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Which headache sign does not warrant an immediate investigation?

Which headache sign does not warrant an immediate investigation?

Question options:






                aggravated or relieved by change of position




                precipitated by Valsalva maneuver




                new onset after age 50


                relieved with use of common analgesics


Question 2


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?


Question options:






he is forgetful


he sleeps less than 4 hours nightly


he does not complete tasks


he blurts out answers in class inappropriately


Question 4


Which risk factor is not associated with breast cancer? Question options:


use of hormone replacement therapy


personal or family history of breast cancer


postmenopausal obesity


low socioeconomic status


Question 5


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?


Question options:






oral corticosteroid


short acting beta agonist


long acting beta agonist


inhaled corticosteroid


Question 7


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?


Question options:






Coumadin (warfarin)


Vitamin B-12


Tagamet (cimetidine)


Altace (ramipril)


Question 8


What suggests hyperandrogenism in an adolescent female? Question options:






polycystic ovaries


high pitched voice






Question 9


Which is a synovial joint? Question options:




vertebral bodies of the spine




pubic symphysis of the pelvis


Question 10


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?


Question options:




regular use of an antacid


increased exercise


weight loss






decreased creatinine clearance


Question 11


Which medication is contraindicated in a child with acute sinusitis?


Question options:




nasal steroids








Question 12


Which best describes the lower extremity calf pain associated with peripheral artery disease?


Question options:






electric shock


pulsating pain


sharp, stabbing pain


dull aching or cramping


Question 13


Jugular venous distention accompanied by chest pain is associated with:


Question options:












heart failure


Question 14


Which immunization protects against a virus that is transmitted through blood and body fluids and can lead to chronic liver disease?


Question options:




Hepatitis C


Typhoid fever vaccine


Hepatitis A


Hepatitis B


Question 15


A pediatric patient has areas of scaling on the scalp with round patches of hair loss. What is the likely diagnosis?


Question options:






alopecia areata




tinea capitis






seborrheic dermatitis


Question 16


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?


Question options:






cheilosis, a serious disease of the mouth and oropharynx


secondary hypothyroidism


pernicious anemia due to insufficient intrinsic factor


a neurological disorder such as Parkinson’s disease


Question 17


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?


Question options:






ankylosing spondylitis


cauda equina syndrome




spinal stenosis


Question 18


Which is not a typical symptom of late stage HIV? Question options:






lymphadenopathy of more than 3 months


persistent vomiting


night sweats


persistent, unexplained fatigue


Question 19


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?


Question options:






decrease in cardiac output


decrease in systemic vascular resistance


decrease in stroke volume


decrease in preload


Question 20


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?


Question options:






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


Question 21


Rapid HIV testing would be most appropriate for a patient with complaints of:


Question options:




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


Question 22


What is a frequent side effect of SSRIs? Question options:




















You might suspect small bowel obstruction in a patient who complains of:


Question options:


hematemesis and bloody stool






nausea and diarrhea


vomiting and pain


indigestion and anorexia


Question 24


What finding would be suggestive of osteosarcoma in a pediatric patient?


Question options:






pathologic fracture


pain in the affected bone


repeat fracture


apophyseal avulsion


Question 25


What clinical manifestation suggests primary syphilis? Question options:


no symptoms


a single painless genital lesion


rash marked by red or reddish-brown penny sized lesions on the palms and soles


poor muscle coordination


Question 26


What medication is used first line for a patient with benign positional vertigo?




Question options:














Question 27


Which symptom is most associated with testicular torsion? Question options:


testicular swelling


penile warts


erectile dysfunction


testicular pain


Question 28


A clinical breast exam should include palpation at the tail of Spence. Where is this located?


Question options:




laterally across the anterior axillary fold


lower inner quadrant


lower outer quadrant


upper inner quadrant




Question 29


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 chancre


a nontender, indurated penile nodule


papules with a variety of shapes


Question 31


What is important to consider before prescribing metronidazole for giardiasis?


Question options:




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


Question 32


In which condition would the use of triptans for migraine headaches be contraindicated?


Question options:






kidney stones








Question 33


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.


Question 34


When measuring the fundal height of a pregnant woman at 32 weeks, which measurement would prompt the nurse practitioner to suspect fetal growth restriction?




Question options:




29 cm


30 cm


31 cm


32 cm


Question 35


What is the term for excess fluid that accumulates in the pleural cavity between the visceral and parietal spaces?


Question options:






pericardial effusion


pleural effusion




pleural empyema


Question 36


Which pathogen is associated with common UTIs? Question options:






Proteus mirabalis


E coli




Question 37


Which medication inhibits blood coagulation by selectively blocking the active site of factor X-a?


Question options:






Coumadin (warfarin)


Pradaxa (dabigatran)


Lovenox (enoxaparin)


Eliquis (apixaban)


Question 38


Which is a contraindication for menopausal estrogen replacement therapy in a 55 year old woman?


Question options:






history of phlebitis


family history of lung cancer


prior breast or uterine carcinoma


current or past migraine headaches


Question 39


During abdominal exam, which sound over the bulging area of the abdomen would indicate ascitic fluid?


Question options:










normal resonance


Question 40


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


Question 41


What is the most common presenting symptom of a woman with trichomoniasis?


Question options:




vaginal discharge


painless, ulcerated vulvar lesion with vaginal discharge


dyspareunia and abdominal pain


fever, papules, and vaginal discharge with burning


Question 42


What is the single dose treatment for chlamydia?




Question options:






Rocephin (ceftriaxone) 250 mg IM


Zithromax (azithromycin) 1 g po


Vibramycin (doxycycline) 200 mg po


Flagyl (metronidazole) 2 g po


Question 43


What is the mechanism of action of prostaglandin E1 in a patient with transposition of the great arteries?


Question options:






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


Question 44


How do 5-alpha reductase inhibitors work to reduce the symptoms of BPH?


Question options:






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


Question 45


Which condition is best treated by using alpha adrenergic antagonists?


Question options:






renal insufficiency


urge incontinence


functional incontinence


overflow incontinence


Question 46


What should not be prescribed for migraine prophylaxis in a 42 year old woman?


Question options:






verapamil (Verelan)


amitriptyline (Elavil)


metoprolol (Lopressor)


sumatriptan (Imitrex)


Question 47


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


Question 48


What is the most common characteristic among patients with migraine headache?


Question options:






initial onset after age 35




family history


focal deficits


Question 49


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


Question 50


Which is not a location of pain associated with kidney and ureter disorders?




Question options:












Question 51


Which medication is appropriate for a woman with bladder sphincter dysfunction and stress incontinence?


Question options:






Minipress (prazosin)


Urecholine (bethanechol)


Urispas (flavoxate)




Question 52


Which condition is associated with chronic, bloody diarrhea? Question options:


celiac disease


irritable bowel syndrome


Hepatitis A


Crohn’s disease




Question 53


Which medication is indicated for patients with Generalized Anxiety Disorder (GAD)?


Question options:






Citalopram (Celexa)


Imipramine (Tofranil)


Buspirone (Buspar)


Bupropion (Wellbutrin)


Question 54


At what point in pregnancy should Rh negative women receive Rhogam (Rho D immune globulin)?


Question options:






6 weeks


35 weeks


28 weeks


12 weeks


Question 55


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


Question 56


What historical finding may predispose a patient to testicular cancer?


Question options:








inguinal hernia


testicular torsion




Question 57


What would you advise for a patient taking an oral glucocorticoid?


Question options:






take it in an empty stomach


crush it in applesauce


chew it prior to a high fat meal


take it with food


Question 58


A child with enuresis should be treated with nasal desmopressin (DDAVP) for which symptom?




Question options:






daytime incontinence


urinary pain


secondary enuresis


nocturnal enuresis


Question 59


Which medication is not contraindicated in a patient with sulfa allergy?


Question options:






celecoxib (Celebrex)


sumatriptan (Imitrex)


glimepride (Amaryl)


silver sulfadiazine (Silvadene)


Question 60


What is likely to be elevated in a woman with polycystic ovarian syndrome?


Question options:


















Question 61


Which medication should not be prescribed during an acute gout flare?


Question options:














Question 62


A Hispanic woman at 26 weeks of pregnancy tells you that she has been eating ice. What should the NP do?


Question options:






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


Question 63


A 40 year old female patient has breasts with a soft texture, but uneven contour bilaterally. What is the most likely diagnosis?


Question options:








normal finding




cystic breasts


Question 64


What test of renal function is the best measure of renal insufficiency?


Question options:




24 hour creatinine clearance


serum creatinine


serum uric acid




Question 65


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?


Question options:






pleural effusion




rib fracture








Question 66


Which cranial nerves are assessed when assessing bilateral eye movement?


Question options:








III, IV, and VI






Question 67


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?


Question options:














Question 69


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?


Question options:




G4 T1 P1 A1 L3


G3 T1 P1 A1 L3


G4 T1 P2 A1 L3


G5 T1 P2 A2 L2


Question 70


The right lymphatic ducts drain into what part of the circulatory system?


Question options:










capillary bed






Question 71


What is the most likely presenting symptom in a pediatric patient with croup?


Question options:






nocturnal symptoms


shortness of breath


A barking cough


sudden onset of symptoms


Question 72


Which medication targets postprandial glucose by blocking its transport across the intestine into the bloodstream?


Question options:




acarbose (Precose)


glipizide (Glucotrol)


metformin (Glucophage)


rosiglitazone (Avandia)


Question 73


Which type of insulin will help to reduce nocturnal hypoglycemia?


Question options:














Question 74


What symptoms in a college student living in a dorm would be suspicious for atypical community acquired pneumonia?


Question options:






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


Question 75


How would you describe the lesions of condyloma accuminata in a male patient?


Question options:






a chancre


a red, nontender, enlarging nodule with induration


a group of small, scattered vesicles


multiple papular lesions with a verrucous appearance




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