AANP Study Questions

A diagnosis of sinusitis is based on a combination of all but which of the following? a. bleeding b. physical examination c. nasal cytology d. clinical history

a. bleeding

The average age for spermarche in boys is what age? a. 12.2 years b. 13.4 years c. 14.5 years d. 15 years

b. 13.4 years

A 5 year old has tonsillitis and his throat swab is negative. What other test would you run? a. DRE. b. CFS. c. CBC. d. ANA.

c. CBC.

Discussion of the major stressors in a patient's life is typical part of which of the following? a. Cultural assessment. b. Lethality assessment. c. Psychosocial assessment. d. Spiritual assessment.

c. Psychosocial assessment.

When reading a chest x-ray which area will look black? a. heart b. skeletal thorax c. lungs d. mediastinum

c. lungs

You are determining the peak expiratory flow (PEF) for a 67-year-old female patient who suffers from asthma. Which of the following is NOT a factor in determining peak expiratory flow (PEF) for this patient? a. age b. height c. weight d. gender

c. weight

Appendicitis is uncommon in which of the following groups? a. young adults b. adolescents c. school age children d. infants

d. infants

Your patient is a child who has had surgery to repair a deformity in his foot. The wound site requires that the dressing be changed often. The nurse has gone over the procedure for changing the dressing with the child's parents. What is the best way for you to know that the parent will be able to change the dressing properly? a. Document the procedure in writing. b. Observe the parent performing the change of dressing. c. Repeat instructions before the child is discharged from the hospital. d. Ask the parent if he or she understands what is required.

b. Observe the parent performing the change of dressing.

The iliopsoas muscle and the __________ muscle should be evaluated by the nurse practitioner when testing for acute appendicitis? a. Sartorius b. Obturator c. Trapezius d. Deltoideus

b. Obturator A positive psoas sign occurs when pain occurs with passive extension of the thigh while the patient is lying on their side with knees extended. A positive obturator sign occurs when pain is elicted by the internal rotation of the right hip from 90 degrees hip/knee flexion.

When performing an assessment of an infant, how long do you observe respiration? a. 30 seconds. b. One minute. c. 45 seconds. d. 15 seconds.

b. One minute.

Jacob wants to order a bone density test for one of his patients. The purpose of this test is to possibly diagnose what? a. Iron deficiency. b. Osteoporosis. c. Low blood platelets. d. The size of the bone.

b. Osteoporosis.

When palpating the head and neck of an adult, what would be an abnormal finding? a. Soft lymph nodes. b. Palpable lymph nodes. c. Round lymph nodes. d. Nonpalpable lymph nodes.

b. Palpable lymph nodes.

The nurse practitioner assesses a 40 year old male patient that is complaining of a severe hacking cough that has lasted for going on 3 weeks. Which of the following might they suspect? a. Pneumonia b. Pertussis c. COPD d. Lung cancer

b. Pertussis With the adult patient that has experienced a severe hacking cough that has lasted going on 3 weeks, pertussis should be suspected. In addition, they might experience a low-grade fever and rhinorrhea with a mild cough which might become severe with inspiratory "whooping" sound.

The NANDA I list is used in which part of a nursing diagnosis? a. Etiology. b. Problem. c. Symptoms. d. Wellness.

b. Problem.

What test would you use to determine lung capacity of a patient you believe has asthma? a. CTA scan. b. Spirometry. c. BUN. d. Chest x-ray.

b. Spirometry.

When the elderly patient shows signs of becoming confused, agitated, and combative, starting at dusk but the symptoms resolve when the sun comes up, which of the following terms would it typically be referred to as? a. Resolution b. Sundowning c. Down's syndrome d. Crazy night person

b. Sundowning

An example of a secondary prevention measure for a 55-year-old healthy and physically active female is which of the following? a. yearly flu shot b. doing a mammogram and Pap smear c. educating her about skin cancer from sun exposure d. recommending the use of bicycle helmets

b. doing a mammogram and Pap smear Secondary prevention measures include activities provided to identify and treat asymptomatic persons who might be at risk for a particular disease or condition. Doing a mammogram and Pap smear is a secondary prevention measure. All of the other choices are primary prevention measures.

Veronica is a 45-year-old patient who works in retail and stands for most of the work day. She comes to you complaining of varicose veins. After confirming the diagnosis you would recommend which of the following? a. refrain from elevating the leg b. elastic compression stockings up to the knee c. Vasotec d. high sodium diet

b. elastic compression stockings up to the knee You would also recommend weight loss if necessary and prescribe hydrochlorothiazide when there is fluid retention.

You are caring for an elderly patient who has had a cerebrovascular accident (CVA) and has urinary incontinence. The family should be taught to: a. insert a Foley catheter b. establish a scheduled voiding pattern c. restrict fluid intake d. reposition the patient often to reduce the discomfort of urgency

b. establish a scheduled voiding pattern

When assessing an adolescent who reports using lysergic acid diethylamide (LSD), the nurse practitioner knows the patient is at risk for: a. experiencing disorientation and delusional feelings b. experiencing flashbacks and depression c. developing intolerance and hives d. experiencing withdrawal symptoms within 24 hours

b. experiencing flashbacks and depression Lysergic acid diethylamide (LSD) can cause flashbacks, depression, and psychotic behavior. There are no withdrawal symptoms or physical dependence. The adolescent commonly remains oriented but experiences hallucinations and altered bodily sensations.

You would refer a person who has hidradenitis suppurativa to a surgeon for assessment in which of the following cases? a. oral antibiotics did not resolve the case in 7 days b. extensive involvement c. Aristospan diluted with lidocaine does not resolve the problem immediately d. in all of the above cases

b. extensive involvement

Which of the following is NOT considered a contraindication to DTP/DTaP vaccination? a. anaphylaxis b. family history of SIDS c. fever equal or > 105° F within 48 hours of a dose d. encephalopathy

b. family history of SIDS Also not considered a contraindication is a family history of seizures and a fever of less than 105° F from prior DTaP vaccination.

In certain countries the incidence of appendicitis is less. This is because the diet of these countries is high in which of the following? a. omega 3 fatty acids b. fiber c. protein d. carbohydrates

b. fiber

Which of the following laboratory tests is NOT matched with its correct reference range? a. hemoglobin: 13.5 to 17.5 g/dL (males) b. hematocrit: 41% to 53% (females) c. MCV: 80 to 100 fL d. platelet count: 150,000 to 400,000/mm3

b. hematocrit: 41% to 53% (females) The correct reference range for hematocrit for females is 36% to 46%. The reference range for males is 41% to 53%.

A 50-year-old man who suffers from hypertension has been diagnosed with a dissecting aneurysm. Which of the following symptoms is indicative of this condition? a. renal failure b. tearing pain in chest c. dull chest pain d. tachycardia

b. tearing pain in chest

What type of headache is typically described as "pressing" in quality? a. migraine headache b. tension-type headache c. cluster headache d. simple stress headache

b. tension-type headache

Utilization review can best be described as which of the following? a. a system of monitoring and assessing for high-risk areas and procedures b. the process of evaluating the appropriateness of inpatient hospitalization c. the process used for accreditation d. the process used for case management

b. the process of evaluating the appropriateness of inpatient hospitalization

The majority of breast cancers are located in which of the following positions on the breast? a. lower outer quadrant b. upper outer quadrant c. lower inner quadrant d. upper inner quadrant

b. upper outer quadrant

The majority of breast cancers occur in which area of the breast? a. beneath the nipple and areola b. upper outer quadrant c. lower outer quadrant d. upper inner quadrant

b. upper outer quadrant

Mr. Hochman is an elderly male patient with a history of heavy cigarette smoking. He complains of gradually worsening dyspnea over several years that is now limiting his physical activity. He has a chronic cough producing large amounts of yellowish sputum. The most likely diagnosis is which of the following? a. bacterial pneumonia b. atypical pneumonia c. COPD d. acute bronchitis

c. COPD

If a patient has severe watery diarrhea for 10-15 stools which is also accompanied by lower abdominal pain, cramping, and a fever, which of the following conditions might be suspected? a. Crohn's disease b. Peritonitis c. Clostridium difficile d. GERD

c. Clostridium difficile

When reviewing symptoms you should _____ similar symptoms. a. Ignore. b. Analyze. c. Cluster. d. Interpret.

c. Cluster.

Effective ____________ would be considered a core skill in primary care? a. Boundaries b. Relationship c. Communication d. Literacy

c. Communication

A 23 year old patient is conscious and requires an x-ray for a differential diagnosis of a broken arm. What is the first step to the process? a. Prepare the machine. b. Position the patient. c. Consent. d. Inform radiology.

c. Consent.

Your 85-year-old patient presents with localized swelling in her knees, as well as redness in her knees. After testing, you determine she is positive for Bursitis. Which of the following would LEAST likely be a differential diagnosis for Bursitis? a. Joint effusion. b. Osteoarthritis. c. Dementia. d. Gout.

c. Dementia.

A patient with Type I diabetes has a ketone level of 3.0 mmol/liter. He is also experiencing abdominal pain and confusion. What is the possible diagnosis? a. Hyperglycemia. b. Heart disease. c. Diabetic ketoacidosis. d. Hypoglycemia.

c. Diabetic ketoacidosis.

Which of the following statements about Parkinson's disease (PD) is least accurate? a. As a general rule, use the least amount of medication in the lowest dose for the longest time to achieve reasonable control of symptoms. b. Drugs can help with symptoms, but they do not halt the progression of PD. c. Dopamine can cross the blood-brain barrier in its pure form to help increase dopamine activity in patients with PD. d. Resting tremor is the initial complaint of most patients with PD.

c. Dopamine can cross the blood-brain barrier in its pure form to help increase dopamine activity in patients with PD. Dopamine cannot cross the blood-brain barrier in its pure form. It is given as levodopa, usually with carbidopa.

You are educating Laura, a patient who suffers from GERD, about the condition. Which of the following statements would indicate that Laura understands your teaching about the condition? a. "I will eat smaller meals." b. "I will lower the head of my bed." c. "I can smoke no more than one pack of cigarettes per week." d. "I will avoid exercise."

a. "I will eat smaller meals."

How long would it typically take for a patient who is taking Parcopa (carbidopa-levodopa) orally to help control his symptoms? a. 1 - 2 months b. 1 - 2 weeks c. 3 - 4 months d. the effect is immediate

a. 1 - 2 months It takes at least 1 to 2 months for this medication to be effective. Sometimes it takes as much as 6 months. The patient is not likely to see any improvement in symptoms in 10 days.

A patient presents with emotional distress. What is the likely pulse rate? a. 100 b. 70 c. 50 d. 30

a. 100

A diastolic pressure of which of the following would indicate stage II hypertension? a. 110 mm Hg b. 89 mm Hg c. 84 mm Hg d. 72 mm Hg

a. 110 mm Hg

You are examining Mickey, a 30-year-old pregnant female. If you find that the uterus is about grapefruit size, you understand that it is most likely that Mickey is in what week of pregnancy? a. 12th b. 16th c. 9th d. 20th

a. 12th At 12 weeks the uterus is about softball or grapefruit size. It is rising above symphysis pubis and the uterine fundus is palpable through the abdominal wall.

The expected course for bacterial conjunctivitis with treatment is which of the following? a. 2 - 5 days b. 5 - 7 days c. 5 - 14 days d. 2 - 3 weeks

a. 2 - 5 days The expected course with treatment is 2 - 5 days. Without treatment it is 5 - 7 days.

You are going to do a breast examination of a patient. You know that the best time to do this examination is: a. 7 - 9 days after menses b. 7 - 9 days before menses c. 7 - 9 days before ovulation d. 7 - 9 days after ovulation

a. 7 - 9 days after menses

Of the following, which would be considered the normal reference range for the MCV laboratory test? a. 80-100 fL b. 10-50 fL c. 500-550 fL d. 1-10 fL

a. 80-100 fL

You are examining a 16-year-old female who you think is suffering from anorexia nervosa. One of the criteria for diagnosis of anorexia nervosa is a body weight of what percentage (or less) of the normal weight for age and height? a. 85% b. 89% c. 92% d. 95%

a. 85%

In terms of hemoglobin, which of the following would indicate anemia in females? a. <12 g/dL b. <14 g/dL c. <15 g/dL d. <20 g/dL

a. <12 g/dL

Bactrim should NOT be prescribed to which of the following patients? a. A 1-month old child. b. A woman who is in the 15th week of pregnancy. c. A 55 year old man. d. A 60 year old woman.

a. 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.

The NP notices a mass in her patient's left breast. The patient expresses that she has felt the mass for a while and it's getting more painful. What should the NP order for further testing? a. A breast ultrasound. b. A referral to a dermatologist. c. A breast biopsy. d. Recommend surgery to remove the mass.

a. A breast ultrasound.

The ANP is prescribing a pseudoephedrine/phenylephrine preparation for his patient. Of the following, which would the ANP prescribe? a. Entex. b. Rhinocort. c. Muro 128. d. Bacitracin 500 u/g.

a. Entex. - Entex = Pseudoephedrine/Phenylephrine preparation - Rhinocort = Inhaled Nasal Steroid - Muro 128 = Lubricating Ophthalmic Drop - Bacitracin 500 u/g = Anti-staphylococcal

When you are examining a newborn you find white papules on the gum line. They resemble an erupting tooth. You know that these are known as which of the following? a. Epstein's pearls b. epispadias c. hypospadias d. Moro lesions

a. Epstein's pearls Epstein's pearls are small white or yellow cystic vesicles (1 to 3 mm in size) often seen in the mouth of newborn infants. They do not require treatment because they resolve spontaneously over the first few weeks of life.

Which of the following statements about cervical adenitis is least accurate? a. Epstein-Barr virus is the most common cause. b. The most common site is submandibular and anterior cervical. c. It is rarely due to trauma. d. It may be easily mistaken for a goiter or thyroid nodule.

a. Epstein-Barr virus is the most common cause. Epstein-Barr virus is one of the less common causes of cervical adenitis which is enlargement of a cervical lymph node. The most common pathogens include: S. aureus, S. pyogenes (Group A Strep), and atypical mycobacteria.

A mother brings her 6-month old child into the clinic for a well-baby check. The mother is concerned about her child's teething. The FNP might tell her all of the following about teething EXCEPT: a. Eruption typically begins at approximately 9 months of age. b. Signs of teething include local sensitivity and inflammation. c. The child may have increased drooling and biting. d. There is no evidence that teething causes fever, diarrhea or other systemic illnesses.

a. Eruption typically begins at approximately 9 months of age. Eruption typically begins at approximately 6 months of age.

You are providing patient education about breast self exam. Which of the following should be the first step in any self exam? a. Examine the breasts in a mirror with the arms in several different positions. b. Examine the breasts while lying down. c. Press the surface of the breasts with the pads of the fingers, in a wedge pattern. d. Closely examine the skin of the breasts for any bumps.

a. Examine the breasts in a mirror with the arms in several different positions.

All of the following are changes in the gastrointestinal system that occur in the elderly EXCEPT: a. Large bowel transit time is faster. b. There is delayed gastric emptying. c. Sensitivity of the taste buds decreases. d. Constipation is more common.

a. Large bowel transit time is faster. Besides the other three choices changes include: receding gums and dry mouth; decreased efficiency in absorbing some vitamins; and higher risk of gastritis and GI damage from decreased production of prostaglandins.

A patient who has been prescribed Xanax for anxiety should be advised of all but which of the following potential side effects? a. Unusual hair growth. b. Drowsiness. c. Dependency. d. Increased saliva production.

a. Unusual hair growth. Hair growth is not a documented side effect of Xanax (alprazolam). Patients taking Xanax do have a risk of developing dependency. Increased saliva production, drowsiness, dizziness, and changes in sex drive may also occur.

Which of the following drugs is a Category D drug that should only be prescribed for pregnant women if the benefits outweigh the risks of using the drug? a. Valium b. Keflex c. Cipro d. MacroBid

a. Valium

You are conducting an assessment with a female patient that will involve a pelvic exam. What type of lubricant should be used on the speculum? a. Water-based lubricant. b. Warm water. c. KY jelly. d. Petroleum jelly.

a. Water-based lubricant.

A 65-year-old patient has presented with what is determined to be Crohn's disease. Of the following, which sign/symptom is LEAST likely noted with the patient? a. Weight gain. b. Low-grade fever. c. Abdominal pain. d. Malaise.

a. Weight gain. Weight gain is typically not noted, but weight loss is. Other common signs/symptoms are postprandial bloating, nonbloody diarrhea, and abdominal mass in the lower quadrants.

Which of the following types of wounds is most likely to present a risk for tetanus infection? a. a puncture wound from a gardening tool b. an abrasion on the knee c. a surgical incision d. a laceration on the palm of the hand

a. a puncture wound from a gardening tool

Initial conservative therapy for tennis elbow, injury to the extensor tendon at the lateral epicondyle, includes all but which of the following? a. a short arm cast b. avoidance of the precipitating activity c. application of appropriate splints d. use of NSAIDs

a. a short arm cast

Mr. Gibbons complains of feeling facial pressure that worsens when he bends over. He also tells you that he has pain in his molars and a headache that is centered in his forehead area. The most likely diagnosis for this patient is: a. acute sinusitis b. rhinitis medicamentosa c. otitis externa d. otitis media

a. acute sinusitis

A patient has been diagnosed with H. Pylori-negative ulcers. Which of the following would NOT be a part of the patient's recovery plan? a. antibiotics b. H2 blockers c. proton pump inhibitor d. all of the above

a. antibiotics

Which of the following bronchodilator categories would include ipratropium bromide and glycopyrrolate? a. anticholinergics b. methylxanthines c. beta-agonists d. combination beta-agonist and anticholinergic

a. anticholinergics

You would advise the parents of a child who has mumps to do which of the following? a. avoid acidic food and drink for the child b. suck on peppermint candies for relief c. avoid giving too many fluids d. no isolation is necessary

a. avoid acidic food and drink for the child Peppermint should be avoided as it irritates the mucous membranes. Fluids should be pushed, as well as bed rest and warm or cold compresses to the affected area (whichever is more soothing) and the child should be isolated until the swelling disappears.

You have a patient with deep vein thrombosis. Which of the following is NOT considered a risk factor for DVT? a. being underweight b. oral contraceptives c. rheumatoid disease d. high altitude

a. being underweight

The Jones criteria are the major criteria for ARF. Which of the following is NOT part of these criteria? a. breast tenderness b. carditis c. polyarthritis d. erythema marginatum

a. breast tenderness

Lorenzo is a 7-year-old male patient with pertussis. He will be highly infectious in which of the following stages of the disease? a. catarrhal stage b. prodromal stage c. paroxysmal stage d. convalescent stage

a. catarrhal stage The catarrhal stage is of pertussis usually lasts 1 to 2 weeks. The person with pertussis is highly infectious during this stage. Lorenzo should not return to school until 5 days of antibiotic treatment have been completed.

You are evaluating a patient who has had a potential stroke. The nurse practitioner knows that which of the following is the most common cause of a stroke? a. cerebral ischemia b. cerebral hemorrhage c. venous insufficiency d. subdural hemorrhage

a. cerebral ischemia About 80% of strokes are due to cerebral ischemia, which makes cerebral ischemia the most common cause of strokes. Further, about 15% of strokes are due to cerebral hemorrhage. Then, about 5% of strokes are due to subarachnoid hemorrhage. Venous insufficiency is not a cause.

All of the following would indicate failure to thrive (FTT) in an infant or child EXCEPT: a. chronic gastrointestinal problems b. failure to gain weight c. falling below the fifth percentile on growth charts d. dropping more than 2 standard deviations on the growth curve

a. chronic gastrointestinal problems

The FNP has an elderly patient who is complaining of a gradual onset of dyspnea, a dry cough and swollen feet and ankles. He also tells her that he has gained weight. Examination reveals bibasilar crackles on the lung base and the presence of the S3 heart sound. The FNP know that these are indications of which of the following? a. congestive heart failure b. myocardial infarction c. bacterial endocarditis d. acute abdominal aneurysm

a. congestive heart failure

Which of the following factors would increase the susceptibility of a person for glaucoma? a. corticosteroid therapy b. mental illness c. history of pneumonia d. history of heart disease

a. corticosteroid therapy Others include: eye inflammation or trauma; neoplasm; neovascularization; and increasing age.

You have a patient who needs to incorporate foods with iron into the diet. Which of the following foods would you suggest to her to increase iron in the diet? a. dried peas and beans b. canola oil c. orange juice d. sauerkraut

a. dried peas and beans Organ meats, egg yolk, tofu, raisins, broccoli, and collard greens (among other foods) are also rich in iron.

Mr. Stuckey is a 55-year-old male who is suffering from hemorrhoids. You might counsel Mr. Stuckey to do all of the following EXCEPT: a. eat a low fiber diet b. control his weight c. participate in exercise regularly d. increase his fluid intake

a. eat a low fiber diet Strategies for hemorrhoid relief include eating a high fiber diet. Treatment for acute flare-ups includes the use of astringents and topical corticosteroids.

You are treating a 42-year-old male with moderate anxiety. You would seek consultation with a mental health specialist when which of the following occurs? a. escalation of symptoms to the point of refusal of treatment b. patient has a sleep disturbance c. patient has loss of appetite d. increase in stressors

a. escalation of symptoms to the point of refusal of treatment Other reasons include: psychotic paranoid thought processes; suicidal or homicidal ideation; level of anxiety reaches panic state; and no response to standard treatment.

The American Cancer Society colorectal cancer screening guidelines recommend which of the following as a screening test for colorectal cancer? a. fecal occult blood test at home with collection of two samples from three consecutive specimens b. fecal occult blood test obtained via the digital rectal examination in the provider's office c. toilet bowl fecal occult blood test d. digital rectal examination

a. fecal occult blood test at home with collection of two samples from three consecutive specimens

You have a patient with pyelonephritis. In terms of follow-up on this patient, all of the following are indications for urologic investigation such as intravenous pyelogram or ultrasonography EXCEPT: a. female gender b. patients with evidence of renal scarring c. recurrent UTIs d. clients with gross hematuria

a. female gender

You have a patient who has diverticulosis. You would recommend all of the following to prevent colonic diverticulitis EXCEPT: a. foods low in uric acid b. aerobic exercise c. sufficient hydration d. a high-fiber diet

a. foods low in uric acid

An 82-year-old male is brought to the clinic by his daughter because he is not able to perform some tasks at home that he previously had no trouble doing. Your assessment for functional limitations would include all but which of the following? a. having the patient rate himself b. assessing the chronology of the limitations c. using family assessment of the limitation d. considering environmental factors

a. having the patient rate himself The patient usually tends to be more optimistic about his abilities and overrates them. This is, therefore, not a reliable method of assessment.

As a practicing NP you know that the leading cause of death for all ages and genders is which of the following? a. heart disease b. motor vehicle crashes c. cancer d. unintentional injuries

a. heart disease Heart disease is the leading cause of death for all ages and genders. Motor vehicle crashes are the leading cause of death in adolescents. Cancer is the second leading cause of death for all ages and genders; and unintentional injuries are the leading cause of death for children aged 12 months to 9 years.

You have a female patient for whom laboratory tests have confirmed your diagnosis of iron deficiency anemia. Which of the following patient results would NOT support this diagnosis? a. hematocrit: 40% b. TIBC: 550 µg/dL c. serum ferritin: 10 ng/dL d. serum iron: 40 µg/dL

a. hematocrit: 40%

Mr. Egan comes to the clinic complaining of a painful red pustule on his upper eyelid. Which of the following is the most likely diagnosis? a. hordeolum b. chalazion c. herpes keratitis d. pinguecula

a. hordeolum The patient usually complains of an itchy eyelid and an acute onset of a red papule or pustule on either the upper or lower eyelid.

Arcus senilis in a patient aged 40 years old may be a sign of which of the following? a. hypercholesterolemia b. hypertension c. diabetes mellitus d. none of the above

a. hypercholesterolemia

You have a 35-year-old male patient who comes to you with a raised yellow plaque on his upper eyelid. You diagnose xanthelasma. You know that in a person of his age, this could indicate which of the following? a. hyperlipidemia b. glaucoma c. melanoma d. acne

a. hyperlipidemia

An 81-year-old female is in the office. She has been taking ibuprofen over-the-counter in large dosages for a long time. The nurse practitioner comprehends which side effect is likely regarding this situation? a. impairment of renal function b. liver failure c. neuropathy d. none of the above

a. impairment of renal function

Which of the following is one of the most common causes of failure to thrive in an infant? a. improper feeding b. hypothyroidism c. cystic fibrosis d. celiac disease

a. improper feeding

The nurse practitioner understands that when treating a child on long-term antihistamine therapy there will be a need for supplements due to decreased absorption of: a. iron b. magnesium c. niacin d. calcium

a. iron Antihistamines block the absorption of iron, vitamin B12, and folate. Iron, a mineral, helps the body make myoglobin, located in the muscles and hemoglobin, located in the red blood cells. Additionally, the iron helps the body to store and move oxygen.

Which of the following is considered the gold standard for diagnosis of endometriosis? a. laparoscopy b. CA 125 c. MRI d. pelvic ultrasound

a. laparoscopy Laparoscopy is considered the gold standard for diagnosis by enabling direct visualization of endometrial implants. They may appear as: classic brown "powder burn" lesions; reddish-blue lesions on pelvic viscera; or endometrioma "chocolate cysts" on the ovary.

Osteoporosis is indicated by a bone density score of which of the following? a. less than -2.5 b. between -1 and -2.5 c. greater than -1 d. none of the above

a. less than -2.5

You have prescribed morphine for pain relief for a patient. You know that this patient must be monitored for respiratory depression. If this patient experiences narcotic-induced respiratory depression, which of the following drugs is most likely to be prescribed to address this? a. naloxone b. codeine c. butorphanol d. dilaudid

a. naloxone

Elmer is a client who comes to you complaining of difficulty hearing. He works in an automotive plant with loud machinery in use at all times. He has been exposed to this environment for 25 years. This supports a diagnosis of which of the following? a. noise trauma b. otosclerosis c. presbycusis d. ototoxicity

a. noise trauma Also termed acoustic trauma, it can be related to a single, very loud noise or by exposure to a noise at a lower decibel over a long period of time. Sounds louder the 85 dB are potentially damaging to the cochlea, especially with prolonged exposure such as having worked in a factory for over 20 years.

You have a patient who is complaining that her menstrual period now occurs every 45 days instead of the usual 28 days. Your notation in the records of this woman will be which of the following? a. oligomenorrhea b. metrorrhagia c. dysmenorrhea d. hypermenorrhea

a. oligomenorrhea

Development of a child is usually assessed in four areas. Which of the following is NOT one of these areas? a. personality b. gross motor skills c. fine motor skills d. social skills

a. personality

You are seeing an uncircumcised client that presents with a complaint of not being able to retract the foreskin over the glans penis. What is the likely diagnosis? a. phimosis b. paraphimosis c. lateral phimosis d. Peyronie's disease

a. phimosis

A 70-year-old male comes to the FNP with a raised, red lesion in his oral cavity. He tells the FNP that he is afraid that it is cancer. Besides evaluating the lesion the FNP evaluates the man's risk for oral cancer. These risks include all of the following EXCEPT: a. poor diet b. alcohol abuse c. tobacco abuse d. advanced age

a. poor diet

You are treating a 24-year-old man with infectious mononucleosis for tonsillar hypertrophy, exudative pharyngitis, difficulty swallowing, and a patent airway. For this case, you know that you should prescribe: a. prednisone b. acyclovir c. amoxicillin d. ibuprofen

a. prednisone In this case, the treatment would include a corticosteroid, such as prednisone 40 to 60 mg/day for 3 days.

You have a client who has not had her period in over 2 months. She is 35 years of age. Which of the following is a first-line test for amenorrhea in this 35-year-old woman? a. pregnancy test b. prolactin level c. TSH level d. HIV test

a. pregnancy test

Mr. Sellers has prostatitis that is causing painful urination. He tells you that he finds it hard to urinate and has a decreased urinary flow with hesitancy. He admits to having some back pain. Which type of prostatitis does Mr. Sellers most likely have? a. prostatodynia b. chronic bacterial prostatitis c. nonbacterial prostatitis d. acute bacterial prostatitis

a. prostatodynia Prostatodynia, also called chronic pelvic pain syndrome, presents with no fever and all of the other symptoms listed in the question. There are no other physical findings as there might be in other types of prostatitis.

A mother brings in her 10-year-old son who is having recurrent abdominal pain. After organic diseases are ruled out, you develop a therapeutic plan for this child. This plan would include which of the following? a. reassuring the parent that there is no organic cause b. avoiding fiber supplement c. decreasing fiber in the diet d. increasing juice intake

a. reassuring the parent that there is no organic cause

Which of the following are you likely to find in pulmonary function tests for a patient with COPD? a. reduced FVC b. increased FEV1 c. increased ratio of FEV1 to FVC d. decreased RV

a. reduced FVC Pulmonary function studies for a person with COPD include; reduced FVC, reduced FEV1, reduced ratio of FEV1 to FVC, increased RV, and increased TLC. COPD affects more than 10 million people in the United States.

A 35-year-old female patient tells you that she has not had a period in over 6 months. She tells you that until now she has been quite regular with her periods. This condition is which of the following? a. secondary amenorrhea b. primary amenorrhea c. physiologic amenorrhea d. functional amenorrhea

a. secondary amenorrhea

Which of the following symptoms would NOT be consistent with a moderate level of anxiety in a patient? a. significant changes in eating habits b. muscle tension c. restlessness d. selective inattention

a. significant changes in eating habits

A patient comes into the clinic for an employee physical examination. In the course of the examination the FNP finds that the patient has a blood pressure reading of 168/105. The FNP knows that this means that this patient is in which stage of hypertension? a. stage 2 b. stage 1 c. normal d. prehypertension

a. stage 2

Mrs. Ross is a 65-year-old patient who has been diagnosed with degenerative joint disease (DJD). You might prescribe all of the following medications to address this disease EXCEPT: a. systemic oral steroids b. NSAIDs c. analgesics d. steroid injection on inflamed joints

a. systemic oral steroids

You have a 59-year-old male patient of Vietnamese ethnicity who has lived in the United States since shortly after birth. A routine CBC reveals microcytic and hypochromic red blood cells. The total red blood cell count was mildly elevated. Which of the following diseases/conditions might these results indicate? a. thalassemia minor b. acute leukemia c. pernicious anemia d. normocytic anemia

a. thalassemia minor

The extent of involvement of the body in burns is measured by using the "rule of nines." Which of the following percentages of body involvement according to this rule is NOT accurate? a. torso = 27% b. posterior head = 4.5% c. front of right leg = 9% d. genitalia = 1%

a. torso = 27% Both torso and abdomen, as well as the back are 18%. Another estimate of extent of involvement is to equate the patient's palm size as 1% of total body size.

A "strawberry cervix" is most associated with which of the following? a. trichomonas vaginitis b. bacterial vaginosis c. candidal vaginitis d. atrophic vaginitis

a. trichomonas vaginitis Trichomonas vaginitis is caused by a unicellular protozoan parasite with flagella that infects genitourinary tissue. Infection causes inflammation of the vagina/urethra and a "strawberry cervix" from small points of bleeding on the cervical surface is a common finding.

Which of the following diagnostic procedures is used to detect fluid in the middle ear? a. tympanogram b. speech discrimination testing c. audiogram d. THI

a. tympanogram

You have a patient who has requested a prescription for oral contraceptives. Which of the following is NOT a contraindication for oral contraceptives? a. ulcerative colitis b. CVA c. migraines with focal aura d. thrombus or emboli

a. ulcerative colitis Besides the other three choices, contraindications include: liver tumor, CAD, pregnancy or suspected pregnancy, active liver disease, estrogen dependent tumor, undiagnosed genital bleeding, and smoking aged 35 or older.

Which of the following would be considered a second-line test for recurrent abdominal pain in children? a. ultrasound of the abdomen b. ESR c. urine analysis d. CBC

a. ultrasound of the abdomen The other choices are first-line tests, along with stool examination for ova and parasites and blood.

Mrs. Budner is a 68-year-old patient who is recovering from knee replacement surgery. She is taking OxyContin for pain relief. You recognize that you must assess her for which of the following side effects? a. urinary retention b. sharp increase in blood pressure c. diarrhea d. respiratory alkalosis

a. urinary retention

There are several different classes of innocent heart murmurs in children. A vibratory murmur (Still's murmur) has all but which of the following characteristics? a. usually detected at 8 - 14 years old b. described as musical, buzzing sound c. heard best at the middle left sternal border or between the left lower sternal border and the apex when the patient is supine d. not accompanied by a thrill

a. usually detected at 8 - 14 years old This type of murmur is usually detected at 3 - 6 years old and is uncommon before 2 years old.

You are seeing a 7-year-old patient with diarrhea, sore throat, coryza and hoarseness. What is the most likely etiology? a. viral etiology b. H. parainfluenzae c. group A Streptococcus d. mycoplasma

a. viral etiology Group A Streptococcus is usually not accompanied by coryza and H. Further, parainfluenzae is not a common cause of pharyngitis. Mycoplasma is not associated with upper respiratory tract infections, but seen in lower respiratory infections.

The FNP has a patient who has been diagnosed with Bell's palsy. The FNP knows that all of the following are true about treatment of the disease EXCEPT: a. Systemic corticosteroid therapy has been shown to limit the length and severity of the paralysis. b. Systemic corticosteroid therapy is effective no matter when it is started during the progression of the disease. c. Acyclovir is associated with some controversy as a treatment for Bell's palsy. d. Supportive care to help avoid ocular and oral injury is needed.

b. Systemic corticosteroid therapy is effective no matter when it is started during the progression of the disease. Systemic corticosteroid therapy is most effective when started early in the disease. It is of no use if begun more than 10 days after the onset of symptoms.

What test do you perform to confirm a diagnosis if the ELISA test comes back positive? a. Enzyme-linked immunosorbent assay. b. Western blot test. c. PCR. d. CPK.

b. Western blot test. This is typically followed by the Western blot test to confirm a diagnosis of Lyme disease.

Which of the following is NOT one of the standard lethality assessment questions? a. Do you have a suicide plan? b. What do you think happens after we die? c. Do you feel as though your life is no longer worth living? d. Have you thought about taking your own life?

b. What do you think happens after we die?

Which of the following would be considered a test for bacterial vaginosis? a. Potassium slide b. Whiff test c. Smell test d. Smear test

b. Whiff test To perform this test, drop one or two drops of KOH on a slide or cotton swab that is soaked with vaginal discharge. If there is a strong, fishlike odor, the test would be considered positive for BV.

Which of the following statements should be avoided when interviewing a patient? a. I don't understand. b. Why? c. When did this begin? d. Where?

b. Why?

A 45 year old patient has a history of alcoholism. He comes in with tremors, anxiety, and complaining of insomnia. What is the most likely differential diagnosis? a. Alcohol poisoning. b. Withdrawal. c. Depression. d. OCD.

b. Withdrawal.

You are managing a 74-year-old patient who has osteoarthritis and chronic pain. Which of the following medications increases the risk of a gastrointestinal related ulceration? a. warfarin b. celecoxib c. pravastatin d. thiazide diuretic

b. celecoxib Warfarin does not increase the risk of ulceration, but if one occurs, the risk of bleeding is increased. Statins and diuretics are not considered ulcerogenic.

In doing a neurological examination the Romberg test would be associated with which of the following? a. mental status b. cerebellar system c. sensory system d. motor exam

b. cerebellar system

Mrs. Harris a 67-year-old woman who is in the early stages of Alzheimer disease. She suffers from mild dementia. In this type of Alzheimer dementia which of the following would you use as the mainstay treatment? a. Vitamin E 1000 IU twice daily b. cholinesterase inhibitors c. NSAIDS d. Selgiline 5 mg twice daily

b. cholinesterase inhibitors These include donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne). They have a clear, although minor and time-limited benefit.

A 48-year-old male patient complains of a sudden onset of severe "ice pick" pains behind one eye. He tells you that the headache is accompanied by tearing, a clear runny nasal discharge, and a drooping eyelid. What type of headache would you diagnose? a. muscle tension headache b. cluster headache c. migraine headache d. temporal arteritis

b. cluster headache

Which of the following types of headaches typically lasts several weeks to months? a. tension headaches b. cluster headaches c. migraine headaches without aura d. migraine headaches with aura

b. cluster headaches

All of the following are examples of clinical problems with multi-factorial etiology that are better understood through a transactional perspective EXCEPT: a. failure to thrive b. congenital anomalies c. hyperactivity d. eating disorders

b. congenital anomalies Transactional models describe risk and protective factors associated with vulnerability and resilience in the face of adversity. Examples of clinical problems that are better understood through a transactional perspective are failure to thrive, child abuse, attention deficit, hyperactivity, conduct and eating disorders.

A family member brings her elderly mother into the office with a new onset of fecal incontinence. The nurse practitioner knows that the most common cause is: a. poor fluid consumption b. constipation c.medication related d. inactivity

b. constipation Risk factors include age greater than 80 years, impaired mobility, and neurologic disorders including dementia. While inactivity and poor fluid consumption may contribute to constipation, they are not the cause of fecal incontinence.

You are examining Gerald, an older patient who has a history of smoking and high cholesterol. Gerald is having pain when he walks that has become worse over time. If, as you suspect, this patient has peripheral arterial disease you might see all of the following in your examination of this patient EXCEPT: a. shiny hairless ankles b. decreased capillary refill time c. cool ankles d. decreased dorsal pedal pulse

b. decreased capillary refill time

Medicaid is a federal program administered by the states. All of the following statements regarding Medicaid are true EXCEPT: a. Medicaid pays NPs 70% to 100% of the fee-for-service rates set for physicians by state Medicaid agencies. b. Federal law controls the rates paid by Medicaid. c. Medicaid reimbursement generally is lower than the rate paid by commercial insurers. d. Many states have applied to the federal government for a Medicaid waiver in order to administer Medicaid in ways that differ from federal laws and regulations.

b. Federal law controls the rates paid by Medicaid.

If an FNP wants to prescribe a topical corticosteroid with the lowest potency, he would prescribe which of the following? a. Desoximetasone b. Fluocinolone c. Clobetasol propionate d. Betamethasone

b. Fluocinolone Fluocinolone is a medium potency topical corticosteroid. Desoximetasone is high potency; Clobetasol propionate and Betamethasone are very high potency.

Which of the following drugs is a neuropathic analgesic? a. Cefalexin b. Gabapentin c. Ciprofloxacin d. Dicloxacillin

b. Gabapentin

An 18-month-old male child presents with a low-grade fever. Your initial treatment for this patient would be which of the following? a. Do nothing. b. Give antipyretics and observe. c. Obtain a CBC. d. Give prophylactic antibiotics for 3 days pending blood culture results.

b. Give antipyretics and observe. If fever is over 102° F, then you would obtain a CBC. If the WBC is greater than 15,000/mm3, then you would obtain a blood culture and administer IM Ceftriaxone.

Which of the following would be considered the correct term for a court-appointed guardian that is assigned to act in the best interest of the ward? a. Power of attorney b. Guardian Ad Litem c. Ombudsman d. Health Care Power of Attorney

b. Guardian Ad Litem

A 32 year old female patient reports feeling achy and nauseous for three weeks. She also says her urine is very dark. Her temperature is 100.7F. She has a long-term history of multiple male sexual partners. Which of the following tests would you order for this patient, based on her signs and symptoms? a. Urinalysis. b. Hepatitis B surface antigen. c. Hepatitis C antigen. d. Liver function.

b. Hepatitis B surface antigen.

You are educating the parents of a child who has been diagnosed with sickle cell anemia. In the course of this education you tell them that hydration is extremely important, primarily for which of the following reasons? a. Hydration promotes sickling. b. Hydration promotes hemodilution and circulation of the red cells through the blood vessels. c. Hydration eliminates the need for supplemental iron to be given to the child. d. Hydration will help keep the sickled cells from flowing through capillary beds.

b. Hydration promotes hemodilution and circulation of the red cells through the blood vessels. Dehydration promotes sickling. Iron is not necessary for a child with sickle cell anemia because it is not caused by an iron deficiency. It is the fact that the cells are sickled that keeps them from flowing through capillary beds.

You are conducting an assessment with a 40 year old male patient. He says that he is urinating more frequently, though this may be because he is drinking so much water due to being thirsty all the time. He also reports being frequently tired and having headaches. This patient should be further assessed for which of the following? a. Hypoglycemia. b. Hyperglycemia. c. Myocardial infarction. d. Anemia.

b. Hyperglycemia.

The nurse practitioner (NP) is examining a child for a sore throat. Which of the following statements is true regarding tonsils? a. Most cases of tonsillitis are caused by beta-hemolytic streptococcal infection. b. Hypertrophied tonsils in children usually represent a normal finding. c. Tonsils enlarge as the child grows older. d. Children with large tonsils are more prone to tonsillitis than those with small tonsils.

b. Hypertrophied tonsils in children usually represent a normal finding. Only about 25% of tonsillitis is caused by streptococcal infection. Further, children with large tonsils are more prone to tonsillitis than those with small tonsils is a false statement.

You are providing care to a patient who is presenting symptoms of angina. He is confused and agitated, and his skin is clammy. This patient is experiencing which of the following? a. Hyperpoxia. b. Hypoxia. c. Dehydration. d. Myocardial infarction.

b. Hypoxia.

A murmur is suspected in an elderly patient. The sound is loud and accompanied by palpable thrill. Which of the following grades is this type of murmur? a. III/VI. b. IV/VI. c. V/VI. d. II/VI.

b. IV/VI. Each of the preceding murmur grades is defined below: - III/VI - Moderately loud - IV/VI - Loud with palpable thrill - V/VI - Very loud and heard with the stethoscope partially off the chest; palpable thrill - II/VI - Quiet but heard as soon as the stethoscope is placed on the chest

Which of the following statements about Medicaid is incorrect? a. The federal government has given most of the rule-making and administrative duties for Medicaid to the individual states. b. If NPs are not included as providers in the language of a state waiver to enroll all Medicaid patients in managed care, they may not care for Medicaid patients covered by traditional Medicaid either. c. In most cases state law controls Medicaid activities. d. States must follow CMS rules and regulation regarding administration of Medicaid.

b. If NPs are not included as providers in the language of a state waiver to enroll all Medicaid patients in managed care, they may not care for Medicaid patients covered by traditional Medicaid either.

Mrs. Worley is a 78-year-old patient who has diverticulitis. Which of the following medications are you least likely to prescribe for Mrs. Worley? a. trimethoprim/sulfamethoxazole b. Imitrex c. metronidazole d. Cipro

b. Imitrex

When treating an infection in an elderly adult, it is important that the nurse practitioner considers: a. Immune function increases with age. b. Immune function declines with age. c. Antibody production increases. d. Thymus-derived immunity is increased.

b. Immune function declines with age. Notable immune function declines with age, making the older adult more susceptible to infection. Elderly people have less thymus-derived immunity due to the shrinking of the thymus gland, thus making it more difficult for the older adult to produce antibodies.

In making your diagnosis, you describe your elderly patient's skin condition as being annular. What does that mean? a. In streaks. b. In a ring. c. Netlike cluster. d. Along a neurocutaneous dermatome.

b. In a ring. Annular - in a ring Reticular - netlike cluster Dermatomal - along a neurocutaneous dermatome Linear - in streaks

What is the significance of an S4 heart sound? a. It is a marker of ventricular overload or systolic dysfunction or both. b. It is a marker of poor diastolic function, most often found in poorly controlled hypertension or recurrent myocardial ischemia. c. It marks the end of systole and is produced by events surrounding closure of aortic and pulmonic valves. d. It marks the beginning of systole and is produced by events surrounding closure of the mitral and tricuspid valves.

b. It is a marker of poor diastolic function, most often found in poorly controlled hypertension or recurrent myocardial ischemia.

Grace is a 17 year-old female patient with anorexia nervosa. You are educating her parents about this condition. Which of the following statements would you NOT make to these parents? a. Approximately 90% of patients are female. b. It is associated with OCD in 86% of cases. c. It is associated with depression in 65% of cases. d. The maximum frequency of occurrence is 12 - 25 years of age.

b. It is associated with OCD in 86% of cases. Anorexia nervosa is associated with OCD in 26% of cases.

A diet often recommended for hypertension management is the DASH diet. Which of the following is NOT true of this diet? a. It is high in calcium. b. It is very low in protein. c. It is high in magnesium. d. It is high in potassium.

b. It is very low in protein.

Which of the following statements about pharmacologic maintenance treatment for a patient with Meniere's disease is least accurate? a. The aim is to attempt to modify the endolymphatic hydrops by lowering endolymphatic pressure. b. Long-term maintenance therapy is always recommended. c. Maintenance therapy usually includes diet modifications combined with pharmacologic interventions. d. Medical options include intratympanic aminoglycosides to control vertigo.

b. Long-term maintenance therapy is always recommended. Long-term maintenance therapy is usually not recommended because of the fluctuant nature of the disease.

An athletic individual presents with an acute knee injury. The knee remained swollen for days and occasionally gives out. Which test will determine the most likely cause? a. CBC. b. MRI. c. Spinal tap. d. RBC count.

b. MRI.

A 56-year-old Caucasian female is in the office inquiring about menopause. What is the best way to define menopause and counsel her? a. Menopause is the last menstrual period. b. Menopause is the completion of 12 months of amenorrhea after the last menstrual period. c. Menopause is indicated by a FSH level of 30 and estradiol level of 30. d. Menopause does not cease the ability for natural reproduction.

b. Menopause is the completion of 12 months of amenorrhea after the last menstrual period.

After thorough testing of your elderly patient, you diagnose him as being positive for Mushroom picker's disease. Of the following, which was he MOST likely exposed to that caused this illness? a. Rotting maple tree bark. b. Moldy compost. c. Moldy cork dust. d. Contaminated humidifier.

b. Moldy compost. Maple bark stripper's disease is typically caused by rotting maple tree logs or bark, and Mushroom picker's disease, moldy compost. Suberosis is caused by moldy cork dust and "Humidifier" lung, contaminated humidifiers, air conditioners, or heating systems.

Jill, a 42-year-old patient is being prescribed a topical steroid with medium potency. Which of these is it? a. Hydrocortisone acetate 1%. b. Mometasone furoate 0.1%. c. Amcinonide 0.1%. d. Clobetasol propionate 0.05%.

b. Mometasone furoate 0.1%.

You are crafting a plan of care for a 32 year old female patient who has large uterine fibroids. These are causing her intense discomfort and anemia from heavy periods. She says she hopes to have children within the next several years. Which of the following procedures is the best choice for this patient? a. Partial hysterectomy. b. Myomectomy. c. Fibroid embolization. d. Uterine ablation

b. Myomectomy. A myomectomy removes fibroids but leaves the uterus intact. For patients who have child bearing plans, this is often the best choice. Healthy pregnancies are common after myomectomy. However, fibroids may return.

Typically, what is the drug of choice to use for a child with juvenile rheumatoid arthritis (JRA)? a. acetylsalicylic acid b. NSAID c. corticosteroids d. etanercept

b. NSAID ASA (aspirin) is not recommended because of the possibility of Reye's syndrome.

In terms of newborn vision, which of the following statements is correct? a. Newborns are farsighted. b. Newborns can focus best at a distance of about 8 - 10 inches. c. Preferred colors are yellow and blue. d. Newborns have excessive tears when crying.

b. Newborns can focus best at a distance of about 8 - 10 inches.

At a follow-up appointment, a patient tells you that he tried the low-salt diet recommended for management of his hypertension, but just couldn't follow it. This patient would be diagnosed with which of the following? a. Ineffective individual coping. b. Noncompliance. c. Nutrition pattern, altered. d. Powerlessness.

b. Noncompliance.

An elderly patient presents with diarrhea. She explains to the NP that her stool is large and liquid. Testing shows that her stool shows no signs of blood or leukocytes. The NP will MOST likely give a diagnosis of what type? a. Shigella. b. Norovirus. c. Campylobacter jejuni. d. Salmonella.

b. Norovirus.

Information obtained through the nurse's senses during an assessment, such as skin temperature or bowel sounds, is known as a. Subjective data. b. Objective data. c. Signifying data. d. Symptomatic data.

b. Objective data.

Which of the following statements in regard to interpreting developmental landmarks and milestones is least accurate? a. Loss of developmental milestones previously achieved is a significant finding in any developmental assessment. b . Fine motors skills are sensitive indicators of intellectual development. c. Early attainment of gross motor skills is a significant indicator of advanced intellectual development. d. Language is a sensitive indicator of intellectual development.

c. Early attainment of gross motor skills is a significant indicator of advanced intellectual development.

In terms of educating the older population about health maintenance and preventive care which of the following statements is least accurate? a. Teach them to rise to an upright position slowly. b. Encourage use of family, friend, and community support systems. c. Encourage use of over-the-counter medications for financial savings. d. Encourage counseling to prevent illness.

c. Encourage use of over-the-counter medications for financial savings. The FNP should discourage the use of over-the-counter medications as they may interact with prescribed drugs. The FNP should review all medications yearly and encourage the patient to throw away outdated drugs and prescriptions.

Which of the following would place the patient at risk for aspiration? a. Anxiety. b. Defensive coping. c. Enteral feeding. d. High blood pressure.

c. Enteral feeding.

Your patient is a 9-year-old female child who is 4 feet 4 inches and weighs 110 lb. This child has a body mass index over the 95th percentile and is therefore overweight. You understand that all of the following are true in regard to the management and treatment of obesity in children EXCEPT: a. Promote prevention in infancy through parent education regarding nutritional needs and feeding strategies. b. Discuss moderate modification of diet while increasing exercise. c. Establish a goal for younger children to include weight reduction. d. Use behavior modification strategies.

c. Establish a goal for younger children to include weight reduction.

Nurse Sara is consulting with a patient who was tested for a Vitamin D deficiency. She instructs the patient to incorporate more Vitamin D rich foods into her diet to keep her levels up, which includes which of the following foods? a. Starch vegetables, such as potatoes or peas. b. Lean red meats. c. Fish, such as tuna or salmon. d. Fresh citrus fruits.

c. Fish, such as tuna or salmon.

Gretchen is a 32-year-old sexually active female patient with symptoms of PID. She complains of right upper quadrant abdominal pain and tenderness on palpation. Liver function tests are normal. You understand that this is most likely which of the following? a. Reiter's syndrome b. Jarisch-Herxheimer reaction c. Fitz-Hugh-Curtis Syndrome d. none of the above

c. Fitz-Hugh-Curtis Syndrome Fitz-Hugh-Curtis Syndrome is a complication of disseminated GC and/or PID. It is an infection of the liver capsule. It results in extensive scarring between the liver capsule and abdominal contents.

A college student is dehydrated with irregular heartbeat and vomiting. The family interview reveals that she frequently uses energy drinks to stay awake while studying. What question should the patient be asked? a. Are the symptoms new? b. When was your last medical exam? c. How many energy drinks have you had recently? d. How long have you been using energy drinks?

c. How many energy drinks have you had recently?

Which of the following would not be considered signs and symptoms of Rocky Mountain Spotted Fever? a. High fever b. Small red spots starting on hands and feet c. Hyperglycemia d. Severe headaches

c. Hyperglycemia Signs and symptoms of Rocky Mountain Spotted Fever (RMSF) would include: - An abrupt onset of high fever (103-105 degrees F) - In 3 days, small red spots will start to erupt on both their hands and feet progressing rapidly to their trunk and then becoming generalized. - Nausea/vomiting - Severe headaches - Myalgia - Red eyes - Arthralgia

You are performing an assessment with a 32 year old female patient who reports that her menstrual periods are irregular and extremely light. She also expresses frustration at the difficulty of losing weight that has accumulated around her abdomen. She also notes that she has been experiencing unusual hair growth on her upper lip for the last several months. All but which of the following are potential diagnoses for this patient? a. PCOS. b. Hypothyroidism. c. Hyperthyroidism. d. Cushing's syndrome.

c. Hyperthyroidism.

You are evaluating your elderly patient and determine that she has a heart murmur. When listening to it, you note the sound is faint and sometimes cannot be heard when your patient changes positions. How would this murmur be graded? a. III/VI. b. IV/VI. c. I/VI. d. II/VI.

c. I/VI. I/VI: Heart murmur makes faint sound and may not be heard when patient changes position. II/VI: Heart murmur is quiet but can be heard as soon as the stethoscope is placed on the chest. III/VI: Heart murmur is moderately loud. IV/VI: Heart murmur is loud and accompanied by a palpable thrill. V/VI: Heart murmur is very loud and can be heard with the stethoscope partially off the chest. VI/VI: Heart murmur is very loud and can be heard with the stethoscope completely off the patient's chest.

Which of the following statements about clinical observations in the assessment of children is least accurate? a. The abdomen is usually prominent in infants while standing. b. The liver may be felt 1 - 3 cm below the rib edges in infants and children. c. In older children the liver is felt even further below the rib edges than in infants and children. d. The abdomen is usually flat in infants when lying down.

c. In older children the liver is felt even further below the rib edges than in infants and children. In older children the liver should not be felt below the rib edges. When assessing the abdominal system you would also assess for peristaltic waves, hernias, abnormal masses, and organomegaly; and observe umbilicus for drainage, inversion, eversion, and hernia.

During infancy, which of the following would be considered the first teeth that would come through? a. Canines b. Molars c. Incisors d. None of the above

c. Incisors

Which of the following medications or treatments is least likely to be prescribed for head lice? a. permethrin 1% cream rinse b. nit removal with a fine tooth comb c. Lindane 1% shampoo d. soaking brushes and combs in Nix shampoo

c. Lindane 1% shampoo This is least likely to be prescribed because of neurotoxic effects. It is definitely contraindicated in infants, toddlers, or any patient with neuro or seizure disorder.

If the nurse practitioner administers the influenza immunization to a patient, which of the following side effects might they instruct the patient they might experience from the injection? a. Nausea/vomiting b. Severe headaches c. Localized reactions-soreness/redness at the injection site d. Joint pain

c. Localized reactions-soreness/redness at the injection site

Louis is a 67-year-old male patient with open-angle glaucoma. Your follow-up for Louis should include which of the following? a. Caution the person to avoid exercise. b. Monitor a high-protein, low-fat diet. c. Monitor for side effects of beta blocker use. d. Follow up IOP and visual field changes every six weeks.

c. Monitor for side effects of beta blocker use. Even with topical use, bronchoconstriction may be a side effect of these drugs.

You are conducting an assessment with a patient with Type 2 diabetes. In order to assess the patient's level of feeling in the feet, which of the following tests would you perform? a. Skin turgor test. b. Capillary response test. c. Monofilament test. d. Tilt table test.

c. Monofilament test.

Which of the following statements would not be considered correct regarding polioviruses? a. The polioviruses are considered to be transmitted by the fecal-oral route. b. Polioviruses are considered contagious. c. The rates of infection among households can be as high as 20%. d. North and South America are considered to be declared free of indigenous poliomyelitis.

c. The rates of infection among households can be as high as 20%. The rates of infection among households can be as high as 96%.

A 16-year-old Native American male is in the clinic with complaints of fever, sore throat, and "knots" on his neck. The nurse practitioner knows since she suspects acute mononucleosis that in assessing him she expects to find which of the following? a. swollen strawberry tongue, red rash generalized, yellow nasal discharge b. unremarkable abdomen, slightly pink throat and tonsilar hypertrophy c. cervical lymphadenopathy, red edematous tonsils and fever d. adventitious lung sounds, reddened oropharynx, clear nasal discharge

c. cervical lymphadenopathy, red edematous tonsils and fever

Which type of seizure is characterized by an unusual sense of smell or taste, visual or auditory hallucinations, and stomach upset followed by a vague stare and facial movements, muscle contraction and relaxation? a. tonic-clonic (grand mal) b. myoclonic c. complex partial d. absence (petit mal)

c. complex partial

Alex is a 39-year-old male patient who presents with fever and chills. He has splinter hemorrhages on his nailbeds and violet-colored painful nodes on his fingers. You perform a cardiac exam and find a heart murmur. Which of the following is most likely to be a diagnosis for this patient? a. congestive heart failure b. myocardial infarction c. bacterial endocarditis d. Raynaud's phenomenon

c. bacterial endocarditis

A sexually active female complains of embarrassing vaginal odor that is worse after intercourse. She also has a vaginal discharge that is thin and of milk-like consistency. Examination shows no redness or irritation. The FNP might suspect which of the following? a. Candida vaginitis b. polycystic ovary syndrome c. bacterial vaginosis d. Trichomonas vaginitis

c. bacterial vaginosis

A patient who has giant cell arteritis may present with all but which of the following symptoms? a. painful paralysis of a shoulder b. jaw claudication c. below normal body temperature d. severe headaches particularly at temples

c. below normal body temperature Below normal body temperature is not a symptom of giant cell arteritis. Fever is more likely. Other symptoms include: dry cough, scalp tenderness, visual changes, and vague pain in the tongue, head, neck, nose, or ears (among other symptoms).

You have a 50-year-old patient who has a fibroid tumor. Which of the following factors is most likely to support this diagnosis? a. multiparity b. active lifestyle c. black ethnicity d. smoker

c. black ethnicity Others include sedentary lifestyle; obesity; nulliparity; nonsmoker; age older than 35 years; family history; history of infertility; oral contraceptive use; and intrauterine device use.

For a patient with acute gastroenteritis you might recommend the BRATY diet when it is appropriate. Which of the following foods is NOT part of this diet? a. applesauce b. rice c. bran flakes d. yogurt

c. bran flakes

Which of the following would NOT be a treatment option for a person who has lymphogranuloma venereum? a. tetracycline b. azithromycin c. cefixime d. erythromycin

c. cefixime Treatment options for lymphogranuloma venereum, which is an STI caused by Chlamydia trachomatis, include tetracycline, azithromycin, and erythromycin. Cefixime would be used for gonococcal urethritis.

Maggie is a 35-year-old patient with multiple sclerosis. Which of the following factors would predict a more adverse outcome for Maggie? a. younger age at onset b. female gender c. cerebellar involvement d. long first inter-attack intervals

c. cerebellar involvement Other factors are: older age at onset, male gender, persisting deficits in brain stem, and short first inter-attack interval.

You have a patient who has had a gradual onset of dry cough, dyspnea, and swollen ankles. She tells you that she has gained some weight. Your examination reveals bibasilar crackles on the lung base and the presence of the S3 heart sound. Your diagnosis will be which of the following? a. bacterial endocarditis b. community pneumonia c. congestive heart failure d. pericarditis

c. congestive heart failure

You have a patient with chronic cholecystitis. As far as dietary changes for this patient you might suggest which of the following to help this patient have fewer episodes? a. eat fewer canned foods b. avoid bananas c. decrease fat in the diet d. decrease fiber in the diet

c. decrease fat in the diet You would also tell her to eat a low-carbohydrate, high-fiber (and low-fat) diet and to get more physical activity.

You are evaluating your patient who has conjunctivitis caused by chlamydia. Which of the following would indicate that this patient has an advanced infection? a. profuse tearing b. itchy eyes c. decreased visual acuity d. crusty discharge

c. decreased visual acuity Decreased visual acuity is an indicator of advanced infection in conjunctivitis caused by chlamydia. Photophobia and severe pain would also indicate this. Symptoms that chlamydia is the cause include pre-auricular lymphadenopathy and genitourinary symptoms.

In which layer of the skin are blood vessels, sebaceous glands, and hair follicles located? a. topmost layer of epidermis b. bottom layer of epidermis c. dermis d. subcutaneous layer

c. dermis

Mr. Calabrese is a 70-year-old patient in the middle stage of Alzheimer's disease. You understand that all but which of the following may indicate that you should consult or refer the patient? a. major depression b. Parkinson type symptoms c. diabetes d. psychosis

c. diabetes

You are doing an eye examination of a patient who may have glaucoma. Which of the following signs and symptoms are most related to this diagnosis? a. heavy mucopurulent discharge b. constricted pupils c. diffuse redness of the bulbar conjunctiva d. normal visual acuity

c. diffuse redness of the bulbar conjunctiva Diffuse redness of the bulbar conjunctiva is the symptom most related to glaucoma diagnosis. Visual acuity is decreased and there is no discharge, but possibly tears. Other findings include increased intraocular pressure and larger pupils.

The FNP is treating a 55-year-old male patient with primary open angle glaucoma (POAG). Which of the following medications is the FNP least likely to use to treat this patient? a. dorzolamide/Trusopt b. timolol/Timoptic c. pilocarpine/Pilocar d. latanoprost/Xalatan

c. pilocarpine/Pilocar Because of its ability to cause pupillary constriction, pilocarpine and similar medications are now seldom used.

Chronic sun exposure may cause a yellow, triangular thickening of the bulbar conjunctiva. This is known as which of the following? a. chalazion b. subconjunctival hemorrhage c. pinguecula d. hordeolum

c. pinguecula A pinguecula is a yellow, triangular thickening of the bulbar conjunctiva (the skin covering the eyeball). It may be located on both the inner and outer margins of the cornea.

Which of the endocrine glands stores and secretes vasopressin and oxytocin? a. hypothalamus b. parathyroid c. posterior pituitary gland d. anterior pituitary gland

c. posterior pituitary gland

You are educating a woman about osteoporosis. You tell her that the group at highest risk for development of osteoporosis is which of the following? a. postmenopausal thin, Hispanic women b. postmenopausal overweight, African-American women c. postmenopausal thin, white women d. postmenopausal overweight, Asian women

c. postmenopausal thin, white women

You have an adult type 2 diabetic client. You are telling him what his goals should be in terms of laboratory test results. All of the following would be appropriate goals EXCEPT: a. LDL cholesterol: < 100 mg/dL b. A1C: < 7% c. preprandial capillary plasma glucose (fasting): 50 - 80 mg/dL d. peak postprandial capillary plasma glucose (2 hours after meal: < 180 mg/dL

c. preprandial capillary plasma glucose (fasting): 50 - 80 mg/dL The appropriate goal for preprandial capillary plasma glucose (fasting) is 70 - 130 mg/dL.

Carol is a 19-year-old female patient who comes to you because she has not had a menstrual period for several months. She is extremely thin for her height and you have determined that she is not pregnant. You suspect anorexia nervosa. Which of the following symptoms would NOT be consistent with this diagnosis? a. dizziness b. obsession with exercise c. profuse sweating d. gastrointestinal disorders

c. profuse sweating

The person designated by a patient as the power of attorney for healthcare to make his future health care decisions in the event that he becomes mentally incompetent is known as which of the following? a. next of kin b. guardian ad litem c. proxy d. all of the above

c. proxy

Your follow-up of Theresa, a child with scoliosis, would include all of the following EXCEPT: a. evaluating the child's psychologic adjustment to the condition b. evaluating her adherence to the treatment c. rechecking her every month d. referring her when there is indication that the curve is progressing

c. rechecking her every month You would recheck the child every 6 months; not every month.

Malpractice is the failure of a professional to exercise that degree of skill and learning commonly applied by the average prudent, reputable member of the profession. There are four elements of malpractice. Which of the following is NOT one of these elements? a. duty b. causation c. relationship d. breach of duty

c. relationship The four elements are: duty, breach of duty, causation and damages (injury).

You have a patient who complains of a "stuffy nose." She has been using a nasal decongestant spray for several weeks. As an FNP you understand that prolonged use of topical nasal decongestants can cause which of the following conditions? a. chronic sinusitis b. rhinitis c. rhinitis medicamentosa d. asthma

c. rhinitis medicamentosa It causes rebound effects that result in severe and chronic nasal congestion.

Erythema migrans in Lyme disease has an annular pattern. This is indicated by a pattern in the shape of which of the following? a. Christmas tree b. horizontal scale c. ring d. unformed edges

c. ring

A patient comes into the clinic for a physical examination. In the course of the examination the FNP finds that the patient has a blood pressure reading of 165/101. This would be considered which stage of hypertension? a. normal b. stage 1 c. stage 2 d. prehypertension

c. stage 2

All of the following are symptoms that are consistent with Fifth disease EXCEPT: a. mild malaise b. open pattern on extremities c. strawberry tongue d. mild fever

c. strawberry tongue Strawberry tongue is associated with scarlet fever and Kawasaki Syndrome not Fifth's disease.

You have a female patient who has a fibroid that is located in the uterine endometrium. You understand that is known as which of the following? a. subserous fibroid b. intramural fibroid c. submucosal fibroid d. degenerative fibroid

c. submucosal fibroid A fibroid that is located in the uterine endometrium is a submucosal fibroid. This type of fibroid is usually palpable only as an enlarged uterus.

Which of the following is the only treatment known to prolong life in COPD patients? a. prednisone b. Atrovent c. supplemental oxygen therapy d. rescue inhalers

c. supplemental oxygen therapy

Mr. Keller is a male patient who has had gastroenteritis. As part of this patient's education, you would tell him that all but which of the following are factors that would protect him from gastroenteritis in the future? a. normal bacterial flora of the intestine b. normal motility of the GI tract c. taking antacids d. acidity of the stomach

c. taking antacids

Your patient is recovering from triple bypass surgery. Part of his discharge plan is to attend cardiac rehab. You understand that this is which of the following levels of preventive medicine? a. primary b. secondary c. tertiary d. It is not a prevention measure of any kind

c. tertiary

A 16-year-old male comes to the clinic and tells the FNP that he awoke with severe scrotal pain in the left testicle. He has felt nauseated and has had abdominal pain since this happened. What is the likely cause of this teenager's pain and nausea? a. testicular cancer b. priapism c. testicular torsion d. chronic prostatitis

c. testicular torsion

The FNP has a 59-year-old male patient of Greek ethnicity who has lived in the United States since shortly after birth. A routine CBC revealed microcytic and hypochromic red blood cells. The total red blood cell count was mildly elevated. Which of the following diseases/conditions might these results indicate? a. pernicious anemia b. acute leukemia c. thalassemia minor d. normocytic anemia

c. thalassemia minor

You have a 58-year-old male patient with possible pancreatic cancer. You will not order an abdominal ultrasound for diagnosis because it is limited by which of the following? a. previous history of pancreatic disease b. patient's age c. the presence of intestinal gas d. size of tumor

c. the presence of intestinal gas

Mrs. Anderson suffers from psoriasis. Your physical examination of Mrs. Anderson is likely to reveal which of the following? a. patches of hair loss b. Low-grade fever c. thick keratotic scaling d. inflammation of the oral cavity

c. thick keratotic scaling

You have prescribed escitalopram for a patient with generalized anxiety disorder. The patient should be educated about all but which of the following side effects? a. Dry mouth. b. Decreased appetite. c. Muscle pain. d. Nausea.

c. Muscle pain. Muscle pain is not a documented side effect of escitalopram, though it does accompany some other medications for GAD. The patient should be educated about possible side effects of escitalopram including dry mouth, nausea, and decreased appetite. These side effects often disappear as the patient's body acclimates to the drug and are not typically cause for concern.

A female patient who presents with symptoms consistent with gallstones should also be assessed for which of the following? a. Irritable bowel syndrome. b. Ectopic pregnancy. c. Myocardial infarction. d. Peptic ulcer.

c. Myocardial infarction.

All except which of the following conditions may delay a diagnosis of pneumonia? a. COPD. b. Congestive heart failure. c. Myocardial infarction. d. Influenza.

c. Myocardial infarction. A diagnosis of pneumonia may be delayed because the symptoms of the condition are similar to many other conditions. Patients who have congestive heart failure or COPD may have the characteristic cough and wheeze, while influenza may result in coughing, fever, and chills. Myocardial infarction may involve chest pain, but is unlikely to mimic pneumonia.

Which of the following would not be considered a side effect of chronic use of glucosteroids/steroids? a. An increased risk of infection b. HPA suppression c. Nausea/vomiting d. Osteoporosis

c. Nausea/vomiting

Of the following, which would be considered a topical nasal decongestant? a. Zyrtec (cetirizine) b. Sudafed (pseudoephedrine) c. Neo-Synephrine (phenylephdrine) d. Benadryl (diphenhydramine)

c. Neo-Synephrine (phenylephdrine) Some of the topical nasal decongestants would include: - Neo-Synephrine (phenylephdrine) - Afrin (oxymetazoline)

As part of the education of a patient who has chlamydia you would tell her all but which of the following? a. Use barrier protection for sexual encounters. b. Do not have sexual intercourse until treatment is completed in both partners. c. No backup method of contraception is needed if on OCPs during antibiotic treatment. d. Protect the skin from sunlight if doxycycline is prescribed.

c. No backup method of contraception is needed if on OCPs during antibiotic treatment.

Which of the following would be considered a risk factor of hypoglycemia? a. Overeating b. Not enough insulin or oral hypoglycemic c. Not eating enough food d. Not enough exercise

c. Not eating enough food

If a patient has a BMI (body mass index) of 32, which of the following classifications would they be considered? a. Underweight b. Grossly obese c. Obese d. Normal weight

c. Obese The classifications of body mass index (BMI) would include: - Underweight- <18.5 - Normal weight-18.5-24.9 - Overweight- 25-29.9 - Obese-30-39.9 - Grossly obese- >40.0

Which of the following statements about evaluation and follow-up of a patient with IBD is least accurate? a. Most patients follow a cyclic course of remission and flare-up. b. An estimated 50% to 65% of patients with Crohn's disease undergo surgery at some point in their lives for intestinal resection or colectomy. c. Overall mortality for ulcerative colitis is between 35% and 40%. d. Ulcerative colitis patients have a risk for serious complications such as hemorrhage and perforation.

c. Overall mortality for ulcerative colitis is between 35% and 40%. The overall mortality for ulcerative colitis is much lower - between 12% and 15%. This is because of risk for serious complications such as hemorrhage, perforation, and toxic megacolon.

A 21 year old female patient admits to being sexually active in an assessment. What will you recommend the physical exam include? a. Abdominal exam. b. Respiratory exam. c. Pelvic exam. d. Breast exam.

c. Pelvic exam.

The GNP determines that her 67-year-old patient should be prescribed an H2-receptor antagonist for her GI condition. Which of the following is NOT an example of an H2-receptor antagonist? a. Zantac (ranitidine) b. Pepcid (famotidine) c. Prilosec (omeprazole) d. Axid (nizatidine)

c. Prilosec (omeprazole)

PSA stands for which of the following? a. Physical System Assessment b. Pituitary System Assessment c. Prostate-Specific Antigen d. Physical Specific Assessment

c. Prostate-Specific Antigen

Signs and symptoms of the onset of menopause include all but which of the following? a. Irregular menstrual periods b. Cyclic mood changes c. Regular menstrual changes d. Hot flashes

c. Regular menstrual changes

When examining an elderly patient with an acute urinary tract infection and confusion, you notice bruises on her arms and chest region. You suspect abuse but are not sure of this. The son of this elderly patient is her caregiver. What should you do in this situation? a. Ask the son about the elderly patient's bruises. b. Do not report this as abuse until you are certain of this fact. c. Report this suspected abuse to the appropriate authorities. d. Rule out the elder abuse since the son is the caregiver.

c. Report this suspected abuse to the appropriate authorities.

All of the following tests can be used to detect malnutrition, kidney and liver dysfunction except for: a. Blood urea nitrogen. b. Creatinine. c. Serum lipids. d. Serum albumin/pre-albumin.

c. Serum lipids.

What is needed to turn a possible nursing diagnosis into a definitive nursing diagnosis? a. Problems. b. Cues. c. Signs and symptoms. d. Causes.

c. Signs and symptoms.

A 75 year old patient who is hypertensive comes in with a sudden, extreme jump in blood pressure. What is the probable cause? a. Temperature. b. Cholesterol. c. Sodium. d. Depression.

c. Sodium.

Given the Fontaine classification of peripheral vascular disease (PVD), which stage would involve rest pain? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4

c. Stage 3 Stage 1 is asymptomatic. Stage 2 it is intermittent claudication. Stage 3 is rest pain. Stage 4, ulceration or gangrene.

You are conducting an assessment with a patient who presents with frequent, bloody diarrhea. In order to rule out a bacterial cause, which of the following would you order? a. Colonoscopy. b. Urine culture. c. Stool culture. d. Occult blood test.

c. Stool culture.

A patient diagnosed with osteoporosis is instructed to consume more vitamin D in order to do what? a. Increase energy. b. Decrease nausea. c. Strengthen their bones. d. Sleep better.

c. Strengthen their bones.

You are explaining to a patient some facts about toxic shock syndrome (TSS) as well as how to avoid TSS. Which of the following statements would you include in your explanation? a. Toxins causing TSS are always symptomatic. b. Women should change tampons every 8 hours to decrease potential for TSS. c. TSS usually begins within 5 days of menstrual period in women who use tampons. d. Women diagnosed with TSS should use diaphragms for contraception.

c. TSS usually begins within 5 days of menstrual period in women who use tampons. Toxins causing TSS are often asymptomatic. Women should change tampons every 2 hours to decrease potential for TSS. Women diagnosed with TSS should not use tampons or diaphragms in the future. Symptoms of TSS include high fever, as well as myalgia, nausea, vomiting, diarrhea, diffuse sunburn-like rash, hypotension, agitation, and confusion, among others.

A patient who has been prescribed Oracea (doxycycline) for gonorrhea should be advised to do which of the following? a. Take the medication with a full meal. b. Take the medication with milk. c. Take the medication on an empty stomach with a full glass of water. d. Take the medication on an empty stomach with only a small amount of water.

c. Take the medication on an empty stomach with a full glass of water.

A patient who has been prescribed Adderall should be educated to notify his healthcare provider if he experiences which of the following side effects? a. Nausea. b. Headache. c. Teeth grinding. d. Difficulty sleeping.

c. Teeth grinding.

Which of the following might be considered the common term used for lateral epicondylitis? a. Hives b. Golfer's elbow c. Tennis elbow d. Nose bleed

c. Tennis elbow

Knowledge concerning health literacy is part of the nurse practitioner practice environment. This is where the patient and family understand and act on health information. Which of the following is TRUE regarding health literacy? a. Health literacy is now recognized as a small contributor to health outcome. b. The Institute of Medicine (IOM) has launched efforts to help nurse practitioners and physicians teach patients. c. The Institute of Medicine (IOM) and the Agency for Health Care Research and Quality (AHRQ) have launched efforts to quantify and offer solutions to the problems that result from inadequate health literacy. d. None of the above are correct.

c. The Institute of Medicine (IOM) and the Agency for Health Care Research and Quality (AHRQ) have launched efforts to quantify and offer solutions to the problems that result from inadequate health literacy.

You are creating a plan of care for a patient who has been diagnosed with fibromyalgia. You prescribe milnacipran. She has a 3 month old infant whom she is breastfeeding. When providing patient education to this patient, which of the following is appropriate? a. The patient should continue breast feeding as normal. b. The patient should deal with the pain until the baby is weaned. c. The patient should be prescribed an alternative medication. d. The patient can feed her child expressed breast milk as long as it is boiled first.

c. The patient should be prescribed an alternative medication. The manufacturer indicates that no studies have been done on the effect on babies whose mothers are taking milnacipran. Because of this, the patient should not breastfeed her child while she is on this medication. Therefore, an alternate medication may be preferred.

You are providing care to a male patient who is suffering from hemorrhoids. He asks if there is anything he can do to help prevent a recurrence. Which of the following is NOT an appropriate recommendation for this patient? a. The patient should take a daily fiber supplement. b. The patient should increase fruits, vegetables, and legumes in his diet. c. The patient should decrease his fluid intake. d. The patient should exercise daily.

c. The patient should decrease his fluid intake.

Which of the following statements would not be considered correct regarding tuberculosis testing? a. The sputum C & S that is performed as a sputum test for TB typically takes approximately 3-6 weeks. b. An individual that has a latent TB infection (LTBI) would more than likely have a false negative reaction to the tuberculosis skin test. c. The patient with > 10 mm could include the HIV+ and the patient with a recent contact with infectious TB. d. When performing a TB skin test, 0.1 mL of 5TU-PPD would be injected subdermally.

c. The patient with > 10 mm could include the HIV+ and the patient with a recent contact with infectious TB.

In terms of newborn vision, which of the following statements is accurate? a. Newborns have 20/100 vision. b. They can focus best at distances of 24 inches. c. The preferred colors are black, red, and white. d. Lacrimal ducts are mature at birth.

c. The preferred colors are black, red, and white. Newborns have 20/200 vision that becomes 20/20 by age 6. They can focus best at distances of 8-12 inches. Lacrimal ducts mature by age 2 to 3 months; newborns do not have tears when crying.

The optimum daily intake of calcium for a woman who is 30 years old is which of the following? a. 1200 mg b. 800 mg c. 1500 mg d. 1000 mg

d. 1000 mg After 50 years, women who are postmenopausal need 1200 mg per day.

If a 14 month-old child weighs 24 lbs, what is the average energy requirement (calorie intake) recommended for this child? a. 800 calories b. 920 calories c. 872 calories d. 1090 calories

d. 1090 calories In determining the energy requirements for a child, the FNP would use the average kcal/kg/day for a child of that age. The average kcal/kg/day for a child of 14 months of age is 100.24 lbs = 10.9 kg (24 ÷ 2.2)10.9 kg x 100 cal = 1090 calories per day

Lead poisoning may be prevented by inspection of home built before lead paint was banned. This year is which of the following? a. 1950 b. 1963 c. 1970 d. 1978

d. 1978

Your patient has been treated for warts by using laser therapy. How long after treatment will this therapy become effective? a. immediately b. within 48 hours c. within 10 days d. 4 - 6 weeks

d. 4 - 6 weeks

What is the lifetime risk to the average American man of having latent prostate cancer? a. 10% b. 3% c. 67% d. 40%

d. 40%

When prescribing treatment for genital herpes, which of the following would be considered a typical initial dose option for Acyclovir? a. 50 mg BID x 5 days b. 1000 mg QID x 14 days c. 2 grams TID x 7 days d. 400 mg TID x 7-10 days

d. 400 mg TID x 7-10 days

Of the following, which would be considered the normal range of theophylline level in the adult patient? a. 10-20 mcg/mL b. 1-3 mcg/mL c. 40-45 mcg/mL d. 5-15 mcg/mL

d. 5-15 mcg/mL

According to the USPSTF (United States Preventive Services Task Force), at what age should your female patient begin mammogram screening? a. 40 b. 35 c. 45 d. 50

d. 50

Injuries cause approximately what percentage of all child deaths? a. 10% b. 25% c. 40.5% d. 50%

d. 50%

The highest incidence of AOM (acute otitis media) is in which of the following age groups? a. 10 - 12 years b. 7 - 8 years c. 4 - 6 years d. 6 months to 3 years

d. 6 months to 3 years

You have a patient with AIDS. You recognize that a low CD4 T-cell count puts the patient at risk for opportunistic infections. You are reviewing his lab reports and see that his CD4 T-cell count is indeed low. Which of the following is the normal range for CD4 T-cell count? a. 800 -1400 b. 700 -1400 c. 400 - 1000 d. 600 -1200

d. 600 -1200

Of the following, what is the target dosage for an adult patient on Norpramin (desipramine)? a. 75 - 300 mg q hs. b. 75 - 150 mg qd or divided. c. 50 - 150 mg divided. d. 75 - 300 mg qd.

d. 75 - 300 mg qd. The following dosages are associated with: Elavil (amitriptyline): 50 - 150 mg divided; Norpramin (desipramine): 75 - 300 mg qd; Tofranil (imipramine): 75 - 300 mg q hs; Pamelor (nortriptyline): 75 - 150 mg qd or divided

For a child patient with moderately severe croup you would follow-up with phone contact or clinic visit in how long? a. 5 days b. 3 days c. one week d. 8 - 24 hours

d. 8 - 24 hours

You are prescribing a high daily dosage of Flunisolide (250 mcg/puff) to your 51-year-old patient. Of the following, which range of prescription is appropriate for this medication? a. 1000 - 2000 mcg. b. >480 mcg. c. 80 - 240 mcg. d. >2000 mcg.

d. >2000 mcg. Low: 500 - 1000 mcg Medium: 1000-2000 mcg High: >2000 mcg

Which of the following patients would it be considered the most appropriate for the nurse practitioner to order a tetanus immunization for? a. A 12 year old female patient that falls off her bike and obtains an abrasion from the concrete sidewalk. b. A 60 year old female that cut her arm with a kitchen knife. c. A 24 year old male patient that received a human bite in a fight. d. A 30 year old male that has stepped on a rusty nail.

d. A 30 year old male that has stepped on a rusty nail. The tetanus infection is caused by Clostridium tetani which is an anaerobic gram-positive, spore-forming rod.

The CMS has developed "Documentation Guidelines for Evaluation and Management" that FNPs and other Medicare providers are expected to follow in coding patient visits. Which of the following is incorrect in terms of these guidelines? a. Medical record documentation must support the level of care billed. b. An FNP must distinguish between a new patient and an established patient. c. History taking, examination and medical decision making are the key components in determining code selection. d. A billable visit may not occur in a patient's home.

d. A billable visit may not occur in a patient's home.

If the patient is prescribed amantadine, which of the following would be considered correct for patient education? a. Avoid any hazardous activities if dizziness/blurred vision occurs b. Instruct the patient to only take the medication exactly as prescribed. c. The medication should not be discontinued abruptly. d. All of the above

d. All of the above

When would Aldactone be contraindicated? a. When the patient has hyperkalemia (serum potassium of greater than 5.5 mEq/L. b. When the patient has renal insufficiency (serum creatinine greater than 2.0 mg/dL. c. If the patient has type 2 diabetes mellitus with microalbuminuria. d. All of the above

d. All of the above

Which of the following would be considered signs and symptoms of a Jarisch-Herxheimer reaction? a. Headaches b. Fever c. Chills d. All of the above

d. All of the above This would be considered an acute febrile reaction which can occur during the first 24 hours after treatment for early syphilis.Some of the signs and symptoms of a Jarisch-Herxheimer reaction would include: Headaches, Fever, Chills, Myalgia

The results of a serum creatinine test are affected by which of the following? a. Gender. b. Ethnicity. c. Medications. d. All of the above.

d. All of the above.

A 7-year-old boy is in the clinic with his mother. He is diagnosed with contact dermatitis from exposure to the poison ivy plant. The nurse practitioner knows to discuss all of the following with the mother EXCEPT: a. Wash potentially contacted clothing. b. Bathe in tepid water with soap to wash allergen/irritant off the skin. c. The use of cool compresses with astringent (Domeboro solution) will ease pruritus. d. Apply hydrogen peroxide to neutralize the irritant.

d. Apply hydrogen peroxide to neutralize the irritant.

A 60 year old patient presents with respiratory problems. There are no signs or symptoms of heart disease, and a chest x-ray is negative. Which test is most accurate in determining the diagnosis? a. Oximetry. b. Acute Otitis Media (AOM). c. Carcinoembryonic antigen (CEA) test. d. Arterial Blood Gas (ABG) test.

d. Arterial Blood Gas (ABG) test.

Which of the following would NOT be part of an assessment leading you to conclude that an elderly patient's death is near? a. patient states that he is dying b. Cheyne-Stoke respirations c. body is in a rigid position d. BP is 81/56 mm Hg

d. BP is 81/56 mm Hg

Which of the following assessments or tests is most likely to provide valuable information about the state of renal perfusion? a. creatinine level b. osmolality c. urine volume d. BUN level

d. BUN level The BUN level provides valuable information about the state of renal perfusion. The creatinine level is more precise in evaluating actual tubular function. Urine volume and osmolality, along with specific gravity, are useful in identifying the kidney's ability to excrete and concentrate fluid.

All but which of the following would be considered one of the layers of the skin? a. Dermis b. Epidermis c. Subcutaneous layer d. Basal layer

d. Basal layer

You are going to prescribe an antihistamine for your patient with allergies. You do not want the drug to have sedating effects on the patient. Therefore, you would NOT prescribe: a. Claritin b. Zyrtec c. Allegra d. Benadryl

d. Benadryl

You assess decreased saliva production in your elderly patient which has resulted in dry mouth. You understand that this can lead to which of the following? a. tooth decay b. increased susceptibility to infection c. esophageal spasm d. Both A and B

d. Both A and B

When certain medications are discontinued abruptly, it may result in the patient's condition flaring up, rebound, and/or cause adverse effects. Which of the following might be considered some of these medications? a. Paxil b. Oral steroids c. Amoxicillin d. Both A and B

d. Both A and B Some of the medication which need to be weaned/tapered off when discontinuing them would include: Paxil, Oral steroids, Beta blockers, Benzodiazepines, Anticonvulsants, Paroxetine, Antiarrhythmias, Antipsychotics

Which of the following medications provides the greatest analgesic effect in the shortest amount of time for a tension-type or migraine headache? a. Naprosyn b. Aleve c. Anaprox d. Both Aleve and Anaprox

d. Both Aleve and Anaprox Plain naproxen (Naprosyn) has a relatively slow onset of analgesic activity, whereas naproxen sodium (Aleve or Anaprox) use is associated with a significantly more rapid onset of pain relief.

Complications from Rocky Mountain Spotted Fever (RMSF) could include which of the following? a. Hair loss b. Neuropathy c. Hearing loss d. Both B and C

d. Both B and C Some of the complications from RMSF would include:Neuropathy, Hearing loss, Paraparesis, Death, Others

There is a female patient who complains of fatigue. She has a family history of breast cancer, and has not had a breast exam in five years. What is the correct course of action? a. Pap smear. b. Serum cholesterol. c. Sensory exam. d. Breast exam.

d. Breast exam.

The sac-like structures that are located on the anterior/posterior areas of a joint which acts as padding would be considered which of the following? a. Synovial space b. Tendons c. Muscles d. Bursae

d. Bursae

If the nurse practitioner is assessing a 60 year old female patient that is experiencing facial asymmetry, drooping of the mouth, along with impaired eyelid movement and absent nasolabial fold, which of the following cranial nerves would most likely be involved? a. CN I b. CN X c. CN XII d. CN VII

d. CN VII

What test would you order if you suspect a patient has meningitis? a. BRCA2. b. CA-125. c. CEA. d. CSF.

d. CSF.

Of the following, which would be considered a third-generation cephalosporin? a. Cefalexin b. Cefaclor c. Amoxicillin d. Cefdinir

d. Cefdinir Cefaclor is a second-generation cephalosporin antibiotic and cefalexin is a first-generation cephalosporin antibiotic.

Placing the symptoms on a _____ will help determine a nursing diagnosis. a. Scale. b. Snellen chart. c. Cluster. d. Concept map.

d. Concept map.

Long-term use of contact lenses can have the potential to cause which of the following? a. Diabetes mellitus b. Chronic glaucoma c. Presbyopia d. Corneal abrasions

d. Corneal abrasions

Choose the signs and symptoms that support a nursing diagnosis. a. Risk of injury. b. Acute confusion. c. COPD. d. Crying and lack of sleep.

d. Crying and lack of sleep.

You have prescribed Cymbalta for a patient with depression. She asks whether she should take the medication with food. Which of the following is an appropriate response to this patient? a. Cymbalta should always be taken on an empty stomach. b. Cymbalta should always be taken on a full stomach. c. Cymbalta should always be taken with a small amount of food such as crackers or a glass of milk. d. Cymbalta may be taken with or without food.

d. Cymbalta may be taken with or without food.

Functional assessment of the elderly may include which of the following tests? a. Tinetti Balance and Gait Evaluation b. SPMSQ c. MMSE d. IADL Scale

d. IADL Scale The Instrumental Activities of Daily Living (IADL) Scale is one of the tools used to do a functional assessment of the elderly. It assesses the more complex activities such as shopping and laundry.

A 42-year-old obese male is in the clinic with chest pain. The ECG shows signs of a myocardial infarction and the ambulance is called to transfer him to the emergency department. Which of the following is NOT a proper acute treatment measure for you to provide him while waiting for the transfer? a. O2 via nasal cannula at 2 liters b. nitroglycerin SL 0.3-0.6 mg every 5 minutes, total three doses c. chewable aspirin 160-325 mg d. IV of NS with 10 mEq of KCL at 125 cc/ hr

d. IV of NS with 10 mEq of KCL at 125 cc/ hr

Which of the following is NOT one of the basic requirements/allowances of the HIPAA privacy rule? a. Providers releasing patient information for marketing purposes must explain to the patient how the information will be used, to whom it will be disclosed, and the time frame. b. Providers and their staff are restricted to conveying the "minimum necessary information" about patients. c. Providers may disclose health information to oversight agencies. d. In general, providers may disclose psychotherapy notes without patient consent.

d. In general, providers may disclose psychotherapy notes without patient consent.

Testing shows that an elderly patient has edema and hyperemia of mucous membranes as well as post nasal drainage and tender cervical lymph nodes. Which of the following would the NP MOST likely diagnose the patient with? a. Allergic rhinitis. b. Vasomotor rhinitis. c. Atrophic rhinitis. d. Infectious rhinitis.

d. Infectious rhinitis.

You are treating a pregnant female and she inquires about HIV testing. The nurse practitioner has the understanding that: a. It is better performed in the third trimester b. It is an "opt-in" approach. c. It produces many false positives. d. It is recommended by the ACOG.

d. It is recommended by the ACOG.

All but which of the following would be considered a side effect of the receptor antagonist "Aldosterone?" a. Vomiting b. Gynecomastia c. Stomach cramps d. Joint pain

d. Joint pain

Of the following, which would not be considered correct for one of the characteristics that can be used to diagnose "metabolic syndrome" (ATP III)? a. Hypertension b. Hyperlipidemia c. Abdominal obesity d. Joint pain

d. Joint pain

Bowel sounds in a healthy adult patient should sound like all but the following? a. Gurgling. b. Bubbling. c. High pitch. d. Loud splashing.

d. Loud splashing. Loud splashing may indicate an obstruction or other condition.

When determining which medication to prescribe for your elderly patient's condition, you decide against a particular opioid analgesic/antagonist because its use increases fall risk. Of the following, which is an opioid analgesic/antagonist that is known for this? a. Oxazepam. b. Amitriptyline. c. Risperidone. d. Meperidine.

d. Meperidine. -) Oxazepam - Anxiolytic/Hypnotic -) Amitriptyline - Antidepressant -) Risperidone - SGA -) Meperidine - Opioid analgesic/antagonist.

Humulin insulin 70/30 would be considered a mixture of? a. Regular insulin 70% and NPH insulin 30% b. Lantus insulin 70% and regular insulin 30% c. Lispro insulin 70% and NPH insulin 30% d. NPH insulin 70% and regular insulin 30%

d. NPH insulin 70% and regular insulin 30% This mixture usually has an onset of 30 minutes, peak of 4.4 hours, and duration of 24 hours.

You are educating a 32 year old female patient about self breast exam. When should you recommend the patient conduct her self exams? a. Once a year. b. Once every six months. c. Once a month on whatever day is convenient. d. Once a month on a day in the week following her menstrual period.

d. Once a month on a day in the week following her menstrual period.

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? a. voided urine b. vaginal swab for pH, saline, or KOH c. endocervical swab for NAAT or culture d. Papanicolaou testing

d. Papanicolaou testing

During a health assessment with a female patient, you notice several scars on her inner arms and a couple of burns that are in various stages of healing. In the interview, the patient indicates that she sometimes feels numb and that burning her skin makes her feel better. She stresses that she does not want to kill herself, and is always very careful about how long she holds the heat on her skin. What is an appropriately worded nursing diagnosis for this patient? a. Patient is suicidal. b. Patient is suicidal and in denial. c. Coping, ineffective. d. Patient is at risk for self-harm, as evidenced by burns on inner arms.

d. Patient is at risk for self-harm, as evidenced by burns on inner arms.

A 45-year-old female comes to the clinic reporting that she has had several episodes of a blue color in her fingertips accompanied by a tingling and numbness of these fingertips. The FNP diagnoses Raynaud's phenomenon. Which of the following would the FNP NOT do for the patient suffering from this condition? a. Tell her to stop smoking. b. Tell her to avoid cold weather. c. Prescribe Norvasc (amlodipine). d. Prescribe Imitrex (sumatriptan).

d. Prescribe Imitrex (sumatriptan).

An assessment which documents the major social and emotional factors in a patient's life that may impact health is known as which of the following? a. Relational assessment. b. Sociolcultural assessment. c. Functional assessment. d. Psychosocial assessment.

d. Psychosocial assessment.

Nurse Grace is speaking with the family of an Alzheimer's patient. The patient is showing signs of increased confusion and even depression. Grace suggests which of the following options for the family to try first? a. Recommend she join a club or organization. b. Buy her a notepad to write things down. c. Prescribe an anti-depressant medication. d. Recommend family members bring pictures to the patient often.

d. Recommend family members bring pictures to the patient often. Alzheimer's patients are at an increased risk for confusion, depression and general forgetfulness. These patients are encouraged to have regular interaction with family and friends, as well as have mementos such as photos or keepsakes nearby. This helps to stimulate the patient's mind and memory and can actually help reduce confusion and other symptoms.

Which of the following is true when recording subjective data during an assessment? a. Only record the data that can be independently verified. b. Record that data in the simplest possible language. c. Make notes about where your observations contradict the data. d. Record the data in the patient's own words.

d. Record the data in the patient's own words.

What reflex of the eyes would you test on a two month old infant? a. Step reflex. b. Plantar flexion reflex. c. Babinski reflex. d. Red reflex.

d. Red reflex.

Jerri is examining a patient that has possibly fractured his wrist after a sports injury. What is the best course of action Jerri should take for this patient? a. Treat the patient for a wrist fracture and schedule a follow up appointment. b. Reschedule the patient to see one of the physicians in the clinic at a later date. c. Give the patient instructions on how to care for the injury at home. d. Refer the patient to an orthopedic doctor that can perform the necessary tests and offer correct treatment options.

d. Refer the patient to an orthopedic doctor that can perform the necessary tests and offer correct treatment options.

Your 40-year-old male patient has a history of urethritis. He complains of swollen joints and redness that he says, comes and goes. He also has an ulcer on the skin of the glans penis. Which of the following is your most likely diagnosis? a. Jarisch-Herxheimer reaction b. Fitz-Hugh-Curtis syndrome c. perihepatitis d. Reiter's syndrome

d. Reiter's syndrome

The classic finding of a mitral valve prolapse would be considered which of the following? a. S4 b. S3 c. Decreased apical pulse sound d. S2 click

d. S2 click

Which of the following heart sounds is caused by the increased resistance from a stiff left ventricle? a. S1 systole b. S2 diastole c. S3 heart sound d. S4 heart sound

d. S4 heart sound It usually indicates left ventricular hypertrophy. It may be considered as a normal finding in some elderly patients with no heart disease.

You have diagnosed a 35-year-old female patient with dysthymia. Which of the following is most likely to support this diagnosis? a. She has gained a significant amount of weight without having increased her caloric intake. b. She has a number of phobias. c. She recently has had difficulty making decisions. d. She has been depressed more often than not for at least the last two years.

d. She has been depressed more often than not for at least the last two years.

A patient comes in with nasal congestion. He also has a fever and green mucous discharge from his nose. There is no chest congestion or muscle ache. What is the best differential diagnosis? a. Allergic rhinitis. b. Rhinitis. c. Cold. d. Sinusitis.

d. Sinusitis.

When discussing atypical pneumonia or "walking pneumonia" with a patient, the nurse practitioner knows all of the following organisms are atypical bacteria EXCEPT: a. Mycoplasma pneumoniae b. Chlamydia pneumoniae c. Legionella pneumoniae d. Streptococcal pneumoniae

d. Streptococcal pneumoniae Mycoplasma pneumoniae, Chlamydia pneumoniae and Legionella pneumoniae are all atypical bacteria that cause infection of the lungs.

A 55 year old female patient lives in a house with a smoker. She also takes hormone replacement therapy. This increases her risk for which of the following? a. Heart disease. b. Diabetes. c. Lung cancer. d. Stroke.

d. Stroke.

A new mother is unable to breast feed. The FNP's advice about bottle feeding would include all but which of the following? a. The amount of formula the infant needs at 0 to 1 month is about 2 - 4 oz. every 3 to 4 hours. b. The amount of formula the infant needs at 2 - 4 months is about 5 - 7 oz. every 4 to 5 hours. c. Iron-fortified formulas are best. d. Suggest partial hydrolysate formula if the infant is at risk for cognitive deficiencies.

d. Suggest partial hydrolysate formula if the infant is at risk for cognitive deficiencies. The FNP would only suggest partial hydrolysate formula if the infant is at risk for atopic diseases, for instance a strong family history of atopic disease.

A patient who has been prescribed Tagamet for GERD should be advised to seek immediate medical attention if he experiences which of the following side effects? a. Headache. b. Diarrhea. c. Stomach cramps. d. Swelling of the tongue.

d. Swelling of the tongue.

Which of the following would be considered correct for the action that Folic acid takes in order to help prevent anencephaly in the fetus during pregnancy? a. The Folic acid helps by increasing the woman's appetite. b. The Folic acid helps by increasing the calcium production. c. The Folic acid helps by decreasing the amount of glucose in the blood of the fetus. d. The Folic acid supplements help by decreasing the risk of neural tube defects.

d. The Folic acid supplements help by decreasing the risk of neural tube defects.

You have a hospitalized patient who has had a sudden and rapid drop in the hemoglobin (< 6 g/dL). This patient has clammy skin, tachycardia, and hypotension. This may indicate which of the following? a. anemia b. neutropenia c. thrombocytopenia d. acute hemorrhage

d. acute hemorrhage

You have a patient with impacted cerumen. You realize that there are certain conditions in which irrigation of the ear to remove the cerumen is contraindicated. Which of the following is NOT a contraindication? a. tympanostomy tube b. perforated tympanic membrane c. organic foreign body in ear d. advanced age

d. advanced age

Scabies is commonly seen in which of the following populations? a. children b. institutionalized persons c. persons with AIDS d. all of the above

d. all of the above

Your patient comes in complaining of a fullness in his ear and loss of hearing. You check the ear and find impacted cerumen. Your management of this patient's problem may consist of which of the following? a. irrigation with warm water to dislodge the cerumen b. instilling 1-2 drops of oil to soften the hardened cerumen prior to irrigation c. maintenance to avoid recurrence consisting of 3 drops of hydrogen peroxide and water d. all of the above

d. all of the above

Mary Beth is a 32-year-old female who complains of excessive facial and body hair, infrequent periods, and acne. You suspect polycystic ovary syndrome. If this is true you would find which of the following in this patient? a. atrophied ovaries b. FSH levels elevated c. serum testosterone low d. androstenedione elevated

d. androstenedione elevated

Burning mouth syndrome is a sensation of older patients that one's tongue is tingling or burning. All of the following are contributing factors EXCEPT: a. vitamin B deficiencies b. local trauma c. gastrointestinal disorders d. anticholinergic medications

d. anticholinergic medications

Your patient has otitis media and the initial antibiotic treatment has failed to help. Which of the following might be a good choice for a second antibiotic? a. amoxicillin-clavulanate b. ceftriaxone c. cefuroxime axetil d. any of the above

d. any of the above

Upon examining the eyes of your 70-year-old male patient you find an opaque grayish to white ring at the periphery of the cornea. You understand that this indicates which of the following? a. cataracts b. presbyopia c. macular degeneration d. arcus senilis

d. arcus senilis

You would refer a patient to a burn center in all but which of the following cases? a. deep second-degree burns b. burns over a joint c. burns that are circumferential d. burns of greater than 8% TBSA

d. burns of greater than 8% TBSA If burns are greater than 10% TBSA in patients under 10 years of age or over 50, you would refer to a burn center. You also would refer to a burn center if burns are greater than 20% of TBSA in all other patients.

A 65-year-old female patient comes to you complaining of bowel and bladder incontinence and a numbness of the buttocks area. You might suspect that his patient has which of the following diseases/conditions? a. supraspinatus tendonitis b. osteoarthritis c. rheumatoid arthritis d. cauda equina syndrome

d. cauda equina syndrome

Angelina is a 60-year-old woman who is in the early stages of Alzheimer disease. She suffers from mild dementia. In this type of Alzheimer-type dementia which of the following is considered to be the mainstay treatment? a. Vitamin E 1000 IU twice daily b. Selgiline 5 mg twice daily c. NSAIDS d. cholinesterase inhibitors

d. cholinesterase inhibitors The mainstay treatment for mild to moderate stage Alzheimer-type dementia is the use of cholinesterase inhibitors. These include donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne). They have a clear, although minor and time-limited benefit.

Which of the following is a prenatal diagnostic test rather than a prenatal screening test? a. ultrasound b. NIPT c. maternal serum d. chorionic villus sampling

d. chorionic villus sampling

Which of the following types of headaches occurs more often in males than in females? a. migraine with aura b. tension c. migraine without aura d. cluster

d. cluster

The FNP has a 56-year-old menopausal woman patient who is troubled by hot flashes. The FNP recommends some simple lifestyle changes to reduce the occurrence of the hot flashes. All of the following would be a hot flash trigger EXCEPT: a. spicy food b. cigarette smoking c. elevated humidity d. cold baths or showers

d. cold baths or showers

All of the following are nonpharmacologic treatments you might use for a patient with sinusitis EXCEPT: a. hydration steam b. inhalation c. saline irrigation d. cold facial packs

d. cold facial packs The patient should also avoid exposure to cigarette smoke or fumes, sleep with the head of the bed elevated, and avoid caffeine and alcohol.

The nurse practitioner knows that certain diseases put patients at risk for anemia of chronic disease. All of the following are known diseases to cause this type of anemia EXCEPT: a. hypothyroidism b. rheumatoid arthritis c. renal insufficiency d. diabetes

d. diabetes

Which of the following would be a risk factor for carpal tunnel syndrome (CTS)? a. hypertension b. depression c. tennis elbow d. diabetes

d. diabetes Metabolic disorders such as diabetes, trauma to the wrist, arthritis, cancer, or thyroid disease are other risk factors.

A 30-year-old sexually active female comes to the clinic complaining of lower abdominal pain and cramping. She tells the FNP that she has not had a period for about 7 weeks. The pain worsens when the woman is lying down on her back. The FNP might suspect which of the following conditions/diseases? a. ovarian cancer b. Candida vaginitis c. atrophic vaginitis d. ectopic pregnancy

d. ectopic pregnancy

Your adult female patient comes to you complaining of varicose veins. After confirming the diagnosis you would recommend which of the following? a. refrain from elevating the leg b. high sodium diet c. Vasotec d. elastic compression stockings up to the knee

d. elastic compression stockings up to the knee

Your patient is an adolescent with moderate acne vulgaris. In the treatment of acne vulgaris, and you are prescribing an antimicrobial agent which is also anti-inflammatory and is indicated in treatment of mild to moderate inflammatory acne vulgaris. Which of the following drugs would fall into this classification? a. tretinoin b. azelaic acid 20% cream c. Accutane d. erythromycin (topical antibiotic)

d. erythromycin (topical antibiotic)

In the course of educating a patient who suffers from migraine headaches, the FNP would advise the patient to avoid all but which of the following foods? a. chocolate b. pickled beets c. lima beans d. fish

d. fish Foods to be avoided include: chocolate, broad beans, any pickled, fermented or marinated food, sour cream, ripened cheeses, sausages, pizza, MSG, nuts, figs, citrus foods, bananas, caffeinated beverages and alcoholic beverages.

You are evaluating fifth grade students at school for scoliosis. Part of your evaluation is using the Adam's forward bend test. This involves which of the following? a. checking asymmetry in scapula height or prominence b. assessing for lateralization of the spine c. assessing for equal distance between the arms and the spine d. having the child bend forward with the head and hands down to assess for rib hump

d. having the child bend forward with the head and hands down to assess for rib hump

Your patient has had an acute onset of painful red nodules and pustules under her left axilla. She reports that they have begun to drain a pus-like liquid. Your most likely diagnosis of the following choices is: a. impetigo b. pityriasis rosea c. scabies d. hidradenitis suppurativa

d. hidradenitis suppurativa Hidradenitis suppurativa is a bacterial infection of the sebaceous glands of the axilla by Gram-positive S. aureus. It is marked by flare-ups and resolution.

Which of the following medications would you prescribe for an adult patient with oral candidiasis (thrush)? a. Castellani paint b. miconazole 2% topical cream c. oral fluconazole d. nystatin oral suspension

d. nystatin oral suspension Nystatin (Mycostatin) oral suspension 4 - 6 mL to swish and swallow q.i.d. is prescribed for adult patients with thrush. Thrush is characterized by painful or sensitive white lesions of the oral mucosa with decreased taste and painful swallowing.

This extended release formula of a narcotic pain reliever was prescribed to an elderly patient. Which medication is it? a. ER Oxycodone. b. Ibuprofen. c. Naproxen. d. Morphine 30 mg.

a. ER Oxycodone.

For which of the following conditions/diseases would you be testing when you use Phalen's sign? a. Bell's Palsy b. carpal tunnel syndrome c. osteoporosis d. glaucoma

b. carpal tunnel syndrome

Knowledge of the cranial nerves (CNs) is critical for accurate neurologic assessment. Which of the following is the oculomotor nerve? a. CN I b. CN II c. CN III d. CN IV

c. CN III

You have a 22-year-old female patient with severe acne. She tells you that she wants to get pregnant. Which of the following acne drugs would you NOT prescribe for this woman who wants to get pregnant? a. Accutane b. benzoyl peroxide cream c. Tretinoin d. erythromycin

a. Accutane

When treating the elderly population, the nurse practitioner should always consider which of the following theories when prescribing medications? a. Always start at a low dose and increase slowly b. Always start at the highest dose and decrease slowly c. Always start at a low dose and increase quickly d. Always start at a low dose and decrease if needed

a. Always start at a low dose and increase slowly

Which of the following medications would be temporarily contraindicated for the pediatric patient that has received an influenza vaccine? a. Aspirin b. Tylenol c. Steroids d. Calcium-channel blockers

a. Aspirin If a child receives the vaccine, they should not take aspirin for at least 4 weeks following the vaccination.There are also some antivirals such as osletamivir, zanamivir, rimantadine, and amantadine that should not be administered for 48 hours prior to the administration of the vaccine and for at least 14 days afterwards for any patient. If it is administered, it could interfere with the antibody production.

Which test would you NOT order if you suspect a patient has an autoimmune condition? a. BRCA2. b. ANA. c. RF blood test. d. SED rate.

a. BRCA2.

Your patient has presented in the second stage of Syphilis. Which of the following is the recommended treatment option? a. Benzathine penicillin G 2.4 million U IM as a one-time dose. b. Benzathine penicillin G 2.4 million U IM x 2 weekly doses. c. Benzathine penicillin G 2.4 million U IM x 4 weekly doses. d. Benzathine penicillin G 2.4 million U IM x 3 weekly doses.

a. Benzathine penicillin G 2.4 million U IM as a one-time dose. The above drug is the recommended treatment option, but for those with penicillin allergies, there are alternative treatment options. These are Doxycycline 100 mg PO bid x 2 weeks or Tetracycline 500 mg PO qid x 2 weeks.

An adult patient has an abnormal Babinski reflex. What does this look like? a. Big toe extends. b. Plantar flexion reflex. c. Toes curl under. d. Big toe curls under.

a. Big toe extends.

A patient with risk factors for heart disease came in with a sudden, severe headache. She is also dizzy and confused. After an exam, what test will you most likely order? a. CTA scan. b. Mammogram. c. CEA. d. CBC.

a. CTA scan.

Norvasc (amlodipine) would be considered which of the following classifications of medications? a. Calcium channel blocker b. Diuretics c. Alpha-1 blocker/agonist d. Beta-blocker

a. Calcium channel blocker

Of the following, which would the ANP prescribe when prescribing a miotic? a. Carbachol. b. Carteolol 1%. c. Alphagan 0.2%. d. Cosopt 2%.

a. Carbachol. Carteolol 1% = Beta Adrenergic Antagonist Alphagan 0.2% = Sympathomimetic Cosopt 2% = Carbonic Anhydrase Inhibitor Carbachol = Miotic

A patient on levothyroxine for hypothyroidism presents in the clinic with complaints of chest pain after only taking this medication 3 weeks. What would be the appropriate thing to do? a. Decrease dose of levothyroxine, order an ECG, and consult with your collaborating physician. b. Prescribe an anxiolytic agent. c. Schedule the patient for a sedimentation rate test. d. Discontinue levothyroxine because chest pain is a contradiction to its continuance.

a. Decrease dose of levothyroxine, order an ECG, and consult with your collaborating physician.

A 30 year old female patient presents abdominal pain as her chief complaint. She also mentions alternating between constipation and diarrhea. There is no fever. What do you need to pay close attention to in the assessment? a. Diet and exercise. b. Diet. c. Exercise. d. Depression.

a. Diet and exercise. A diet that is low in fiber can contribute to IBS and other problems. A sedentary lifestyle will also negatively affect digestion.

Of the following, which is a Class IA antidysrhythmic drug you can prescribe to help treat your patient's ventricular tachycardia? a. Disopyramide. b. Lidocaine. c. Encainide. d. Bretylium.

a. Disopyramide. Disopyramide - Class IA Lidocaine - Class IB Encainide - Class IC Bretylium - Class III

Janet is reviewing a patient's test results and determines he has hypothyroidism, which means the thyroid does what? a. Does not produce enough thyroid hormone. b. Swells up in size. c. Produces too much thyroid hormone. d. Shrinks in size.

a. Does not produce enough thyroid hormone.

A 57-year old man comes to you complaining of severe pain in his foot. You diagnose gout. In instructing this man about how he can avoid another attack which of the following is the most appropriate statement? a. Drink a lot of fluids so that uric acid is excreted from the body. b. It is especially important to avoid eating poultry. c. Only changes in diet can help avoid another attack. d. Eating organ meats is important to the diet.

a. Drink a lot of fluids so that uric acid is excreted from the body.

The Patient Self-Determination Act (PSDA) was passed by the U.S. Congress in 1990. Which of the following policy changes did it result in? a. Federally funded managed care organizations (MCOs) are required to inform subscribers about their rights under state law to create "advance directives." b. Hospitalized patients are obligated to select a surrogate decision-maker to make care decisions for them if they become incapacitated. c. Home health agencies are required to have "do not resuscitate" (DNR) order on file for all terminally ill patients. d. Hospitals are mandated to assist every patient to create a "living will."

a. Federally funded managed care organizations (MCOs) are required to inform subscribers about their rights under state law to create "advance directives."

In terms of Fee-for-service Medicare, which of the following statements about CPT codes and related items is incorrect? a. Fees for CPT codes are the same in every location and for every provider. b. All reimbursable services have a CPT code. c. CPT codes were developed by the AMA. d. All CPT codes have a corresponding Medicare fee.

a. Fees for CPT codes are the same in every location and for every provider.

A patient is in extreme pain. How should the history be taken? a. Focus on the immediate complaint. b. Have the patient fill out the questionnaire. c. Gather a complete history. d. Fill out questionnaire for the patient.

a. Focus on the immediate complaint.

A 75 year old patient has a serum cholesterol of 140. What system will you want to examine? a. Gastrointestinal. b. Cardiovascular. c. Nervous. d. Urinary.

a. Gastrointestinal. Low cholesterol can be a sign of gastrointestinal problems. Cholesterol below 160 indicates the need for a GI exam. Cholesterol over 240 is too high.

If a 22 year old has not been immunized with the MMR vaccine, which of the following would be considered correct? a. He/she should receive 1 or 2 doses of the vaccine at least 1 month apart. b. He/she should receive 3 doses of the vaccine at intervals of 1 month apart. c. He/she should receive one dose of the vaccine. d. He/she should receive 2 doses of the vaccine at least 1 week apart.

a. He/she should receive 1 or 2 doses of the vaccine at least 1 month apart. The initial dose should be administered and the second dose at least 1 month from the first dose.

A child is typically assessed in all but which of the following areas for their development? a. Hearing b. Social skills c. Fine motor d. Language

a. Hearing

An adult patient presents with painful red nodules and pustules under his arm. He tells the FNP that some of the lumps have started to drain pus. The FNP is most likely to diagnose which of the following? a. Hidradenitis Suppurativa b. impetigo c. meningococcemia d. herpes zoster

a. Hidradenitis Suppurativa Hidradenitis Suppurativa is a bacterial infection of the sebaceous glands by Gram-positive Staphylococcus aureus. It develops when the hair follicle is blocked, most commonly, near the sweat glands. The areas most commonly affected are the armpits, the groin, between the buttocks, and under the breasts. It is marked by flare-ups and resolution. It can be confirmed by a C&S of the purulent discharge.

The ANP is prescribing her patient an anticonvulsant for a neurological disorder. Which of the following will she prescribe? a. Hydantoin. b. Piperazine. c. Flurazepam. d. Bromocriptine.

a. Hydantoin. - Hydantoin - Anticonvulsant - Piperazine - Anthelmintic - Flurazepam - Benzodiazepine - Bromocriptine - Dopamine Agonist

A patient may be prescribed Prinivil (lisinopril) for which of the following conditions? a. Hypertension. b. Hypotension. c. High cholesterol. d. Nerve pain associated with shingles.

a. Hypertension.

Which of the following statements about dysphagia is least accurate? a. It can be attributed to normal aging. b. It may be a structural or neuromuscular problem. c. It may present as difficulty swallowing solids or liquids. d. It may present as chest pain.

a. It can be attributed to normal aging.

In the management of adolescent acne, nurse practitioners often prescribe benzoyl peroxide. What is an important instruction point regarding this medication? a. It can cause photosensitivity of the skin to occur. b. Do not apply this product more than once daily. c. Hypersensitivity can occur with repeated use. d. This often causes peeling of the skin.

a. It can cause photosensitivity of the skin to occur.

In terms of a migraine headache without aura which of the following is NOT true? a. It is usually bilateral, although occasionally unilateral. b. The female to male ratio with this type of headache is 3:1. c. During the headache nausea or vomiting may occur. d. Photophobia occurs with this type of headache.

a. It is usually bilateral, although occasionally unilateral.

You have a 60-year-old male patient who has recently been treated for syphilis. He begins to have severe chills and fever accompanied by myalgia and tachycardia. You understand that this is a complication known as which of the following? a. Jarisch-Herxheimer reaction b. Kawasaki disease c. Fitz-Hugh-Curtis syndrome d. Jones reaction

a. Jarisch-Herxheimer reaction Jarisch-Herxheimer reaction is the sudden massive destruction of spirochetes after a penicillin G injection causes an immune-mediated reaction that usually resolves spontaneously. Treatment is supportive.

Your patient with psoriasis has new psoriatic plaques forming over areas where she has had skin trauma. This is known as which of the following? a. Koebner phenomenon b. Auspitz sign c. Koplik's spots d. lipomas

a. Koebner phenomenon

A 23 year old female who presents with symptoms consistent with appendicitis should also be assessed for which of the following? a. Miscarriage. b. Ectopic pregnancy. c. Gallstones. d. Diverticulosis.

b. Ectopic pregnancy.

You are treating a child with lead poisoning. As part of the education and follow-up for this family you would tell the parents which of the following? a. Lead must be removed by a professional. b. Decrease calcium and iron in the child's diet. c. Most homes built before 1990 contain lead paint. d. Lead testing kits are not sufficient to detect lead in the home.

a. Lead must be removed by a professional. You should tell the parents to increase calcium and iron in the child's diet and to consider buying a simple lead testing kit for paint and water that is available from most hardware stores. Most homes built before 1950 contain lead paint.

Which of the following tests is a diagnostic test as opposed to a screening test? a. MRI scan b. Mantoux test c. hemoglobin test d. fasting blood glucose test

a. MRI scan

You have a 25-year-old male patient with a knee injury. Which of the following tests would be positive if there is damage to the meniscus? a. McMurray sign b. anterior drawer sign c. Lachman sign d. posterior drawer sign

a. McMurray sign When the knee locks up and the patient is unable to fully extend the knee the sign is positive.

Your 30-year-old female patient is suffering from primary dysmenorrhea. You will prescribe the treatment of choice for this condition which is which of the following? a. NSAID b. acetaminophen c. aspirin d. magnesium

a. NSAID

Jenny is a 30-year-old female patient who suffers from primary dysmenorrhea. What treatment of choice will you prescribe for this condition? a. NSAIDs b. acetaminophen c. aspirin d. magnesium

a. NSAIDs

Which of the following is a symptom, as opposed to a sign? a. Patient reports night sweats. b. Patient's skin is cool and clammy to the touch. c. Patient's temperature is 97F. d. Patient's blood pressure is 140/70.

a. Patient reports night sweats. Symptoms are reported by the patient. They are thus subjective -- they are not externally verifiable. If a patient reports symptoms, it is key for the NP to conduct relevant assessments to determine the nature of those symptoms.

Rheumatoid arthritis would be considered a systemic autoimmune disorder that is more common in the female patients. Of the following, which might be considered a complication of this disorder? a. Pericarditis b. Nausea/vomiting c. Severe headaches d. Rash over the torso

a. Pericarditis Some of the complications of rheumatoid arthritis would be considered: Pericarditis, Uveitis, Scleritis, Vasculitis, Increased risk of certain malignancies

NP Shana is completing a full body physical of a patient. She notices small, hemorrhagic spots that are purple in color along the patient's face. The nurse makes a preliminary diagnosis as: a. Petechiae. b. Scarlet Fever. c. Body acne. d. Rosacea.

a. Petechiae.

A 2 month old infant is losing weight. She suffers from severe vomiting and constipation. Her mothers says that she is always hungry. What is the probable diagnosis? a. Pyloric stenosis. b. Hernia. c. Ulcerative colitis. d. Infant reflux.

a. Pyloric stenosis.

NP Betty is following up with a patient who has been prescribed aspirin therapy after a recent heart attack. What is one symptom she checks for before continuing the therapy? a. Recent hearing loss. b. Fatigue. c. Weight gain. d. Increased muscle cramps

a. Recent hearing loss. extended use of aspirin can sometimes lead to bilateral hearing loss of 30-40 decibels. This side effect usually resolves itself and hearing is restored within a few weeks of stopping the therapy. The NP should provide routine checks on the patient's hearing to monitor its severity and if the therapy will need to be discontinued.

A woman with preeclampsia calls complaining of vomiting, neck pain, and pain in the upper abdomen. What is the correct response? a. Refer to an emergency care facility. b. Schedule an appointment. c. Refer to a specialist. d. Tell her to rest.

a. Refer to an emergency care facility. The patient is describing symptoms of HELLP syndrome. HELLP syndrome is associated with preeclampsia. This can be fatal and requires emergency care.

When assessing the patient for possible acute appendicitis, the nurse practitioner deeply palpates the left lower quadrant of the abdomen which results in pain in the right lower quadrant. Which of the following maneuvers would this be considered? a. Rovsing's sign b. Markle test c. McBurney's point d. Murphy's maneuver

a. Rovsing's sign

Which of the following heart sounds is caused by the increased resistance from a stiff left ventricle? a. S4 heart sound b. S3 heart sound c. S2 diastole d. S1 systole

a. S4 heart sound

Polycystic Ovary Syndrome (PCOS) is considered a hormonal abnormality which can be marked by all but which of the following? a. Severe abdominal pain b. Infertility c. Insulin resistance d. Anovulation

a. Severe abdominal pain

Which of the following is classified under Love and Belonging in Maslow's Hierarchy of needs? a. Social isolation. b. Communication impaired. c. Chronic sorrow. d. Deficient knowledge.

a. Social isolation.

Your patient is a 60-year-old woman with a family history of osteoporosis. You will order tests to screen this woman for osteoporosis. The available screening tests for osteoporosis include all but which of the following? a. Spurling test b. ultrasound c. peripheral quantitative computed tomography d. dual-energy x-ray absorptiometry

a. Spurling test The Spurling test is a very specific, but not sensitive physical examination maneuver in diagnosing cervical spondylosis or acute cervical (neck) radiculopathy.

A 58-year-old male presents in the office with a glucose of 309 mg/dL and is symptomatic for Type II diabetes mellitus. What should be done to manage him FIRST? a. Start insulin b. Start metformin plus pioglitazone c. Have him return tomorrow to recheck his blood glucose d. Start metformin

a. Start insulin Most oral agents will have little effect on his glucose and it should be lowered immediately. Therefore, insulin is the best agent to reduce the blood sugar so that oral agents will have a chance to work. He should return to the clinic the next day for a recheck of the blood glucose and medication adjustment.

After examining his patient, Andy diagnoses his main complaint as dysphagia, which means the patient has difficulty while doing what? a. Swallowing. b. Breathing. c. Sleeping. d. Urinating.

a. Swallowing.

In diagnosing a toothache (pulpitis), the nurse practitioner has knowledge that all of the following are correct except: a. Systemic manifestations do not occur from dental caries and pulpitis. b. You should inquire about fever and chills. c. Dental caries are the most frequent type of injury that causes pulpitis. d. There is diverse flora involved in the infectious process, including gram-positive anaerobes and bacteroides.

a. Systemic manifestations do not occur from dental caries and pulpitis. Systemic manifestations often occur and they include lymphadenopathy, malaise, fever, and pain. The remaining answer choices are true regarding this condition.

When counseling a patient on side effects of her medication, a question comes up. What is the best way to manage and alleviate a common side effect of trazodone? a. Take this medication at bedtime. b. Eat more fiber while on this medication. c. Drink a big glass of water with each dose. d. Take this medication in the morning

a. Take this medication at bedtime.

Which of the following is NOT part of a typical psychosocial health assessment? a. Taking the patient's vital signs. b. Discussion of the patient's diet. c. Discussion of the patient's family situation. d. Discussion of the patient's religious beliefs.

a. Taking the patient's vital signs.

Reimbursement for services provided by nurse practitioners (NPs) to patients occurs through several mechanisms. Which of the following is NOT an accurate statement regarding this? a. The NP's services are covered at 100% in the Medicare Part B structure of payment without billing "incident-to." b. In managed care plans, NPs may receive payment as an identified provider for a panel of patients. c. NPs who are not identified as the primary provider of care but are employed by a professional practice group may receive payment through their employer's managed care arrangement. d. Salaries can be based on revenues generated by NPs.

a. The NP's services are covered at 100% in the Medicare Part B structure of payment without billing "incident-to."

When assessing the patient, where would the nurse practitioner locate the apical impulse? a. The apical impulse would be located at the 5th intercostal space by the midclavicular line on the left side of the chest. b. The apical impulse would be located at the 5th intercostal space by the midclavicular line on the right side of the chest. c. The apical impulse would be located at the 2nd intercostal space by the midclavicular line on the right side of the chest. d. The apical impulse would be located at the 6th intercostal space on the right side of the chest.

a. The apical impulse would be located at the 5th intercostal space by the midclavicular line on the left side of the chest.

A patient who has received stitches that are covered with a bandage asks how often she should change the dressing. Which of the following is NOT an appropriate response to this patient? a. The bandage only needs to be changed if it gets wet or dirty. b. The bandage should be changed every 24 hours. c. The bandage should be changed any time it gets wet. d. The bandage should be changed any time it gets dirty.

a. The bandage only needs to be changed if it gets wet or dirty.

A father brings his 14-year-old son into the clinic with complaints of knee pain. The boy plays basketball and states that it gets worse with jumping. It is important for the nurse practitioner to consider Osgood's Schlatter's disease and to know that: a. The pain is the result of microtears of the patellar tendon and overuse of the quadricep muscles of the knees. b. This is a condition caused by stress and trauma of the femoral tendon. c. This condition is more common in girls but boys have it too. d. Athletic individuals are not at risk for this condition.

a. The pain is the result of microtears of the patellar tendon and overuse of the quadricep muscles of the knees.

There are certain fundamental assumptions regarding the role of the primary care professional nurse. Which of the following is NOT one of them? a. The primary care role is specific to one health profession. b. The primary care role is not limited as to the population served. c. The primary care role requires from its practitioners independent and autonomous decision making based on professional knowledge. d. The primary care role is not limited to health problems encountered or duration of practitioner-patient relationship.

a. The primary care role is specific to one health profession.

You are treating a 64-year-old man who has the following PSA levels. What can be concluded about the following annual readings? Year 1: 3.8 ng/mL Year 2: 4.5 ng/mL Year 3: 5.5 ng/mL a. There is a steady increase that is worrisome. b. There is a steady increase but it is not worrisome. c. They are all within normal range. d. None are within normal range.

a. There is a steady increase that is worrisome. Typically, the normal range for the PSA level is below 4 ng/mL in an elderly male and below 2.5 ng/mL in a younger male. In the case of the 64-year-old patient, his PSA level during year 1 was 3.8 ng/mL, which is in the normal range. However, starting at year 2, the patient's PSA level increased to 4.5 ng/mL, which is outside of the normal range. Then, it elevated to 5.5 ng/mL in year 3, demonstrating his PSA level is steadily increasing outside of the normal range of 4 ng/mL. This elevation in PSA levels is a sign that some condition is causing the patient's PSA level to rise, such as prostatitis, benign prostatic hyperplasia (BPH) or even prostate cancer, for instance. Therefore, the patient should be referred for further testing, including a referral to an urologist for a prostate biopsy to rule out prostate cancer. Statistics reveal that about two thirds of elderly male individual's develop prostate cancer, when their PSA levels are elevated more than 10 ng/ mL. Further, statistics suggest that about 25% of males who have elevated PSA levels between 4 to 10 ng/mL have a condition contributing to the increase in the PSA.

You are going to prescribe an SNRI for a first-line treatment for your patient with depression. Which of the following drugs would you prescribe? a. Xanax b. Effexor c. Tegretol d. Elavil

b. Effexor

You are treating an adult patient with early Lyme disease. How long should this patient be treated? a. 7 - 10 days b. 14 - 21 days c. 21 - 28 days d. 30 - 60 days

b. 14 - 21 days You would treat an adult with early Lyme disease with doxycycline 100 mg b.i.d p.o. for 14 - 21 days. For late disease you would do the same but for 21 - 28 days.

A diabetic patient experiences severe dry mouth with severe thirst and hunger. What blood sugar level would lead to a diagnosis of hyperglycemia? a. 100 mg/dL. b. 250 mg/dL. c. 80 mg/dL. d. 70 mg/dL.

b. 250 mg/dL.

The Moro reflex usually disappears by what age? a. 1 - 2 months b. 3 - 4 months c. 6 - 12 months d. 12 - 24 months

b. 3 - 4 months

Your elderly patient has a moderate hearing loss. You understand that this means that the loss is in which of the following ranges? a. 26 - 40 dB b. 41 - 55 dB c. 56 - 70 dB d. 71 - 90 dB

b. 41 - 55 dB

According to the American Cancer Society Guidelines for the Early Detection of Cancer, yearly mammograms are recommended for women who are: a. in good health and are 35 years of age or over b. 45 years of age at average risk c. in good health and are 35 years of age or over and continuing every 2 or 3 years if the mammogram is negative d. in good health and are 40 years of age or over and continuing every 2 or 3 years if the mammogram is negative

b. 45 years of age at average risk

For patients with fibromyalgia, the maximum dose of Lyrica is which of the following? a. 100 mg/day. b. 450 mg/day. c. 1000 mg/day. d. 150 mg/day.

b. 450 mg/day. The maximum dose of Lyrica for neuropathic pain associated with fibromyalgia is 300-450 mg/day. It is given in two or three doses during the day. Patients typically start on a lower dose of 150 mg/day and build up to 300-450 mg/day over the course of a week.

At which of the following years of age should the Shingrix vaccine be administered? a. 21 b. 50 c. 40 d. 60

b. 50

In males, puberty is considered precocious if it occurs before: a. 12 years of age b. 9 years of age c. 14 years of age d. 10 years of age

b. 9 years of age In boys, puberty usually starts at about 11.5 years of age. It is considered precocious puberty if it begins before 9 years of age. In girls puberty starts at 10.5 years of age and is considered precocious if it begins before 8 years of age.

When prescribing drugs for a pregnant patient you would consider the risk category of the drug. Which of the following is the category with the lowest risk? a. 0 b. A c. X d. C

b. A

Peter suspects his patient may have pneumonia, but the X-ray did not confirm this. What other test can Peter order to ensure his diagnosis? a. A sputum test. b. A CT scan. c. A urinalysis. d. An ultrasound.

b. A CT scan.

A patient who has recently begun using Avonex complains that she experiences flu-like symptoms each time she injects the medication. Which of the following is NOT a step the patient can take to minimize these symptoms? a. Administer the injection right before bed time. b. Administer the injection first thing in the morning. c. Take fever reducers such as Tylenol before administering the injection. d. Take ibuprofen before administering the injection.

b. Administer the injection first thing in the morning. Patients can minimize these effects and the discomfort they cause by administering the injection immediately prior to bedtime. Ibuprofen or acetaminophen may also be taken prior to injection.

The NP advises her elderly patient to treat his pain with Ibuprofen. Which of the following drugs is a brand name for Ibuprofen? a. Aleve. b. Advil. c. Naprosyn. d. Celebrex.

b. Advil.

With senile purpura, diagnostic test include the platelet count, coagulation studies, and complete blood count (CBC). The values for these test will be: a. All will be slightly elevated. b. All values will be normal. c. Platelets and CBC will be elevated, coagulation studies and differential will be decreased. d. Platelets and CBC will be decreased, coagulation studies and differential will be elevated.

b. All values will be normal. Senile purpura (also called vascular purpura) is a common and benign condition in the elderly. The platelet count, coagulation studies, CBC, and differential values for this condition will all be normal.

You are providing care to a patient who has experienced an MI. The results of his treadmill stress test are poor, and treatment with aspirin and heparin have been ineffective. What is likely to be the next intervention for this patient? a. Coronary bypass surgery. b. Angioplasty. c. Repeat stress test. d. Heart transplant.

b. Angioplasty. Angioplasty, the insertion of a catheter with a balloon on the end into an artery or vein to remove an obstruction, is the preferred nonsurgical intervention. For patients with poor stress test results and who have not responded to anticoagulant therapy, angioplasty is likely to be a next step. Coronary bypass may follow if angioplasty proves unsuccessful.

Which potential diagnosis would you give a patient who wrings his or her hands during the interview? a. Ineffective coping. b. Anxiety. c. Disturbed personal identity. d. Infection risk.

b. Anxiety.

When you are interviewing a patient who does not speak English and you use a translator, which of the following actions is most appropriate? a. Try to speak to the patient if you know a few words of the patient's language. b. Ask questions to the patient by looking at him directly. c. Have the translator leave the room when conducting the physical part of the interview. d. Ask questions to the translator and look at the patient when he responds.

b. Ask questions to the patient by looking at him directly.

You are preparing to perform an assessment with an elderly female patient. Her daughter has brought her to the hospital for her appointment and is in the room. Which of the following is the appropriate next step before beginning the assessment interview? a. Ask the daughter to leave the room. b. Ask the patient if she would like her daughter present for her assessment. c. Ask the daughter if she wants to remain in the room. d. Begin the assessment.

b. Ask the patient if she would like her daughter present for her assessment.

Carol is an adult patient whom you are treating for acne. You would do all of the following in a follow-up visit with this patient EXCEPT: a. Assess for problems with skin irritation. b. Assess for weight gain or loss. c. Note the number and types of lesions present. d. Consider the effectiveness of the treatment.

b. Assess for weight gain or loss.

What test would you order if you suspect a patient has liver disease? a. CBC. b. Bilirubin test. c. RF blood test. d. ABG test.

b. Bilirubin test. Any result over 1 mg/dL of total bilirubin indicates liver damage.

A patient who takes iron supplements is likely to have which of the following? a. Bright red stools. b. Black or darkening stools. c. Watery stools. d. Diarrhea.

b. Black or darkening stools.

Bony nodules on the proximal interphalangeal joints are known as which of the following? a. Heberden's nodes b. Bouchard's nodes c. degenerative joint nodes d. none of the above

b. Bouchard's nodes

At each follow-up visit for asthma sufferers all of the following should be determined EXCEPT: a. PEFR (peak expiratory flow rate) b. CBC c. an action plan for improvement of symptoms d. compliance with medication therapy

b. CBC

A 52 year old male has a history of heart disease. His chief complain is a cough. The cough is wet and the patient has a fever. What test would you run to rule out infection? a. BRCA2. b. CBC. c. PSA. d. CPK.

b. CBC.

You conduct a physical exam of a patient with a cough. There are sounds of rales. What test would you order? a. Biopsy. b. Chest x-ray. c. CEA test. d. Endoscope.

b. Chest x-ray.

If the female patient has blotchy hyperpigmentation on the cheeks, forehead, nose or upper lid, it could be considered? a. Hives b. Chloasma c. Roseola d. Scurvy

b. Chloasma the female patient has blotchy hyperpigmentation on the cheeks, forehead, nose or upper lid, it would be considered chloasma (Melasma). This condition can be related to a high estrogen level. Patient's that take birth control pills sometimes experience this condition.

Adverse effects of penicillins could include which of the following? a. Headaches b. Clostridium difficile-associated diarrhea c. Joint pain d. Elevated blood pressure

b. Clostridium difficile-associated diarrhea The adverse effects of penicillins would include: Clostridium difficile-associated diarrhea, Vaginitis-typically candida, Diarrhea

Category X FDA classification drugs would be used for studies in humans or animals to help demonstrate fetal abnormalities. Which of the following medications would not be considered a Category X drug? a. Accutane b. Cocaine c. Cytotec d. Coumadin

b. Cocaine The list of Category X FDA drugs would include: - Accutane - Cytotec - Coumadin - Proscar - Propecia - Birth-control pills - HRT - Testosterone - Live virus vaccines such as rubella, measles, and mumps - Thalidomides such as methimazole

Alfred is a 54-year-old male patient with high cholesterol. You are going to prescribe a bile acid sequestrants for him. Which of the following drugs is a bile acid sequestrant? a. Zocor b. Colestid c. TriCor d. Pravachol

b. Colestid TriCor (fenofibrate) is a fibrate drug. Pravachol and Zocor are HMG CoA Reductase Inhibitors (statins).

Nurse Cherri's patient has recently been diagnosed with Ulcerative Colitis (UC). Cherri refers the patient to have routine colorectal exams, since patients with UC are more susceptible to what? a. Hemorrhoids. b. Colorectal cancer. c. Unusual polyps in the colon. d. Increased constipation.

b. Colorectal cancer.

A patient who has been prescribed Interferon should be advised to seek immediate medical attention if she experiences which of the following? a. Redness at the injection site. b. Difficulty breathing. c. Flu-like symptoms. d. Fatigue.

b. Difficulty breathing.

Your patient has been diagnosed with Parkinson's disease. He has been taking carbidopa and levodopa orally for 10 days and is concerned that it is not helping to control his symptoms. What would be the appropriate response to his concern? a. Immediately notify his health care provider that the medication has not been effective. b. Tell the patient that it takes 1 to 2 months before the medication is effective in controlling symptoms. c. Ask the patient if he is adhering to the recommended diet. d. Make sure that the patient is taking the medication properly.

b. Tell the patient that it takes 1 to 2 months before the medication is effective in controlling symptoms. Sometimes it takes as much as 6 months. The patient is not likely to see any improvement in symptoms in 10 days. Reminding the patient that it takes a while for the medication to be effective would be the appropriate response to his concern.

An older female patient comes to the FNP complaining of a generalized itchiness at night that keeps her up. The FNP diagnoses scabies. In treating the patient the FNP would do all of the following EXCEPT: a. Prescribe permethrin lotion to be left on for 8 to 14 hours. b. Tell the patient that the itching should disappear with the first use of the prescribed lotion. c. Tell the patient to wash all of her bedclothes and other items in hot water. d. Tell the patient that she can place bedclothes in plastic storage bags for a week to get rid of the mites that cause scabies.

b. Tell the patient that the itching should disappear with the first use of the prescribed lotion.

Of the following, which is a benzodiazepine that can be used to treat neurological disorders? a. Pergolide. b. Temazepam. c. Dibenzothiazepine. d. Gabapentin.

b. Temazepam. Pergolide - Dopamine Agonist Temazepam - Benzodiazepine Dibenzothiazepine - Antipsychotic Gabapentin - Anticonvulsant

Which of the following statements about the care and billing of Medicare patients is incorrect? a. NPs can expect that their Medicare bills will be audited. b. The US Justice Department makes the rules regarding the care of Medicare patients and the billing of Medicare. c. CMS clarifies how providers, hospitals and medical groups should bill. d. NPs are expected to know the rules for choosing appropriate evaluation and management codes.

b. The US Justice Department makes the rules regarding the care of Medicare patients and the billing of Medicare.

All but which of the following would be included when writing a prescription for a patient? a. The name of the person the medication is being prescribed for b. The cost of the medication c. The date the prescription was written d. The nurse practitioner's name

b. The cost of the medication

Which of the following statements about a comprehensive admission assessment for critically ill patients is least accurate? a. Comprehensive admission assessments determine the physiologic and psychosocial baseline so that future changes can be compared. b. The effects of aging are not incorporated into comprehensive assessments. c. The comprehensive admission assessment defines the patient's pre-event health status. d. The comprehensive admission assessment includes a physical examination of each body system.

b. The effects of aging are not incorporated into comprehensive assessments.

You are assessing a 67-year-old male who has come to the office for a routine visit. As you conduct your assessment you suspect that this patient may be suffering from a hearing loss. Which of the following would NOT support this suspicion? a. The patient nods and agrees with everything you say. b. The patient is slow to answer questions but answers them appropriately. c. The patient turns his head to favor one ear. d. The patient leans in toward you when you speak.

b. The patient is slow to answer questions but answers them appropriately.

A patient who has been prescribed miconazole for athlete's foot asks how long he should use the medication. Which of the following is an appropriate response to this patient? a. The patient should use the medication for 3 days. b. The patient should use the medication for 1 month. c. The patient should use the medication until symptoms are gone. d. The patient should use the medication for 2 weeks.

b. The patient should use the medication for 1 month.

Which of the following statements about bronchiolitis is least accurate? a. The majority of cases are caused by the respiratory syncytial virus. b. The peak incidence in children is between 3 and 6 years of age. c. Small airways become obstructed. d. Risk factors include low socioeconomic status.

b. The peak incidence in children is between 3 and 6 years of age. Bronchiolitis is an acute inflammation of the bronchioles resulting in obstruction of the small airways. The peak incidence in children is between 3 and 6 months of age.

Melanie is a patient who is 26 weeks pregnant. She presents with what you diagnose as Fifth Disease. You understand that all of the following are special considerations for this patient EXCEPT: a. Infections during pregnancy may cause fetal hydrops and death. b. The risk of fetal hydrops and death is relatively high in pregnant women. c. The risks associated with Fifth Disease are lower in this patient since she was exposed after 20 weeks of pregnancy. d. B19 infected fetuses may be treated with intrauterine blood transfusions.

b. The risk of fetal hydrops and death is relatively high in pregnant women. The risk of fetal hydrops and death is relatively low. The highest risk is if the mother is exposed during the first 20 weeks of pregnancy.

A 50 year old patient comes in for a check up. His wife mentions that he does not see cars in his periphery while driving. He has not had an eye exam in three years. What test may you choose to run? a. Biopsy. b. Tonometry. c. Blinking reflex. d. CT scan.

b. Tonometry. The patient is at an age where glaucoma may appear. Tonometry measure eye pressure and will show if it is high. A full visual exam is necessary to diagnose glaucoma.

Your patient has chronic asthma with frequent flare-ups. You are prescribing a rescue drug for this patient. Which of the following would you prescribe? a. Asmanex b. Ventolin c. Singulair d. Flovent

b. Ventolin

A 64-year-old Caucasian female is in the office with osteoporosis. You are instructing her on the use of alendronate (Fosamax). What information should you include when teaching this patient about this medication? a. You should take it with food. b. You should remain upright after taking the medication. c. You should take this medication midmorning. d. You should take it with a full glass of orange juice.

b. You should remain upright after taking the medication. Patients taking aledronate are instructed to take the medication when they get up in the morning, 30 minutes before eating and with a full glass of water. They should be instructed to remain upright to avoid esophageal irritation. If they take this medication with food, it will reduce the bioavailability by 40%. Taking alendronate with coffee or orange juice will reduce bioavailabiliy by 60%.

In terms of burn victims, a surgical procedure that is done to eliminate a scar contracture is which of the following? a. allograft b. Z-plasty c. escharotomy d. sheet graft

b. Z-plasty An incision is made in the shape of a "Z." This allows the contracture to change configuration and lengthen the scar.

In which of the following patients would blepharitis be more common? a. an African-American male b. a light-skinned Irish female c. an olive-skinned Greek male d. a Filipina female

b. a light-skinned Irish female

Your patient has episodes of blank staring lasting 3 - 50 seconds accompanied by impaired level of consciousness. You understand that this is an indication of which of the following types of seizures? a. tonic-clonic b. absence c. simple partial d. myoclonic

b. absence

Which of the following would NOT be considered a "red flag" for diagnosis of a headache that is something other than primary headache? a. change in attack frequency b. absence of systemic symptoms c. sudden or abrupt onset d. onset of headache with exertion

b. absence of systemic symptoms

Surgical intervention in the management of benign prostatic hypertrophy (BPH) should be considered with all of the following EXCEPT: a. recurrent complicated urinary tract infections b. acute tubular necrosis c. urinary bladder stones d. failure on medication therapy

b. acute tubular necrosis recurrent urinary tract infections, recurrent or persistent gross hematuria, bladder stones, or renal insufficiency would warrant surgery.

A 20-year-old college student is in the clinic with complaints of weakness. She is 15% below ideal body weight. She reports doing well in her classes, drinking alcohol every night and coffee throughout the day. She is bradycardic and gets dizzy when she stands up. What other findings may be seen in this patient? a. sleep apnea b. amenorrhea c. hypertension d. mitral regurgitation

b. amenorrhea More than 90% of patients with anorexia are amenorrheic. Hypotension is more common than hypertension and many patients with anorexia also exhibit mitral valve prolapse, not regurgitation.

You have an older patient with whom you are discussing eye health. The patient is concerned about developing cataracts. You might encourage the patient to consume which of the following to protect against this vision problem? a. iron b. antioxidants c. calcium d. lecithins

b. antioxidants Antioxidants such as vitamin E or C can reduce the likelihood of developing cataracts, since oxidative stress plays a role in cataract formation. Minerals and lecithins (emulsifiers) in general do not have anti-oxidant functions.

Missy is an account analyst who enters data via keyboard for 6 - 8 hours a day. As a result she has developed carpal tunnel syndrome. You might suggest all of the following nonpharmacologic treatments EXCEPT: a. limiting activities that stress the wrist b. applying heat to decrease inflammation c. applying a cock-up splint d. avoiding repetitive activities

b. applying heat to decrease inflammation To decrease inflammation cold therapy is recommended. Pharmacologic treatment includes NSAIDs and oral corticosteroids.

In terms of cardiac arrhythmias which of the following would be characterized by an irregularly irregular rhythm with no p waves seen on the EKG and a heart rate ranging from 80 to 180 beats/min.? a. paroxysmal atrial tachycardia b. atrial fibrillation c. mitral valve prolapse d. none of the above

b. atrial fibrillation

You are educating Christina, a patient with bipolar disorder, about how to live with this disorder. You might tell her all but which of the following? a. be aware of early warning signs b. avoid activity c. maintain a stable sleep pattern d. avoid alcohol and other drugs

b. avoid activity

Which of the following best describes the presentation of a patient during a myoclonic seizure? a. blank stare lasting 3 - 50 seconds with impaired level of consciousness b. awake state or momentary loss of consciousness with abnormal motor behavior lasting seconds to minutes c. rigid extension of arms and legs followed by sudden jerking movements d. aura characterized by unusual sense of smell or taste, visual or auditory hallucinations and stomach upset

b. awake state or momentary loss of consciousness with abnormal motor behavior lasting seconds to minutes

Your patient is on a sodium-restricted diet. You advise him to avoid which of the following foods? a. fresh chicken b. bacon c. fresh spinach d. cooked white beans

b. bacon Other foods to avoid (among many) are: quick breads, instant hot cereals, canned vegetables, regular catsup, and salted snack foods like pretzels.

The FNP has a 25-year-old female patient who presents with a profuse milk-like vaginal discharge and she complains of a "fishy" vaginal odor. The vulva is not red nor is it itchy. This patient most likely has which of the following vaginal infections? a. Trichomonas vaginitis b. bacterial vaginosis c. Candidal vaginitis d. atrophic vaginitis

b. bacterial vaginosis Labs will show clue cells (large numbers of bacteria on the cell surface) and the Whiff test will show a positive pH that is > 4.5 alkaline.

The postauricular lymph nodes are located: a. just above the clavicle b. behind the ear c. in front of the ear d. at the chin

b. behind the ear

Your 25-year-old female patient of Irish descent presents with redness, scaling and crusting of the eyelid. She tells you that she has a history of rosacea. Your diagnosis for this patient would be which of the following? a. chalazion b. blepharitis c. hordeolum d. lice infestation

b. blepharitis

Most kidney stones are composed of which of the following? a. uric acid b. calcium c. cystine d. struvite

b. calcium

A patient has come to you with a fever of 103° F, pharyngitis, a headache and backache. She has been vomiting and has had diarrhea. Your physical exam revels 1 mm vesicles and ulcers on the anterior tonsillar pillars. Which of the following diseases/conditions is most likely responsible for these symptoms? a. influenza b. herpangina c. Lyme disease d. rubella

b. herpangina Herpangina is an acute viral illness causing fever, ulcerative mouth lesions, cough, coryza, and pharyngitis. It is seen more frequently in temperate climates (summer and fall). The patient may have a fever as high as 106° F, malaise, headache, backache, anorexia, drooling, vomiting, and diarrhea.

John is a patient with acute renal failure. His inability to regulate electrolytes might be evidenced by all but which of the following conditions? a. hyperkalemia b. hyperlipidemia c. hypocalcemia d. hypernatremia

b. hyperlipidemia

Which of the following is a relative contraindication to hormone replacement therapy? a. suspected breast cancer b. hypertension c. active liver disease d. undiagnosed genital bleeding

b. hypertension Other relative contraindications include: malignant melanoma, gallstones, endometriosis and leiomyomas.

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? a. clumped lesions b. itching c. previous trauma to the face d. superficial large vesicles that have not ruptured

b. 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.

A 52-year-old male patient presents in the office and you notice a yellowish plaque on his upper eyelid that is painless. What should the nurse practitioner look for? a. liver function studies b. lipid levels c. sedimentation rate d. vision in the affected eye

b. lipid levels

You are assessing the lab work for a patient who is pregnant. You notice that AFP is high. Which of the following might this indicate? a. Down's syndrome b. neural tube defect c. fetal demise d. chromosome abnormality

b. neural tube defect A high AFP might indicate neural tube defect. It can also result from multiple gestations. Down's syndrome and fetal demise and other chromosome abnormalities would be possibilities with a low AFP.

Your pregnant patient has a high Serum Alpha-fetoprotein (AFP). This might indicate which of the following? a. Down's syndrome b. neural tube defect c. fetal demise d. all of the above

b. neural tube defect Down's syndrome and fetal demise would be possibilities with a low AFP.

Mrs. Martin is a 30-year-old pregnant patient who has been diagnosed with placenta previa. Your plan for Mrs. Martin would include all except which of the following? a. abdominal ultrasound b. normal sexual intercourse c. avoid placing any object in the vagina or rectum d. bedrest

b. normal sexual intercourse

According the CDC classification of overweight and obesity, a person with a BMI (kg/m2) of 27.0 would be classified as: a. healthy weight b. overweight c. obese d. extremely obese

b. overweight

What is the first-line drug intervention in an anaphylactic episode? a. oral prednisone therapy b. parenteral epinephrine c. inhaled epinephrine d. oral diphenhydramine

b. parenteral epinephrine

Your patient has experienced a TIA. You understand that there are certain risk factors for TIAs that include all of the following EXCEPT: a. atherosclerosis b. peptic ulcer disease c. cardiac valve problems d. oral contraceptive use

b. peptic ulcer disease

Which of the following would NOT be a common cause of epilepsy in older adults? a. cerebrovascular disease b. premature birth c. neoplasms d. head trauma

b. premature birth

You have a 60-year-old male patient who has some vision loss. You tell him that there is a certain amount of normal vision loss associated with aging. This type of vision loss is known as which of the following? a. hyperopia b. presbyopia c. glaucoma d. myopia

b. presbyopia Presbyopia is the natural loss of accommodation that is caused by aging. Hyperopia is the inability to see near objects clearly because of failure to accommodate. Myopia is the inability to see distant objects. Glaucoma is a disease of the eye.

Jason is a 45-year-old male patient in the early stage of Lyme disease, erythema migrans. When you examine Jason at this stage of the disease you would expect to see which of the following? a. honey-colored crusts b. red target lesions c. Koplik's spots d. sandpaper-type rash

b. red target lesions This disease is caused by the bite of an Ixodes tick infected with Borrelia burgdorferi. If untreated, infection becomes systemic and affects multiple organ systems.

A mother brings in her 6-year-old male child with a rash on his face that has spread to the trunk and extremities. You find that these lesions are pink, maculopapular eruptions. The mother tells you that the child has also had mild diarrhea. Your diagnosis for this child is most likely to be which of the following? a. roseola b. rubella c. scabies d. impetigo

b. rubella Common symptoms include a pink maculopapular eruption that begins on the face and spreads down to the trunk and extremities. The facial rash clears as extremity rashes erupt.

Lou is a 72-year-old patient who is suffering from a nosebleed that you determine is anterior epistaxis. The first-line intervention for Lou would be which of the following? a. nasal packing b. simple pressure to the area superior to the nasal alar cartilage c. cautery d. topical thrombin

b. simple pressure to the area superior to the nasal alar cartilage

A patient who has loss of urine with activity that causes increase in intra-abdominal pressure, such as coughing, sneezing or exercise has which of the following types of urinary incontinence? a. urge incontinence b. stress incontinence c. urethral obstruction d. transient incontinence

b. stress incontinence Stress incontinence is the most common form of incontinence in women; it is rare in men. It is caused by a weakness of the pelvic floor and urethral muscles. It is characterized by a loss of urine with activity that causes increase in intra-abdominal pressure, such as coughing, sneezing or exercise.

For girls, when Tanner Stage II starts it is typically how long before the girl starts menses? a. 1 month b. 6 months c. 1 - 2 years d. 3 years

c. 1 - 2 years

Mary is concerned because her 12-year-old son shows no signs of puberty. You would tell her that the average age of onset for males is which of the following? a. 10 - 12 years b. 13 - 16 years c. 10.5 - 16 years d. 10.5- 13 years

c. 10.5 - 16 years

Of the following, which would be considered correct for the amount of CFU's that would indicate a urinary tract infection? a. 10,000 b. 20,000 c. 100,000 d. 10-50

c. 100,000

You are seeing a 2-year-old male child in the clinic with community acquired pneumonia (CAP). When managing this patient, you know that what percentage of children have an episode of pneumonia by age 5? a. less than 10% b. 10% c. 20% d. 30%

c. 20%

The FNP has a 6-year-old male patient with impetigo. She prescribes antibiotic therapy for the child and tells his mother that he should not return to school until: a. one week after initiation of antibiotic therapy b. 3 days after initiation of antibiotic therapy c. 24 hours after initiation of antibiotic therapy d. the impetigo has resolved

c. 24 hours after initiation of antibiotic therapy

After taking a job with a professional organization, you are a practicing nurse practitioner in a rural community. You are involved in work-related surveillance and know that the records related to this must be held for how many years after employment? a. 10 years b. 20 years c. 30 years d. They can be destroyed only after the employee's death.

c. 30 years

The FNP is calculating the BMI for a female patient who wants to lose weight. If the patient is 5 feet 6 inches and weighs 200 lbs. what is her BMI to the nearest tenth? a. 23.2 b. 33.2 c. 32.3 d. 30.3

c. 32.3 The BMI is calculated by dividing the weight in pounds by the height in inches squared and multiplying that by 703.

As an FNP you will be dispensing topical creams and ointments for various conditions. What is the amount of cream or ointment that would be needed for a one-time application to the left leg of the body? a. 2 g b. 3 g c. 6 g d. 30 g

c. 6 g For the posterior trunk of the body the amount needed would be 3g. This is also the amount needed for one arm or for the anterior trunk of the body. For hands, head, face, or anogenital region, 2 g is the amount needed. For the entire body 30-60 g is needed.

At which age does a child develop a pincer grasp? a. 3 months b. 6 months c. 9 months d. 12 months

c. 9 months The child should also be able to pull himself or herself up to stand, as well as crawl and bear weight well.

A patient says that he is constantly fatigued. What is MOST likely the correct diagnosis? a. Anxiety. b. Defensive coping. c. Activity intolerance. d. Spiritual distress.

c. Activity intolerance.

Edward is a 50-year-old male patient who has peripheral vascular disease. You are prescribing a neuropathic analgesic for him. Which of the following drugs would you prescribe? a. Pentoxifylline b. Persantine c. Amitriptyline d. Clindamycin

c. Amitriptyline

A patient comes in complaining of anxiety. At the interview, the patient explains that he was given steroids to treat inflammation. Medical records confirm the steroid use. What is a side effect of steroids? a. Weight loss. b. Chills. c. Anxiety. d. Loss of appetite.

c. Anxiety.

Delores is a patient who has Alzheimer's disease. In the course of a discussion with the patient's spouse which of the following statements would indicate that he understands the diagnosis? a. I have been doing verbal exercises with her to help her improve her memory. b. We have been taking long walks in hopes that physical exercise will help her condition to improve. c. Are there support services available for her and for my family to help us cope with this diagnosis? d. I have been researching medications that will reverse the progression of this disease.

c. Are there support services available for her and for my family to help us cope with this diagnosis?

You are educating a patient for whom you have prescribed Xanax for anxiety regarding cautions to be observed while taking this medication. Which of the following would NOT be one of these cautions? a. Avoid antihistamines. b. Avoid alcohol. c. Avoid antioxidants. d. Avoid barbiturates.

c. Avoid antioxidants.

All but which of the following increases a patient's risk for falling? a. Fear of falling. b. Blood pressure medication c. Being female. d. Being male.

c. Being female.

A 37 year old male patient has a family history of skin cancer. He has a nodule on his right forearm. It is red, firm, and occasionally bleeds. What test would you order? a. CTA scan. b. CBC. c. Biopsy. d. RBC count.

c. Biopsy. The patient's symptoms appear to be squamous cell carcinoma. This requires a biopsy to confirm the diagnosis.

The FNP has a patient who desires to quit smoking. She asks the FNP if there is anything that can help her in trying to quit. The FNP understands that all of the following are true in regard to smoking cessation EXCEPT: a. Bupropion, an atypical antidepressant, is used for smoking cessation. b. Bupropion can be used with nicotine products such as gum or nasal sprays. c. Bupropion is safe to use for persons with a history of seizures. d. Nicotine patches should not be used with other nicotine products.

c. Bupropion is safe to use for persons with a history of seizures.

Which of the following cranial nerves would be responsible for the sense of smell? a. CN VI b. CN IX c. CN I d. CN III

c. CN I CN VI would be associated with abducens. CN IX would be associated with Glossopharyngeal. CN III would be associated with Oculomotor.

Which of the following statements about the MMR vaccine is false? a. The MMR vaccine is safe to use during lactation. b. The MMR vaccine is a live, attenuated vaccine. c. The recommended schedule for early childhood immunization is two immunizations one month apart. d. Systemic reaction to the MMR vaccine is rare.

c. The recommended schedule for early childhood immunization is two immunizations one month apart. The recommended schedule for early childhood immunization is two doses of MMR vaccine given between 12 and 15 months and between 4 and 6 years. Two immunizations one month apart are recommended for older children who were not immunized earlier in life.

One of the complications of epistaxis would be considered posterior nasal bleeds. If this complication occurs, which of the following interventions would be considered appropriate? a. To instruct the patient to lie supine with head down for 1 hour. b. To instruct the patient to schedule an appointment to see their general practitioner as soon as possible (within the week). c. To instruct the patient to go to an emergency room. d. To instruct the patient that the bleed should eventually stop with no treatment needed.

c. To instruct the patient to go to an emergency room.

Which of the following statements about evaluation and follow-up of a child diagnosed with ADHD is least accurate? a. A multidisciplinary approach is most successful. b. The family should be involved in the development of the treatment plan. c. Treatment of ADHD is short term. d. Referral and/or consultation may be necessary.

c. Treatment of ADHD is short term.

A 27 year old patient has a history of psoriasis. He comes in with a new rash on his upper thigh. What might lead you to believe this is not psoriasis? a. Evidence of plaque. b. Papule appearance. c. Vesicles are apparent. d. Redness.

c. Vesicles are apparent. Redness is common with most skin rashes. Vesicles are not associated with psoriasis. The other answers are seen in patients with psoriasis.

A patient who has been prescribed betamethasone for psoriasis should be advised to contact her healthcare provider immediately if she experiences which of the following? a. Weight gain. b. Stomach upset. c. Vomit that looks like coffee grounds. d. Changes in her menstrual period.

c. Vomit that looks like coffee grounds.

Electronic patient records raise specific legal concerns, many of which are concepts of the evolving status of traditional rights and responsibilities associated with ownership and control of patient information. All of the following are accurate statements regarding legal issues related to electronic patient records EXCEPT: a. A computerized medical record system must be designed, installed, and maintained to preserve both the confidentiality and the integrity of patient health information. b. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has standards related to patient record confidentiality and integrity set up for organizations to adhere to. c. When medical record data is transmitted across state lines, it is always the state where the patient was treated in which the law applies. d. Computerization of patient data increases the risk of unauthorized disclosure of medical information.

c. When medical record data is transmitted across state lines, it is always the state where the patient was treated in which the law applies.

Acute pyelonephritis is a bacterial infection of the kidneys which may, for certain patients require hospitalization. Which of the following persons is least likely to be hospitalized for this condition? a. a 6-month-old infant b. a 3-year-old female c. a 25-year-old male d. a 30-year-old pregnant woman

c. a 25-year-old male Children and pregnant women should be hospitalized for IV antibiotics.

Which of the following patient with burns should be hospitalized? a. a patient with second-degree burns over more than 5% of the body b. a patient with second-degree burns on the arm c. a patient with chemical burns d. a patient with first degree burns on the arm

c. a patient with chemical burns Other to be hospitalized include all patient with second-degree burns over more than 10% of the body; electrical burns or lightning strike; and circumferential burns.

Juvenile rheumatoid arthritis has different presentations. The presentation that is accompanied by a salmon macular rash, arthritis, splenomegaly, leukocytosis, and polyserositis is which of the following? a. pauciarticular disease b. polyarticular pattern c. acute febrile form d. none of the above

c. acute febrile form Acute febrile form is juvenile rheumatoid arthritis with salmon macular rash, arthritis, splenomegaly, leukocytosis, and polyserositis. This form is characterized by high and intermittent fever that usually occurs in the morning and evening, sometimes with shaking chills.

Yolanda is an adult female patient who complains of feeling facial pressure that worsens when she bends over. She also has pain in her molars and a headache that is centered in the forehead area. The most likely diagnosis for Yolanda is which of the following? a. otitis media b. rhinitis medicamentosa c. acute sinusitis d. cluster headache

c. acute sinusitis Acute sinusitis is an infection of the sinuses by Gram-positive and Gram-negative bacteria. The patient usually complains of unilateral facial pressure that worsens when bending down, along with pain in the upper molar teeth, and possible frontal headache.

You prescribe nasal corticosteroid spray for a patient with allergic rhinitis. What is the anticipated onset of symptom relief with its use? a. immediately with the first spray b. within 1 to 2 days c. after a few days d. 2 or more weeks

c. after a few days

Which of the following is an absolute contraindication to thrombolytic therapy in a patient with MI symptoms? a. a history of chronic, severe, poorly controlled hypertension b. pregnancy c. any prior intracranial hemorrhage d. active peptic ulcer

c. any prior intracranial hemorrhage

You are testing a patient for dementia and ask her to spell "world" and then to spell it backward. You are testing for what area in particular? a. orientation b. recall c. attention and calculation d. copying

c. attention and calculation

You are testing your patient for dementia. When you ask her to spell "white" and then to spell it backward, you are testing for what area in particular? a. orientation b. recall c. attention and calculation d. copying

c. attention and calculation

Dry, red lesions with a rough texture that are a precursor for squamous cell carcinoma are which of the following? a. Stevens-Johnson syndrome b. melanoma c. erythema multiforme d. actinic keratoses

d. actinic keratoses

Your follow-up for patients with pernicious anemia would include which of the following? a. seeing patient every year after the initial follow-up b. checking initial hematologic response in 24 hours c. following up older adults in 48 hours d. avoiding iron supplementation

c. following up older adults in 48 hours This is something you would do as follow-up on an older adult patient with pernicious anemia. You would see the patient every 6 months after initial follow-up, with stool check for occult blood since the incidence of gastric cancer increases with pernicious anemia. You would check initial hematologic response in 4 - 6 weeks. And you would consider iron supplementation.

The first-line treatment for osteoarthritis in European nations that is a nutritional supplement here in the United States is which of the following? a. timed antacid use b. sucralfate c. glucosamine d. misoprostol

c. glucosamine

According to the CDC an obese person would have a Body Mass Index (BMI) of: a. greater than or equal to 18.5 b. greater than or equal to 25 c. greater than or equal to 30 d. greater than or equal to 40

c. greater than or equal to 30

You have a patient who you suspect may be anemic. Diagnostic procedures for this patient would include which of the following? a. ACTH b. TSH c. hematocrit d. AST

c. hematocrit

Which of the following is NOT a typical characteristic of basal cell carcinoma? a. long latency period b. slow-growing nodules c. high metastatic risk d. grows less rapidly than squamous cell carcinoma

c. high metastatic risk There is a low metastatic risk in basal cell carcinoma. Still, early recognition and intervention is recommended, since untreated BCC can lead to significant deformities and possible altered function.

The FNP has an adult patient who presents with a rash on the hands and neck that consists of bright red weepy lesions. The FNP diagnoses eczema. Which of the following should be avoided in the treatment of this disease? a. topical steroids b. skin lubricants c. hot water baths d. systemic oral antihistamines

c. hot water baths Hot water baths, harsh detergents, chemicals and wool clothing should be avoided. Medications for this disease include topical steroids, systemic oral antihistamines and skin lubricants such as Eucerin, Keri lotion and baby oil.

You are a proponent of the theory that learners are unique persons who learn optimally when they are treated with positive regard and are involved in decision making. This is which of the following learning theories? a. behaviorist b. cognitive c. humanistic d. andragogy

c. humanistic

You are evaluating a patient who is having an asthma flare. What would you expect to find upon physical examination? a. inspiratory crackles b. a tripod posture c. hyperresonance on thoracic percussion d. increased vocal fremitus

c. hyperresonance on thoracic percussion Physical findings upon examination include hyperresonance on thoracic percussion, decreased tactile fremitus, wheezing, prolonged expiratory phase, and low diaphragms. Individuals asthma can try to avoid the things that triggers the asthma attack, if known, in order to help prevent future asthma flare-ups.

Amy is an 11-year-old female who comes to the clinic with her mother. The mother tells you that she has noticed that one of the child's hips seems to be higher than the other, but Amy has no pain. Upon exam, you discover a lateral curvature of the spine. The Adams Forward Bend Test shows asymmetry of the spine. Which of the following would be the most likely diagnosis for this patient? a. Osgood-Schlatter disease b. Turner's syndrome c. idiopathic scoliosis d. none of the above

c. idiopathic scoliosis

All of the following are typical changes to the gastrointestinal system that come with aging EXCEPT: a. decreased liver size b. decreased muscle tone in bowel c. increased absorption of calcium d. atrophy of salivary glands

c. increased absorption of calcium

You are teaching a patient with diabetes to recognize the signs of hyperglycemia. Which of the following is one of these signs? a. weakness b. sweating c. increased thirst d. anxiety

c. increased thirst Other signs of hyperglycemia are: headaches, fatigue, weight loss, frequent urination, and difficulty concentrating.

With knowledge of the alternative dispute resolution (ADR), which of the following is NOT a form of this? a. binding and nonbinding arbitration b. settlement conference c. jury trial d. mediation

c. jury trial

Lois is an older female patient who is suffering from hypothyroidism. When you do an assessment of this patient which of the following characteristics would you expect to find? a. sweating b. heat intolerance c. lethargy d. tachycardia

c. lethargy

Which of the following would be considered a common secondary skin lesion? a. papule b. patch c. lichenification d. vesicle

c. lichenification Lichenification is a skin thickening resembling callus formation. It is seen in areas of recurrent scratching and is considered a common secondary skin lesion.

You are treating a 68-year-old African-American male in the clinic. He presents with back and trunk pain. You rule out pain from a cardiovascular origin and find that he has normocytic/normochromic anemia with hypercalcemia. A likely diagnosis is: a. leukemia b. prostate cancer c. multiple myeloma d. lymphoma

c. multiple myeloma This disease is a neoplastic proliferation in the bone marrow and results in skeletal destruction. It is more common in older adults with the average age of this diagnosis at 66 years old. The significant findings are pain in the long bones such as the trunk/back region, legs and arms. Other associated findings are anemia, usually normocytic/normochromic, hypercalcemia, and renal insufficiency.

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? a. a maximum 18 mg/dL rise in cortisol levels at 60 minutes b. a minimum 10 mg/dL rise in cortisol levels above the baseline c. no response d. exaggerated response

c. 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.

Which of the following tests is NOT considered a first-line diagnostic test for erectile dysfunction? a. serum glucose level b. TSH level c. penile angiography d. lipid profile

c. penile angiography

After completing a physical examination, you suspect that a 16-year old girl has acute appendicitis. She presents with acute abdominal pain and you order a white blood cell (WBC) count with differential and an x-ray of the abdomen. You receive the laboratory report back first and are still waiting on the x-ray. By looking at the laboratory report, which of the following values would you expect to see in a patient with acute appendicitis? a. total WBCs 1200 mm³ neutrophils 4% bands 1% lymphocytes 44% b. total WBCs of 500mm³ neutrophils 10% bands 2% lymphocytes 39% c. total WBCs 16,000 mm³ neutrophils 67% bands 8% lymphocytes 23% d. None of the above would indicate acute appendicitis.

c. total WBCs 16,000 mm³ neutrophils 67% bands 8% lymphocytes 23% You would expect a "left shift." This includes leukocytosis (elevated WBCs), neutrophilia (an absolute neutrophil count (ANC) of greater than 7000 neutrophils/mm. ANC is calculated by multiplying the percentage of neutrophils by the total WBC in mm.

Which of the following factors would NOT increase the susceptibility to diarrhea? a. acute diarrhea b. lactose intolerance c. underfeeding d. NSAIDs

c. underfeeding

An elderly male has a diagnosis of left-sided congestive heart failure (CHF). The nurse practitioner would identify which of the following as a common condition associated with CHF? a. ventricular dysrhythmias b. peripheral vascular disease c. untreated hypertension d. chronic obstructive pulmonary disease

c. untreated hypertension

Jeff is a 30-year-old male who has a condition that results from dilated veins in the spermatic cord. He tells you that he and his wife have been trying to have a baby for several years but have not had any luck. Jeff is suffering from which of the following? a. hydrocele b. epidymitis c. varicocele d. testicular torsion

c. varicocele

Your African-American patient has hypo-pigmented patches of skin on his forearms. This is known as which of the following skin diseases/conditions? a. xanthelasma b. nevi c. vitiligo d. melasma

c. vitiligo

The FNP has a patient who is refusing treatment that the FNP thinks is necessary. Which of the following actions should the FNP take? a. If the treatment is life-saving, administer it anyway. b. Document the refusal but keep trying to change the patient's mind. c. Document the fact that risks have been explained and keep trying to change the patient's mind. d. Document that the FNP has explained the risks, benefits and alternatives of treatment and the risks of refusing treatment and that the patient refuses treatment.

d. Document that the FNP has explained the risks, benefits and alternatives of treatment and the risks of refusing treatment and that the patient refuses treatment.

During a brown bag review, which of the following is NOT an appropriate question? a. How long have you been taking this medication? b. Who prescribed this medication for you? c. What do you take this medication for? d. Does your insurance pay for this medication?

d. Does your insurance pay for this medication?

A 62 year old female patient has signs of Stage 2 hypertension and several risk factors in her health history. Upon auscultation, the patient also has carotid bruits. Further diagnostic tests should include a(n): a. Electrocardiogram. b. Magnetic resonance imaging. c. Endoscopy. d. Doppler imaging.

d. Doppler imaging.

Of the following, which antibiotic is typically used to treat the patient that has been diagnosed with Lyme disease? a. Erythromycin b. Levaquin c. Amoxicillin d. Doxycycline

d. Doxycycline A normal dosage might be considered: 100 mg PO BID x 21 days.

Which of the following is an incorrect statement regarding the expected course and follow-up of a person with acute otitis media? a. Simple cases are resolved in 2 - 3 days. b. Middle ear effusion commonly persists after the course of treatment. c. Recheck can be made in 2 - 8 weeks depending on the reliability of the patient or parent. d. Effusion is present in 10% of cases at 2 weeks.

d. Effusion is present in 10% of cases at 2 weeks. Effusion is present in 60% of cases at 2 weeks. It decreases to 40% at 4 weeks, 20% at 2 months, and 10% at 3 months.

How often would you screen a sexually active 21 year old patient for Chlamydia? a. Every two years. b. Every three years. c. Every four years. d. Every year.

d. Every year.

Janelle is a 35-year-old female patient who complains of right upper quadrant abdominal pain. You find that there is tenderness upon palpation of the area. Janelle is sexually active. You might suspect which of the following conditions/diseases? a. Jarisch-Herxheimer reaction b. syphilis c. Reactive arthritis d. Fitz-Hugh-Curtis syndrome

d. Fitz-Hugh-Curtis syndrome Fitz-Hugh-Curtis syndrome is a chlamydial and/or gonococcal infection of the liver capsule resulting in extensive scarring between the liver capsule and abdominal contents. The disease is treated as a complicated gonorrheal/chlamydial infection with 14-day treatment.

You are examining a patient who has a cardiac murmur. Which of the following is most likely to be found if this patient's murmur is associated with aortic stenosis? a. Grade 1-3/6 early to mid systolic murmur b. Grade 2-3/6 systolic ejection murmur c. Grade 1-3/4 high-pitched blowing diastolic murmur d. Grade 1-4/6 harsh systolic murmur

d. Grade 1-4/6 harsh systolic murmur It is usually in a crescendo-decrescendo pattern and it is heard best at the second right intercostal space.

A patient has a colonoscopy. The presence of which of the following suggests Crohn's disease rather than ulcerative colitis? a. Ulcers. b. Diverticulosis. c. Hernia. d. Granuloma.

d. Granuloma. Ulcers are apparent in patients with ulcerative colitis and Crohn's disease. Granulomas are only seen in patients who have Crohn's disease.

The FNP is going over the lab results for a low-risk patient who has had a lipid screening. The results are as follows: Total cholesterol: 175 mg/dL HDL: 30 mg/dL LDL: 100 mg/dL Triglycerides: 285 mg/dL What conclusion would the FNP come to with these results? a. LDL is normal; all others are not within the reference range. b. All of the results are not within the reference ranges. c. Total cholesterol is high; all others are within the reference range. d. HDL and triglycerides are not within the reference range.

d. HDL and triglycerides are not within the reference range. HDL should be > 40 mg/dL and triglycerides should be < 150 mg/dL. Total cholesterol and LDL are within the normal reference range for a low-risk patient.

You have an African-American male patient who is 42 years old. His older brother has been diagnosed with prostate cancer recently, and he asks when he should begin prostate cancer screening. You would tell him which of the following? a. He is too young to begin screening. b. He should not worry about screening because being of the African-American race reduces his risk. c. He should have begun screening when he was 21 years old. d. He should begin immediately because he has a higher risk of prostate cancer.

d. He should begin immediately because he has a higher risk of prostate cancer. Normally a man should begin prostate cancer screening at age 50. But since this patient has a brother who has prostate cancer and he is also of the African-American race he has a higher risk and should begin yearly screening immediately. Age 40 is the recommended age for high risk patients.

A 57 year old female patient of East Asian descent has a calcium level of 12 mg/dl in her routine blood work. What would be your differential diagnosis? a. Osteoporosis. b. Renal failure. c. Pancreatitis. d. Hyperparathyroidism.

d. Hyperparathyroidism. Increased levels of calcium indicates hyperparathyroidism because the bone is being broken down and there is more calcium in the blood. The patient's age and heredity make this a more likely diagnosis. The other answers are related to low levels of calcium. Normal calcium levels are 8.8 to 10.3 mg/dl.

Of the following, which would not be considered a potential sign or symptom of pregnancy-induced hypertension (preeclampsia)? a. Edema b. Hypertension c. Proteinuria d. Hypotension

d. Hypotension

You are conducting an assessment with a female patient who has come in complaining of fatigue and frequent leg cramps. She says that she has gained several pounds lately, though this may be because it is so difficult to exercise when she is tired and weak much of the time. Her skin is rough and pale. The patient should be further evaluated for which of the following? a. Hyperthyroidism. b. Grave's disease. c. Type 1 diabetes. d. Hypothyroidism.

d. Hypothyroidism.

You are providing care to a female patient who is suffering from hemorrhoids. She is not pregnant. Which of the following is NOT an appropriate recommendation for this patient? a. The patient should use OTC hemorrhoid medications such as Preparation H for 7 to 10 days. b. The patient should take OTC pain relievers to help with discomfort. c. The patient should take warm sitz baths to help relieve discomfort. d. The patient should use OTC hemorrhoid medications such as Preparation H for as long as necessary.

d. The patient should use OTC hemorrhoid medications such as Preparation H for as long as necessary. While the patient can use such treatments for 7 to 10 days at a time, it is important that she is educated not to use them indefinitely. These medications contain ingredients that can damage tissue and actually make the problem worse. She can also use warm sitz baths and OTC analgesics to help alleviate pain and discomfort.

Of the following statements, which would not be considered correct regarding cauda equina syndrome? a. A change in bowel/bladder control is considered a sign of this syndrome. b. This syndrome would be considered a surgical emergency. c. With this syndrome, there is acute pressure on the sacral nerve root causing inflammatory/ischemic changes to the nerves. d. This syndrome never leads to permanent damage.

d. This syndrome never leads to permanent damage.

The NP has diagnosed her elderly patient with shigella. Which of the following medications would she MOST likely prescribe her? a. Metronidazole. b. Erythromycin. c. Ampicillin. d. Trimethoprim-sulfamethoxazole.

d. Trimethoprim-sulfamethoxazole. The preceding drugs are typically used in treating the following: - Campylobacter jejuni: Erythromycin - Salmonella: Ampicillin - Shigella: Trimethoprim-sulfamethoxazole ​ - Giardia lamblia: Metronidazole

An 81 year old patient with gastropathy presents to the NP with pain. The patient states at one time, earlier in life, she was given an NSAID for pain and asked if she could have it again. The NP said, "Unfortunately, due to your gastropathy condition, I am unable to offer NSAIDs as an option." At what risk would the NP be putting the patient if she prescribed an NSAID? a. Decreased effectiveness of diuretics. b. Fluid retention. c. Hypoxia. d. Ulcer and bleeding risk.

d. Ulcer and bleeding risk.

When listening to your 86-year-old patient's heart murmur, you note that it is so loud that it can be heard with the stethoscope completely off the chest. How do you grade the murmur? a. IV/VI. b. I/VI. c. V/VI. d. VI/VI.

d. VI/VI. Grading heart murmurs follows this system: I/VI: Heart murmur makes faint sound and may not be heard when patient changes position. II/VI: Heart murmur is quiet but can be heard as soon as the stethoscope is placed on the chest. III/VI: Heart murmur is moderately loud. IV/VI: Heart murmur is loud and accompanied by a palpable thrill. V/VI: Heart murmur is very loud and can be heard with the stethoscope partially off the chest. VI/VI: Heart murmur is very loud and can be heard with the stethoscope completely off the patient's chest.

Medicaid is a health insurance plan that many nurse practitioners (NPs) will submit claims to for reimbursement of services rendered to patients. It is important that the NP has understanding of this program. All of the following are true statements regarding Medicaid EXCEPT: a. Medicaid funds are provided by the federal and state government and administered by the states. b. The Omnibus Budget Reconciliation Act of 1989 allowed for NPs to receive direct payment in the Medicaid program without the need for supervision or association with physicians or other health care providers. c. All states have complied with federal legislation mandating Medicaid coverage of pediatric services in Medicaid programs. d. Very few states at this time include nurse practitioners in coverage for their Medicaid programs.

d. Very few states at this time include nurse practitioners in coverage for their Medicaid programs.

The Snellen chart would be used to assess which of the following? a. Hearing. b. Balance. c. Smell. d. Vision.

d. Vision.

A vegan complains of GI problems. The patient does not take vitamin supplements. What test should be run? a. Blood glucose. b. Vitamin C. c. Serum albumin. d. Vitamin B12.

d. Vitamin B12.

Of the following which is a leukotriene receptor antagonist you'd prescribe for your patient's pulmonary disorder? a. Hydrocodone. b. Mucinex. c. Flunisolide. d. Zafirlukast.

d. Zafirlukast.

You must determine if your patient who would like to begin oral contraceptives has any contraindications before prescribing them. You understand that which of the following patients would have an absolute contraindication for oral contraceptives? a. a 28-year-old female who has migraine headaches without aura b. a 35-year-old female who is a light smoker c. a 31-year-old female who suffers from moderate depression d. a 22-year-old female who has previously had undiagnosed genital bleeding

d. a 22-year-old female who has previously had undiagnosed genital bleeding

Which of the following persons would not be a candidate for the antipneumococcal vaccine? a. a 65-year-old healthy female living with her family b. a 35-year-old patient with HIV infection c. a 58-year-old male resident of a nursing home d. a 55-year-old female living alone

d. a 55-year-old female living alone The antipneumococcal vaccine is not indicated for an otherwise healthy person who is under the age of 65 unless there are other health factors involved. Living alone has no bearing on the need for the vaccine. The vaccine is indicated for persons with HIV infection, persons living in nursing homes, and all adults 65 years or older regardless of health status.

Which of the following best describes anisocoria? a. a fine tremor of the hand with unknown cause b. a unilateral headache caused by impingement c. a unilateral pain in the temporal area d. a condition in which the two pupils are not of equal size

d. a condition in which the two pupils are not of equal size A fine tremor of the hand with unknown cause is benign familial tremor. A unilateral headache caused by impingement is trigeminal neuralgia. A unilateral pain in the temporal area is temporal arteritis.

Which of the following types of wounds is most likely to present a risk for tetanus infection? a. a laceration on the palm of the hand b. an abrasion on the knee c. a surgical incision d. a puncture wound from a gardening tool

d. a puncture wound from a gardening tool

When doing an ophthalmologic assessment of a patient all of the following would be normal findings EXCEPT: a. yellow-white disc b. well-defined disc margins c. arteries enter at optic disc d. absent cup

d. absent cup

Type 2 diabetes mellitus testing should be considered in all adults who are overweight and have additional risk factors. All of the following are additional risk factors to consider EXCEPT: a. history of cardiovascular disease b. women with polycystic ovarian syndrome c. member of a high risk population d. history of hypotension

d. history of hypotension All of the other choices are additional risk factors along with: physical inactivity, first-degree relative with diabetes, women who delivered an infant weighing over 9 pounds, women who have had gestational diabetes, hypertension, HDL cholesterol level of < 35 mg/dL, triglyceride level > 250 mg/dL, impaired glucose tolerance and other clinical conditions associated with insulin resistance.

You have been treating Kevin, a 45-year-old male patient with Bell's palsy. You would refer Kevin to an appropriate physician in which of the following cases? a. if the patient has altered taste b. if the patient has decreased tearing c. if hypersensitive hearing occurs d. if the patient has a corneal abrasion

d. if the patient has a corneal abrasion

The fact that a systemic viral infection such as measles produces lasting immunity means that this disease has a high degree of which of the following? a. communicability b. incubation c. virulence d. immunogenicity

d. immunogenicity Systemic viral infections, such as measles, produce lasting immunity. Rhinovirus, on the other hand primarily acts locally, and results in a poor systemic immune response.

Which of the following diseases is more likely to cause chronic pelvic pain rather than acute pelvic pain? a. ectopic pregnancy b. PID c. ovarian cysts d. interstitial cystitis

d. interstitial cystitis Other causes of chronic pelvic pain include: endometriosis, leiomyomas, and malignancy.

The telescoping of part of the bowel into another part of the bowel is known as which of the following? a. Meckel's diverticulum b. incarcerated inguinal hernia c. Hirschsprung's disease d. intussusception

d. intussusception

At approximately what age would you expect the 6th year molar of a child to be lost? a. 8 years b. 10 years c. 12 years d. it is a permanent tooth

d. it is a permanent tooth

You have a patient who has severe pain in the great toe. You suspect gout. Which of the following tests would you do as a confirmatory test for acute gout? a. serum uric acid b. x-ray c. BUN d. joint aspiration

d. joint aspiration

Which of the following terms is used for the process by which an agency of state government grants permission to individuals (such as FNPs) for the practice of a profession to engage in the practice of that profession and prohibits all others from legally doing so? a. accreditation b. certification c. endorsement d. licensure

d. licensure

You have a 66-year-old female patient who is worried about a lump on her leg. Upon examination you find a fatty, cystic tumor located in the subcutaneous layer of skin. It is oval shaped and painless. This is most likely which of the following skin conditions? a. melisma b. nevus c. xanthelasma d. lipoma

d. lipoma

You have an elderly patient whose daughter is concerned because he refuses to drink much during the day. As a result he is suffering from dehydration. You have determined that his state of dehydration is moderate. Which of the following suggests moderate dehydration? a. agitation b. capillary refill less than 3 seconds c. tachycardia d. loss of skin turgor

d. loss of skin turgor Loss of skin turgor indicates moderate dehydration (6% - 9% deficit). Capillary refill would be 3 - 4 seconds with moderate dehydration and there would be a slight increase in pulse but no tachycardia as well as possible listlessness.

The National Practitioner Data Bank is a repository for which of the following types of information? a. personal information b. professional credentials c. licensure information d. malpractice payments

d. malpractice payments

Which of the following diseases must be reported to the CDC? a. chicken pox b. community acquired pneumonia c. psoriasis d. meningococcemia

d. meningococcemia

A 24-year-old female presents with a headache. She describes throbbing pain behind one eye, light sensitivity, nausea and vomiting, and recurrence right before menstruation. The nurse practitioner suspects which of the following? a. temporal arteritis b. cluster headache c. trigeminal neuralgia d. migraine without aura

d. migraine without aura A cluster headache, more common in middle-aged men, involves piercing pain with tearing, rhinorrhea, ptosis, and often, miosis on one side. Temporal arteritis involves warmness over an artery and scalp tenderness at the temporal area. Trigeminal neuralgia involves a very brief intense sharp stabbing pain.

If you diagnose a Grade III ankle sprain in your client you would have observed all but which of the following? a. severe bruising b. severe pain c. inability to ambulate at least 4 steps d. moderate swelling

d. moderate swelling A Grade III sprain is a complete rupture of ligaments. The client would display inability to bear weight immediately after the injury; inability to ambulate at least 4 steps; and tenderness over the posterior edge of the lateral or medial malleolus. Other findings would include: resisting any foot motion, severe bruising, and severe pain.

All of the following would be normal findings for an older adult EXCEPT: a. lentigines b. thinner epidermis, dermis, and subcutaneous layers c. less skin elasticity d. more collagen

d. more collagen

Which of the following is an indication for hospitalization for an adult with community-acquired pneumonia? a. age older than 40 b. diastolic BP <90 mm Hg c. respiratory rate greater than 20 breaths per minute d. no resources for self-care at home

d. no resources for self-care at home Those aged 60 and older, those with a systolic BP <90 mm Hg, and those with a respiratory rate greater than 30 breaths per minute may also require hospitalization.

Which of the following drugs has been demonstrated to have use in preventing dementia? a. Aricept b. Exelon c. Cognex d. none of the above

d. none of the above

A 42-year-old male is in the clinic and has been diagnosed with peptic ulcer disease (PUD). The nurse practitioner (NP) understands that which of the following would be prescribed as the initial treatment for this disease in an uncomplicated state. a. doxepin (Sinequan) 25 mg at hs b. pirenzepine 50 mg tid c. clarithromycin 500 mg bid d. omeprazole (Prilosec) 20 mg qd

d. omeprazole (Prilosec) 20 mg qd A proton pump inhibitor will heal 90% of duodenal ulcers after 4 weeks and 90% of gastric ulcers after 8 weeks. Doxepin and pirenzepine are anticholinergic drugs and are limited by side effects and not used in the U.S. at this time. Clarithromycin is part of the eradication therapy to treat Helicobacter pylori associated problems.

Which of the following conditions is least likely to be found in a person with acute cholecystitis? a. fever b. jaundice c. vomiting d. palpable internal joint

d. palpable internal joint

As a health care provider, you are aware that Bell's palsy is more common in which of the following groups? a. African-Americans b.men under 50 c. women over 50 d. persons with diabetes

d. persons with diabetes Bell's palsy is an acute idiopathic unilateral paralysis of the facial muscles. It is more common in men over 50 and in women under 50. It encompasses all races.

Which of the following systemic corticosteroids would be considered of medium potency? a. Betamethasone, 0.6 -0.75 mg b. hydrocortisone, 20 mg c. dexamethasone, 0.75 mg d. prednisone, 5 mg

d. prednisone, 5 mg Other medium potency corticosteroids include: methylprednisolone, 4 mg; triamcinolone, 4 mg; and prednisolone, 5 mg.

You are treating a 48-year-old male with recurring gout. The nurse practitioner knows that all of the following are treatment options during the acute phase except: a. indomethacin (Indocin) BID b. colchicine 0.5mg, every hour until relief or until diarrhea occurs c. naproxen sodium (Anaprox) BID PRN d. probenecid

d. probenecid Indomethacin (Indocin), colchicine and naproxen sodium (Anaprox) are all treatments for the acute phase of therapy for gout. Probenecid and allopurinol are two medications used for maintenance, control and prevention of gout, not treatment during the acute phase.

You think that your patient may have mitral valve prolapse. You must rule out other diagnoses however. All of the following may be differential diagnoses for mitral valve prolapse (MVP) EXCEPT: a. pericarditis b. papillary muscle dysfunction c. tricuspid valve prolapse d. pulmonary embolus

d. pulmonary embolus Pericarditis, hypertrophic cardiomyopathy, stenotic mitral or tricuspid valve, tricuspid valve prolapse, and papillary muscle dysfunction are all differential diagnoses.

You have a patient with blepharitis. You follow-up with this patient in one month and find that there has been no improvement. Of the following choices which would be the most appropriate next step? a. scrub eyelid b. check for acute conjunctivitis c. inquire about use of decongestants d. refer for biopsy

d. refer for biopsy It may be an unusual presentation of basal or squamous cell carcinoma.

A patient comes to the clinic in an exceptionally good mood. You say to her, "You seem very happy today." This is an example of which of the following therapeutic communication techniques? a. focusing b. clarifying c. confrontation d. reflection

d. reflection This is a reflective response that indicates an awareness of what the client is experiencing. Acknowledging the feeling tone of the client's message helps the client explore his or her own feelings.

Multiple sclerosis (MS) is usually classified into different forms. Your patient has the type of MS in which episodes resolve with good neurologic function between exacerbations. This type of MS is which of the following? a. primary progressive MS b. secondary regressive MS c. secondary progressive MS d. relapsing, remitting MS

d. relapsing, remitting MS

Aileen is an adult patient of Scottish descent who reports a red, acne-like area around her nose and mouth. She tells you that it comes and goes. Your most likely diagnosis of the following choices would be: a. cheilosis b. tinea barbae c. cystic acne d. rosacea

d. rosacea

Which of the following skin conditions affects mainly men 30 years of age and older? a. psoriasis b. melanoma c. plantar warts d. seborrheic keratosis

d. seborrheic keratosis

A person who has been prescribed three daily medications for asthma - an antiinflammatory agent, a long-acting bronchodilator, and an oral glucocorticoid is most likely to have which category of asthma? a. mild intermittent b. moderate persistent c. mild persistent d. severe persistent

d. severe persistent

Which of the following symptoms in a person with acute bronchitis is least likely to prompt you to order a chest x-ray to rule out pneumonia? a. temperature > 100° F b. abnormal lung exam c. pulse > 100 b/m d. sinus tenderness

d. sinus tenderness

You would advise all but which of the following for an adult or a child with the common cold? a. cleaning pillow linens often b. purchasing a new toothbrush c. avoiding tobacco smoke d. sleeping on pillows that are slightly damp

d. sleeping on pillows that are slightly damp

A nurse practitioner wants to make a change in the state's law concerning the dispensing of prescription medications by nurse practitioners. Who would this case need to be taken to? a. state board of nursing b. state board of pharmacy c. nursing specialty organization d. state legislature

d. state legislature

You have initiated a treatment plan for your patient with osteoporosis that includes weight-bearing exercises most days of the week. All of the following are considered weight-bearing exercises EXCEPT: a. walking b. biking c. aerobic dance d. swimming

d. swimming

Which of the following is NOT a tertiary prevention measure? a. cardiac rehabilitation b. Alcoholics Anonymous c. pain management program d. testing for STDs

d. testing for STDs

You are instructing a patient who was diagnosed with ulcerative colitis as to what she should do (other than take the medication prescribed for her) to alleviate the symptoms of ulcerative colitis. You would tell her all but which of the following? a. to eliminate dairy products from her diet b. to avoid caffeine c. to eat a well-balanced low-fat, high-protein diet d. to avoid taking vitamin supplements and iron

d. to avoid taking vitamin supplements and iron A person with ulcerative colitis should take vitamin supplements and iron to make up for what might be lost by avoiding certain types of food such as dairy products. She should eat a nutritious and well-balanced diet consisting of low-residue, low-fat, high-protein, high-calorie foods with no dairy products. She should also avoid smoking, caffeinated beverages, pepper and alcohol.

An elderly female is brought to the office by her daughter for a check up. During the exam the nurse practitioner suspects Parkinson's disease. The suspicion arises with the knowledge that the most common presentation in this disease is: a. muscular rigidity b. bradykinesia c. falling d. tremor

d. tremor

Your patient is pregnant. In her third trimester of pregnancy she is complaining of heartburn. You might suggest all of the following to her to ease the heartburn EXCEPT: a. taking small frequent meals b. refraining from lying recumbent after eating c. avoiding fried foods d. using an antacid with aluminum

d. using an antacid with aluminum

When assessing the patient with unstable angina, the nurse practitioner knows that the causes include all of the following EXCEPT: a. vasoconstriction b. nonocclusive thrombus c. inflammation or infection d. ventricular hypertrophy

d. ventricular hypertrophy

Which of the following rashes describes the diagnosis of Impetigo? a. a raised nodular lesion that is > 1 cm, mobile b. raised plaque lesions, > 1 cm, that is silver in color c. vesicular fluid filled lesions that are <1 cm d. vesicle-like lesions with serous content

d. vesicle-like lesions with serous content - An epidermal cyst is a raised nodular lesion that is > 1 cm, mobile. - Psoriasis is a raised plaque lesion that is > 1 cm and is silver in color. - Varicella is a vesicular fluid filled lesion that is <1 cm.

You have a 65-year-old female patient with a gradual onset of numbness starting in her hands and feet. The CBC on this patient reveals a macrocytic anemia and a peripheral smear shows multisegmented neutrophils. This patient most likely has which of the following conditions/diseases? a. neutropenia b. non-Hodgkin's lymphoma c. thrombocytopenia d. vitamin B12 deficiency

d. vitamin B12 deficiency Vitamin B12 deficiency is indicated since the patient has a gradual onset of paresthesias (numbness, tingling or pricking) starting in the hands and feet with a CBC that reveals a macrocytic anemia and a peripheral smear that shows multisegmented neutrophils. Pernicious anemia is the most common cause of vitamin B12 deficiency.

A young female patient is in the clinic complaining of tenderness and burning of her vulva. A pelvic exam is performed and she is notably reddened, edematous, and excoriated. The nurse practitioner does a wet prep with saline and KOH and finds pseudohyphae and spores. The diagnosis for this client is: a. gonorrhea b. bacterial vaginosis c. chlamydial infection d. vulvovaginal candidiasis

d. vulvovaginal candidiasis Bacterial vaginosis would reveal clue cells and a positive amine odor. Then, chlamydia and gonorrhea requires a cervical culture to be diagnosed.

You are determining the peak expiratory flow (PEF) for a patient who suffers from asthma. Which of the following is NOT a factor in determining peak expiratory flow (PEF) for this patient? a. age b. height c. gender d. weight

d. weight

Jack is a 2-year-old male child who has had recurrent diarrhea. You should teach the parents the signs of dehydration in the child. You would tell them that all of the following are signs of dehydration EXCEPT: a. irritability b. sunken eyes c. no tears d. weight gain

d. weight gain

In assessing a female patient for Addison's disease, you would look for all of the following indicators EXCEPT: a. hyperpigmentation of buccal mucosa b. loss of axillary hair c. muscle wasting d. weight gain

d. weight gain You might note also, orthostatic hypotension, tachycardia, and muscle weakness.

The FNP has a patient who is hypertensive. The FNP is making some suggestions of lifestyle modifications as recommended by the JNC-8 report. Which of the following recommendations is likely to produce the best average systolic blood pressure reduction rate? a. moderation of alcohol consumption b. aerobic physical activity c. dietary sodium reduction d. weight reduction

d. weight reduction Weight reduction will give the patient a 5 - 20 mm Hg reduction for every 10 kg of weight lost. Moderation of alcohol consumption will give a 2 - 4 mm Hg reduction; aerobic physical activity will give a 4 - 9 mm Hg reduction; and dietary sodium reduction will give a 2 - 8 mm Hg reduction.

If antiviral medication is used for a patient with influenza, how soon after the onset of symptoms does it need to be started in order to be effective? a. within 10 days b. within one week c. within 4 days d. within 48 hours

d. within 48 hours

You are examining the skin of an elderly male patient. You might expect to find all of the following EXCEPT: a. thinner subcutaneous layers b. less fat c. thinner epidermis d. wound healing faster

d. wound healing faster