A 25-year-old presents with the chief complaint of decreased mobility and pain of the right shoulder
exacerbated by movement. The patient reports that he participated in extensive house painting 24
hours prior to the onset of pain. He denies any trauma. Passive ROM is intact. No redness or ecchymosis
is present. What is the next step to be taken in order to make a diagnosis?
1) Xray of shoulder
2) Palpate structures around the shoulder.
3) MRI of shoulder
4) EMG (correct answers)2) palpate structures
,A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle spotting.
She has not missed any doses and uses no other medication. Which of the following is appropriate?
1) Changing to Ortho-Novum 1/35
2) Discontinue use
3) Providing reassurance
4) Double dose-for two days (correct answers)3) provide reassurance
According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT a
current recommendation guideline for preventive care in elderly female patients?
1) Mammogram and clinical breast exams
2) Fecal Occult blood test and/or sig
3) Rubella serology or vaccination history
4) Pnuemo and influenza vaccines (correct answers)3) Rubella serology or vaccination history
87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R 10. The best action
is to:
1) initiate passive warming
2) apply a rebreather
3) Perform fluid replacement
4) initiate active warming (correct answers)1) initiate passive rewarming
A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How would you educate
this patient on recognizing the signs and symptoms of hypoglycemia?
,1) Edema
2) Tachycardia
3) palpitations
4) sweating (correct answers)4) sweating
A 65-year-old overweight patient is diagnosed with plantar fasciitis. Initial therapy of NSAIDs, stretching,
ice, and rest has proven ineffective after 3 weeks. The best follow-up plan of care would be to:
1) stop NSAID, apply a heel cup and encourage exercise and wt loss.
2) continue NSAID, apply an arch support and encourage wt loss and exercise
3) continue NSAID, xray and add a short-leg night splint
4) COntinue NSAID, xray and add a metatarsal bar (correct answers)2) continue NSAID, apply an arch
support and encourage wt loss and exercise
Fundoscopic exam of Hypertensive patient.
1) nicking of arteriols and viens, and small retinol hemorrages
2) drusen bodies and pale retina
3) pale macula and swollen disk margins
4) microaneurysms and optic disc cupping (correct answers)1) nicking of arteriols and viens, and small
retinol hemorrages
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
1) elevated TSH
2) Thyroid enlargement
, 3) atrial fibrillation
4) abnormal T3 suppression (correct answers)3) atrial fibrillation
A 35-year-old lawn maintenance worker presents reporting "something in my eye" since the previous
day. The eye was rinsed with over-the-counter eyewash, without relief. The patient denies visual
disturbances or drainage. In formulating a plan of care, the nurse practitioner would FIRST:
1) send to ophthalmologists
2) florescreen staining
3) test visual field
4) prescribe eyedrops (correct answers)3) test visual field
A 72-year-old patient presents with dry, itchy eyes. During the course of the physical examination, the
nurse practitioner notes the presence of a gray band of opacity in the cornea that encircles the iris. The
band is 1.0-1.5 mm wide. This finding is most consistent with a diagnosis of a/an:
1. corneal abrasion
2. arcus senilis
3. corneal ulcer
4. herpetic infection of the eye (correct answers)2) arcus senilis
A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night sweats, and a
cough that has been present for 4 weeks. The diagnostic study to perform first would be:
1) xray
2) pulmonary function test
3) bronchoscopy
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