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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

 

obesity

 

hirsutism

 

Question 9

 

Which is a synovial joint? Question options:

 

skull

 

vertebral bodies of the spine

 

shoulder

 

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

 

decongestants

 

expectorants

 

antihistamines

 

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:

 

 

 

 

 

hypertension

 

asthma

 

pneumonia

 

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

 

trichotillomania

 

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

 

bursitis

 

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:

 

 

 

 

 

pseudoephedrine

 

hydrochlorothiazide

 

promethazine

 

meclizine

 

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

 

hypertension

 

osteoarthritis

 

vertigo

 

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

 

chylothorax

 

pleural empyema

 

Question 36

 

Which pathogen is associated with common UTIs? Question options:

 

Streptococcus

 

Klebsiella

 

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:

 

tympany

 

 

 

dullness

 

hyperresonance

 

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

 

weakness

 

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:

 

 

 

suprapubic

 

abdominal

 

flank

 

back

 

Question 51

 

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

 

Question options:

 

 

 

 

 

Minipress (prazosin)

 

Urecholine (bethanechol)

 

Urispas (flavoxate)

 

pseudoephedrine

 

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:

 

 

 

 

 

epididymitis

 

inguinal hernia

 

testicular torsion

 

cryptorchidism

 

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:

 

 

 

 

 

renin

 

estrogen

 

insulin

 

 

 

 

 

progesterone

 

Question 61

 

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

 

Question options:

 

 

 

 

 

Colchicine

 

Steroids

 

NSAIDs

 

Allopurinol

 

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:

 

 

 

 

 

malignancy

 

normal finding

 

fibroadenoma

 

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

 

BUN

 

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

 

COPD

 

rib fracture

 

 

 

 

 

pneumothorax

 

Question 66

 

Which cranial nerves are assessed when assessing bilateral eye movement?

 

Question options:

 

 

 

 

 

II, III, IV

 

III, IV, and VI

 

III, IV, VII

 

II, IV, 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:

 

Urge

 

 

 

 

 

Stress

 

Overflow

 

Functional

 

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:

 

 

 

 

 

arteriovenous

 

venous

 

capillary bed

 

arterial

 

 

 

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:

 

NPH

 

 

 

 

 

regular

 

immediate-acting

 

long-acting

 

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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