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GCU FNP 652 ALL PRACTICE QUIZZES QUESTION AND
ANSWERS ACCURATE SUMMER-FALL ANSWERS
GRADED A
A patient with esophageal adenocarcinoma has associated lymphadenopathy, what does this infer? poor prognosis for cure- metastasis A patient presents with chest pain that occurs regardless of activity, is not relieved by rest, and has already had one dose of nitro with no relief, what is the next action Administer a Beta Blocker (most likely experiencing micro angina) Factors causing heart murmurs
- Backwards flow through a septal defect
- Forward flow into dilated vessel - High rates of flow through normal valve Secondary HTN causes in pediatric patients? Assess renal function and plasmarenin testing
Patient with right scrotal pain and on palpation feels like a "bag of worms" - what will you do? Varicocele - right side is rare, they need US and to find underlying cause How to assess an infant with swollen and painful scrotum? Transillumination What will you order for a patient with painless scrotal swelling? Ultrasound Signs and symptoms of nephrolithiasis Painful urination, flank pain, U/A w/ hematuria What is the first line treatment for nephrolithiasis? Hydration - at least 2L/day A pediatric male presents with pinpoint opening of foreskin, tightness, thickened/inflammed - what will you do next? Phimosis - refer to urology
While reviewing lab results you note a PSA of 12, what should you be concerned about? Prostate CA (>10) Asymptomatic pregnant woman has positive leukocytes and positive nitrates, what will you do next? Send urine for culture Elderly woman with weight loss and coughing/choking as she eats - what type of dysphagia is this? Pharyngeal A 3-year-old has mild/moderate dehydration, stable - how will you manage? Oral rehydration, f/u in 24 hours A patient has a midsystolic murmur that gets louder when they lay flat. What type of murmur is this? Stills Murmur
An elderly patient has a permanent loss of the sense of smell and diminished taste. What will be included in teaching this patient about managing these symptoms?
- The importance of installing smoke detectors
- Putting dates on food in the fridge
- Eating regular meals at scheduled times A toddler exhibits exotropia of the right eye during a cover-uncover screen. The primary nurse practitioner will refer to a pediatric ophthalmologist to initiate which treatment? Patching of the unaffected eye for 2 hours each day An adolescent has localized bleeding of the gums when brushing the teeth. An exam of the mouth reveals the presence of plaque and calculus on the teeth which are not loose. What will the primary care nurse practitioner recommend? Consistently brushing and flossing the teeth twice daily A provider is recommending a cerumenolytic for a patient who has chronic cerumen buildup. The provider notes that the patient has dry skin in the ear canal. Which preparation is FDA approved for this use? Carbamide peroxide
A patient reports painful swelling in the mouth with increased pain at mealtimes. The provider notes a mass in the salivary gland region. What is the likely cause of these symptoms? Sialolithiasis A child complains of itching in both ears and is having trouble hearing. The primary care nurse practitioner notes periauricular edema and marked swelling of the external auditory canal and elicits severe pain when manipulating the external ear structures. Which is an appropriate intervention? Order ototopical antibiotic/corticosteroid drops During a well child assessment of an African American infant, the primary care nurse practitioner notes a dark red-brown light reflex in the left eye and a slightly brighter, red-orange light reflex in the right eye. The nurse practitioner will... Refer the infant to an opthalmologist Which are risk factors for development of cataracts?
- Smoking
- Advancing Age
- UV Light
A preschool age child who attend daycare has a 2 day history of matted eyelids in the morning and burning and itching of the eyes. The primary care NP notes yellow-green purulent discharge from both eyes, conjunctival erythema and mild URI symptoms. Which action is correct? Prescribe topical antibiotic drops An 18-month-old child with no previous history of otitis media awoke during the night with right ear pain. The primary care NP notes an axillary temperature of 100.5 and an erythematous, bulging TM. A tympanogram reveals a peak of +15-mm H2O. What is the recommended treatment for this child? An analgesic medication and watchful waiting A patient complains of otalgia and difficulty hearing from one ear. The provider performs an otoscopic exam and notes a dark brown mass in the lower portion of the external canal blocking the patient's TM. What is the initial action? Ask the patient about previous problems with the ear The primary care NP is treating an infant with lacrimal duct obstruction who has developed bacterial conjunctivitis. After 2 weeks of treatment with topical antibiotics along with massage and frequent cleaning of secretions, the infant's symptoms have not improved. Which action is correct? Refer to an ophthalmologist A patient has a chronic swelling of the parotid gland that is unresponsive to antibiotics and which has not increased in size. Which diagnostic test is indicated?
The primary care NP is reviewing lab work and diabetes management with a school- aged child whose HbA1C is 7.6% who reports usual blood sugars before meals as being 80 - 90mg/dL. The NP will consult with the child's endocrinologist to consider which therapy? Continuous glucose monitoring The primary care NP notes a musty odor when examining a newborn at a 2-week checkup. What will the NP suspect? Phenylketonuria A patient who is obese has recurrent UTIs and reports feeling tired most of the time. What initial diagnostic test will the provider order in the clinic at this visit? HbA1C A patient who has diabetes has a blood pressure of 140/90 and albuminuria. Which initial action by the primary care NP is indicated for management of this patient? Consulting with a nephrologist The primary care NP is performing a well-child examination on a 2-year-old child with a history of intrauterine growth retardation whose height remains less than the 3rd percentile on a WHO growth chart. What will the NP do? Refer the child to a pediatric endocrinologist
An infant has congenital adrenal hyperplasia. At a routine well baby checkup, the primary care NP notes vomiting, poor feeding, lethargy, and mild dehydration. Which action is correct? Refer the infant to the ED for fluids, dextrose, and steroids A patient with T2DM becomes insulin dependent after a year of therapy with oral diabetes medication. When explaining this change in therapy, the provider will tell the patient: This is because of the natural progression of the disease A 16-year-old female whose BMI is at the 90th percentile reports irregular periods. The primary care NP notes widespread acne on her face and back and an abnormal distribution of facial hair. The NP will evaluate her further based on a suspicion of which diagnosis? PCOS A patient recently diagnosed with T1DM is in clinic for a follow-up evaluation. The provider notes that the patient appears confused and irritable and is sweating and shaking. What intervention will the provider expect to perform once the POC blood glucose is known? Giving a rapid acting carbohydrate
The primary care NP is performing a well-child examination on a 5-year-old girl. The parents ask if the child's adult height can be predicted. The NP learns that the mother is 5'8" tall and the father is 5'11" tall. The NP will estimate which expected adult height for this child? 5'7" A diabetic patient who is taking a statin drug to treat dyslipidemia has begun a diet and exercise program. The patient reports new onset of muscle pain several weeks after beginning therapy. What is the initial action of the provider? obtain a creatinine kinase level The mother of a female infant is concerned that her daughter is developing breasts. The primary care NP notes mild breast development but no pubic or axillary hair. What is the likely diagnosis? Premature thelarche which will resolve over time Which thyroid stimulating hormone (TSH) level indicates hyperthyroidism 0.2uIU/L A patient with T2DM has a low-density lipoprotein (LDL) level of 110mg/dL. What is recommended to manage this patient? Prescription of a moderate or high intensity statin
The primary care NP performs a physical examination on a 9-month-old infant with congenital hypothyroidism who takes daily levothyroxine sodium and notes a recent slowing of the infant's growth rate. What will the NP order? Free serum T4 and TSH levels A 6-year-old female has had a recent growth spurt and an exam reveals breast and pubic hair development. Her bone age is determined to be 8 years. What will the NP do next? Refer the child to a pediatric endocrinologist for management The primary care NP is performing a well child examination on a 13-year-old child who was diagnosed with T1DM at age 9. The child had a lipid screen at age 10 with an LDL of <100mg/dL. What will the NP recommend as part of ongoing management for this child? Comprehensive ophthalmologic exam The primary care NP evaluates children's growth to screen for endocrine and metabolic disorders. Which is a critical component of this screening? obtaining serial measurements to assess patterns over time
Therapy for hemorrhoids does not include low fat diet What has the highest fiber content 1 cup of cooked oatmeal Risk factors for development of hemorrhoids
- excessive ETOH use
- prolonged sitting
- chronic diarrheai Which of the following is not a sign of acute appendicitis in young adults marked febrile response Which best represents peak ages for acute appendicitis 10 - 30 years
Which is not usually seen with acute cholecystitis? elevated serum creatinine Most common serious complication of cholecystitis pancreatitis Most likely to be noted in person with colorectal cancer few symptoms To avoid development of acute diverticulitis, management includes use of fiber supplements Most appropriate diagnostic approach to ruleout free air in the abdomen includes plain abdominal film Lower GI hemorrhage associated with diverticular disease usually manifests as a painless event
A teen who has otitis externa has severe swelling of the external auditory canal that persists after 2 days of therapy with ototopical antibiotic/corticosteroid drops. What is the next step in treatment for this child? Insert a wick into the external auditory canal A patient reports tooth pain in a lower molar and the provider notes a mobile tooth with erythema and edema of the surrounding tissues without discharge. Which is the initial course of action by the provider? Prescribe amoxicillin and refer to a dentist in 2-3 days Gastric parietal cells produce hydrochloric acid H2RA most likely to cause drug interaction with phenytoin & theophylline is cimetidine NSAID-induced peptic ulcer can be best limited by use of misoprostol
Which is a PPI lansoprazole PUD can occur in any of the following locations except large intestine With symptomatic GERD, you prescribe PPI to increase the pH of the stomach ROME IV Criteria for IBS Abd pain with two of three: related to defecation, associated with change in stool frequency, or with form/appearance of stool
- present at least 1 day a week
- may also have dyspepsia, heartburn, chest pain, HA, fatigue, anx, depression Patient with a cough, HA, sore throat and X-ray shows patchy nonhemogenous infiltrates, which is the likely organism cause of pneumonia? Atypical mycoplasma
