AANP AGPCNP PSI Test 1 & 2 Latest Fall 2022 (answered and graded)

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An 88-year-old presents with right-side weakness after being unable to rise unassisted following a fall to the bathroom floor. History includes aphasia and noncompliance with hypertension medication r... egimen. What is the most likely diagnosis? Left-sided or right-sided CVA? LEFT-SIDED CVA Which of the following signs/symtpoms are often associated with headahces due to intracranial tumor? 1) pain worse laying down, focal neurological signs 2) Hyperflexia, personality change 3) acute onset: hours to days 4) pupillary constriction; stupor 1) pain worse laying down, focal neurological signs Which of the following pharmacotherapeutics would be most important to administer to a patient who has a corneal abrasion? 1) Timolol 2) Gentamicin ophthalmic 3) Cromolyn optha 4) Olopatadine 2) Gentamicin ophthalmic (Genoptic) A 25-year-old presents with the chief complaint of decreased mobility and pain of the right shoulder exacerbated by movement. The patient reports that he participated in extensive house painting 24 hours prior to the onset of pain. He denies any trauma. Passive ROM is intact. No redness or ecchymosis is present. What is the next step to be taken in order to make a diagnosis? 1) Xray of shoulder 2) Palpate structures around the shoulder. 3) MRI of shoulder 4) EMG 2) palpate structures A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle spotting. She has not missed any doses and uses no other medication. Which of the following is appropriate? 1) Changing to Ortho-Novum 1/35 2) Discontinue use 3) Providing reassurance 4) Double dose-for two days 3) provide reassurance According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT a current recommendation guideline for preventive care in elderly female patients? 1) Mammogram and clinical breast exams 2) Fecal Occult blood test and/or sig 3) Rubella serology or vaccination history 4) Pnuemo and influenza vaccines 3) Rubella serology or vaccination history 87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R 10. The best action is to: 1) initiate passive warming 2) apply a rebreather 3) Perform fluid replacement 4) initiate active warming 1) initiate passive rewarming A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How would you educate this patient on recognizing the signs and symptoms of hypoglycemia? 1) Edema 2) Tachycardia 3) palpitations 4) sweating 4) sweating A 65-year-old overweight patient is diagnosed with plantar fasciitis. Initial therapy of NSAIDs, stretching, ice, and rest has proven ineffective after 3 weeks. The best follow-up plan of care would be to: 1) stop NSAID, apply a heel cup and encourage exercise and wt loss. 2) continue NSAID, apply an arch support and encourage wt loss and exercise 3) continue NSAID, xray and add a short-leg night splint 4) COntinue NSAID, xray and add a metatarsal bar 2) continue NSAID, apply an arch support and encourage wt loss and exercise Fundoscopic exam of Hypertensive patient. 1) nicking of arteriols and viens, and small retinol hemorrages 2) drusen bodies and pale retina 3) pale macula and swollen disk margins 4) microaneurysms and optic disc cupping 1) nicking of arteriols and viens, and small retinol hemorrages Which of the following is a common presenting feature of hyperthyroidism in the elderly? 1) elevated TSH 2) Thyroid enlargement 3) atrial fibrillation 4) abnormal T3 suppression 3) atrial fibrillation A 35-year-old lawn maintenance worker presents reporting "something in my eye" since the previous day. The eye was rinsed with over-the-counter eyewash, without relief. The patient denies visual disturbances or drainage. In formulating a plan of care, the nurse practitioner would FIRST: 1) send to ophthalmologists 2) florescreen staining 3) test visual field 4) prescribe eyedrops 3) test visual field A 72-year-old patient presents with dry, itchy eyes. During the course of the physical examination, the nurse practitioner notes the presence of a gray band of opacity in the cornea that encircles the iris. The band is 1.0-1.5 mm wide. This finding is most consistent with a diagnosis of a/an: 1. corneal abrasion 2. arcus senilis 3. corneal ulcer 4. herpetic infection of the eye 2) arcus senilis A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night sweats, and a cough that has been present for 4 weeks. The diagnostic study to perform first would be: 1) xray 2) pulmonary function test 3) bronchoscopy 4) H & H 1) xray (tb-night sweats) A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort and fatigue. On physical examination, her lungs are clear bilaterally. There are a midsystolic click and a grade II/VI systolic murmur at the apex. Further evaluation would include which of the following? 1) EKG, flat plate of the abdomen, lipid profile 2) Echocardiogram, Doppler, EKG 3) Labs and benzo's 4) EEG, Anxiety Scale, and electrolytes 2) Echocardiogram, Doppler, EKG A healthy 84 y/o would like to start an exercise program, what would you do before this takes place? 1) physical exam 2) EKG 3) knee xrays 4) PT Stress test 1) Physical Exam 29 y/o has uncomplicated Chlamydia infection will exhibit: 1) green penile discharge 2) uticartia 3) unremarkable symtpoms 4) penile ulcer 3) unremarkable symptoms 37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be: 1) spirometry 2) MRI 3) COntract venogra[hy 4) helical CT pulmonary angiograph 4) helical CT pulmonary angiography. A 12-lead EKG shows an undulating baseline with no visible P waves and an irregularly irregular R-R interval. This arrhythmia is: 1) atrial flutter 2) atrial fibrillation 3) second degree heart block 4) Wolff-White Syndrome 2) atrial fibrillation After a 3-week camping trip, a 17-year-old is seen for a target lesion with central clearing, located in the inguinal area. The patient has had a severe headache, malaise, fatigue, and generalized musculoskeletal pain for several days. Pharmacologic management of this condition includes: 1) Bactrim 2) azithromycin 3) doxycycline (Doryx). 4) metronidazole 3) doxycycline (Doryx). Rocky Mountain spotted fever (Lyme disease-test with WEstern Blot) According to the American Diabetes Association, the newest standard for determining the presence of diabetes mellitus based on fasting plasma sugar level is a value equal to or greater than: 1) 110 mg/dL. 2) 126 mg/dL. 3) 135 4) whatever 2) 126 mg/dl In the elderly, one pathophysiologic mechanism of isolated systolic hypertension involves: 1) decreased cardiac output. 2) loss of vascular tissue elasticity. 3) hyperactive baroreceptors 2) loss of vascular tissue elasticity A 58-year-old female presents with shoulder and pelvic girdle pain for the past 6 months. She reports recent unintentional weight loss. On physical examination, there is pain on ROM, with no weakness noted. Laboratory studies show a low hemoglobin and an elevated sedimentation rate. Which of the following is the most likely diagnosis? 1) Polymyalgia rheumatica 2) polymyositis 3) osteoarthritis 4) Fibromyalgia 1) polymyalgia rheumatica An 85-year-old male relates that on the way to his annual physical examination, he suffered a sudden loss of vision in his right eye characterized by "a bunch of lights" and a feeling that "a curtain came down." All of the following would be included in the differential diagnosis EXCEPT: 1) opthalmolic migraine 2) retinal detachment. 3) diabetic retinopathy. 4) TIA 3) diabetic retinopathy A patient with diabetes mellitus who is on NPH and regular insulin split-dosing presents with complaints of early morning rise in fingerstick blood glucose. A review of self blood glucose monitoring reveals increased morning levels. After an increase in the evening insulin dose, the problem worsens. This is most likely an example of: 1) insulin resistance 2) the Somogyi effect. 3) needing more insulin in the mornings 4) Need to increase insulin at night 2) Somogyi effect In a healthy elder, which of the following TRADITIONALLY defines a positive urine culture? 1) ≥100,000 colonies/mL of a single organism 2) ≥10,000 colonies/mL of a single organism 3) ≥100,000 colonies/mL of a two or more organisms ≥100,000 colonies/mL of a single organism A 55-year-old patient exhibits a verified serum calcium level of 13 mg/dL [normal = 8.9-10.2 mg/dL]. The next step in determining the presence of pathology is to order a: 1) BUN and serum creatinine. 2) 24 hour urine 3) parathyroid hormone level. 4) thyroid panel 3) parathyroid hormone level An 88-year-old female presents with a 3-day history of vertigo. The patient has a past medical history of hypertension controlled with metoprolol, 50 mg daily. She reports that the presenting symptoms are constant, severe, and accompanied by nausea and vomiting. She denies experiencing diplopia, slurring of speech, chest pain, dyspnea, or diaphoresis. She exhibits mild anxiety and reluctance to change position or turn the head. BP = 126/76; P = 78; R = 16/min; and T = 98.2°F (36.8°C). HEENT examination reveals 17 beats of horizontal nystagmus on right lateral gaze; the nystagmus stops after several repetitions of the maneuver. Funduscopic, cardiac, pulmonary, abdominal, and neurologic examination results are normal. The most likely diagnosis is: 1) acoustic neuroma 2) vestibular neuritis. 3) vertibailar insufficiency 4) TIA 2) vestibular neuritis When initiating thyroid hormone replacement in the older adult, care must be taken to evaluate the patient's: 1) coronary status. 2) weight 3) renal function 4) mental state 1) coronary status Which of the following would be most appropriate to perform in the initial evaluation of a patient with symptoms of acute prostatitis? 1) Prostate-specific antigen (PSA) 2) Urinalysis and urine culture 3) Scrotal massage and urine sample 4) CBC with diff 2) urinalysis and urine culture Which of the following wet-mount results confirms a preliminary diagnosis of bacterial vaginosis? 1) Organisms about the size of white blood cells with undulating flagellum, occasional lactobacillus, many white blood cells 2) Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, many white blood cells 3) Squamous epithelial cells with stippling appearance and indistinct borders, many lactobacillus rods, few white blood cells 2) Squamous epithelial cells with stippling appearance and indistinct borders, no lactobacillus rods, many white blood cells Which of the following physical findings would best alert a nurse practitioner to the probability of a herniated lumbar disc? 1) Positive Patrick's sign, decreased thoracolumbar ROM, positive straight-leg raise at 90° 2) Decreased thoracolumbar ROM, positive crossed straight-leg raise, positive straight-leg raise at 30° 3) Negative Patrick's sign, decreased thoracolumbar ROM, positive straight-leg raise at 80° 2) Decreased thoracolumbar ROM, positive crossed straight-leg raise, positive straight-leg raise at 30° An 87-year-old obese female presents with complaints of calf pain in her right leg. The patient reports that the pain is increased with ambulation and has been increasing over the past 24 to 48 hours. The patient denies the following: any recent injury to the leg, smoking, or recent surgery. To assess this patient's symptoms, you would initially assess: 1) calf circumference and perform Doppler studies. 2) popliteal pulses and Doppler studies 3) Femoral pulses and skin temperature 4) Patrick's signs and popliteal pulses 1) calf circumference and perform Doppler studies What type of exercise would you recommend for a 74-year-old patient with hypertension and degenerative joint disease (DJD)? 1) Stationary bike 2) Aqua exercises 3) aerobic walking 2) Aqua exercises Trigeminal neuralgia 1) electric shock like unilateral pain 2) jaw pain extending to the neck 3) Bilateral burning pain 1) electric shock like unilateral pain A manifestation of autonomic neuropathy in a 70-year-old patient with diabetes mellitus is: 1) tremors. 2) orthostatic hypotension. 3) hypertension 4) color blindness 2) orthostatic hypotension The most common fluid and electrolyte imbalance in patients over 65 years of age is: 1) hypokalemia 2) due to dehydration. 3) Hypercalcemia 4) due to fluid overload 2) due to dehydration Office spirometry performed with an albuterol nebulizer treatment can confirm a diagnosis of asthma because it indicates: 1) a patient has pulmonary fibrosis 2) chronic carbon dioxide retension 3) if a patient has reversible airway obstruction. 3) if a patient has reversible airway obstruction. To assess ability to reason abstractly, you would ask the patient to: 1) the meaning of a common proverb 2) ask what they would do if there was a fire in the house 3) count backwards by 7's 1) the meaning of a common proverb A 66-year-old patient presents with bilateral otitis media with effusion and white patches in the mouth that do not rub off when wiped with a 4 × 4. The patient should be evaluated for: 1) lichen planus 2) HIV infection. 3) lymphoma 4) Candida lingua 2) HIV infection (hairy luekaplakia-immune) A 70-year-old patient presents with complaints of vague epigastric pain occurring at night, causing early morning awakening, and decreased appetite with early satiety. Significant history includes recent use of ibuprofen for headaches. Rectal examination was negative. While awaiting the results of ordered diagnostic tests, the practitioner should recommend all of the following EXCEPT: 1) starting H2 blockers. 2) taking off from work until the work-up is complete. 3) Reporting nausea/vomiting 4) Discontinue NSAIDS 2) taking off work until the work-up is complete A 32-year-old patient reports a 6-month history of intermittent symmetrical swelling of the wrists and daily morning stiffness lasting 1 hour or more in and around other joints. What is the most likely diagnosis? 1) Rheumatoid arthritis 2) Osteoarthritis 3) Gouty arthritis 1) Rheumatoid arthritis An 18-year-old college student presents for an athletic physical. When asked about current medications, she mentions she takes "some herb" she bought at the health food store for migraines and menstrual cramps. Which of the following herbal remedies has been commonly used for these conditions? 1) Echinacea 2) St. JOhn's Wort 3) ginko biloba 4) Feverfew 4) Feverfew The most common bacterial agents responsible for pneumonia in older adults residing in the community are: 1) Streptococcus pneumoniae and Haemophilus influenzae. 2) staphylococcus aureas and Haemophilus influenzae. 3) Psuedomonas aeruginosa and Klebsiella pneumonae 4) Legionnaires and streptococcus pneumoniae 1) Streptococcus pneumoniae and Haemophilus influenzae. Which cranial nerves test the oculomotor eye movement and strabismus? 1) CN I III, IV 2) CV III, IV and VI 3) CN III, V, VII 2) CV III, IV and VI The management of COPD in the elderly is best guided by: 1) pulse oximetry 2) arterial blood gases 3) radiographic images 4) symptomology 4) symptomology Which of the following is the most serious outcome of Barrett's esophagus? 1) Esophageal adenocarcinoma 2) esophageal varices 3) GERD 4) Stricture 1) Esophageal adenocarcinoma Which of the following is most important in enhancing a nurse practitioner's clinical assessment when promoting health behaviors in young adults? 1) Personality 2) Include the parents with the pateint 3) Taking developmental stages into consideration 4) Provide a chart of growth physical changes 3) Taking developmental stages into consideration Pulmonary status findings of increased total lung capacity and residual volume in a 74-year-old patient are indicative of: 1) emphysema. 2) COPD 3) chronic bronchitis 4) Asthma 1) emphysema A 65-year-old patient with hypertension and associated angina requests a flu vaccine. The patient had a pneumococcal vaccine 10 years ago. The most appropriate plan of care would include: 1) influenza vaccine, 0.5 mL IM, 2) influenza vaccine, 0.5 mL IM, and pneumococcal vaccine, 0.5 mL IM. 3) pneumococcal vaccine, 0.5 mL IM. 2) influenza vaccine, 0.5 mL IM, and pneumococcal vaccine, 0.5 mL IM. An 87-year-old patient is being treated for major depression with a selective serotonin reuptake inhibitor. Which of the following would have the greatest probability of remaining in the serum long after being discontinued? 1) Celexa 2) Prozac 3) Paxil 4) Zoloft 2) Fluoxetine (Prozac) Age-related macular degeneration leads to which of the following? 1) Loss of central vision 2) Loss of peripheral vision 3) hemianopsia bilateral 1) loss of central vision The approved therapeutic International Normalized Ratio (INR) for a patient on warfarin (Coumadin) therapy for atrial fibrillation is: 1) 1.0-2.0 2) 2.0-3.0 3) 2.5-3.5 2) 2.0-3.0 A 57-year-old patient presents for a physical examination. The patient has been in good health, takes no medications, has a family history of hypertension and heart disease, denies alcohol use, and has never smoked. The patient's last tetanus booster was 9 years ago. Which of the following vaccines is indicated at this time? 1) TD 2) Influenza 3) PNA 4) Hep B 2) Influenza A patient with a diagnosis of diverticulosis presents with localized left lower quadrant discomfort, a palpable mass, mild leukocytosis, and T = 100° (37.8°C). The patient does not appear toxic and can tolerate fluids. An appropriate plan should include: 1) NPO, BARIUM enema 2) low fiber diet and referral to GI 3) clear liquids and oral antibiotics. 4) admit to hospital 3) clear liquids and oral antibiotics. A frail elder who is on total bed rest suddenly develops urinary and fecal incontinence. This condition is frequently an indication of: 1) dementia. 2) fecal impaction. 3) cholecystitis. 4) parkinsons. 2) fecal impaction. A 65-year-old female with diabetes mellitus presents for a routine follow up. BP is 142/88, Hgb A1c is 8.4%, fasting blood glucose is 160 mg/dL, and microalbumin is 60 mg/L (normal < 30 mg/L). In addition to changing the diabetes medications, the nurse practitioner would also ensure that the patient is taking: 1) nifedipine 12.5mg daily 2) Amlodipine 10mg daily 3) benazepril, 10 mg daily. 4) atenolol 25mg BID 3) benazepril, 10 mg daily. A 67-year-old patient with type 2 diabetes mellitus, congestive heart failure (CHF), and mild coronary artery disease is currently taking digoxin, 0.25 mg daily; hydrochlorothiazide, 25 mg daily; glipizide, 10 mg daily; and atorvastatin (Lipitor), 20 mg h.s. Which of the following is an accurate statement regarding this regimen? 1) Glipizide will deplete potassium stores 2) The hydrochlorothiazide will predispose the patient to digoxin toxicity. 3) atorvastatin will worsen the diabetes 2) The hydrochlorothiazide will predispose the patient to digoxin toxicity. An 18-year-old patient presents with complaints of maxillary facial pain and yellow nasal discharge for 14 days. What is the appropriate initial pharmacologic intervention? 1) Amoxicillin 2) Diphenhydramine 3) Doxycycline 4) erythromycin 1) Amoxicillin Therapy for temporal arteritis would include: 1) Tylenol with codiene 2) ibuprofen 800mg TID 3) prednisone, 60 mg daily PO and re-evaluate in 1 month. 3) prednisone, 60 mg daily PO and re-evaluate in 1 month. In addressing suspected domestic violence in an adult relationship, it is appropriate to: 1) just do a physical assessment, not social 2) make an assessment of battering. 3) avoid making a battering assessment, it is legal 2) make an assessment of battering. Over the past 6 months, a nurse practitioner has been treating a 62-year-old construction worker for chronic/recurrent right biceps tendonitis. He has had good and bad days, but seems to respond well to NSAIDs and muscle relaxants. Today he returns to the clinic after feeling a "snapping" sensation in his right upper arm while lifting a cinder block. To aid in diagnosis, the nurse practitioner would evaluate: 1) Right shoulder ROM, and strength 2) for the presence of right upper arm bulge ("Popeye muscle") and biceps strength. 3) radial pulses and right biceps tendon 4) right supination/pronation 2) for the presence of right upper arm bulge ("Popeye muscle") and biceps strength. Which of the following accurately describes the phenomenon of isolated systolic hypertension, as opposed to isolated diastolic or combined systolic/diastolic hypertension, in the elderly? 1) Considered a significant risk factor for MI or stroke 2) demonstrated to be related to smoking 3) Occurs primarily in men 4) Not considered to be a major risk 1) Considered a significant risk factor for MI or stroke An 87-year-old long-term care facility resident was hospitalized for an abdominal surgery procedure, and the incision has become infected with methicillin-resistant Staphylococcus aureus (MRSA). The hospital is planning to return the patient to the same facility, which has no private rooms. According to CDC guidelines, the alternative placement would be to: 1) inform the hospital that the patient will have to go to another facility. 2) have the patient share a room with a resident who also has MRSA. 3) have the patient share a room with a resident who has VRSA. 4) Delay discharge until the wound is clear 2) have the patient share a room with a resident who also has MRSA. Which of the following laboratory tests are most widely accepted as indicators of the progression of HIV infection? 1) CD4 count and viral load 2) CD4 and Western Blot 3) CD4 and ELISA 4) WBC count and viral load 1) CD4 count and viral load Which class of antihypertensive agents has been associated with acute renal failure, and is absolutely CONTRAINDICATED in patients with bilateral renal artery stenosis? 1) Thiazide diuretics 2) Angiotensin-converting enzyme (ACE) inhibitors 3) Calcium channel blockers 4) Potassium sparing diuretics 2) Angiotensin-converting enzyme (ACE) inhibitors In geriatric patients, the polyvalent pneumococcal vaccine: 1) prevents or lessens the severity of 60%-70% of pneumococcal infections. 2) has no affect on immunocompromised patients 3) prevents pneumonia 100% of the time 1) prevents or lessens the severity of 60%-70% of pneumococcal infections A 39-year-old patient was diagnosed with acute bronchitis in the emergency department and treated with acetaminophen, dextromethorphan, and metaproterenol (Alupent). The patient's history reveals a smoking habit of 1 pack per day. He now presents to your office with a fever of 101.2°F (39.4°C) and a cough productive of thick, yellow-green, foul-smelling sputum. You would encourage smoking cessation and prescribe: 1) a penicillin antibiotic 2) a macrolide antibiotic. 3) theophylline 4) inhalors 2) macrolide antibiotic A 68-year-old female presents with a 3-week history of itching that increases in intensity at night. Red papules with scale crusts are noted on the axilla, groin, and interdigital webs of the hands. The most likely diagnosis is: 1) xerosis 2) herpes zoster 3) eczema 4) scabies. 4) scabies A 68-year-old male with Parkinson's disease was placed on haloperidol (Haldol), 1 mg PO t.i.d. after presenting in the emergency department with visual and auditory hallucinations. On a visit to the office 2 days later for follow-up, the immediate course of action should be to: 1) decrease the dose of haloperidol. 2) prescribe a more potent neroleptic 3) discontinue the haloperidol. 4) add SSRI 3) discontinue the halperidol A 70-year-old farmer was hit in the eye with a tree branch. The first step in the assessment of a possible corneal abrasion is to: 1) check for pupillary reaction. 2) measure visual acuity. 3) irrigate the eye 4) perform a fundoscopic exam 2) check for visual acuity Which of the following is considered the most important factor in understanding and predicting an individual's health across the life span? 1) Psychological profile 2) Body habitus 3) Family history 4) diet history 3) family history A 68-year-old patient with a recent diagnosis of mild transient ischemic attack has been placed on aspirin, 325 mg PO daily with food. The patient develops an aspirin allergy. You would discontinue aspirin and: 1) change to clopidogrel (Plavix). 2) change to valproic acid 3) refer for endoarectomy 4) change to bulibital 1) change to clopidorel An 85-year-old female presents with a 2-hour history of diminished vision and severe pain in the right eye, plus nausea and vomiting. Visual acuity is decreased, the left pupil reacts to light, the right pupil does not react to light, and the conjunctiva is injected. The nurse practitioner would: 1) immediately refer to an ophthalmologist. 2) administer steroids 3) complete a comprehensive eye vision test 4) administer pilotarpine eye drops 1) immediately refer to an ophthalmologist. (acute angle closure glaucoma) Which of the following statements about preventive health care for the elderly is incorrect? 1) Elderly people usually have adequate insurance coverage. 2) CALORIC needs are reduced in the elderly 3) femoral fractures are caused by uncoordinated muscle action than by the impact of the fall 4) Exercise EB to reduce mortality from CAD 1) Elderly people usually have adequate insurance coverage. 1. An older adult presents with severe abdominal pain. The husband reports that earlier in the afternoon, the patient's abdominal hernia had been firm and bulged out 4 inches (10.2 cm). The patient had him press on the hernia and immediately felt burning pain throughout the abdomen. Which of the following is the nurse practitioners' NEXT action? 1. Abdominal CT scan 2. Complete blood count with differential 3. Abdominal ultrasound 4. Referral to the ED 4. Referral to the ED 2. A young adult female who is 34 weeks pregnant presents with the complaint of urinary frequency every 1 to 2 hours. The patient has no fever and denies back pain. A urine dipstick test is positive for leukocyte esterase and nitrites. Microscopic analysis reveals 15-20 WBCs/hpf and a few bacteria. The BEST choice for treatment of this patient's urinary tract infection would be: 1. trimethoprim-sulfamethoxazole (Bactrim), 160 mg/800 mg twice daily for 3 days. 2. cephalexin (Keflex), 500 mg four times daily for 7 days. 3. ciprofloxacin (Cipro), 500 mg twice daily for 7 days. 4. erythromycin, 250 mg three times daily for 5 days. 2. cephalexin (Keflex), 500 mg four times daily for 7 days. 3. An adult male presents with new-onset pain and tenderness in the low back and pain in the right great toe after a weekend of golf. He denies experiencing numbness and tingling. Which of the following would the nurse practitioner expect to find an investigation of this patient's low back pain? 1. Exacerbation of extremity symptoms with straight-leg raising 2. Loss of bowel and bladder function 3. Increased ankle jerk on evaluation of deep tendon reflexes 4. Increased lumbar lordosis 1. Exacerbation of extremity symptoms with straight-leg raising 4. A true statement about essential tremors is that they: 1. often begin with "pill-rolling" of one hand and may affect the legs, feet, and toes. 2. are often barely visible, rapid tremors. 3. are a characteristic of Parkinson's disease. 4. are slow tremors that are absent or minimal at rest and usually involve the hands. 4. are slow tremors that are absent or minimal at rest and usually involve the hands. 5. Which opioid medication is the MOST potent? 1. Codeine 2. Morphine 3. Oxycodone 4. Hydromorphone 4. Hydromorphone 6. Which symptom documented in a menstrual diary is diagnostic of PMS? 1. Irritability 2. Decreased libido 3. Menstrual cramps 4. Dyspareunia 1. Irritability 7. Which of the following is the medication of choice for monotherapy of an older adult with hypertension and no related comorbid conditions? 1.Alpha-blocker 2.Vasodilator 3.Thiazide diuretic 4.Beta-blocker 3.Thiazide diuretic 8. An elderly, obese female presents for evaluation of a painful rash, first noticed 2 weeks ago, located under both breasts. The rash is visible as an area of confluent, beefy-red, excoriated lesions with smaller satellite lesions extending beyond the borders of the main lesions. The KOH prep reveals pseudohyphae. The nurse practitioner would recommend a/an: 1. course of oral steroids and air drying of skin after showers. 2. topical antifungal and order a fasting blood glucose. 3. oral antibiotic and order a hemoglobin A1c. 4. high-potency topical corticosteroid and use of dry dressings. 2. topical antifungal and order a fasting blood glucose. 9. An older adult female complains of problems with urination. She reports that whenever she feels the need to urinate, she is unable to "make it to the bathroom in time," and wets herself. Which type of incontinence is MOST likely? 1. Urge 2. Overflow 3. Transient 4. Stress 1. Urge 10. A young adult female presents with painful swelling of the right cheek anterior to the TMJ. The diagnosis is sialadenitis. In addition to antibiotics, treatment for this patient should include: 1. hot soaks and lemon drops. 2. alternating heat and cold. 3. cold compresses and massage. 4. hot soaks and mucolytics. 1. hot soaks and lemon drops. 11. Initial therapy for older adult patients with arthritic joints is: 1. naproxen, 1000 mg twice daily. 2. ibuprofen, 600 mg four times daily. 3. glucosamine, 750 mg twice daily. 4. acetaminophen, 1000 mg four times daily. 4. acetaminophen, 1000 mg four times daily. 12. Which of the following is an example of gross negligence? 1. Prescription of a drug that causes a fatal allergic reaction 2. Misdiagnosis of appendicitis, resulting in peritonitis and a prolonged hospital stay 3. Refusal to return the emergency phone call of a patient who has chest pain evolving into an MI 4. Failure to diagnose a problem at an unrelated routine visit 3. Refusal to return the emergency phone call of a patient who has chest pain evolving into an MI 13. What is the correct order of pharmacokinetics of drugs in the body? 1. absorption, distribution, metabolism, excretion 2. distribution, absorption, metabolism, excretion 3. absorption, metabolism, distribution, excretion 4. metabolism, distribution, absorption, excretion 1. absorption, distribution, metabolism, excretion 14. An older adult female is brought in by her daughter, who has been visiting her. The daughter reports that her mother seems confused and anxious, and is moving oddly as if she is stiff. The daughter has brought along the mother's medications. She is taking hydrochlorothiazide, levothyroxine (Synthroid), sertraline (Zoloft), baby aspirin, a multivitamin, and St. John's wort. Which condition would the nurse practitioner MOST urgently suspect? 1. Alzheimer's disease 2. Serotonin syndrome 3. Vascular dementia 4. Aspirin toxicity 2. Serotonin syndrome 15. An adolescent male presents with marked itching in the inguinal region but not on the scrotum. Examination shows a peripherally-spreading, sharply-demarcated, centrally-clearing, erythematous lesion. The MOST likely diagnosis is: 1. poor hygiene. 2. tinea versicolor. 3. pediculosis pubis. 4. tinea cruris. 4. tinea cruris. 16. A young adult presents with a 3-day history of a sore throat, fever [102°F (38.9°C)], and malaise. Physical examination reveals posterior cervical lymphadenopathy and splenomegaly. A complete blood count (CBC) reveals a lymphocytosis. Which of the following patient care instructions is MOST appropriate? 1. Avoid strenuous activity and contact sports until advised. 2. Restrict symptomatic antipyretic therapy to acetaminophen. 3. Restrict symptomatic antipyretic therapy to NSAIDs. 4. Avoid close contact with others for 2 weeks. 1. Avoid strenuous activity and contact sports until advised. 17. A nurse practitioner is treating an adult with iron deficiency anemia. At what point would the hematocrit level be expected to return to baseline? 1. 3 weeks 2. 2 months 3. 6 months 4. 1 year 2. 2 months 18. An older adult complains of fatigue, stiffness in the shoulders and neck, recent onset of temporal headache, and an episode of transient visual loss in one eye. Erythrocyte sedimentation rate (ESR) is 72 mm/h [normal value = <15 mm/h]. These findings are consistent with: 1. migraine headache. 2. glaucoma. 3. giant cell (temporal) arteritis. 4. Sjögren's syndrome. 3. giant cell (temporal) arteritis. 19. The triple approach for evaluation of a dominant breast mass in an adult female includes a clinical breast examination, mammography, and: 1. bilateral ultrasound. 2. ductal lavage. 3. fine-needle aspiration. 4. MRI. 3. fine-needle aspiration. 20. Which of the following drugs is the BEST choice for prevention of coronary artery disease in elderly patients? 1. Enteric-coated ASA 2. Warfarin (Coumadin) 3. Dipyridamole-ASA (Aggrenox) 4. Clopidogrel (Plavix) 1. Enteric-coated ASA 21. An older adult presents with vague epigastric pain occurring at night, causing early morning awakening, and decreased appetite with early satiety. Significant history includes recent use of ibuprofen for headaches. Which is the MOST likely diagnosis? 1. Gastroparesis 2. Reflux esophagitis 3. Duodenal ulcer 4. Crohn's disease 3. Duodenal ulcer 22. An older adult female is diagnosed with urge urinary incontinence. The patient is alert and cognitively intact. The MOST appropriate management is: 1. urinating frequently to avoid urgency. 2. bladder retraining. 3. wearing protective garments, such as continence pads. 4. reducing fluid intake to four 8-oz glasses a day. 2. bladder retraining. 23. Which of the following asymptomatic skin conditions can an older adult manage at home? 1. Actinic keratosis 2. Basal cell lesions 3. Seborrheic keratosis 4. Squamous cell lesions 3. Seborrheic keratosis 24. The MOST common bacterial cause of cellulitis in patients with diabetes mellitus is: 1. group A beta-hemolytic Streptococcus. 2. Vibrio vulnificus. 3. Pseudomonas aeruginosa. 4. Staphylococcus aureus. 4. Staphylococcus aureus. 25. An adult with coronary artery disease has had angioplasty twice, as well as a two-vessel bypass graft. The patient presents with increasing shortness of breath, dyspnea on exertion, paroxysmal and nocturnal dyspnea, and mild edema of the lower extremities. Which of the following findings is MOST likely? 1. Diastolic murmur 2. Systolic ejection murmur 3. Pericardial friction rub 4. Third heart sound 4. Third heart sound 26. An elderly male farmer presents with an oval, pearly nodule, 0.6 inch (1.5 cm) long, on the lower eyelid. The lesion has a rolled, translucent border and is surrounded by multiple small telangiectasias. The MOST likely diagnosis is: 1. actinic keratosis. 2. chancre of syphilis. 3. dermatofibroma. 4. basal cell carcinoma. 4. basal cell carcinoma. 27. Which of the following is the MOST common type of hearing loss in older adults? 1. Otitis media 2. Heredity 3. Conductive 4. Sensorineural 4. Sensorineural 28. An elderly male who is a pipe smoker presents with a non-healing ulcerative lesion of the lower lip. Biopsy of the lesion reveals squamous cell carcinoma. What is the INITIAL recommendation for management? 1. Surgical excision 2. Radiation therapy 3. Chemotherapy 4. Watchful waiting 1. Surgical excision 29. An older adult female presents with loss of appetite and dark stools. Physical examination of the abdomen produces normal results. Rectal examination reveals stools positive for blood. Current medications include a calcium channel blocker, a selective serotonin reuptake inhibitor, a bisphosphonate, and a statin. Which medication should be held until an evaluation can be completed? 1. Statin 2. Bisphosphonate 3. Selective serotonin reuptake inhibitor 4. Calcium channel blocker 2. Bisphosphonate 30. Which of the following are risk factors for the development of osteoporosis? 1. High caffeine intake, hypertension, and breastfeeding 2. Smoking, diabetes mellitus, and low calcium intake 3. Drinking fluoridated water, hypothyroidism, and excess exercise 4. Early menopause, low calcium intake, and low body weight 4. Early menopause, low calcium intake, and low body weight 31. A man calls to report that his elderly wife awakened this morning with confusion, slurred speech, and paresthesia of her right arm and leg. Although no prior episodes of these symptoms have been reported, the woman's medical history reveals that she has diabetes and hypertension. At present, her symptoms have resolved. Based on the symptoms reported, what is the MOST likely diagnosis? 1. Hypoglycemic episode 2. Hypothyroidism 3. Right-sided CVA 4. Transient ischemic attack 4. Transient ischemic attack 32. An older adult with a history of hypertension and atrial fibrillation is brought to the ED after a fall. She is diagnosed with a fracture of the neck of the left femur and has left open reduction internal fixation (ORIF). She is discharged for rehabilitation on enoxaparin (Lovenox), 30 mg SC twice daily. On the third day of rehabilitation, she reports increased swelling and tightness of the left leg. She is hospitalized for acute respiratory distress and placement of a Greenfield filter. The usual indication for this filter is: 1. prevention of cerebral embolism. 2. atrial fibrillation. 3. clot migration. 4. venous insufficiency. 3. clot migration. 33. Which of the following symptoms of depression is more commonly seen in older adults rather than younger adults? 1. Cognitive impairment 2. Loss of interest in usual activities 3. Inattention to personal hygiene 4. Hopelessness 1. Cognitive impairment 34. A young adult with a history of allergic rhinitis presents with facial pain, congestion, eye pain, and fatigue. She has frontal sinus tenderness and yellow nasal discharge. Chart review reveals that she has completed two courses of amoxicillin (Amoxil) within the past 30 days. Which action should the nurse practitioner take? 1. Prescribe oral corticosteroids. 2. Transilluminate the sinuses. 3. Change the antibiotic to amoxicillin-clavulanic acid (Augmentin). 4. Refer the patient to ENT and/or an allergist. 4. Refer the patient to ENT and/or an allergist. 35. An older adult male presents to the office with abdominal pain for three days. The left lower quadrant pain is constant. He has nausea, vomiting, diarrhea, and fever. On physical exam, there is guarding, a palpable mass, and hypoactive bowel sounds. These symptoms are consistent with: 1. appendicitis. 2. Crohn's disease. 3. diverticulitis. 4. colitis. 3. diverticulitis. 36. An older adult male presents with a sudden onset of severe, tearing chest pain that radiates to the back. What is the MOST likely working diagnosis? 1. Pulmonary embolism 2. Aortic dissection 3. Pancoast tumor 4. Spinal cancer 2. Aortic dissection 37. An older adult with a history of hypertension and atrial fibrillation is brought to the ED after a fall. She is diagnosed with a fracture of the neck of the left femur and has left open reduction internal fixation (ORIF). She is discharged for rehabilitation on enoxaparin (Lovenox), 30 mg SC twice daily. On the third day of rehabilitation, she reports increased swelling and tightness of the left leg. The nurse practitioner would order a/an: 1. arterial Doppler. 2. arteriogram. 3. venous duplex ultrasound. 4. venous pyelogram. 3. venous duplex ultrasound. 38. The presence of anti-HBs in a patient's blood is MOST often an indicator of: 1. HIV infection. 2. immunity to hepatitis B virus. 3. acute hepatitis B. 4. cirrhosis. 2. immunity to hepatitis B virus. 39. A patient presents with unilateral ear pain of 1-week duration, nasal congestion, and a sore throat. Physical examination reveals an opaque, hypomobile left tympanic membrane. The nurse practitioner performs a tuning fork test, expecting to find that the: 1. Weber test shows lateralization to the left. 2. air conduction threshold is greater than bone conduction on the left. 3. air conduction threshold is less than bone conduction on the right. 4. Weber test shows lateralization to the right. 1. Weber test shows lateralization to the left. 40. An adult female was recently diagnosed with hypothyroidism. The nurse practitioner starts the patient on levothyroxine (Synthroid). In evaluating proper treatment of this patient, the MOST appropriate laboratory test the nurse practitioner should order is: 1. thyroid-stimulating hormone (TSH). 2. follicle-stimulating hormone (FSH). 3. T 3 -T 4. 4. cholesterol. 1. thyroid-stimulating hormone (TSH). 41. An elderly female has been living with her 70-year-old, widowed daughter and granddaughter. The patient's daughter schedules an appointment with a nurse practitioner to "discuss a few things." She reports that she now has sole responsibility for the care of her mother, because her daughter has moved out of state. As the patient's daughter talks, she begins to cry. She does not want to put her mother into a nursing facility, but feels unable to continue to care for her alone. Which of the following is the BEST initial step in assisting this patient? 1. Refer the patient's daughter to a social worker for counseling. 2. Discuss community resources available to provide assistance and respite care. 3. Review placement options. 4. Call the granddaughter to discuss the situation. 2. Discuss community resources available to provide assistance and respite care. 42. An elderly patient with Stage 4 heart failure, severe COPD, and end-stage renal disease reports feeling very hopeless and says he is "close to death." What is the MOST appropriate intervention for this patient? 1. Discuss an antidepressant with the patient and family. 2. Explore the option of referring the patient to a hospice program. 3. Use motivational interviewing to help patient feel more hopeful. 4. Refer the patient to the activities coordinator for diversional activities. 2. Explore the option of referring the patient to a hospice program. 43. A healthy, older adult male has just had a normal yearly physical in a nurse practitioner's clinic. The patient has no chronic illnesses, and all results from screening tests performed in the clinic are normal. The BEST advice the practitioner can give is that it is: 1. important to undergo a dilated funduscopic examination every 1-2 years. 2. acceptable to delay examination by an ophthalmologist. 3. not necessary to undergo an examination. 4. particularly important to undergo an examination to evaluate for presbyopia. 1. important to undergo a dilated funduscopic examination every 1-2 years. 44. An older adult presents with left-side "rib pain" the past few days, headache, a feverish feeling, and general malaise. Physical examination reveals an area of papular eruptions with a few vesicles on the left side of the chest. What is the MOST likely cause of the patient's symptoms? 1. Herpes zoster 2. Eczema 3. Intertrigo 4. Actinic keratosis 1. Herpes zoster 45. A young adult presents with a 1-week history of excessive thirst, excessive urination, and persistent hunger. There is concern because the patient's grandmother had the same symptoms and was diagnosed with diabetes mellitus. The patient reports some nausea and flu-like sensations. On the basis of this information, which of the following tests would be MOST critical to the immediate diagnosis and treatment? 1. 24-hour creatinine 2. Serum glucose 3. 3-hour glucose tolerance test 4. Serum amylase 2. Serum glucose 46. An older adult female reports pain with intercourse. Following inspection of the genitalia, the nurse practitioner's initial plan of care would be to: 1. start vaginal hormone cream. 2. start low-dose hormones. 3. advise use of vaginal lubricants. 4. refer to a gynecologist for vaginal evaluation. 3. advise use of vaginal lubricants 47. An older adult presents with angina, dyspnea on exertion, and syncope. Examination reveals a delay in carotid upstroke, a paradoxically split S2 heart sound, and a harsh systolic murmur. Which of the following is the MOST likely diagnosis? 1. Aortic regurgitation 2. Aortic stenosis 3. Mitral valve prolapse 4. Chordae tendineae rupture 2. Aortic stenosis 48. A nurse practitioner is examining an adult male who has pain in his right hand. The patient fell onto his outstretched hand, jamming his thumb. He has pain in the "snuffbox" area. The patient's X-ray is negative. An appropriate follow-up evaluation would be to: 1. place the wrist in a universal wrist splint for 6 weeks. 2. check for full ROM in 3 days. 3. evaluate strength return in 1 week. 4. X-ray the wrist again in 2 weeks. 4. X-ray the wrist again in 2 weeks. 49. NSAIDs should be used with caution in the elderly because of the potential for causing: 1. bradykinesia. 2. acute renal failure. 3. hypotensive crisis. 4. pulmonary fibrosis. 2. acute renal failure. 50. "Natural" weight loss products may be extremely harmful to patients with potential cardiac problems if the products contain: 1. ephedrine sulfate. 2. St. John's wort. 3. kava kava. 4. melatonin. 1. ephedrine sulfate. 51. A patient with hypertension has a normal serum uric acid level. The patient is currently taking hydrochlorothiazide (HCTZ), 25 mg PO daily. The patient's blood pressure is very well controlled, and there are no symptoms of gout. In this situation, the nurse practitioner should: 1. get a 24-hour urine for uric acid determination. 2. discontinue the hydrochlorothiazide. 3. start the patient on allopurinol (Zyloprim), 300 mg PO daily. 4. continue the patient on the same medication. 4. continue the patient on the same medication. 52. An elderly patient with a history of smoking presents with increased pedal edema and dyspnea on exertion. The patient has a long history of poorly controlled blood pressure on physical examination. The nurse practitioner hears an S4 gallop and orders an echocardiogram. The results show an ejection fraction of 35%. Which diagnosis is MOST descriptive of these signs and symptoms? 1. Congestive heart failure 2. Mitral valve regurgitation 3. Pleural effusion 4. COPD 1. Congestive heart failure 53. Chest radiography of an older adult reveals a flat diaphragm, hyperaeration, and increased AP to lateral diameter. The nurse practitioner would suspect: 1. diaphragmatic hernia. 2. CHF. 3. COPD. 4. tension pneumothorax. 3. COPD. 54. Which of the following is the appropriate pharmacologic treatment for sudden sensorineural hearing loss to prevent permanent deafness? 1. Diuretics 2. Corticosteroids 3. Antibiotics 4. NSAIDs 2. Corticosteroids 55. An adolescent presents with a leg injury. The test for the anterior drawer sign should be performed to evaluate for which of the following orthopedic problems? 1. Knee effusion 2. Collateral ligament damage 3. Compartment syndrome 4. Anterior cruciate ligament damage 4. Anterior cruciate ligament damage 56. A young adult female presents because she fainted while in the bathroom putting on makeup. She recalls awakening on the floor but remembers nothing prior to awakening other than putting on makeup. She is alert, oriented, and afebrile. BP = 120/70, P = 72, R = 16/min. The NEXT step in the evaluation of this syncopal episode is: 1. radiographic testing. 2. a detailed health history. 3. a complete physical examination. 4. laboratory testing. 2. a detailed health history. 57. In addition to a complete blood count (CBC) which of the following diagnostic labs are included in the workup for dementia in an older adult? 1. Three blood cultures and magnesium 2. Creatinine and alkaline phosphate 3. Thyroid-stimulating hormone (TSH) and CMP 4. Alkaline phosphate and magnesium 3. Thyroid-stimulating hormone (TSH) and CMP 58. An adult presents with wheezing, dyspnea, "tight chest," tachycardia, chills, and nausea. The patient was diagnosed 2 weeks ago with hemorrhagic tonsillitis and treated with cephalexin (Keflex), followed by ciprofloxacin (Cipro). Diagnostic/laboratory assessment findings include: white blood count (WBC) = 22,500/μL (22.5 × 109/L); sputum culture shows Gram-positive cocci; chest X-ray shows right lower lobe infiltrates. Based on these findings, which of the following is the MOST appropriate diagnosis? 1. Right lower lobe atelectasis 2. Mycoplasma pneumoniae infection 3. Streptococcus pneumoniae infection 4. Methicillin-resistant Staphylococcus aureus 3. Streptococcus pneumoniae infection 59. An adult female who just became insured presents for an initial visit. She has been sexually active for at least 10 years, but has never had a Pap smear. The nurse practitioner assesses for higher risk of cervical intraepithelial neoplasia (CIN). Which of the following is MOST important to include in the history? 1. Number of previous pregnancies 2. Age of menarche 3. Number of sexual partners 4. Herpes infections 3. Number of sexual partners 60. What does a nurse practitioner tell an adult patient who presents with 3 days of nasal drainage and sinus pressure who wants antibiotics? 1. Antibiotics will be prescribed for 7 days to prevent the patient from being contagious. 2. Antibiotics are not indicated unless the symptoms have been present for 14 days or have worsened. 3. Prednisone will be prescribed to decrease the swelling inside the nose and decrease drainage. 4. A CT scan will be ordered in order to diagnose an acute rhinosinusitis. 2. Antibiotics are not indicated unless the symptoms have been present for 14 days or have worsened. 61. Prior to initiating thiazide diuretics for a new patient with hypertension, which of the following is the MOST important baseline data? 1. Chest X-ray 2. Electrolytes 3. Urinalysis 4. EKG 2. Electrolytes 62. An elderly nursing facility resident has had a cough for the past month. The patient has been treated with prednisone for wheezing. A tuberculosis test administered one year ago was negative. In addition to a chest X-ray, which is the NEXT BEST test to order? 1. Complete blood count (CBC) 2. Interferon gamma release assay (IGRA) 3. Sputum culture 4. Tuberculin tine test 2. Interferon gamma release assay (IGRA) 63. Neurological symptoms of pernicious anemia are: 1. loss of coordination and fine motor control. 2. focal seizures and loss of coordination. 3. muscle weakness and paralysis. 4. headaches and muscle weakness. 1. loss of coordination and fine motor control 64. The MOST likely suspected diagnosis in an elderly patient who has been exhibiting a progressive decline in cognitive status would be: 1. an occult infection. 2. myocardial infarction. 3. Alzheimer's dementia. 4. subdural hematoma. 3. Alzheimer's dementia. 65. During the past 24 hours, an older adult has experienced abdominal pain that radiates to the back. The patient also reports several episodes of nausea and vomiting, a low-grade temperature, and a history of excessive drinking. Physical examination reveals a distended abdomen. Laboratory serum values indicate elevated alkaline phosphatase, amylase, and serum lipase. The MOST likely diagnosis is: 1. alcoholic liver disease. 2. perforated duodenal ulcer. 3. acute cholecystitis. 4. acute pancreatitis. 4. acute pancreatitis. 66. A young adult male is triaged to the fast-track area to repair a cut on his third digit. The injury occurred while he was deboning a chicken. In addition to evaluating the finger for tendon rupture and foreign body, an important component of his treatment should include which of the following? 1. Assessing tetanus immunization status 2. Scrubbing the wound with Betadine solution 3. Assessing for salmonella infection 4. Irrigating vigorously with sterile water 1. Assessing tetanus immunization status 67. Which of the following would a nurse practitioner expect to find in a patient with bacterial vaginosis? 1. Positive "whiff" test 2. Anal pruritus 3. Frequent urination 4. pH < 4.5 1. Positive "whiff" test 68. What is the MOST important aspect of health promotion and disease prevention in the elderly? 1. Minimizing the impact of disease on functioning 2. Preventing the occurrence of disease 3. Preventing age-related changes in the immune system 4. Minimizing the occurrence of risky behaviors 1. Minimizing the impact of disease on functioning 69. An older adult is taking multiple medications for hypertension, hyperlipidemia, and COPD. The patient's laboratory values are checked every 3 months. The serum creatinine level has shown significant increases at each of the two most recent measurements. Which of the following medications could be contributing to the serum creatinine increase? 1. Angiotensin-converting enzyme (ACE) inhibitor 2. Calcium channel blocker 3. Corticosteroid 4. HMG-CoA reductase inhibitor 1. Angiotensin-converting enzyme (ACE) inhibitor 70. If a nurse practitioner suspects malignant otitis externa, an urgent referral must be made to a(n): 1. audiologist. 2. otolaryngologist. 3. neurologist. 4. vestibular specialist. 2. otolaryngologist. 71. A nurse practitioner suspects that an older adult, obese patient may have obstructive sleep apnea. The patient cannot afford a sleep study. Screening of this patient for sleep apnea could be completed by: 1. spot pulse oximetry. 2. home nocturnal pulse oximetry. 3. echocardiography. 4. arterial blood gases. 2. home nocturnal pulse oximetry. 72. Which factor carries the HIGHEST risk for breast cancer? 1. Age at first live birth 2. Age at menopause 3. Use of oral contraceptives 4. First-degree female relative 4. First-degree female relative 73. An older adult male comes to the clinic having had bright red rectal bleeding for the past 2 weeks. There is no family history of colon cancer. He denies weight loss, abdominal pain, or changes in stool color or shape. The patient recently had an episode of constipation that was relieved by over-the-counter laxatives. Which of the following diagnostic procedures would be completed FIRST? 1. Abdominal ultrasound 2. Barium colon X-ray 3. CT scan 4. Colonoscopy 4. Colonoscopy 74. Routine cervical Papanicolaou screening is categorized as which type of prevention? 1. Primary 2. Secondary 3. Tertiary 4. Routine 2. Secondary 75. An elderly female presents with postmenopausal bleeding. The MOST likely diagnosis is: 1. endometriosis. 2. uterine leiomyoma. 3. endometrial carcinoma. 4. vulvar carcinoma. 3. endometrial car [Show More]

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