18 Oct When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

 

Ye s

 

No

 

Question 2The most common cancer found on the auricle is:

 

Actinic keratosis

 

Basal cell carcinoma

 

Squamous cell carcinoma

 

Acral-lentiginous melanoma

 

Question 3Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?

 

Xanthines

 

Antihistimine s

 

Steroids

 

Anticholinerg ics

 

Question 4A 47 year old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On examination, external hemorrhoids are noted. How should the nurse practitioner proceed?

 

Instruct the patient on measures to prevent hemorrhoids such as bowel habits and diet.

 

Order a topical hemorrhoid cream along with a stool softener.

 

Refer the patient for a barium enema and sigmoidoscopy.

 

Refer the patient for a surgical hemorrhoidectomy.

 

Question 5Which of the following patient characteristics are associated with chronic bronchitis?

 

Overweight, cyanosis, and normal or slightly increased respiratory rate

 

Underweight, pink skin, and increased respiratory rate

 

 Overweight, pink skin, and normal or slightly increased respiratory rate

 

Normal weight, cyanosis, and greatly increased respiratory rate

 

•             Question 6A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent care with new onset left lower quadrant pain. Her current medications include omeprazole 20 milligrams po daily, lisinopril 20 milligrams po daily, simvastatin 20 milligrams po daily, and prednisone 12 milligrams po daily. The nurse practitioner suspects acute diverticulitis and possibly an abscess. The most appropriate diagnostic test for this patient at this time is:

 

 

 

CBC/dif

 

Erythrocyte sedimentation rate

 

Abdominal ultrasound

 

CT scan

 

Question 7A patient reports “something flew in my eye” about an hour ago while he was splitting logs. If there were a foreign body in his eye, the nurse practitioner would expect to find all except:

 

Purulent drainage Tearing Photophobia

 

A positive fluorescein stain

 

Question 8A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect:

 

Viral conjunctivitis Common pink eye

 

Gonococcal conjunctivitis

 

Allergic conjunctivitis

 

Question 9A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 diferent thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect:

 

A common case of shingles and prescribe an analgesic and an antiviral agent

 

A complicated case of shingles and prescribe acyclovir, an analgesic, and a topical cortisone cream

 

Herpes zoster and consider that this patient may be immunocompromised

 

A recurrence of chickenpox and treat the patient’s symptoms

 

Question 10Which type of lung cancer has the poorest prognosis?

 

Adenocarcinoma

 

Epidermoid carcinoma

 

Small cell carcinoma

 

Large cell carcinoma

 

Question 11An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3– 4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has:

 

Acute diarrhea

 

Chronic diarrhea Irritable bowel

 

Functional bowel disease

 

Question 12Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect?

 

An allergic reaction

 

Relapsing polychondritis

 

Lymphocytoma cutis

 

Systemic lupus erythematosus

 

Question 13Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes?

 

Chronic sinusitis

 

Acute bronchitis Bacterial pneumonia

 

Acute exacerbation of chronic bronchitis

 

Question 14Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations afect her activities and they occur at least twice weekly and may last for days. She is afected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in?

 

Mild intermittent

 

Mild persistent

 

Moderate persistent

 

Question 15Which of the following is the most appropriate therapeutic regimen for an adult patient with no known allergies diagnosed with group A B-hemolytic strep?

 

Penicillin V 500 milligrams PO every 8 hours for 10 days

 

Ampicillin 250 milligrams PO twice a day for 10 days

 

Clarithromycin 500 milligrams po daily for 7 days

 

None of the above

 

Question 16A cashier complains of dull ache and pressure sensation in her lower legs. It is relieved by leg elevation. She occasionally has edema in her lower legs at the end of the day. What is the most likely cause of these problems?

 

Congestive heart failure

 

Varicose veins

 

Deep vein thrombosis

 

Arterial insufficiency

 

Question 17Which statement below is correct about pertussis?

 

It is also called whooping cough

 

It begins with symptoms like strep throat It lasts about 3 weeks

 

 It occurs most commonly in toddlers and young children

 

Question 18Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis?

 

Pneumo nia

 

Asthma Sinusitis

 

 Pertussis

 

Question 19 A 70 year old patient presents with left lower quadrant (LLQ) abdominal pain, a markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition?

 

Diverticulo sis

 

Diverticula

 

 Diverticulit is

 

Diverticulu m

 

Question 20Sylvia, age 83, presents with a 3 day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect?

 

Varicella

 

Herpes zoster

 

Syphilis Rubella

 

Question 21A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is:

 

Alcohol

 

Gallstone s

 

Medicatio ns

 

Pregnanc y

 

Question 22When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action?

 

Order abdominal x-rays

 

Order an abdominal ultrasound

 

Refer the patient to a surgeon for evaluation

 

Prescribe pain medication

 

Question 23A false-positive result with the fecal occult blood test can result from:

 

ingestion of large amounts of vitamin C

 

a high dietary intake of rare cooked beef

 

a colonic neoplasm that is not bleeding

 

stool that has been stored before testing

 

Question 24 A 76-year-old male complains of weight loss, nausea, vomiting, abdominal cramping and pain. Physical findings include an abdominal mass and stool positive for occult blood. The nurse practitioner pain suspects a tumor in the small intestine. The best diagnostic test for this patient is:

 

Colonoscopy

 

Small bowel follow- through

 

Barium enema

 

CT abdomen

 

Question 25A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with:

 

Mitral regurgitation

 

Systolic heart failure

 

Cardiac myxoma

 

Diastolic heart failure

 

Question 26Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized?

 

Multilobar involvement on chest x-ray with the inability to take oral medications

 

 Alert and oriented, slightly high but stable vital signs, and no one to take care of her at home

 

Sputum and gram positive organisms

 

A complete blood count showing leukocytosis

 

Question 27A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him:

 

“It is the most common cause of death in patients with skin cancer.”

 

“It can be cured with surgical excision or radiation therapy.”

 

“It is a slow growing skin cancer that rarely undergoes malignant changes.”

 

“It can be cured using 5-flurouracil cream twice daily for 2 to 4 weeks.”

 

Question 28Expected spirometry readings when the patient has chronic emphysema include:

 

Decreased residual volume (RV)

 

Increased vital capacity (VC)

 

Increased forced expiratory volume (FEV-1)

 

Increased total lung capacity (TLC)

 

Question 29An 80-year-old male admits to difficulty swallowing during the review of systems. The nurse practitioner recognizes the diferential diagnosis for this patient’s dysphagia is:

 

 

 

Esophageal cancer

 

Chest pain GERD

 

A and C

 

All of the above

 

Question 30A 40 year old female with history of frequent sun exposure presents with a multicolored lesion on her back. It has irregular borders and is about 11mm in diameter. What should the nurse practitioner suspect?

 

Squamous cell carcinoma

 

Malignant melanoma

 

A common nevus

 

Basal cell carcinoma

 

Question 31Which of the following is not a goal of treatment for the patient with cystic fibrosis?

 

Prevent intestinal obstruction

 

Provide adequate nutrition

 

Promote clearance of secretions

 

Replace water-soluble vitamins

 

Question 32The nurse practitioner is performing a physical exam on a middle-aged African-American man. Which of the following areas is a common site for melanomas in African-Americans and other dark-skinned individuals?

 

Scalp Nails

 

Feet

 

B and C

 

All of the above

 

Question 33An adult presents with tinea corporis. Which item below is a risk factor for its development?

 

Topical steroid use

 

Topical antibiotic use

 

A recent laceration

 

 Cold climates

 

Question 34A patient has experienced nausea and vomiting, headache, malaise, low grade fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is elevated with a shift to the left. He is requesting medication for diarrhea. What is the most appropriate response?

 

Prescribe loperamide (Immodium) or atropine-diphenoxylate (Lomotil) and a clear liquid diet for 24 hours.

 

Prescribe a broad-spectrum antibiotic such as ciprofloxacin (Cipro), and symptom management.

 

Ofer an anti-emetic medication such as ondansetron (Zofran) and provide oral fluid and electrolyte replacement instruction.

 

Order stool cultures.

 

Question 35Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order?

 

Aspirin NSAIDs

 

Opioids

 

 Antihistami nes

 

Question 36Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is:

 

Peripheral edema

 

Weight gain

 

Shortness of breath

 

Nocturnal dyspnea

 

Question 37A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe?

 

Ibuprofen

 

Erythromyci n

 

Amoxicillin

 

Acetaminop hen

 

Question 38A 70 year old man who walks 2 miles every day complains of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 2 mile walk. What question asked during the history, if answered affirmatively, would suggest a diagnosis of arteriosclerosis obliterans?

 

“Are you wearing your usual shoes?”

 

“Do you also have chest pain when you have leg pain?”

 

“Is your leg pain relieved by rest?”

 

“Do you ever have the same pain in the other leg?”

 

Question 39Which of the following statements about malignant melanomas is true?

 

They usually occur in older adult males

 

The patient has no family history of melanoma They are common in blacks

 

The prognosis is directly related to the thickness of the lesion

 

Question 40 Sheila, age 78, presents with a chief complaint of waking up during the night coughing. You examine her and find an S3 heart sound, pulmonary crackles that do not clear with coughing, and peripheral edema. What do you suspect?

 

Asthma

 

Nocturnal allergies

 

Valvular

 

 disease

 

Heart failure

 

Question 41Which antibiotic would be the most efective in treating community acquired pneumonia (CAP) in a young adult without any comorbid conditions?

 

Erythromycin

 

Clarithromycin (Biaxin)

 

Doxycycline (Vibramycin)

 

Penicillin

 

Question 42Which of the following dermatologic vehicles are the most efective in absorbing moisture and decreasing friction?

 

Powde rs

 

Gels

 

Cream s

 

 Lotion

 

Question 43A 70 year old patient presents with a slightly raised, scaly, erythematous patch on her forehead. She admits to having been a “sun worshiper.” The nurse practitioner suspects actinic keratosis. This lesion is a precursor to:

 

Squamous cell carcinoma

 

Basal cell carcinoma

 

Malignant melanoma

 

 Acne vulgaris

 

Question 44An elderly patient is being seen in the clinic for complaint of “weak spells” relieved by sitting or lying down. How should the nurse practitioner proceed with the physical examination?

 

Assist the patient to a standing position and take her blood pressure.

 

Assess the patient’s cranial nerves.

 

Compare the patient’s blood pressure lying first, then sitting, and then standing.

 

Compare the amplitude of the patient’s radial and pedal pulses.

 

Question 45What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery?

 

Ursodiol Ibuprofen

 

Prednisone

 

 Surgery is the only answer

 

Question 46A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is:

 

Staphylococcus aureus

 

Group A beta hemolytic streptococcus

 

Haemophilus influenza

 

Pseudomonas aeruginosa

 

Question 47Which of the following is not a symptom of irritable bowel syndrome?

 

Painful diarrhea Painful constipation

 

Cramping and abdominal pain

 

Weight loss

 

Question 48A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed?

 

Any recent trauma Difficulty swallowing

 

Stifness in the right shoulder

 

Change in sleeping habits

 

Question 49Marvin, age 56, is a smoker with diabetes. He has just been diagnosed as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis?

 

ACE Inhibitor

 

Beta Blocker

 

Calcium channel blocker

 

Diuretic

 

Question 50The diferential diagnosis for a patient complaining of a sore throat includes which of the following?

 

Gonococcal

 

 infection Thrush Leukoplakia B only

 

A, B, and C

 

Question 51A patient presents to the primary care provider complaining of a rash on his right forehead that started yesterday and is burning and painful. The physical exam reveals an erythematous, maculopapular rash that extends over the patient’s right eye to his upper right forehead. Based on the history and examination, the most likely cause of this patient’s symptoms is:

 

Rhus dermatitis

 

Ophthalmic zoster

 

Chemosis

 

Optic neuritis

 

Question 52Before initiating an HMG CoA-reductase inhibitor for hyperlipidemia, the nurse practitioner orders liver function studies. The patient’s aminotransferase (ALT) is elevated. What laboratory test(s) should be ordered?

 

Serologic markers for hepatitis

 

 Serum bilirubin

 

Serum cholesterol with HDL and LDL

 

A liver biopsy

 

Question 53A patient with elevated lipids has been started on lovastatin. After 3 weeks of therapy, he calls to report generalized muscle aches. The nurse practitioner should suspect:

 

A drug interaction

 

Hepatic dysfunction

 

Hypersensitivity to lovastatin

 

Rhabdomyolysis

 

Question 54Treatment of acute vertigo includes:

 

Bedrest and an antihistamine

 

Fluids and a decongestant

 

A sedative and decongestant

 

Rest and a low sodium diet

 

Question 55Treatment of H.pylori includes which of the following?

 

Proton pump inhibitor

 

Antibiotic therapy

 

Bismuth subsalicylate

 

A and B

 

A, B, and C

 

Question 56Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect?

 

Cataracts Glaucoma

 

Retinal detachment

 

Iritis

 

Question 57In order to decrease deaths from lung cancer:

 

All smokers should be screened annually

 

All patients should be screened annually

 

Only high risk patients should be screened routinely

 

Patients should be counseled to quit smoking

 

Question 58John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia?

 

Every 5 years

 

Every 2 years Every year

 

 Whenever blood work is done

 

Question 59Mort is hypertensive. Which of the following factors influenced your choice of using an alpha blocker as the antihypertensive medication?

 

Mort is black

 

Mort also has congestive heart failure

 

 Mort has benign prostatic hyperplasia

 

Mort has frequent migraine headaches

 

Question 60John, age 59, presents with recurrent, sharply circumscribed red papules and plaques with a powdery white scale on the extensor aspect of his elbows and knees. What do you suspect?

 

Actinic keratosis Eczema

 

Psoriasis

 

Seborrheic dermatitis

 

Question 61Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg daily, and Calcium 1500 mg daily. At today’s visit. Her blood pressure is 170/89. According to JNC VIII guidelines, what should you do next to control Harriet’s blood pressure?

 

Increase her Lisinopril to 20mg daily

 

Add a thiazide diuretic to the Lisinopril 5mg daily

 

Discontinue the Lisinopril and start a combination of ACE Inhibitor and calcium channel blocker

 

Discontinue the Lisinopril and start a diuretic

 

Question 62An active 65-year-old man under your care has known acquired valvular aortic stenosis and mitral regurgitation. He also has a history of infectious endocarditis. He has recently been told he needs elective replacement of his aortic valve. When he comes into the office you discover that he has 10 remaining teeth in poor repair. Your recommendation would be to:

 

defer any further dental work until his valve replacement is completed

 

instruct him to have dental extraction done cautiously, having no more than 2 teeth per visit removed.

 

suggest he consult with his oral surgeon about having all the teeth removed at once and receiving appropriate antibiotic prophylaxis

 

coordinate with his cardiac and oral surgeons to have the tooth extractions and valve replacement done at the same time to reduce the risk of anesthetic complications.

 

Question 63Appropriate therapy for peptic ulcer disease (PUD) is:

 

Primarily by eradication of infection

 

Based on etiology

 

Aimed at diminishing prostaglandin synthesis

 

Dependent on cessation of NSAID use

 

Question 64Shirley, age 58, has been a diabetic for 7 years. Her blood pressure is normal. Other than her diabetes medications, what would you prescribe today during her routine office visit?

 

A calcium channel blocker

 

A beta blocker

 

An ACE Inhibitor

 

No hypertension medication

 

Question 65Medicare is a federal program administered by the Centers for Medicare and Medicaid Services (CMS). The CMS has developed guidelines for Evaluation and Management coding, which all providers are expected to follow when coding patient visits for reimbursement. Which of the following is an important consideration regarding billing practices?

 

It is important to “undercode” so that one does not get charged with Medicare fraud

 

The practice of “overcoding” is essential in this age of decreasing reimbursements

 

Failing to bill for billable services will lead to unnecessarily low revenues

 

Time spent with the patient is a very important determinant of billing

 

Question 66A 2 year old presents with a white pupillary reflex. What is the most likely cause of this finding?

 

Viral conjunctivitis

 

Glaucoma

 

 Corneal abrasion

 

Retinoblastom a

 

Question 67Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?

 

Pharmacological therapy

 

A labyrinthectomy

 

A vestibular neurectomy

 

Wearing an earplug in the ear with the most hearing loss

 

Question 68Which of the following is not a risk factor for coronary arterial insufficiency?

 

Hyperhomocystein emia

 

Smoking Genetic factors

 

 Alcohol ingestion

 

Question 69An 18-year-old female presents to the urgent care center complaining of severe pruritus in both eyes that started 2 days ago. Associated symptoms include a headache and  fatigue. On examination, the nurse practitioner notes some clear discharge from both eyes and some erythema of the eyelids and surrounding skin. Which of the following is the most likely cause of this patient’s symptoms?

 

Allergic conjunctivitis

 

Bacterial conjunctivitis

 

Gonococcal conjunctivitis

 

 Viral conjunctivitis

 

Question 70A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most efective in keeping him symptom-free?

 

A long-acting bronchodilator

 

An inhaled corticosteroid and cromolyn

 

Theophylline and a short acting bronchodilator

 

A bronchodilator PRN and an inhaled corticosteroid

 

Question 71Acute rheumatic fever is an inflammatory disease which can follow infection with:

 

Group A Streptococcus

 

Staphlococcus areus

 

Β-hemolytic Streptococcus

 

 Streptococcus pyogenes

 

Question 72A 60 year old male diabetic patient presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which “is better.” His temperature is 100°F and pulse is 102 bpm. The most appropriate initial action is to:

 

Start an oral antibiotic, refer the patient to a dentist immediately, and follow up within 3 days

 

Order mandibular x-rays and question the patient about physical abuse

 

Start an oral antibiotic, mouth swishes with an oral anti-infective, and an analgesic

 

Initiate a parenteral antibiotic and consider hospital admission

 

Question 73If a patient presents with a deep aching, red eye and there is no discharge, you should suspect:

 

Iritis

 

 Allergic conjunctivitis

 

Viral conjunctivitis

 

Bacterial conjunctivitis

 

Question 74The National Cholesterol Education Program’s Adult Treatment Panel III recommends that the goal for low density lipoproteins in high risk patients be less than:

 

160

 

mg/dL

 

130

 

mg/dL

 

100

 

mg/dL

 

70

 

mg/dL

 

Question 75A patient presents with classic symptoms of gastroesophageal reflux disease (GERD). He is instructed on life style modifications and drug therapy for 8 weeks. Three months later he returns, reporting that he was “fine” as long as he took the medication. The most appropriate next step is:

 

Referral for surgical intervention such as a partial or complete fundoplication

 

Dependent upon how sever the practitioner believes the condition

 

To repeat the 8 week course of drug therapy while continuing lifestyle modifications

 

 Investigation with endoscopy, manometry, and/or pH testing

 

Question 76Group A β-hemolytic streptococcal (GABHS) pharyngitis is most common in which age group?

 

Under 3 years of age

 

Preschool children

 

6 to 12 years of age

 

Adolescents

 

Question 77The most appropriate treatment for a child with mild croup is:

 

A bronchodilator An antibiotic

 

A decongestant

 

A cool mist vaporizer

 

Question 78A child complains that his “throat hurts” with swallowing. His voice is very “throaty” and he is hyperextending his neck to talk. Examination reveals asymmetrical swelling of histonsils. His uvula is deviated to the left. What is the most likely diagnosis?

 

Peritonsillar abscess

 

Thyroiditis Mononucleosis

 

Epiglottitis

 

Question 79Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication?

 

It is not efective during an acute asthma attack.

 

It may take 2 to 3 days to begin working. This drug works within 10 minutes.

 

 This drug may be used by patients 6 years and older.

 

Question 80Which intervention listed below is safe for long term use by an adult with constipation?

 

Bulk-forming agents

 

 Stool softeners Laxatives

 

Osmotic agents

 

Question 81A 40 year old presents with a hordeolum. The nurse practitioner teaches the patient to:

 

Apply a topical antibiotic and warm compresses.

 

Apply cool compresses and avoid touching the hordeolum.

 

Use an oral antibiotic and eye flushes.

 

 Apply light palpation to facilitate drainage.

 

Question 82Sarah has allergic rhinitis and is currently being bothered by nasal congestion. Which of the following meds ordered for allergic rhinitis would be most appropriate?

 

An antihistamine intranasal spray

 

A decongestant nasal spray

 

Ipratropium Omalizumab

 

Question 83What is the Gold standard for the diagnosis of asthma?

 

Patient’s perception of clogged

 

airways

 

Validated quality-of-life questionnaires

 

Bronchoscopy

 

Spirometry

 

Question 84A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough?

 

Methyldopa

 

Enalapril Amlodipine

 

Hydrochlorothia zide

 

Question 85Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by:

 

Herpes simplex

 

 Aphthous ulcers

 

Candidiasis

 

Oral cancer

 

Question 86Risk factors for acute otitis media (AOM) include all of the following except:

 

Household cigarette smoke

 

Group daycare attendance

 

Sibling history of acute otitis media

 

African-American ethnicity

 

Question 87Which of the following can result from chronic inflammation of a meibomian gland?

 

A

 

chalazion Uveitis Keratitis

 

A

 

pterygiu m

 

Question 88What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?

 

You must initiate the plan of care for the patient

 

The physician must be on-site and engaged in patient care

 

You must be employed as an independent contractor

 

You must be the main health care provider who sees the patient

 

Question 89Of the following choices, the least likely cause of cough is:

 

Asthma

 

Gastroesophageal reflux

 

Acute pharyngitis Allergic rhinitis

 

Question 90The most common correlate(s) with chronic bronchitis and emphysema is(are):

 

Familial and genetic

 

factors

 

Cigarette smoking

 

 Air pollution

 

Occupational environment

 

Question 91Which choice below is least efective for alleviating symptoms of the common cold?

 

Antihistamines

 

Oral decongestants

 

Topical decongestants

 

Antipyretics

 

Question 92When teaching a patient with hypertension about restricting sodium, you would include which of the following instructions?

 

Diets with markedly reduced intakes of sodium may be associated with other beneficial efects beyond blood pressure control

 

Sodium restriction can cause serious adverse efects

 

A goal of 3 g of sodium chloride or 1.2 g of sodium per day is easily achievable

 

Seventy-five of sodium intake is derived from processed foods

 

Question 93 Which of the following heart murmurs warrants the greatest concern?

 

Systolic murmur

 

Venous hum murmur

 

Diastolic murmur

 

Flow murmur

 

Question 94A patient presents with an inflamed upper eyelid margin. The conjunctiva is red and there is particulate matter along the upper eyelid. The patient complains of a sensation that “there is something in my eye.” What is the diagnosis and how should it be treated?

 

Hordeolum; treat with a topical antibiotic and warm compress Conjunctivitis; treat with topical antibiotic and warm compresses

 

Blepharitis; treat with warm compresses and gentle debridement with a cotton swab

 

Chalazion; refer to an ophthalmologist for incision and drainage

 

Question 95A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory?

 

Inferior wall

 

Anterior wall

 

Apical wall

 

 Lateral wall

 

Question 96 The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The least likely diagnosis for this patient is:

 

 Acute otitis media (AOM)

 

Otitis media with efusion

 

Mucoid otitis media

 

 Serous otitis media

 

Question 97 Alan, age 54, notices a bulge in his midline every time he rises from bed in the morning. You tell him it is a ventral hernia, also known as:

 

 

 

inguinal hernia

 

epigastric hernia

 

umbilical hernia

 

incisional hernia

 

Question 98A 58-year-old man is diagnosed with Barrett’s esophagus after an endoscopy. He has no known allergies. Which of the following medications is MOST appropriate to treat this patient’s disorder?

 

Omeprazole Ranitidine An antacid

 

 None of the above

 

Question 99Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to:

 

Quit smoking

 

Maintain aggressive hypertension therapy

 

Stick to a low-fat, low-sodium diet

 

 Continue with his exercise program

 

Question 100 Risk factors for acute arterial insufficiency include which of the following?

 

Recent myocardial infarction

 

Atrial fibrillation Atherosclerosis

 

All of the above

 

Question 101 Impetigo and folliculitis are usually successfully treated with:

 

Systemic antibiotics

 

Topical antibiotics

 

Topical steroid creams

 

Cleansing and debridement