A young adult presents with a history of sore throat, enlarged posterior
cervical nodes, and complaints of "no energy at all for the last several
months." During the acute stages, what recommendations does the nurse
practitioner provide? Select all that apply.
Limit physical activity for 4 weeks
Avoid close contact
Avoid any sharing of toothbrushes and utensils
Treats symptoms with over-the-counter medication
Penicillin therapy ✔✔CORRECT ANSWER✔✔Solution: The correct answers
are A, B, C and D.
Symptoms present are indicative of infectious mononucleosis. Treatment
consists of treating symptoms and monitoring for complications of
splenomegaly and hepatomegaly, thus limiting physical activity. Avoid using
any amoxicillin for throat infections or other antibiotics if not needed.
A 70-year-old male presents for a routine physical. Upon obtaining a
complete history, the nurse practitioner notes a 40-year smoking history,
chicken pox as a child, no known allergies, and type-2 diabetes. The patient
has not had a physical performed in several years. What vaccines should the
nurse practitioner include in the plan of treatment? Select all that apply.
Influenza vaccine
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,Pneumococcal vaccine
Zoster vaccine live
Meningococcal conjugate vaccine
Varicella vaccine ✔✔CORRECT ANSWER✔✔All adults older than 65 years of
age should receive a pneumococcal vaccine. A shingles vaccine should be
given to adults at age 60 and over who have a history of a previous chicken
pox diagnosis. An influenza vaccination is recommended for adults as a
seasonal precaution. A meningococcal conjugate vaccine is administered to
younger individuals such as preteens, teens, and college-aged adults. A
varicella vaccine is given in children to prevent chicken pox.
A 46-year-old African American male, without a family history of prostate
cancer, presents to the clinic for an annual physical exam. Which screening
would be recommended for this patient? Select all that apply.
Prostate-specific antigen (PSA) test
Computerized tomography (CT) scan
Digital rectal examination (DRE
Colonoscopy
Ultrasound ✔✔CORRECT ANSWER✔✔Solution: The correct answers are A
and C.
The American Cancer Society recommends that men at high risk for prostate
cancer begin testing (prostate-specific antigen [PSA] and digital rectal
examination [DRE]) at age 45, including African Americans and men with a
first-degree relative (father, brother, son) diagnosed with prostate cancer
before age 65. Testing should begin at age 40 for those at higher risk (more
than one first-degree relative diagnosed with prostate cancer at an early
age). Otherwise, testing should be offered yearly beginning at age 50. The
incidence of prostate cancer increases after age 50. The digital rectal
2|Page
,examination, which identifies enlargement or irregularity of the prostate,
and the PSA test, a tumor marker for prostate cancer, are effective
diagnostic measures. A colonoscopy does not screen for cancer of the
prostate. An ultrasound and computerized tomography (CT) scan would be
ordered to determine how far cancer has spread, not as a screening tool.
What is an inflammatory reaction to a strep infection?
Peritonsillar abscess
Post-streptococcal glomerulonephritis
Acute rheumatic fever
Scarlet fever ✔✔CORRECT ANSWER✔✔The correct answer is C.
Acute rheumatic fever is an inflammatory reaction to a strep infection that
may affect the heart, joints, and brain. Peritonsillar abscess is a displaced
uvula with a red bulging mass on one side of pharyngeal space. Post-
streptococcal glomerulonephritis is a response to pharyngitis due to a
nephritogenic strain of Strep A. Scarlet fever is a pink rash with sore throat
and a red sore tongue.
Which question will the nurse practitioner ask during assessment of an 67-
year-old patient with anemia?
"Are you sleeping well?"
"Have you recently fallen?"
"Has your appetite decreased?"
"Have you had any unexplained pain in your calves?" ✔✔CORRECT
ANSWER✔✔Solution: The correct answer is B.
3|Page
, Anemia is a decrease in circulating red blood cells or hemoglobin. The
symptoms associated with anemia, including low energy levels, fatigue,
vertigo, and generalized weakness, place elderly patients at an increased
risk for falls. A patient who is anemic will often report fatigue and increased
sleep. Anemia does directly affect appetite. Anemia is not associated with
symptoms of thrombosis, which may present with calf pain.
The nurse practitioner is reviewing the medical record of a 6-month-old
infant with normocytic hemolytic anemia and notes the electrophoresis
result of hemoglobin S with a 20% concentration of hemoglobin F (fetal
hemoglobin). Based on these findings, which additional diagnosis will the
nurse practitioner assign to the patient?
Aplastic anemia
Hemolytic anemia
Sickle-cell anemia
Thalassemia major ✔✔CORRECT ANSWER✔✔Solution: The correct answer is
C.
A patient with normocytic hemolytic anemia who has electrophoresis results
of hemoglobin S with a 20% concentration of hemoglobin F would be given a
diagnosis of sickle-cell anemia. Electrophoresis is not used to diagnose
hemolytic or aplastic anemia; therefore, these anemias are not an option.
Thalassemia major appears within the first 2 years of life and is associated
with life-threatening anemia. Thalassemia major is associated with non-
hemolytic normocytic anemia.
non-hemolytic anemia ✔✔CORRECT ANSWER✔✔No effects on red cells. No
lysis of red cells or discoloration.
4|Page
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