NRNP 6531 Midterm Exam (3 Versions, 300 Q & A, Latest-2022-2023)NRNP-6531N Midterm Exam, Exams of Nursing

Download NRNP 6531 Midterm Exam (3 Versions, 300 Q & A, Latest-2022-2023)NRNP-6531N Midterm Exam and more Exams Nursing in PDF only on Docsity! NRNP 6531 Midterm Exam (3 Versions, 300 Q & A, Latest-2022/2023)NRNP-6531N Midterm Exam: Walden University | 100% Verified Q & A • Question 1 0 out of 0 points When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Selected Answer: Ye s Answers: Ye s • Question 2 The most common cancer found on the auricle is: Selected Answer: Basal cell carcinoma Answers: Actinic keratosis 1 out of 1 points No Basal cell carcinoma Squamous cell carcinoma Acral-lentiginous melanoma • Question 3 0 out of 1 points Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient? • Question 8 1 out of 1 points A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect: Selected Answer: Answers: Gonococcal conjunctivitis Viral conjunctivitis Common pink eye Gonococcal conjunctivitis Allergic conjunctivitis • Question 9 0 out of 1 points A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 different thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect: Selected Answer: Answers: A complicated case of shingles and prescribe acyclovir, an analgesic, and a topical cortisone cream A common case of shingles and prescribe an analgesic and an antiviral agent A complicated case of shingles and prescribe acyclovir, an analgesic, and a topical cortisone cream Herpes zoster and consider that this patient may be immunocompromised A recurrence of chickenpox and treat the patient’s symptoms • Question 10 0 out of 1 points Which type of lung cancer has the poorest prognosis? Selected Answer: Answers: Adenocarcinoma Adenocarcinoma Epidermoid carcinoma Small cell carcinoma Large cell carcinoma • Question 11 1 out of 1 points An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3– 4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has: Selected Answer: Answers: Chronic diarrhea Acute diarrhea Chronic diarrhea Irritable bowel Functional bowel disease • Question 12 1 out of 1 points Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect? Selected Answer: Systemic lupus Answers: An allergic reaction Relapsing polychondritis Lymphocytoma cutis Systemic lupus erythematosus • Question 13 1 out of 1 points Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes? Selected Answer: Answers: Acute bronchitis Chronic sinusitis Acute bronchitis Bacterial pneumonia Acute exacerbation of chronic bronchitis • Question 14 0 out of 1 points Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations affect her activities and they occur at least 6 1 out of 1 points Final Exam compliation Answer: It is also called whooping cough Answers: It is also called whooping cough It begins with symptoms like strep throat It lasts about 3 weeks It occurs most commonly in toddlers and young children • Question 18 0 out of 1 points Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis? Selected Answer: Answers: Asthma Pneum o nia Asthma Sinusitis Pertussis • Question 19 1 out of 1 points A 70 year old patient presents with left lower quadrant (LLQ) abdominal pain, a markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition? Selected Answer: Answers: Diverticulit is Diverticulo sis Diverticula 8 NRNP 6531 Final Exam compliation Diverticulit is Diverticulu m • Question 20 1 out of 1 points Sylvia, age 83, presents with a 3 day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect? Selected Answer: Answers: Herpes zoster Varicella Herpes zoster Syphilis Rubella • Question 21 0 out of 1 points A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is: Selected Answer: Answers: Medicati o ns Alcohol Gallstone s Medicatio ns Pregnanc y • Question 22 9 Answers: Colonoscopy Small bowel follow- through Barium enema CT abdomen • Question 25 1 out of 1 points A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with: Selected Answer: Answers: Systolic heart failure Mitral regurgitation Systolic heart failure Cardiac myxoma Diastolic heart failure • Question 26 1 out of 1 points Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized? 11 Selected Answer: Answers: Multilobar involvement on chest x-ray with the inability to take oral medications Multilobar involvement on chest x-ray with the inability to take oral medications Alert and oriented, slightly high but stable vital signs, and no one to take care of her at home Sputum and gram positive organisms A complete blood count showing leukocytosis • Question 27 0 out of 1 points A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him: Selected Answer: Answers: “It is the most common cause of death in patients with skin cancer.” “It is the most common cause of death in patients with skin cancer.” “It can be cured with surgical excision or radiation therapy.” “It is a slow growing skin cancer that rarely undergoes malignant changes.” “It can be cured using 5-flurouracil cream twice daily for 2 to 4 weeks.” • Question 28 1 out of 1 points Expected spirometry readings when the patient has chronic emphysema include: 12 Selected Answer: Answers: Increased total lung capacity (TLC) Decreased residual volume (RV) Increased vital capacity (VC) Increased forced expiratory volume (FEV-1) Increased total lung capacity (TLC) • Question 29 1 out of 1 points An 80-year-old male admits to difficulty swallowing during the review of systems. The nurse practitioner recognizes the differential diagnosis for this patient’s dysphagia is: Selected Answer: Answers: A and C Esophage al cancer Chest pain GERD A and C All of the above • Question 30 0 out of 1 points A 40 year old female with history of frequent sun exposure presents with a multicolored lesion on her back. It has irregular borders and is about 11mm in diameter. What should the nurse practitioner suspect? 13 Cold climates • Question 34 0 out of 1 points A patient has experienced nausea and vomiting, headache, malaise, low grade fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is elevated with a shift to the left. He is requesting medication for diarrhea. What is the most appropriate response? Selected Answer: Answers: Order stool cultures. Prescribe loperamide (Immodium) or atropine-diphenoxylate (Lomotil) and a clear liquid diet for 24 hours. Prescribe a broad-spectrum antibiotic such as ciprofloxacin (Cipro), and symptom management. Offer an anti-emetic medication such as ondansetron (Zofran) and provide oral fluid and electrolyte replacement instruction. Order stool cultures. • Question 35 1 out of 1 points Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order? Selected Answer: Answers: Antihista mi nes Aspirin NSAIDs Opioids 15 NRNP 6531 Final Exam compliation Antihistami nes • Question 36 0 out of 1 points Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is: Selected Answer: Answers: Peripheral edema Peripheral edema Weight gain Shortness of breath Nocturnal dyspnea • Question 37 1 out of 1 points A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe? Selected Answer: Answers: Amoxicillin Ibuprofen Erythromyc i n Amoxicillin Acetaminop hen • Question 38 1 out of 1 points A 70 year old man who walks 2 miles every day complains of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 16 2 mile walk. What question asked during the history, if answered affirmatively, would NRNP 6531 Final Exam compliation suggest a diagnosis of arteriosclerosis obliterans? Selected Answer: Answers: “Is your leg pain relieved by rest?” “Are you wearing your usual shoes?” “Do you also have chest pain when you have leg pain?” “Is your leg pain relieved by rest?” “Do you ever have the same pain in the other leg?” • Question 39 0 out of 1 points Which of the following statements about malignant melanomas is true? Selected Answer: Answers: They usually occur in older adult males They usually occur in older adult males The patient has no family history of melanoma They are common in blacks The prognosis is directly related to the thickness of the lesion • Question 40 1 out of 1 points Sheila, age 78, presents with a chief complaint of waking up during the night coughing. You examine her and find an S3 heart sound, pulmonary crackles that do not clear with coughing, and peripheral edema. What do you suspect? Selected Answer: Heart failure Assess the patient’s cranial nerves. Compare the patient’s blood pressure lying first, then sitting, and then standing. Compare the amplitude of the patient’s radial and pedal pulses. • Question 45 1 out of 1 points What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery? NRNP 6531 Final Exam compliation Selected Answer: Ursodiol Answers: Ursodiol Ibuprof en Predn isone Sur gery is the only answ er • Question 46 0 out of 1 points A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is: Selected Answer: Answers: Staphylococcus aureus Staphylococcus aureus Group A beta hemolytic streptococcus Haemophilus influenza Pseudomonas aeruginosa 20 • Question 47 0 out of 1 points Which of the following is not a symptom of irritable bowel syndrome? Selected Answer: Answers: Painful diarrhea Painful diarrhea Painful constipation Cramping and abdominal pain Weight loss • Question 48 1 out of 1 points A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed? Selected Answer: Answers: Any recent trauma Any recent trauma Difficulty swallowing Stiffness in the right shoulder Change in sleeping habits • Question 49 0 out of 1 points Marvin, age 56, is a smoker with diabetes. He has just been diagnosed as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis? Selected Answer: Answers: ACE Inhibitor ACE Inhibitor Beta Blocker Calcium channel blocker Diuretic • Question 50 antihistamine Answers: Bedrest and an antihistamine Fluids and a decongestant A sedative and decongestant Rest and a low sodium diet • Question 55 Treatment of H.pylori includes which of the following? Selected Answer: Answers: A, B, and C Proton pump inhibitor Antibiotic therapy Bismuth subsalicylat e A and B A, B, and C • Question 56 1 out of 1 points 1 out of 1 points Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect? Selected Answer: Retinal detachmen Answers: t Cataracts Glaucoma Retinal detachment Iritis • Question 57 1 out of 1 points In order to decrease deaths from lung cancer: Selected Answer: Answers: Patients should be counseled to quit smoking All smokers should be screened annually All patients should be screened annually Only high risk patients should be screened routinely Patients should be counseled to quit smoking • Question 58 1 out of 1 points John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia? Selected Answer: Answers: Every 5 years Every 5 years Every 2 years Every year Whenever blood work is done • Question 59 1 out of 1 points Mort is hypertensive. Which of the following factors influenced your choice of using an alpha blocker as the antihypertensive medication? Selected Answer: Answers: Mort has benign prostatic hyperplasia Mort is black Mort also has congestive heart failure Mort has benign prostatic hyperplasia Mort has frequent migraine headaches • Question 60 1 out of 1 points John, age 59, presents with recurrent, sharply circumscribed red papules and plaques with a powdery white scale on the extensor aspect of his elbows and knees. What do you suspect? Selected Answer: Answers: Psoriasis Actinic keratosis Eczema Psoriasis Seborrheic dermatitis Dependent on cessation of NSAID use • Question 64 1 out of 1 points Shirley, age 58, has been a diabetic for 7 years. Her blood pressure is normal. Other than her diabetes medications, what would you prescribe today during her routine office visit? Selected Answer: An ACE Inhibitor Answers: A calcium channel blocker A beta blocker An ACE Inhibitor No hypertension medication • Question 65 1 out of 1 points Medicare is a federal program administered by the Centers for Medicare and Medicaid Services (CMS). The CMS has developed guidelines for Evaluation and Management coding, which all providers are expected to follow when coding patient visits for reimbursement. Which of the following is an important consideration regarding billing practices? Selected Answer: Answers: Failing to bill for billable services will lead to unnecessarily low revenues It is important to “undercode” so that one does not get charged with Medicare fraud The practice of “overcoding” is essential in this age of decreasing reimbursements Failing to bill for billable services will lead to unnecessarily low revenues Time spent with the patient is a very important determinant of billing • Question 66 1 out of 1 points A 2 year old presents with a white pupillary reflex. What is the most likely cause of this finding? Selected Answer: Answers: Retinoblasto m a Viral conjunctivitis Glaucoma Corneal abrasion Retinoblastom a • Question 67 0 out of 1 points Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo? Selected Answer: Answers: A labyrinthectomy Pharmacological therapy A labyrinthectomy A vestibular neurectomy Wearing an earplug in the ear with the most hearing loss • Question 68 0 out of 1 points Which of the Genetic factors Selected Answer: Answers: Hyperhomocystein emia Hyperhomocystein emia Smoking Alcohol ingestion • Question 69 1 out of 1 points An 18-year-old female presents to the urgent care center complaining of severe pruritus in both eyes that started 2 days ago. Associated symptoms include a headache and fatigue. On examination, the nurse practitioner notes some clear discharge from both eyes and some erythema of the eyelids and surrounding skin. Which of the following is the most likely cause of this patient’s symptoms? Selected Answer: Answers: Allergic conjunctiviti s Allergic conjunctiviti s Bacterial conjunctiviti s Gonococcal conjunctiviti s Viral conjunctivitis • Question 70 0 out of 1 points A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most effective in keeping him symptom-free? Selected Answer: Answers: A long-acting bronchodilator A long-acting bronchodilator An inhaled corticosteroid and cromolyn Theophylline and a short acting bronchodilator 1 out of 1 points A patient presents with classic symptoms of gastroesophageal reflux disease (GERD). He is instructed on life style modifications and drug therapy for 8 weeks. Three months later he returns, reporting that he was “fine” as long as he took the medication. The most appropriate next step is: Selected Answer: Answers: Investigation with endoscopy, manometry, and/or pH testing Referral for surgical intervention such as a partial or complete fundoplication Dependent upon how sever the practitioner believes the condition To repeat the 8 week course of drug therapy while continuing lifestyle modifications NRNP 6531 Final Exam compliation Investigation with endoscopy, manometry, and/or pH testing • Question 76 0 out of 1 points Group A β-hemolytic streptococcal (GABHS) pharyngitis is most common in which age group? Selected Answer: Answers: Under 3 years of age Under 3 years of age Preschool children 6 to 12 years of age Adolescents • Question 77 The most appropriate treatment for a child with mild croup is: Selected Answer: Answers: A decongestant A bronchodilator An antibiotic A decongestant A cool mist vaporizer • Question 78 0 out of 1 points 33 0 out of 1 points A child complains that his “throat hurts” with swallowing. His voice is very “throaty” and he is hyperextending his neck to talk. Examination reveals asymmetrical swelling of his NRNP 6531 Final Exam compliation tonsils. His uvula is deviated to the left. What is the most likely diagnosis? Selected Answer: Answers: Epiglottitis Peritonsilla r abscess Thyroiditis Mononucleosis Epiglottitis • Question 79 1 out of 1 points Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication? Selected Answer: Answers: It is not effective during an acute asthma attack. It is not effective during an acute asthma attack. It may take 2 to 3 days to begin working. This drug works within 10 minutes. This drug may be used by patients 6 years and older. • Question 80 0 out of 1 points Which intervention listed below is safe for long term use by an adult with constipation? 34 What is the Gold standard for the diagnosis of asthma? Selected Answer: Answers: Spirometry Patient’s perception of clogged airways Validated quality-of-life questionnaires Bronchoscopy Spirometry • Question 84 1 out of 1 points 0 out of 1 points A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough? Selected Answer: Answers: Methyldopa Methyldopa Enalapril Amlodipine Hydrochlorothia zide • Question 85 1 out of 1 points Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by: Selected Answer: Candidiasis Herpes 36 Answers: simplex Aphthous ulcers Candidiasis Oral cancer • Question 86 1 out of 1 points Risk factors for acute otitis media (AOM) include all of the following except: • Question 87 1 out of 1 points Which of the following can result from chronic inflammation of a meibomian gland? Selected Answer: A chalazion Answers: 37 Selected Answer: Answers: African-American ethnicity Household cigarette smoke Group daycare attendance Sibling history of acute otitis media African-American ethnicity A chalazion Uveitis Keratitis A pterygiu m • Question 88 0 out of 1 points What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare? Selected Answer: Answers: You must initiate the plan of care for the patient You must initiate the plan of care for the patient The physician must be on-site and engaged in patient care You must be employed as an independent contractor You must be the main health care provider who sees the patient • Question 89 1 out of 1 points Of the Acute pharyngitis Allergic rhinitis • Qu est ion 90 1 out of 1 points The most common correlate(s) with chronic bronchitis and emphysema is(are): Selected Answer: Answers: Acute pharyngitis Asthma Gastroesophageal reflux • Question 93 1 out of 1 points Which of the following heart murmurs warrants the greatest concern? Selected Answer: Answers: Diastolic murmur Systolic murmur Venous hum murmur Diastolic murmur Flow murmur • Question 94 1 out of 1 points 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? Selected Answer: Answers: Blepharitis; treat with warm compresses and gentle debridement with a cotton swab Hordeolum; treat with a topical antibiotic and warm compress Conjunctivitis; treat with topical antibiotic and warm compresses Blepharitis; treat with warm compresses and gentle debridement with a cotton swab Chalazion; refer to an ophthalmologist for incision and drainage • Question 95 1 out of 1 points A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory? Selected Answer: Inferior wall Answers: Inferior wall Anterior wall Apical wall Lateral wall • Question 96 0 out of 1 points The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The least likely diagnosis for this patient is: Selected Answer: Answers: Otitis media with effusion Acute otitis media (AOM) Otitis media with effusion Mucoid otitis media Serous otitis media • Question 97 0 out of 1 points Alan, age 54, notices a bulge in his midline every time he rises from bed in the morning. You tell him it is a ventral hernia, also known as: Selected Answer: Answers: incisiona l hernia inguinal hernia epigastric hernia umbilical hernia incisional hernia • Question 98 1 out of 1 points A 58-year-old man is diagnosed with Barrett’s esophagus after an endoscopy. He has no known allergies. Which of the following medications is MOST appropriate to treat this patient’s disorder? Selected Answer: Answers: Omeprazol e Omeprazole Ranitidine An antacid None of the above • Question 99 1 out of 1 points Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to: Selected Answer: Quit smoking What differentiates primary adrenocortical insufficiency from secondary adrenocortical insufficiency? Skin hyperpigmentation is present in primary adrenocortical insufficiency What is Trousseau's sign? A carpal spasm elicited by compression of the upper arm with a BP cuff that indicates hypocalcemia. What is Chovstek's sign? A hemifacial tic that is induced by tapping the facial nerve below the maxilla that indicates hypocalcemia. What is Babinski's sign? An upward response (extension) of the hallux when the sole of the foot is stimulated with a blunt instrument. Can identify spinal cord disease in adults. What is Romberg's sign? Loss of balance in standing when eyes are closed. Usually indicating a loss of proprioception or lesion in the cerebellum. What is Homan's sign? pain on passive dorsiflexion of ankle, associated with DVT. What is the clinical presentation of Goodpasture's syndrome? Urinalysis: Specific gravity: 1.020. pH 5.5, 1+ albumin and large blood present. Chest XR positive for bilateral diffuse infiltrates. BUN 30, Cr 3.0 Symptoms: dyspnea with hemoptysis What is Goodpasture syndrome? Damage to alveolar and renal glomerular basement membranes by cytotoxic antibody. Initial treatment for Goodpasture's syndrome? Hospitalization, pulse dose of steroids, begin plasmapheresis and cyclophosphamide therapy. Characteristics of Grave's disease Ophthalmopathy (lid retraction, scleral show, proptosis) and hyperthyroidism What organism causes the formation of a staghorn calculus? Proteus mirabilus What organism causes Toxic shock syndrome? Staphylococcus aureus What electrolyte disturbance is most likely to lead to tetany and neuromuscular irritability? Hypocalcemia Features of hypercalcemia include? 45 "Stones, groans, moans, and bones." Delerium and renal stones When you see hypochloremia, the patient may have? Metabolic Alkalosis Hyperkalemia is associated with what cardiac abnormalities? peaked T-waves, wide QRS, and ventricular arrhythmias. A patient presents with arcus cornea, LDL 285, TG 110, HDL 45, and father died of an MI at age 45. What is his most likely diagnosis? Heterozygous familial hypercholesterolemia A fasting blood glucose level of 130 mg/dL indicates: Diabetes What are risk factors for ectopic pregnancy? smoking, previous tubal surgery, previous ectopic pregnancy, exposure to diethylibestrol, current IUD, PID, advanced maternal age, infertilitiy for more than 2 years. What hormones are most critical to replace in a patient at risk for anterior pituitary insufficiency? Glucocorticoids, and thyroid hormone What is diabetes insipidus? a disorder caused by inadequate amounts of ADH which causes excessive water loss CKD Stage 1 GFR >90 with evidence of renal damage, as indicated by proteinuria. CKD Stage 2 GFR 60-89 benign prostatic hyperplasia, bladder cancer, nephrolithiasis, neuromuscular disorders, prostate cancer, strictures, trauma What is are intrinsic causes of renal failure? Acute glomerulonephritis, ischemic injury, nephrotoxins, malignant hypertension What classification of drugs cause urinary retention? anticholinergics (ipratropium) Common secondary causes of nephrotic syndrome lupus and diabetes Presenting symptoms of nephrotic syndrome loss of appetite, fatigue, ascites, lower extremity edema, proteinuria, low blood albumin, and hyperlipidemia. What is the initial insulin loading dose for a patient in DKA? 0.1 to 0.15 units/kg/hr with hourly glucose monitoring What is Hashimoto's thyroiditis? autoimmune destruction of thyroid gland, Anti-thyroid stimulating hormone (TSH) receptor antibodies inhibit release of thyroid hormone. Upgrade to remove ads Only $2.99/month What would you do first for an incidental finding of an adrenal mass? Overnight dexamethasone suppression test. Clinical signs of PCOS oligomenorrhea, infertility, hirsutism, obesity, and 2/3 Rotterdam criteria: 48 oligo-ovulation or anovulation clinic of biochemical signs of hyperandrogenism polycystic ovaries on US Treatment for simple cystitis 5 days of nitrofurantoin Define the acronym MUDPILES Acronym for identifying a high anion gap metabolic acidosis: Methanol Uremia Diabetic ketoacidosis Paraldehyde Iron, isoniazid Lactate Ethanol, ethylene glycol Salicylates First-line evaluation of vulvovaginal candidiasis wet mount Prolonged nausea and vomiting can result in: Metabolic alkalosis loss of gastric acid Clinical signs/symptoms of uremic pericarditis worsening anemia, absence of diffuse ST-segment T-wave elevations, fever, pleuritic chest pain, pain that increases in recumbent position. Hemodialysis treatment should be heparin free. What is hepatorenal syndrome? chronic or acute renal disease with advanced hepatic failure and portal hypertension. What complaint is common with patients who have acute on chronic urinary retention? urinary incontinence Aside from potassium chloride as a supplement, what can be used to treat hypokalemia? Magnesium For a patient who is lethargic and hyperkalemic, what is the first line therapy? Calcium gluconate or calcium chloride Priapism is a known side effect of what medication? Trazodone What is the maximum compensation of PaCO2 in metabolic acidosis? 26 signs of preeclampsia BP > 140/90 proteinuria >300 mg of protein in urine in 24 hours headache visual changes 2+ pitting edema Question 2. Which of the following is a potential acquired cause of thrombophilia Homocysteinuria Protein C deficiency Factor V Leiden Antiphospholipid antibodies Question 3 Phalen's test, 90°wrist flexion for 60 seconds, reproduces symptoms of: Ulnar tunnel syndrome Carpal tunnel syndrome Tarsal tunnel syndrome Myofascial pain syndrome Question 4 Which patient would benefit most from screening for type 2 diabetes? A 30 year old female with unintended weight loss. A 25 year old male with family history of type 1 diabetes An obese female with recurrent vaginitis A 50 year old hyperlipidemic male Question 5 A 72 year old female patient reports a 6 month history of gradually progressive swollen and painful distal interphalangeal (DIP) joints of one hand. She has no systemic symptoms but the erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), and rheumatoid factor (RF) are all minimally elevated. What is the most likely diagnosis? Rheumatoid arthritis (RA) Osteoarthritis (OA) Lupus Peripheral neuropathy Decreased TSH and decreased T3 Elevated TSH and increased T4 Question 17 Risk factors for prostate cancer include all of the following except: Family history Benign prostatic hypertrophy African American race Age Question 18 What information should patients with diabetes and their families receive about hypoglycemia? Hypoglycemia is a rare complication. Hypoglycemia requires professional medical treatment. Hypoglycemia is serious, dangerous, and can be fatal if not treated quickly. Hypoglycemia occurs only as a result of insulin overdose. Question 19 Which history is commonly found in a patient with glomerulonephritis? Beta-hemolytic strep infection Frequent urinary tract infections Kidney stones Hypotension Question 20 Which of the following is characteristic of a manic episode? weight loss of gain insomnia or hypersomnia diminished ability to think or concentrate grandiose delusions Question 21 Central obesity, "moon" face, and dorsocervical fat pad are associated with: Metabolic syndrome Unilateral pheochromocytoma Cushing's syndrome None of the above Question 22 Which of the following is the most common cause of low back pain? Lumbar disc disease Spinal stenosis Traumatic fracture Osteoporosis Question 23 A middle-aged female presents complaining of recent weight loss. The physical exam reveals an enlarged painless cervical lymph node. The differential diagnosis for this patient's problem includes: Infection Toxoplasmosis Mononucleosis All of the above None of the above Question 24 An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for this patient, the nurse practitioner is most concerned with which of the following side effects? Weight gain Fracture risk Hypoglycemia Weight loss Question 25 A patient has HIV infection and is having a problem with massive diarrhea. You suspect the cause is cryptococcosis toxoplasmosis cryptosporidiosis cytomegalovirus Question 26 Which of the following is the most common causative organism of nongonococcal urethritis? Chlamydia trachomatis Ureaplasma urealyticum Mycoplasma hominis Trichonomas vaginalis Question 27 The most common symptoms of transient ischemic attack (TIA) include Nausea, vomiting, syncope, incontinence, dizziness, and seizure. Weakness in an extremity, abruptly slurred speech, or partial loss of vision, and sudden gait changes. Headache and visual symptoms such as bright spots or sparkles crossing the visual field. Gradual onset of ataxia, vertigo, generalized weakness, or lightheadedness Question 28 What is the first symptom seen in the majority of patients with Parkinson's disease? Rigidity Bradykinesia Rest tremor Flexed posture Question 29 A 21-year-old female presents to the office complaining of urinary frequency and urinary burning. The nurse practitioner suspects a urinary tract infection when the urinalysis reveals 1-4 red blood cells per high-powered field Specific gravity 1.012 Urobilinogen 10- white blood cells per high-powered field Question 30 A 26 year old female presents with elbow pain that is described as aching and 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: Radial tunnel syndrome Ulnar collateral ligament sprain Olecranon bursitis Lateral epicondylitis: Tennis Elbow Question 31 Maria, age 17, was raped when she was 13 year old. She is now experiencing sleeping problems, flashbacks, and depression. What is your initial diagnosis? Depression Panic disorder Anxiety Post-traumatic stress disorder Question 32 An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days later, he returns to the office complaining of left great toe pain. On exam, the nurse practitioner notes an edematous, erythematous tender left great toe. The likely precipitant of this patient's pain is: Trauma Question 43 The diagnosis which must be considered in a patient who presents with a severe headache of sudden onset, with neck stiffness and fever, is: Migraine headache Subarachnoid hemorrhage Glaucoma Meningitis Question 44 What conditions must be met for you to bill "incident to" the physician, receiving 100% reimbursement from Medicare? You must initiate the plan of care for the patient The physician must be on-site and engaged in patient care You must be employed as an independent contractor You must be the main health care provider who sees the patient Question 45 The most commonly recommended method for prostate cancer screening in a 55 year old male is: Digital rectal examination (DRE) plus prostate specific antigen (PSA) Prostate specific antigen (PSA) alone Transrectal ultrasound (TRUS) alone Prostate specific antigen (PSA) and transrectal ultrasound (TRUS) Question 46 The primary goals of treatment for patients with alcohol abuse disorder are: Reduction in withdrawal symptoms and reduction in desire for alcohol Psychotherapeutic and pharmacological interventions to decrease desire for and effects of alcohol Abstinence or reduction in use, relapse prevention, and rehabilitation Marital satisfaction, improvement in family functioning, and reduction in psychiatric impairment Question 47 You are assessing a patient after a sports injury to his right knee. You elicit a positive anterior/posterior drawer sign. This test indicates an injury to the: Lateral meniscus Cruciate ligament Medical meniscus Collateral ligament Question 48 Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue syndrome, which have many similarities. Which of the following is more characteristic of fibromyalgia? Musculoskeletal pain Difficulty sleeping Depression Fatigue Question 49 Differential diagnosis of proteinuria includes which of the following? Orthostatic proteinuria Nephrotic syndrome Infection Trauma A and B Question 50 A patient presenting for an annual physical exam has a BMI of 25 kg/m2 This patient would be classified as: Underweight Normal weight Overweight Obese Question 51 Reed-Sternberg B lymphocytes are associated with which of the following disorders: Aplastic anemia Hodgkin's lymphoma Non Hodgkin's lymphoma Myelodysplastic syndromes Question 53 A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects: Arthritis Ulnar neuritis Septic arthritis Olecranon bursitis Question 54 Establishment of a definitive diagnosis of osteomyelitis requires: A known causative injury such as a puncture wound, bite, or decubitus ulcer. Biopsy of culture of the pathogen from blood or bone aspirate. Visualization of purulent material draining into soft tissue. Lucent areas identified on plain x-ray. Question 55 The most accurate measure of diabetes control is: Avoidance of micro- and macro-vascular complications. Insulin sensitivity. Early morning glucose levels. HgbA1c Question 56 A patient has been diagnosed with generalized anxiety disorder (GAD). Which of the following medications may be used to treat generalized anxiety disorder? Alprazolam or diazepam Venlafaxine or buspirone Trazodone or sertraline Venlafaxine or hydroxyzine pamoate Question 57 The most common presentation of thyroid cancer is: Generalized enlargement of the thyroid gland. A solitary thyroid nodule. A multinodular goiter. Abnormal thyroid function tests. Question 58 Which of the following accounts for half of the bladder tumors among men and one-third in women? Cigarette smoke, both active and passive inhalation Chemicals from plastic and rubber Chronic use of phenacetin-containing analgesic agents Working long hours and not voiding often Question 59 You have a new patient that presents with generalized lymphadenopathy. You know that this is indicative of: Federal statutes State laws and regulations Certifying bodies Question 70 Which of the following physical modalities recommended for treatment of rheumatoid arthritis provides the most effective long term pain relief? Superficial and deep heat Application of cold Transcutaneous electrical nerve stimulation (TENS) Exercise Question 71 A patient presents with dehydration, hypotension, and fever. Laboratory testing reveals hyponatremia, hyperkalemia, and hypoglycemia. These imbalances are corrected, but the patient returns 6 weeks later with the same symptoms of hyperpigmentation, weakness, anorexia, fatigue, and weight loss. What action(s) should the nurse practitioner take? Obtain a thorough history and physical, and check serum cortisol and ACTH levels. Obtain a diet history and check CBC and FBS. Provide nutritional guidance and have the patient return in 1 month. Consult home health for intravenous administration of fluids and electrolytes. Question 72 Jack, age 55, comes to the office with a blood pressure of 144/98 mm Hg. He states that he did not know if it was ever elevated before. When you retake his blood pressure at the end of the exam, it remains at 144/98. What should your next action be? Start him on an ACE Inhibitor Start him on a diuretic Have him monitor his blood pressure at home Try nonpharmacological methods and have him monitor his blood pressure at home Martin is complaining of erectile dysfunction. He also has a condition that has reduced arterial blood flow to his penis. The most common cause of this condition is: Parkinson's disease Epilepsy Multiple sclerosis Diabetes mellitus Question 74 Which of the following is not a risk factor associated with the development of syndrome X and type 2 diabetes mellitus? Hypertriglyceridemia and low high-density lipoprotein (HDL) Gestational diabetes and polycystic ovarian syndrome Hispanic, African-American, Native-American, and Pacific Islander ethnicity Postprandial hypoglycemia Question 75 A 28-year-old female presents to the office requesting testing for diagnosis of hereditary thrombophilia. Her father recently had a deep vein thrombosis and she is concerned about her risk factors. The nurse practitioner explains that: The patient should start anticoagulant therapy immediately. Hereditary thrombophilia does not always require anticoagulation therapy. Women of childbearing age cannot take anticoagulant therapy. Genetic and risk management counseling are recommended. B and D Question 76 The 4 classic features of Parkinson's disease are Mask-like facies, dysarthria, excessive salivation, and dementia. Tremor at rest, rigidity, bradykinesia, and postural disturbances. Depression, cognitive impairment, constipation and shuffling gait. Tremor with movement, cogwheeling, repetitive movement, and multi-system atrophy. Question 77 Which of the following set of symptoms should raise suspicion of a brain tumor? Recurrent, severe headaches that awaken the patient and are accompanied by visual disturbances. Vague, dull headaches that are accompanied by a reported sense of impending doom. Periorbital headaches occurring primarily in the evening and accompanied by pupillary dilation and photophobia. Holocranial headaches present in the morning and accompanied by projective vomiting without nausea. Question 78 The most common cause of elevated liver function tests is: Hepatitis Biliary tract obstruction Chronic alcohol abuse A drug-induced injury Question 79 The physiological explanation of syncope is: Accelerated venous return and increased stroke volume resulting in deactivation of the parasympathetic nervous system. A cycle of inappropriate vasodilation, bradycardia, and hypotension. A sudden rise in blood pressure due to overly efficient vasoconstriction. Emotional stress resulting in hypertension, tachycardia, and increased venous return. Question 80 A 60 year old male patient with multiple health problems presents with a complaint of erectile dysfunction (ED). Of the following, which medication is most likely to be causing the problem? Thiazide diuretic Insulin Famotidine (Pepcid) Albuterol Question 81 The cardinal sign of infectious arthritis is: Affected joint is painful at rest, with movement and weight bearing Rapid onset that wakes the patient during the night Long history of severe pain with associated joint swelling None of the above Question 82 A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains: Primary hyperparathyroidism is treated with Vitamin D restriction Primary hyperparathyroidism is treated with parathyroidectomy Primary hyperparathyroidism is treated with daily magnesium Primary hyperparathyroidism is treated with parenteral parathyroid hormone (PTH) Question 83 Which of the following is not appropriate suppression therapy for chronic bacterial prostatitis? Doxycycline 100 mg qd Nitrofurantoin 100 mg qd Bactrim DS qd Question 93 The intervention known to be most effective in the treatment of severe depression, with or without psychosis, is: Psychotherapy Electroconvulsive therapy (ECT) A selective serotonin reuptake inhibitor (SSRI) A tricyclic antidepressant (TCA) Question 94 The initial clinical sign of Dupuytren's contracture is: Pain with ulnar deviation Painless nodule on palmer fascia Pain and numbness in the ring finger Inability to passively extend finger Question 95 Which of the following is the most common complication of the myelodysplastic syndromes Fatigue Cardiomyopathy Falls Bleeding Question 96 What information should a 42 year old patient with newly diagnosed diabetes receive about exercise? Buy good walking shoes with support and a flexible sole. Exercise at least 5 days per week. Snack before exercise. Do not exercise if your blood sugar is greater than 180 mg/dL Question 97 What is the most commonly abused substance? Heroin Cocaine Alcohol Marijuana Question 98 Sam, age 67, is a diabetic with worsening renal function. He has frequent hypoglycemic episodes, which he believes means that his diabetes is getting "better." How do you respond? "You're right; it seems like your diabetes is improving." "Because your kidneys are not functioning well, your insulin is not being metabolized and excreted as it should, so you need less of it." "You have watched your diet for all these years and as a result, your body is using less insulin." "I will have to change your oral hyperglycemic agents as it seems your body is making more insulin." Question 99 A child with type 1 diabetes mellitus has experienced excessive hunger, weight gain and increasing hyperglycemia. The Somogyi effect is suspected. What steps should be taken to diagnose and treat this condition? Decrease the evening insulin dose and check capillary blood glucose (CBG) at 2:00 am. Instruct the child's parents on physical activities to help weight loss. Increase the evening insulin dose and check CBG at 2:00 am. Refer the child for instruction on a strict diabetic diet. Question 100 At what age is screening most likely to detect scoliosis? 4 to 6 years 8 to 10 years 12 to 14 years 18 to 20 years Question 101 The most reliable indicator(s) of neurological deficit when assessing a patient with acute low back pain is(are): Patient report of bladder dysfunction, saddle anesthesia, and motor weakness of limbs. History of significant trauma relative to the patient's age. Decreased reflexes, strength, and sensation in the lower extremities. Patient report of pain with the crossed straight leg raise. A patient who has had a swollen, nontender scrotum for one week is found to have a mass within the tunica vaginalis that transilluminates readily. The family nurse practitioner suspects: a.) a hydrocele. b.) a varicocele. c.) an indirect inguinal hernia. d.) carcinoma of the testis. a hydrocele. A client had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute: A) Prerenal inflammation B) Bladder outlet obstruction C) Tubular necrosis D) Intrarenal nephrotoxicity Bladder outlet obstruction Mr. S. comes to you with scrotal pain. The examinations of his scrotum, penis, and rectum are normal. Which of the following conditions outside of the scrotum may present as scrotal pain? A. Inguinal herniation and peritonitis B. Renal colic and cardiac ischemia C. Pancreatitis and Crohn ' s disease D. Polyarteritis nodosa and ulcerative colitis Inguinal herniation and peritonitis The most common type of hernia is a(n): A. indirect inguinal hernia. B. direct inguinal hernia. C. femoral hernia. D. umbilical hernia. indirect inguinal hernia. Max, age 70, is obese. He is complaining of a bulge in his groin that has been there for months. He states that it is not painful, but it is annoying. You note that the origin of swelling is above the inguinal ligament directly behind and through the external ring. You diagnose this as a(n): A. indirect inguinal hernia. B. direct inguinal hernia. C. femoral hernia. D. strangulated hernia. direct inguinal hernia. A 35 year old sexually active man presents with a 1 week history of fever and pain over the left scrotum. It is accompanied by frequency and dysuria. The scrotum is edematous and tender to touch. He denies flank pain, nausea, and vomiting. He reports that eh pain is lessend when he uses scrotal-support briefs. The urinalysis shows 2 + blood and a large number of leukocytes. What is the most likely diagnosis? A. Acute urinary tract infection B. Acute pyelonephritis C. Acute orthitis D. Acute epididymitis Milton, a 72 year old unmarried, sexually active white man presents to your clinic with complaints of hesitancy, urgency, and occasional uncontrolled dribbling. Although you suspect benign prostatic hypertrophy, what else should your differential diagnosis include? Urethral stricture (may develop as a result of sexually transmitted diseases and should be considered in a sexually active individual no matter what the age) Harry has BPH and complains of some incontinence. Your first step in diagnosing overflow incontinence would be to order a: Post void residual urine measurement Lower urinary tract symptoms in males can present as a constellation of storage or voiding symptoms. Storage symptoms include: urgency and nocturia A 63-year-old man presents to you with hematuria, hesitancy, and dribbling. DRE reveals a moderately enlarged prostate that is smooth. The client's PSA is 1.2. What is the most appropriate management strategy for you to follow at this time? Prescribe an alpha adrenergic blocker, which will relax bladder and prostate smooth muscle to improve flow and relieve symptoms. According to the AUA guideline on the management of BPH, when is referral for invasive surgery automatically warranted? With the presence of refractory retention and bladder stones. What differentiates prostate cancer symptoms from BPH? Symptoms of prostate cancer in general tend to progress more rapidly than those of BPH. The most common gram-negative bacteria that causes both acute and chronic bacterial prostatitis is A. Staphylococcus aureus B. Klebsiella C. Escherichia coli D. Enterobacteriaceae Escherichia coli 73 A history of urinary tract infections in males is often seen in men with chronic bacterial prostatitis. Other signs and symptoms of chronic bacterial prostatitis includes A. irritative voiding symptoms, low back pain, and perineal pain. B. nausea and vomiting, as well as fever. C. loss of appetite and weight loss. D. irritative voiding symptoms, inability to ambulate, and fever. irritative voiding symptoms, low back pain, and perineal pain. When performing a prostate examination, you note a tender, warm prostate. What do you suspect? A. Benign prostatic hypertrophy B. Prostatic abscess C. Prostate cancer D. Bacterial prostatitis Bacterial prostatitis Gerard is complaining of a scrotal mass; however, the scrotum is so edematous that it is difficult to assess. How do you determine if it is a hernia or a hydrocele? Bowel sounds may be heard over a hernia. Mr. S comes to you with scrotal pain. The examinations of his scrotum, penis, and rectum are normal. Which of the following conditions outside of the scrotum may present as scrotal pain? Inguinal hernia and peritonitis A 17 year old boy reports feeling something on his left scrotum. On palpation, soft and movable blood vessels that feel like a "bag of worms" are noted underneath the scrotal skin. It is not swollen or reddened. The most likely diagnosis is A. Chronic orchitis B. Chronic epididymitis C. Testicular torsion D. Varicocele Varicocele 74 What risk factors contribute to varicocele? A. Younger age B. Current cigarette smoker C. Multiple sex partners D. None of the above None of the above Treatment options for varicocele repair include all of the following except: A. Open surgery B. Laparoscopic surgery C. Treatment with a thrombolytic agent D. Percutaneous embolization Treatment with a thrombolytic agent There is a higher risk of balanitis in which of the following conditions? A. Renal Insufficiency B. Diabetes Mellitus C. Graves' disease D. Asthma Diabetes Mellitus Balanitis is caused by: A. Staphylococcus aureus B. Streptococcus pyogenes C. Candida albicans D. Trichomonads Candida albicans Balanitis is a symptom of which one of the following diseases A. Psoriatic arthritis B. Reactive arthritis C. Alkylosing Spondylitis D. Rheumatoid arthritis Reactive arthritis The average American man has an approximately % lifetime risk of prostate cancer and an approximately % likelihood of clinical disease. A. 15, 5 B. 25, 8 C. 40, 10 D. trichloroacetic acid Topical acyclovir What antibiotic would you expect NOT to give to a pregnant woman with a UTI? Bactrim - TMP avoid use during pregnancy secondary to possible risk of teratogenicity What is the most common symptom of upper UTI in young children? Fever What lab result will be altered if a patient has taken an antibiotic? Urine Culture What is the preferred method to collect a urine specimen in children who are not toilet-trained? catheterization When would you consider a CT scan or renal ultrasound for patients with acute pyelonephritis? If the patient has not improved after 48-72 hours on an appropriate antibiotic. What four reasons would you consider the infection complicated until proven otherwise? If the patient is a man, an older adult, or child, or has symptoms lasting more than 7 days What medication would you expect not to use in acute pyelonephritis? Do not use nitrofurantoin because poor tissue concentrations are achieved in the renal parenchyma To decrease the production of uric acid stones, the family nurse practitioner orders which medication? A. allopurinol (zyloprim) B. indomethacin (indocin) C. bethanechol (urecholine) D. phenazopyridine (pyridium) allopurinol (zyloprim) You see a 58-year-old man diagnosed with a kidney stone who reports pain primarily during urination. You consider all of the following except: A. improved hydration. B. alpha blocker use. C. prescribing a diuretic. D. analgesia use prescribing a diuretic. Your 35-year-old patient is being worked up for microscopic hematuria. All of the following are differential diagnoses of microscopic hematuria except: A) Kidney stones B) Bladder cancer 527 C) Acute pyelonephritis D) Renal artery stenosis Renal artery stenosis A 65-year-old carpenter complains of stiffness and pain in both hands and right knee shortly after waking and worsens in the afternoon. He feels some relief with rest. On, exam the nurse practitioner notices the presence of Heberden's nodes. Which of the following is most likely? a. Osteoporosis b. Rheumatoid Arthritis c. Osteoarthritis d. Reiter's syndrome Osteoarthritis Mary, age 72, has severe osteoarthritis of her right knee. She obtains much relief from corticosteroid injections. When she asks you how often she can have them, how do you respond? A. Only once a year in the same joint B. No more than twice a year in the same joint C. No more than three to four times a year in the same joint D. No more than five to six times a year in the same joint No more than three to four times a year in the same joint Your 75-year-old client with osteoarthritis of the knee will be starting on a course of NSAIDs for pain management. The most important teaching point for your patient currently is: A. You should start with a high dose first and taper down the dose as needed. B. You should continue to take your Coumadin as you have been. C. Report any excessive stomach upset or if you notice that your stools become dark or bloody. D. At this point, it will not be helpful to lose weight. Report any excessive stomach upset or if you notice that your stools become dark or bloody. A 45-year-old woman in complaining of generalized stiffness, especially in both her wrist and hands. It is much worse in the morning and last a few hours. She also complains of fatigue and generalized body aches that have been present for the past few months. Which of the following is most likely? a. Osteoporosis b. Rheumatoid arthritis c. Osteoarthritis d. Gout Rheumatoid arthritis Ginny, age 48, has rheumatoid arthritis and gets achy and stiff after sitting through a long movie. This is referred to as A. longevity stiffness B. gelling A 48-year old obese female presents to the clinic with complain of pain on the bottom of her feet with the first few steps in the morning that gets worse with prolonged walking. You would suspect: A. Gout B. Morton's Neuroma C. Rheumatoid Arthritis D. Plantar fasciitis Plantar fasciitis Which of the following is used to evaluate patients with medial collateral ligament injury? a. Varus test b. McMurray test c. Lachman test d. Valgus test Lachman test The Lachman maneuver is used to detect which of the following? A. instability of the knee B. nerve damage of the knee due to past knee injuries C. integrity of the patellar tendon D. tears on the meniscus of the knee tears on the meniscus of the knee A positive drawer sign supports a diagnosis of: a. sciatica b. cruciate ligament injury c. hip dislocation d. patellar ligament injury cruciate ligament injury A 15-year-old high school athlete complains of a painful area below both knees. He tells you they feel bone-like and are tender to palpation. He denies any hot joints, fever, rash, or difficulties with weight- bearing. Which of the following conditions is most likely? a) osteomyelitis b) internal tibial torsion c) Osgood-Schlatter Disease d) Calve-Perthe's Disease Osgood-Schlatter Disease 82 When caring for the child with Osgood-Schlatter Disease, the nurse practitioner would know her treatment has been effective when: a. The child no longer complains of pain at lower knee at rest b. The child no longer complains of pain at the ankle at rest. c. The child no longer complains of pain at the hip during exercise. d. The child no longer complains of pain at lower knee during exercise. The child no longer complains of pain at lower knee during exercise. Common risk factors for Osgood Schlatter Disease include: a. Highly active with open growth plates b. Significant Growth Spurt c. Typically asymmetrical but can occur bilaterally d. Boys> Girls e. All of the above All of the above What must you you do to diagnose a distal femur, patellar, and proximal tibia fracture? Obtain imaging according to Ottawa knee rules What are the key physical findings of patellar fractures? palpable DEFECT on patella, HEMARTHROSIS, Failure to do STRAIGHT LEG RAISE = failure of EXTENSOR MECHANISM (retinaculum displaced) Heidi, age 29, is a nurse who has an acute episode of back pain. You have determined that it is a simple "mechanical" backache and order A) Bedrest for 2 days B) Muscle relaxants C) "Let pain be your guide" and continue activities D) Back-strengthening exercises "Let pain be your guide" and continue activities Beth, age 49, comes in with low back pain. An x-ray of the lumbar/sacral spine is within normal limits. Which of the following diagnoses do you explore further? A. Scoliosis B. Osteoarthritis C. Spinal stenosis D. Herniated nucleus pulposus Herniated nucleus pulposus John, age 17, works as a stock boy at the local supermarket. He is in the office for a routine visit. You notice that he had an episode of low back pain 6 months ago from improperly lifting heavy boxes. In discussing proper body mechanics with him to prevent future injuries, you tell him, A. " Bend your knees and face the object straight on. " B. " Hold boxes away from your body at arm 's length. " C. " Bend and twist simultaneously as you lift. " D. " Keep your feet firmly together. " " Bend your knees and face the object straight on. " With the straight-leg-raising test, the NP is evaluating tension on which of the following nerve roots? A. L1 and L2 B. L3 and L4 C. L5 and S1 D. S2 and S3 L5 and S1 The most common sites for lumbar disk herniation are: A. L1 to L2 and L2 to L3. B. L2 to L3 and L4 to L5. C. L4 to L5 and L5 to S1. D. L5 to S1 and S1 to S2 L4 to L5 and L5 to S1 Immediate diagnostic imaging for low back pain should be reserved for all of the following EXCEPT: A. presence of signs of the cauda equina syndrome. B. presence of severe neurological deficits. C. presence of risk factors for cancer. D. presence of moderate pain lasting at least 2 weeks. presence of moderate pain lasting at least 2 weeks. First-line therapy for prepatellar bursitis should include: A. bursal aspiration. B. intrabursal corticosteroid injection. C. acetaminophen. D. knee splinting. bursal aspiration. Clinical conditions with a presentation similar to acute bursitis include which of the following? (More than one can apply.) A. rheumatoid arthritis B. septic arthritis C. joint trauma D. pseudogout all of the above