It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic - ANSA
72 yo woman has been on hydrochlorothiazide 12.5mg for many years to control her Stae I
HTN. Her blood pressure at this visit is 168/96. She is currently complaining of pain in her right
hip and on both knees. She has increased her dose of ibuprofen from 400mg 3 times a day to
800mg 3 times a day. She is still in pain and would like something stronger. Which of the
following statements is the best explanation of the effects of ibuprofen on her disease.
Acute appendicitis - ANSThe NP would test the obturator and iliopsoas muscle to evaluate for
what?
A prescription of methyldopa (Aldomet) to control BP - ANSTreatment for mild preeclampsia
includes all of the following except:
A) Bed rest except for bathroom privileges
B) Close monitoring of weight and blood pressure
C) Close follow-up of urinary protein, serum creatinine, and platelet count
D) A prescription of methyldopa (Aldomet) to control BP.
Nursing home care - ANSAll of the following services are covered under Medicare Part A
except:
A) Inpatient hospitalizations
B) Medicines administered to a patient while hospitalized
C) Nursing home care
D) Surgeons
Mycoplasma pneumonia - ANSA 28 yo student is seen in the school health clinic with
complaints of hacking cough that is productive of small amounts of sputum and runny nose. He
does not take any meds, denies any allergies, and has no significant medical history. Physical
exam reveals a low-grade temperature of 99.9 degrees F, respirations of 16/min, pulse =90, and
diffuse fine crackles in the base of the lungs. A chest x-ray shows diffuse infiltrates in the lower
lobe of the right lung. The total white blood cell count is 10,500/uL. What is the likely diagnosis?
10mm - ANSA 39 yo migrant worker presents to the clinic 2.5 days after a purified protein
derivative (PPD) test. What minimum size of induration would be considered positive for this
patient?
The patient's spouse has the right to override the agent's decisions - ANSAll of the following are
correct statements regarding the role of the person named in a durable power of attorney
except:
A) The agent's decisions are legally binding
B) The agent can make decisions in other areas of the patient's life such as financial issues.
,C) The agent can decide for the patient who is on life support when that life support can be
terminated.
D) The patient's spouse has the right to override the agent's decisions
The patient has a medical illness that causes an anxiety reaction and denial - ANSThe following
statement regarding Munchausen syndrome is false:
Beta-blockers - ANSWhich antihypertensive medications should the NP avoid when treating
patient with emphysema?
Perform a complete and thorough history - ANSA 30 y/o chef complains of pruritic hives over
her chest and arms but denies difficulty breathing. She reports a family history of allergic rhinitis
and asthma. What intervention is most appropriate?
Edema of the face and upper extremities - ANSWhich finding is most likely in young
primigravidas with pregnancy induced hypertension?
Tingling and numbness of both feet - ANSWhich symptom is associated with B12 deficiency
anemia?
Order an ultrasound - ANSA second triple screen on a 35 yo primigravida reveals abnormal low
levels of the alpha fetoprotein and estriol and high levels of human chorionic gonadotropin.
Which of the following interventions is the best choice for this patient?
Chlamydia trachoma's - ANSPts. diagnosed with gonorrhea should also be treated for what
other infections?
Osteoporosis - ANSKyphosis is a late sign of
Higher than normal - ANSA 35 y/o primigravida who is at 28wks gestation is expecting twins.
What would you would expect her alpha fetal protein (AFP) to be?
Calcium channel blockers - ANSWhich of the following antihypertensive medications has
beneficial effects for an elderly white female with osteoporosis?
Knee instability - ANSThe Lachman maneuver is used to detect which of the following?
Tanner Stage III - ANSWhen an adolescent male's penis grows more in length than width, at
which of the following Tanner stages is he classified?
Toxoplasma gondii, other infections, rubella, cytomegalovirus and herpes - ANSFetal TORCH
infections can cause microcephaly, mental retardation, hepatosplenomegaly, and intrauterine
growth retardation. The acronym for TORCH stands for:.
,Laryngeal neoplasia - ANSHPV infection of the larynx has been associated with:
Degenerative joint disease - ANSMr. Brown is a 65 y/o carpenter complaining of morning
stiffness and pain in both his hands and right knee upon awakening. He feels some relief after
warming up. On exam, the nurse notices the presence of Heberden's nodes. What is most likely
diagnosis?
Instability of the knee - ANSWhat does the positive posterior drawer sign in a 10 yr old soccer
player signify?
From 33-35 cm - ANSA multigravida who is at 34 wks gestation wants to know at what level her
uterine funds should be. The best answer is to advise the mother that her funds is:
Advise mother that her pregnancy is progressing well - ANSA multigravida who is 28wks
gestation has a fundal height of 29cm. What is the best recommendation for this patient?
Creatinine - ANSWhich laboratory test is used in primary care to evaluate renal function?
Chronic intake of non steroidal anti-inflammatory drugs (NSAIDs) can cause the disorder -
ANSAll of the following are false statements regarding acute gastritis except:
A) Chronic intake of non steroidal anti-inflammatory drugs (NSAIDs) can cause the disorder
B) Chronic lack of dietary fiber is the main cause of the disorder
C) The screening rest for the disorder is the barium swallow test
D) The gold standard to evaluate the disorder is a colonoscopy.
Apraxia and fatigue - ANSSigns and symptoms of depression do not include:
A) Upon deep inspiration by the patient, palpate firmly in the right upper quadrant of the
abdomen below the costovertebral angle. - ANSWhich of the following is an accurate
description of eliciting for Murphy's sign?
A) Upon deep inspiration by the patient, palpate firmly in the right upper quadrant of the
abdomen below the costovertebral angle
B) Bend the patient at the hips and knees at 90 degrees, then passively rotate hip externally,
then internally
C) Ask the patient to quit, then place the stethoscope on the apical area.
D) Press into the abdomen deeply, then released it suddenly
Murphy's Sign - ANSPositive if pain occurs when performing RUQ palpation while patient takes
a deep breath, causing the patient to abruptly stop the deep breath due to pain. As the liver is
palpated, it will descend and push up against the inflamed gallbladder and cause sharp pain
(cholecystitis)
Apraxia - ANSa disorder of the nervous system in which the brain is affected and the patient is
unable not move the arms/legs when asked to do so.
, Common signs of depression - ANS1. anhedonia
2. unintentional weight loss or gain
3. fatigue
4. change in appetite
5. insomnia or hypersomnia
6. Feelings of guilt and worthlessness
7. recurrent thought of suicide.
Anhedonia - ANSloss of interest in activities that the patient finds pleasurable
What does Chronic NSAID use do? - ANSDisrupts the product of prostaglandins, which
decreases blood supply and then breaks down the protective layer of the mucosa, which leads
to gastric disease.
Why is Serum creatinine in measured? - ANSTo evaluate renal function. Creation is the end
product of creatine metabolism. Creatinine clearance is not affected by fluid or dietary intake of
meat.
After 20 wks - ANSAt how many weeks gestation should fundal height equal weeks gestation?
2cm or greater - ANSWhen measuring fundal height, how many centimeters variation should
warrant further testing to evaluate fetal growth
The drawer sign - ANSPerformed on the knee or ankle to assess for knee instability. The
affected knee/ankle will have more laxity when compared to the unaffected knee/ankle.
Heberden's nodes - ANSThese are commonly seen in degenerative joint disease, and are bony
nodules located on the distal interphalangeal joints (DIPs)
Laryngeal neoplasia - ANSHPV infection of the larynx has been associated with:
Cervical cancer. - ANSHPV infection of the cervix is associated with:
Tanner Stage III: Male - ANSConsist of penis lengthening and darker, course pubic hair, which
begins to curl.
The Lachman maneuver - ANSTest performed to assess for knee instability. Knee instability
indicated a tear of the anterior cruciate ligament.
Calcium channel blockers - ANSAntihypertensive medication that acts by blocking the calcium
channels in the heart muscle and the blood vessels, thereby keeping more calcium in the
bones. Should be used in elderly patients with osteoporoisis
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