22 Sep Which headache sign does not warrant an immediate investigation?
Which headache sign does not warrant an immediate investigation?
aggravated or relieved by change of position
precipitated by Valsalva maneuver
new onset after age 50
relieved with use of common analgesics
During a migraine, what happens to the cerebral arteries? Question options:
You are evaluating a 15 year old patient for bipolar disorder. His parents tell you that he has severe mood swings, is easily distracted, and constantly corrects his teachers. You would have a high suspicion for bipolar if which symptom was present?
he is forgetful
he sleeps less than 4 hours nightly
he does not complete tasks
he blurts out answers in class inappropriately
Which risk factor is not associated with breast cancer? Question options:
use of hormone replacement therapy
personal or family history of breast cancer
low socioeconomic status
A 26 year old woman with bulimia is likely to be: Question options:
What medication is used to relieve acute wheezing in a patient with asthma?
short acting beta agonist
long acting beta agonist
You are evaluating an 80 year old patient for recent episodes of incontinence and confusion. His family states that this is unusual for him and he has become increasingly forgetful over the past two weeks. Which medication might be responsible for this?
What suggests hyperandrogenism in an adolescent female? Question options:
high pitched voice
Which is a synovial joint? Question options:
vertebral bodies of the spine
pubic symphysis of the pelvis
A 67 year old woman with atrial fibrillation and an ejection fraction of 48% is on digoxin and has had normal digoxin levels of 0.8- 2 ng/dL for the past 9 months. Today, the level is 0.4 ng/dL. What could account for this change?
regular use of an antacid
decreased creatinine clearance
Which medication is contraindicated in a child with acute sinusitis?
Which best describes the lower extremity calf pain associated with peripheral artery disease?
sharp, stabbing pain
dull aching or cramping
Jugular venous distention accompanied by chest pain is associated with:
Which immunization protects against a virus that is transmitted through blood and body fluids and can lead to chronic liver disease?
Typhoid fever vaccine
A pediatric patient has areas of scaling on the scalp with round patches of hair loss. What is the likely diagnosis?
Your 70 year old patient complains of a sore mouth that prevents her from eating. On exam you note a beefy red, glossy smooth tongue. What do you suspect?
cheilosis, a serious disease of the mouth and oropharynx
pernicious anemia due to insufficient intrinsic factor
a neurological disorder such as Parkinson’s disease
A 62 year old male presents with leg pain and occasional numbness that is worse with ambulation and improved with lumbar flexion. What is the likely diagnosis?
cauda equina syndrome
Which is not a typical symptom of late stage HIV? Question options:
lymphadenopathy of more than 3 months
persistent, unexplained fatigue
A pregnant patient presents for her 16 week prenatal visit. Her blood pressure had reduced from 118/79 to 109/68. What hemodynamic change is responsible for this?
decrease in cardiac output
decrease in systemic vascular resistance
decrease in stroke volume
decrease in preload
Your 62 year old patient has been taking Griseofulvin 500 mg po BID for 3 weeks to treat tinea capitis and has only had marginal improvement. What is your next step?
have the patient shave his head and warn him that hair regrowth will be slow
continue the current therapy for 6-8 weeks
Add 2.5% selenium sulfide shampoo twice weekly to the regimen
prescribe a short course or oral steroids
Rapid HIV testing would be most appropriate for a patient with complaints of:
painful urination, dyspareunia, and penile or vaginal discharge
painful bowel movements, anal itching, and abnormal menstrual bleeding or painful and swollen te
painful urination, lower abdominal pain, and dyspareunia
fever, headache, and lymphadenopathy
What is a frequent side effect of SSRIs? Question options:
You might suspect small bowel obstruction in a patient who complains of:
hematemesis and bloody stool
nausea and diarrhea
vomiting and pain
indigestion and anorexia
What finding would be suggestive of osteosarcoma in a pediatric patient?
pain in the affected bone
What clinical manifestation suggests primary syphilis? Question options:
a single painless genital lesion
rash marked by red or reddish-brown penny sized lesions on the palms and soles
poor muscle coordination
What medication is used first line for a patient with benign positional vertigo?
Which symptom is most associated with testicular torsion? Question options:
A clinical breast exam should include palpation at the tail of Spence. Where is this located?
laterally across the anterior axillary fold
lower inner quadrant
lower outer quadrant
upper inner quadrant
Which area does not drain to the right lymph duct? Question options:
Which presentation is most suspicious for penile cancer? Question options:
a group of small, scattered vesicles
a nontender, indurated penile nodule
papules with a variety of shapes
What is important to consider before prescribing metronidazole for giardiasis?
whether the patient drinks alcohol
whether the patient is at least 18 years of age
presence of a sulfa allergy
past medical history of peptic ulcer disease
In which condition would the use of triptans for migraine headaches be contraindicated?
Which is a true statement about varicose veins? Question options:
They are usually diagnosed on clinical presentation.
They are not affected by pregnancy.
They are due to congenital valve deformities.
They are more symptomatic during ovulation.
When measuring the fundal height of a pregnant woman at 32 weeks, which measurement would prompt the nurse practitioner to suspect fetal growth restriction?
What is the term for excess fluid that accumulates in the pleural cavity between the visceral and parietal spaces?
Which pathogen is associated with common UTIs? Question options:
Which medication inhibits blood coagulation by selectively blocking the active site of factor X-a?
Which is a contraindication for menopausal estrogen replacement therapy in a 55 year old woman?
history of phlebitis
family history of lung cancer
prior breast or uterine carcinoma
current or past migraine headaches
During abdominal exam, which sound over the bulging area of the abdomen would indicate ascitic fluid?
What is a typical finding in a patient with a meniscal tear? Question options:
fixed patellar subluxation
positive McMurray’s test
audible click at the joint line
positive anterior drawer test
What is the most common presenting symptom of a woman with trichomoniasis?
painless, ulcerated vulvar lesion with vaginal discharge
dyspareunia and abdominal pain
fever, papules, and vaginal discharge with burning
What is the single dose treatment for chlamydia?
Rocephin (ceftriaxone) 250 mg IM
Zithromax (azithromycin) 1 g po
Vibramycin (doxycycline) 200 mg po
Flagyl (metronidazole) 2 g po
What is the mechanism of action of prostaglandin E1 in a patient with transposition of the great arteries?
to prevent cyanotic episodes by trapping blood in the lower extremities
to produce vasodilation and adequate oxygen saturation
to maintain patency of the great arteries
to maintain equal pressure in the ventricles
How do 5-alpha reductase inhibitors work to reduce the symptoms of BPH?
relax smooth muscle in the bladder neck
decrease the size of the prostate
relax smooth muscle in the prostate capsule
increase blood flow to the prostate
Which condition is best treated by using alpha adrenergic antagonists?
What should not be prescribed for migraine prophylaxis in a 42 year old woman?
How would a 60 year old man typically describe prostate pain? Question options:
Located in the glans penis
Located in the suprapubic area
Located in the perineum
Located in the lower back
What is the most common characteristic among patients with migraine headache?
initial onset after age 35
Which patient would be at highest risk for contracting TB? Question options:
A nursing home resident
A low income immigrant
A person who smoke 2 packs per day
Someone who had recent contact with an infected patient
Which is not a location of pain associated with kidney and ureter disorders?
Which medication is appropriate for a woman with bladder sphincter dysfunction and stress incontinence?
Which condition is associated with chronic, bloody diarrhea? Question options:
irritable bowel syndrome
Which medication is indicated for patients with Generalized Anxiety Disorder (GAD)?
At what point in pregnancy should Rh negative women receive Rhogam (Rho D immune globulin)?
Which is common among patients with psoriasis? Question options:
pruritis, positive Auspitz sign, and pitted nails
pruritis, pitted nails, and satellite lesions
dermatomal rash and satellite lesions
pitted nails and plaques
What historical finding may predispose a patient to testicular cancer?
What would you advise for a patient taking an oral glucocorticoid?
take it in an empty stomach
crush it in applesauce
chew it prior to a high fat meal
take it with food
A child with enuresis should be treated with nasal desmopressin (DDAVP) for which symptom?
Which medication is not contraindicated in a patient with sulfa allergy?
silver sulfadiazine (Silvadene)
What is likely to be elevated in a woman with polycystic ovarian syndrome?
Which medication should not be prescribed during an acute gout flare?
A Hispanic woman at 26 weeks of pregnancy tells you that she has been eating ice. What should the NP do?
check the patient for diabetes
encourage her to eat more at mealtimes
tell her this is a dangerous cultural practice
check the patient for anemia
A 40 year old female patient has breasts with a soft texture, but uneven contour bilaterally. What is the most likely diagnosis?
What test of renal function is the best measure of renal insufficiency?
24 hour creatinine clearance
serum uric acid
You are seeing a 63 year old male who has decreased chest expansion, symmetric thorax with moderate kyphosis, and bilateral diaphragm distention of 2 cm. What is the most likely diagnosis?
Which cranial nerves are assessed when assessing bilateral eye movement?
II, III, IV
III, IV, and VI
III, IV, VII
II, IV, VI
What pathological finding is noted in asthma? Question options:
Which type of incontinence is most likely in a patient with Alzheimer’s disease who cannot reach the toilet in time?
Using GTPAL nomenclature, how would you document a patient currently pregnant with a history of an uncomplicated term vaginal delivery, preterm delivery of liveborn twins, and an 8 week elective abortion?
G4 T1 P1 A1 L3
G3 T1 P1 A1 L3
G4 T1 P2 A1 L3
G5 T1 P2 A2 L2
The right lymphatic ducts drain into what part of the circulatory system?
What is the most likely presenting symptom in a pediatric patient with croup?
shortness of breath
A barking cough
sudden onset of symptoms
Which medication targets postprandial glucose by blocking its transport across the intestine into the bloodstream?
Which type of insulin will help to reduce nocturnal hypoglycemia?
What symptoms in a college student living in a dorm would be suspicious for atypical community acquired pneumonia?
temp of 102, dyspnea, and diminished lung sounds on auscultation
low grade fever, malaise, and crackles audible throughout the lung fields
temp of 101.2, sore throat, and diminished lung sounds on auscultation
low grade fever, malaise, and clear lung fields on auscultation
How would you describe the lesions of condyloma accuminata in a male patient?
a red, nontender, enlarging nodule with induration
a group of small, scattered vesicles
multiple papular lesions with a verrucous appearance
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