Term
| When does rooting reflex disappear? |
|
Definition
|
|
Term
| When should moro reflex disappear? |
|
Definition
|
|
Term
| What does absence of moro reflex on one side in a child under 3 to 4 months tell the NP they should add to their differentials? |
|
Definition
| Brachial Plexus injury, fracture, shoulder dystocia |
|
|
Term
| If MMR vaccine is given before 12 months, what should the NP expect to tell the parents? |
|
Definition
| The vaccine will need to be repeated. It is not recommended before 12 months due to immune system immaturity. |
|
|
Term
| The ability of a test to detect a person who has a disease is defined as _______. |
|
Definition
|
|
Term
| The ability of a test to detect a person who is healthy (or to detect a person without the disease) is defined as ___________. |
|
Definition
|
|
Term
| This type of study follows a group of people who share some common characteristics to observe the development of disease over time: |
|
Definition
|
|
Term
| Trauma to Kiesselbach's plexus will lead to: |
|
Definition
| An anterior nose bleed (Epistaxis). |
|
|
Term
| What is the gold standard test for sickle cell? |
|
Definition
|
|
Term
| What is the gold standard test for Alpha/Beta Thalassemia? |
|
Definition
| Hemoglobin Electrophoresis |
|
|
Term
| If the patient has a penicillin allergy and a gram-positive infection, what are possible alternatives? |
|
Definition
| Macrolides or Clindamycin |
|
|
Term
| A Patient with COPD is prescribed Atrovent for dyspnea. On follow up, the patient complains that his symptoms are not relieved. The next step would be to prescribe: |
|
Definition
| An albuterol inhaler (ventolin) |
|
|
Term
| A butterfly (malar) rash is a characteristic of which disease? |
|
Definition
|
|
Term
| What is first line treatment for PMR (Polymyalgic rheumatica)? |
|
Definition
| Long-term, low dose steroids. |
|
|
Term
| Patients with which condition are more susceptible to temporal arteritis? |
|
Definition
|
|
Term
| Which maneuver would indicate DeQuervains tenosynovitis? |
|
Definition
|
|
Term
| A positive McMurray's sign may indicate what? |
|
Definition
| Meniscus injury of the knee. |
|
|
Term
| In regards to an opthalmoscopic exam, what might the following findings indicate: Neovascularization, hard exudates, cotton wool spots, and microaneurysms? |
|
Definition
|
|
Term
| In regards to an opthalmoscopic exam, what might the following findings indicate: AV nicking, silver and/or copper wire arterioles? |
|
Definition
|
|
Term
| When checking deep tendon reflexes in a patient with severe sciatica or diabetic peripheral neuropathy, what might the NP suspect to find on ankle jerk reflex (achilles reflex)? |
|
Definition
| Absent or hypoactive reflex |
|
|
Term
| A rare but serious adverse effect of ACE inhibitors: |
|
Definition
|
|
Term
| First line drugs to treat hypertension in diabetics and patients with mild renal disease because of their renal-protective properties |
|
Definition
|
|
Term
| Name three common macrilodes: |
|
Definition
| Erythromycin, Azithromycin, clarithromycin |
|
|
Term
| Name a first generation cephalosporin: |
|
Definition
|
|
Term
| Name 3 second generation cephalosporins: |
|
Definition
|
|
Term
| Name a 3 third generation cephalosporins: |
|
Definition
| Rocephin, suprax, omnicef |
|
|
Term
| Name 2 quinolones (no gram+ coverage): |
|
Definition
| Ciprofloxacin (cipro), ofloxacin (floxin) |
|
|
Term
| Name 3 quinolones with gram + coverage: |
|
Definition
| Levofloxacin (levaquin); moxifloxacin (Avelox), and Gatifloxacin (tequin) |
|
|
Term
|
Definition
| Trimethoprim/Sulfamethazole (Bactrim,Septra); Nitrofurantoin (Macrobid) |
|
|
Term
|
Definition
| Tetracycline;doxycycline, minocycline (minocin) |
|
|
Term
| What risk do nitrofurantoin and sulfa drugs present when taken during the third trimester? |
|
Definition
| Increased risk of hyperbilirubinemia |
|
|
Term
| What is the preferred treatment for cutaneous anthrax? |
|
Definition
| Ciprofloxacin 500mg orally BID for 60 days or 8 weeks. If patient is allergic, use Doxycycline 100mg BID. |
|
|
Term
| Name the Stages of Change or "Decision" as theorized by Prochaska. |
|
Definition
| Pre-comtemplation, contemplation, preparation, action and maintenance |
|
|
Term
| At what age can children understand abstract concepts and become better at logical thinking? |
|
Definition
|
|
Term
| When you see a range of normals on an AANP exam, what should you do? |
|
Definition
| Write them on your scratch paper because they will only be listed once. |
|
|
Term
| And MCV below 80 and a hemoglobin of less than 3.5g/dl in males is indicative of what? |
|
Definition
|
|
Term
| What type of prevention are breast and genital self exams? |
|
Definition
|
|
Term
| Two common side effects of a patient being treated with HCTZ include: |
|
Definition
| Hyperuricemia and hyperglycemia |
|
|
Term
| What is the most common overall cancer death from? |
|
Definition
|
|
Term
| What is the most common overall cancer? |
|
Definition
|
|
Term
| What is the most common cancer in females? |
|
Definition
|
|
Term
| What is the most cancer in males? |
|
Definition
|
|
Term
| What disease causes the most overall deaths? |
|
Definition
|
|
Term
| What is the most common cause of death in adolescents? |
|
Definition
|
|
Term
| What is the most common type of skin cancer? |
|
Definition
|
|
Term
| What is the most common gynecological cancer? |
|
Definition
| Uterine/Endometrial cancer |
|
|
Term
| What is the second most common gynecological cancer? |
|
Definition
|
|
Term
| What is the USPSTF screening recommendation for ovarian cancer? |
|
Definition
| The USPSTF does not recommend routine screening of women for ovarian cancer. |
|
|
Term
| Give 3 examples of benign physiological variants. |
|
Definition
| Geographic tongue, torus palatinus, and split or fishtail uvula. |
|
|
Term
| What benign variant is indicated by a chronic bony growth located midline in the hard palate? |
|
Definition
|
|
Term
| A slow-growing white plaque that has a firm to hard surface that is slightly raised on the tongue or inside the mouth. Considered a precancerous lesion. Commonly seen in tobacco users (especially snuff) |
|
Definition
|
|
Term
| A painless white patch (or patches) that appears corrugated. It is located on the lateral aspects of the tongue and is associated with HIV and AIDS infection. It is caused by Epstein-Barr virus infection of the tongue. It is not considered a premalignant lesion. |
|
Definition
|
|
Term
| When does the USPSTF recommend baseline breast cancer screening? |
|
Definition
|
|
Term
| How often after initial baseline screening (negative) does the USPSTF recommend breast cancer screening? |
|
Definition
| Every 2 years until age 74. Stop at age 75 or older. |
|
|
Term
| When does the USPSTF recommend baseline cervical cancer screening? |
|
Definition
|
|
Term
| When does the USPSTF recommend routine prostate cancer screening? |
|
Definition
| Routine screening is not recommended (2012) |
|
|
Term
| When does the USPSTF recommend routine testicular cancer screening? |
|
Definition
|
|
Term
| When does the USPSTF recommend baseline colon cancer screening? |
|
Definition
| Age 50-75 years. Baseline at 50 years old. Use high-sensitivity fecal occult blood test (yearly) or sigmoidoscopy (every 5 years) or colonoscopy (every 10 years). |
|
|
Term
| When does the USPSTF recommend baseline skin cancer counseling? |
|
Definition
| Age 10 to 24 years. Educate fair-skinned persons to avoid sunlight (10am-3pm), use sunblock SPF 15 or higher. |
|
|
Term
| When does the USPSTF recommend baseline ovarian cancer screening? |
|
Definition
| Do not screen unless high risk (Ashkenazi Jew, BRCA gene, family history of two or more first or second degree relative) |
|
|
Term
| When does the USPSTF recommend baseline AAA screening? |
|
Definition
| One-time screening (only men aged 65-75 years) who are cigarette smokers. Screening test is ultrasound of the abdomen. |
|
|
Term
| A 65 year old female smoker presents with a history of Barrett's esophagus, and gastroesophageal reflux disease (GERD). The patient reports that her gastroenterologist's prescription for esomeprazole (Nexium) 40mg daily ran out a few days ago. She is complaining of severe heartburn and a sore throat. During the physical exam, the NP notes an erythematous posterior pharynx without tonsillar discharge and mild dental enamel loss on the rear molars. What is the best initial action for the NP to follow? |
|
Definition
| Give the patient a refill of her proton pump inhibitor (PPI) prescription and advise her to schedule an appointment with her gastroenterologist. |
|
|
Term
| What can happen if a patient abruptly discontinues a high-dose PPI? |
|
Definition
|
|
Term
| What is another name for Tanner stage 1? |
|
Definition
|
|
Term
| What happens for girls in tanner stage II? |
|
Definition
| Breast bud and areola starts to develop. |
|
|
Term
| What happens for girls in tanner stage III? |
|
Definition
| Breast continues to grow with nipples/areola (one mound/no separation). |
|
|
Term
| What happens for girls in tanner stage IV? |
|
Definition
| Nipples and areola become elevated from the breast (a secondary mound) |
|
|
Term
| What does visual inspection reveal for girls in tanner stage V? |
|
Definition
|
|
Term
| What does visual inspection reveal for boys in tanner stage II? |
|
Definition
| Testes with scrotum starts to enlarge (scrotal skin starts to get darker/more ruggae). |
|
|
Term
| What does visual inspection reveal for boys in tanner stage III? |
|
Definition
| Penis grows longer (length) and testes/scrotum continues to become larger. |
|
|
Term
| What does visual inspection reveal for boys in tanner stage IV? |
|
Definition
| Penis becomes wider and continues growing in length (testes are larger with darker scrotal skin and more ruggae. |
|
|
Term
| A 14 year old boy is brought in by his mother for a physical exam. Both are concerned about his breast enlargement. The teen denies breast tenderness. On physical exam, the NP palpates soft breast tissue that is not tender. No dominant mass is noted. The skin is smooth and there si no nipple discharge with massage. The teen has a BMI of 29. Which of the following statements is correct? |
|
Definition
| Educate the mother that her son has pseudo-gynecomastia. |
|
|
Term
Which of the following foods are known to have a high K+ content?
A) Low-fat yogurt, soft cheeses and collard greens.
B) Aged cheese, red wine and chocolate
C) Potatoes, apricots, and brussels sprouts.
D) Black beans, red meat, and citrus juice |
|
Definition
| C) Potatoes, apricots, and brussels sprouts. |
|
|
Term
| The mediterranean diet is high in which fats? |
|
Definition
|
|
Term
| List foods high in folate: |
|
Definition
| Breakfast cereals fortified with folate, green leafy vegetables (i.e. spinach), liver. |
|
|
Term
|
Definition
| Beef, liver, black beans, black-eyed peas. |
|
|
Term
| For patient's with celiac disease, which dietary adjustments should be made? |
|
Definition
| Lifetime avoidance of gluten-containing cereals such as wheat, rye, barley, and oats. |
|
|
Term
| Which patient population is at higher risk of aspirin and NSAID allergies? |
|
Definition
| Those with an atopic history: Asthma, Eczema, allergic rhinitis. |
|
|
Term
| What is the reaction classification for anaphylaxis? |
|
Definition
| Type I IgE-dependent reaction. |
|
|
Term
| Why are patients with anaphylaxis discharged from ER with medrol dose pack and a long-acting antihistamine? |
|
Definition
| Because biphasic anaphylaxis occurs in up to 23% of cases (symptoms recur within 8-10 hours after initial episode). |
|
|
Term
| During life-threatening situations, managing the airway, breathing and circulation is always the top priority. If the question does not describe conditions requiring the ABCs, then the next level of priority is what? |
|
Definition
| The acute or sudden change in the mental status and the level of consciousness (LOC). |
|
|
Term
Which of the following is most likely to be found in patients with a long-standing case of iron-deficiency anemia?
A) Pica
B) Fatigue
C) Pallor
D) Irritability |
|
Definition
A) Pica
Test-taking pearl: Always pick out the most specific answer to a question when it is asking about the specific signs & symptoms of a disease. Learn the unique or the most specific signs/symptoms associated with the disease. Fatigue and irritability are found in many conditions. |
|
|
Term
| A patient has excoriated pruritic rashes located in the finger webs and penis. This should be considered _____ until proven otherwise. |
|
Definition
|
|
Term
| What is recommended in regard to all family members and close contacts related to scabies? |
|
Definition
| All family members and close contacts should be treated at the same time as the patients. Also, wash used clothes/sheets in hot water, then dry or iron in high heat. |
|
|
Term
| Patient has a rash with sandpaper-like texture tjat os accp,[amoed by a spre throat, strawberry tongue, and skin desquamination (peeling) of the palms and soles. It is not pruritic. What is the most likely diagnosis? |
|
Definition
| Scarletina (Scarlet fever) |
|
|
Term
A 21 year old woman with a history of mild intermittent asthma and allergic rhinitis complains of a cough that has been waking her up very early in the morning. She reports that she is wheezing more than usual. Her last office visit was 8 months ago. Which of the following is the best initial course of action?
A) Initiate a prescrption of a short-acting-beta 2 agonist QID PRN.
B) Refer the patient to an allergist for a scratch test.
C) Discuss her symptoms and other factors associated with the asthmatic exacerbation
D) Perform a thorough physical examination and obtain blood work. |
|
Definition
| C) Discuss her symptoms and other factors associated with the asthmatic exacerbation. |
|
|
Term
| A skin rash that has both color and texture (raised or with papules) |
|
Definition
|
|
Term
| A skin condition with a maculopapular rash in a lace-like pattern |
|
Definition
|
|
Term
| A skin condition that presents as a maculopapular rash with papules, vesicles and crusts: |
|
Definition
|
|
Term
| A skin condition that presents as maculopapular rashes that are oval-shaped with a herald patch? |
|
Definition
|
|
Term
| A skin condition that presents as vesicular rashes on an erythematous base: |
|
Definition
| Herpes simples, genital herpes |
|
|
Term
A 14 year old complains of pain and fullness in her left ear that is getting steadily worse. She has a history of allergic rhinitis and is allergic to dust mites. On physical exam, the left tympanic membrane is red with cloudy fluid inside. The landmarks are displaced in the same ear. The patient denies frequent ear infections, and the last antibiotic she took was 8 months ago for a urinary tract infection. She is allergic to sulfa and tells the NP that she will not take any medication with erythromycin because it makes her very nauseated. Which of the following is the best choice of treatment for this patient?
A) Amoxicillin 500mg PO TID for 10 days.
B) Pseudoephedrine (Sudafed) 20mg PO as needed every 4 to 6 hours
C) Fluticasone (flonase) nasal inhaler 1 to 2 sprays each nostril every 12 hours
D) Biaxin (clarithromycin) 500mg PO two times a day for 10 days. |
|
Definition
| A) Amoxicillin 500mg PO TID for 10 days. |
|
|
Term
Which of the following is the best location to auscultate for the S3 heart sound?
A) Aortic area
B) Pulmonic area
C) Tricuspic area
D) Mitral area |
|
Definition
|
|
Term
| The S3 heart sound is pathognomic for: |
|
Definition
|
|
Term
A middle-aged nurse is having his PPD or Mantoux test result checked. A reddened area of 10.5mm is present. It is smooth and soft and does not appear to be indurated. During the interview, the patient denies fever, cough and weight loss. Which of the following is a true statement?
A) The PPD result is negative.
B) The PPD result is borderline.
C) The PPD should be repeated in 2 weeks.
D) A chest x-ray and sputum culture are indicated. |
|
Definition
| A) The PPD result is negative. |
|
|
Term
| Another name for degenerative joint disease (DJD) |
|
Definition
|
|
Term
| Another name for Atopic dermatitis? |
|
Definition
|
|
Term
| Another name for Senila Arcus |
|
Definition
|
|
Term
| Another name for acute otitis media (AOM) |
|
Definition
|
|
Term
| Another name for Group A Streptococcus? |
|
Definition
|
|
Term
| Another name for Tinea corporis? |
|
Definition
|
|
Term
| Another name for Enterobiasis? |
|
Definition
|
|
Term
| Another name for Vitamin B12 |
|
Definition
| Cobalamin or cyanocobalamin |
|
|
Term
| Another name for Vitamin B1 |
|
Definition
|
|
Term
| Another name for Scarlet fever? |
|
Definition
|
|
Term
| Another name for otitis externa |
|
Definition
|
|
Term
| Another name for condyloma acuminata |
|
Definition
|
|
Term
| Another name for Tic douloureaux |
|
Definition
|
|
Term
| Another name for Tinea cruris |
|
Definition
|
|
Term
| Another name for thalassemia minor |
|
Definition
| thalassemia trait (alpha or beta) |
|
|
Term
| Another name for Giant cell arteritis |
|
Definition
|
|
Term
| Another name for Psoas sign |
|
Definition
|
|
Term
| Another name for Light reflex |
|
Definition
|
|
Term
| Another name for sentinel nodes |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Another name for erythema migrans |
|
Definition
|
|
Term
| Another name for sinisitis |
|
Definition
|
|
Term
Which of the following drug classes is indicated as a first-line treatment of both major depression and OCD?
A) SSRIs
B) TCAs
C) Mood stabilizers
D) Benzodiazepines |
|
Definition
|
|
Term
| Mood stabilizers such as lithim salts are used to treat: |
|
Definition
|
|
Term
A 16 year old teen with a history of ADHD is brought in to the ED by his mother. She does not want her son to be alone in the room. The NP doing the intake notes several burns on the teen's trunk. Some of the burns appear infected. The NP documents the burns as mostly round in shape and about 0.5cm in size. Which of the following questions is most appropriate to ask the child's mother?
A) "Your son's back looks terrible. What happened to him?"
B) "Does your son have more friends outside of school?"
C)"Did you burn his back with a cigarette?"
D) "Can you please tell me what happened to your son?" |
|
Definition
| D) "Can you please tell me what happened to your son?" |
|
|
Term
| What questions do the CAGE Pnemonic stand for? |
|
Definition
C: Do you feel the need to CUT DOWN?
A: Are you ANNOYED when your friends/spouse comment about your drinking?
G: Do you feel GUILTY about your drinking?
E: Do you need to drink EARLY in the morning? (EYE-OPENER) |
|
|
Term
Which of the following is least likely to have an alcohol abuse problem?
A) A housewife who gets annoyed if her best friend talks about her drinking habit
B) A carpenter who drinks one can of beer nightly while playing cards with friends.
C) A nurse who feels shaky when she wakes up, which is relieved by drinking wine
D) A college student who tells his friend that he drinks only on weekends but feels that he should be drinking less. |
|
Definition
| B) A carpenter who drinks one can of beer nightly while playing cards with friends. |
|
|
Term
Which of the following drugs is considered the first-line treatment for an uncomplicated case of hypertension according to the Joint National Committe on Evaluation, Management and Treatment of High Blood Pressure (JNC)?
A) ACE inhibitors
B) Thiazide diuretics
C) Calcium channel blockers
D) Beta blockers |
|
Definition
|
|
Term
An older woman complains of a new onset of severe pain in her right ear after taking swimming classes for 2 weeks. On physical exam, the right ear canal is red and swollen. Purulent green exudate is seen inside. All of the following are true statements except:
A) Pulling on the tragus
B) The tympanic membrane is translucent with intact landmarks
C) The external ear canal is swollen and painful
D) Pain on palpation of the mastoid area. |
|
Definition
| D) Pain on palpation of the mastoid area. |
|
|
Term
Which of the following is a correct statement about colonic diverticula?
A) Diverticula are more common in young adults
B) Diverticula formation happens over a period of months
C) Mild cases of diverticulitis can be managed outside the hospital.
D) Dietary fiber supplementation is not recommended. |
|
Definition
| C) Mild cases of diverticulitis can be managed outside the hospital. |
|
|
Term
Two part question:
An adolescent male reports the new onset of symptoms 1 week after returning from a hiking trip in North Carolina. He presents with complaints of high fever, severe headache, muscle aches and nausea. The symptoms are accompanied by a generalized red rash that is not pruritic. The rash initially appeared on both ankles and wrists and then spread toward the patient's trunk. The rash involves both the palms and the soles. Which of the following conditions is most likely?
A) Meningococcemia
B) Rocky mountain spotted fever
C) Idipathic thrombocytopenic purpura (ITP)
D) Lyme disease
Part 2
Which of the following is the best treatment plan to follow?
A) Refer the patient to the hospital ED
B) Refer the patient to an infectious disease specialist
C) Initiate a prescription of oral glucocorticoids
D) Collect a blood specimen for culture and sensitivity. |
|
Definition
Part 1:
B) Rocky mountain spotted fever
Part 2
A) Refer the patient to the hospital ED |
|
|
Term
Which of the following is the second highest cause of mortality among adolescents and young adults in this country?
A) Suicide
B) Smoking
C) Homicide
D) Illicit drug use |
|
Definition
|
|
Term
All of the following can be considered emancipated minors except:
A) A 15 year old who is married
B) A 16 year old who is married and has 1 child
C) A 17 year old who is on active duty with the US army
D) A 16 year old who has his own job |
|
Definition
| D) A 16 year old who has his own job |
|
|
Term
A 57-year-old male walks into an urgent care center. The patient complains of an episode of chest pain with his upper sternum that is relieved after he stops the offending activity. He has had several episodes of the chest pain before. A fasting total lipid profile is ordered. The result reveals total cholesterol of 180 mg/dl, an LDL of 120 mg/dl, and an HDL of 25 mg/dl. Which of the following is most likely?
A) Acute esophagitis
B) MI
C) GERD
D) Angina |
|
Definition
|
|
Term
While performing a routine physical exam on an older white male with a history of cigarette smoking, the NP palpates a pulsatile mass in the patient's mid-abdominal area. A bruit is auscultated over the soft mass. Which of the following is the recommended imaging method?
A) CT scan
B) Abdominal ultrasound
C) Radiography of the chest
D) Plain film of the abdomen |
|
Definition
|
|
Term
| What are the general s/s of AAA rupture? |
|
Definition
| Abrupt onset of severe abdominal pain with low back pain and abdominal distentsion with s/s of shock. |
|
|
Term
Which of the following lab tests is a sensitive indicator of renal function in people of African descent?
A) Serum blood urea nitrogen (BUN)
B) Serum creatinine concentration
C) Estimated glomerular filtration rate (GFR)
D) Serum BUN-to-creatinine ratio |
|
Definition
|
|
Term
| A GFR value of _____ or less is a sign of kidney damage (Refer to nephrologist) |
|
Definition
|
|
Term
| Dehydration will _____ the BUN value. |
|
Definition
|
|
Term
| Sulfa drugs will interact with _____, resulting in an elevation of the INR and the risk of bleeding. |
|
Definition
|
|
Term
| Which organs are the main participants in drug metabolism? |
|
Definition
| liver (cytochrome P450 enzyme system), kidneys, GI tract (breakdown by bacteria) and lungs (CO2). |
|
|
Term
| The amoung of time in which drug concentration decreases by 50%. |
|
Definition
|
|
Term
| The average amount of a drug in the blood after a dose is given. It is a measure of the availability of a drug after it is administered. |
|
Definition
| Area under the curve (AUC). |
|
|
Term
| The lowest concentration of an antibiotic that will inhibit the growth of organisms: |
|
Definition
| Minimum inhibitory concentration (MIC) |
|
|
Term
| The highest concentration of a drug after a dose |
|
Definition
|
|
Term
| The lowest concentration of a drug after a dose. |
|
Definition
| Trough (minimum concentration) |
|
|
Term
| Name 7 drugs with a narrow therapeutic index: |
|
Definition
| Warfarin (coumadin), Digoxin (lanoxin), Theophylline, Carbamazepine (Tegretol), Phenytoin (Dilantin), Levothyroxine, & Lithium |
|
|
Term
| What should be monitored when a patient is put on Coumadin? |
|
Definition
|
|
Term
| What should be monitored when a patient is put Digoxin? |
|
Definition
| Digoxin level, EKG, electrolytes (Potassium, magnesium, calcium) |
|
|
Term
Which of the following laboratory tests is a sensitive indicator of renal function in people of African descent?
A) Serum blood urea nutrigen (BUN)
B) Serum creatinine concentration
C) Estimated glomerular filtration rate (GFR)
D) Serum BUN-to-creatinine ratio |
|
Definition
|
|
Term
| What is the black box warning for Thiazolidinediones? |
|
Definition
| May cause or exacerbate CHF in some patients. Do not use if NYHA Class III or IV heart failure. |
|
|
Term
| What was we be mindful of for patients bein prescribed Pioglitazone (Actos)? |
|
Definition
| Stop if: c/o dyspnea, weight gain, cough (heart failure) |
|
|
Term
| What is the black box warning and safety issues for Atypical antipsychotics (Risperdol, zyprexa and serouel). |
|
Definition
| High risk of weight gain, metabolic syndrome, and type II diabetes. Monitor weight every 3 months. Black box warning: higher mortality in elderly patients. |
|
|
Term
| What must the nurse practitioner be mindful of in warning patients when prescribing biphosphonates (Fosamax, Actonel)? |
|
Definition
| Jaw pain (jaw necrosis), chest pain, difficulty swallowing, burning mid-back (perforation). Take alone upon awakening with 8oz of water (not juice) before breakfast. Do not lie down x 30min afterward. do not mix with other drugs. Take first thing in the morning with breakfast. |
|
|
Term
| What must the nurse practitioner warn patients of when prescribing statins? |
|
Definition
| Do not mix with grapefruit juice. Drug-induced hepatitis or rhabdomyolysis higher if mixed with Azole antifungals. High dose Zocor (80mg) has the highest risk of rhabdo (muscle pain/tenderness). CK (creatinine kinase) level goes up. |
|
|
Term
| What should the nurse practitioner warn a patient about who has been prescribed a lincosamide (Clindamycin/Cleocin)? |
|
Definition
| Higher risk of C-diff associated diarrhea (CDAD) |
|
|
Term
| What are the s/s of digoxin toxicity? |
|
Definition
| Initial symptoms are GI upset (anorexia, nausea/vomiting, abdominal pain). Others are arrhythmias, confusion, and visual changes (yellowis green tinged-color vision, scotomas). |
|
|
Term
| What is severe digoxin toxicity treated with? |
|
Definition
| Digoxin-binding antibodies (Digibind). |
|
|
Term
| What laboratory test should be ordered if digoxin toxicity is suspected? |
|
Definition
| Digoxin level, electrolytes (K+, magnesium, calcium), creatinine, and serial EKGs. |
|
|
Term
| What are critical K+ values for the adult to elderly population? |
|
Definition
| Less than 2.5 or greater than 6.5mEq/L |
|
|
Term
| What are normal values for K+ for the adult to elderly population? |
|
Definition
|
|
Term
| What is target INR for a patient on coumadin for A-Fib? |
|
Definition
|
|
Term
| A patient has an INR of 8.0. Physical examination is negative for petichiae, bleeding gums, bruising or dark stools. What is the best treatment plan for this patient? |
|
Definition
| INR between 5.0 and 9.0 (without bleeding): Hold the warfarin for 1 to 2 doses. Recheck INR every 2 to 3 days until it is stable (INR between 2.0 and 3.0). |
|
|
Term
| How much is the risk of stroke increased when a patient with a. fib has an INR below 2.0? |
|
Definition
|
|
Term
| What are 3 major food products high in vitamin K? |
|
Definition
| Mayonnaise, canola oil and soybean oil |
|
|
Term
| For a new-onset hypertension patient that also has hypertension, what is a good medication to help both conditions? |
|
Definition
|
|
Term
| Name 3 thiazide diuretics |
|
Definition
| HCTZ, Chlortalidone and Indapamide (Lozol) |
|
|
Term
| Name 4 adverse effects of thiazide diuretics: |
|
Definition
| Hyperglecemia, Elevated triglycerides and LDL, elevated uric acid (gout), and hypokalemia (muscle weakness and arrythmia). |
|
|
Term
| How do thiazide diuretics help with bone density? |
|
Definition
| Reduce calcium excretion by the kidneys and stimulate the osteoblasts which helps build bone. |
|
|
Term
| What is the black box warning for aldosterone antagonists (Aldactone/Spironolactone)? |
|
Definition
| Increases risk of both benign and malignant tumors |
|
|
Term
| What are the adverse effects of beta-blockers? |
|
Definition
Bronchospasm
Bradycardia
Depression, fatigue
Erectile dysfunction
Blunts hypoglycemic response (warn diabetics) |
|
|
Term
| Beta blockers are contraindicated in patients with which conditions? |
|
Definition
Asthma
COPD
Chronic bronchitis
Emphysema
Bradycardia and AV block (second to third degree block) |
|
|
Term
| How long after a stroke or MI should the NP wait to prescribe cialis (Tadalafil)? |
|
Definition
|
|
Term
| What pregnancy category are ACE inhibitor and ARBs? |
|
Definition
| Category C (first trimester) and Category D (second to third trimesters) |
|
|
Term
| Captopril is associated with which blood disorders? |
|
Definition
| Agranulocytosis, neutropenia and leuopenia (rare). Monitor CBC |
|
|
Term
| Should a breastfeeding mother be prescribed and ACE/ARB? |
|
Definition
| Both are excreted in breast milk. Breastfeeding mothers should avoid them. |
|
|
Term
| What are contraindications to calcium channel blockers? |
|
Definition
AV-Block (second to third degree block)
Bradycardia
Congestive heart failure |
|
|
Term
| What medication is a first line choice for males with BPH and hypertension? |
|
Definition
| Alpha-blockers (Terazosin) |
|
|
Term
An 18 year old female has a positive throat C&S for strep pyogenes (Group A beta streptococci). The patient reports a history of an allergic reaction to penicillin with "swollen lips" accompanied by urticaria. Which of the following is an appropriate treatment?
A) Clarithromycin (Biaxin) 250mg PO BID X 10 days
B) Gargle with salt water 3 times a day
C) Cephalexin (Keflex) 250mg PO QID x 10 days
D) Doxycycline 100mg PO BID x 10 days |
|
Definition
| A)Clarithromycin (Biaxin) 250mg PO BID X 10 days |
|
|
Term
A 16 year old high school athlete is returning for follow up for a severe sore throat. The test result reveals a positive throat culture for Group A beta hemolytic strep and a positive monospot test (heterophile antibody test). What is the best initial clinical management of this patient?
A) Initiate a prescription of amoxicillin 500mg PO TID x 10 days.
B) Initiate a prescription of penicillin VK 250mg PO QID x 10 days.
C) Order an Epstein-Barr virus (EBV) titer to determine whether the patient has an acute or a reactivated mononucleosis infection.
D) Write a prescription for an abdominal ultrasound to determine the size of the patient's liver and spleen. |
|
Definition
| B) Initiate a prescription of Penicillin VK 250mg PO QID x 10 days. |
|
|
Term
A 25 year old healthy adult is diagnosed with atypical pneumonia by the NP. The patient reports a history of nausea, upset stomach, and vomiting with erythromycin. The patient is complaining of a shore throat. The vital signs are 99 degrees, pulse of 80/minute, and resp rate of 12 breaths/min. What is the most appropriate treatment plan for this patinet?
A) Initiate a prescription of azithromycin (Z-pack) PO x 5 days.
B) Initiate a prescription of trimethoprim-sulfamethazole (bactrim) 1 tab PO BID x 10 days.
C) Order a chest x-ray with the anterior-posterior and lateral views.
D) order a sputum culture and sensitivity. |
|
Definition
| A) Initiate a prescription of azithromycin (Z-pack) PO x 5 days. |
|
|
Term
| A 65-year-old male presents with a history of large amounts of off-white to light-yellow colored sputum. The patient reports a history of cigarette smoking. The chest x-ray reveals hyperinflation with flattened diaphragms and several small bullae. Which of the following drug classes is the initial treatment of choice for this condition? |
|
Definition
A) short-acting B2 agonists.
B) Anticholinergics.
C) Pneumococcal polysaccharide vaccine (Pneumovax)
D) Oxygen by nasal cannula. |
|
|
Term
| What is the initial treatment of choice for chronic bronchitis/COPD? |
|
Definition
| Ipratropium bromide or atrovent (an anticholinergic) |
|
|
Term
| If question asks you for the next step for COPD/chronic bronchitis after Iprotropium bromide or atrovent, what is the answer? |
|
Definition
| Add a short acting beta-2 agonist (albuterol) or both drugs combined (combivent). |
|
|
Term
| What vaccine is indicated as a primary prevention measure for all COPD patients? |
|
Definition
|
|
Term
| Why must adolescents wait until age 13 or 14 to be placed on tetracycline for acne? |
|
Definition
| Tetracyclines may cause permanent discoloration of teeth. By this age, all of the permanant teeth have errupted. |
|
|
Term
| What are two adverse effects of tetracycline other than tooth discoloration and birth defects? |
|
Definition
-Photosensitivity reaction (severe sunburns) from minimal sunlight exposure; use sunblock, wide brim hats, and sunglasses.
-Esophageal ulcerations (rare). Swallow tablet completely using a full glass of water.
-Also: GI distress (especially erythromycin)
-Ototoxicity, cholestatic jaundice
-QTc prolongation (risk of torsades de pointes). |
|
|
Term
| True or false: Tetracycline may be used for mild acne (comedones) |
|
Definition
| False. Use only topicals. |
|
|
Term
| True of false: A common side effect of minocycline is vertigo and dizziness. |
|
Definition
|
|
Term
| Tetracycline should be taken with food. True or false? |
|
Definition
| False. Tetracycline bunds to some minerals. (Calcium, dairy proucts, iron, magnesium, zinc). It's best to take on an empty stomache. Take 1 hour before or 2 hours after a meal. |
|
|
Term
| A patient with moderate acne is not responding to topical prescriptions after 2 to 3 monts. |
|
Definition
| Consider adding tetracycline |
|
|
Term
| What effect does tetracycline have on oral contraceptive pills? |
|
Definition
| It decreases their effectiveness. |
|
|
Term
| Why should patient be advised to throw away expired tetracycline pills? |
|
Definition
| They may degenerate and cause nephropathy or fanconi syndrome. |
|
|
Term
| All macrolides are category B except: |
|
Definition
| clarithromycin and telitromycin (both are category C; avoid using in pregnancy). |
|
|
Term
| What are common drug interactions of clarithromycin? |
|
Definition
| -QT prolongations/bradyarrhythmias with verapamil (calan), amlodipine (Norvasc), diltiazem (Cardizem), amiodarone, others |
|
|
Term
| What is a black box contraindication for Ketek (telithromycin)? |
|
Definition
| Patients with myasthenia gravis. Cases of liver failure have been reported. Also contraindicated in patients with a history of jaundice/hepatitis from previous macrolide use. |
|
|
Term
| What infections are treated by first-generation cephalosporins? |
|
Definition
| Gram-positive bacterial infections (cellulitis, mastitis) |
|
|
Term
| What infections are second-generation cephalosporins effective against? |
|
Definition
| Considered a "broad-spectrum" antibiotic. Used to treat infections caused by both gram-positive and gram-negative bacteria (i.e. sinusitis, otitis media) |
|
|
Term
| What infections are third-generation cephalosporins effective against? |
|
Definition
| Better coverage for gram-negative infections (i.e. Neisseria gonorrheae) and against enteric bacteria. |
|
|
Term
| What are the main extended-spectrum penicillins? |
|
Definition
| Amoxicillin and ampicillin. They are effective against gram-positive bacteria as well as some gram-negative bacteria. |
|
|
Term
| What are 3 main adverse reactions to penicillins? |
|
Definition
| Diarrhea, C. Diff, vaginitis (usually candida) |
|
|
Term
| In patients with mononeucleosis, what antibiotic should be avoided and why? |
|
Definition
| Amoxicillin, because it causes a generalized rash not related to allergy. Use penicillin VK instead. |
|
|
Term
| What type of reaction is anaphylaxis and angioedema? |
|
Definition
| Type 1 IgE-mediated reactions |
|
|
Term
| What are main indications for Keflex and what is the drug class? |
|
Definition
| UTI inpregnancy. 1st generation cephalosporin. |
|
|
Term
| What are two indications for Ceftin and what is the drug class? |
|
Definition
| Sinusitis and otitis media. Second generation cephalosporin. |
|
|
Term
| What are main indications for ceclor and what is the drug class? |
|
Definition
| AOM, sinusitis, skin infections. Second generation cephalosporin. |
|
|
Term
| True or false: Achilles tendon rupture is a serious complication of quinolone therapy. |
|
Definition
|
|
Term
| If a patient on quinolones reports a new onset of difficulty walking, what is the course of action? |
|
Definition
| Order an ultrasound to rule out achilles tendon rupture and discontinue medication. |
|
|
Term
| How is bioterrorism-related inhalation of anthrax treated? |
|
Definition
| Treated with ciprofloxacin 500mg BID x 60 days. |
|
|
Term
| What patient population is at highest risk for tendon rupture from quinolones? |
|
Definition
| Those on steroids and older patients. |
|
|
Term
| What infection type are sulfonamides effective for? |
|
Definition
| Gram-negative bacteria (E. Coli, Klebsiella, H. Influenzae) |
|
|
Term
| Patients with a UTI who are on coumadin should not be prescribed what antibiotic? |
|
Definition
|
|
Term
| What is the preferred treatment for traveler's diarrhea? |
|
Definition
| Cipro 500mg BID x 3 days. |
|
|
Term
| Pregnant women with a UTI can be treated with which medications? |
|
Definition
| Amoxicillin or cephalosporins |
|
|
Term
| What are 4 infections Ofloxacin (Floxin) BID is indicated for and what is the class? |
|
Definition
| UTIs, pyelonephritix, epididymitis, prostatitis. Quinolone. |
|
|
Term
| What are 5 infections Levofloxacin (levaquin) daily is indicated for and what is the drug class? |
|
Definition
| CAP, acute exacerbation of chronic bronchitis, pyelonephritis, epididymitis, prostatitis. Quinolone. |
|
|
Term
| What are 3 infections that moxifloxacin (Avelox) and Gemifloxacin (Factive) is indicated for and what is the drug class? |
|
Definition
| Osteomyelitis, sinusitis, AOM |
|
|
Term
| Which patient population is at a 25%-50% risk of sulfa-related Stevens-Johnson syndrome? |
|
Definition
|
|
Term
| Which drug is the second most frequent cause of allergic drug ractions? |
|
Definition
| Sulfonamide antibiotics (PCN and cephalosporins are 1st). |
|
|
Term
| What is an indication for Floxin gtts? |
|
Definition
| OM with perforated TM, otitis externa. |
|
|
Term
| What is an indication for ocuflox opthalmic (gtts)? |
|
Definition
| Bacterial conjunctivitis. |
|
|
Term
| What is the cause of rhinitis medicamentosa? |
|
Definition
| Chronic use of oxymetazoline (afrin) or phenylephrine (neo-synephrine)/nasal decongestants for greater than 3 days. |
|
|
Term
| For elderly patients, what is considered a safer alternative to benadryl? |
|
Definition
| Loratadine (claritin), since it has a lower incidence of sedation. |
|
|
Term
| Which drug class is considered 1st line (by CDC) for pertussis? |
|
Definition
| Macrolides (Zithromax, clarithromycin) |
|
|
Term
| What are 2 examples of beta-lactam abx? |
|
Definition
|
|
Term
| What is the typical population for S. Pneumonia? |
|
Definition
| Age > 65 years, patients with comorbidities, recent (3 monts) antibiotic exposure, alcoholics, immunosuppressed, exposure to child in daycare. |
|
|
Term
| What is the typical presentation for S. Pneumonia? |
|
Definition
| Abrupt onset with fever, chills, cough, pain in side or chest, rust-colored sputum, *older patients exhibit fewer symptoms (confusion, absence of fever). |
|
|
Term
| What is the typical population for atypical pneumonia? |
|
Definition
| Young, othewise healthy, nonsmokers, community outbreak. |
|
|
Term
| What is the typical presentation for atypical pneumonia? |
|
Definition
| Low-grade fever, cough, chills, headache, malaise, rash, joint aches, arrhytmias. |
|
|
Term
| What abx should be avoided in s. pneumonia? |
|
Definition
| Macrolides, because they have a 25-40% resistance rate. |
|
|
Term
| What is the treatment for s.pneumonia? |
|
Definition
| Fluiroquinolone (levaquin) or high-dose amoxicillin or amoxicillin with clavulanate. |
|
|
Term
| What is the preferred treatment for atypical pneumonia? |
|
Definition
| Macrolides or doxycycline. |
|
|
Term
| What Abx should be avoided in atypical pneumonia? |
|
Definition
|
|
Term
| What is a common characteristic of sputum with S. Pneumonia? |
|
Definition
|
|
Term
A 38 year old mother of two teenagers recovered from mycoplasma pneumonia about 2 weeks ago. She asks if she should receive the "pneumonia shot." How should the NP reply?
Meds: she takes levothyroxine 88mcg daily but is otherwise healthy.
1. Yes, you can receive in about 1 monts
2. Yes, you are able to receive it now.
3. No, it's too soon after your recent infection
4. No, it's not indicated. |
|
Definition
| 4. No, it's not indicated. |
|
|
Term
A 70 year old patient in your exam room has undiagnosed COPD. Which 4 findings support a diagnosis of COPD?
1. A cough that started 3 monts ago
2. History of cigarette smoking
3. Family history of COPD
4. Family history of asthma
5. Chronic sputum production
6. Dyspnea on exertion
7. Wife smoked cigarettes for 40 years. |
|
Definition
2. History of cigarette smoking
5. Chronic sputum production
6. Dyspnea on exertion
7. Wife smoked cigarettes for 40 years. |
|
|
Term
| What spirometry result is required to establish a diagnosis of COPD? |
|
Definition
|
|
Term
A 70 year old house painter is a patient in your xam room. He reports a 4-week history of exertional dyspnea and chest tightness and cough for the past 3 months. He states that he's never smoked. What 4 diagnoses should b part of the NP's differential diagnosis?
1. Angina
2. Asthma
3. GERD
4. COPD
5. Tuberculosis
6. Heart failure
7. Pneumonia |
|
Definition
1. Angina
4. COPD
5. Tuberculosis
6. Heart failure |
|
|
Term
| What are the clinical characteristics of COPD? |
|
Definition
Mid-life onset
Slow progression of symptoms
History of exposure to lung irritants |
|
|
Term
| What are the clinical characteristics of heart failure? |
|
Definition
| Dilated heart, pulmonary edema on chest x-ray, no aiflow limitation |
|
|
Term
| What are the clinical characteristics of asthma? |
|
Definition
Onset usually early in life
wide vatiation in symptoms from day to day
Symptoms may worsen in early AM or evening/night
Atopic history (allergic rhinitis, eczema)
Family history |
|
|
Term
| What are the clinical characteristics of TB? |
|
Definition
| Any age, infiltrate on chest x-ray, need sputum confirmation |
|
|
Term
| What is Gold 1 or mild airway limitation defined as? |
|
Definition
| Fev1 Greater then or equal to 80% predicted. |
|
|
Term
| What is GOLD 2 or moderate airway limitation defined as? |
|
Definition
| 50% less than or equal to FEV1, less than 80% predicted. |
|
|
Term
| What is GOLD 3 or severe airway limitation defined as? |
|
Definition
| 30% less than or equal to FEV1 and less than 50% predicted. |
|
|
Term
| What is GOLD 4 or Very Severe airway limitation defined as? |
|
Definition
| FEV1 less than 30% predicted. |
|
|
Term
|
Definition
| Forced vital capacity; volume of air forcibly exhaled from the point of max inspirations. |
|
|
Term
|
Definition
| Volume of air exhaled during the first second of the maneuver. |
|
|
Term
A 72 year old woman has been on HCTC 12.5 for many years to control her stage II HTN. Her BP at this visit is 168/96. She is currently complaining of pain on her right hip and on both knees. She has increased her dose of ibuprofen from 400mg 3 times per day to 800mg TID. 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?
A) It increases the chances of adverse effects to her health.
B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic.
C) It prolongs the therapeutic effects of HCTZ and other diuretics.
D) None of the statements are true. |
|
Definition
B) It inhibits the effect of renal prostaglandins and blunts the effectiveness of the diuretic.
NSAIDs and ASA inhibit the vasidilatory effects of prostaglandins, which predisposes the kidney to ischemia. NSAIDs and duretics can cause acute prerenal failure by decreasing renal blood flow. |
|
|
Term
All of the following are infections that affect mostly the labia and vagina except:
A) Bacterial vaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis |
|
Definition
D) Chlamydia trachomatis.
Infections that commonly affect the labia and vagina include bacterial vaginosis, candidiasis, and trichomoniasis. Chlamydia trachomatis commonly affects the cervix, endometrial lining, fallopian tubes, and pelvic cavity. |
|
|
Term
The nurse practitioner would test the obturator and iliopsas muscle to evaluate for:
A) Cholecystitis
B) Acute appendicitis
C) Inguinal Hernia
D) Gastric Ulcer |
|
Definition
B) Acute appendicitis
Signs and symptoms of an acute abdomen include involuntary guarding, rebound tenderness, boardlike abdomen, and a positive obturator and psoas sign. A positive obturator sign occurs when pain is elicited by internal rotation of the hip from 90 degrees hip/knee flexion. The psoas sign is positive when pain occurs with passive extension of the thigh while the patient is lying on his/her side with knees extended, or when pain occurs with active flexion of his/her thigh at the hip. |
|
|
Term
Treatment 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 blood pressure |
|
Definition
| D) A prescription of methyldopa (aldomet) to control blood pressure |
|
|
Term
All of the following are services covered under medicare part A except:
A) inpatient hospitalization
B) Medicines administered to a patient while hospitalized
C) Nursing home care
D) Surgeons |
|
Definition
|
|
Term
A 28 year old student is seen in the school health clinic with complaints of a hacking cough that is productive of small amounts of sputum and a runny nose. He does not take any medications, denies any alleries and has no significant medical history. Physical examination reveals a low grade temperature of 99.9 degrees, respirations of 16/min, a pulse of 90 bpm, and diffuse fine crackles in the base of the lungs. A chest radiograph shows diffuse infiltrates on the lower lobe of the right lung. The total white blood cell count is 10,500/ul. What is the most likely diagnosis?
A) Strep pneumonia
B) Mycoplasma pneumonia
C) Acute bronchitis
D) Legionnare's disease |
|
Definition
|
|
Term
A 38 year old 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?
A) 3mm
B) 5mm
C) 10mm
D) 15mm |
|
Definition
|
|
Term
All 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 decision |
|
Definition
| D) The patient's spouse has the right to override the decision. |
|
|
Term
9. All of the following are true statements regarding Munchasen syndrome except:
A) It is considered a mental illness
B) The patient has a medical illness that causes an anxiety reaction and denial
C) The patient fakes an illness in order to gain attention from health care providers
D) The patient has an inconsistent medical history along with a past history of frequent hospitalizations |
|
Definition
| B) The patient has a medical illness that causes an anxiety reaction and denial |
|
|
Term
10. Which of the following antihypertensive medications should the nurse practitioner avoid when treating patients with emphysema?
A) Calcium channel blockers
B) Angiotensin-converting enzyme (ACE) inhibitors
C) Give an injection of epinephrine 1:1000 intramuscularly stat
D) Call 911 |
|
Definition
C) Beta blockers
Beta blockers should be avoided in patients with a history of emphysema. Studies have shown evidence of a recduction in forced expiratory volume in 1 second (FEV1), increased airway hyperresponsiveness, and inhibition of bronchodilator response to beta agonists in patients receiving non-selective beta blockers and high doses of cardioselective beta-blockers. |
|
|
Term
A 30 year old chef complains of pruritic hives over her chest and arms but denies difficulty swallowing or breathing. She reports a family history of allergic rhinitis and asthma. Which of the following interventions is most appropriate?
A) Perform a complete and thorough history
B) Prescribe an oral antihistamine such as diphenhydramine 25 mg PO QID
C) Give an injection of epinephrine 1:1000 intramuscularly stat.
D) Call 911 |
|
Definition
| A) Perform a complete and thorough history |
|
|
Term
A 30 year old chef complains of pruritic hives over her chest and arms but denies difficulty swallowing or breathing. She reports a family history of allergic rhinitis and asthma. Which of the following interventions is most appropriate?
A) Perform a complete and thorough history
B) Prescribe an oral antihistamine such as diphenhydramine 25 mg PO QID
C) Give an injection of epinephrine 1:1000 intramuscularly stat.
D) Call 911 |
|
Definition
| A) Perform a complete and thorough history |
|
|
Term
Which of the following is most likely in young primigravidas with pregnancy-induced HTN?
A) Abdominal cramping and constipation
B) Edema of the face and upper extremities
C) Shortness of breath
D) Dysuria and frequency |
|
Definition
| B) Edema of the face and upper extremities |
|
|
Term
13. Which of the following symptoms is associated with vitamin B12 deficiency anemia?
A) Spoon shaped nails and pica
B) An abnormal neuro exam
C) A vegan diet
D) Tingling and numbness of both feet |
|
Definition
| D) Tingling and numbness of both feet |
|
|
Term
14. A second triple screen on a 35 year old primigravida reveals abnormally low levels of AFP and striol and high levels of HCG. Which of the following interventions is the best choice for this patient?
A) Order an ultrasound
B) Order a CT of the abdomen
C) Order a 24 hour urine for protein clearance
D) Assess for history of illicit drug or alcohol abuse |
|
Definition
A) order an ultrasound
These are not normal during pregnancy and the fetus should be evaluated for down syndrome or fetal demise. |
|
|
Term
15. All of the following are true statements about diverticula exept:
A) Diverticula are located in the colon
B) A low fiber diet is associated with the condition
C) Most diverticula in the colon are infected with gram-negative bacteria
D) Supplementing with giver such as psyllium (Metamucil) is recommended. |
|
Definition
| C) Most diverticula in the colon are infected with gram-negative bacteria |
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Term
16.Patients who are diagnosed with gonorrhea should also be treated for which of the following infections?
A) Chancroid
B) Chlamydia trachomatis
C) Herpes genitalis
D) PID (Pelvic inflammatory disease) |
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Definition
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Term
17. Kyphosis is a late sign of:
A) Old age
B) Osteopenia
C) Osteoporosis
D) Osteoarthritis |
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Definition
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Term
18. A 35 year old primigravida who is at 28 weeks of gestation is expecting twins. What would you expect her alpha fetoprotein (AFP) values to be?
A) Normal
B) Higher than normal
C) Lower than normal
D) None of the above |
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Definition
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Term
19. Which of the following antihypertensive medications has beneficial effects for an elderly white female with osteoporosis?
A) Calcium channel blocker
B) Angiotensin-converting enzyme (ACE) inhibitor
C) Beta-blocker
D) Diuretic |
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Definition
A) Calcium channel blocker
These act by blocking calcium channels in the heart and blood vessels, thereby keeping more calcium in the bones. |
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Term
20. The Lachman maneuver is used to detect with of the following?
A) Knee instability
B) Nerve damage of the knee due to past knee injuries
C) The integrity of the patellar tendon
D) Tears on the meniscus of the knee |
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Definition
A) Knee instability.
The Lachman maneuver is a test that checks for knee instability. Knee instability indicates tears of the ACL. |
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Term
| 21. When an adolescent male's penis grows more in length than width, which of the following tanner stages is he classified? |
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Definition
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Term
22. Fetal TORCH infections can cause microcephaly, mental retardation, hepatosplenomegaly, and intrautarine growth retardation. The acronym TORCH stands for:
A) Toxoplasma Gondiim, other infections, rubella, cytomegalovirus, and herpes zoster
B) Toxic shock syndrome, ocular infections, rubella, cytomegalovirus and herpes zoster
C) Tetanus, ophthalmic infections, roseola, cancer, and head abnormalities
D) Toxins, other infections, roseola, candidiasis, and head abnormalities |
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Definition
| A) Toxoplasma Gondiim, other infections, rubella, cytomegalovirus, and herpes zoster |
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Term
HPV infection of the larynx has been associated with:
A) Laryngeal neoplasia
B) Esophageal stricture
C) Cervical cancer
D) Metaplasia of esophageal squamous cells |
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Definition
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Term
24. Mr brown is a 65 year old carpenter complaining of morning stiffness and pain in both his hands and right knee upon waking. He feels some relief after warming up. On exam, the nurse notices the presence of Heberden's nodes. Which of the following is most likely?
A) Osteoporosis
B) Rheumatoid arthritis
C) Degenerative Joint disease
D) Reiter's syndrome |
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Definition
C) Degenerative joint disease
Bony nodule located on the distal interphalangeal joints (DIPs). |
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Term
What does a positive posterior drawer sign in a 10 year old soccer player signify?
A) An abnormal knee
B) Instability of the knee
C) A large amount of swelling on the knee
D) An injury of the meniscus |
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Definition
| B) instability of the knee |
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Term
A multigravida who is at 28 weeks of gestation has a fundal height of 29cm. Which of the following is the best recommendation for this patient?
A) Advise the mother that her pregnancy is progressing well.
B) Order an ultrasound of the uterus
C) Refer her to an obstetrician for an amniocentesis
D) Recommend bed rest with bathroom privileges |
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Definition
A) Advise the mother that her pregnancy is progressing well.
From 20-35 weeks gestation, fundal height should equal weeks gestation. If greater than 2cm within the gestational week of pregnancy, further testing should be performed to evaluate fetal growth. |
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Term
| What fundal height should be found if a mother is at 34 weeks gestation? |
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Definition
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Term
Which of the following lab tests is used in primary care to evaluate renal function?
A) electrolyte panel
B) creatinine
C) Alkaline phosphatase
D) BUN to Creatinine ratio |
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Definition
B) Creatinine
Serum creatinine is measured to evaluate renal function. Creatinine is the end product of creatinine metabolism. Creatinine clearance is not affected by fluid or dietary intake of meat. |
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Term
29. All of the following are false statements regarding acute gastritis except:
A) Chronic intake of NSAIDS is a cause
B) Chronic lack of dietary fiber is the main cause of the disorder
C) The screening test for the disorder is the barium swallow test
D) The gold standard to evaluate the disorder is a colonoscopy |
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Definition
| A) Chronic use of NSAIDs can cause the disorder |
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Term
| Signs and symptoms of depression include all of the following except: |
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Definition
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Term
31. Which 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's hip snad knees at 90 degrees, then passively rotate hip externally, then internally
C) Ask the patient to squat, then place the stethoscope on the apical area
D) Press into the abdomen deeply, then release it suddenly. |
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Definition
| A) Upon deep inspiration by the patient, palpate firmly in the right upper quadrant of the abdomen below the costovertebral angle. |
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Term
A 28 year old multipara who is at 32 weeks of gestation presents to your office complaining of a sudden onset of small amounts of bright red vaginal bleeding. She has had several episodes and appears anxious. On exam, her uterus is soft to palpation. Which of the following is most likely?
A) Placenta abriptio
B) Placenta previa
C)Acute cervicitis
D) Molar pregnancy |
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Definition
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Term
33. Epidemiologic studies show that hashimoto's disease occurs most commonly in:
A) Middle-aged to older women
B) Smokers
C) Obese individuals
D) Older men |
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Definition
| A) Middle aged to older women. |
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Term
34. A 48 year old woman is told by a physician that she is starting menopause. All of the following are possible findings except:
A) Hot flashes
B) Irregular menstrual periods
C) Severe vaginal atrophic changes
D) Cyclic mood swings |
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Definition
| C) Severe vaginal atrophic changes |
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Term
35. A 63 year old patient with a 10 year history of poorly controlled hypertension presents with a cluster of physical exam findings. Which of the following indicate target organ damage commonly seen in hypertensive patients?
A) Pedal edema, hepatomegaly, and enlarged kidneys
B) Hepatomegaly, AV nicking, bibasilar crackles
C) Renal infection, S3, neuromuscular abnormalities
D) Glaucoman, jugular vein atrophy, heart failure |
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Definition
| B) Hepatomegaly, AV nicking, bibasilar crackles |
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Term
A 30 year old primigravida is diagnosed with a possible threatedned abortion. The result of the urine pregnancy test is positive. Which of the following statements is true regarding threatened abortion?
A) Vaginal bleeding and cramping are present, but the cervix remains closed
B) VAginal bleeding and cramping are present along with a dilated cervix.
C) The fetus and placenta are all expelled.
D) The products of conception and the placenta are all expelled |
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Definition
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