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100 Cards in this Set
- Front
- Back
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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?
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Effexor Effexor is an SNRI. SNRIs increase the levels of the neurotransmitters norepinephrine and dopamine in the brain. |
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You need to collect a urine sample from a patient in order to confirm a diagnosis of urinary tract infection. When instructing the patient to do a "clean catch" sample, which of the following is NOT among the instructions?
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The patient should scoop urine out of the toilet.
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Of the following, which is a 5HT3 antagonist you'd prescribe for your patient's gastrointestinal disorder?
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Alosetron.
Senna - laxative, Cisapride - promotility agent, Tegaserod - 5HT4, Alosetron - 5HT3 |
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When conducting a review of systems (ROS), how many systems are covered in the interview?
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10 The review of systems (ROS) is part of a comprehensive history. When conducting an ROS, 10 systems should be examined. |
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A patient exhibits signs of kidney disease. Which test would you order for a diagnosis?
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Blood urea nitrogen test (BUN),
A blood urea nitrogen test (BUN) measures urea in the blood stream. High levels can indicate that the kidneys are not working properly. A low level indicates liver problems. |
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Frankie is a 59-year old female patient who has been vomiting blood. Her stools appear black and tarry. She has also complained of abdominal cramping. Of the following choices which is most likely to cause these signs and symptoms?
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Gastrointestinal Bleeding
Gastrointestinal bleeding can range from minor to severe. About 85% of GI bleeding involves the upper GI tract. The patient who vomits blood, has black and tarry stools, and abdominal cramping is likely suffering gastrointestinal bleeding. |
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As an FNP you understand that the classic diagnostic triad for cystic fibrosis (CF) includes all of the following EXCEPT:
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heart defects
All of the first three choices are part of the classic diagnostic triad for CF. Heart defects are not. CF is the most common lethal genetic disease in the United States. It is caused by a defect on chromosome 7, autosomal recessive inheritance pattern |
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The FNP is educating a group of women about prevention of osteoporosis. In this class, the FNP would tell the group all but which of the following?
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The recommended minimal dose of vitamin D is 3000 IU/d daily. This statement would not be included in the talk. It is incorrect. The recommended minimal dose of vitamin D is 600 – 900 IU/d daily. Daily doses of up to 2000 IU/d are likely safe, but 3000 IU/d is too much. |
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You are performing an assessment for a patient whose breath sounds are high, loud, and hollow-sounding. Which of the following is the correct nursing diagnosis for this patient?
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Bronchial breath sounds. This patient is exhibiting bronchial breath sounds. These are typically high and loud with a hollow quality. |
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A clinically significant stenosis is considered to be an obstruction of what percentage (or more) of a major coronary artery or one of its major branches?
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70%
A clinically significant stenosis is considered to be an obstruction of 70% or more in a major coronary artery or one of its major branches. Frequently, the microvasculature, or smaller vessels branching off the major coronary artery, may also have blockages. |
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You are performing the obturator sign for a patient who may have acute appendicitis. Which of the following choices describes this procedure?
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Rotating the right hip through full range of motion. Positive if pain with movement or flexion of the hip. The obturator sign (supine position) is used for acute appendicitis or any suspected retroperitoneal area acute process (for instance, ruptured ectopic pregnancy). It is done by rotating the right hip through full range of motion. It is positive if there is pain with movement or flexion of the hip. |
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A patient who has been prescribed gabapentin for nerve pain associated with shingles should be advised of all but which of the following potential side effects?
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Vomiting.
Stomach upset and vomiting is not typically associated with gabapentin. Patients may experience drowsiness, tiredness, tremors, and blurred vision. These side effects are usually not cause for concern. |
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You have a 55-year-old female patient with H. Pylori-negative ulcers. Which of the following would NOT be a part of the patient’s recovery plan?
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antibiotics
Antibiotics would not be prescribed because there is no infection in H. Pylori-negative ulcers. H2 blockers would be the first line of treatment. If no relief is had or the results are poor with this treatment, then a switch to a proton pump inhibitor would be indicated. |
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Mrs. Romeo is a 69-year-old female patient with congestive heart failure (CHF). You have prescribed a diuretic for her. When should she be seen for a follow-up visit?
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every 1 – 2 weeks until symptom free, then every 3 – 6 months
Patients with CHF who have been prescribed a diuretic should be see every 1 – 2 weeks until they are symptom free. After that they should be seen every 3 – 6 months. |
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Tufts of hair on a child overlying the spinal column which may be a sign of spina bifida occulta is which of the following?
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faun tail nevus
Faun tail nevus occurs when there are tufts of hair overlying the spinal column usually at the lumbosacral area. The may be a sign of spina bifida occulta. An ultrasound of the lesion should be done to rule out spina bifida |
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Which of the following would be considered a presumptive sign of pregnancy?
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amenorrhea, Goodell’s sign, Hegar’s sign, ballottement
This is a presumptive sign of pregnancy, along with fatigue, nausea, breast changes, urinary frequency, and a slight increase in body temperature. The other choices are probable signs of pregnancy
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Which of the following medications is NOT appropriate to prescribe for the management of genital herpes?
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Zovirax.Diflucan.Valtrex.Famvir.
Diflucan Diflucan, or flucanazole, is an oral medication prescribed for the treatment of vaginal yeast infections. The other choices are suppressive medications prescribed for the management of genital herpes. |
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Enuresis is involuntary urination after a child has reached the age when bladder control is usually attained. Management of primary nocturnal enuresis includes all of the following EXCEPT:
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limiting fluid intake before bedtime
double voiding before bedtime avoiding punishment withholding verbal praise so as not to call attention to the problem Verbal praise is an excellent means of motivational therapy for a child with primary nocturnal enuresis. Other means of motivational therapy include a reward system and keeping a dryness calendar. |
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When assessing for an urinary tract infection in a geriatric patient, it is important for the nurse practitioner to know:
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There is always a fever present.It is an uncommon finding in catheterized patients.Elderly people may or may not demonstrate symptoms other than mental status change with this type of infection.Dysfunctional voiding pattern or infrequent voiding are not contributing factors to the development of a urinary tract infection.
Geriatric patients with a urinary tract infection usually do not have a fever. It is common in patients with catheters and dysfunctional voiding pattern and infrequent voiding are contributing factors in the development of a urinary tract infection |
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Medicaid is a federal program, administered by the states for mothers and children who qualify on the basis of poverty and for adults who are disabled for the short term or who qualify on the basis of poverty. Which of the following statements about Medicaid is false?
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Some patients covered by Medicaid are enrolled in MCOs.Medicaid pays NPs 70 to 100% of the fee-for-service rates set for physicians.Federal law controls the rate paid to physicians and NPs.Medicaid reimbursement is generally lower than the rates paid by commercial insurers.
This is false. State law controls the rate paid to physicians and NPs. This rate is generally lower than the rates paid by commercial insurers. |
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The Romberg test is used to evaluate which of the following?
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cerebellar system mental status, sensory system, fine motor movements
The Romberg test is used to evaluate the cerebellar system. Tandem gait is also used for testing the cerebellar system |
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If you are using the short portable mental status questionnaire (SPMSQ) for assessment of organic brain deficit in an elderly patient and the patient has a score of 3-4 errors this would indicate which of the following?
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mild intellectual impairment no intellectual impairment severe intellectual impairment moderate intellectual impairment
A score of 3-4 errors on the SPMSQ indicates mild intellectual impairment. The scale ranges from 0-2 errors (intact) to 8 – 10 errors (severe) |
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A 35 year old patient complains of abdominal pain. The pain is located mainly on the upper right side. She also has back pain and unexpected weight loss. What is the most likely diagnosis?
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Gout.Heart disease.Carcinoma.Gallstones.
The gallbladder is located in the upper right quadrant of the abdomen. The weight loss and back pain are also common with gallstones. It is important to rule out kidney infection with image and blood tests. |
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Eleanor is a 90-year-old patient whose condition is conducive to delirium. During the periods of delirium Eleanor experiences urinary incontinence. This type of incontinence is considered which of the following?
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transient
stress functional muscular Since the urinary incontinence is present only when the patient is having an episode of delirium, it is considered transient incontinence. Other causes of transient incontinence include: infection, atrophic vaginitis, urethritis or certain drugs. |
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You are assessing a child for developmental dysplasia of the hip. In doing so you position the child supine with knees fully adducted and held together. This is known as which of the following?
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Ortolani’s sign
Galeazzi sign Barlow’s test none of the above The Galeazzi sign is used for children when developmental dysplasia of the hip is suspected. If one femur is shorter than the other, the result is positive. |
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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?
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to eliminate dairy products from her diet
to weigh herself at least twice a week to monitor for weight loss to eat a well-balanced low-fat, high-protein diet to avoid taking vitamin supplements or 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. |
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In which of the following diseases would you be most likely to have a BUN:Cr ratio of >20:1?
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acute interstitial nephritis
acute tubular necrosis acute glomerulonephritis none of the above With acute glomerulonephritis the BUN:Cr ration will be >20:1. Urinalysis will show renal casts, and RBCs. |
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A 22-year old female presents with sudden onset of edema of the lips and face and a sensation of "throat tightness and shortness of breath," after a bee sting. Her physical examination reveals inspiratory and expiratory wheezing. Her blood pressure is stable but her heart rate is elevated at 110 bpm. Her clinical presentation is most consistent with the diagnosis of:
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angioedema
anaphylaxis urticaria reactive airway disease Anaphylaxis is a life-threatening acute systemic reaction that is an example of a type I immune response, allergic reaction, or hypersensitivity. Common allergens include insect venoms, latex and medications |
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A 28-year-old afebrile female patient with no health problems is in the clinic complaining with dysuria and frequency of urination. You assess a urinalysis and find that results are positive for nitrites and leukocyte esterase. What do you consider she has? |
a gram-negative urinary tract infection a urinary tract infection caused by Staphylococcus saprophyticus overactive bladder syndrome interstitial cystitis Surrogate marker for bacteriuria is nitrites. Their presence indicates bacterial reduction of dietary nitrates to nitrites by select gram-negative uropathogens, including E. coli and Proteus spp. Positive leukocyte esterase results indicate the presence of neutrophils, which is an indicator of a urinary tract infection (UTI) as well. |
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The nurse practitioner knows that when treating depression with selective serotonin reuptake inhibitors (SSRIs) the patient may exhibit: |
weight loss and hypoglycemia weight gain and decreased libido cognitive changes and urinary retention sleepiness and decreased libido The selective serotonin reuptake inhibitors (SSRIs) are commonly associated with decreased libido after several weeks of taking them. Patients who take tricyclic antidepressants have more weight gain and the tricyclic and heterocyclic compounds are more often associated with blood sugar elevations. Jitteriness and restlessness are commonly associated with SSRI use. |
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A 38-year-old male patient complains of a sudden onset of severe “ice pick” pains behind one eye. The headache is accompanied by tearing, a clear runny nasal discharge and a drooping eyelid. What type of headache does he have? |
muscle tension headache migraine headache cluster headache temporal arteritis Cluster headaches are severe headaches with lancinating pain behind one eye that occurs several times a day, usually at the same times every day. Their cause is unknown and they are more common in adult males in their 30s and 40s |
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Which of the following readings for hemoglobin is the threshold at which anemia may be suspected in females? |
<11 g/dL <12 g/dL <15 g/dL <18 g/dL Anemia may be suspected when the hemoglobin for females is <12 g/dL. In males the threshold is <13.5 g/dL |
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Which test is used to detect candidiasis? |
Gentian Violet. McBurney's Point. Schilling's test. Potassium Hydroxide (KOH). Correct answer: Potassium Hydroxide (KOH) Potassium hydroxide (KOH) is used to test for candidiasis. Gentian violet is a dye that has anti-fungal properties and is used to treat candida. The other answer choices are test used to identify other conditions. |
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You have a patient who you are examining after he suffered a TIA. You would consider the diagnosis of stroke if signs and symptoms do not resolve within what maximum time frame? |
24 hours 12 hours one week 36 hours All signs and symptoms of a TIA, including numbness, weakness and flaccidity, visual changes, ataxia or dysarthria resolve usually within minutes but certainly by 24 hours after onset. If changes persist beyond 24 hours, the diagnosis of stroke should be considered. |
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Jeannie is a patient who has hypertension which has been stabilized by medication for many years. How often should you see this patient to follow up on the status of her hypertension? |
every month every 3 – 6 months every 8 – 12 months every year Once your patient’s blood pressure has stabilized, follow-up should be at 3 to 6 month intervals. Normotensive patients should be evaluated every 1 to 2 years. Annual evaluations should be performed for those clients with hereditary or medical risks. |
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In terms of ethical concepts for nurse practitioners, which concept is based on respect for the patient? |
beneficence
non-maleficence human dignity accountability Correct Answer:human dignityThe ethical concept of human dignity is based on respect for the patient. Beneficence is the duty to help others; non-maleficence is the duty to avoid harm to others; and accountability is taking responsibility for one’s actions. |
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The FNP has a 67-year-old female patient with GERD. The FNP wants to prescribe a proton pump inhibitor (PPI) for her. Which of the following drugs would the FNP NOT be prescribing? |
Omeprazole
Misoprostol Lansoprazole Esomeprazole Correct Answer: Misoprostol is a prostaglandin analogue, a drug specifically designed for gastric protection with NSAID. PPIs are a group of drugs whose main action is a pronounced and long-lasting reduction of gastric acid production. |
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Your patient complains of eye pain that has come on suddenly and tells you that light bothers him and his vision seems blurred. Your examination reveals a rash on the side of the temple and on the tip of his nose. This is which of the following diseases? |
hordeolum
chalazion herpes keratitis primary open-angle glaucoma Hide ExplanationExplanation:Correct answer:herpes keratitis Herpes keratitis is damage to the corneal epithelium caused by the herpes virus, commonly shingles. The patient usually has acute onset of eye pain, photophobia, and blurred vision in the affected eye. |
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Xanthelasma can best be described as which of the following? |
benign fatty, cystic tumors located in the subcutaneous layer of the skin
round macules ranging in color from light tan to dark brown soft and round wart-like fleshy growths on the trunk raised and yellow soft plaques located under the eyebrow Hide ExplanationExplanation:Correct answer:raised and yellow soft plaques located under the eyebrow Xanthelasma are raised and yellow soft plaques located under the eyebrow. They can be on the upper or lower lids of the eyes and are located on the nasal side. |
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A patient who has been prescribed hyoscyamine for symptoms of IBS mentions that she also takes an antacid frequently for heartburn. Which of the following is an appropriate response to this patient?
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The patient should cease taking the antacid.
The patient should take the antacid after taking hysocyamine and after a meal. The patient should take the antacid at least one hour before taking the hyoscyamine. The patient should take the antacid and the hysocyamine together. Hide ExplanationExplanation:Correct Answer:The patient should take the antacid after taking hysocyamine and after a meal.Antacids can interfere with hyoscyamien. The patient should take the antacid after the hyoscyamine. She should also take her antacid after meals. |
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A 34-year-old female with multiple sclerosis (MS) is in the office. She is now under your care after relocating from another state to live with relatives who can help her. The nurse practitioner understands that which of the following is NOT part of her management plan:
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Physical and occupational therapy.
Complex treatment regimen must be coordinated with a neurologist. Acute exacerbations should be treated with prednisone 60-80 mg/day for 1 week, taper over 2-3 weeks. Corticosteroids are often used for maintenance. Hide ExplanationExplanation:The Correct answer is:Corticosteroids are often used for maintenanceCorticosteroids are only for acute exacerbations, not for maintenance. The remaining answer choices are treatment options for this condition |
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The World Health Organization has put forth some precautions for use of copper-containing IUDs. According to WHO in which of the following medical situations would a patient be advised to refrain from use? |
uterine fibroids with no distortion of the uterine cavity cirrhosis with severe decompensation unexplained vaginal bleeding vascular disease Unexplained vaginal bleeding is one of the medical situations that falls in the WHO Category 4, refrain from use. The other choices fall into either Category 1, no restriction; Category 2, the advantages outweigh the risk; or Category 3, exercise caution. |
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Your patient has been diagnosed with H. Pylori-negative ulcers. Which of the following would NOT be included in this patient’s recovery plan? |
antibiotics H2 blockers proton pump inhibitor diet modification Antibiotics would not be prescribed because there is no infection in H. Pylori-negative ulcers. H2 blockers would be the first line of treatment. If no relief is had or the results are poor with this treatment, then a switch to a proton pump inhibitor would be indicated. Dietary changes should be made. |
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Marian is a 45-year-old female who presents with a mild vaginal infection. You diagnose it as bacterial vaginosis. The management of this infection might include all of the following EXCEPT: |
Flagyl 500 mg orally bid x 7 days sexual abstinence estrogen therapy Metronidazole 2 g po as a single dose (as an alternative treatment) This is not a treatment recommendation for bacterial vaginosis. Bacterial vaginosis is a mild vaginal infection caused by overgrowth of two or more organisms as a result of increased pH and subsequent replacement of normal flora lactobacillus. It is not considered an STD |
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This is not a treatment recommendation for bacterial vaginosis. Bacterial vaginosis is a mild vaginal infection caused by overgrowth of two or more organisms as a result of increased pH and subsequent replacement of normal flora lactobacillus. It is not considered an STD |
poor fluid consumption constipation medication related inactivity The most common cause of fecal incontinence in elderly adults is underlying 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. |
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Mrs. Shelley has brought her 2-month old female infant into the office for immunizations. After administering the proper immunizations you counsel the mother about care at home. Which of the following is NOT one of the things you would say to this mother? |
A cold washcloth on the thigh injection site at each diaper change will ease the soreness. The infant may be irritable and have redness and soreness at the injection site for 2 or 3 days. Acetaminophen (10 – 15 mg/kg) may be administered orally every 4 – 6 hours. Call the health care provider if seizures, high fever or high-pitched crying occurs. A warm washcloth on the thigh injection site at each diaper change will ease the soreness not a cold one. The other statements are things that you would tell the mother after immunization of her infant. |
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A mother brings her 6-month-old infant to the clinic with a rash that has the appearance of a slapped cheek. The FNP knows that this is probably which of the following rashes? |
Roseola Infantum Kawasaki disease scarlet fever Fifth disease Fifth disease (Erythema Infectiosum) is caused by human Parvovirus B 19. The rash has three stages: the “slapped cheek” stage, a lace-like maculopapular rash the next day on arms and legs and a rash that may recur for 2 to 3 weeks if aggravated by sunlight or heat. |
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All of the following are signs of delirium in your patient EXCEPT: |
altered level of consciousness from baseline memory impairment perceptual disturbance loss of cognitive function Loss of cognitive function is not associated with delirium which has an acute onset. It is associated with dementia, which is defined as chronic loss of intellectual or cognitive function of sufficient severity to interfere with social or occupational function. |
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In managing a patient with a substance abuse problem, the patient tells you, "I wish I had never used cocaine, it has ruined my life." What is the most appropriate response by the nurse practitioner? |
"Things will work out, don't you worry." "You shouldn't be so hard on yourself. You can change." "You should think before you do something." "It sounds like you've thought a lot about your cocaine use." The nurse practitioner's statement is open ended. It allows for the patient to discuss and clarify his feelings. Further, the remaining statements are inappropriate responses. |
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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: |
Eruption typically begins at approximately 9 months of age. Signs of teething include local sensitivity and inflammation. The child may have increased drooling and biting. There is no evidence that teething causes fever, diarrhea or other systemic illnesses. This is incorrect. Eruption typically begins at approximately 6 months of age. |
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When percussing over the kidneys, which of the following would you expect to hear? |
Resonance.Tympany.Dullness.Hollowness. Correct Answer: Dullness Percussing over muscles or dense organs such as the kidneys should result in a dull, flat sound. Resonance or hollowness are cause for concern and further assessment. |
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Medical decision making refers to the complexity of establishing a diagnosis and/or selecting a management option. The four levels of evaluation and management services include all of the following EXCEPT: |
high complexity moderate complexity straightforward frank There is no frank level of E/M services. The four types of medical decision making are: straightforward, low complexity, moderate complexity, and high complexity. |
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You have a patient who has been diagnosed with pancreatitis. Which of the following test results is most likely to be consistent with this diagnosis? |
Lipase is lowered. White blood count will be elevated if the pancreatitis is acute. Bilirubin is grossly elevated. Glucose may be severely decreased if pancreatitis is severe. White blood count will be elevated if the pancreatitis is acute. Lipase is elevated in pancreatitis. Bilirubin is mildly elevated in 20% of patients. Glucose may be increased in severe pancreatitis. |
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Of the following patients which one should you refer to an ophthalmologist immediately? |
55-year-old female with temporal arteritis
37-year-old male with cluster headache 65-year-old male with migraine headaches 35-year-old female with migraine headaches with aura Hide ExplanationExplanation:Correct answer:55-year-old female with temporal arteritis Temporal arteritis is a systemic inflammatory process of the medium and large arteries of the body. A patient with temporal arteritis should be referred to an ophthalmologist stat. Permanent blindness can result if the person is not diagnosed and treated early. |
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The nurse practitioner is treating a 42-year-old obese Caucasian male who has an allergy to sulfa. She understands that which of the following medications is contraindicated in this patient? |
ramipril
hydrochlorothiazide verapamil amiloride Hide ExplanationExplanation:The Correct answer is:HydrochlorothiazideHydrochlorothiazide has a sulfonamide ring in its chemical structure, generally referred to as "sulfa." This can initiate an allergic reaction in a patient with a sulfa allergy. The other answer choices, verapamil, ramipril and amiloride, are medications that can be used without concern because they have no sulfonamide component. |
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A CT scan indicates that a patient may have a brain tumor. Which test will follow up to determine the specific diagnosis? |
CTA scan.
PET scan. Polysomnogram. Cerebral angiogram. Hide ExplanationExplanation:Correct Answer:PET scan.A Positron emission tomography is a PET scan. It shows brain function and highlights abnormal tissue. This test is often done after an abnormal CT scan. |
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Which of the following body fluids is considered a material with doubtful risk of HIV transmission? |
semen
saliva vaginal fluids pleural fluid Hide ExplanationExplanation:Correct Answer:salivaSaliva is the only choice that is of doubtful risk of HIV transmission. Fluids with known risk include blood, bloody fluids, semen, vaginal fluids, and concentrated HIV materials in research labs. |
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A patient comes to you complaining of chest pain. You administer prescribed sublingual nitroglycerin to the patient. If the patient continues to have pain what should you do next? |
Call the emergency room physician to check the patient. Wait to see if the patient feels better. Take the patient’s blood pressure. Administer another dose of the medication. Hide ExplanationExplanation:Correct Answer:Administer another dose of the medication.Nitroglycerin tablets can be administered - three tablets 5 minutes apart to relieve chest pain. Only after the third tablet does not work would you proceed to another action. You would refer the patient to the ER if third dose does not relieve the pain. |
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You are explaining to a class of student nurses some facts about toxic shock syndrome (TSS) as well as how to avoid TSS. You would tell them all of the following EXCEPT: |
Toxins causing TSS are often asymptomatic.
Women diagnosed with TSS should use diaphragms for contraception. Women should change tampons every 2 hours to decrease potential for TSS. Symptoms of TSS include high fever. Hide ExplanationExplanation:Correct answer:Women diagnosed with TSS should use diaphragms for contraception. This statement is not accurate. 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. |
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Which of the following is NOT a factor in determining peak expiratory flow (PEF) for asthmatics? |
ageheightweightgender
Hide ExplanationExplanation:Correct answer:weight Weight is not a factor in determining PEF. The PEF is based on height (H), age, (A), and gender (G) – HAG. |
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You have a patient who has developed hives after eating shellfish. You understand that hives are characterized by which of the following types of skin lesions?
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papule
pustule wheal plaque Hide ExplanationExplanation:Correct answer:wheal A wheal is a circumscribed area of skin edema. Hives are characterized by wheals. |
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Which of the following is NOT a typical characteristic of basal cell carcinoma? |
long latency period
slow-growing nodules high metastatic risk grows less rapidly than squamous cell carcinoma Hide ExplanationExplanation:Correct answer: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. |
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Which of the following will help prevent guarding during palpation? |
Do not speak during exam.
Touch the patient quickly. Cool hands. Warm hands. Hide ExplanationExplanation:Correct answer: Warm hands Patients may become guarded when palpation is performed. Cold hands will increase the chance of guarding. Hands should be warmed before the an examination. |
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Which of the following types of prostatitis is most closely associated with dysuria, decreased urinary flow, post-void dribbling, and hesitancy and may be accompanied by back pain or pain in the testicles although the patient has no fever? |
acute bacterial prostatitis chronic bacterial prostatitis nonbacterial prostatitis prostatodynia Hide ExplanationExplanation:Correct Answer:prostatodyniaProstatodynia 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. |
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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? |
bananas
avocados toast yogurt Hide ExplanationExplanation:Correct answer:avocados Avocados are not part of the BRATY diet. The diet consists of: bananas, rice, applesauce, toast, and yogurt. |
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A teenage patient comes in and his chief complaint is painful urination. What will you want to determine in the interview? |
Exercise. Diet. Family history. Sexual activity. Hide ExplanationExplanation:Correct Answer:Sexual activity.Sexual activity is more likely to begin during the teen years. Different sexually transmitted diseases present with painful urination. Sexual activity will determine the tests needed to determine the condition. |
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A Rapid Strep Test is used to help the NP diagnose what condition? |
Whooping cough. Strep throat. The common cold. Tuberculosis (TB). Hide ExplanationExplanation:Correct answer:Strep throatThe streptococcus bacteria in the throat, commonly known as strep throat, is a common infection that should be treated with antibiotics. However, to confirm the infection, a Rapid Strep Test is performed by testing the mucus in the throat. The results are normally back the same day. |
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Your patient has been diagnosed with blepharitis. Your nonpharmacologic treatment for this disease would include which of the following? |
cold compresses q.i.d. for 15 minutes using tear-free shampoo for daily cleansing of the eyelid with warm, damp cotton tip meibomian gland massage eye patch Hide ExplanationExplanation:Correct answer:using tear-free shampoo for daily cleansing of the eyelid with warm, damp cotton tip Of the four choices this is the only one that would be recommended for blepharitis. In addition, warm, moist compresses would help to soften encrustation. Contact lenses and eye makeup should be discontinued during treatment. |
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Which of the following statements about the MMR vaccine is incorrect? |
The MMR is not safe to use during lactation.
Its use in pregnant women is discouraged. Systemic reaction to the MMR vaccine is rare. The MMR vaccine is typically well tolerated with rare reports of transient adverse reactions. Hide ExplanationExplanation:Correct answer:The MMR is not safe to use during lactation. This is incorrect. The MMR is safe to use during lactation. Its use in pregnant women is discouraged because of the possible risk of passing the virus on to the unborn child. This risk exists in theory but has not been noted in ongoing observation. |
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A young male patient experiences itching between his toes. The examination shows that the sides and bottom of his feet are dry. What is the likely diagnosis? |
Athlete's foot.
Ringworm. Eczema. Dandruff. Hide ExplanationExplanation:Correct answer: Athlete's foot Dandruff appears near hair follicles. Both athlete's foot and ringworm are caused by a fungus. The observations, however, are consistent with athlete's foot. |
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When treating a patient with reactive arthritis (also known as Reiter syndrome), the nurse practitioner knows that in a sexually active man this will include: |
Corticosteroids
Antibiotics DMARDs (disease modifying antirheumatics) All of the above Hide ExplanationExplanation:Correct Answer:All of the aboveTreatment includes the use of anti-inflammatory drugs such as NSAIDs and an antibiotic such as tetracycline. Corticosteroids and DMARDs are also used for treatment. |
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You are prescribing Lisinopril for your 70-year-old patient with heart failure. What is the maximum daily dosage the patient can take of this medication? |
4 mg/day. 20 mg once per day. 40 mg/day. 16 mg/day. Hide ExplanationExplanation:Correct Answer:40 mg/day.There are a variety of drugs prescribed to patients to help manage heart failure. For example, the maximum daily dosage for Lisinopril is 40 mg once per day. The daily max. for Fosinopril is 40 mg/day. The daily maximum for Perindopril is 16 mg/day and Trandolapril, 4 mg/day. |
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Your education for wound care to a client would include which of the following? |
Keep the wound moist. Clean suture lines with soap and water daily. Keep the dressing in place for at least one week. Keep the wound area below the heart to decrease swelling. Hide ExplanationExplanation:Correct Answer:Clean suture lines with soap and water daily.This is a valid instruction. The other choices are not. The wound should be kept clean and dry. The dressing should be kept in place for 24 to 48 hours. The wound should be elevated above the heart to decrease swelling. You would also tell the patient to watch for signs of infection including redness, red streaks, swelling, pus, and fever. |
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According to the American College of Rheumatology, which of the following is one of the criteria for diagnosing RA in a patient? |
Morning stiffness that lasts ≥2 hour in and around joint. Morning stiffness that lasts ≥3 hour in and around joint. Morning stiffness that lasts ≥1 hour in and around joint. Morning stiffness that lasts ≥4 hour in and around joint. Hide ExplanationExplanation:Correct Answer:Morning stiffness that lasts ≥1 hour in and around joint. Four of the six following criterion outlined by the American College of Rheumatology must be present for ≥6 weeks in order for a diagnosis of RA to be made. The criterion are morning stiffness, symmetrical arthritis, hands involved, rheumatoid nodules, arthritis of three or more joints, serum rheumatoid factor, and radiographic changes. |
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The spontaneous expulsion of fetal and placental tissue from the uterine cavity at less than 20 weeks’ gestation is which type of abortion? |
complete abortion incomplete abortion inevitable abortion recurrent abortion Hide ExplanationExplanation:Correct answer:complete abortion This would be a complete abortion. The uterus would appear empty on sonogram. |
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Which of the following waist circumference measurements is an indication of obesity in a male? |
greater than 34 inches greater than 35 inches greater than 38 inches greater than 40 inches Hide ExplanationExplanation:Correct answer:greater than 40 inches A waist circumference of over 40 inches in a male is an indication of obesity in a male; greater than 35 inches for females. Waist-to-hip ratio should be under 1.0 for males and under 0.8 for females. |
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Wanda is treating a patient who has been recently diagnosed with panic attacks. What prescription medicines would prove most effective in preventing these attacks? |
Hormone therapy. Anti-depressants. Tranquilizers. Mild mood stabilizers. Hide ExplanationExplanation:Correct answer: Anti-depressants Anti-depressants have proven effective in treating patients with panic attacks in most cases. While there are side effects, they are still the preferred choice for reducing these panic attacks in patients. |
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At about what age does the Moro reflex disappear in an infant? |
1 – 2 months 4 – 6 months 6 – 12 months 12 – 24 months Hide ExplanationExplanation:Correct answer:4 – 6 months The Moro Reflex is the startle reflex. Sudden loud noise causes symmetric abduction and extension of the arms followed by adduction and flexion of the arms over the body. It disappears by 4 to 6 months. |
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A 42-year-old African-American female is being treated for trichomoniasis with a prescription of metronidazole. What instructions should the nurse practitioner give her? |
expect to take this medication through an intravenous injection. insert the medication into the rectum. This medication should not be taken with alcohol. Do not take this medication if you have had multiple sex partners to prevent vaginal burning. Hide ExplanationExplanation:The Correct answer is:This medication should not be taken with alcoholMetronidazole may be associated with a disulfiram reaction when mixed with alcohol and may initiate nausea, flushed skin and a decrease in the white blood cell count. Therefore, patients should avoid consuming alcohol while taking metronidazole. Metronidazole is an oral medication and patients should take it by mouth. Further, metronidazole is not recommended in females who are pregnant, unless the patient is three months or more within the pregnancy. |
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Evaluation of heart sounds is an important part of the assessment of any patient with a cardiovascular problem. Which of the following best describes the S4 heart sound? |
closure of the tricuspid and mitral valves closure of the aortic and pulmonary valves low-frequency sound heard early in diastole low-frequency sound heard late in diastole Hide ExplanationExplanation:Correct answer:low-frequency sound heard late in diastole The S4 heart sound is a low-frequency sound heard late in diastole. It is rare in infants and children. It is always pathological and it is seen in conditions with decreased ventricular compliance. |
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Gentamicin Sulfate cream or ointment 0.1% for folliculitis is prescribed in which of the following dosages? |
Apply tid before antibiotic ointment.2%, apply bid X 10 days and cover with DSD. Apply to area bid-tid. 0.5 to 1 mg/kg/day PO in divided doses. Hide ExplanationExplanation:Correct Answer:Apply to area bid-tid.The preceding medications should be administered at the following dosages: Mupirocin ointment - 2%, apply bid X 10 days and cover with DSD. Gentamicin Sulfate cream or ointment - Apply to area bid-tid. Isoretinoin - 0.5 to 1 mg/kg/day PO in divided doses. Anhydrous ethyl alcohol with 6.25% aluminum chloride - Apply tid before antibiotic ointment. |
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With senile purpura, diagnostic test include the platelet count, coagulation studies, and complete blood count (CBC). The values for these test will be: |
All will be slightly elevated. All values will be normal. Platelets and CBC will be elevated, coagulation studies and differential will be decreased. Platelets and CBC will be decreased, coagulation studies and differential will be elevated. Hide ExplanationExplanation:Correct answer: 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. |
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You are checking the results of a lipid screening that you ordered for your 45-year-old female patient. If her total cholesterol reading is 208 mg/dL it would be considered which of the following? |
below normal
normal high borderline high Hide ExplanationExplanation:Correct Answer:borderline highThis patient would have borderline high cholesterol (200 to 239 mg/dL). Normal would be under 199 mg/dL. High would be over 240 mg/dL. |
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The FNP is doing a well-child exam on a 6-year-old boy. The FNP can expect that all of the following developmental milestones are likely to be exhibited in this child EXCEPT: |
catches a ball knows his age knows his right from his left hand draws persons with at least 16 parts Hide ExplanationExplanation:Correct answer:draws persons with at least 16 parts All of the choices are developmental milestones likely to be exhibited by a 6-year-old child except this one. A child of this age will typically draw a person with 6 – 8 parts. At the age of 7 or 8 years, a child will typically draw a person with at least 16 parts. |
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You have a young patient who has just been diagnosed with acute lymphocytic leukemia. The parents of this child want to know more about the disease. Which of the following statements would NOT be made to the parents about this disease? |
Acute lymphocytic leukemia accounts for about 80% of childhood leukemia. It is noted for the presence of lymphoblasts which replace normal cells in the bone marrow. The B cell type of acute lymphocytic leukemia has the poorest prognosis. The T lymphocytes type of acute lymphocytic leukemia has the poorest prognosis.Hide ExplanationExplanation: This statement would be incorrect. Actually, the B cell type of acute lymphocytic leukemia has the better prognosis. All of the other statements are true. |
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When treating a client with allergic rhinitis what education information should the nurse practitioner include? |
Remain inside during allergy season. Avoid working in the garden or yard. Use a surgical-type mask when going outdoors. Monitor air quality and the allergy index. Hide ExplanationExplanation:The Correct answer is:Monitor air quality and the allergy indexIn the patient with allergic rhinitis, they should be aware of the air quality and allergy index in their area. Remaining indoors is unrealistic. Further, if the patient monitor what is in their garden, patients can enjoy a summer garden. A surgical mask will not filter out small allergens. |
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Screening is recommended for all of the following EXCEPT: |
colorectal cancer breast cancer lung cancer cervical cancer Hide ExplanationExplanation:Correct Answer:lung cancer Lung cancer screenings are only recommended for those with a history of smoking. |
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Which of the following is least likely to be considered a genetic red flag that may warrant genetic testing or referral to genetic counseling? |
advanced maternal age consanguinity extremely tall stature of mother, father, or other relatives high blood pressure in mother Hide ExplanationExplanation:Correct answer:high blood pressure in mother While high blood pressure in mother is a concern, it is not a reason for genetic counseling or referral. Besides the other three choices, other reasons include: high-risk ethnic heritage, family history, congenital blindness or dearness in family members, or developmental delays in mother, father, offspring, or close relatives. |
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You are treating a 38-year-old mildly obese female with peptic ulcer disease symptoms. The most cost effective, sensitive and specific test for Helicobacter pylori infection is: |
fecal DNA testing organism-specific stool antigen testing serological testing for antigen related to the infection stool Gram stain, looking for the offending organism Hide ExplanationExplanation:The Correct answer is:Organism-specific stool antigen testingThe most cost-effective method of diagnosing H. pylori infection is the organism-specific stool antigen testing. Serological testing is also available but has limitations. H. pylori is transmitted via the oral-fecal and oral-oral route. It is a gram-negative, spiral shaped organism that is seen in duodenal ulcer and gastric ulcer disease. |
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Families and patients in critical care need to be educated about what is happening and what must be done. All of the following are appropriate guidelines for educational sessions EXCEPT: |
Keep the time frame as set. Do not repeat information. This can cause stress. Educate in more than one meeting. Avoid details. Hide ExplanationExplanation:Correct Answer:Do not repeat information. This can cause stress.This would not be an appropriate guideline. It is best to provide repetition of the information. Stress and the critical care environment can alter comprehension. For this reason repetition is necessary. |
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A patient who has been prescribed azithromycin for an inner ear infection should be advised to seek immediate medical attention if he experiences which of the following? |
Spreading purple skin rash. Stomach pain. Dizziness. Vomiting. Hide ExplanationExplanation:Correct Answer:Spreading purple skin rash. This is a sign of a potentially serious reaction and immediate attention should be sought. Patients may experience mild rash or itching, which is not considered a serious concern unless it worsens or spreads. |
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When first observing an elderly patient, you notice that he appears disheveled. What do you need to focus on in the interview? |
Medical history. Cognitive function. Sensory exam. Stepping reflex. Hide ExplanationExplanation:Correct answer: Cognitive function There could be a simple reason for a disheveled appearance. It is important, however to assess cognitive function. This will help determine if the patient is still capable of functioning alone. |
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You are prescribing a medium daily dosage of Beclomethasone HFA (40 mcg/puff) to your 32-year-old patient. Of the following, which range of prescription is appropriate for this particular medication? |
320 - 640 mcg. >240 - 480 mcg. 180 - 540 mcg. 1000 - 2000 mcg. Hide ExplanationExplanation:Correct Answer:>240 - 480 mcg. These are the daily dosages for Beclomethasone HFA (40 or 80 mcg/puff) Low: 80-240 mcg Medium: >240-480 mcg High: >480 mcg |
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An infant with a low birth weight is having problems with nutrition. What condition should be considered in the assessment? |
Neuropathy. Serum cholesterol. Depression. GERD. Hide ExplanationExplanation:Correct answer: GERD Infants with a low birth weight are prone to reflux. This is indicated by spitting up and cries of pain. |
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Of the following screening tests, which would confirm hypertension due to pheochromocytoma? |
CT angiography. 24-hour urinary metanephrine and normetanephrine. Doppler flow study; magnetic resonance angiography. Estimated GFR. Hide ExplanationExplanation:Correct answer:24-hour urinary metanephrine and normetanephrine The preceding screening tests are used to confirm or refute hypertension due to the following:CT angiography - Coarctation of the aorta24-hour urinary mentanephrine and normetanephrine - PheochromocytomaDoppler flow study; magnetic resonance angiography - Renovascular hypertensionEstimated GFR - Chronic kidney disease |
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In relation to uterine size during pregnancy, the nurse practitioner knows that the uterus is approximately tennis-ball sized at what stage of pregnancy? |
6 weeks
8 weeks 12 weeks 20 weeks Hide ExplanationExplanation:Correct Answer:8 weeksThe uterus is the size of a lemon nongravid and is mobile, firm and nontender. By 8 weeks gestation, it has grown to the size of a tennis ball or orange. At 12 weeks, the uterus is the size of a softball or grapefruit. By 20 weeks, the uterine fundus is at the umbilicus. |
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Which of the following would you NOT expect to see in the physical examination of a person with asthma? |
increased tactile fremitus
prolonged expiratory phase of forced exhalation low diaphragms hyperresonance on thoracic percussion Hide ExplanationExplanation:Correct answer:increased tactile fremitus In the physical examination of a person with asthma you would not find increased tactile fremitus; you would find decreased tactile fremitus. You may also see (in addition to the findings in the other three choices): wheezing, increased anterior-posterior diameter and a reduction in forced expiratory volume at one second. |
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Which of the following would NOT be a characteristic of delirium? |
insidious onset and gradual change in mental status
duration of hours to days change in psychomotor activity, either hyperactive or hypoactive perceptual disturbances Hide ExplanationExplanation:Correct answer:insidious onset and gradual change in mental status Delirium does not have and insidious onset; its onset is abrupt. It can usually be noted as a precise date as a rapidly progressive change in mental status |
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Which of the following characteristics is least associated with Still’s murmur, a vibratory murmur? |
can be described as a “twanging string” usually detected at 8 – 14 years of age intensity may increase with fever not accompanied by a thrill Hide ExplanationExplanation:Correct answer:usually detected at 8 – 14 years of age Still’s murmur is usually detected at 3 – 6 years of age. It is heard best at the middle left sternal border or between the left lower sternal border and apex when the patient is in the supine position. |
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A patient who has received several stitches for a wound in her arm asks when the stitches will be removed. Which of the following is an appropriate response? |
3-5 days. 5-10 days. 14 days. 7-14 days. Hide ExplanationExplanation:Correct Answer:5-10 days.In most cases, stitches from the arms and hands can be removed in 5-10 days. If the wound is over a joint, 7-14 days is a more appropriate timeframe. |
