NR 603 Week 4 APEA Predictor Exam Review Questions-Answers

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A patient report that she is taking kava kava regularly for anxiety with the results. What should the nurse practitioners evaluate? A person with 20/80 vision: One exception to the recommendation to... limit dietary fat intake The most effective treatment for anemia of chronic disease is: Salicylates and other non-steroidal anti-inflammatory agents have all of the following actions EXCEPT- Which of the following does NOT increase a woman’s risk of developing cervical cancer? All of the following principles apply to drug therapy for elders except A female patient believes that she was exposed to HIV through sexual intercourse several months ago. She asks for “the test for AIDS.” Which statement is NOT correct? The nurse practitioner teaches the parents of a 2-month-old infant with GERD that treatment typically includes all of the following interventions except A widowed 85-year-old was recently moved from her home of 65 years to a bedroom in her daughter’s home. According to reports by family members, she is now “cantankerous” gets “mixed up” easily and cries for no apparent reason. Factors in the client history that are consistent with delirium may include all of the following except The two tests that can indicate current infection with hep B are: A characteristic of elders which affects the pharmacotherapeutics of drug therapy in that population is an increase in An elder’s caretaker is planning the elder’s menu. The elder is on a bland diet. The nurse practitioner reviews the meal plans and notes that which of the following is NOT appropriate? The leading cause of death from injury in childhood is Therapeutic International normalized ratio (INR) for a patient taking warfarin (coumadin) for a chronic atrial fibrillation is expected to be: The most accepted recommendation regarding a skin cancer prevention is: Antibiotic administration has been demonstrated to be of little benefit in the treatment of which of the following disease processes? An anxious parent brings her three-day old female infant to see the nurse practitioner because of the serosanguineous vaginal discharge. The nurse practitioner tells the mother: A common finding associated with temporal arteritis is: What information would best help the parent who is concerned about a school age child eating habits? Which of the following scenarios in a 75-year-old patient would be inappropriately managed in an outpatient setting (i.e. the patient should be referred for hospital admission)? A patient with diabetes brings his glucose diary from the past seven days for the nurse practitioner to review and evaluate. What changes should be made? Day one through Appropriate nutritional guidance for the pregnant patient is: The most successful patient interview is likely to: RhoGAM is not administered to an Rh-negative mother with negative anti-d antibodies The most common presentation of thyroid cancer is A benign thyroid nodule, that’s painless presents as SMOOTH Initial treatment of a child presenting with a severe head injury is: Which red blood cell (RBC) index is most useful for differentiating types of anemias? A 31-year-old female is informed that her pregnancy test is positive, and she is about three weeks pregnant. The nurse practitioner is very concerned about the patient reported history of alcohol use. She correctly tells the patient that babies born to women who drink alcohol during pregnancy are at risk for all of the following except: According to Erikson, the developmental task of the early adult is: The parents of a two-year-old Report that she is not saying any words, but make sounds, babbles, and understand simple commands from her parents. The parents are not concerned. The nurse practitioner responds: Which group is considered to be at high risk for the development of testicular tumors? An urgent call is received from a patient’s wife who states that her husband is having chest pain I’m relieved by three nitroglycerin tablets. The nearest hospital is 40 minutes away. Besides having the patient reach the hospital as soon as possible, what intervention can the nurse practitioners suggest might influence a positive outcome? Which of the following postpartum mothers should receive RhoGAM (BayRho-D) to prevent Rh iso-immunization? A patient with a history of alcohol abuse presents with acute nausea, vomiting, and severe retrosternal pain that radiates to the back. Based on the most probable diagnosis, the nurse practitioner would appropriately order a CBC, chemistry profile, and: A female patient asks, “how do I calculate my ideal body weight?” The nurse practitioner response: A 35-year-old woman with prior history of extreme nervousness has been treated with diazepam (valium) for four weeks. She reports improvement. Today her pulse is 112bpm and blood pressure is 130/92 mmHg. She is 5’4” in weighs 105 pounds. What is the most likely diagnosis? Which of the following is not a common early sign of benign prosthetic hyperplasia (BPH)? Acute idiopathic thrombocytopenia purpura (ITP) is most commonly seen in childhood following: The nurse practitioner diagnosis epididymitis in a 24-year-old sexually active male patient. The drug of choice for treatment of this patient is: A 55-year-old man is … with basal cell carcinoma. The nurse practitioner correctly tells him: A characteristic of delirium that is typically absent and dementia is: A 42-year-old male executive has been … with depression. He is otherwise healthy. And appropriate initial treatment choice is a: the CAGE/ AUDIT questionnaire is useful to assess: A 16-year-old athlete complains of pain underneath his heel every time he walks. There is verrucous surface level with the skin of the heel. What pharmacologic intervention should the nurse practitioner prescribed for this patient? Previously immunized elderly patients should receive a tetanus and diphtheria (Td) booster every: The nurse practitioner is canceling a young woman who desires pregnancy. She discontinued her oral contraceptives for months ago. Her urine pregnancy test is negative. She expresses concern that she might have an infertility problem. The nurse practitioner accurately tells her that a couple is not considered infertile until there has been unprotected intercourse without conception for what period of time? When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action? An eight-year-old female has been brought to the nurse practitioner on five occasions in the past nine weeks with a complaint of abdominal pain. The evaluation each time is negative, but her mother is convinced the child is truly experiencing pain. The most likely diagnosis is: What is the most common cause of Cushing’s syndrome? Which of the following maternal situations is considered an absolute contraindication to breast-feeding? A three-year-old male patient is being evaluated by a nurse practitioner for frequent respiratory infections and fatigue. His laboratory test show thrombocytopenia, granulocytopenia, and anemia. Which of the following is consistent with these lab bindings? Factors known to be associated with early sexual activity include: A 26-year-old female presents with elbow pain that is described as aching in burning. There is point tenderness along the lateral aspect of the elbow and painful passive flexion and extension. She reports she has been playing tennis almost daily for the past month. The most likely diagnosis is: A two-year-old African-American child is being evaluated by the nurse practitioner. His clinical appearance and history are consistent with sickle cell anemia. What is the appropriate laboratory test to diagnose sickle cell anemia? Which activities are not characteristic of preschool children? What type of question is most useful when opening an interview? All of the following agents/ medication classes are generally contraindicated in pregnancy except: A 35-year-old female with a history of mitral valve prolapse is scheduled for routine dental cleaning. According to the 2007 American Heart Association’s guidelines for endocarditis prophylaxis, what would you advise this patient? What diabetic complications result from hyperglycemia? Which of the following diagnostic assessments must be considered before developing any plan of care for a 27-year-old female presenting to a family practice clinic? The process by which a professional association confers recognition that a licensed professional has demonstrated mastery of a specialized body of knowledge and skills is termed: A 15-year-old male has a history of cryptorchidism which was surgically repaired. Because of this information, it is essential for a nurse practitioner to teach him about: A 30-year-old female comes into a clinic with classic signs and symptoms of appendicitis. The nurse practitioner fails to refer the patient tree surgeon. D appendix ruptured and the woman dies. This is an example of: And elderly patient is being seen in the clinic for a complaint of “weak spells” relieved by sitting or lying down. The nurse practitioner checks the patient’s blood pressure while he is lying, sitting, and standing. The nurse practitioner suspects: The nurse practitioner knows that the frail elderly alright high risk for malnutrition. Indicators of malnutrition in this population included all of the following except: The patient reports, “something flew in my eyes” about an hour ago while he was splitting logs. If there was a foreign body in his eye, the nurse practitioner would expect to find all except: Inappropriate initial treatment for external genital warts caused by human papilloma virus (HPV) in a non-pregnant patient is: A new patient presents to the nurse practitioner clinic stating she wants a second opinion. She started propylthioutacil (PTU, Propyl-Thyracil) 75 mg three times today a week ago as therapy for newly … Graves’ disease. She still feels irritable and jittery. How should the nurse practitioner respond? What advice should be given to the parents of an infant at risk for SIDS? A six-month-old patient with type III metatarsus adductus (i.e., rigid and does not correct to neutral) should be treated with: Patient should be advised to purchase the same brand name for each of the following drugs except: Which activity during the first trimester could be deleterious to the fetus? The mother of an 18-month-old child is in the office. She is not yet immunized her child because the child’s grandmother “doesn’t believe in that.” The nurse practitioner should: The nurse practitioner is conducting a routine health assessment of a 28-year-old patient. He states he is very “Health conscious” and that he ran 6 miles daily. He denies current Health problems and his past medical history is unremarkable. Routine urinalysis reveals proteinuria. What is the most likely cause of the proteinuria? What is the earliest age that MMR immunization can be administered? The nurse practitioner examines a six-year-old who has had a sore throat and fever for less than 24 hours. Based on the most common cause of pharyngitis in this age group, the most appropriate action is to: Physical examination findings consistent with emphysema include all of the following except: Which choice below is not a contraindication to receiving the diphtheria, pertussis, and tetanus (DPT) vaccine? All of the following are included in the differential diagnosis of hyperthyroidism except: A middle-aged patient has a history of smoking, chronic cough, and sputum production. He reports chronic dyspnea. A diagnosis of COPD should be confirmed with: A patient requests information about foods to include in his diet while vacationing in Mexico to avoid “Montezuma’s revenge.” The nurse practitioner should advise him to ingest only: An eight-month-old male presents with hemarthrosis of both knees and hematuria. The parents gave no history of trauma but say “he has always bruised easily.” The most likely diagnosis is: Of the following for malpractice issues for which an APRN may incur liability, which is the most prevalent cause of action? Which of the following factors is (are) associated with increased incidence of cervical cancer? Following the finding of prostate gland abnormalities on DRE, the nurse practitioner orders appropriate labs. When preparing to view lab reports with the patient, and Nurse practitioner knows all of the following are true except: Which characteristic is not indicative of heart failure? A 32-year-old male patient complains of urinary frequency and burning on urination for three days. Urinalysis reveals bacteriuria and positive nitrates. He denies any past history of urinary tract infections. The initial treatment should be: On trans illumination of the scrotum, the nurse practitioner identifies a hydrocele in a three-month-old infant. What course of action should be taken? Which of the following is an appropriate drug for initial treatment of gastroesophageal reflux disease (GERD) in adults? The major health risk associated with oral contraceptive therapy is? The most effective treatment of primary and secondary encopresis focuses on: A 55-year-old male patient complains of blood in his urine for the past two weeks. He denies dysuria. Urinalysis is positive for red blood cells and negative for leukocytes and nitrates. The initial evaluation of this patient should include: A 50-year-old non-smoker with no comorbidities presents to the clinic an is … with community acquired pneumonia. His vital signs are normal except for temperature 101.6°F. a sputum specimen is collected and sent for culture and sensitivity. What action should the nurse practitioner take today? Influenza vaccine should be given annually to all persons 65 years or older, anti-persons six months or older who are And chronic care facilities, or who suffer chronic cardiopulmonary disorders, metabolic disorders, hemoglobinopathies, or immunosuppression. Simple cases of impetigo and folliculitis are usually successfully treated with: A patient on oral contraceptives reports that she has forgotten to take her pill the last two days in A row. What should you advise her? 1-take two tablets daily for the next two days, then resumed a regular schedule. 2-begin a new compact of tablets starting the first day of the next cycle. 3-use an additional method of contraception for the rest of the pill pack.4-take one tablet, discard the second, and continue as scheduled. A three-year-old has enlarged, warm, tender cervical lymph nodes, indicating: A 62-year-old female has been … with osteoporosis. She refuses hormone replacement therapy as well as new medication shown to increase bone density. Important education for this patient should include: The tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) have demonstrated efficacy in the treatment of each of the following conditions except: Which finding below would be unusual and patient with diabetic retinopathy? A two-year-old child is … with hemophilus influenza type B. The child’s parents will not allow any of their children to be immunized. There are two other children in the home, ages one year and three years, how should the nurse practitioner manage contacts? Atenolol (Tenormin) should be avoided in: The results of the Weber tuning fork test is the lateralization of sound to the right ear. This finding indicates: A male patient with chronic atrial fibrillation takes a generic brand of Coumadin (warfarin). He should report all of these to his healthcare provider except: The side effect of the medroxyprogesterone (depo-Provera) that often leads women to discontinue use is: The mother of a two-week-old infant with hypospadias request circumcision for her infant. The nurse practitioner’s best response to this mother should be: A patient complains of “stomach pains” on and off for the past month. In distinguishing between a gastric and duodenal ulcer, what question is least important to ask? Enlargement of the scrotum and testes with little change in size of the penis characterizes which tanner stage of sexual development? Which of the following ecchymotic lesions in a four-year-old patient most likely represents a possible bleeding disorder: The mother of a six-month-old infant asked about the use of an infant walker. The most appropriate response is to: The developmental task for the family of an adolescent is to: Which of the following diseases is not acquired trans placentally? A two-year-old has iron deficiency anemia and has not had an increase in hemoglobin for the past three months despite Iron supplementation. The nurse practitioner should: A 38-year-old penicillin allergy patient has folliculitis on A bearded part of his face. The nurse practitioner prescribes erythromycin and tells the patient: A 45-year-old male is … with hypertension. His blood pressures have been gradually increasing overtime, with a reading today of 152/98. Diagnostic studies are normal. The most likely diagnosis for this patient is: Which of the following signs and symptoms are typical of hypothyroidism? The most commonly recommended method for prostate cancer screening in a 55-year-old man is: An obese 43-year-old has recurrent superficial fungal skin infections over the past two years. Today, she presents with intertriginous candida. Her skin is macerated from frequent rubbing and scratching. The plan of care should include: If 37-year-old female patient with A history of a single episode of depression and frequent complaints of PMS is being treated for hypothyroidism. Today she complains of poor concentration and fatigue. The nurse practitioner should: Which of the following drugs has a beneficial effect on benign prosthetic hyperplasia? A patient that has 20/80 Visual acuity can see: The goals of treatment for patients with alcohol abuse disorder are: The nurse practitioner correctly teaches the patient with diabetes mellitus that if blood glucose is less than 100mg/dl (5.6 mmol/L) prior to exercise, the patient should first consume 15 g of carbohydrates, such as: Characteristics of prescription and OTC drug use in the elder population include all of the following except: Acute lymphocytic leukemia (ALL) is usually … by: Subsequent to successful completion of the nurse practitioner certification exam, the candidate is considered to be: An obese hyperlipidemic patient, newly … with type II diabetes mellitus has fasting blood glucose values 180 to 250 mg/dL (10.1-14 mmol/L). What is the most appropriate initial treatment to consider? All of the following are typical of toddlers except: Interest practitioner has treated an infant for the last three weeks for thrush with nystatin (Mycostatin) oral suspension. What diagnostic test could the nurse practitioner platform which might quickly confirm a diagnosis of oral candidiasis? Which of the following physical findings is consistent with a diagnosis of Beta-thalassemia major? An adult female patient is seeking information about her ideal weight. She is 5’7” tall using the” height weight formula”, what is her ideal body weight? The most appropriate therapy for an elderly patient with pernicious anemia is: Which of the following patients is most likely to have a diagnosis of type II diabetes mellitus? The recent Beta-adrenergic blockers should … avoided in patients with diabetes is because they may: The nurse practitioner is initiating levothyroxine (Synthroid) for primary hypothyroidism in a 71-year-old female. The usual starting dose of levothyroxine is 50 Nurse practitioner is evaluating a 35-year-old female nurse. She has a history of hospitalization for hepatitis B infection two years ago. Her laboratory tests demonstrate positive HBsAg/ surface antigen. The nurse practitioner would most likely diagnose: Phalen’s test, 90° wrist flexion for 60 seconds, reproduces symptoms of: According to the American nurses Association (ANA), the role of the nurse practitioner who provides primary healthcare is: Health maintenance organization (HMOs) and preferred provider organizations (PPOs) are: A nurse practitioner has been sued by a patient for malpractice. The nurse practitioner is considered to be a: A young couple is being seen by the nurse practitioner for preconception counseling. They Express the wish for pregnancy within the next three months and are very eager to know what they can do now to “make the baby as healthy as possible”. Which of the following should the nurse practitioner in courage to decrease the chance of neural tube defect in the fetus? An active 82-year-old male in good health complains “I don’t see as well as I used to and my eyes are very sensitive to glare.” His near and distant visual acuity is diminished, and he has a bilateral white pupillary reflex. The most likely diagnosis is: The Papanicolaou (PAP) smear report on a 36-year-old female patient indicate atypical squamous cells of undetermined significance (ASCUS). Which of the following constitutes appropriate care for this patient? A 23-year-old female college student is being evaluated by the nurse practitioner for immunization status. She has documentation of completion of IPV, DTaP, and MMR series. She states, “I got a shot when I was 12 years old, but none since then.” Which vaccines should she received today? A 20-month-old Child has been brought to the clinic after having a simple febrile seizure. The most appropriate intervention is to: A 75-year-old female complains that she awakens 3 to 4 times each night sensing bladder fullness, but is unable to “hold it” until she can get seated on the bathroom toilet. This type of urinary incontinence is termed: A one-month old presents with reported recurrent diarrhea, screaming, and drawing up of the legs followed by periods of lethargy. On physical examination, A” sausage-like” mass is palpated in the upper right quadrant of the distended abdomen. Which of the following is the most likely diagnosis? A critically ill patients states, “my family is well provided for”. The nurse practitioner must interpret this meaning as the patient: A 46-year-old female has hypertension and is well managed on propranolol (Inderal). Which of the following is a beneficial secondary effect of this drug? During pregnancy, it is important to be physically active. The nurse practitioner should encourage her pregnant patient who has a very sedentary lifestyle to: A 19-year-old pregnant patient, at 20 weeks gestation, complains of pain in the right lower quadrant. She is afebrile and denies nausea and vomiting. The most likely diagnosis is: Which of the following is not covered by Medicare part B? Which of the following patient characteristics are associated with chronic bronchitis? Which of the following patients would appropriately be diagnosed with isolated systolic hypertension (ISH)? Which of the following drugs is considered safe for use during pregnancy? A 44-year-old patient complains of stiffness and soreness in his hands, hips, and knees. There is noticeable PIP and DIP joint enlargement in his hands. The nurse practitioner suspects arthritis. All of the following questions are helpful in differentiating between rheumatoid arthritis (RA) and osteoarthritis (OA) except: A 55-year-old male patient presents with dysuria, urgency, peroneal pain, and temperature of 10 1°F. What is the most likely diagnosis? The nurse practitioner receives a call from a 23-year-old patient who is 10 weeks pregnant. She reports that a few days after spending the day babysitting a friend’s toddler, the toddler develops a rash. The nurse practitioner would be least concerned if the patient was exposed to: For the general adult population, total dietary fat intake should be no more than what percent of total calories? The mechanism for handling first contacts into the healthcare system and providing a continuum of care, evaluation and management of systems maintenance of health, and appropriate referrals is called: The four classic features of Parkinson’s disease are: The most common symptoms of transient ischemic attack (TIA) include: A 15-year-old patient has a complaint of vaginal discharge. She is sexually active with multiple partners. Which of the following symptoms should leave the nurse practitioner to suspect pelvic inflammatory disease (PID)? The nurse practitioner wants to assess intactness of a patient’s cerebellar function. Which of the following clinical test will provide information relative to cerebellar function? A patient presents with distorted area and a blind spot in the visual field. The painless condition was first noticed on awakening this morning. The nurse practitioner would most appropriately include all of the following in the plan of care except: Which murmur is associated with radiation to the neck? The correct order of physical examination of the abdomen is: What disease process is Bouchard’s nodes most commonly associated with? A patient has Kawasaki syndrome. Which characteristic would be unusual? The nurse practitioner should instruct the mother of an infant with thrush to: A 24-year-old female taking oral contraceptives has missed her last 2 pills. What should the nurse practitioner advise her to do? A 65-year-old diabetic patient has newly diagnosed peripheral artery disease in her lower extremities. She is exhibiting symptoms of this disease. In assessing this patient, the nurse practitioner would expect to find: A patient recovering from a recent stroke is starting anticoagulant therapy. The nurse practitioner should teach the patient to avoid all of the following except: The anatomical site currently believed to be the best location for subcutaneous insulin administration is: A patient presents with periorbital erythema and edema, fever, and nasal drainage. The nurse practitioner should: A nurse practitioner is examining a 2-month-old infant. What question is most important to ask about the baby? Which of the following patients is least likely to develop osteoporosis secondary to a comorbid condition? A 72-year-old man has chronic prostatitis. What is the initial drug treatment of choice for this patient? Practitioners working with physically active girls need to be aware of the “female athlete triad” in order to develop an effective plan for prevention, recognition, and treatment. The component of the female athlete triad are: Which of the following drug classes may potentiate hyperkalemia in a patient taking potassium-sparing diuretic or potassium supplement? Salicylates and other nonsteroidal anti-inflammatory agents have all of the following actions except: The obesity associated with type II diabetes mellitus is: Retinopathy specifically associated with poorly controlled hypertension is manifest clinically as: Electro cardiogram markers of hypokalemia include all of the following except: Ideally, antepartum care should begin: A nurse practitioner is providing guidance to a newly diagnosed diabetic patient who is being treated with insulin. The nurse practitioner would be correct to tell the patient to self-treat signs and symptoms of hypoglycemia with: An 18-year-old college student lives in the dormitory. He has been treated for scabies infestation with permethrin (Nix). He was asymptomatic for two weeks but now complaints again of itching and skin burrows. How should the nurse practitioner proceed? What is the most common causative pathogen found in cystitis, pyelonephritis, and prostatitis? A 26 -year-old female presents with vaginal itching and a malodorous vaginal discharge. What prep is positive for budding hyphae and flagellated protozoa a negative for wbc’s and clue cells. KOH is positive. Based on these lab and microscopic findings, the most likely diagnoses are: Which of the following maybe caused by long-term glucocorticoid treatment? The most appropriate treatment for a child with mild croup is: A patient states “I just found out my old boyfriend died of AIDS.” She is worried that she has contracted illness and wants to be tested. The nurse practitioner correctly offers this patient the: A 40-year-old patient presents with a hordeolum. The nurse practitioner teaches the patient to: When counseling a woman who is breast-feeding her six month old infant, the nurse practitioner should recommend a caloric intake over her pre-pregnancy requirement of: A seven-year-old male presents with a painless limp, antalgic gait, muscle spasm, mildly restricted hip abduction and internal rotation, proximal thigh atrophy, and slightly short stature. Most likely diagnosis is: Among adolescents in the US, the greatest known risk factor for contracting hepatitis B is: A 45-year-old obese premenopausal female complains of indigestion, flatulence, RUQ and epigastric “crampy pain” that radiates to the right scapula. Symptoms are exacerbated by a high fat meal. What is the most likely diagnosis? A 51-year-old postmenopausal female, request guidance regarding osteoporosis risk. The nurse practitioner would be correct to recommend all of the following except: A 40-year-old female with a history of frequent sun exposure presents with a multi colored lesion on her back. It has irregular borders and is about 8 mm in diameter. What should the nurse practitioner suspect? A 60-year-old male patient with multiple health problems presents with a complaint of erectile dysfunction. Of the following, which medication is most likely to be causing the problem? On examination of the skin a 65-year-old male, the nurse practitioner notes erythematous eruptions with scaly and flaky, but oily, yellowish plaques over the nasolabial fold, scalp, and area of the eyebrows. The patient reports that condition is always present and exacerbated by stress. What is the most likely diagnosis? A 21-year-old college student presents to the student health center with copious, markedly purulent discharge from her left die. The nurse practitioner should suspect: A 32-year-old mother and her 10-year-old child each have a 10 cm round, reddened patch on the trunk. There is Central clearing of the lesion. Different lesions run parallel to each other in a Christmas tree pattern. The mother has been treating the “ringworm” with an antifungal cream for seven days without success. The nurse practitioner’s best response is: The nurse practitioner is disgusting contraception options to be used during lactation with a 24-year-old pregnant patient. Which of the following methods of contraception would not be appropriate for use while breast-feeding? The hyperinsulinemia and insulin resistance associated with the diagnosis of syndrome X causes all of the following except: A 49-year-old Hispanic female has a blood pressure of 145/95 mmHg during a routine annual evaluation. She has no previous history of hypertension. She takes a Statin for dyslipidemia. How should the nurse practitioner proceed with this patient? A 16-year-old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, in Palatine petechia. Without a definitive diagnosis for this patient, what drugs would be the least appropriate to prescribe? What is an appropriate drug for prophylactic treatment of migraine headaches and a 21-year-old female? Introduction of solid foods to infants should begin: A 16-year-old sexually active student presents with complaints of a greenish gray frothy vaginal discharge and vaginal itching. The nurse practitioner should suspect: All of the following principles apply to drug therapy for elders except: Criteria for the diagnosis of Alzheimer’s disease include: A 10-year-old presents with hematuria, periorbital edema, and elevated blood pressure. He has a history of streptococcal pharyngitis two weeks earlier. What is the most likely diagnosis? After being thoroughly examined, a child is diagnosed with recurrent abdominal pain. Patient and parent counseling should include: Eligibility requirements for the ANP or FNP exam include all of the following except: Which of the following can result from chronic inflammation of a Meibomian gland? The nurse practitioner is caring for a 19 year old female college student with iron deficiency anemia secondary to heavy menstrual bleeding. An appropriate initial treatment for this patient is: A 23-year-old female presents with scaly hypo pigmented macular lesions on her trunk, shoulders, and upper arms. The lesions flouresce under Wood’s lamp. Appropriate treatment for this condition is: P6 do-year-old male patient with a past history of glaucoma and frequent sinusitis presents today with hypertension. On his last two visits to the clinic, his blood pressures were 150 to 160 / 90 to 98. The nurse practitioner decides to treat the hypertension with long acting propranolol (Inderal). Before prescribing it the nurse practitioner should ask: Once a competent adult patient is identified as a victim of domestic violence, the best plan is to: A patient has been taking enalapril (Vasotec) for a period of 14 months to treat heart failure. Despite feeling well otherwise, she has developed you dry, nonproductive cough. The nurse practitioner knows that: A 20-year-old female patient presents to the emergency department with lower abdominal pain, moderate vaginal bleeding, and right shoulder pain. Her blood pressure is 90/50 mmHg, pulse is 120, respirations 20, and temperature 98°F. She has a history of pelvic inflammatory disease (PID). Her urine pregnancy test is positive. Which of the following is the most likely diagnosis? A 27-year-old female patient with epilepsy is well controlled with phenytoin (Dilantin). She requests information about contraception. The nurse practitioner should instruct her that: Microalbuminuria is a measure of: What problem would be least expected any pregnancy complicated by gestational diabetes? Which of the following findings would raise the nurse practitioners’ suspicion of bulimia and a 17-year-old female? A first-time mother asks the nurse practitioner how much her baby will grow in the first three months of life. The nurse practitioner explains that the normal baby will grow: Which of the following has been shown by research to be most influential in promoting smoking cessation in the adolescent population? A 23-year-old college student presents to the campus health clinic with a generalized rash on her trunk. The lesions are oriented in a Christmas tree pattern and I’m widely pruritic. She describes a “round ringworm” that appeared in about one week ago, but now has disappeared. What is the patient’s diagnosis and how should she be treated? Healthy people 2010 published by the US Department of Health and Human Services: Is a set of national health objectives designed to improve the overall health of people Which case epistaxis should concern the nurse practitioner most? A very active 35-year-old male has painful hemorrhoids, but he does not want hemorrhoidal surgery at this time. His diet has been indiscriminate as his job requires frequent travel. The most appropriate recommendation is for him to select foods that are: The CDC recommends the pneumococcal polysaccharide vaccine for: 1. Adults > 60 years of age. 2. Asplenic person > or equal to two years of age. 3. HIV it affected individuals and diabetic adults. 4. Patients with CHF, or chronic liver disease. A patient has been diagnosed with hypothyroidism in thyroid hormone replacement therapy is prescribed. When should the nurse practitioner check the patients TSH? It is recommended that the therapeutic management of children with juvenile rheumatoid arthritis (JRA) should include: The child with type I diabetes mellitus brings in a glucose diary indicating consistent morning hyperglycemia. How can the nurse practitioner differentiate the Somogyi effect from Dawn phenomenon? A 16-year-old presents for a sports physical for football. The nurse practitioner auscultates a diastolic murmur. It is a grade II/VI. He has no hx of a murmur. The patient denies symptoms. What is the most appropriate action for the NP? Which age group is at higher risk for testicular cancer? At what age is screening most helpful in detecting scoliosis? What disease process are Heberden nodes most commonly associated with? A pre-adolescent male expresses concern about his physical growth and development as compared to girls his age. The NP correctly tells his that pubertal growth spurt occurs about: The mother of a 3-year-old male asks about her son’s nocturnal enuresis. Which of the following responses is appropriate? Persons with thalassemia should avoid: When examining a pregnant patient, where should the fundal height be at 22 wks.? My question asked about a 20 week old pt The nurse practitioner preforms a routine physical examination of a 3-years old. A hard, painless mass is palpated in the abdomen, along with the lymph node enlargement and lower limb paresis. Blood imaging studies provide markers for neuroblastoma. What information is correct to give the parents? Which of the following is a “red flag” indicating possible developmental delay? Babies should begin oral iron supplementation at A patient with moderate persistent asthma will probably be most effectively managed with daily; A 17-year old presents with a wound received while building a fence. He has completed a primary vaccination series and he had a Td booster 3 years ago. Does he need a Td booster today? The infant 1 to 6 months of age with a diagnosis of developmental hip dysplasia is correctly treated with: A 60-year old female patient complains of sudden onset unilateral, stabbing, surface pain in the lower part of her face lasting a few minutes, subsiding and then returning. The pain is triggered by touch or temp extremes. Physical exam is normal. The patient had a negative dental evaluation. CT scan is normal. Erythrocyte sedimentation rate is normal. Which of the following is the most likely diagnosis? Which of the following demonstrates that a 30-year old male has successfully achieved the developmental task of young adulthood? Diagnostic radiological studies are indicated for low back pain: A healthy 50-year-old patient presents to the clinic for a routine physical examination. He has no significant personal or family history of clinical heart disease. What should be part of his CV assessment? Patients diagnosed with polycystic ovarian disease are at increased risk for developing: Why is it important that a post-menopausal woman with an intact uterus receive combined estrogen-progestin hormone replacement therapy rather than estrogen alone? A professional liability insurance policy that provides coverage for injuries arising out of incidents occurring during the period the policy was in effect, even if the policy subsequently expires, or is not renewed by the policy holder, is termed a(an): When prescribing an iron supplement to a child it is most important to tell the mother: An 87-year old was placed on low dose amlodipine (Norvasc) for the treatment of hypertension and angina. She takes an ASA daily, but, takes no other medications. What side effects might be expected from taking amlodipine? An 18-year old female applying for college admission presents to the health clinic because evidence of rubella vaccination is required for admission. She says” I don’t ever remember getting that shot” she has a negative serologic evidence of rubella antibody. The nurse practitioner should: An overweight male complains of low back pain after helping to move a refrigerator over 2 days ago. To avoid future problems, the nurse practitioner should teach him: Infants with celiac disease (gluten enteropathy) are at risk for multiple complications. The most urgent complication of the disease is: An elderly patient’s digoxin level has decreased to 0.4 ng/dl and she has begun to have atrial fibrillation again. For the past 14 months, her digoxin level had been well controlled when her digoxin level was 1.4 to 1.5 ng/dl. What could not have accounted for this change in digoxin level? Normal digoxin level is (0.8-2 ng/dl). An 83-year-old man has a resting tremor. What disease process is this type of tremor most commonly associated with? A 70-year-old patient presents with left lower quadrant abdominal pain, markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition? A 16-year-old sexually active female presents to the clinic. She has never had vaccinations for hepatitis A or B, she has had one MMR immunization, and her last tetanus vaccination was four years ago. Which vaccination would be contraindicated without further testing? Patients with human immunodeficiency virus (HIV) are at increased risk for pneumocystis carinii pneumonia (PCP) which is associated with significant morbidity and mortality. For this reason, prophylaxis is recommended. Which of the following is inappropriate drug for PCP prophylaxis? A 15-year-old female reports she is a strict vegetarian. Which of the following is the most appropriate response by the nurse practitioner? Right sided heart failure is characterized by all of the following clinical findings except: The nurse practitioner diagnoses eczema on the cheeks of a two-year-old female. The patient’s mother explains that she is embarrassed to take the child in public because her face is so red, dry, and crusted. She asked for a “strong” cortisone cream so the eczema will clear rapidly. The nurse practitioner knows that: A patient presents with a normal complete blood count and a positive stool for occult blood. The nurse practitioner decides to repeat this stool for occult blood after having the patient eliminate certain foods from the diet for 72 hours. Which of the following should be included in the list of foods to omit? Which term most accurately describes the prostate gland of a patient with prostate cancer? A 30 year old female patient presents to the clinic with heat intolerance, tremors, nervousness and weight loss inconsistent with appetite. Which choice below would be most helpful in identifying the etiology of this patient’s complaints? Diagnosis of systemic lupus erythematosus (SLE) is made: A three-year-old female with a palpable right upper quadrant abdominal mass, anemia, and fever is being evaluated for Wilms’ tumor. Which of the following diagnostic test would be most useful? In July 1996, the advisory committee on immunization practices of the centers for disease control and prevention issued which of the following recommendations for the use of the live attenuated varicella vaccine? Advances in obstetrics in neonatal care have: What is the most common chronic condition in the elder population in the United States? In comparing sensitivity to specificity, sensitivity refers to a: The best way for a pregnant woman to avoid injury to herself and her fetus in the event of a motor vehicle accident is to: A 25 year old female patient presents for routine well woman exam. On physical examination, the nurse practitioner notes a scant nipple discharge, absence of a palpable mass, and absence of lymph node enlargement. Which of the following is the most likely diagnosis? A 22-year-old patient has a single, nontender, freely movable lump in her right breast. She denies any nipple discharge. Which of the following diagnosis is this clinical presentation most consistent with? The most effective treatment for anemia of chronic disease is: A 65 year old African-American patient was screened at his local church for “High cholesterol”. His total cholesterol (nonfasting) was 215mg/dl. What action below is most appropriate for the nurse practitioner? A 72-year-old female patient reports a six month history of progressively more swollen and painful distal interphalangeal joints of one hand. There are no systemic symptoms but the erythrocyte sedimentation rate, antinuclear antibody, and rheumatoid factor are all minimally elevated. What is the most likely diagnosis? When discussing treatment options with the patient, the nurse practitioner would be correct to say that surgery can be curative for: A 26-year-old female was informed that she is four weeks pregnant. Because of her history of smoking half a pack of cigarettes per day, the nurse practitioner explains that smoking during pregnancy increases the risk of her infant being born: A 12-year-old presents with ear pain of 36 hours duration. The nurse practitioner diagnosis acute otitis media because the: Which of the following is an example of secondary prevention? A 17-year-old female presents with a painful the secular lesion on her vulva. Which of the following would be the most definitive diagnostic test? The nurse practitioner correctly diagnoses a second degree burn injury which is described as: Long-range disease prevention programs are most likely to be successful if: The programs are shaped to fit the cultural and health profiles of the population Salmeterol (serevent) in combination with an inhaled steroid is prescribed for a patient with moderate persistent asthma. What is the most important teaching point about salmeteral? A 66 year old patient exhibits sudden onset of fluctuating restlessness, agitation, confusion, and impaired attention. This is accompanied by visual hallucinations and sleep disturbance. What is the most likely cause of this behavior? A 15 year old pregnant patient presents for her first prenatal visit. On physical examination, her uterus is approximately 24 week gestational size. She does not know when her last menstrual period was nor does she know when she might have conceived. Gestational age for this patient can most accurately be assessed by: Which of the following is the most important diagnosis to rule out in a patient with acute bronchitis? Upon ophthalmoscopic examination of a 78-year-old patient, the nurse practitioner observes dark spots against a red retina. What the diagnosis is this finding most consistent with? A prenatal patient is in the 10th week of pregnancy. Rubella tighter was 1:18 on her first prenatal visit, at six weeks gestation. She believes she was exposed to rubella at yesterday and asks how this will affect her pregnancy. Which of the following responses by the nurse practitioner is appropriate? Herniated nucleus pulposus typically presents clinically by all of the following except: The nurse practitioner correctly teaches an insulin-dependent patient the signs and symptoms of early hypoglycemia, which include: The most reliable indicator of neurological deficit when assessing a patient with acute low back pain is (are): An 86-year-old Caucasian male requests screening for prostate cancer. What is the best approach to his request? In order to decrease death from lung cancer: Acute rheumatic fever is diagnosed using the modified Jones criteria. Which is not a major criteria in the Jones system? A 50-year-old male is scheduled for his annual wellness visit. The nurse practitioner would appropriately recommend all of the following except: Considering mortality statistics for the adolescent age group, education targeted toward this group should first focus on: Licensure is: A nurse practitioner is holding a prenatal nutrition class for a group of parents. Considering knowledge about cultural variations, which of the following women may be at increased risk for inadequate calcium intake? An 80-year-old Caucasian female has heart failure. Which symptom below is an early indication of failure? An elderly patient presents with a great white ring around the periphery of the iris. This is probably: A 73 year old patient presents with a very sore, glossy, smooth, beefy-red tongue. This clinical presentation most likely reflects Which of the following statements about medications in a 45 year old patient with diabetes is correct The most appropriate treatment for a child with mild croup is Which of the following statements about tuberculosis (TB) is accurate A 65-year-old diabetic patient has newly diagnosed peripheral artery disease in her lower extremities. She is exhibiting symptoms of this disease. In assessing this patient, the NP would expect to find A 12-month-old has conjunctivitis in his right eye with a mucopurulent discharge. The mother asks if the child can forego the antibiotic eye drops because he doesn’t take drops put in his eyes. The NP replies that A 30-year-old female patient presents to the clinic with heat intolerance, tremors, nervousness and weight loss inconsistent with appetite. Which choice below would be most helpful in identifying the etiology of this patient’s complaints A new patient presents to the nurse practitioner clinic stating she wants a second opinion. She started prophlthiouracil (PTU, prophyl-thyracil) 75mg 3 times a day a week ago as therapy for newly diagnosed Grave’s disease. She still feels irritable and jittery. How should the NP respond Which of the following is not true regarding the diagnosis of scoliosis in children Which of the following descriptions of the Denver II Developmental screening test is most accurate A young female reports onset of right flank pain 2 days ago that is now severe. Last night she discovered a “burning rash” in the same area. The NP identifies popular fluid filled lesions that are confluent and follow a linear distribution along the t-8 dermatome. The NP would appropriately order A 28 year old pregnant woman reports a history of smoking 1 pack of cigarettes per day. The NP is correct when she explains to the patient that cigarette smoking could be associated with Which of the following patients most warrants screening for hypothyroidism Simple cases of impetigo and folliculitis are usually successfully treated with When examining a 5 year old the NP knows that this is an appropriate age to teach the child about A 43 year old male presents with a large and painful furuncle, the 3rd one in the past 6 months. The NP should plan all of the following except A 32 year old mother and her 10 year old child each have a 10cm round, reddened patch on the trunk. There is central clearing in the lesion. Different lesions run parallel to each other in a Christmas tree pattern. The mother has been treating the “ringworm” with an antifungal cream for 7 days without success. The NPs best response is The result of the Weber tuning fork test is lateralization of sound to the right ear. This finding indicates a Which commonly used herbal remedy is not associated with anxiety and/or depressive symptom relief Which of the following patients is least likely to exhibit secondary hypertension Which of the following must be present for the diagnosis of bacterial vaginosis A 49 year old man sees the NP for the evaluation of a 2 mm macular lesion on his back. The lesion is brown with regular borders. The most appropriate action for the NP is to The family of a 78 year old man moved him into an assisted living center because he can no longer be left at home alone. He is unable to toilet when asked to do so and he has had several episodes of incontinence. He has walked out of the facility twice and been unable to find his way back from 3 blocks away. On examination he is pleasant but mildly confused. Which of his medication is least likely contributing to his behavior A 4 year old female complains of leg pain at night which resolves by morning. This has lasted for the past 4 months. The NP should tell the patient’s mother that Which of the following diseases is not acquired transplacentally A palpable thyroid nodule is benign. How does it feel on palpation Which term most accurately describes the prostate gland of a patient with prostate cancer A 10 year old female’s mean corpuscular volume (MCV) is 73 fl. What type anemia would the NP suspect What information should patients with diabetes and their families receive about hypoglycemia The cornerstone of treatment for stress fracture of the femur or metatarsal stress fracture is Patients with benign prostatic hyperplasia (BPH) should be taught to avoid which of the following drug classes A mother who has diabetes mellitus wants to breast feed her infant. The NP should An important measure to prevent complications in children with sickle cell anemia is A 32 year old male patient complains of urinary frequency and burning on urination for 3 days. Urinalysis reveals bacteriuria and positive nitrates. He denies any past history of UTI. The initial treatment should be A 25 year old patient presents with complaints of pain and burning in the vulvar area. Upon examination, the NP notes 4 vesicles with an erythematous base arranged in a group on the patient’s labia majora. The most likely diagnosis is Oral and parenteral contraceptive methods What is the recommendation of the US Department of Health and Human Resources regarding nicotine replacement therapy Therapeutic international normalized ratio (INR) for a patient taking warfarin for chronic atrial fibrillation is expected to be A 48 year old female presents with a chief complaint of insomnia. On further investigation, she reports fatigue, nervousness, and agitation during the daytime and feeling hot most of the time. Which of the following would not be included in the differential diagnosis An 8 year old female has been brought to the nurse practitioner on 5 occasions in the past 9 weeks with a complaint of abdominal pain. The evaluation each time is negative, but her mother is convinced the child is truly experiencing pain. The most likely diagnosis is Patients with human immunodeficiency virus (HIV) are at increased risk for pneumocystitis carinii pneumonia (PCP) which is associated with significant morbidity and mortality. For this reason, prophylaxis is recommended. Which of the following is an appropriate drug for PCP prophylaxis The nurse practitioner would be correct to tell a 27 year old newly diagnosed hypertensive patient that Which of the following drug classes would be most effective in decreasing elevated triglyceride levels Which of the following drugs classes would be most effective in decreasing elevated triglyceride levels A 52 year old female has a firm nontender one cm mass in the right lower quadrant of her breast. There are no palpable axillary lymph nodes. A mammogram the month before her examination was negative. The most appropriate nurse practitioner action today is to A 26 year old female patient presents with cracked and sore nipples. She is breastfeeding her first child who is 4 weeks old. The nurse practitioner would be accurate to advise the patient to A nurse practitioner is providing guidance to a newly diagnosed diabetic patient who is being treated with insulin. The nurse practitioner would be correct to tell the patient to self treat signs and symptoms of hypoglycemia with On examination a 67 year old patient is noted to have high tone hearing loss. This finding is consistent with what diagnosis A patient with a past history of documented coronary arterial blockage less than 70% complains of chest pain several times per day (while at rest) which is relieved with nitroglycerin. What is the most appropriate initial action for the nurse practitioner? A newborn with cyanosis secondary to a cardiac anomale probably has A patient with diabetes mellitus calls the clinic reporting signs and symptoms of viral syndrome. She asks, “Should I skip my diabetes medicine until I get my appetite back?” The nurse practitioner reviews the sick day guidelines, which include all of the following except A 1 month old presents with reported recurrent diarrhea, screaming and drawing up of the legs followed by periods of lethargy. On physical examination, a “sausage like” mass is palpated in the upper right quadrant of the distended abdomen. Which of the following is the most likely diagnosis Upon ophthalmoscopic examination of a 78 year old patient, the nurse practitioner observes dark spots against a red retina. What diagnosis is this finding most consistent with Of the following, the patient who should be referred for periodic colonoscopy is the patient with Adolescents are at increased risk for contracting the HIV due to What is the most appropriate NP intervention for a 2 month old febrile infant who appears ill but has no evidence of specific infection upon examination Which immunizations are contraindicated in an immunodeficient individual? 1 varicella 2 ipv 3 mmr 4hbv To differentiate testicular torsion from epididymitis, the np should order Expected findings associated with a diagnosis of folic acid deficiency include all of the following except The drug of choice for acute episodes of gout is colchicine. What is the most common early sign of colchicine toxicity A 27 year old male athlete presents with complaints of exquisite pain over his right shin. He runs an average of 6 to 8 miles per day. He wonders if he has a right tibial stress fracture. Which response by the NP is not correct A 25 year old married woman is being taught the natural family planning method of contraception by the nurse practitioner. Which of the following statements by the patient demonstrates her understanding of nfp A 65 year old presents with a past medical history of coronary artery disease, temperature 101 degrees F, tachypnea 24 breaths per minute, and consolidation in the left lower lobe. A chest x-ray confirms left lower lobe pneumonia. What antimicrobial agents should the NP prescribe A 26 year old female was informed that she is 4 weeks pregnant. Because of her history of smoking half a pack of cigarettes per day, the NP explains that smoking during pregnancy increases the risk of her infant being born The NP strongly suspects hyperthyroidism in a 62 year old patient. Which of the following would not be an appropriate initial intervention Which of the following oral medications should be avoided in a child under 8 years of age The NP is holding a prenatal nutrition class for a group of patients. Considering knowledge about cultural variations, which of the following women may be at increased risk for inadequate calcium intake A professional liability insurance policy that provides coverage for injuries arising out of incidents occurring during the period of policy was in effect, even if the policy subsequently expires, or is not renewed by the police holder is termed A patient with uncontrolled primary hypertension presents with a complaint of frequent headaches. Headaches which may be attributed to the patient’s blood pressure elevation are typically described as All patients with renal calculi should be taught that the best prevention is Which of the following medications may predispose the patient to hypoglycemia An urgent call is received from a patients wife who states that her husband is having chest pain unrelieved by 3 nitroglycerin tablets. The nearest hospital is 45 minutes away. Besides having the patient reach the hospital as soon as possible, which intervention can the NP suggest which might influence a positive outcome A patient taking levothyroxine is being over-replaced. What condition is he at risk for The NP suspects a TMJ disorder. As the patient slowly opens and closes the lower jaw, the NP palpates the temporomandibular joint bilaterally It is clear that in alzheimers disease, environmental forces as well as genetic factors exert considerable influence. One potential treatable risk factor currently receiving much attention is A mother presents with a 3 year old who has croup. The plan for home care would appropriately include A patient presents with periorbital erythema and edema, fever, and nasal drainage. The NP should Patients diagnosed with polycystic ovaridan disease are at increased risk of developing Which drug class is associated with elevated serum lipid levels Which choice below is not a contraindication to receiving the diptheria, pertussis, and tetanus vaccine A patient with hepatic cirrhosis presents with pedal edema. He reports that his wife prepares the same lunch for him every day :a ham and cheese sandwhich on white bread with mustard, a bowl of fresh vegetable soup What diabetic complications result from hyperglycemia? 1 retinopathy 2 hypertension resistant to treatment 3 peripheral neuropathy 4 accelerated atherogenesis 1, 3, 4 The following are all important tests of visual acuity in infants and children up to 3 years of age except Which of the following medication classes is considered first line therapy for patients who have heart failure An adolescent goes to Colorado for a ski trip. He is unaccustomed to the high altitude and very dry air. He develops nose bleeds & visits the NP. What intervention is least effective Screening for increased intra-ocular pressure or early glaucoma is The most effective intervention to prevent stroke is Which of the following should not be avoided when the patient has BPH An appropriate initial treatment for benign positional vertigo is The NP palpates an enlarged right epitrochlear lymph node. The next action is to assess the Educating parents to avoid putting their children to bed with a baby body The major health risk associated with oral contraceptive therapy is All of the following are associated with erectile dysfunction except At what age does vision normally become approximately 20/20 The NP is performing a routine assessment of a 47 year old female who wants to lose weight. She has truncal obesity with relatively slender forearms and lower legs. Her BMI is 38. Upon review of her history, physical examination, and laboratory results, the NP diagnoses syndrome x. This diagnosis is based on the previous findings plus all of the following except The long term prognosis for a patient with diagnosis of dementia is A 75 year old patient is well controlled on timolol maleate for chronic open angle glaucoma. Prescribing propranolol for this patient may precipitate Which of the following is least likely to be the cause of ophthalmia neonatorum What information should 42 year old patient with newly diagnosed diabetes receive about exercise Which of the following are characteristic of patients with type 2 diabetes? 1 beta cell destruction 2 high body mass 3 central obesity 4 unexplained weight loss The NP correctly diagnoses iron deficiency anemia in a female patient whose lab report reveals A 19 year old female reports that she is having panic attacks. The NP knows that panic attacks are characterized by At what age is screening most helpful in detecting scoliosis A 66 year old female presents to your clinic. She states that yesterday evening she had chest pain for 20-30 minutes. Which finding most strongly correlates with myocardial infarction A 27 year old female patient with epilepsy is well controlled with phenytoin. She requests information about contraception. The NP should instruct her that Which of the following statements concerning informed consent is false With a history of ankle sprain, the NP would most likely elicit a history of The diagnosis of Meniere’s disease is based on A patient presents with an inflamed upper eyelid margin. The conjunctiva is red and there is particulate matter along the upper eyelid. The patient complains of a sensation that there is something in my eye. What is the diagnosis and how should it be treated A 43 year old female patient complains of dull ache around both ankles after a days work as a cashier. Her symptoms are relieved by sitting and elevating her legs. She reports ankle edema at the end of the day. What is the most likely cause of these problems An elder’s caretaker is planning the elders menus. The elder is on a bland diet. The NP reviews the meal plans and notes that which of the following is not appropriate Microscopic examination of expressed prostatic secretions and post prostate massage urine is positive for WBCs >10 to 20/HPF and negative for bacteria. The most likely diagnosis is A 41 year old woman presents with multiple painful vesicular lesions in the vulvar area. She has been with the same sexual partner for 25 years. Which of the following is the most likely diagnosis In the differential diagnosis of thyroid dysfunction, the typical patient with hypothyroidism has all of the following characteristic features except A 16 year old male presents with mid sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient what drug would be the least appropriate to prescribe Which of the following is not a component of the fetal biophysical profile Which of the following ecchymotic lesions in a 4 year old patient most likely represents a possible bleeding disorder Today, a patient is diagnosed with iron deficiency anemia and started on a daily iron supplement. In order to best assess the adequacy of supplementation, the np would appropriately order a follow up Antibiotic administration has been demonstrated to be of little benefit in the treatment of which of the following disease processes A 44 year old male Caucasian patients blood pressures are consistently 170 and 100-110 He has no significant medical history and is of normal weight. His lab tests and ecg are normal. What is the appropriate action at this time A 50 year old male is scheduled for his annual wellness visit. The NP would appropriately recommend all of the following except A 2 week old infant is brought to the NP clinic after a difficult delivery. The mother says the infant fusses when handled or picked up. On physical examination the NP notes decreased movement of the right arm during the moro reflex and crepitus on palpation of the right clavicle. The diagnosis is fracture of the clavicle. The recommended management is A 3 year old female with a palpable right upper quadrant abdominal mass, anemia, and fever is being evaluated for Wilm’s tumor. Which of the following diagnostic tests would be most useful A patient presents with pruritic lesions on both knees. There are visible silver scales. How should his condition be managed Persons with thalassemia should avoid Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis A patient on oral contraceptives complains of breast fullness, tenderness and some nausea. The patient is concerned. How should the np manage this The client with iron deficiency anemia should be advised to take the iron supplement A 45 year old diabetic patient has periorbital cellulitis secondary to sinus infection. What course of action should the np take A 26 year old male patient in good health has a blood pressure of 145/80. How soon should his blood pressure be reassessed An 8 year old is sent home from school with a mucopurulent discharge from his eye. He is brought to the nurse practitioner for treatment. What is the most appropriate intervention Which of the following tests are used for diagnosis of cystic fibrosis Swan neck and boutonniere deformities are typical clinical findings in the later presentation of The minimum age for routine immunization with the MMR vaccine is A 32 year old woman reports a 10 year history of stuffy nose with clear rhinorrhea, sneezing, and itchy watery eyes. The MOST effective class of medications for this condition is A 65 year old man complains of shoulder pain lasting 3 months. He denies trauma and states that initially the pain was severe. However, over time the pain has lessened and stiffness of the joint has increased. Which diagnosis should be included as a differential A 50 year old homeless woman presents with persistent, productive cough for the past month, as well as night sweats and weight loss. The most appropriate approach to diagnosis of this patient is A 35 year old black man presents with a complaint of superficial irritation of the skin after shaving his facial hair. The physical examination identifies small raised erythematous lesions with pruritic pustules at the site. This is an assessment finding consistent with A 20 year old woman with depression states that she is thinking about killing herself. The next step would be to ask her The term used to describe breath sounds audible over the center part of the anterior chest is A 32 year old man presents with a 24 hour history of fever, diarrhea, nausea, and dehydration. The symptom most suggestive of infection with an invasive organism is Treatment for which of the following conditions can result in the development of cataracts When evaluating a 55 year old man for his understanding of self testicular exams, he needs further instruction if he says that The recognition and validation of knowledge, skills, competency and qualifications to function as an advanced practice registered nurse is X-link dominant disorders Which of the following diagnoses would not be considered a possible complication in a 61 year old man with prostatitis A 26 year old woman who is 10 weeks pregnant has a negative rubella titer. This patient should A 62 year old woman is diagnosed with shingles and concerned about spreading the virus to others. Which of the following statements is correct A 10 year old boy is diagnosed with otitis externa. The symptom not usually seen in patients with otitis externa is The daily performance of cardiovascular exercise has many benefits, including The nurse practitioner documents a blowing, high pitched decrescendo murmur at the left sternal border. This finding is consistent with A 20 year old veterinarian intern presents with right inguinal lymphadenopathy. The nurse practitioner suspects a typical case of cat scratch disease (CSD) and knows that Depressed mood and teeth erosion are present in a 16 year old girl. Initially she should be referred to a Which of the following is a violation of HIPPA A 49 year old man presents with an erythematous swollen and painful proximal interphalangeal joint on the right foot. Which medication should not be initiated during an acute attack A patient presents with a foreign body sensation in the eye, photophobia and tearing after removal of a contact lens. A fluorescein stain confirms a corneal abrasion. The best choice for treatment is Which answer best describes hidradenitis suppurativa When a payment arrangement is establish for service and a set fee per patient per month is paid for the provision of primary care services, it is known as A 59 year old nurse has varicose veins in her lower extremities. Which of the following can be attributed to varicose veins Which of the following diagnostic tests has the highest sensitivity and specificity in diagnosing deep vein thrombosis (DVT) Ophthalmoscopic examination of the retina reveals arteriovenous nicking (AV nicking). This appears as if the On assessment, a patient is diagnosed with koilonychia. This is indicative of The history and assessment of a 50 year old woman identify stress incontinence. The patient asks what could cause this condition. The most appropriate response is A 70 year old man has been diagnosed with tinnitus. The initial workup should include Briar has had type 2 diabetes for 6 years. He is now diagnosed with elevated low density lipoprotein (LDL) cholesterol. The best pharmacologic management to manage his lipids is A 38 year old woman complains of a headache. A finding that could indicate a serious underlying cause is A 60 year old man has been diagnosed with heart failure. Which item would be most beneficial in managing his condition at home An 18 year old woman with anorexia nervosa returns for a 1 month evaluation of the effectiveness of cognitive behavioral therapy (CBT). On examination, she is hypotensive, has a heart rate of 55, and a body temp 96F. Her weight has fallen below the 75th The nurse practitioner should A 5 year old boy is brought in with lesions around the mouth and nose. If the presentation is impetigo, the nurse practitioner would expect to find A 30 year old mother of three school aged boys complains of a sore throat. The least worrisome finding would be a A 44 year old man reports gradual hearing loss over the past 3 months. Results of the Rinne tuning fork test are right ear air conduction (AC) greater than bone conduction (BC) and left ear BC greater than AC. This finding indicates A 16 year old patient is advised to take nonsteroidal anti-inflammatory drugs (NSAIDs) for dysmenorrhea because they Inhibit prostaglandin synthesis When examining the breathing pattern of a 20 year old man, the diaphragm moves upward during inspiration and downward during expiration. The type of breathing is documented as Whitt, a mother of five children, is complaining of stress urinary incontinence. The next step in evaluating this condition is to recommend The characteristic that is associated with the highest risk for cervical cancer in a black woman in her 30s is a A risk factor associated with hepatitis a infection in a young woman is According to the national heart lung and blood institute (NHLBI), a normally healthy 12 year old should undergo lipid screening Cervical cancer screening guidelines recommend that screening begin at age A 27 year old man presents with a blood pressure of 150/95 mmHg. Gynecomastia and shrunken testicles are noted on exam. The nurse practitioner suspects An 81 year old woman comes to the office with mental status changes. Her daughter says that she has been confused for the past 3 days, and that she has complained of fatigue and headache. The initial diagnostic test in the evaluation of this patient is a How long after delivery should a pregnant patient with hypothyroidism have a TSH drawn A 25 year old pregnant woman is diagnosed with a urinary tract infection. The safest antibiotic to treat this patient is A 6 year old boy exhibits nuchal rigidity. In children, this finding is indicative of A 36 year old man presents with facial plethora, wide reddened striae, and easy bruising. These findings are most consistent with When performing a physical examination in a patient with suspected acute otitis media, a positive tug test will elicit pain when Wilson is started on a selective serotonin reuptake inhibitor (SSRI) for depression. Which one of the following statements is true about SSRIs A 13 year old girl has never received the varicella immunization and her history is unclear about varicella infection. The initial step is to A 10 month old infant girl has a history of prematurity and prolonged febrile seizures occurring on two occasions. When discussing the prognosis with the mother, the nurse practitioner informs her that An extract of the fruit of saw palmetto is sold over the counter and is commonly used to A 55 year old woman with diabetes complains of eye pain and headaches and states that she sees halos around bright lights. The differential diagnosis would include A 40 year old man has suspected epididymitis. Which test is best to assess the probability of this condition? A 42 year old man presents with dyspnea of sudden onset. This complaint could indicate A 48 year old man presents with a fourth acute attack of gout in 6 months. To prevent future acute flare ups, the best choice of medication is Bladder catheterization for postvoid residual urine volume and a voiding diary are beneficial in identifying Symptoms of fatigue, occasional shortness of breath, and paroxysmal nocturnal dyspnea in a 58 year old woman could be indicators of Symptoms of trichomoniasis in a 35 year old man could include Approximately 1 hour ago, a 10 month old infant experienced a febrile seizure. The mother should be informed that Which of the following diagnoses is most likely to be considered as a differential diagnosis in the presence of anuria? An infant presents for a routine exam. Anticipatory guidance about teething should be discussed with the parent when the infant is The NP treats a family of four with albendazole (Albenza) for pinworms. The mother inquires about reinfection and the NP explains that A 19 year old patient with a negative rapid strep test has a throat swab that is positive for beta hemolytic streptococcus. What is the best action by the NP When educating a patient about the initiation of insulin, the NP should explain that a common effect of insulin use is At what age should anticipatory guidance about tobacco, alcohol, and drugs take place The diagnostic criteria for chronic kidney disease do not include A 40 year old man presents with persistent wheezing localized to one area of the lung. It is most noticeable at night, when he experiences paroxysmal coughing. The most likely diagnosis is The term used to describe a difference of 10 mm Hg between the highest systolic pressure reading and the lowest systolic pressure is A 44 year old man with new onset gout should be advised to lose weight and adjust diet by A 67 year old patient with a history of diabetes has a total cholesterol level of 195mg/dl. LDL level of 129 mg/dl, HDL level of 35 mg/dl, and triglyceride of 100 mg/dl. The most appropriate treatment is A 16 year old baseball pitcher presents with symptoms of medial epicondylitis. On assessment, the NP should suspect A 17 year old girl has been taking an over the counter decongestant for weeks without adequate relief from persistent nasal congestion, hoarseness, and occasional nose bleeds. On examination, boggy mucous membranes and a small perforation in the nasal septum are observed. These findings are most consistent with The most appropriate initial treatment of idiopathic facial nerve palsy (Bell’s palsy) for a patient who began to notice a facial droop 2 days prior is The NP is teaching a patient who is newly diagnosed with diabetes how to properly administer insulin glargine (Lantus). She explains that he can expect the medication to start working within 1 hour and that it has a duration of approx. Which of the following symptoms would be most suggestive of chlamydia trachomatis infection in a woman Mild bladder prolapse in a 42 year old woman may be treated with When determining whether an infant is on track in terms of gross motor skill development, it is important to know that he can roll from prone to supine by A patient can be diagnosed with pernicious anemia if During routine follow up of a patient with obstructive sleep apnea, the NP knows that the patient may need to be referred for adjustment of positive airway pressure therapy if he experiences A breastfeeding mother presents with symptoms of mastitis. Which of the following is not included in the clinical approach to treatment When treating a woman with urinary incontinence, the lifestyle medication that is not appropriate is Which credential is typically listed first behind a NP’s name Which one of the following is not part of the diagnostic criteria for attention deficit disorder in the diagnostic and statistical manual of mental disorders A 2 year old boy presents with shortness of breath temp of 103Fand lethargy. Four weeks ago, he underwent surgery to repair a congenital heart defect. Based on his past history and these symptoms, the next step should be to After completion of a 7 day course of doxycycline for the treatment if chlamydia, an 18 year old adolescent returns to the clinic for a follow up exam. Symptoms appear to have resolved and the NP instructs the patient to return for retesting The most common cause of bacterial pneumonia in 2 year old is The most likely history or physical finding in a patient with migraine headaches is The best method for preventing gonorrhea and chlamydia in teenagers is to An example of secondary prevention is to Which immunization is contraindicated during pregnancy A 6 year old girl was treated for pinworms 1 week ago and now presents with scattered honey-colored crusts of nonbullous lesions on her right hand. The NP should A 20 year old woman states that her 45 year old mother was recently diagnosed with breast cancer. The best tool to assess her risk for developing breast cancer would be the White or grayish/brown speckling on the periphery of the iris of a 6 month old boy with down syndrome is documented as A 16 year old boy is diagnosed with genital warts and wonders what caused this condition. The appropriate response would be that the most common cause is What type of seizure is characterized by 2-15 seconds of staring, eye flutters, and automatisms Laboratory findings for a 66 year old woman show a low serum iron level, elevated total iron binding capacity, and low serum ferritin level. These results are consistent with The diagnostic criterion for COPD is FEV1/FVC ratio of The risk of developing metabolic alkalosis in a 48 year old man with a 35 pack year smoking history is most likely related to Which condition is not likely to have an associated symptom of hemoptysis Bronchiectasis An ankle brachial index (ABI) to determine if a patient has peripheral arterial disease Is positive for the disease if the ABI reading is <0.9 An elevated alpha fetoprotein (AFP) level is documented in a 34 year old pregnant woman. The most likely reason for the elevation is that A 45 year old man places his hand over his sternum and complains of nausea and chest pain. This gesture could be suggestive of A 40 year old woman who underwent gastric bypass surgery approximately 12 weeks ago returns for follow up. Labs reveal a hematocrit of 33%, hemoglobin of 11, MCV of 72, and mch of 26. Based on these results, the best action for the NP to initiate next is to The symptom not associated with an anterior cystocele in a 40 year old woman is The most common cause of urethritis in men is When using the gtpal system to document a woman’s maternal history, the “t” stands for term births, which is considered delivery after A 62 year old patient is complaining of pain and stiffness in both hands. During the examination, the NP notes hard, bony swelling in the distal interphalangeal joints. These are known as Persistent facial redness, flushing, dryness, and sensitivity of the cheeks that worsens with exercise and with ingestion of spicy foods are the presenting symptoms of a 29 year old woman. These symptoms are most likely associated with A 45 year old woman receives immunotherapy injections weekly, along with fexofenadine and fluticasone nasal spray daily. Today she is diagnosed with a viral upper respiratory infection. The most appropriate intervention would be to Chronic bacterial prostatitis is not likely to be caused by The most common congenital heart defect is A 6 month old infant boy with a history of ventricular septal defect presents with a poor appetite wheezing cough and shortness of breath. To evaluate these symptoms the NP should order Expected spirometry readings in a patient who has chronic bronchitis include A 30 year old woman has … unilateral palsy of the right cheek for the past 36 hours. Which cranial nerve is most likely to be involved A 38 year old man has polycythemia vera and is scheduled for phlebotomy. The goal of therapeutic phlebotomy is to reduce blood viscosity. It is aimed at bringing which component of the cbc into normal range A 48 year old woman has a history of diethylstilbestestrol exposure while in utero. Because of her history, this patient may be at increased risk for A lack of fat in a child’s diet can negatively impact the growth and development of the brain. Therefore, limiting fat consumption should not occur before at least Recommendations intended to optimize patient care and that are … by a systematic review of evidence and an assessment of the benefits and harms of alternative care options are known as A 56 year old woman states that she is experiencing shock like intermittent right sided pain in her lips, face, mouth and cheek when yawning. It subsides abruptly. The diagnosis is most likely When initiating a thiazolidinedione for the treatment of type 2 diabetes in an older adult the best practice would be to A patient with mechanical heart valve is receiving warfarin. Once the inr is … at therapeutic levels it should be monitored at least A straightleg raise in the supine position is positive on the left side between 30 and 60 degrees. This most likely indicates Complications of untreated chlamydia in a 40 year old woman are not likely to include The NP should expect adolescents between the ages of 12 and 14 to Acetaminophen 500 mg tid is prescribed for an 85 year old woman to treat left knee pain caused by osteoarthritis. Acetaminophen has not been effective in relieving her pain, therefore, the next step should be A patient with type 2 diabetes is started on insulin glargine. To reduce the risk of hypoglycemia, which drug class should be discontinued A patient with acute epicondylitis needs further education about the management of symptoms if he says Which one of the following is a diagnostic criterion for bacterial vaginosis A 42 year old woman with a history of surgically induced menopause is complaining of stress incontinence. She is found to have mild bladder prolapse. The most appropriate treatment for this patient is When considering preventive screening in adults, which of the following statements is incorrect A high potency steroid should be avoided on the face and which other area on the body A young woman presents with a swollen painful ankle after stepping in a hole. History reveals that she has likely inverted her ankle, which is likely to cause a The leading cause of vision loss among patients older than 65 years is Which of the following is true about multiphasic forms of oral contraceptives Aa 20 year old pitcher is diagnosed with epicondylitis of the elbow. The assessment is most likely to reveal A 30 year old man complains of heaviness in his scrotum and palpable mass of the inguinal canal. The least likely differential diagnosis is A NP student is preparing to take the certification exam for practice as a NP. Which of the following is a certifying body for NPs When prescribing pregabalin a schedule V substance for a patient with neuropathy the prescription should not A patient presents with loss of function and sensation in the fifth digit. The NP identifies hypothenar atrophy which is suggestive of A 13 year old boy presents with an abrupt onset of high fever and sore throat and he exhibits the sniffing position. These symptoms are consistent with After providing instructions for activities of daily living to a 66 year old man with heart failure the NP understands that he needs further education after he states A 68 year old patient presents with a painful erythematous maculopapular rash over the left posterior scapular area. The rash does not extend beyond midline. The clinician suspects A 40 year old woman with a longstanding history of asthma has been treated with inhaled steroids for about 20 years. Assessment of this patient might reveal A 68 year old man who underwent a mitral valve replacement 3 months ago has been on warfarin therapy. This patient needs to … that the warfarin A 40 year old complains of breathing difficulty that awakens him from sleep. He states that when he sits up his breathing improves. The most likely diagnosis is A sleep disturbance that might be reported by a 20 year old woman … with anxiety is Medicare Part A coverage provides payment for A 78 year old woman is … with pneumonia. Further examination reveals that she is moderately dehydrated. However, her chest x-ray does not demonstrate infiltrates because A 30 year old premenopausal woman presents with a breast lump. The lump is nontender and is approximately 1 cm in diameter. The NP should An adult man complains of two episodes of erectile dysfunction. The LEAST important assessment of sexual dysfunction is The assessment of a 72 year old man causes the NP to have concerns that include risk for suicide. Which one of the following is not a risk factor for suicide in older adults? A 25 year old woman complains that the presence of hirsutism over her face and chest is negatively affecting her quality of life. The most effective initial pharmacologic therapy for this patient would be A lack of fat in a child’s diet can negatively impact the growth and development of the brain. Therefore, limiting fat consumption should not occur before at least A 30 year old patient is starting a career in the healthcare industry. The NP knows that the hepatitis B vaccine A 70 year old woman has diffuse lentigo spots on her arms that have developed over time. The NP should inform the patient that A NP is treating a 12 year old child for suspicious injuries. Which statement is correct about reporting suspected child abuse in the US? A 36 year old woman’s pap results reveal precancerous cells. The NP knows that the most common type of cervical cancer is The vaccine that can minimize complications … to the disease that causes painful … , blistering rash that follows a dermatomal pattern is the A 45 year old man complains of acute flank pain radiating toward the groin and testicles. For … nephrolithiasis, the first line treatment regimen includes Toradol IM plus A sexual maturity assessment of a 12 year old boy indicates that he is starting puberty. The most likely finding was A mother is inquiring about the HPV vaccine for her son. The NP advises her that this vaccine is recommended Evaluation of cognitive function in a 70 year old man reveals that he has transient difficulty recalling names of people, objects or certain details of specific events. Reasoning and judgment skills are intact. These symptoms are consistent with A patient has been taking a histamine 2 blocker for reflux symptoms. Which H2 blocker is … with the most drug-drug interactions? A 51 year old man with atrial fibrillation is taking warfarin. Therapeutic anticoagulation should … with an An adult patient is … with acute bacterial rhinosinusitis. He was … with azithromycin 4 weeks ago for sore throat. He is allergic to penicillin. The next best treatment is A NP-led clinic has received a wood’s lamp. The NP knows that this device is NOT beneficial in diagnosing When evaluating a patient with … depression, the finding that is … to diagnose depression is A 33 year old woman … with depression has been … for 8 months with Lexapro 20 mg daily. She states that her mood is better and she would like to discontinue the medication. The NP should reassess her symptoms and if improved: A 52 year old patient with type 2 diabetes has been receiving Levaquin for the treatment of acute sinusitis. What new symptom indicates that this patient will need IV therapy? [Show More]

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