NRNP-6531-11/NRNP-6531C-11-Adv Prac Care Adlt across Lif-2021-Winter-QTR-Term-wks-1-thru-11-(11/29/2021-02/13/2022)-PT27

 

Question 1

The National Standards require a minimum of how many hours of direct patient care for APRNs?

 A.400 hours
 B.500 hours
 C.600 Hours
 D.700 hours

B

Question 2

What is the purpose of Level II research?

 a.To define characteristics of interest of groups of patients
 b.To demonstrate the effectiveness of an intervention or treatment
 c.To describe relationships among characteristics or variables
 d.To evaluate the nature of relationships between two variables

D

Question 3

To reduce adverse events associated with care transitions, the Centers for Medicare and Medicaid Service have implemented which policy?

 a.Mandates for communication among primary caregivers and hospitalists
 b.Penalties for failure to perform medication reconciliations at time of discharge
 c.Reduction of payments for patients readmitted within 30 days after discharge
 d.Requirements for written discharge instructions for patients and caregivers

C

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Question 4

The Consensus Model identifies 3 core courses that all ANPs must take. All the following are Advanced core courses except:

 A.Public Health
 B.Physiology
 C.Pharmacology
 D.Physical Assessment

A

Question 5

What was an important finding of the Advisory Board survey of 2014 about primary care preferences of patients?

 a.Associations with area hospitals
 b.Costs of ambulatory care
 c.Ease of access to care
 d.The ratio of providers to patients

C

Question 6

Which is the most appropriate research design for a Level III research study?

 a.Epidemiological studies
 b.Experimental design
 c.Qualitative studies
 d.Randomized clinical trials

C

Question 7

The care provided by APRNs is not limited by setting but by patient care needs.

True

False

A

Question 8

According to multiple research studies, which intervention has resulted in lower costs and fewer rehospitalizations in high-risk older patients?

 a.Coordination of posthospital care by advanced practice health care providers
 b.Frequent posthospital clinic visits with a primary care provider
 c.Inclusion of extended family members in the outpatient plan of care
 d.Telephone follow-up by the pharmacist to assess medication compliance

A

Question 9

What is the purpose of clinical research trials in the spectrum of translational research?

 a.Adoption of interventions and clinical practices into routine clinical care
 b.Determination of the basis of disease and various treatment options
 c.Examination of safety and effectiveness of various interventions
 d.Exploration of fundamental mechanisms of biology, disease, or behavior

C

Question 10

Which statement made by a health care provider demonstrates the most appropriate understanding for the goal of a performance report?

 a.“This process allows me to critique the performance of the rest of the staff.”
 b.“Most organizations require staff to undergo a performance evaluation yearly.”
 c.“It is hard to be personally criticized but that’s how we learn to change.”
 d.“The comments should help me improve my management skills.”

D

Question 11

During a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient’s nose. What will the provider do?

 a.Consult with a dermatologist about possible melanoma.
 b.Reassure the patient that this is a benign lesion.
 c.Refer the patient for possible electrodessication and curettage.
 d.Tell the patient this is likely a squamous cell carcinoma.

C

Question 12

Ashley a 24 y/o female comes to the clinic with the following chief complaint: “I have these reddish/purple raised patches all over my skin. On physical exam the NP notes that the lesions are erythematous with discrete borders that are irregular, oval or round. The most likely diagnosis based on the physical exam is:

 A.Seborrheic keratoses
 B.Urticaria
 C.Xanthelasma
 D.Melasma

A

Question 13

All of the following are gram- positive bacteria than can cause cellulitis, except:

 A.Staphylococcus aureus
 B.Streptococci
 C.Staphylococci
 D.Salmonella

D

Question 14

Severe cases of Hidradenitis Suppurativa with bullae should be treated with all the following except:

 A.Keflex
 B.Dicloxacillin
 C.Azithromycin
 D.Clindamycin
 E.All the Above
 F.None of the above

E

Question 15

Olga was making French fries for her kids and gets splashed with hot oil. At the clinic the NP notes that she has red colored skin with superficial blisters and pain where the oil splashed. The most likely diagnosis is:

 A.First degree burn
 B.Second degree burn
 C.Third degree burn
 D.Fourth degree burn

B

Question 16

Patty comes to the clinic with these soft fatty cystic lesions on her neck, trunk and arms. The most likely diagnosis is:

 A.Nevi
 B.Acanthosis Nigricans
 C.Acrochordon
 D.Cherry Angioma

D

Question 17

A female patient is diagnosed with hidradenitis suppurativa and has multiple areas of swelling, pain, and erythema, along with several abscesses in the right femoral area. When counseling the patient about this disorder, the practitioner will include which information?

 a.Antibiotic therapy is effective in clearing up the lesions.
 b.It is often progressive with relapses and permanent scarring.
 c.The condition is precipitated by depilatories and deodorants.
 d.The lesions are infective, and the disease may be transmitted to others.

B

Question 18

Complications associated with Carbuncles include which of the following;

 A.Osteomyelitis
 B.Septic Arthritis
 C.Sepsis
 D.All the Above
 E.B & C only

D

Question 19

A provider is prescribing a topical dermatologic medication for a patient who has open lesions on a hairy area of the body. Which vehicle type will the provider choose when prescribing this medication?

 a.Cream
 b.Gel
 c.Ointment
 d.Powder

B

Question 20

A patient comes to the clinic after being splashed with boiling water while cooking. The patient has partial thickness burns on both forearms, the neck, and the chin. What will the provider do?

 a.Clean and dress the burn wounds.
 b.Order a CBC, glucose, and electrolytes.
 c.Perform a chest radiograph.
 d.Refer the patient to the emergency department (ED).

D

 

Question 21

A patient has actinic keratosis and the provider elects to use cryosurgery to remove the lesions. How will the provider administer this procedure?

 a.Applying one or two freeze-thaw cycles to each lesion
 b.Applying two or more freeze-thaw cycles to each lesion
 c.Applying until the freeze spreads laterally 1 mm from the lesion edges
 d.Applying until the freeze spreads laterally 4 mm from the lesion edges

C

Question 22

During a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient’s nose. What will the provider do?

 a.Consult with a dermatologist about possible melanoma.
 b.Reassure the patient that this is a benign lesion.
 c.Refer the patient for possible electrodessication and curettage.
 d.Tell the patient this is likely a squamous cell carcinoma.

C

Question 23

The most common type of melanoma in African Americans and Asians is:

 A.Basal Cell carcinoma
 B.Actinic Keratosis
 C.Acral Lentiginous Melanoma
 D.Toxic Epidermal Necrolysis

C

Question 24

What is the initial approach when obtaining a biopsy of a potential malignant melanoma lesion?

 a.Excisional biopsy
 b.Punch biopsy
 c.Shave biopsy
 d.Wide excision

A

Question 25

A provider is considering an oral contraceptive medication to treat acne in an adolescent female. Which is an important consideration when prescribing this drug?

 a.A progesterone-only contraceptive is most beneficial for treating acne.
 b.Combined oral contraceptives are effective for non-inflammatory acne only.
 c.Oral contraceptives are effective because of their androgen enhancing effects.
 d.Yaz, Ortho Tri-Cyclen, and Estrostep, are approved for acne treatment.

D

Question 26

Agnes is a 72 y/o grandmother who comes to the clinic with an acute onset of severe eye pain. She has been having headaches, nausea and vomiting, and seeing halos around lights. Eye exam reveals cupping of optic nerve the pupil is oval and the cornea is cloudy. Her most likely diagnosis is:

 A.Orbital Cellulitis
 B.Acute Angle Closure Glaucoma
 C.Retinal Detachment
 D.Optic Neuritis

B

Question 27

A patient reports using artificial tears for comfort because of burning and itching in both eyes but reports worsening symptoms. The provider notes redness and discharge along the eyelid margins with clear conjunctivae. What is the recommended treatment?

 a.Antibiotic solution drops four times daily
 b.Warm compresses, lid scrubs, and antibiotic ointment
 c.Oral antibiotics given prophylactically for several months
 d.Reassurance that this is a self-limiting condition

B

Question 28

A patient diagnosed with alopecia is noted to have scaling on the affected areas of the scalp. Which confirmatory test(s) will the provider order?

 a.Examination of scalp scrapings with potassium hydroxide (KOH)
 b.Grasping and pulling on a few dozen hairs
 c.Serum iron studies and a complete blood count
 d.Venereal Disease Research Laboratory (VDRL) test

A

Question 29

Audrey is a 16 y/o female who comes to the clinic because her teacher says that she is having a hard time hearing in class. The NP examines her ears and notes that she has otitis media.

In performing the Rinne test on Audrey the tuning fork would be placed on the:

 A.Midline of forehead
 B.Mastoid process
 C.Temporal area of the head.

B

Question 30

Bryce is a 17 y/o male who comes to the clinic with chief complaint of ear sudden onset of pain, popping noises, and muffled hearing. During the ear exam the NP notices that the TM has ruptured. The most likely diagnosis is:

 A.Acute otitis media
 B.Bullous Myringitis
 C.Otitis externa
 D.Swimmer’s ear

A

Question 31

During an eye examination, the provider notes a red-light reflex in one eye but not the other. What is the significance of this finding?

 a.Normal physiologic variant
 b.Ocular disease requiring referral
 c.Potential infection in the “red” eye
 d.Potential vision loss in one eye

B

Question 32

A female patient is diagnosed with androgenetic alopecia. Which medication will the primary health care provider prescribe?

 a.Anthralin
 b.Cyclosporine
 c.Finasteride
 d.Minoxidil

C

Question 33

Audrey is a 16 y/o female who comes to the clinic because her teacher says that she is having a hard time hearing in class. The NP examines her ears and notes that she has otitis media. In such a condition the Rinne Test would show which of the following results:

 A.BC > AC
 B.AC > BC
 C.AC = BC
 D.None of the above

A

Question 34

Which is the most common cause of orbital cellulitis in all age groups?

 a.Bacteremic spread from remote infections
 b.Inoculation from local trauma or bug bites
 c.Local spread from the ethmoid sinus
 d.Paranasal sinus inoculation

C

Question 35

An adult patient with a history of recurrent sinusitis and allergic rhinitis reports chronic tearing in one eye, ocular discharge, and eyelid crusting. The provider suspects nasolacrimal duct obstruction. Which initial treatment will the provider recommend?

 a.Antibiotic eye drops
 b.Nasolacrimal duct probing
 c.Systemic antibiotics
 d.Warm compresses

D

Question 36

Aaron an 18 y/o male comes to the clinic with the following symptoms: nasal stuffiness, sneezing, scratchy irritated throat and hoarseness. He also complains of a low-grade fever and a cough that he has had for the past 4 days.

Prevention of Aaron’s condition would include which of the following:

 A.Good hand washing
 B.Adequate rest
 C.Zinc Lozenges
 D.All the above
 E.A & B only

A

Question 37

A patient is seen in the clinic for patches of hair loss. The provider notes several well-demarcated patches on the scalp and eyebrows without areas of inflammation and several hairs within the patch with thinner shafts near the scalp. Based on these findings, which type of alopecia is most likely?

 a.Alopecia areata
 b.Anagen effluvium
 c.Cicatricial alopecia
 d.Telogen effluvium

A

Question 38

Audrey is a 16 y/o female who has had several boyfriend over the past 6 months. She comes to the clinic today with a sore throat, enlarged posterior cervical lymph nodes and fatigue that has been going on for 3 weeks. On PE the NP discovers that she has hepatomegaly and a tender spleen on palpation. Her most likely diagnosis is:

 A.Tonsillitis
 B.Infectious Mononucleosis
 C.Pharyngitis
 D.None of the above

B

Question 39

A patient reports bilateral burning and itching eyes for several days. The provider notes a boggy appearance to the conjunctivae, along with clear, watery discharge. The patient’s eyelids are thickened and discolored. There are no other symptoms. Which type of conjunctivitis is most likely?

 a.Allergic
 b.Bacterial
 c.Chemical
 d.Viral

A

Question 40

A patient is diagnosed with dacryocystitis. The provider notes a painful lacrimal sac abscess that appears to be coming to a head. Which treatment will be useful initially?

 a.Eyelid scrubs with baby shampoo
 b.Incision and drainage
 c.Lacrimal bypass surgery
 d.Topical antibiotic ointment

B

Question 41

A patient diagnosed with allergic conjunctivitis and prescribed a topical antihistamine-vasoconstrictor medication reports worsening symptoms. What is the provider’s next step in managing this patient’s symptoms?

 a.Consider prescribing a topical mast cell stabilizer.
 b.Determine the duration of treatment with this medication.
 c.Prescribe a non-sedating oral antihistamine.
 d.Refer the patient to an ophthalmologist for further care.

B

Question 42

If the BC > AC then the person has a

 A.Conductive hearing loss
 B.Sensorineural hearing loss.

A

Question 43

A patient has an elevated, yellowish-white lesion adjacent to the cornea at the 3 o’clock position of the right eye. The provider notes pinkish inflammation with dilated blood vessels surrounding the lesion. What information will the provider provide the patient about this lesion?

 a.Artificial tear drops are contraindicated.
 b.Spontaneous bleeding is likely.
 c.UVB eye protection is especially important.
 d.Visine may be used for symptomatic relief.

C

Question 44

A retinal detachment would be identified by a shower of floaters with the addition of sudden flashes of light.

True

False

A

Question 45

A patient who has symptoms of a cold develops conjunctivitis. The provider notes erythema of one eye with profuse, watery discharge and enlarged anterior cervical lymph nodes, along with a fever. Which treatment is indicated?

 a.Antihistamine-vasoconstrictor drops
 b.Artificial tears and cool compresses
 c.Topical antibiotic eye drops
 d.Topical corticosteroid drops

B

Question 46

Karen is a 65 y/o female who has just returned from a 14-hour car ride from Texas up to Arizona. She comes to the clinic with the following chief complaint: “My lower legs are painful, red and swollen, and it hurts whenever I flex my toes backward. The NP proposes the following diagnosis:

 A.Raynaud’s Phenomenon
 B.Rhabdomyolysis
 C.Deep Vein Thrombosis (DVT)
 D.Restless foot syndrome

B

Question 47

Ashley is a 47 y/o female who comes to the clinic with a chief complaint of sudden onset of palpitations and a feeling of weakness and dizziness. Additionally she notes that she has dyspnea on exertion. On the physical exam the NP notes that he HR is 120 bpm and her BP drops to 98/60.   Her EKG shows  no discrete p waves and irregularly irregular rhythm.

Ashley should be placed on an anticoagulant for her condition. The INR should be kept between:

 A.INR: 1 to 2
 B.INR: 2 to 3
 C.INR: 3 to 4
 D.INR: >4

B

Question 48

A patient has native valve endocarditis (NVE). While blood cultures are pending, which antibiotics will be ordered as empirical treatment?

 A.A beta-lactamase-resistant penicillin and an antifungal drug
 B.Imipenem-cilastatin and ampicillin
 C.Penicillin G and an aminoglycoside antibiotic
 D.Vancomycin and quinupristin-dalfopristin

C

Question 49

Patients with hypertensive retinopathy will have all of the following except:

 A.Copper wire arterioles
 B.Silver wire arterioles
 C.Atriovenous nicking
 D.Optic disc with blurred margins

D

Question 50

A split S2 is best heard at the upper left sternum.

True

False

A

Question 51

Patients with diabetic retinopathy will have which of the following:

 A.Neovascularization
 B.Cotton wool spots
 C.Microaneurysms
 D.All the Above
 E.A & C only

D

Question 52

Dorsiflexion of the foot that produces lower leg pain is termed Homan’s Sign.

True

False

A

Question 53

A patient is in clinic for evaluation of sudden onset of abdominal pain. The provider palpates a pulsatile, painful mass between the xiphoid process and the umbilicus. What is the initial action?

 a.Order a CBC, type and crossmatch, electrolytes, and renal function tests.
 b.Perform an ultrasound examination to evaluate the cause.
 c.Schedule the patient for an aortic angiogram.
 d.Transfer the patient to the emergency department for a surgical consult.

D

Question 54

In coarctation of the aorta the BP of the arms is higher than the BP of the legs.

True

False

A

Question 55

Guy is a 65 y/o male who comes to the clinic with the following chief complaint: “I have been feeling feverish, have chills, and am tired all the time. My heart also makes a funny sound. In the physical exam the NP auscultates a heart murmur, and notices that he patient has subungual hemorrhages, petechiae on the palate, violet colored nodes on the fingers and feet, and nontender red nodes on the palms and soles of his feet.

The violet colored nodes on the fingers and feet are known as:

  Osler nodes
  Janeway Lesions
  Roth Nodes
  None of the above

A

Question 56

Guy is a 65 y/o male who comes to the clinic with the following chief complaint: “I have been feeling feverish, have chills, and am tired all the time. My heart also makes a funny sound. In the physical exam the NP auscultates a heart murmur, and notices that he patient has subungual hemorrhages, petechiae on the palate, violet colored nodes on the fingers and feet, and nontender red nodes on the palms and soles of his feet. The most likely diagnosis for Guy is:

 A.CHF
 B.Infective Endocarditis (IE)
 C.Acute MI (AMI)
 D.Dissecting Abdominal Aortic Aneurysm (AAA)

B

Question 57

A patient who is an avid long-distant runner is diagnosed with viral myocarditis. What will the provider tell this patient when asked when resuming exercising is permitted?

 a.Exercise is contraindicated for life.
 b.Exercise may resume when symptoms subside.
 c.He may resume exercise in 6 months.
 d.He must be symptom-free for 1 year.

D

Question 58

A 75-year-old patient reports pain and a feeling of tiredness in both legs that only relieves after sitting for 30 minutes or more. What the does provider suspect as the cause for these symptoms?

 a.Buerger’s disease
 b.Cauda equina syndrome
 c.Diabetic neuropathy
 d.Peripheral arterial disease (PAD)

B

Question 59

A young adult patient is diagnosed with a mitral valve prolapse. During a routine 3-year health maintenance exam, the provider notes an apical systolic murmur and a mid-systolic click on auscultation. The patient denies chest pain, syncope, or palpitations. What action will the provider take?

 a.Admit the patient to the hospital for evaluation and treatment.
 b.Consult with the cardiologist to determine appropriate diagnostic tests.
 c.Continue to monitor the patient every 3 years.
 d.Reassure the patient that these findings are expected.

B

Question 60

A previously healthy patient presents with sudden onset of dyspnea, fatigue, and orthopnea. A family history is negative. The provider suspects myocarditis. What is the most likely etiology for this patient?

 a.Autoimmune disorder
 b.Bacterial infection
 c.Protozoal infection
 d.Viral infection

D

Question 61

An elderly adult patient without prior history of cardiovascular disease reports lower leg soreness and fatigue when shopping or walking in the neighborhood. The primary care provider notes decreased pedal pulses bilaterally. Which test will the provider order initially to evaluate for peripheral arterial disease based on these symptoms?

 a.Digital subtraction angiography
 b.Doppler ankle, arm index
 c.Magnetic resonance angiography
 d.Segmental limb pressure measurement

B

Question 62

Guy is a 65 y/o male who comes to the clinic with the following chief complaint: “I have been feeling feverish, have chills, and am tired all the time. My heart also makes a funny sound. In the physical exam the NP auscultates a heart murmur, and notices that he patient has subungual hemorrhages, petechiae on the palate, violet colored nodes on the fingers and feet, and nontender red nodes on the palms and soles of his feet.

In a patient with Guy’s diagnosis, on funduscopic exam one might see:

 A.Cotton wool spots
 B.Silver wire vessels
 C.Retinal hemorrhages
 D.A & B only

C

Question 63

In performing a follow-up exam on a patient the NP discovers that the patient has a new murmur. The murmur is best heard at the apex of the heart, radiates to the axilla, and is a loud blowing and high-pitched murmur.

This type of murmur  is associated with which of the following conditions:

 A.Mitral Regurgitation
 B.Aortic Stenosis
 C.Mitral Stenosis
 D.Aortic Regurgitation

A

Question 64

Ashley is a 47 y/o female who comes to the clinic with a chief complaint of sudden onset of palpitations and a feeling of weakness and dizziness. Additionally she notes that she has dyspnea on exertion. On the physical exam the NP notes that he HR is 120 bpm and her BP drops to 98/60.   Her EKG shows  no discrete p waves and irregularly irregular rhythm.

Lifestyle changes for Ashley would include which of the following:

 A.Caffeine
 B.Nicotine
 C.Decongestants
 D.All the Above
 E.A & B only

E

Question 65

A patient has a cardiac murmur that peaks in mid-systole and is best heard along the left sternal border. The provider determines that the murmur decreases in intensity when the patient changes from standing to squatting and increases in intensity with the Valsalva maneuver. Which will the provider suspect is causing this murmur?

 a.Aortic stenosis
 b.Hypertrophic cardiomyopathy
 c.Mitral valve prolapse
 d.Tricuspid regurgitation

B

Question 66

A nonsmoking adult with a history of cardiovascular disease reports having a chronic cough without fever or upper airway symptoms. A chest radiograph is normal. What will the provider consider initially as the cause of this patient’s cough?

 a.ACE inhibitor medication use
 b.Chronic obstructive pulmonary disease
 c.Gastroesophageal reflux disease
 d.Psychogenic cough

A

Question 67

A patient reports shortness of breath when in a recumbent position as well as coughing and pain associated with inspiration. The provider notes distended neck veins during the exam. What is the likely cause of these findings?

 a.Congestive heart failure (CHF)
 b.Hepatic disease
 c.Pulmonary embolus
 d.Pulmonary infection

A

Question 68

A young adult patient without a previous history of lung disease has an increased respiratory rate and reports a feeling of “not getting enough air.” The provider auscultates clear breath sounds and notes no signs of increased respiratory effort. Which diagnostic test will the provider perform initially?

 a.Chest radiograph
 b.Complete blood count
 c.Computerized tomography
 d.Spirometry

B

Question 69

Martin is a 73 y/o male who has a 50 year/pack history of smoking and comes to the clinic for his annual physical. As you are leading him back to the exam room you note that he has dyspnea with minimal cough, a barrel chest, and appears to have lost weight since his last visit. Your physical exam confirms a 20 lb. weight loss, and a more noticeable pursed lip breathing. Your diagnosis is:

 A.Chronic Bronchitis
 B.Emphysema
 C.COPD

C

Question 70

Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some rhinitis and low-grade fever

Potential organisms that might have caused Sam’s condition include which of the following:

 A.Mycoplasma pneumoniae
 B.Chlamydia pneumoniae
 C.Legionella pneumonia
 D.All the above
 E.None of the above

D

Question 71

A patient recovering from a viral infection has a persistent cough 6 weeks after the infection. What will the provider do?

 a.Perform chest radiography to assess for secondary infection
 b.Perform pulmonary function and asthma challenge testing
 c.Prescribe a second round of azithromycin to treat the persistent infection
 d.Reassure the patient that this is common after such an infection

D

Question 72

Rescue drugs for patients with respiratory problems such as Asthma or COPD would include both SABAs and LABAs.

True

False

A

Question 73

A patient with a smoking history of 35 pack years reports having a chronic cough with recent symptoms of pink, frothy blood on a tissue. The chest radiograph shows a possible nodule in the right upper lobe. Which diagnostic test is indicated?

 a.Coagulation studies
 b.Computed tomography (CT)
 c.Fiberoptic bronchoscopy
 d.Needle biopsy

B

Question 74

Martin is a 73 y/o male who has a 50 year/pack history of smoking and comes to the clinic for his annual physical. As you are leading him back to the exam room you note that he has dyspnea with minimal cough, a barrel chest, and appears to have lost weight since his last visit. Your physical exam confirms a 20 lb. weight loss, and a more noticeable pursed lip breathing.

Given Martin’s condition the first line treatment would be all the following except:

 A.Albuterol
 B.Salmeterol
 C.Levalbuterol
 D.metaproterenol

A

Question 75

Mike is a 22 y/o male who comes to your clinic with a 5-day history of cough without sputum production. He states that his cough is worse in the morning and he has some hoarseness, post-nasal drip and a low-grade fever. Mike has otherwise been healthy

Differentials for Mike might include which of the following:

 A.Pneumonia
 B.Sinusitis
 C.COPD
 D.All the Above
 E.A & B only

D

Question 76

Which is characteristic of obstructive bronchitis and not emphysema?

 a.Damage to the alveolar wall
 b.Destruction of alveolar architecture
 c.Mild alteration in lung tissue compliance
 d.Mismatch of ventilation and perfusion

C

Question 77

Mike is a 56 y/o male who lives in an abandoned building. With about 40 other street people. He comes to the clinic with a social worker who describes his symptoms as: a cough, dyspnea, pleuritic chest pain, fever and tachypnea. Your physical exam notes that he has some consolidation in the lower lobes with an audible friction rub.

To treat Mike’s problem the most appropriate pharmacological agent would be:

 A.Levofloxacin
 B.Macrolide
 C.Cefoxitin
 D.Moxifloxacin

B

Question 78

Mike is a 56 y/o male who lives in an abandoned building. With about 40 other street people. He comes to the clinic with a social worker who describes his symptoms as: a cough, dyspnea, pleuritic chest pain, fever and tachypnea. Your physical exam notes that he has some consolidation in the lower lobes with an audible friction rub. The most likely diagnosis for this man would be:

 A.COPD
 B.Asthma
 C.Community Acquired pneumonia (CAP)
 D.Bronchitis

C

Question 79

COPD can be a combination of which disease processes?

 A.Chronic Bronchitis
 B.Emphysema
 C.Asthma
 D.All the Above
 E.A & B only

E

Question 80

A young adult patient develops a cough persisting longer than 2 months. The provider prescribes pulmonary function tests and a chest radiograph, which are normal. The patient denies abdominal complaints. There are no signs of rhinitis or sinusitis and the patient does not take any medications. What will the provider evaluate next to help determine the cause of this cough?

 a.24-hour esophageal pH monitoring
 b.Methacholine challenge test
 c.Sputum culture
 d.Tuberculosis testing

B

Question 81

An adult patient reports intermittent, crampy abdominal pain with vomiting. The provider notes marked abdominal distention and hyperactive bowel sounds. What will the provider do initially?

 a.Admit the patient to the hospital for consultation with a surgeon
 b.Obtain upright and supine radiologic views of the abdomen
 c.Prescribe an antiemetic and recommend a clear liquid diet for 24 hours
 d.Schedule the patient for a barium swallow and enema

B

Question 82

Danny is a 37 y/o male who returns to the clinic for review of lab results. When he came in a week ago he complained of a “sour” taste when he belched, and severe pain in his stomach. A serum fasting gastrin level was drawn and sent to the lab. The results were 300 pg/ml. His diagnosis on this basis is:

 A.Ulcerative colitis
 B.Crohn’s disease
 C.Zollinger-Ellison Syndrome
 D.Colon Cancer

A

Question 83

A 50-year-old, previously healthy patient has developed gastritis. What is the most likely cause of this condition?

 a.H. pylori infection
 b.NSAID use
 c.Parasite infestation
 d.Viral gastroenteritis

A

Question 84

A patient with a history of diverticular disease asks what can be done to minimize acute symptoms. What will the provider recommend to this patient?

 a.Avoiding saturated fats and red meat
 b.Consuming a diet high in fiber
 c.Taking an anticholinergic medication
 d.Using bran to replace high-fiber foods

B

Question 85

Amylase and Lipase are sensitive tests used to assess for pancreatitis.

True

False

A

Question 86

A patient has recurrent constipation which improves with laxative use but returns when laxatives are discontinued. Which pharmacologic treatment will the provider recommend for long-term management?

 a.Bisacodyl
 b.Docusate sodium
 c.Methylcellulose
 d.Mineral oil

C

Question 87

Jeremiah, a 47 y/o male presents to the clinic with episodic gastric pain he describes as gnawing and burning. He notes that the pain is temporarily relieved by food or antacids but return in full force after a couple of hours. He notes that his stools are “tarry” and he sometimes has coffee colored vomit. On this basis the NP provides a diagnosis of:

 A.Irritable bowel syndrome
 B.Duodenal ulcer
 C.GERD
 D.Acute Diverticulitis

B

Question 88

Classic pain of acute pancreatitis is severe midgastric pain that refers to the midback.

True

False

A

Question 89

A patient is diagnosed with fibrotic liver disease; a liver biopsy shows micronodular cirrhosis. What is the most common cause of this form of cirrhosis?

 a.Alcoholism
 b.Hepatitis C
 c.Hepatocellular carcinoma
 d.Right-sided heart failure

A

Question 90

A patient with a history of diverticular disease experiences left-sided pain and reports seeing blood in the stool. What is an important intervention for these symptoms?

 a.Ordering a CBC and stool for occult blood
 b.Prescribing an antispasmodic medication
 c.Referring the patient for a lower endoscopy
 d.Reminding the patient to eat a high-fiber diet

 

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