NSG6420 WEEK 5 QUIZ (3 VERSIONS) / NSG 6420 WEEK 5 QUIZ NSG6420 WEEK 5 MIDTERM QUIZ / NSG 6420 WEEK 5 MIDTERM QUIZ (NEWEST-2021): SOUTH UNIVERSITY |100% VERIFIED AND CORRECT ANSWERS|

NSG6420 WEEK 5 QUIZ (3 VERSIONS) / NSG 6420 WEEK 5 QUIZ NSG6420 WEEK 5 MIDTERM QUIZ / NSG 6420 WEEK 5 MIDTERM QUIZ (NEWEST-2021): SOUTH UNIVERSITY |100% VERIFIED AND CORRECT ANSWERS| NSG6420 Week 5 Midterm Quiz / NSG 6420 Week 5 Midterm Quiz (latest): South University South University NSG 6420 Week 5 Midterm Quiz / South University NSG6420 Week 5 Midterm Quiz Question 1: Which of the following symptoms is common with acute otitis media? Bulging tympanic membrane Bright light reflex of tympanic membrane Increased tympanic membrane mobility All of the above Question 2. The cytochrome p system involves enzymes that are generally: Inhibited by drugs Induced by drugs Inhibited or induced by drugs Associated with decreased liver perfusion Question 3. In AR disorders, carriers have: Two mutated genes; one from each parent that cause disease A mutation on a sex chromosome that causes a disease A single gene mutation that causes the disease One copy of a gene mutation but not the disease Question 4. A 56-year-old male complains of anorexia, changes in bowel habits, extreme fatigue, and unintentional weight loss. At times he is constipated and other times he has episodes of diarrhea. His physical examination is unremarkable. It is important for the clinician to recognize the importance of: CBC with differential Stool culture and sensitivity Abdominal X-ray Colonoscopy Question 5. Which of the following findings should trigger an urgent referral to a cardiologist or neurologist? History of bright flash of light followed by significantly blurred vision History of transient and painless monocular loss of vision History of monocular severe eye pain, blurred vision, and ciliary flush All of the above Question 6. In examination of the nose, the clinician observes gray, pale mucous membranes with clear, serous discharge. This is most likely indicative of: Bacterial sinusitis Allergic rhinitis Drug abuse Skull fracture Question 7. An 82-year-old female presents to the emergency department with epigastric pain and weakness. She admits to having dark, tarry stools for the last few days. She reports a long history of pain due to osteoarthritis. She self-medicates daily with ibuprofen, naprosyn, and aspirin for joint pain. On physical examination, she has orthostatic hypotension and pallor. Fecal occult blood test is positive. A likely etiology of the patient’s problem is: Mallory-Weiss tear Esophageal varices Gastric ulcer Colon cancer Question 8. Your patient is a 78-year-old female with a smoking history of 120-pack years. She complains of hoarseness that has developed over the last few months. It is important to exclude the possibility of: Thrush Laryngeal cancer Carotidynia Thyroiditis Question 9. Your patient has been using chewing tobacco for 10 years. On physical examination, you observe a white ulceration surrounded by erythematous base on the side of his tongue. The clinician should recognize that very often this is: Malignant melanoma Squamous cell carcinoma Aphthous ulceration Behcet’s syndrome Question 10. The best way to diagnose structural heart disease/dysfunction non-invasively is: Chest X-ray EKG Echocardiogram Heart catheterization Question 11. (*There are multiple questions on this exam related to this scenario. Be sure to read the whole way through to the question.) Mr.Keenan is a 42-year-old man with a mild history of GERD and a remote history of an appendectomy, presenting with an acute onset of significant right upper-quadrant abdominal pain and vomiting. His pain began after a large meal, was unrelieved by a proton-pump inhibitor, was unlike his previous episodes of heartburn, but upon questioning, reports milder, prodromal episodes of similar post-prandial pain. His pain seems to radiate to his back. Despite a family history of cardiac disease, he reports no classic anginal signs or chest pain. He furthermore denies respiratory or pleuritic signs and denies fever, night sweats, and unintended weight loss. Finally, there are no dermatologic signs, nor genitourinary symptoms. Of the following lab studies, which would provide little help in determining your differential diagnosis? Abdominal plain films Liver function tests Amylase/lipase Urinalysis Question 12. The pathophysiological hallmark of ACD is: Depleted iron stores Impaired ability to use iron stores Chronic unable bleeding Reduced intestinal absorption of iron Question 13. A 72-year-old woman and her husband are on a cross-country driving vacation. After a long day of driving, they stop for dinner.Midway through the meal, the woman becomes very short of breath, with chest pain and a feeling of panic. Which of the following problems is most likely? Pulmonary edema Heart failure Pulmonary embolism Pneumonia Question 14. A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The patient reports a smoking history of 2 packs of cigarettes per day since age 16. This would be recorded in the chart as: 50 x 2-pack years 100-pack years 50-year, 2-pack history 100-pack history Question 15. An 86-year-old patient who wears a hearing aid complains of poor hearing in the affected ear. In addition to possible hearing aid malfunction, this condition is often due to: Acoustic neuroma Cerumen impaction Otitis media Ménière’s disease Question 16. Which symptom is more characteristic of Non-Cardiac chest pain? Pain often radiates to the neck, jaw, epigastrium, shoulder, or arm Pain tends to occur with movement, stretching or palpation Pain usually lasts less than 10 minutes and is relieved by nitroglycerine Pain is aggravated by exertion or stress Question 17. Aortic regurgitation requires medical treatment for early signs of CHF with: Beta blockers ACE inhibitors Surgery Hospitalization Question 18. In examining the mouth of an older adult with a history of smoking, the nurse practitioner finds a suspicious oral lesion. The patient has been referred for a biopsy to be sent for pathology. Which is the most common oral precancerous lesion? Fictional keratosis Keratoacanthoma Lichen planus Leukoplakia Question 19. Iron Deficiency Anemia (IDA) is classified as a microcytic, hypochromic anemia. This classification refers to which of the following laboratory data? Hemoglobin and Hematocrit Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH) Serum ferritin and Serum iron Total iron binding capacity and transferrin saturation Question 20. A key symptom of ischemic heart disease is chest pain. However, angina equivalents may include exertional dyspnea. Angina equivalents are important because: Women with ischemic heart disease many times do not present with chest pain Some patients may have no symptoms or atypical symptoms; diagnosis may only be made at the time of an actual myocardial infarction Elderly patients have the most severe symptoms A & B only Question 21. An older patient reports burning pain after ingestion of many foods and large meals. What assessment would assist the nurse practitioner in making a diagnosis of GERD? Identification of a fluid wave Positive Murphy’s sign Palpable spleen Midepigastric pain that is not reproducible with palpation Question 22. When interpreting laboratory data, you would expect to see the following in a patient with Anemia of Chronic Disease (ACD): Hemoglobin 12 g/dl, MCV decreased, MCH decreased Hemoglobin 12 g/dl, MCV increased, MCH increased Hemoglobin 12 g/dl, MCV normal, MCH normal Hemoglobin 12 g/dl, MCV decreased, MCH increased Question 23. Symptoms in the initial human immunodeficiency virus (HIV) infection include all of the following except: Sore throat Fever Weight loss Headache Question 24. Epistaxis can be a symptom of: Over-anticoagulation Hematologic malignancy Cocaine abuse All of the above Question 25. In a patient presenting with suspected recurrence of diverticulitis, abdominal pain usually presents where in the abdomen? Left upper quadrant Right upper quadrant Left lower quadrant Right lower quadrant Question 26. Jeff, 48 years old, presents to the clinic complaining of fleeting chest pain, fatigue, palpitations, lightheadedness, and shortness of breath. The pain comes and goes and is not associated with activity or exertion. Food does not exacerbate or relieve the pain. The pain is usually located under the left nipple. Jeff is concerned because his father has cardiac disease and underwent a CABG at age 65. The ANP examines Jeff and hears a mid-systolic click at the 4th ICS mid-clavicular area. The ANP knows that this is a hallmark sign of: Angina Pericarditis Mitral valve prolapse Congestive heart failure Question 27. The first assessment to complete related to the eyes is: Eye lids Visual acuity Extraocular movements Peripheral vision Question 28. Rheumatic heart disease is a complication that can arise from which type of infection? Epstein-Barr virus Diphtheria Group A beta hemolytic streptococcus Streptococcus pneumoniae Question 29. A 22-year-old female comes to your office with complaints of right lower quadrant abdominal pain, which has been worsening over the last 24 hours. On examination of the abdomen, there is a palpable mass and rebound tenderness over the right lower quadrant. The clinician should recognize the importance of: Digital rectal examination Endoscopy Pelvic examination Urinalysis Question 30. Patients that have atopic disorders are mediated by the production of Immunoglobulin E (IgE) will have histamine stimulated as an immediate phase response. This release of histamine results in which of the following? Sinus pain, increased vascular permeability, and bronchodilation Bronchospasm, vascular permeability, and vasodilatation Contraction of smooth muscle, decreased vascular permeability, and vasoconstriction Vasodilatation, bronchodilation, and increased vascular permeability Question 31. Which of the following is the most common cause of heartburn-type epigastric pain? Decreased lower esophageal sphincter tone Helicobacter pylori infection of stomach Esophageal spasm Peptic ulcer disease Question 32. Which of the following statements is true concerning anti-arrhythmic drugs? Amiodarone is the only one not associated with increased mortality and it has a very favorable side effect profile. Both long-acting and short-acting calcium channel blockers are associated with an increased risk of cardiovascular morbidity and mortality. Most anti-arrhythmics have a low toxic/therapeutic ratio and some are exceedingly toxic. Anti-arrhythmic therapy should be initiated in the hospital for all patients. Question 33. During auscultation of the chest, your exam reveals a loud grating sound at the lower anterolateral lung fields, at full inspiration and early expiration. This finding is consistent with: Pneumonia Pleuritis Pneumothorax A and B Question 34. Which of the following would be considered a “red flag” that requires more investigation in a patient assessment? Colon cancer in family member at age 70 Breast cancer in family member at age 75 Myocardial infarction in family member at age 35 All of the above Question 35. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or patients? Clinical practice guideline Clinical decision rule Clinical algorithm Clinical recommendation Question 36. Your patient complains of a feeling of heaviness in the lower legs daily. You note varicosities, edema, and dusky color of both ankles and feet. Which of the following is the most likely cause for these symptoms? Femoral vein thrombosis Femoral artery thrombus Venous insufficiency Musculoskeletal injury Question 37. What is the most common valvular heart disease in the older adult? Aortic regurgitation Aortic stenosis Mitral regurgitation Mitral stenosis Question 38. Upon assessment of respiratory excursion, the clinician notes asymmetric expansion of the chest. One side expands greater than the other. This could be due to: Pneumothorax Pleural effusion Pneumonia Pulmonary embolism Question 39. A nurse practitioner reports that your patient’s abdominal X-ray demonstrates multiple air-fluid levels in the bowel. This is a diagnostic finding found in: Appendicitis Cholecystitis Bowel Obstruction Diverticulitis Question 40. According to the Genetic Information Nondiscrimination Act (GINA): Nurse Practitioners (NPs) should keep all genetic information of patients confidential NPs must obtain informed consent prior to genetic testing of all patients Employers cannot inquire about an employee’s genetic information All of the above NSG6420 Week 5 Midterm Quiz / NSG 6420 Week 5 Midterm Quiz (Latest): South University South University NSG 6420 Week 5 Midterm Quiz / South University NSG6420 Week 5 Midterm Quiz 1. Question : A 26-year-old, non-smoker, male presented to your clinic with SOB with exertion. This could be due to: Exercise-induced cough Bronchiectasis Alpha-1 deficiency Pericarditis Question 2. Question : A 74-year-old obese female presents complaining of persistent right upper quadrant pain. She reports that she has not had any prior abdominal surgeries. Which of the following laboratory studies would be most indicative of acute cholecystitis? C-reactive protein level of 3 mg White blood cell count of 11,000 Direct serum bilirubin level of 0.3 mg/dl Serum amylase level of 145 U/L Question 3. Question : What is the most common valvular heart disease in the older adult? Aortic regurgitation Aortic stenosis Mitral regurgitation Mitral stenosis Question 4. Question : Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or patients? Clinical practice guideline Clinical decision rule Clinical algorithm Clinical recommendation Question 5. Question : A nurse practitioner reports that your patient’s abdominal X-ray demonstrates multiple air-fluid levels in the bowel. This is a diagnostic finding found in: Appendicitis Cholecystitis Bowel Obstruction Diverticulitis Question 6. Question : During physical examination of a patient, you note resonance on percussion in the upper lung fields. This is consistent with: COPD Pneumothorax A normal finding Pleural effusion Question 7. Question : Essential parts of a health history include all of the following except: Chief complaint History of the present illness Current vital signs IN All of the above are essential history components Question 8. Question : Your patient complains of a feeling of heaviness in the lower legs daily. You note varicosities, edema, and dusky color of both ankles and feet. Which of the following is the most likely cause for these symptoms? Femoral vein thrombosis Femoral artery thrombus Venous insufficiency Musculoskeletal injury Question 9. Question : A key symptom of ischemic heart disease is chest pain. However, angina equivalents may include exertional dyspnea. Angina equivalents are important because: Women with ischemic heart disease many times do not present with chest pain Some patients may have no symptoms or atypical symptoms; diagnosis may only be made at the time of an actual myocardial infarction Elderly patients have the most severe symptoms A & B only Question 10. Question : Susan P., a 60-year-old woman with a 30 pack year history, presents to your primary care practice for evaluation of a persistent, daily cough with increased sputum production, worse in the morning, occurring over the past three months. She tells you, “I have the same thing, year after year.” Which of the following choices would you consider strongly in your critical thinking process? Seasonal allergies Acute bronchitis Bronchial asthma Chronic bronchitis Question 11. Question : Your patient is a 78-year-old female with a smoking history of 120-pack years. She complains of hoarseness that has developed over the last few months. It is important to exclude the possibility of: Thrush Laryngeal cancer Carotidynia Thyroiditis Question 12. Question : Which of the following is considered a “red flag” when diagnosing a patient with pneumonia? Fever of 102 Infiltrates on chest X-ray Pleural effusion on chest X-ray Elevated white blood cell count Question 13. Question : Patients that have atopic disorders are mediated by the production of Immunoglobulin E (IgE) will have histamine stimulated as an immediate phase response. This release of histamine results in which of the following? Sinus pain, increased vascular permeability, and bronchodilation Bronchospasm, vascular permeability, and vasodilatation Contraction of smooth muscle, decreased vascular permeability, and vasoconstriction Vasodilatation, bronchodilation, and increased vascular permeability Question 14. Question : Which of the following is not a contributing factor to the development of esophagitis in older adults? Increased gastric emptying time Regular ingestion of NSAIDs Decreased salivation Fungal infections such as Candida Question 15. Question : A 66-year-old patient presents to the clinic complaining of dyspnea and wheezing. The patient reports a smoking history of 2 packs of cigarettes per day since age 16. This would be recorded in the chart as: 50 x 2-pack years 100-pack years 50-year, 2-pack history 100-pack history Question 16. Question : Epistaxis can be a symptom of: Over-anticoagulation Hematologic malignancy Cocaine abuse All of the above Question 17. Question : The most common cause of eye redness is: Conjunctivitis Acute glaucoma Head trauma Corneal abrasion Question 18. Question : Your patient complains of lower abdominal pain, anorexia, extreme fatigue, unintentional weight loss of 10 pounds in last 3 weeks, and you find a positive hemoccult on digital rectal examination. Laboratory tests show iron deficiency anemia. The clinician needs to consider: Diverticulitis Colon cancer Appendicitis Peptic ulcer disease Question 19. Question : An 82-year-old female presents to the emergency department with epigastric pain and weakness. She admits to having dark, tarry stools for the last few days. She reports a long history of pain due to osteoarthritis. She self-medicates daily with ibuprofen, naprosyn, and aspirin for joint pain. On physical examination, she has orthostatic hypotension and pallor. Fecal occult blood test is positive. A likely etiology of the patient’s problem is: Mallory-Weiss tear Esophageal varices Gastric ulcer Colon cancer Question 20. Question : A 22-year-old female comes to your office with complaints of right lower quadrant abdominal pain, which has been worsening over the last 24 hours. On examination of the abdomen, there is a palpable mass and rebound tenderness over the right lower quadrant. The clinician should recognize the importance of: Digital rectal examination Endoscopy Pelvic examination Urinalysis Question 21. Question : Which of the following is the most common cause of heartburn-type epigastric pain? Decreased lower esophageal sphincter tone Helicobacter pylori infection of stomach Esophageal spasm Peptic ulcer disease Question 22. Question : Your 35-year-old female patient complains of feeling palpitations on occasion. The clinician should recognize that palpitations are often a sign of: Anemia Anxiety Hyperthyroidism All of the above Question 23. Question : Mr. A presents to your office complaining of chest pain, mid-sternal and radiating to his back. He was mowing his lawn. He reports the pain lasting for about 8 minutes and went away after sitting down. What is his most likely diagnosis based on his presenting symptoms? Acute MI GERD Pneumonia Angina Question 24. Question : Which disease process typically causes episodic right upper quadrant pain, epigastric pain or chest pain that can last 4-6 hours or less, often radiates to the back (classically under the right shoulder blade) and is often accompanied by nausea or vomiting and often follows a heavy, fatty meal. Acute pancreatitis Duodenal ulcer Biliary colic IN Cholecystitis Question 25. Question : A specific exam used to evaluate the gall bladder is: Psoas sign Obturator sign Cullens sign Murphy’s sign Question 26. Question : An older patient reports burning pain after ingestion of many foods and large meals. What assessment would assist the nurse practitioner in making a diagnosis of GERD? Identification of a fluid wave Positive Murphy’s sign Palpable spleen Midepigastric pain that is not reproducible with palpation Question 27. Question : Iron Deficiency Anemia (IDA) is classified as a microcytic, hypochromic anemia. This classification refers to which of the following laboratory data? Hemoglobin and Hematocrit Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH) Serum ferritin and Serum iron Total iron binding capacity and transferrin saturation Question 28. Question : A 20-year-old engineering student complains of episodes of abdominal discomfort, bloating, and episodes of diarrhea. The symptoms usually occur after eating, and pain is frequently relieved with bowel movement. She is on a “celiac diet” and the episodic symptoms persist. Physical examination and diagnostic tests are negative. Colonoscopy is negative for any abnormalities. This is a history and physical consistent with: Inflammatory bowel disease Irritable bowel syndrome Giardiasis Norovirus gastroenteritis Question 29. Question : (*There are multiple questions on this exam related to this scenario. Be sure to read the whole way through to the question.) Mr. Keenan is a 42-year-old man with a mild history of GERD and a remote history of an appendectomy, presenting with an acute onset of significant right upper-quadrant abdominal pain and vomiting. His pain began after a large meal, was unrelieved by a proton-pump inhibitor, was unlike his previous episodes of heartburn, but upon questioning, reports milder, prodromal episodes of similar post-prandial pain. His pain seems to radiate to his back. Despite a family history of cardiac disease, he reports no classic anginal signs or chest pain. He furthermore denies respiratory or pleuritic signs and denies fever, night sweats, and unintended weight loss. Finally, there are no dermatologic signs, nor genitourinary symptoms. Of the following lab studies, which would provide little help in determining your differential diagnosis? Abdominal plain films Liver function tests Amylase/lipase IN Urinalysis Question 30. Question : In examining the mouth of an older adult with a history of smoking, the nurse practitioner finds a suspicious oral lesion. The patient has been referred for a biopsy to be sent for pathology. Which is the most common oral precancerous lesion? Fictional keratosis Keratoacanthoma Lichen planus Leukoplakia Question 31. Question : A 56-year-old male complains of anorexia, changes in bowel habits, extreme fatigue, and unintentional weight loss. At times he is constipated and other times he has episodes of diarrhea. His physical examination is unremarkable. It is important for the clinician to recognize the importance of: CBC with differential Stool culture and sensitivity Abdominal X-ray Colonoscopy Question 32. Question : According to the Genetic Information Nondiscrimination Act (GINA): Nurse Practitioners (NPs) should keep all genetic information of patients confidential NPs must obtain informed consent prior to genetic testing of all patients Employers cannot inquire about an employee’s genetic information All of the above Question 33. Question : What test is used to confirm the diagnosis of appendicitis? CBC Flat plate of abdomen Rectal exam CT of abdomen with attention to appendix Question 34. Question : A 75-year-old patient with community-acquired pneumonia presents with chills, productive cough, temperature of 102.1, pulse 100, respiration 18, BP 90/52, WBC 12,000, and blood urea nitrogen (BUN) 22 mg/dl. He has a history of mild dementia and his mental status is unchanged from his last visit. These findings indicate that the patient: IN Can be treated as an outpatient Requires hospitalization for treatment Requires a high dose of parenteral antibiotic Can be treated with oral antibiotics Question 35. Question : A 64-year-old male presents with erythema of the sclera, tearing, and bilateral pruritus of the eyes. The symptoms occur intermittently throughout the year and he has associated clear nasal discharge. Which of the following is most likely because of the inflammation? Bacterium Allergen Virus Fungi Question 36. Question : An obese middle-aged client presents with a month of nonproductive irritating cough without fever. He also reports occasional morning hoarseness. What should the differential include? Atypical pneumonia Peptic ulcer disease Gastroesophageal reflux Mononucleosis (Epstein-Barr) Question 37. Question : A 59-year-old patient with history of alcohol abuse comes to your office because of ‘throwing up blood”. On physical examination, you note ascites and caput medusa. A likely cause for the hematemesis is: Peptic ulcer disease Barrett’s esophagus Esophageal varices Pancreatitis Question 38. Question : Which of the following medications are commonly associated with the side effect of cough? Beta blocker Diuretic ACE inhibitor Calcium antagonist Question 39. Question : When interpreting laboratory data, you would expect to see the following in a patient with Anemia of Chronic Disease (ACD): Hemoglobin 12 g/dl, MCV decreased, MCH decreased Hemoglobin 12 g/dl, MCV increased, MCH increased Hemoglobin 12 g/dl, MCV normal, MCH normal Hemoglobin 12 g/dl, MCV decreased, MCH increased Question 40. Question : If it has been determined a patient has esophageal reflux, you should tell them: They probably have a hiatal hernia causing reflux They probably need surgery They should avoid all fruit juices Smoking, alcohol, and caffeine can aggravate their problem NSG6420 Week 5 Midterm Quiz / NSG 6420 Week 5 Midterm Quiz (Latest): South University South University NSG 6420 Week 5 Midterm Quiz / South University NSG6420 Week 5 Midterm Quiz 1. A 22-year-old female comes to your office with complaints of right lower quadrant abdominal pain, which has been worsening over the last 24 hours. On examination of the abdomen, there is a palpable mass and rebound tenderness over the right lower quadrant. The clinician should recognize the importance of Digital rectal examination Endoscopy Pelvic examination UrinalysisDefinition 2. Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling to express the likelihood of a condition in select situations, settings, and/or patients? Clinical practice guideline Clinical decision rule Clinical algorithm Clinical recommendation 3. A common auscultatory finding in advanced CHF is S3 gallop rhythm 4. Mr. Keenan is a 42-year-old man with a mild history of GERD and a remote history of an appendectomy, presenting with an acute onset of significant right upper-quadrant abdominal pain and vomiting. His pain began after a large meal, was unrelieved by a proton-pump inhibitor, was unlike his previous episodes of heartburn, but upon questioning, reports milder, prodromal episodes of similar post-prandial pain. His pain seems to radiate to his back. Despite a family history of cardiac disease, he reports no classic anginal signs or chest pain. He furthermore denies respiratory or pleuritic signs and denies fever, night sweats, and unintended weight loss. Finally, there are no dermatologic signs, nor genitourinary symptoms. The chosen imaging study reveals: “GB normal in size without wall-thickening, but with 5-6 stones with shadowing. Common bile duct not dilated. Liver is homogenous and normal in size. Pancreas and kidneys are normal.” What is the most effective therapeutic/management option at this point? chole 5. A patient complains of fever, fatigue, and pharyngitis. On physical examination there is pronounced cervical lymphadenopathy. Which of the following diagnostic tests should be considered? Mono spot Strep test Throat culture All of the above 6. Which of the following is not a contributing factor to the development of esophagitis in older adults? Increased gastric emptying time Regular ingestion of NSAIDs Decreased salivation Fungal infections such as Candida 7. Essential parts of a health history include all of the following except: A) Review of systems B) Thorax and lungs C) Present illness D) Personal and social items 8. What test is used to confirm the diagnosis of appendicitis? 9. The first assessment to complete related to the eyes is Eye lids Visual acuity Extraocular movements Peripheral vision 10. The best way to diagnose structural heart disease/dysfunction non-invasively is Chest X-ray EKG Echocardiogram Heart catheterization 11. Which of the following is considered a “red flag” when diagnosing a patient with pneumonia Fever of 102 Infiltrates on chest X-ray Pleural effusion on chest X-ray Elevated white blood cell count 12. In a patient presenting with suspected recurrence of diverticulitis, abdominal pain usually presents where in the abdomen? Left upper quadrant Right upper quadrant Left lower quadrant Right lower quadrant 13. Mr. A presents to your office complaining of chest pain, mid-sternal and radiating to his back. He was mowing his lawn. He reports the pain lasting for about 8 minutes and went away after sitting down. What is his most likely diagnosis based on his presenting symptoms Acute MI GERD Pneumonia Angina 14. In autosomal recessive (AR) disorders, individuals need Only one mutated gene on the sex chromosomes to acquire the disease Only one mutated gene to acquire the disease Two mutated genes to acquire the disease Two mutated genes to become carriers 15. Susan P., a 60-year-old woman with a 30 pack year history, presents to your primary care practice for evaluation of a persistent, daily cough with increased sputum production, worse in the morning, occurring over the past three months. She tells you, “I have the same thing, year after year.” Which of the following choices would you consider strongly in your critical thinking process? chronic bronichitis 16. The best evidence rating drugs to consider in a post myocardial infarction patient include: ASA, ACE/ARB, beta-blocker, aldosterone blockade ACE, ARB, Calcium channel blocker, ASA Long-acting nitrates, warfarin, ACE, and ARB ASA, clopidogrel, nitrates 17. A 76-year-old patient with a 200-pack year smoking history presents with complaints of chronic cough, dyspnea, fatigue, hemoptysis, and weight loss over the past 2 months. The physical exam reveals decreased breath sounds and dullness to percussion over the left lower lung field. The chest X-ray demonstrates shift of the mediastinum and trachea to the left. These are classic signs of: Lung cancer Tuberculosis Pneumonia COPD 18. Upon assessment of respiratory excursion, the clinician notes asymmetric expansion of the chest. One side expands greater than the other. This could be due to Pneumothorax Pleural effusion Pneumonia Pulmonary embolism 19. A patient presents with eye redness, scant discharge, and a gritty sensation. Your examination reveals the palpable preauricular nodes, which are most likely with: Bacterial conjunctivitis B. Allergic conjunctivitis C. Chemical conjunctivitis D. Viral conjunctivitis 20. Emphysematous changes in the lungs produce the following characteristic in COPD patients? Asymmetric chest expansion Increased lateral diameter Increased anterior-posterior diameter Pectus excavatum 21. An older patient reports burning pain after ingestion of many foods and large meals. What assessment would assist the nurse practitioner in making a diagnosis of GERD? A. Identification of a fluid wave B. Positive Murphy’s sign C. Palpable spleen D. Midepigastric pain that is not reproducible with palpation 22. Which of the following details are NOT considered while staging asthma? A. Nighttime awakenings B. Long-acting beta agonist usage C. Frequency of symptoms D. Spirometry findings 23. The cytochrome p system involves enzymes that are generally Inhibited by drugs : • Inhibited by drugs • Induced by drugs • Inhibited or induced by drugs • Associated with decreased liver perfusion 24. Mr. Keenan is a 42-year-old man with a mild history of GERD and a remote history of an appendectomy, presenting with an acute onset of significant right upper-quadrant abdominal pain and vomiting. His pain began after a large meal, was unrelieved by a proton-pump inhibitor, was unlike his previous episodes of heartburn, but upon questioning, reports milder, prodromal episodes of similar post-prandial pain. His pain seems to radiate to his back. Despite a family history of cardiac disease, he reports no classic anginal signs or chest pain. He furthermore denies respiratory or pleuritic signs and denies fever, night sweats, and unintended weight loss. Finally, there are no dermatologic signs, nor genitourinary symptoms. Of the following lab studies, which would provide little help in determining your differential diagnosis? Abdominal plain films Liver function tests Amylase/lipase Urinalysis 25. Jeff, 48 years old, presents to the clinic complaining of fleeting chest pain, fatigue, palpitations, lightheadedness, and shortness of breath. The pain comes and goes and is not associated with activity or exertion. Food does not exacerbate or relieve the pain. The pain is usually located under the left nipple. Jeff is concerned because his father has cardiac disease and underwent a CABG at age 65. The ANP examines Jeff and hears a mid-systolic click at the 4th ICS mid-clavicular area. The ANP knows that this is a hallmark sign of: Angina Pericarditis Mitral valve prolapse Congestive heart failur 26. Men have faster and more efficient biotransformation of drugs and this is thought to be due to: • Less obesity rates than women • Prostate enlargement • Testosterone • Less estrogen than women 27. An 82-year-old female presents to the emergency department with epigastric pain and weakness. She admits to having dark, tarry stools for the last few days. She reports a long history of pain due to osteoarthritis. She self-medicates daily with ibuprofen, naprosyn, and aspirin for joint pain. On physical examination, she has orthostatic hypotension and pallor. Fecal occult blood test is positive. A likely etiology of the patient’s problem is: Mallory-Weiss tear B. Esophageal varices C. Gastric ulcer D. Colon cancer 28. You have a patient complaining of vertigo and want to know what could be the cause. Knowing there are many causes for vertigo, you question the length of time the sensation lasts. She tells you several hours to days and is accompanied by tinnitus and hearing loss. You suspect which of the following conditions? Ménière’s disease Benign paroxysmal positional vertigo Transient ischemic attack (TIA) MigraineDefinition 29. . Your patient has been treated for glaucoma for 5 years. Which of the following will provide indication of the level of progression during the funduscopic examination for this patient? Checking the macula Estimating cup-to-disk ratio Verifying a red reflex Extraocular movements 30. If it has been determined a patient has esophageal reflux, you should tell them: They probably have a hiatal hernia causing reflux They probably need surgery They should avoid all fruit juices Smoking, alcohol, and caffeine can aggravate their problem 31. The following criterion is considered a positive finding when determining whether a patient with asthma can be safely monitored and treated at home: Age over 40 Fever greater than 101 Tachypnea greater than 30 breaths/minute Productive cough 32. Jenny is a 24 year old graduate student that presents to the clinic today with complaints of fever, midsternal chest pain and generalized fatigue for the past two days. She denies any cough or sputum production. She states that when she takes Ibuprofen and rest that the chest pain does seem to ease off. Upon examination the patient presents looking very ill. She is leaning forward and states that this is the most comfortable position for her. Temp is 102. BP= 100/70. Heart rate is 120/min and regular. Upon auscultation a friction rub is audible. Her lung sounds are clear. With these presenting symptoms your initial diagnosis would be Mitral Valve Prolapse Referred Pain from Cholecystitis Pericarditis Pulmonary Embolus 33. During auscultation of the chest, your exam reveals a loud grating sound at the lower anterolateral lung fields, at full inspiration and early expiration. This finding is consistent with: Pneumonia Pleuritis Pneumothorax A and B 34. Your 35-year-old female patient complains of feeling palpitations on occasion. The clinician should recognize that palpitations are often a sign of Anemia Anxiety Hyperthyroidism All of the above 35. Presbycusis is the hearing impairment that is associated with: Physiologic aging Ménière’s disease Cerumen impaction Herpes zoster 36. Functional abilities are best assessed by : • Self-report of function • Observed assessment of function • A comprehensive head-to-toe examination • Family report of function 37. In examining the mouth of an older adult with a history of smoking, the nurse practitioner finds a suspicious oral lesion. The patient has been referred for a biopsy to be sent for pathology. Which is the most common oral precancerous lesion? Fictional keratosis Keratoacanthoma Lichen planus Leukoplakia 38. The aging process causes what normal physiological changes in the heart? The heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis Cardiology occurs along with prolapse of the mitral valve and regurgitation Dilation of the right ventricle occurs with sclerosis of pulmonic and tricuspid valves Hypertrophy of the right ventricle 39. In assessing the eyes, which of the following is considered a “red flag” finding when associated with eye redness? History of prior red-eye episodes Grossly visible corneal defect Exophthalmos Photophobia 40. Helicobacter pylori is implicated as a causative agent in the development of duodenal or gastric ulcers. What teaching should the nurse practitioner plan for a patient who has a positive Helicobacter pylori test? A. It is highly contagious and a mask should be worn at home. B. Treatment regimen is multiple lifetime medications. C. Treatment regimen is multiple medications taken daily for a few weeks. D. Treatment regimen is complicated and is not indicated unless the patient is symptomatic.