18 Oct Which of the following is a potential acquired cause of thrombophilia?

Which of the following is a potential acquired cause of thrombophilia?

 

Homocysteinuria

 

Protein C deficiency

 

Factor V Leiden

 

Antiphospholipid

 

antibodies

 

Question 3Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of:

 

Ulnar tunnel

 

syndrome

 

Carpal tunnel

 

syndrome

 

Tarsal tunnel

 

syndrome

 

Myofascial pain

 

syndrome

 

Question 4Which patient would benefit most from screening for type 2 diabetes?

 

A 30 year old female with unintended weight loss.

 

A 25 year old male with family history of type 1 diabetes

 

An obese female with recurrent vaginitis

 

A 50 year old hyperlipidemic male

 

Question 5 A 72 year old female patient reports a 6 month history of gradually progressive swollen and painful distal interphalangeal (DIP) joints of one hand. She has no systemic symptoms but the erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), and rheumatoid factor (RF) are all minimally elevated. What is the most likely diagnosis?

 

Rheumatoid arthritis (RA)

 

Osteoarthritis (OA)

 

Lupus

 

Peripheral

 

neuropathy

 

Question 6A 32 year old male patient complains of urinary frequency and burning on urination for 3days. Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial treatment should be:

 

Trimethoprim-sulfamethoxazole for 3 days

 

Ciprofloxacin for 7-10 days

 

Trimethoprim-sulfamethoxazole for 14 days

 

Ciprofloxacin for 3 days

 

Question 7 A thymectomy is usually recommended in the early treatment of which disease?

 

Parkinson’s

 

disease

 

Multiple

 

sclerosis

 

Myasthenia

 

gravis

 

Huntington’s

 

 

 

chorea

 

Question 8The diagnosis of human papilloma virus (HPV) infection in males is usually made by:

 

Clinical

 

appearance

 

Viral culture

 

Tzanck smear

 

KOH prep

 

Question 9The most effective intervention(s) to prevent stroke is (are):

 

81 mg of aspirin daily

 

Carotid endarterectomy for patients with high-grade

 

carotid lesions

 

Routine screening for carotid artery stenosis with

 

auscultation for bruits

 

Smoking cessation and treatment of hypertension

 

Question 10What is the most common cause of Cushing’s syndrome?

 

Excessive ACTH production

 

Administration of a glucocorticoid or ACTH

 

Pituitary adenoma or a non-pituitary ACTHproducing

 

tumor

 

Autonomous cortisol production from adrenal

 

tissue

 

Question 11Diagnostic radiological studies are indicated for low back pain:

 

Routinely after 3 weeks of low back pain symptoms.

 

To screen for spondylolithiasis in patients less than 20 years of age with 2 weeks of more of low back pain.

 

When there is a suspicion of a space-occupying lesion, fracture, cauda equina, or infection.

 

As a part of a pre-employment physical when heavy lifting is included in the job description.

 

Question 12After treating a patient for Helicobacter pylori infection, what test do you order to see if it

 

has been cured?

 

An enzyme-linked immunosorbent

 

assay titer

 

A urea breath test

 

A rapid urease test

 

A repeat endoscopy

 

Question 13Which appropriate test for the initial assessment of Alzheimer’s disease provides the

 

performance ratings on 10 complex, higher order activities?

 

MMSE

 

CAGE questionnaire

 

FAQ – Functional Activities

 

Questionnaire

 

Holmes and Rahe social

 

readjustment scale

 

Question 14Major depression occurs most often in which of the following conditions?

 

A. Myocardial

 

infarction

 

Parkinson’s disease

 

Stroke

 

Alzheimer’s disease

 

Question 15Which of the following statements about multiple sclerosis (MS) is correct?

 

MS is a chronic, untreatable illness that is almost always fatal.

 

MS is a disease of steadily progressive and unrelenting neurologic deterioration.

 

MS is a chronic, treatable illness with unknown cause and a variable course.

 

Patients with MS who take active steps to improve their health have

 

the best cure rate.

 

Question 16Diagnostic evaluation of hypothyroidism reveals:

 

Elevated TSH and

 

decreased T4

 

Decreased TSH and

 

increased T4

 

Decreased TSH and

 

decreased T3

 

Elevated TSH and

 

increased T4

 

Question 17 Risk factors for prostate cancer include all of the following except:

 

Family history

 

Benign prostatic

 

hypertrophy

 

African American race

 

Age

 

Question 18 What information should patients with diabetes and their families receive about

 

hypoglycemia?

 

Hypoglycemia is a rare complication.

 

Hypoglycemia requires professional medical treatment.

 

Hypoglycemia is serious, dangerous, and can be fatal if not

 

treated quickly.

 

Hypoglycemia occurs only as a result of insulin overdose.

 

Question 19 Which history is commonly found in a patient with glomerulonephritis?

 

Beta-hemolytic strep

 

infection

 

Frequent urinary tract

 

infections

 

Kidney stones

 

Hypotension

 

Question 20 Which of the following is characteristic of a manic episode?

 

weight loss of gain

 

insomnia or hypersomnia

 

diminished ability to think or

 

concentrate

 

grandiose delusions

 

Question 21 Central obesity, “moon” face, and dorsocervical fat pad are associated with:

 

Metabolic syndrome

 

Unilateral

 

pheochromocytoma

 

Cushing’s syndrome

 

None of the above

 

Question 22Which of the following is the most common cause of low back pain?

 

Lumbar disc

 

disease

 

Spinal stenosis

 

Traumatic

 

fracture

 

Osteoporosis

 

Question 23A middle-aged female presents complaining of recent weight loss. The physical exam reveals

 

an enlarged painless cervical lymph node. The differential diagnosis for this patient’s

 

problem includes:

 

Infection

 

Toxoplasmosis

 

Mononucleosi

 

s

 

All of the

 

above

 

None of the

 

above

 

Question 24An 81-year-old female is diagnosed with type 2 diabetes. When considering drug therapy for

 

this patient, the nurse practitioner is most concerned with which of the following side

 

effects?

 

Weightgain

 

Fracturerisk

 

Hypoglyce Mia

 

Weight loss

 

Question 25A patient has HIV infection and is having a problem with massive diarrhea. You suspect the

 

cause is:

 

cryptococcosi

 

s

 

toxoplasmosi

 

s

 

cryptosporidi

 

osis

 

cytomegalovi

 

ru

 

Question 26Which of the following is the most common causative organism of nongonococcal urethritis?

 

Chlamydia

 

trachomatis

 

Ureaplasma

 

urealyticum

 

Mycoplasma

 

hominis

 

Trichonomas

 

vaginalis

 

Question 27The most common symptoms of transient ischemic attack (TIA) include:

 

Nausea, vomiting, syncope, incontinence, dizziness, and seizure.

 

Weakness in an extremity, abruptly slurred speech, or partial loss of vision, and

 

sudden gait changes.

 

Headache and visual symptoms such as bright spots or sparkles crossing the

 

visual field.

 

Gradual onset of ataxia, vertigo, generalized weakness, or lightheadedness

 

Question 28What is the first symptom seen in the majority of patients with Parkinson’s disease?

 

Rigidity

 

Bradykinesi

 

a

 

Rest tremor

 

Flexed

 

posture

 

Question 29A 21-year-old female presents to the office complaining of urinary frequency and urinary

 

burning. The nurse practitioner suspects a urinary tract infection when the urinalysis reveals

 

1–4 red blood cells per highpowered

 

field

 

Specific gravity 1.012

 

Urobilinogen

 

10- white blood cells per highpowered

 

field

 

Question 30A 26 year old female presents with elbow pain that is described as aching and burning.

 

There is point tenderness along the lateral aspect of the elbow and painful passive flexion

 

and extension. She reports she has been playing tennis almost daily for the past month. The

 

most likely diagnosis is:

 

Radial tunnel syndrome

 

Ulnar collateral ligament

 

sprain

 

Olecranon bursitis

 

Lateral epicondylitis

 

Question 31

 

Maria, age 17, was raped when she was 13 year old. She is now experiencing sleeping

 

problems, flashbacks, and depression. What is your initial diagnosis?

 

Depression

 

Panic disorder

 

Anxiety

 

Post-traumatic stress

 

disorder

 

Question 32An elderly man is started on lisinopril and hydrochlorhiazide for hypertension. Three days

 

later, he returns to the office complaining of left great toe pain. On exam, the nurse

 

practitioner notes an edematous, erythematous tender left great toe. The likely precipitant

 

of this patient’s pain is:

 

Trauma

 

Tight shoes

 

Arthritis flare

 

Hydrochlorothia

 

zide

 

Question 33Which of the following is a contraindication for metformin therapy?

 

Insulin

 

therapy

 

Creatinine >1.5 Edema

 

None of theabove

 

Question 34A positive drawer sign supports a diagnosis of:

 

Sciatica

 

Cruciate ligament

 

injury

 

Meniscal injury

 

Patellar ligament

 

injury

 

Question 35Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him how to

 

reduce his lower esophageal sphincter pressure, which substances do you recommend that

 

he avoid?

 

Apples

 

Peppermint

 

Cucumbers

 

Popsicles

 

Question 36A patient taking levothyroxine is being over-replaced. What condition is he at risk for?

 

Osteoporosis

 

Constipation

 

Depression

 

Exopthalmia

 

Question 37

 

Diabetes screening recommendations for asymptomatic adults age 45 and over include

 

which of the following:

 

HbA1C

 

2-hour 75 gram oral glucose

 

tolerance test

 

C-peptide level

 

A and B

 

 

 

All of the above

 

Question 38

 

Dave, age 38, states that he thinks he has an ear infection because he just flew back from a

 

business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your

 

next action?

 

Prescribe systemic antibiotics

 

Prescribe antibiotic ear drops

 

Prescribe nasal steroids and oral

 

decongestants

 

Refer him to an ear, nose, and throat

 

specialist

 

Question 39

 

Josh, age 22, is a stock boy and has an acute episode of low back pain. You order and NSAID

 

and tell him which of the following?

 

Maintain moderate bed rest for 3-4 days

 

Call the office for narcotics if there is no relief with the NSAID

 

in 24-48 hours

 

Begin lower back strengthening exercises depending on pain

 

tolerance

 

Wear a Boston brace at night

 

Question 40

 

Risk factors for Addison’s disease include which of the following?

 

Tuberculosis

 

Autoimmune

 

disease

 

AIDS

 

All of the above

 

Question 41Urine cultures should be obtained for which of the following patients?

 

Suspected urinary tract infection in

 

pregnancy

 

Febrile patients

 

Young men

 

All of the above

 

Question 42Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How

 

do you respond?

 

“Caffeine has not effect on osteoporosis.”

 

“A high caffeine intake has a diuretic effect that may cause calcium to be excreted

 

more rapidly.”

 

“Caffeine affects bone metabolism by altering intestinal absorption of calcium and

 

assimilation of calcium into the bone matrix.”

 

“Caffeine increase bone resorption.