WT FNP 2019 study guide

Which of the following laxatives listed below is safe for long-term use?

*With this text there was no option for polyethylene glycol, which has been the answer on previous exams* Bulk-forming laxatives (Metamucil, Citrucel, etc.)

A 37 year old female with a history of single episode depression and frequent complaint of 'PMS" is being followed for hypothyroidism. Today she is complaining of poor concentration and appears distraught. The correct plan is:

-I can't find the answer to this and I got it wrong, but I imagine the correct answer involves drawing a TSH

A risk factor for external otitis is:

-Swimming -Hot/humid climates -Trauma (qtips, pens etc) -Hearing aids (trauma) -Atopic dermatitis

You are a nurse practitioner who is initiating levothyroxine for primary hypothyroidism in a 71 year old female. The usual starting dose of levothyroxine is 50-100 mcg per day. What dose would be the most appropriate initial therapy for this patient?

25 mcg per day

What is the duration of action for Humulin R insulin?

6-10 hours Criteria for the diagnosis of type 2 DM include:* a plasma glucose level of 126 mg/dL or greater after an 8 hour or greater fast on more than one occasion

Which of the following women is the best candidate for progestin-only pill use?

A 32 year old woman who is breastfeeding

Which of the following should be periodically monitored with the use of a thiazolidinedione?

ALT

Which of the following medications can cause acute urinary retention in a man with BPH?

Amitriptyline

Use of flunitrazepam (Rohypnol) has been associated with:

Amnesia

Harriet, age 40, has had type 1 diabetes for 20 years and takes a combination of NPH and regular insulin every day. She comes to the clinic because she has developed a severe upper respiratory infection with chills, fever, and production of yellow sputum. Because of her acute infection, you know that she is likely to require

An increase in her insulin

You are assessing David, age 16, after a football injury to his right knee. You elicit a positive drawer sign. This test indicates an injury to the:

Anterior cruciate ligament

Andrew, age 16, sprained his ankle playing hockey. He is confused as to whether to apply heat or cold. What do you tell him?

Apply cold for 20 minutes, then take it off for 30-45 minutes

Which of the following choices best describes the proper order of steps for performing the Lachman's test?

Bend the nee 20 degrees, apply pressure to proximal tibia, and stabilize the thigh

Which of the following is a sign of hypothyroidism?

Brittle hair

You are performing some neurological assessment tests on Daniel. When you ask Daniel to lie supine and flex his head to his chest, what are you assessing?

Brudzinski sign

The most likely causative pathogen in a 26 year old woman with PID is:

C. Trichamotis

A patient asks for advice about a medication that will produce rapid relief if he is having heartburn symptoms. What should the nurse practitioner recommend?

Calcium carbonate

Which of the following antihypertensive agents would most likely produce a rebound hypertensive crisis following its abrupt withdrawal?

Clonidine

The first choice of therapy for a client who is positive for HIV and has oral candidiasis is :

Clotrimazole troches (10mg) five times daily or nystatin (Mycostatin) suspension 500,000-1,000,000 units three to five times daily - Because of the common recurrence of oral candidiasis and increased rates of drug resistance, systemic fungicides, such as fluconazole, ketoconazole, and griseofulvin, should be reserved for severe cases, such as esophageal candidiasis and clients with dysphagia.

Urine specific gravity is increased in patients with:

Dehydration

Which of the following is a predisposing condition for furunculosis?

Diabetes mellitus - Predisposing conditions for furunculosis or carbuncles include diabetes mellitus, HIV, and injection drug use

Daniel, a patient with type 1 diabetes, is hospitalized with a diagnosis of diabetic ketoacidosis. Which of the following signs and symptoms would be consistent with this condition?

Dry skin and ketonuria and polyuria

Which of the following laboratory tests are utilized to confirm diagnosis of HIV?

ELISA, Western Blot

After a history, exam and lab tests, a patient is diagnosed with irritable bowel syndrome. Which initial treatment is considered most appropriate?

Either adoption of high fiber diet or excluding trigger foods from diet

What would you expect to find in a patient with acute rhinosinusitis?

Erythematous & edematous nasal mucosa w/o purulence & watery discharge

One of the more common sites for atopic dermatitis in an adult is:

Flexor surfaces

Daniel is a 12 month old male who is new to your practice. His mother brings him in one day with a chief complaint of vomiting for 2 days. Before you step into the exam room to see him you know the most frequent cause of vomiting in this age group is related to which of the following?

Gastroenteritis (I'm pretty sure)

You receive a urinalysis back from the lab with a finding of RBC casts and microscopic hematuria. What is the patient's likely diagnosis?

Glomerulonephritis

Kathy has celiac disease. You place her on which diet?

Gluten-free diet

Anna presents to your clinic with an ankle sprain. She is unable to walk unassisted, and has egg-shaped swelling around the affected area. How should her ankle sprain be classified?

Grade 3

John, age 49, is a construction worker. He has a nevus on his shoulder that has recently changed from brown to bluish black in color. You advise him to

Have an excisional biopsy

What is a causative factor in the formation of blood clots causing deep venous thrombus?

Hypercoagulability

When assessing a patient with acute opioid withdrawal, you would expect to find:

Hypertension

When assessing a person with acute opioid withdrawal, you expect to find:

Hypertension (if that's not an answer choose diarrhea)

Which brand name medication is a Glucagon like peptide?

I don't remember the options, but the more popular ones are Byetta and Victoza

What is the best treatment for a child with asymptomatic swallowed foreign body?

I'm not sure what answer I chose at the moment or what the correct answer actually is, but I believe that with any non-toxic substance lacking sharp edges the answer is Careful observation for 24 hours post ingestion

For your client with a knee injury, you order an NSAID to be taken on a routine basis for the next 2 weeks. Your teaching should include which of the following?

If you have addition pain, an occasional acetaminophen (Tylenol) is permitted in between the usual doses of the NSAID

What immunizations may be safely administered during the first trimester of pregnancy?

Influenza -TDAP can technically be given, but is recommended at third trimester

The proper order of assessing the abdomen is:

Inspection, auscultation, percussion, palpation

Marvin asks you for a prescription for sildenafil (Viagra). The only medication he takes is isosorbide mononitrate. He has a history of diet controlled diabetes. What do you tell him?

It's contraindicated with isosorbide mononitrate, let's discuss other options

Mrs. Jones, age 82, has a curvature of the spine. This is likely to indicate which age-related change?

Kyphosis

Which of the following lab values would most likely confirm a diagnosis of hyperthyroidism?

Low TSH, increased free T3, normal free T4

Therapy for hemorrhoids includes all of the following EXCEPT:

Low-fat diet

Treatment of viral conjunctivitis can include:

No Antibiotic Therapy Needed

Which symptom can be used to rule out a fracture?

No symptom can rule out a fracture

You are suspecting an appendicitis in Andrew, who is age 18 years. With his right hip and knee flexed, you slowly rotate his right leg internally to stretch a muscle. He states that it is painful over his right lower quadrant area. Which sign did you elicit?

Obturator Sign

Dan, age 76, has GERD. When teaching him how to reduce his lower esophageal sphincter pressure, which substances do you recommend that he avoid?

Peppermint

The "herald patch" is present in almost all cases of

Pityriasis rosea

Joanne, age 16, has had her asthma well controlled by using only a beta-adrenergic metered-dose inhaler. Lately, she has had difficult breathing during the night, and her sleep has been interrupted about three times a week. What do you do?

Prescribe an inhaled steroid

Developmental tasks of early adulthood (ages 20-45) include which of the following?

Psychological separation from parents and developing a capacity for intimacy with a partner

All of the following are likely reported in the woman with an initial episode of genital human herpesvirus-2 infection except:

Pustular lesions

Urinary tract infections in the male patient are divided into upper and lower tract infections. What is an example of an upper tract infection in a male patient?

Pyelonephritis

Virginia, age 62, has type 1 diabetes that is well controlled by insulin. Recently, she has developed an ingrown toenail. As a result of this infection, it is possible that she will

Require an increase in her daily insulin dosage

Which physical examination maneuver for diagnosing appendicitis is done by deep palpation over the left lower quadrant with resultant pain in the right lower quadrant?

Rovsing's test

In patients with varicose veins, which vessel is most often affected?

Saphenous

A 32 year old male tripped and fell on outstretched hands about 2 hours ago. He complains of wrist pain. The APRN should:

Scaphoid fracture

As a FNP, you know that all of the following are insulin analogs that can be used to manage DM except:

Sorry guys, I don't recall the options to choose from

Which factor listed below is not a risk factor for TIAs?

Sorry, I don't remember the options. Here are what ARE risk factors:

To confirm the results of a McMurray test, you ask the patient to:

Squat

What is the most common rosacea trigger?

Sun exposure

John, age 65, experienced a temporary loss of consciousness that was associated with an increased rate of respiration, tachycardia, pallor, perspiration, and coolness of the skin. How would you describe this?

Syncope

Decongestants work primarily through:

Vasoconstriction

Sue has an acute exacerbation of Crohn's disease. Which laboratory test value(s) would you expect to be decreased?

Vitamins A, B complex, and C levels

One of the most prominent clinical features of bronchiolitis is:

Wheezing

When should a rescue course of prednisolone be initiated for an attack of asthma?

Whenever the client needs it, at any time and any step

Which of the following patients would be an appropriate candidate for treatment with teriparatide (Forteo)?

a 64 year old woman with BMD T-score of -2.5 and prior hip fracture

Choose the correct description of fissure.

a linear crack extending from the epidermis to the dermis

The clinical presentation of Irritable Bowel Syndrome most likely includes which set of symptoms?

abdominal pain, diarrhea, constipation

Antihistamines work primarily through:

action on the histamine-1 (H1) receptor sites

Finasteride is helpful in the treatment of BPH because of its effect on

blocks the conversion of testosterone to dihydrotestosterone, reduces prostate size

Which of the following is most consistent with a person presenting with unstable angina?

chest pressure lasting 20 minutes that occurs at rest

Which of the following best describes asthma?

chronic airway inflammation with superimposed bronchospasm

Which of the following should be periodically monitored with the use of a biguanide?

creatinine (Cr) A 43 year old patient comes to your office presenting with nausea and a fever of 104 degrees Fahrenheit. The patient said the fever appeared earlier in the day, and that he has vomited more than once prior to arriving to your office. During the examination, he states that he feels dizzy and lightheaded whenever he stands up. His vital signs indicate that he has low blood pressure. Based on these findings, which of these is the most likely diagnosis?* -Sorry guys I don't recall the options or answer

Physical examination findings in patients with bulimia nervosa often include:

dental surface erosion

Deep vein thrombosis may result in:

generalized edema of the involved extremity

Your patient Kenneth, age 62, presents to the clinic with pruritis and complaints of lymphadenopathy in his neck. He also complains of night sweats and a low grade fever. He has no weight loss and otherwise feels well today. He is widowed and has been dating a new woman recently. On physical exam, you find enlarged supraclavicular nodes. You suspect a diagnosis of

hodgkins lymphoma

Which of the following is among the most common causes of congestive heart failure?

hypertensive heart disease

Physical examination findings in otitis externa include:

increased ear pain with tragus palpation

Dietary management for the patient in acute renal failure includes:

limiting fluids, eating a low-protein diet, limiting salt, potassium, phosphorous, and other electrolytes

According to DSM-5, a diagnosis of depression must include either depressed mood or which of the following?

loss of interest or pleasure

The progestin component of hormone therapy is given to:

minimize the endometrial hyperplasia

When a neonate is initially protected against measles, mumps, and rubella because the mother is immune, this is an example of which type of immunity?

natural passive

The Epstein-Barr virus is primarily transmitted via:

oropharyngeal secretions

The American Diabetes Association recommends intensive management of diabetes for

persons who already have a dx of beginning nephropathy, neuropathy, or retinopathy

The majority of the body's iron is obtained from:

recycled iron content from aged RBCs

All of the following are causes of secondary hyperlipidemia except:

renal failure

Which of the following characteristics BEST applies to type 1 Diabetes Mellitus?

significant hyperglycemia and ketoacidosis result from lack of insulin

Signs of right-sided heart failure include:

signs of fluid retention

Which of the following best describes hearing loss associated with presbycusis?

slowly progressive, usually symmetric, and predominantly high frequency

Rectal bleeding associated with hemorrhoids is usually described as:

streaks of bright red blood on stool

In order to determine how much T4 replacement a patient needs to re-establish a euthyroid state, the FNP considers:

the patient's body weight

The presentation of acute epididymitis includes:

the presence of a positive Prehn sign. Scrotal elevation relieves pain in epididymitis but not torsion

Expected findings in acute otitis media include:

tympanic membrane immobility

Sarah, who is postmenopausal, is taking 1500 mg of calcium but does not understand why she also needs to take vitamin D. You tell her that:

vitamin D increases intestinal absorption of dietary calcium and mobilizes calcium from the bone

With regards to pathology of diabetes mellitus, which of the following factors plays a principal role in causing type 1 DM?

β-cells of the pancreas do not produce sufficient insulin