Question 1.Question : Which of the following is a crucial element of developing a guideline? Creating a physician expert panel Reviewing the literature with ratings of available evidence Conductin... g an external review of a guideline Developing evidence-based tables Question 2.Question : African American patients seem to have a negative reaction to which of the following asthma medications? Inhaled corticosteroids Long-term beta-agonist bronchodilators Leukotriene receptor agonists Oral corticosteroids Question 3.Question : Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean? The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the distant spread cannot be evaluated. The cancer is in situ; it is spreading into the lymph nodes, but the spread cannot be evaluated otherwise. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body. The cancer is about 5 cm in size; nearby lymph nodes cannot be evaluated; and there is no evidence of distant spreading. Question 4.Question : Sondra's peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear? Meclizine Diphenhydramine Diamox Promethazine Question 5.Question : Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a: Filiform/digitate wart Dysplastic cervical lesion Condyloma acuminata Koilocytosis Question 6.Question : Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of? Dementia Alzheimer's disease Parkinson's disease Delirium Question 7.Question : You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her? "Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow." "Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow." "Drive to the emergency room now." "Call 911." Question 8.Question : A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria? NSAIDs Beets Vitamin A Red meat Question 9.Question : Which of the following is an example of tertiary prevention in a patient with chronic renal failure? Fluid restriction Hemodialysis 4 days a week High-protein diet Maintenance of blood pressure at 120/80 Question 10.Question : Which of the following conditions is associated with cigarette smoking? Glaucoma Increased sperm quality Bladder cancer Eczema Question 11.Question : A chronic cough lasts longer than: 3 weeks 1 month 6 months 1 year Question 12.Question : The 'freezing phenomenon' is a cardinal feature of? Parkinson's disease Alzheimer's disease A CVA Bell's palsy Question 13.Question : When administered at the beginning of an attack, oxygen therapy may help this kind of headache? Tension Migraine Cluster Stress Question 14.Question : Which ethnic group has the highest lung cancer incidence and mortality rates? African American men Scandinavian men and women Caucasian women Asian men Question 15.Question : The most significant precipitating event leading to otitis media with eﬀusion is: Pharyngitis Allergies Viral upper respiratory infection (URI) Perforation of the eardrum Question 16.Question : Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of: Severe asthma A common valvular lesion Severe hypertension A prosthetic heart valve Question 17.Question : A 34-year-old patient was treated for a UTI and has not responded to antibiotic therapy. Which of the following actions should be taken next? Send a urine specimen for microscopy and evaluate for fungal colonies. Increase the dose of antibiotic. Order a cytoscopy. Order a diﬀerent antibiotic. Question 18.Question : Which statement best describes a carotid bruit? It is felt with the middle three fingers over the carotid artery. A bruit becomes audible when the lumen is narrowed to 1 mm or less. A low-pitched bruit is a medical emergency. The higher the pitch of the bruit, the higher the degree of stenosis. Question 19.Question : Which statement is true regarding chloasma, the 'mask of pregnancy'? It is caused by a decrease in the melanocyte-stimulating hormone during pregnancy. This condition only occurs on the face. Exposure to sunlight will even out the discoloration. It is caused by increased levels of estrogen and progesterone. Question 20.Question : Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause? "You must be under a lot of stress lately." "It is hereditary. Did your father experience this also?" "The cause is unknown, but we suspect it is due to an immunologic mechanism." "We'll have to do some tests." Question 21.Question : A blood pressure (BP) of 150/90 is considered: Stage 2 hypertension Hypertensive Normal in healthy older adults Acceptable if the patient has DM Question 22.Question : When teaching post MI patients about their NTG tablets, the clinician should stress that the tablets should remain in the light-resistant bottle in which they are packaged and should not be put in another pill box or remain in areas that are or could become warm and humid. Once opened, the bottle must be dated and discarded after how many months? 1 month 3 months 6 months As long as the tablets are kept in this special bottle, they will last forever. Question 23.Question : Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking? He should stop smoking today. He should stop smoking tomorrow. His quit date should be in 1 week. He will be ready to quit after the first 30 days. Question 24.Question : When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are? Spores Leukocytes Pseudohyphae Epithelial cells Question 25.Question : The hallmark of an absence seizure is: No activity at all A blank stare Urine is usually voided involuntarily The attack usually lasts several minutes Question 26.Question : Which medication used for scabies is safe for children 2 months and older? Permethrin cream Lindane Crotamiton lotion and cream Ivermectin Question 27.Question : The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis? Viral conjunctivitis Keratoconjunctivitis Bacterial conjunctivitis Allergic conjunctivitis Question 28.Question : Gabby, aged 22, has Bell's palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her? "Most patients have complete recovery in 3 to 6 months." "Unfortunately, you'll probably have a small amount of residual damage." "Don't worry, I'll take care of everything." "You may have a few more episodes over the course of your lifetime but no permanent damage." Question 29.Question : How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate? Every 3 months Every 6 months Annually Whenever there is a problem Question 30.Question : Immunizations are an example of which type of prevention? Primary Secondary Tertiary Question 31.Question : The result of the patient's 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions? Repeat the test. Refer to a nephrologist. Measure the serum protein. Obtain a blood urea nitrogen (BUN) and creatinine. Question 32.Question : Which cranial nerve is aﬀected in a patient with a cerebrovascular accident who has diﬃculty chewing? CN V CN VII CN IX CN X Question 33.Question : Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer? Kidneys, ureter, bladder x-ray Cystoscopy with biopsy Magnetic resonance imaging Urine tumor marker (NMP22) Question 34.Question : The "B" in the ABCDEs of assessing skin cancer represents: Biopsy Best practice Boundary Border irregularity Question 35.Question : Which statement is true regarding driving and patients with a seizure disorder? Once diagnosed with a seizure disorder, patients must never drive again. After being seizure free for 6 months, patients may drive. Each state has diﬀerent laws governing driving for individuals with a seizure disorder. These persons may drive but never alone. Question 36.Question : Which high-density lipoprotein (HDL) level is considered cardioprotective? Greater than 30 Greater than 40 Greater than 50 Greater than 60 Question 37.Question : The most common cause of CAP is? Streptococcus pneumoniae Klebsiella pneumoniae Legionella pneumoniae Pseudomonas aeruginosa Question 38.Question : Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause? Serum calcium Electrocardiogram (ECG) Thyroid-stimulating hormone test Complete blood cell count Question 39.Question : A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be? The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the oﬀending pathogen. A throat culture should be performed to confirm the results of the rapid strep test. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive. Question 40.Question : Patients with acute otitis media should be referred to a specialist in which of the following situations? Concurrent vertigo or ataxia Failed closure of a ruptured tympanic membrane If symptoms worsen after 3 or 4 days of treatment All of the above Question 41.Question : Which of the following tests is most useful in determining renal function in a patient suspected of CRF? BUN and creatinine Electrolytes Creatinine clearance Urinalysis Question 42.Question : Marci has a wart on her hand. She says she heard something about "silver duct tape therapy." What do you tell her about his? It is an old wives' tale. It is used as a last resort. Salicylic acid is more eﬀective. It is a simple treatment that should be tried first. Question 43.Question : What is the first-line recommended treatment against Group A ?-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis? Penicillin Quinolone Cephalosporin Macrolide Question 44.Question : Which of the following is an example of sensorineural hearing loss? Perforation of the tympanic membrane Otosclerosis Cholesteatoma Presbycusis Question 45.Question : Which of the following is "a linear crack extending from the epidermis to the dermis?" An ulcer A fissure Lichenification An excoriation Question 46.Question : A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma? The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient. Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve. Question 47.Question : The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection? IgA IgE IgG IgM Question 48.Question : A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of diﬀerential diagnoses? Pancreatitis Peptic ulcer disease Diverticulitis All of the above Question 49.Question : Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test? B-type natriuretic peptide C-reactive protein Serum albumin Erythrocyte sedimentation rate Question 50.Question : You are doing a cerumen extraction and touch the external meatus of your patient's ear. He winces and starts coughing. What is the name of this reflex? Baker phenomenon Arnold reflex Cough reflex Tragus reflex * Times are displayed in (GMT-07:00) Mountain Time (US & Canada) Question : The most cost-eﬀective screening test for determining HIV status is which of the following? Western blot Enzyme-linked immunosorbent assay Venereal Disease Research Laboratory test Viral load Question 2.Question : Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process? Erythrocyte sedimentation rate White blood cell count Polymorphonuclear cells C-reactive protein (CRP) Question 3.Question : Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter? GABA Acetylcholine Dopamine Serotonin Question 4.Question : Mrs. Thomas was seen in the oﬃce complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that diﬀerentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is: Ecchymosis, edema, and erythema over the lateral epicondyle Pain at the elbow with resisted movements at the wrist and forearm Inability to supinate and pronate the arm Inability to flex or extend the elbow against resistance Question 5.Question : Which of the following statements concerning the musculoskeletal examination is true? The uninvolved side should be examined initially and then compared to the involved side. The part of the body that is causing the patient pain should be examined first. When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain. Radiographs should always be obtained prior to examination so as not to cause further injury to the patient. Question 6.Question : Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? Decreased C-reactive protein Hyperalbuminemia Morning stiﬀness Weight gain Question 7.Question : Which causes the greatest percentage of mammalian bites? Dogs Cats Humans Rodents Question 8.Question : A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first? Transvaginal ultrasound Endometrial biopsy MRI Abdominal computed tomography scan Question 9.Question : A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate? "Control of glucose will help postpone or delay complications." "Regularly checking blood sugar will help establish a routine." "Monitoring glucose will promote a sense of control." All of the above Question 10.Question : A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiﬀness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next? Serum calcium TSH Electrolytes Urine specific gravity Question 11.Question : Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy? Insulin Metformin Glucotrol Precose Question 12.Question : During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? An enlarged rubbery gland A hard irregular gland A tender gland A boggy gland Question 13.Question : Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step? Remove the insect with tweezers. Immobilize the insect with 2% lidocaine. Sedate Eddie with diazepam. Shine a light in the ear for the insect to "find its way out." Question 14.Question : What is the most common cause of microcytic anemia? Anemia of chronic disease Sideroblastic anemia Iron-deficiency anemia Thalassemia Question 15.Question : An 82-year-old man is seen in the primary care oﬃce with complaints of dribbling urine and diﬃculty starting his stream. Which of the following should be included in the list of diﬀerential diagnoses? Benign prostatic hyperplasia (BPH) Parkinson's disease Prostate cancer All of the above Question 16.Question : Early rheumatoid disease is characterized by: Pain and swelling in both small and large peripheral joints Rigid joints with diminished range of motion Joint swelling and immobility on rising A cardiac rub or pulmonary friction rub Question 17.Question : A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do? Make an immediate referral for an orthopedic evaluation without further assessment. Tell her that it takes time for these bruises to improve, so she should be patient. Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint. Send her to the emergency room for reduction of this obvious wrist fracture. Question 18.Question : The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least: 1 month 3 months 6 months 12 months Points Received: Question 19.Question : A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find? The scrotum will be dark. The scrotum will appear light pink or yellow. The scrotum will appear milky white. The internal structures will be clearly visible. Question 20.Question : According to Kübler-Ross, the stages of grief occur in which order? Anger, denial, depression, bargaining, acceptance Anger, denial, bargaining, acceptance, depression Denial, anger, depression, bargaining, acceptance Denial, anger, bargaining, depression, acceptance Question 21.Question : Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate? A favorable prognostic trend Disease progression The need to be more aggressive with Reuben's medications The eradication of the HIV Question 22.Question : The exanthem of Lyme disease is: Erythema infectiosum Laterothoracic exanthem Erythema migrans Morbilli exanthem Question 23.Question : You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is: Articular Inflammatory Nonarticular A and B Question 24.Question : What is the recommended daily calcium intake for adults over the age of 50 with low bone mass? 1,200 mg/day 1,000 mg/day 1,300 mg/day 1,500 mg/day Question 25.Question : When assessing a woman for infertility, which of the following tests should be done first? Analysis of partner's sperm Magnetic resonance imaging (MRI) Hysterosalpingogram Estrogen level Question 26.Question : Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact? Superficial burns Superficial partial-thickness burns Deep partial-thickness burns Full-thickness burns Question 27.Question : A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination? Human papillomavirus (HPV) Endometrial hyperplasia Vagismus Polycystic ovarian syndrome Question 28.Question : As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin? Two Three Four Five Question 29.Question : Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? Morning stiﬀness and limited mobility of the lumbar spine Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain Fever, chills, and elevated erythrocyte sedimentation rate Pathologic fractures, severe night pain, weight loss, and fatigue Question 30.Question : A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis? Testosterone level Prostate-specific antigen Nocturnal penile tumescence and rigidity Prolactin level Question 31.Question : The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been eﬀective? "I'll take my pill at least 30 minutes before breakfast." "I'll take my Glucotrol before bedtime." "It is important to take my medication right after I eat." "Since I only like to eat two meals a day, I can take the pill between my meals." Question 32.Question : In the United States, what is the second most common connective tissue disease and the most destructive to the joints? Osteoarthritis Systemic lupus erythematosus (SLE) Rheumatoid arthritis Sjögren's syndrome Question 33.Question : The eﬀectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety? Acetylcholine Gamma-aminobutyric acid (GABA) Dopamine Serotonin Question 34.Question : A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action? Refer to a urologist immediately. Obtain a computed tomography (CT) scan. Instruct the patient to elevate the scrotum. Prescribe ibuprofen. Question 35.Question : Which of the following medications can cause hyperglycemia? Prednisone Metformin Synthroid Cephalexin Question 36.Question : During treatment for anaphylaxis, what site is used for the initial injection of epinephrine? IV Abdomen Upper lateral thigh Deltoid Question 37.Question : It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period? Before the initiation of treatment 1 to 2 weeks after the initiation of treatment When switching to a diﬀerent medication 1 to 2 weeks after tapering oﬀ medications Question 38.Question : What is the most common cause of secondary amenorrhea? Pregnancy Pituitary dysfunction Inadequate estrogen levels Genetic disorders Question 39.Question : Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration? Sertraline Fluoxetine Citoprolam Imipramine Question 40.Question : The goals of the 15-minute hour approach include: Enhance self-esteem, expand behavioral repertoire, prevent dire consequences, and reestablish premorbid levels of functioning Emerge with a higher level of functioning and commitment to long-term psychotherapy Accept need for antidepressant therapy and psychiatric referral; share concerns with primary care clinician Improve family functioning and sexual performance as well as accept need for antidepressant medication Question 41.Question : John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear? Valgus stress test McMurray circumduction test Lachman test Varus stress test Question 42.Question : The cardinal subjective symptom of sickle cell crisis is which of the following? Pain Nausea Light-headedness Palpitations Question 43.Question : A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which of the following pelvic pathologies is the most common cause of dysmenorrhea? Pelvic inflammatory disease Endometriosis Sexually transmitted infections Ovarian cyst Question 44.Question : Which arthropod bite can contain cytotoxic and hemolytic toxins that may destroy tissue? Tick Brown recluse spider Wasp Stinging caterpillar Question 45.Question : Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? Gastrocnemius weakness A reduced or absent ankle reflex Numbness in the lateral foot Paresthesia of the perineum and buttocks Question 46.Question : A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the following tests is essential before prescribing any oral contraceptive? Pregnancy test Complete blood cell count Thyroid-stimulating hormone Urine dip for protein Question 47.Question : A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin? Ketoacidosis Cirrhosis Hypoglycemic episodes All of the above Question 48.Question : The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants? SSRIs are more eﬀective than TCAs. SSRIs take less time to work than TCAs. SSRIs have a more favorable side-eﬀect profile than TCAs. SSRIs are not lethal in overdose. Question 49.Question : Which type of bone marrow transplant is obtained from an identical twin? Autogenic Autologous Allogeneic Syngeneic Question 50.Question : Pink, cherry red tissues and skin may result from which type of poisoning? Arsenic Lead Carbon monoxide Strychnine Question 51.Question : Basic human needs are identified as: Autonomy and feeling valued by others Exhilaration and productivity Spirituality Career success and material rewards Question 52.Question : The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient? Overweight Mild obesity Moderate obesity Morbid obesity Question 53.Question : A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self- examination (TSE). Which of the following should be included in the list of diﬀerential diagnoses? Testicular cancer Inguinal hernia Varicocele All of the above Question 54.Question : What is the treatment of choice for a patient diagnosed with testicular cancer? Radical orchidectomy Lumpectomy Radiation implants All of the above Question 55.Question : Which method is used to remove heavy metals, such as lead, that are ingested as poisons? Chelation Dialysis Gastric lavage Bowel irrigation Question 56.Question : A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate? "It is probably just a cyst because that is the most common breast mass." "We will order a mammogram and ultrasound to help establish a diagnosis." "We will go ahead and schedule you for a biopsy because that is the only way to know for sure." "Because your lump is painful, it is most likely not cancer." Question 57.Question : A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate? Fluconazole Estrogen vaginal cream Metronidazole Doxycycline Question 58.Question : The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs? "You should start with the lowest dose that is eﬀective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage." "You should start with the lowest dose that is eﬀective in managing your pain to avoid developing tolerance to the medication." "You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain." "It is important to take NSAIDs on an empty stomach in order to increase absorption." Question 59.Question : A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting of a joint, is more likely related to which musculoskeletal injury? A sprain A strain A partial fracture A fracture Question 60.Question : Which type of heat-related illness involves a core body temperature of at least 104.9°F, acute mental status changes, absent sweat, and tachypnea? Heat cramps Heat syncope Heat exhaustion Heat stroke Question 61.Question : Which of the following may be used to evaluate a person's suicide risk? CAGE SANE SAD PERSONAS DIGFAST Question 62.Question : One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular structure? Bone Synovium Tendons Fascia Question 63.Question : After returning from visiting his grandchildren in England, George, age 59, complains of a flulike illness, including fever, chills, and myalgia. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering? A viral syndrome Lyme disease Rocky Mountain spotted fever Relapsing fever Question 64.Question : A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expect as a manifestation of the disease? Sinus bradycardia Atrial fibrillation Supraventricular tachycardia U waves Question 65.Question : Which of the following tests is essential for a 46-year-old woman who the clinician suspects is perimenopausal? Pregnancy Estrogen level Progesterone level LH level Question 66.Question : After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? Elevated TSH Normal TSH Low TSH Undetectable TSH Question 67.Question : A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment? No treatment at this time Diet and exercise for 6-week trial Diet, exercise, and oral medication Diet, exercise, and exogenous insulin Question 68.Question : Which of the following should be considered in a patient presenting with erectile dysfunction? Diabetes mellitus Hypertension Atherosclerosis All of the above Question 69.Question : Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome? Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel. Only people with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel. An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel. Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance. Question 70.Question : A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea? Ceftriaxone Doxycycline Acyclovir Metronidazole Question 71.Question : Which of the following statements is true regarding the treatment of carpal tunnel syndrome? The goal of treatment is to prevent flexion and extension movements of the wrist. Splints are used in carpal tunnel syndrome, because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection. All of the above Question 72.Question : Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this patient? Elevated uric acid level Elevated blood urea nitrogen Decreased urine pH Decreased C-reactive protein Question 73.Question : Which of the following data is indicative of testicular torsion? Absent cremasteric reflex Pain relieved on testicular elevation Testicle very low in the scrotum Swollen scrotum with "red dot sign" Question 74.Question : A patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer her, the clinician must understand that exercise has what eﬀect on the patient with type 2 diabetes? Reduces postprandial blood glucose Reduces triglycerides and increases high-density lipoprotein (HDL) Reduces total cholesterol All of the above Question 75.Question : A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority? Pregnancy test Pelvic ultrasound Endometrial biopsy Platelet count Question 76.Question : What is the most common cause of generalized musculoskeletal pain in women ages 20 to 55? Chronic fatigue syndrome (CFS) Anemia Fibromyalgia syndrome (FMS) Sports-related injuries Question 77.Question : If the international normalized ratio (INR) result is above the therapeutic range in a patient with atrial fibrillation on warfarin, what might the clinician do? Stop the warfarin for 1 week, and then repeat the INR. Withhold one or more days of anticoagulant therapy. Restart therapy at a lower dose immediately. The prothrombin time and INR should be reevaluated within 1 month of the dosage adjustments. Question 78.Question : A 32-year-old woman is seen in the clinic because she has been unable to get pregnant after 12 months of unprotected sex. In order to determine the cause of the infertility, the clinician should question her about which of these possible causes? Pelvic inflammatory disease Oral contraceptive use for 15 years Early menarche Diet high in soy protein Question 79.Question : Which of the following statements concerning the treatment of fibromyalgia syndrome is true? There is currently no cure for the disorder; however, patients should be made aware that symptom relief is possible. Treatment is directed toward controlling discomfort, improving sleep, and maintaining function. Fibromyalgia syndrome can be diﬃcult to manage, requiring a variety of approaches and multiple medications. All of the above Question 80.Question : The clinician should prescribe an antibiotic that covers which of these organisms for a patient with acute prostatitis? Gram-positive cocci Gram-negative cocci Gram-positive bacillus Gram-negative bacillus Question 81.Question : Which household solution should be used to clean a bathroom if sharing with a friend who has HIV? 100% bleach 50% bleach and 50% vinegar Nine parts H2O to one part bleach The friend must have his or her own bathroom. Question 82.Question : Sandra is 42 years old and has just been diagnosed with leukemia. She is complaining of bone and joint pain. Which type of leukemia is most likely the culprit? Acute lymphocytic leukemia Acute myelogenous leukemia Chronic myelogenous leukemia Chronic lymphocytic leukemia Question 83.Question : Which of the following is identified as an eating disorder in which a person craves food substitutes, such as clay, ice chips, and cotton, and is considered an objective finding associated with severe iron deficiency? Ferritin Porter's syndrome Hypochromasia Pica Question 84.Question : The clinician suspects that a client seen in the oﬃce has hyperthyroidism. Which of the following tests should the clinician order on the initial visit? High sensitivity thyroid-stimulating hormone (TSH) and free T4 Free T4 and serum calcium Free T3 and T4 TSH and thyroxin antibodies Question 85.Question : The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been eﬀective? "As long as I don't need glasses, I don't have to worry about going blind." "I know I need to have my eyes checked every year." "My optometrist checks my eyes." "I will see my eye doctor when my vision gets blurry." Question 86.Question : Triggering factors for acute exacerbations of which of the following conditions include exposure to ultraviolet (UV)-B and UV-A rays? Rheumatoid arthritis Scleroderma SLE Sjögren's syndrome Question 87.Question : Which of the following characteristics separates anaphylaxis from a vasovagal reaction? Bradycardia Extreme diaphoresis Severe bronchoconstriction Hypotension Question 88.Question : Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The clinician has explained to Mr. Jackson that the goals for managing osteoarthritis include controlling pain, maximizing functional independence and mobility, minimizing disability, and preserving quality of life. Mr. Jackson explains to the clinician that his first choice would be to use complementary therapies to control his condition and asks what therapies are most eﬀective in treating osteoarthritis. What would be the most appropriate response from the clinician? "Complementary therapies should be considered only if surgical interventions are not successful." "I am unfamiliar with the available complementary therapies for osteoarthritis and prefer to discuss more mainstream treatments, such as NSAIDs and physical therapy, to manage your condition." "I would be happy to discuss all the treatment options available to you. Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being studied for use in the treatment of osteoarthritis and have shown promise when used with standard medical therapy." "It would be crazy to use complementary therapies to treat such a serious condition." Question 89.Question : One benefit of motivational interviewing (MI) is: It assumes that ambivalence is a normal part of the change process. It can be utilized during routine oﬃce visits. It is a therapeutic technique which is not necessarily time intensive. All are benefits of MI. Question 90.Question : What percentage of burns is involved using the rule of nines if both front legs are burned? 9% 18% 24% 36% Question 91.Question : Women are at the highest risk for developing postpartum depression for up to how long after childbirth? 2 weeks 1 month 3 months 6 months Question 92.Question : Which statement about HIV postexposure prophylaxis (PEP) for health-care workers is the most accurate? PEP should be started within hours of exposure. PEP should be started within 72 hours of exposure. Renal and hepatic function tests should be done 6 weeks after beginning PEP. PEP will prevent potential hepatitis C infection if present. Question 93.Question : The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an x- ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane's description of her injury. Which of the following clues in Diane's examination or history would alert the clinician to the need for obtaining radiographs? Inability to bear weight immediately after the injury Development of marked ankle swelling and discoloration after the injury Crepitation with palpation or movement of the ankle All of the above Question 94.Question : A vegetarian patient with gout asks the clinician about food he should avoid. The clinician should advise the patient to avoid which of the following foods? Rice Carrots Spinach Potatoes Question 95.Question : A patient with a basilar skull fracture may experience an impaired downward gaze or diplopia from which aﬀected cranial nerve? Student Answer: CN II CN III CN IV CN V Question 96.Question : A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack? Pheochromocytoma Hyperthyroidism Cardiac arrhythmias All of the above Question 97.Question : Which test is used to confirm a diagnosis of epididymitis? Urinalysis Gram stain of urethral discharge Complete blood cell count with diﬀerential Ultrasound of the scrotum Question 98.Question : BATHEing the patient refers to: A technique used in primary care to get the patient to accept the need for psychological or psychiatric referral A technique used to facilitate cultural understanding A technique used to perform psychotherapy A technique that is a quick screen for psychiatric issues and interventions for psychological problems Question 99.Question : BATHEing the patient is an advanced practice nursing intervention that allows the practitioner to: Develop a therapeutic relationship without "owning" the patient's problem Conduct psychological counseling within the context of the primary care encounter Focus on the "process" and not the assessment Make the patient and family happier Question 100.Question : A 45-year-old woman is seen in the clinic with abnormal uterine bleeding and pain during intercourse. The clinician should consider which of the following diagnoses? Leiomyoma Pregnancy Ovarian cancer All of the above [Show More]
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