test. The skin test may appear positive if there is exposure to the illness or allergic reaction. Because the patient has no symptoms, the chest x-ray is recommended.
A 34-year-old female with multiple sclerosis (MS) is in the office. She is now under your care after relocating from another state to live with relatives who can help her. The nurse practitioner understands that which of the following is NOT part of her management plan:
Corticosteroids are often used for maintenance Corticosteroids are only for acute exacerbations, not for maintenance. The remaining answer choices are treatment options for this condition.
A patient is diagnosed as dehydrated, anxious, and isolated. What should you give the highest priority?
Dehydration Dehydration is a physiological need, and physiological needs always take the highest priority. The other needs are belonging needs that can be addressed after the physiological needs.
A 15-year-old boy is brought to the hospital complaining of muscle spasms, facial rigidity, and arched back. He recalls having a nail prick two weeks ago. On examination, he has tachycardia alternating with bradycardia. His blood pressure is also labile, and he has generalized hypertonia. What is the most likely underlying mechanism for his fluctuating vital signs?
Disinhibition of autonomic nervous system The clinical features of tetanus include lockjaw, grimace facial expression (risus sardonicus), generalized muscle spasms associated with severe pains, drooling, uncontrolled urination and defecation, and back arching spasm (opisthotonus) that may cause respiratory distress. Autonomic instability can also occur in these patients with fever, dysrhythmia, labile blood pressure and heart rate, respiratory difficulties, catecholamine excretion, and even early death. Autonomic dysfunction is because of the disinhibition of the autonomic nervous system. Clinicians must also provide supportive care, especially for patients with autonomic instability (labile blood pressure, hyperpyrexia, hypothermia). Magnesium is often used in combination with benzodiazepines to manage these complications.
A nurse practitioner will be expected to document critically in her practice. Which of the following documentation is NOT appropriate?
Document your criticism of fellow providers if their clinical decision-making reflects patient care inappropriately so your decisions will be defended. Documenting your criticism of fellow providers if their clinical decision-making reflects patient care inappropriately so your decisions will be defended is inappropriate. Additionally, it is never a good approach because it provides documentation for litigation against the facility. Further, documenting this statement does not contribute to patient care in any way. The remaining answer choices are all necessary and appropriate.
The example of a CT in the above image would allow for better diagnosis (with "slices") of the patient by which of the following ways?
Forms a full three-dimensional computer model of the inside of the patient. It is easier for the physician to pinpoint a problem because of the narrow "slices" that the scanner uses. The above image would be considered an example of a CT image with some section lines.The CT scan machines used for this procedure have much more energy than a regular x-ray does. This allows the x-ray beams to pass through most of the human bodies soft material.Because the CT scanner uses "slices," it:Forms a full three-dimensional computer model of the inside of the patient.It is easier for the physician to pinpoint a problem because of the narrow "slices" that the scanner uses.
When counseling patients who smoke cigarettes, which of the following is NOT good management advice?
For asymptomatic adults, instruct the patient on how it is easier to stop now than when symptomatic. For symptomatic adults, you should instruct on heart disease risk, risks of lung cancer, and facial wrinkles. For new smokers, you should instruct that it is easier to stop now than after smoking a while.
Which of the following fractures might be included with the one in the x-ray image above?
Fracture of proximal tibiaDistal femur fracture The x-ray image above would be an example of a fracture of the knee that has been repaired with a plate and screw in place.Fractures of the knee can also be associated with:Fracture of the proximal tibiaDistal femur fractureFemoral shaft fractureTibial shaft fracture
If a patient is diagnosed with left-heart failure, which of the following medications would the nurse practitioner more than likely use for treatment?
Furosemide Furosemide would be Lasix which is a diuretic. With the left-heart failure patient, it could be used to remove excess fluid.
You are assessing a child for developmental dysplasia of the hip. In doing so you position the child supine with knees fully adducted and held together. This is known as which of the following?
Galeazzi sign The Galeazzi sign is used for children when developmental dysplasia of the hip is suspected. If one femur is shorter than the other, the result is positive.
A 19-year-old male presents with a fever, confusion, and lethargy for a day. He also complains of nausea, vomiting, and a rash on his trunk and lower extremities. The temperature is 39.2 C (102.6 F), the pulse is 102/min, blood pressure is 90/60 mmHg, and the respiratory rate is 14/min. He is irritable. The oropharyngeal examination is normal, with no cervical lymphadenopathy. The patient's neck is stiff, and there is pain and resistance when an attempt is made to extend the leg with a flexed hip. There is a petechial rash on his trunk and lower extremities. Leukocyte count is 18,000/mm3. Which of the following organism is the most likely cause of this patient's condition?
Gram-negative diplococcus Neisseria meningitidis
A 16-year-old male is in the office. He has a insect bite on his left forearm and you suspect a brown recluse spider bite. What medical management would you provide?
Ice pack and elevation of the area Ice packs are preferred to heat to decrease the edema. The area should be immobilized and tetanus toxoid given. Antihistamines may reduce the swelling and relieve site itching.
In treating a 75-year-old Caucasian male with diverticulitis, the nurse practitioner knows that the most common complaint is:
Left lower quadrant pain Diverticular disease is more common in older adults with about 70% of patients diagnosed with diverticulitis having left lower quadrant pain. Belching and flatulence are not common symptoms of diverticulitis. Then, bloating and cramping are seen more with patients with diverticulosis and not diverticulitis. Rectal bleeding is usually not seen.
Marie is a patient in the third trimester of her pregnancy. During a regular checkup she tells you that she is having problems with heartburn. You tell her that this is common in the third trimester and give her some suggestions to relieve the heartburn. Which of the following statements would NOT be appropriate to include?
Lie down and rest after eating. A person who is suffering from heartburn should NOT lie down after eating. She should also avoid eating for at least three hours before bedtime. She should drink at least 2000 mL of fluid per day and eat small, frequent meals that are not spicy or fatty.
Of the models and theories related to health care, which one is used to explain why healthy people do or do not take advantage of screening programs?
Maslow's Hierarchy of Needs Trans-theoretical Model of Change Self-efficacy Theory ModelHealth Belief Model Correct answer: Health Belief Model The Health Belief Model involves variables such as perceptions of susceptibility and seriousness of a disease, benefits of treatment, perceived barriers to change, and expectations of efficacy. It is used to explain why healthy people do or do not take advantage of screening programs.
Which of the following would be considered correct for a fungal infection which is a common skin tissue issue that is typically seen on the extremities, trunk or face?
Ringworm Ringworm(tinea corporis) is caused by Epidermophyton, Microsporum or Trichophyton.The diagnostic tests that can be used for ringworm would include:Gathering a scraping of the border of the lesion so that it can be used for evaluation:Fungal culturesWet prepKOH (potassium hydroxide)
The FNP is prescribing oral iron therapy for a patient with anemia. She will also inform the patient of certain drug interactions when taking this oral iron. Which of the following is NOT one of these drugs that interact with oral iron therapy?
NSAIDs antacids thyroid hormones caffeine Correct Answer: NSAIDs Antacids, caffeine, fluoroquinolones, some antihypertensives, tetracyclines, thyroid hormones and histamine-2 receptor antagonists interact with oral iron therapy.
The nurse practitioner should not cross certain boundaries with patients. Which of the following would not be considered crossing one of these boundaries?
Not sharing personal information with the patient Examples of boundaries the nurse practitioner should not cross would include:Sexual misconductAccepting giftsExploiting the therapeutic relationship for financial, emotional, sexual or personal advantage Embarking on a social relationship with a patient
A 39-year-old man presents with pain and tingling paresthesia in the lower limbs. He has also been experiencing weakness, personality changes, deafness, and visual impairment for the past month. His past medical history includes a positive Venereal disease research laboratory (VDRL) test. Examination reveals positive Romberg's test, impaired pupillary response to light and absent deep tendon reflexes. Spastic weakness, particularly in the lower extremities, sensory loss, and muscular atrophy are also present. What would be the most appropriate treatment of the patient's lower limb painful tingling symptoms?
Opiates Tabes dorsalis is also known as syphilitic myelopathy. A stomping gait is a form of uncoordinated walking and is also referred to as sensory ataxic gait. Related pain may be treated with opiates, valproate, or carbamazepine. Patients with tabes dorsalis can also require physical therapy to deal with muscle wasting and weakness. Due to a disturbance in proprioceptive functions, patients tend to lift their feet high and bring them down hard to sense it. This leads to them developing a stomping quality to their gait. The step length is also affected, and the gait is slower in comparison to cerebellar ataxia. Patients also rely on their sight to compensate for the disturbance in proprioceptive functions. Therefore, the ataxia can be worsened with loss of visual functions, as can be evident with clinical testing such as the Romberg test.
A 68 year old male patient is dehydrated with nausea and vomiting. The abdominal pain radiates to the back. He has a normal diet and family support. What is the best differential diagnosis?
Pancreatitis. The risk for pancreatitis increases with age. The nausea and dehydration are not caused by diet in this case. The radiating pain makes pancreatitis the best differential diagnosis.
You are doing a gynecologic assessment of your 25-year-old female patient. Which of the following specimens would you collect last during this examination?
Papanicolaou testing Papanicolaou testing is the last specimen collected of the choices given. Voided urine would be the first.
You are performing a hearing test on your patient by placing a tuning fork first on the mastoid process and then on the front of the ear, timing each area. This test is which of the following?
Rinne test The Rinne test is done by placing a tuning fork first on the mastoid process and then on the front of the ear, timing each area. A normal finding would be if air conduction lasts longer than bone conduction.
Which of the following might be considered a surgical consideration for the patient with the trauma in the above x-ray image?
Poor healingLoss of motionAdverse reaction to anesthesia The above x-ray would be an example of a person that has the last joint of the index finger. There could be a variety of causes for this to happen, but trauma is the most common.With this type injury, the surgical considerations could include:InfectionPoor healing (according to the patient)Loss of feelingLoss of motionAdverse reactions to the anesthesia Report a problem with this question
Which of the following is incorrect in regard to the length of pharmacological intervention in depression?
Relapse is highest after the second month of treatment. Relapse is more common in the first 2 months after discontinuation of treatment. Maintenance therapy should be considered as with any chronic illness.
You have a patient with a "port wine" stain that is located on half of her facial area. You understand that this can be a sign of which of the following?
Sturge-Weber Syndrome The flat, large, dark ink to purple stain-like lesions occurring in irregular shapes and sizes are nevus flammeus or "port wine" stains. A large lesion located on half the facial area may be a sign of trigeminal nerve involvement and Sturge-Weber Syndrome (a neurological disorder).
According to the structural functional theory of assessment and intervention, which of the following statements is false?
Suprasystems form within the family to reflect functional needs. This is false. Suprasystems form outside the family to reflect functional needs not met within the family. Teachers, schools, religious and civic organizations and friends are examples of suprasystems that meet needs not met by interactions within the family system.
A mother brings in her 6-year-old child who was bitten by their dog. The wound appears to be infected. You might do all but which of the following for this child?
Suture the wound. You would not suture the wound if you suspect that it is infected. You would take all of the other precautions.
A 45-year-old male presents with left knee pain after stepping off a curb awkwardly. He states he heard a pop and had immediate swelling. The pain is mostly on the medial side of his knee. On the lateral radiograph of the knee, it is observed that the distance from the fabella to the femur is markedly increased. The joint space is preserved. No lytic or sclerotic areas are seen. Which of the following is the most likely diagnosis of this patient?
Synovial effusion The fabella sign, displacement of the fabella, is seen with synovial effusion and popliteal masses. The fabella is a sesamoid bone located inside the gastrocnemius. It serves as a radio-opaque marker for the posterior border of the knee's synovium. It is present in about 25% of the population. Be sure to distinguish a fabella from a loose body or osteophyte. The mechanism of injury and the location of the radiopaque marker can help. For example, a Segond fracture, or avulsion fracture of the lateral tibial condyle, can be seen with an ACL tear. The same lateral knee radiograph may also show an increased opacity and widening of the suprapatellar bursa, which should be assessed if one sees the fabella sign.
Which of the following statements about endometriosis is least accurate?
The FNP can manage the patient with endometriosis independently. This is the least accurate statement. The FNP will not manage endometriosis independently but may be involved in collaborative management to some extent.
As an FNP you understand that all of the following statements about chronic heart failure are accurate EXCEPT:
The preponderance is in females until the age of 75, then there is equal occurrence in males and females. Patients who are underweight have a greater risk of CHF. These two statements are not accurate. There is a male preponderance until age 75 and then an equal occurrence in males and females. Patients who are obese are at greater risk.
What is the statute of limitations?
The state law that prescribes the time frame in which a negligent action may be filed These statutes are procedural laws in that they describe the "how-to" parameters within which legal rights may be exercised. Rights to sue are not governed by statutes of limitations.
Which of the following is characteristic of secondary dysmenorrhea?
There may be dyspareunia. Symptoms of secondary dysmenorrhea are more variable, depending on the cause. Pain may occur at any time during the menstrual cycle and tends to increase with age. Pain may occur at times other than during menstruation. There may be dyspareunia.
You have a 35-year-old female patient who is complaining of wrist pain. She is an administrative assistant who does a great deal of computer work in her job. You will test her for carpal tunnel syndrome. When you tap at the volar surface of the wrist you are performing which of the following tests?
Tinel's sign Tinel's sign involves a tap at the volar surface of the wrist. A positive result is reproduced symptoms or tingling into the medial never. This test has a 50% accuracy rate.
A patient who has been prescribed cephalexin should be made aware that all of the following are potential side effects except which?
Tiredness. Vaginal discharge. Dizziness. Weight gain. Correct Answer: Weight gain. Weight gain is not a documented side effect of cephalexin. Patients may experience vaginal itching and discharge, upset stomach and nausea, dizziness, and tiredness. These are not usually considered serious.
A gastrinoma located on the pancreas or the stomach which secretes gastrin, stimulating high levels of acid production in the stomach is which of the following?
Zollinger-Ellison syndrome Zollinger-Ellison syndrome is indicated by a gastrinoma located on the pancreas or the stomach which secretes gastrin, stimulating high levels of acid production in the stomach. The end result is the development of multiple and severe ulcers in the stomach and duodenum. Report a problem with this question
Which of the following found on an ECG would confirm atrial fibrillation?
absent P wavesirregular ventricular rate Atrial fibrillation is a common arrhythmia characterized by nonsynchronized irregular atrial and ventricular activity. An ECG is confirmatory of atrial fibrillation with absent P waves, irregular ventricular rate, and rhythm of 100 - 160 beats per minute. Report a problem with this question
Under a capitated system of reimbursement, NPs and physicians are paid a set fee per patient per month for all services agreed to by contract. Capitated fees for primary care vary based upon which of the following?
age and sex of the patient Capitated fees for primary care vary, based upon the patient's age and sex. If an FNP has agreed to provide all primary care services for a patient, then the FNP must provide an unlimited number of primary care visits.
For a healthcare professional to obtain blood at the request of law enforcement officials without a patient's consent which of the following must be present?
all of the above All of the first three choices are factors that must be present. Two other conditions must also be present: the likelihood that the blood drawn will produce evidence for criminal prosecution; and the test is reasonable and not medically contraindicated.
Your patient has AIDS. He is in the hospital suffering from an infection. He presented with severe watery diarrhea, abdominal cramps, nausea, malaise and has an electrolyte imbalance. Which of the following opportunistic infections do these symptoms best describe?
cryptosporidiosis There are many opportunistic infections to which AIDS patients are susceptible. Cryptosporidiosis is just one of them. It presents with severe watery diarrhea - sometimes as many as 30-40 stools per day. The patient also has abdominal cramps, nausea, malaise and tests will show an electrolyte balance.
Which of the following would NOT be part of the plan for your 55-year-old female patient with irritable bowel syndrome (IBS)?
decrease in dietary fiber A person with IBS should increase (not decrease) dietary fiber. If necessary, dietary fiber should be supplemented with psyllium (Metamucil).
Charles Darwin wrote On the Origin of Species about human evolution. He also is known for which of the following?
developing the "baby journal" as a systematic method to document observed behavioral development In addition to writing On the Origin of Species, Charles Darwin is known for the first use of a "baby journal" as a systematic method to document observed behavioral development. Alfred Binet developed the first standardized measurement of intelligence. Arnold Gesell developed the maturational-organismic theory.
You want to prescribe a drug with a rapid onset for a patient who is being treated for anxiety. Which of the following drugs for treating anxiety has the most rapid onset of action?
diazepam Diazepam has a rapid onset of action and a relatively sustained effect. The other choices all have a slow onset of action and a relatively or highly sustained effect.
When you are taking the history of a patient with acne, you would need to determine all but which of the following?
dietary history Dietary habits do not contribute to acne. All of the other choices do make a difference. You would also ask about work history and psychosocial history.
The FNP is doing a well-child exam on a 6-year-old boy. The FNP can expect that all of the following developmental milestones are likely to be exhibited in this child EXCEPT:
draws persons with at least 16 parts All of the choices are developmental milestones likely to be exhibited by a 6-year-old child except this one. A child of this age will typically draw a person with 6 - 8 parts. At the age of 7 or 8 years, a child will typically draw a person with at least 16 parts.
Your patient has varicose veins. Treatment for this patient would consist of all but which of the following?
elastic compression stockings elevation of leg when sitting HCTZ to ease fluid retention wearing restrictive garments to reduce swelling Correct Answer: wearing restrictive garments to reduce swelling Although elastic compression stocking would be recommended, other garments should not be restrictive. The patient should also avoid prolonged weight-bearing and standing and avoid crossing legs when sitting.
The complex network of nerve fibers that innervate the organs within the abdomen like the gastrointestinal tract, pancreas, and gall bladder is the
enteric nervous system The enteric nervous system is the third part of the autonomic nervous system. The enteric nervous system is a complex network of nerve fibers that innervate the organs within the abdomen like the gastrointestinal tract, pancreas, gall bladder etc. It contains nearly 100 million nerves.
Mrs. White is a 55-year-old female who has been suffering from gastroenteritis. You explain to her that which of the following factors in her history increases her susceptibility to gastroenteritis?
gastric surgery Gastric surgery increases a person's susceptibility to gastroenteritis. Increased age, loss of normal gastric acidity, and poor physical condition can also increase susceptibility.
In addition to being overweight, the American Diabetes Association recommends type 2 diabetes mellitus testing in adults who:
have an HDL level of < 35 mg/dL The ADA recommends type 2 diabetes mellitus testing in adults who are overweight and have additional risk factors such as having an HDL level of < 35 mg/dL. The other choices are not risk factors for diabetes.
Which of the following lab results for your 69-year-old male patient would be out of the normal range?
hemoglobin: 10.0 g/dL A lab result of hemoglobin: 10.0 g/dL is not normal for an adult male. The normal range for hemoglobin in males is 13.0 to 18.0 g//dL. All of the other results are within the normal range.
Which of the following types of hepatitis is transmitted by fecal and oral route from contaminated food?
hepatitis A Hepatitis A is transmitted by fecal and oral route from contaminated food. It is a self-limiting infection and treatment is symptomatic. There is a vaccine available (Havrix) that is recommended for travelers to areas where hepatitis A is endemic.
The effect of a goitrogen could likely be:
hyperthyroidism Any substance that interferes with thyroid function and causes goiter is a goitrogen. The effect may be hypothyroidism or hyperthyroidism. The most common forms are Graves' disease and toxic multinodular goiter.
A mother brings in her 7-year-old child with a red rash on his cheeks and ears. You diagnose Fifth disease. You might recommend all of the following for this child EXCEPT:
isolation You would not recommend isolation. Isolation is not indicated. The child, however, should avoid pregnant women and anyone who is immunocompromised. Report a problem with this question
Jamie is a 9-year-old male patient with impetigo. He has a honey-crusted lesion on his face. What other things would you expect to find upon physical examination of this child that would support the diagnosis of impetigo?
itching itching and soreness are symptoms found with impetigo. The lesions are scattered and discrete. Previous trauma to the face has no effect on the appearance of impetigo. The lesions are usually 1 - 3 cm in size, are small and have ruptured
When oral medications are given, they must go through first-pass metabolism which occurs in the GI tract. In which of the following organs does biotransformation occur before the medication is released into the patient's circulation?
liver When oral medications are given, the first-pass metabolism occurs in the GI tract. It travels from there and enters the portal circulation. In the liver, the medication is metabolized (biotransformation) and then the medication is then released into the patient's systemic circulation.
Mrs. Franer tells you that she has had several headaches recently, each of which lasts about 8 hours. She tells you that they are aggravated by climbing stairs and keep her from doing anything productive during the headache. She often has nausea along with the headache and cannot stand to be in a bright room or in the sun during the headache. After assessment you diagnose which of the following?
migraine without aura The symptoms that the patient experiences during headaches are consistent with the International Headache Society's diagnostic criteria for migraine headache without aura. These headaches are usually a moderate to severe, throbbing, unilateral headache in the temple region or around the eye in persons with a family history of migraine.
A patient with stable angina would exhibit which of the following?
no change in duration of symptoms during the preceding 6 weeks This is a characteristic of stable angina. Types of angina include: stable, unstable, and variant. A recent change in characteristic angina symptoms indicates unstable angina. Variant angina would have transient ST-segment elevation at rest, with angina symptoms related to coronary spasm involving the right coronary artery.
You are testing a 35-year-old male patient for Addison's disease. You perform the test for ACTH stimulation. If this patient has primary adrenal insufficiency he will have which of the following responses to this test?
no response A typical response to ACTH stimulation is a minimum 10 mg/dL rise in cortisol levels above baseline and a maximum 18 mg/dL rise in cortisol levels at 60 minutes. An individual with primary adrenal insufficiency exhibits no response to ACTH stimulation.
Aplastic anemia would be classified as which of the following?
normocytic anemia Aplastic anemia is classified as normocytic. It is the inability to produce red blood cells and tends to progress rapidly.
You have a patient who is experiencing menopause. Which of the following discoveries would cause you the most concern?
palpable ovaries Palpable ovaries are considered an abnormal finding in menopausal women. After several years of menopause, the ovaries are atrophied and a smaller size. Ovarian cancer must be ruled out when a palpable ovary is found.
A mother brings her 5-year-old child to the clinic with a ringlike pruritic rash with some central clearing on the arms and legs. The FNP knows that this is which of the following conditions?
tinea corporis Tinea corporis or tinea circinata is ringworm of the body. It is characterized by ringlike pruritic rash with a collarette of fine scales that slowly enlarges, and some central clearing.
The FNP has a 45-year-old male patient with BPH who has poison ivy. The FNP plans to prescribe Benadryl for this. What is a possible adverse effect with the use of Benadryl for this patient?
urinary retention The anticholinergic activity of Benadryl, a first-generation product, can result in drying of secretions, visual changes, and urinary retention. Urinary retention can be a problem especially in men with benign prostatic hyperplasia (BPH).
Your patient has a superficial skin lesion that is elevated. It is less than 1 cm in diameter and it is filled with serous fluid. Which of the following skin lesions is this?
vesicle A vesicle is an elevated superficial skin lesion less than 1 cm in diameter and filled with serous fluid. An example of a vesicle is a herpetic lesion. A pustule is an elevated superficial skin lesion less than 1 cm in diameter and filled with purulent fluid. A papule is a palpable solid lesion up to 0.5 cm. A macule is a flat nonpalpable lesion smaller than 1 cm in diameter.
