PYC681 Workshop One

Which of the following is true about the MMR vaccine? 1) It contains inactivated virus. 2) Revaccination of an immune person is associated with risk of significant systemic allergic reaction. 3) Its use is contraindicated in patient with an egg allergy. 4) Two doses given at least 1 month apart are recommended for adults who have not been previously immunized.

) Two doses given at least 1 month apart are recommended for adults who have not been previously immunized.

Which wound presents the greatest risk for tetanus infection? 1) A puncture wound obtained while gardening. 2) A laceration obtained while trimming beef. 3) A human bite. 4) An abrasion obtained by falling on a sidewalk.

1) A puncture wound obtained while gardening.

Which of the following is the most appropriate antimicrobial for treatment of CAP in a 2-year-old child who is clinically stable and able to be treated in 1) Amoxicillin 2) TMP-SMX 3) Doxycycline 4) Levofloxacin

1) Amoxicillin

During a preparticipation sports examination, you hear a 2/6 early to midsystolic ejection murmur, heard best at the second intercostal space of the left sternal border, in an asymptomatic young adult. The murmur disappears with position change from supine to standing position. This most likely represents: 1) An innocent flow murmur 2) Mitral valve incompetency 3) Aortic regurgitation 4) MVP

1) An innocent flow murmur

Risks associated with chronic hepatitis B include all of the following except 1) Cholelithiasis 2) Cirrhosis 3) Hepatocellular carcinoma 4) Continue infectivityMULTIPLE SELECT

1) Cholelithiasis

Which of the following is a recommended method of colorectal cancer screening for adults aged 50 to 75? (choose all that apply)? 1) Colonoscopy 2) Sigmoidoscopy 3) Fecal occult blood test (FOBT) 4) Digital rectal examination

1) Colonoscopy 2) Sigmoidoscopy 3) Fecal occult blood test (FOBT)

When answering questions about HAV vaccine, the NP consider that all of the following are true except: 1) Contains live virus 2) Should be offered to adults who frequently travel to developing countries. 3) It is a recommended immunization for health-car workers 4) It generally is well tolerated

1) Contains live virus

In X-linked mutations, which statement is true? 1) Female carriers may be asymptomatic. 2) Males with an X-linked gene disorder pass the gene to their sons. 3) Female carriers are always symptomatic.

1) Female carriers may be asymptomatic.

Which of the following is not criterion for outpatient management of a child with CAP? 1) Parenteral antimicrobial used for initial therapy 2) Adequately hydrated 3) Able to return for follow-up evaluation 4) Able to tolerate oral medications

1) Parenteral antimicrobial used for initial therapy

The use of which of the following medications is often associated with weight gain? 1) Risperidone (Risperdal) 2) Topiramate (Topamax) 3) Metformin (Glucophage) 4) Sitgliptin (Januvia)

1) Risperidone (Risperdal)

In a person with obesity, weight loss of ____% or more yields an immediate reduction in death rates from cardiovascular disease. 1) 5 2) 10 3) 15 4) 20

2) 10

With the use of weight loss medications, if the patient has not achieved a 5% weight loss by week ____ of treatment, the therapy should be discontinued. 1) 6 2) 12 3) 18 4) 24

2) 12

Of the following, who is at greatest risk for invasive pneumococcal infection? 1) 70-year-old man with chronic obstructive pulmonary disease. 2) A 34-year-old woman who underwent splenectomy after a motor vehicle accident. 3) A 50-year-old man with a 20-year history of type 2 diabetes. 4) A 78-year-old woman with decreased mobility secondary to severe osteoporosis.

2) A 34-year-old woman who underwent splenectomy after a motor vehicle accident.

When treating a 3-year-old well child with community-acquired pneumonia (CAP), the NP realizes that the most likely causative pathogen is 1) Mycoplasma pneumonia 2) A respiratory virus 3) H. influenza 4) S. pneumoniae

2) A respiratory virus

When working on weight reduction with a middle-aged man with a body mass index of 34, an NP considers that one of the first actions should be to: 1) Add an exercise program while minimizing the need for dietary changes. 2) Ask the patient about what he believes contributes to his weight issues. 3) Refer the patient to a nutritionist for diet counseling. 4) Ask the patient for a commitment to lose weight.MULTIPLE SELECT

2) Ask the patient about what he believes contributes to his weight issues.

According to current guidelines, STI screening should be done annually in adolescents. Pap smears in female adolescents should begin 1) At age 18. 2) At age 21. 3) When the patient becomes sexually active.

2) At age 21.

The genetic mutation in Huntington's Disease is 1) Autosomal recessive 2) Autosomal Dominant 3) X-linked

2) Autosomal Dominant

You see Jason, a 45-year-old man, who had sexual intercourse with a man within the past week who had acute hepatitis B. Jason has not received the HBV vaccine and has no history of acute or chronic hepatitis B. You advise that Jason: (choose all that apply) 1) Be tested for hepatitis B surface antibody (HBsAb) 2) Consider receiving hepatitis B immune globulin (HBIG) and start the hepatitis B immunization series 3) Consider additional STI testing. 4) Be advised that there is no particular interventional post-HBV exposure therapy.

2) Consider receiving hepatitis B immune globulin (HBIG) and start the hepatitis B immunization series 3) Consider additional STI testing.

When providing care for a febrile 3-year-old patient who appears to have a minor, self-limiting illness, the NP bears in mind that all of the following are true except that: 1) The use of antipyretics is potentially associated with prolonged illness 2) Consistent use of an antipyretic provides a helpful way to shorten the course of infectious illnesses. 3) Fever increases metabolic demand. 4) The presence of fever is associated with reduced morbidity and mortality.

2) Consistent use of an antipyretic provides a helpful way to shorten the course of infectious illnesses.

When assessing a febrile child, the NP considers that: 1) Even minor temperature elevation is potentially harmful. 2) Nuchal rigidity is usually not found in early childhood meningitis 3) Fever-related seizures usually occur at the peak of the temperature 4) Most children aged 3 months to 3 years with temperatures of 38.3 C to 40 degrees C (101F - 104F) have a potentially serious bacterial infection

2) Nuchal rigidity is usually not found in early childhood meningitis

When performing an adolescent health/wellness visit 1) Parents should remain in the exam room for the entire visit for the comfort of the adolescent. 2) Parents should be asked to leave the exam room once the history has been taken and any other concerns have been voiced by the parent. 3) Adolescents should not be asked to disrobe during the visit. 4) Adolescents should never be asked questions that might embarrass them such as sexual history, alcohol or drug use.

2) Parents should be asked to leave the exam room once the history has been taken and any other concerns have been voiced by the parent.

You see a 40-year-old patient who started taking varenicline (Chantix) 4 weeks ago to aid in smoking cessation. Which of the following is the most important question to ask during today's visit? 1) "How many cigarettes a day are you currently smoking?" 2) "On a scale of 0 to 10, how strong is your desire to smoke?" 3) "Have you noticed any changes in your mood?" 4) "Are you having any trouble sleeping?"

3) "Have you noticed any changes in your mood?"

A sedentary, 55-year-old man is diagnosed with hypertension and states, "It is going to be too hard to diet, exercise, and take these pills." What is the least helpful response to her statement? 1) "Try taking your medication when you brush your teeth." 2) "Tell me what you feel will get in your way of improving your health." 3) "You really need to try to improve your health." 4) "Could you start with reducing the amount of salty foods in your diet?"

3) "You really need to try to improve your health."

Assuming all of the following individuals are not immune to measles, mumps and rubella, which of the following is not recommended to receive the MMR vaccination? 1) A 35- year-old woman who is breastfeeding a 4 week-old. 2) A 1- year-old boy with a history of hive form reaction egg ingestion. 3) A 24-year-old woman who is 20 weeks pregnant. 4) d. A 4-year-old girl who was born at 32 weeks of gestation.

3) A 24-year-old woman who is 20 weeks pregnant.

According to the U.S. Preventive Services Task Force, which of the following women would most likely be eligible for genetic testing to detect BRCA mutation in order to assess risk for breast and ovarian cancer? 1) A 42-year-old at average risk of breast cancer 2) A 36-year-old who breastfed three children 3) A 46-year-old with two first-degree relatives with breast and ovarian cancers 4) A 38-year-old with a first-degree relative diagnosed with colorectal cancer

3) A 46-year-old with two first-degree relatives with breast and ovarian cancers

Among individuals younger than 35 years, the most common cause of sudden cardiac death is: 1) Non-ST-segment myocardial infarction 2) ST-segment myocardial infarction 3) A congenital cardiac malformation 4) Aortic stenosis

3) A congenital cardiac malformation

In autosomal dominant (AD) mutations, which statement is true? 1) Females are affected more often. 2) Males are affected more often. 3) Both genders are affected equally.

3) Both genders are affected equally.

In autosomal recessive (AR) mutations, which statement is true? 1) Females are affected more often. 2) Males are affected more often. 3) Both genders are affected equally.

3) Both genders are affected equally.

Fever in a child is defined as 100.4 degrees F when taken rectally. In an infant less than 3 months with a fever the best approach is: 1) It is most often viral so no further work up is indicated 2) Recommend ibuprofen for the fever and increase fluids 3) Consider a viral etiology, but pursue a work up for a bacterial cause as this can be serious.

3) Consider a viral etiology, but pursue a work up for a bacterial cause as this can be serious.

A 4-day-old newborn presents to your office for follow-up for hyperbilirubinemia and is more jaundiced than he was on discharge from the hospital. The mother is breast feeding and you counsel her to 1) Stop breastfeeding for a week. 2) Supplement her breastfeeding with formula. 3) Continue breastfeeding, but increase the frequency.

3) Continue breastfeeding, but increase the frequency.

Which is an example of primary prevention in a 77-year-old female with osteoporosis? 1) Bisphosphonate therapy 2) Calcium supplementation 3) Ensuring adequate illumination in the home 4) Use of a back brace

3) Ensuring adequate illumination in the home

Of the following, the most common route of hepatitis A virus (HAV) transmission is: 1) Needle sharing 2) Raw shellfish ingestion 3) Ingestion of contaminated food or water 4) Exposure to blood and body fluids

3) Ingestion of contaminated food or water

Which of the following statements best describes oseltamivir (Tamiflu) use in the care of patients with or at-risk for influenza? 1) The primary action of this therapy is prevention of influenza A during outbreaks 2) The therapy is active against influenza B. 3) Initiation of therapy early in acute influenza illness can help minimize the severity of the disease when the illness is caused by a nonresistant viral strain. 4) d. The use of this product is an acceptable alternative to influenza vaccine.

3) Initiation of therapy early in acute influenza illness can help minimize the severity of the disease when the illness is caused by a nonresistant viral strain.

Jake is 6-months-old and due for immunizations today in your office. Based on the evidence you tell the mother 1) Jake should be pre-medicated with an antipyretic prior to receiving the vaccines 2) The effectiveness of the vaccine will be decreased if Jake is given antipyretics. 3) It is safe to use antipyretics if fever or discomfort occurs after the vaccine.

3) It is safe to use antipyretics if fever or discomfort occurs after the vaccine.

Important health promotion considerations for the LGBTQ patient includes which of the following: 1) LGBTQ populations do not have increased morbidity and mortality. 2) Depression rates are equal to the general population. 3) Lesbian patients may have increased rates of breast and gynecologic cancer. 4) Tobacco and drug use rates are lower in the LGBTQ population.

3) Lesbian patients may have increased rates of breast and gynecologic cancer.

A 48-year-old female with chronic obstructive pulmonary disease who is about to receive injectable influenza vaccine should be advised that: 1) It is more than 89% effective in preventing influenza. 2) Its use is contraindicated in the presence of psoriasis vulgaris. 3) Localized reactions such as soreness and redness at the site of the immunization are common. 4) A short, intense, flu-like syndrome is common.

3) Localized reactions such as soreness and redness at the site of the immunization are common.

Which of the following would most likely be noted upon chest examination of a normally healthy person who presents with acute bronchitis? 1) Inspiratory wheeze 2) Crackles 3) Normal findings 4) Evidence of consolidation on chest x-ray

3) Normal findings

Which of the following is recommended for a 65-year-old man in generally good health who has not received a pneumococcal vaccine? 1) PCV13 only 2) PPSV23 only 3) PCV13 now and PPSV23 in 1 year 4) PPSV23 now and PCV13 in 8 weeks

3) PCV13 now and PPSV23 in 1 year

Which of the following is most likely to be noted in a 3-year-old child with CAP? 1) Complaint of pleuritic chest pain 2) Sputum production 3) Tachypnea 4) Report of dyspnea

3) Tachypnea

Peak infectivity of persons with hepatitis A usually occurs: 1) At the time of maximum elevation of liver enzymes. 2) During the recovery period. 3) At the time of maximum disease-associated symptoms. 4) Before onset of jaundice

4) Before onset of jaundice

Which of the following are live vaccines: 1) MMR, Influenza and Varicella 2) Polio, Hepatitis B and Diphtheria-Tetanus-Acellular Pertussis 3) Hepatitis C, Rotavirus and Pneumococcal 4) MMR, Varicella and Rotavirus

4) MMR, Varicella and Rotavirus

The action of phentermine is likely due to the release of catecholamines. Which of the following is believed to result in reduced appetite and decreased food consumption? 1) Serotonin 2) Dopamine 3) Epinephrine 4) Norepinephrine

4) Norepinephrine

Which of the following is usually viewed as the most effective form of healthcare? 1) Tertiary prevention 2) Secondary prevention 3) Cancer reduction measures 4) Primary prevention

4) Primary prevention

Immunizations are considered to be 1) Active immunity 2) Passive immunity 3) Natural immunity

Active immunity

Tertiary prevention measure for a 69-year-old woman with heart failure include: 1) Administering pneumococcal vaccine. 2) Adjusting therapy to minimize dyspnea. 3) Surveying skin for precancerous lesions. 4) Reviewing safe handling of food.

Adjusting therapy to minimize dyspnea.

Potential adverse events with acetaminophen use in a child with fever and mild dehydration include: 1) Petechial rash 2) Gastric ulcer 3) Hepatotoxicity 4) Seizure

Hepatotoxicity

When considering the use of dietary supplements in patient care, nurse practitioners should recognize that 1) All dietary supplements are approved by the FDA. 2) Dietary supplements lack clinical evidence to support their use and should not be recommended to patients. 3) Many dietary supplements lack clinical evidence to support their use, however, it's the responsibility of the NP to understand the risks/benefits before integrating into practice.

Many dietary supplements lack clinical evidence to support their use, however, it's the responsibility of the NP to understand the risks/benefits before integrating into practice.

During a preparticipation cardiovascular history, all of the following questions should be included except: 1) Prior use of NSAIDs 2) Past detection of heart murmur 3) Excessive, unexplained, and unexpected shortness of breath 4) Prior occurrence of exertional chest pain/discomfort

Prior use of NSAIDs

Which of the following is usually viewed as preventing complications from an established disease state? 1) Primary prevention 2) Secondary prevention 3) Tertiary prevention 4) d. Cancer-reduction measures

Tertiary prevention

A parent of a 1-year-old does not want to vaccinate her child with the MMR vaccine because of possible risk of autism. The most appropriate response by the NP would be 1) Your concern is reasonable as the research shows that there is an increased risk of autism in children who receive the MMR vaccine. 2) Your concern is reasonable, but there is significant research that does not show any causal relationship between MMR vaccine and autism. 3) Your concern is reasonable, and at this point we really are not sure if autism is related to the MMR vaccine.

Your concern is reasonable, but there is significant research that does not show any causal relationship between MMR vaccine and autism.