The nurse practitioner is evaluating a 34-year-old male who reports a 3-
month history of epigastric pain that he describes as intermittent, burning,
and improves with eating then returns 2-3 hours after meals. The leading
diagnosis is:
Cholecystitis.
Gastritis.
Esophageal reflux.
Duodenal ulcer. Right Ans - Duodenal ulcer.
The nurse practitioner is evaluating a patient with recurrent heartburn. When
considering gastroesophageal reflux as a differential diagnosis, all of the
following symptoms are anticipated except:
Eructation.
Cough.
Dysphonia.
Hematemesis. Right Ans - Hematemesis.
While counseling a patient about the adverse effects of first-generation
antihistamines, the nurse practitioner advises that all of the following usually
occur except:
Sedation.
Dry mouth.
Pruritus.
Urinary retention. Right Ans - Pruritus.
A 20-year-old male complains of being fatigued for the past week. The
physical examination is significant for anterior and posterior cervical
lymphadenopathy and right and left upper quadrant abdominal tenderness. A
white blood cell differential is significant for lymphocytosis with reactive
forms. Which of the following additional findings does the nurse practitioner
anticipate?
,Pharyngitis with exudate
Supraclavicular lymphadenopathy
Diffuse maculopapular rash
Marked sinus tenderness Right Ans - Pharyngitis with exudate
A 33-year-old woman comes to your office and reports that she is "having a
stroke." She has no medical history and no significant risk factors for
cerebrovascular disease, but today she has sudden onset of inability to tightly
close her eyelid and to frown or smile on the right side of her face. Her
physical examination is otherwise unremarkable. The nurse practitioner
recognizes that this likely represents paralysis of cranial nerve (CN):
IV.
V.
VI.
VII. Right Ans - VII (facial)
A 37-year-old female presents with flank pain, fever, and vomiting. Physical
examination is significant for costovertebral angle tenderness. A urinalysis is
likely to reveal:
Urobilinogen.
Specific gravity <1.010.
White blood cell (WBC) casts.
Ketones. Right Ans - White blood cell (WBC) casts.
A 38-year-old woman presents complaining of weight loss, agitation, and new-
onset tremor. The nurse practitioner suspects hyperthyroidism. Laboratory
assessment will most likely include:
,Clinical evaluation of a 43-year-old man with a BMI=42 kg/m2 who presents
with recurrent genital Candida albicans infection should include all of the
following except:
Treatment with oral or topical antifungals.
Offering testing for HIV antibodies.
Avoidance of soap on the genitals.
Checking A1C. Right Ans - Avoidance of soap on the genitals.
Laboratory assessment of a patient with Hashimoto's thyroiditis typically
includes the presence of:
Polycythemia.
TPO antibodies.
Leukocytosis.
Hypokalemia. Right Ans - TPO antibodies.
Mr. Chan is a 60-year-old man with hypertension. On today's office visit, his
blood pressure is noted to be 122/78 mm Hg. The rest of his history and
physical examination are unremarkable. He mentions that, in addition to his
antihypertensive medication you have prescribed, he uses a teaspoon of hot
pepper sauce in a glass of warm water daily to help "clean my blood and lower
the pressure. I feel much better when I take it." Your most appropriate
response is to:
Advise Mr. Chan that there is no evidence of healthful effects of hot pepper
sauce.
Ask Mr. Chan to stop the hot pepper sauce use until you can examine its
contents.
Inform Mr. Chan that this practice can result in serious gastrointestinal
complications.
Explore what Mr. Chan means by "clean my blood." Right Ans - Explore
what Mr. Chan means by "clean my blood."
Physical examination of a patient with symptomatic Graves' disease will likely
reveal:
Generalized hypopigmentation.
Tremor.
, Blunted pupil response.
Thinning hair. Right Ans - Tremor.
The Federal Drug Enforcement Administration (DEA) provides registration
numbers for prescription of controlled substances to which of the following
groups?
-NPs with federal prescription authority
-Physicians, veterinarians, dentists, and NPs who practice in oncology or
palliative care
-NPs with state-determined controlled substance prescriptive authority
-Nationally-certified APRNs with state licensure Right Ans - NPs with state-
determined controlled substance prescriptive authority
****The mechanism of action of saxagliptin includes:
Increase in hepatic glucose utilization.
Enhanced insulin release.
Facilitation of renal glucose excretion.
Enhancement of insulin receptor site activity. Right Ans - Enhanced insulin
release. DPP-4 inhibitor
*****The preferred therapeutic option to resolve the underlying pathology in
Graves' disease is:
Non-cardioselective beta blockade.
Surgical resection of hyperfunctioning nodule.
Radioactive ablation of overactive thyroid tissue.
Levothyroxine suppression therapy. Right Ans - Radioactive ablation of
overactive thyroid tissue.
Thyroid stimulating hormone (TSH) levels are suppressed in all of the
following except:
Graves' disease.
Autonomous toxic nodule.
Acute viral thyroiditis.
Subacute hypothyroidism. Right Ans - Subacute hypothyroidism.
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