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LEIK FNP Final Practice Exam Questions and
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124.nWhichnofnthenfollowingnviralninfectionsnisnassociatednwithnoccasionalnabnormalnformsnofnlymp hocytesnduringnannacuteninfection? A)nCytomegalovirusn(CMV) B)nEpstein-Barrnvirusn(EBV) C)nHumannpapillomanvirusn(HPV) D)nCoxsackienvirusn-nCORRECTnANSWER-B)nEpstein-Barrnvirusn(EBV) AntestnfornannacuteninfectionnofnthenEpstein-Barrnvirusnwillnshownabnormalnformsnofnlymphocytes. 2.nAllnofnthenfollowingnareninfectionsnthatnaffectnmostlynthenlabianandnvaginanexcept: A)nBacterialvaginosis B)nCandidiasis C)nTrichomoniasis D)nChlamydiantrachomatisn-nCORRECTnANSWER-D)nChlamydiantrachomatis Infectionsnthatncommonlynaffectnthenlabianandnvaginanincludenbacterialnvaginosis,ncandidiasis,nandn trichomoniasis.nChlamydiantrachomatisncommonlynaffectsnthencervix,nendometrialnliningn,nfallopia nntubes,nandnpelvicncavity. 411.nWhichnofnthenfollowingnisnthenmostncommonncausenofnnongonococcalnurethritis? A)nEscherichiancoli B)nChlamydiantrachomatis C)nNeisseriangonorrhoeae D)nMycoplasman-nCORRECTnANSWER-B)nChlamydiantrachomatisn ThenmostncommonncausenofnnongonococcalnurethritisnisnChlamydiantrachomatis. An 10 - year- oldnboyncomplainsnofnansuddennonsetnofnscrotalnpainnwhennhenwokenupnthatnmorning.nHenisnalsonco
mplainingnofnseverennauseanandnvomiting.nDuringnthenphysicalnexamination,nthennursenpractitionern findsnantender,nwarm,nandnswollennleftnscrotum.nThencremastericnreflexnisnnegativenandnthenurinendi psticknisnnegativenfornleukocytes,nnitrites,nandnblood.nThenmostnlikelyndiagnosisnis: A)nAcutenepididymitis B)nAnseverensalmonellaninfection C)nTesticularntorsion D)nAcutenorchitisn-nCORRECTnANSWER-C)nTesticularntorsionn Testicularntorsionnsignsnandnsymptomsnincludensuddennonsetnofnunilateralnscrotalnpain,nnausea,nvo miting,nandnabdominalnpain.nAcutenepididymitisncausesnfever,nchills,nnausea,nandnunilateralnpainna ndnisnmostncom- nmonlynseenninnsexuallynactivenmen.nUnilateralnscrotalnpainndoesnnotnoccurnwithnSalmonellaninfecti on.nAcutenorchitisnisnoftennbasednonnhavingnanrecentnmumpsninfec- ntionnornparotitisnwithntesticularnedema. An 10 - year- oldnmalenwhonwasnrecentlynacceptednintonhisnschool'snsoccernteamnhasnanhistorynofnexercise- inducednasthma.nThenchildnwantsntonknownwhennhenshouldntakenhisnalbuterolninhaler.nThennursenpra ctitionernwouldnadvisenthenpatient: A)nPremedicatenhimselfn 20 nminutesnpriorntonstartingnexercise B)nWaitnuntilnhenstartsntonexercisenbeforenusingntheninhaler C)nPremedicaten 60 nminutesnbeforenstartingnexercise D)nWaitnuntilnhenfinishesnhisnexercisenbeforenusingnhisninhalern-nCORRECTnANSWER- A)nPremedicatenhimselfn 20 nminutesnpriorntonstartingnexercisen Exercise- inducednasthmanisnbestncontrollednbynusingnthenProventilninhalern(bronchodilator)napproximatelyn 2 0 nminutesnpriorntonexercise,ntonpreventnvasospasmnofnthenbronchiolesnandnshortnessnofnbreathnwith nexercise.nThesenbronchodilatorsnusuallynlastnapproximatelyn 4 nhours.nTheynalsonworknquicklyntonope nnupnthenbronchiolesnifnannacutenattack/shortnessnofnbreathnoccurs An 12 - year-oldngirlnisncomplainingnofnan 2 - weeknhistorynofnfacialnpressurenthatnworsensnwhennshenbendsnover.nShencomplainsnofntoothnpainninn
catch-upn(ifndidnnotnreceivenatnagen 11 - 12 nyears),nHPVnornGardasilncatch- upn(ifndidnnotnreceivenatnagen 11 - 12 nyears),nandnthenMCV4nornmeningococcalnconjugatenvaccinen(Menactra).nOnlynonendosenofnTdapni snrecommendedn(lifetime).nThereafter,nthenTdnformnofnthenvaccinenisnindicatedneveryn 10 nyears. An 13 - year- oldnboynwantsntonbentreatednfornhisnacne.nHenhasnanlargennumbernofnclosednandnopenncomedonesno nnhisnface.nThenpatientnhasnbeenntreatingnhimselfnwithnOTCnbenzoylnperoxidenandnsalicylicnacidntopi calnproducts.nWhichnofnthenfollowingnwouldnbenrecommendednnext? A)nRetinoicnacidn(Accutane) B)nTetracycline C)nRetinnAn0.25%ngel D)nWashnfacencarefullynwithnmedicatednsoapnatnbedtimen-nCORRECTnANSWER- C)nRetinnAn0.25%ngeln Topicalnagentsnarenthenfirst- linentreatmentnfornacnenvulgaris.nRetinnAn0.25%ngelnwouldnbenthennextnstep.nOralnpreparationsnwoul dnthennbenofferednfornthennextnstepn(tetracycline),nandnAccutanenwouldnbenthenfinalnstepnofntherapy. An 13 - year- oldnmalenisnbroughtninnbynhisnmothernfornanphysicalnexam.nDuringnthengenitalnexam,nthennursenpracti tionernnoticesnthatnthenpatientnisnatnTannernStagenII.nWhichnofnthenfollowingnisnthenbestndescriptionno fnthisnTannernstage? A)nThenpenisnisngrowingnmoreninnlengthnthanninnwidthnandnthentesticlesnbecomenlargernwithndarkernsc rotalnskinnandnthenpubicnhairnisnstartingntoncurl B)nThenpenisnisngrowingnmoreninnwidthnthanninnlengthnwithndarkernscrotalnskinnandnmorennumerousnp ubicnhairsnthatnarendarker,ncurly,nandncoarser C)nThentesticlesnbecomenlargernandnthenskinnofnthenscrotumnstartsntonbecomendarkernwithnstraight,nf ine,ncountablenhairsnonnthengenitalsnandnthenaxilla D)nThentesticles,npenilenwidthnandnlengthnarenallndevelopingnquicklyn-nCORRECTnANSWER- C)nThentesticlesnbecomenlargernandnthenskinnofnthenscrotumnstartsntonbecomendarkernwithnstraight,nf ine,ncountablenhairsnonnthengenitalsnandnthenaxillan
TannernStagenIInisnwhennthentesticlesnstartntongrow.nThenscrotalnskinnbecomesnthickernandnstartsntong etndarkern(hyperpigmentation).nThenpubicnhairnisnofnanfinentexturenandnstraightnandntherenarenfewnco untablenhairsnonnthengenitalsnandnthenaxilla. An 13 - year- oldnpatientnhasnanthroatnculturenthatnisnpositivenfornstrepnthroat.nShenreportsnthatnhernyoungernbroth ernwasnrecentlyndiagnosednwithnstrepnthroatnandntreated.nThenpatientnhasnanseverenallergyntonpenicil linnandnreportsnthatnerythromycinnmakesnhernverynnauseated.nWhichnofnthenfollowingnantibioticsnisnt henbestnchoice? A)nAzithromycinn(Zithromax) B)nCephalexinn(Keflex) C)nCefuroximenaxetiln(Ceftin) D)nLevofloxacinn(Levaquin)n-nCORRECTnANSWER-A)nAzithromycinn(Zithromax)n Ifnthenpatientnhasnanseverenpenicillinnallergy,ntherenisnan10%nchancenofncross- reactivityntoncephalosporinsn(especiallynfirstngeneration).nBecausenthenpatientnisnanchild,nthenlevoflo xacinnisncontraindicated.nNauseanisnancom- nmonnadversenreactionntonerythromycinn(itnisnnotnannallergicnreaction).nThenbestnoptionnisntonusenazit hromycinnbecausenofnitsnminimalnGInadverseneffects.nAzithromycinnhasnfewerndrugninteractionsnco mparednwithnothernmacrolides. An 14 - year- oldnfemalenwhonisnsexuallynactivenisnbroughtninnbynhernmothernfornannimmunizationnupdate.nAccordi ngntonthenmother,nherndaughternhadn 1 ndosenofnhepatitisnBnvaccine.nWhichnofnthenfollowingnvaccinesn wouldnyounadministernatnthisnvisit? A)nTdnandnhepatitisnB B)nDTaPn(diphtheria,ntetanus,nacellularnpertussis)nandnhepatitisnB C)nHepatitisnBnonly D)nMMRn(measles,nmumps,nrubella)nandnTdn-nCORRECTnANSWER-A)nTdnandnhepatitisnBn ThenCDCnrecommendsnTdnandnhepatitisnBnforn 14 - year- oldnfemales.nItnisnrecommendednfornherntoncontinuenthenhepatitisnseries,nwhichnincludesnantotalnofn 3 ninjections. An 14 - year- oldnfemalenwithnamenorrheanisntestednfornpregnancynandnhasnanpositivenresult.nThenpatientntellsnthen
thatnherndaughternisnstartingnTannernStagenII.nWhatnarenthenphysicalnexamnfindingsnduringnthisnstage ? A)nBreastnbudsnandnsomenstraightnpubicnhair B)nFullyndevelopednbreastsnandncurlynpubicnhair C)nBreastntissuenwithnthenareolanonnanseparatenmoundnwithncurlynpubicnhairn D)nNonbreastntissuenandnnonpubicnhairn-nCORRECTnANSWER- A)nBreastnbudsnandnsomenstraightnpubicnhairn TannernStagenIIninnfemalesnincludesnbreastnbudsnandnfewnstraight,nfinenpubicnhairs. An 15 - month- oldnchildnwhonisneatingnandnbehavingnnormallynisnfoundntonhavenanhighnfever.nAfternanfewndays,nthenfe vernresolvesnandntheninfantnbreaksnoutninnanmaculopapularnrash.nThisnisnandescriptionnofnwhichnofnth enfollowingnconditions? A)nErythemaninfectiosum B)nRoseolaninfantum C)nFifthndisease D)nScarletnfevern-nCORRECTnANSWER-B)nRoseolaninfantumn Thensigns/symptomsnofnroseolaninfantumnincludenhighnfevernfornanfewndaysnwithnanmaculopapularnr ashnoccuringnafternthenfevernbreaks.nFifthndiseasenisnanlacy- appearingnrashnthatnusuallynbeginsnonnthenfacenandnmovesntonthenextremitiesnandntrunk.nItnisnknownn bynthen"slappedncheekn"nappearancenatnonset.nErythemaninfectiosumnisnthensamenasnFifthndisease.n Scarletnfevernisnanrednrashnthatnfeelsnlikensandpapernthatnusuallynbeginsnonnthennecknandntrunknandn spreadsntonthenextremities.nPatientsnwillnhavenothernsymptomsnsuchnasnfever,nsorenthroat,nandnbeef ynredntongue.nThisnisncausednbynthenGroupnAnStreptococcusnbacterium. An 15 - month- oldninfantnisninnyournofficenfornanwellnbabyncheck.nThenmotherndeniesnhistorynofnchickenpoxninfection .nWhichnofnthenfollowingnimmunizationsnisnindicatednatnthisnvisit? A)nDTaP,nHib,nIPV,nhepatitisnB B)nDTaP,nHib,nPCV,nIPV,nMMR C)nMMR,nhepatitisnB,nvaricella D)nDTaP,nIPV,nMMR,nvaricellan-nCORRECTnANSWER-D)nDTap,nIPV,nMMR,nvaricellan
Immunizationsnfornan 15 - month-oldnchildnincludenDTap,nIPV,nMMR,nandnvaricellanvaccine. An 15 - year- oldnbasketballnplayernwhonisn 6 nftntallnisnseennforncomplaintsnofnpainfulnlumpsnonnhisnknees.nUponnins pection,nthennursenpractitionernnotesnanbonelikengrowthnonnthenupperntibianmidlinenbelownthenkneec apnonnbothnknees.nThenpatientnhasnfullnrangenofnmotionnwithnnonjointntenderness,nredness,nornswelli ng.nWhichnofnthenfollowingnconditionsnisnbestndescribed? A)nOsteosarcomanofnthentibia B)nJuvenilenrheumatoidnarthritis C)nOsgood-nSchlatterndisease D)nPaget'sndiseasenofnthenbonen-nCORRECTnANSWER-C)nOsgood-Schlatterndiseasen Osgood- Schlatterndiseasenisncharacterizednbynhavingnpainnovernthentibialntuberositynwithnpalpationnofnanbony nmassnovernthenanteriorntuberclenofnonenornbothnknees.nExercisenworsensnthenpain An 15 - year- oldnfemalenwhonattendsnanpublicnschoolnisnreferredntonthennursenpractitionernbynonenofnhernteachers .nThenteennhasnbeennmissingnschoolnandnisnfallingnbehindninnhernschoolwork.nAfternclosingnthenexamn roomndoor,nthennursenpractitionernstartsntoninterviewnthenteen,naskingnaboutnhernmoods,nhernappetit e,nhernsleep,nwhethernshenanynplannofnhurtingnherselfnornothers,nandnothernquestions.nWhatnisnthenle velnofnhealthnpreventionnthatnthennursenpractitionernisnperforming? A)nPrimarynprevention B)nSecondarynprevention C)nTertiarynprevention D)nDropoutnpreventionnprogramn-nCORRECTnANSWER-B)nSecondarynpreventionn Thennursenpractitionernisnevaluatingnthenteenagernfor majorndepression.nBecausenthenteenagernalreadynhasnthendiseasen(depression),nitnisnanscreeningn"te st."nAllnscreeningntests/labsn(mammography,nPapnsmears,netc.)nare secondarynpreventionnactivities. An 15 - year- oldnWhitenmalenisnbroughtninnbynhisnfathernfornanphysicalnexam.nHenisnconcernednthatnhisnsonnisn"toon short"nfornhisnage.nThenfathernreportsnthatnwhennhenwasnthensamenage,nhenwasnmuchntaller.nHisnsonn
D)nCleannthenwoundnwithnsoapnandnwaternandnprescribenAugmentinn500mgnPOnBIDnxn 10 ndaysnfornth enpatientn-nCORRECTnANSWER- D)nCleannthenwoundnwithnsoapnandnwaternandnprescribenAugmentinn 500 nmgnPOnBIDnxn 10 ndaysnfornth enpatientn Catnwoundsnarenmorenlikelyntonbecomeninfectedncomparednwithndognbites;ninnaddition,nthisnpatient' snbitenisnlocatednonnannextremity.nThesenfactsnjustifynthenprescriptionnofnAugmentinn 500 nmgnPOnBIDn xn 10 daysnfornthenpatient. An 17 - year- oldnboynreportsnfeelingnsomethingnonnhisnleftnscrotum.nOnnpalpation,nsoftnandnmovablenbloodnvesse lsnthatnfeelnlikenan"bagnofnworms"narennotednunderneathnthenscrotalnskin.nItnisnnotnswollennornredden ed.nThenmostnlikelyndiagnosisnis: A)nChronicnorchitis B)nChronicnepididymitis C)nTesticularntorsion D)nVaricocelen-nCORRECTnANSWER-D)nVaricocelen Palpationnofnvaricosenveins,nknownnasn"bagnofnworms"ninnthenscrotum,nisnanclassicnsymptomnofnanva ricocele.nChronicnepididymitisnandnchronicnorchi- ntisnarencausednbynanbacterialninfectionnandncommonlynhavenburning,nfrequency,nandnpain.nTesticul arntorsionnisnannemergentnconditionninnwhichnthentesticlenbecomesntwisted,ninterruptingnthenbloodns upplyntonthentestis;ntonavoidndamage,nthenconditionnmustnbencorrectednwithinn 6 nhours. An 17 - year- oldnhighnschoolnstudentnisnconsideringnhernbirthncontrolnoptions.nShenwantsntonknownmorenaboutnSe asonale.nWhichnofnthenfollowingnstatementsnisnfalse? A)nTakingnSeasonalenresultsninnonlyn 4 nperiodsnpernyear B)nHernperiodnwillnoccurnwithinnthen 7 ndaysnwhennshenisnonntheninertnpills C)nItnisnanprogesterone-onlynmethodnofnbirthncontrolnandndoesnnotncontainnestrogen D)nTaken 1 ntabletndailynforn 84 nconsecutivendaysnfollowednbyn 7 ndaysnofninertnpillsn- nCORRECTnANSWER-C)nItnisnanprogesterone- onlynmethodnofnbirthncontrolnandndoesnnotncontainnestrogenn
Seasonalenisnannextended- cyclenformnofnbirthncontrol.nItncontainsnbothnlevonorgestrelnandnethinylnestradiol.nTherenaren 84 npinkn tabletsn(active)nandn 7 nwhitenpillsn(inert).nInngeneral,nmorenspottingn(breakthroughnbleeding)nisnexper ienced withnextended- cyclenpillsnduringnthenfirstnfewnmonthsnofnusen(comparednwithnthenmonthlynbirthncontrolnpills). An 19 - year- oldnfemalenhasnrecentlynbeenndiagnosednwithnacutenhepatitisnB.nShenisnsexuallynactivenandnisnmono gamous.nShenreportsnusingncondomsninconsistently.nWhatnwouldnyounrecommendnfornhernmalensex ualnpartnernwhonwasnalsontestednfornhepatitisnwithnthenfollowingnresults:nHBsAgn(−),nanti- HBsn(−),nanti-HCVn(−),nanti-HAVn(+)? A)nAnhepatitisnBnvaccination B)nHepatitisnBnimmunoglobulin C)nHepatitisnBnvaccinationnandnhepatitisnBnimmunoglobulin D)nNonvaccinationnisnneedednatnthisntimen-nCORRECTnANSWER- C)nHepatitisnBnvaccinationnandnhepatitisnBnimmunoglobulinn HepatitisnBnvaccinationnisngivennfornlong- termnprophylaxisntreatmentntonpreventnhepatitisnBninfection.nHepatitisnBnimmunoglobulinnisngivennfo rnpreventionnofnhepatitisnBninfectionnwhennthenpersonnhasnbeenndirectlynexposedntonthenhepatitisnBni nfection.nThenimmnoglobulinnisnnotnanvaccinenandndoesnnotnprotectnagainstnlong-termnprophylaxis. An 19 - year- oldnmalenathletencomplainsnofnacutenkneenpainnafternanfootballngame.nThennursenpractitionernelicitsn McMurray'snsign,nwhichnisnpositivenonnthenpatient'sninjurednknee.nThisnisnantestnfor: A)nMeniscalninjury B)nInflammationnofnthenkneenjoint C)nOsteophytesnofnthenkneenjoint D)nTenosynovitisn-nCORRECTnANSWER-A)nMeniscalninjuryn Withnannacutenkneeninjury,nthenkneenshouldnbenassessednusingnMcMurray'snsign.nAnpositivenMcMurr ay'snsignnindicatesnanmeniscalninjury.nInflammationnofnthenknee,nosteophytes,nandntenosynovitisnwo uldnnotnelicitnanpositivenMcMurray'snsign.
C)nChondromalacianofnthenpatella D)nDisseminatedngonorrhealninfectionn-nCORRECTnANSWER-D)nDisseminatedngonorrhealninfectionn SymptomsnofnPIDnwithnpainful,nswollennjointsnofnextremitiesnindicatendisseminatedngonorrhealninfe ction.nUntreatedndisseminatedngonorrheancannleadntonsepticnarthritis.nSymptomsnmaynbenmildnfrom nslightnjointnpainnandnnonfeverntonseverenjointnpainnwithnhighnfever.nPIDnsymptomsndonnotnoccurnwithn septicnarthritis,nReiter'snsyndrome,nornchondromalacianofnthenpatella. An 22 - yearnoldnisngoingnonnan 5 - dayncruisenfornhernhoneymoon.nShenreportsnanhistorynofnseverenmotionnsickness.nWhichnofnthenfollo wingnmedicinesncannbenprescribednfornmotionnsickness? A)nDimenhydrinaten(Dramamine) B)nMetochlopramiden(Reglan) C)nOndansetronn(Zofran)n_ D)nScopolaminenpatchn(TransdermnScop)n-nCORRECTnANSWER- D)nScopolaminenpatchn(TransdermnScop)n Scopolaminenpatchn(TransdermnScop)nisnanprescriptionnmedicinenthatnisnusednfornmotion/seansickn ess.nItnisnansmall,ncircularnpatchnthatnisnplacednbehindnthenearnandnisneffectivenforn 3 ndays.nAdvisenthe npatientntonapplynitn 4 nhoursnbeforenthentripntonbeneffective.nBecausenthenquestionnisnaskingnaboutnan" prescribed"nmed,nanswersnwithnOTCsnsuchnasnDramaminenarenincorrect.nZofrannisnindicatednfornca ncer-relatednnauseanandnvomitingn(chemo,nradiation,nsurgery). An 22 - year- oldnmalenisnbroughtntonannurgentncarencenternbynhisnanxiousnmother.nShenreportsnthatnhernsonnreturn ednfromnancampingntripn 2 ndaysnagonwithnanhighnfevernandnbadnheadache.nApparently,nthenpatientnha dncomplainedntonhernofnanpainfulnandnstiffnnecknalongnwithnnauseanshortlynafternhenarrived.nAccordin gntonthenmother,nhernsonnstartednbreakingnoutninnanrashnthendaynbefore,nsomenofnwhichnisnturningnand arknredntonpurplencolor.nDuringnthenphysicalnexam,nthennursenpractitionernevaluatesnthenpatientnforn Kernig'snsign,nwhichnisnpositive.nWhichnofnthenfollowingnconditionsnisnmostnlikely? A)nStevens-Johnsonnsyndrome B)nMeningococcemia C)nRockynMountainnspottednfever D)nErythemanmultiformen-nCORRECTnANSWER-B)nMeningococcemian
Kernig'snmaneuvernisnperformednbynflexingnbothnhipsnandnlegsnandnhavingnthenpatientnstraightennthen legsnagainstnresistance,ntestingnfornmen- ningitis.nAnpositiventestnindicatesnmeningitis.nOtherncharacteristicsnofnmeningitisnincludenhighnfever,n headache,nstiffnneck,nandnnausea/vomiting. An 22 - year- oldnmalenpresentsntonthenurgentncarenclinicnwithnburnsncausednbynanhotnoilnspillnwhilenfryingnfood.nH endeniesnfacialninvolvement,ndyspnea,nornweakness.nDuringnthenphysicalnexam,nthennursenpractition ernnoticesnbrightnrednskinnwithnnumerousnbullaenonnthenrightnarmnandnhandnandnbrightnrednskinnonnth enrightnthighnandnthenrightnlowernleg.nOnnanpainnscalenofn 1 - 10,nhenreportsnthenpainnasn8.nBasednonnthenRulenofnNines,nwhatnisnthenTBSAnofnthisnpatient'snburns? A)n36%n B)n27%n C)n18%n D)n9%n-nCORRECTnANSWER-B)n27%n ThisnpatientnhasnanTBSAnofn27%nandnshouldnbenreferredntonthenemergencyndepartmentnasnsoonnasnp ossible.nChecknthen"ABCs"nandnmonitornthenpatientnfornshock.nDonnotnpuncturenbullae. An 25 - year-oldnfemalenpresentsnwithnannonsetnofnseverenright- sidednpelvicnpainnfornthenpastn 48 nhours.nShenreportsnsmallnamountsnofnvaginalnbleeding.nThenpainnisn aggravatednbynjumpingnornanynmovementnthatnjarsnhernpelvis.nThenbestninitialninterventionnisnwhichno fnthenfollowing? A)nFollicle-stimulatingnhormonen(FSH) B)nSerumnquantitativenpregnancyntest C)nPelvicnultrasound D)nCBCnwithnwhitencellndifferentialsn-nCORRECTnANSWER-B)nSerumnquantitativenpregnancyntestn Severenright-sidednpainnwithnvaginalnbleedingninnan 25 - year- oldnpatientnrequiresnannevaluationnfornpregnancy,nbynperformingnanserumnquantitativenpregnancynte st.nEctopicnpregnancynand/ornmiscarriagenshouldnbenrulednout. An 25 - year- oldnmalenwhonwasninvolvedninnancarnaccidentnisnbroughtninntonthenlocalnemergencyndepartment.nHenr eportsnwearingnanseatnbeltnandnwasnthendrivernofnthenvehicle.nThenpatientnisncomplainingnofnpainnonn hisnrightnleg.nThenskinnisnintact,nbutnthenrightnfootnisnabductednslightly.nThenrightnkneenisntendernandns
A)nMetronidazolen(Flagyl) B)nCeftriaxonensodiumn(Rocephin) C)nDoxycyclinenhyclaten(Vibramycin) D)nClotrimazolen(Gyne-Lotrimin)n-nCORRECTnANSWER-A)nMetronidazolen(Flagyl)n Trichomoniasisnsymptomsnincludendysuria,nseverenvaginalnpruritis,nandnmalodorousnvaginalndischa rge.nWetnprepnwillnshowntrichomonadsnthatnarenpear- shapednandnhavenseveralnflagellan(whiplikentails)natnonenend.nCDCnrecommendationnforntreatmentni snmetronidazole. An 25 - year- oldnwoman'snlastnmenstrualnperiodnwasn 6 nweeksnago.nShenisncomplainingnofnnauseanwithnvomitingni nnthenmorningnandnfatigue.nHernbreastsnfeelnbloated.nThennursenpractitionernsuspectsnthatnshenisnpr egnant.nHernsymptomsnwouldnbenconsidered: A)nPositivensignsnofnpregnancy B)nProbablensignsnofnpregnancy C)nPresumptivensignsnofnpregnancy D)nPossiblensignsnofnpregnancyn-nCORRECTnANSWER-C)nPresumptivensignsnofnpregnancyn Presumptivensignsnofnpregnancynarensymptomsnexperiencednbynthenwoman,nsuchnasnamenorrhea,n breastntenderness,nnausea/nvomiting,nfatigue,nandnincreasednurinarynfrequency. An 28 - year- oldnmalennursenofnHispanicndescentnreportsnanhistorynofnancoldnthatnresolvedn 2 nweeksnagonexceptnfo rnandryncoughnandnpainnovernhisnrightncheeknthatnworsensnwhennhenbendsndown.nThenpatientndeniesnf ever.nHentellsnthenemployeenhealthnnursenpractitionernthatnhenisnverynallergicntonbothncephalexinn(Ke flex)nandnerythromycin.nThenvitalnsignsnshownthatnthenpatient'sntemperaturenisn99.2ndegreesnFahren heit,nanpulsenofn 72 nbeatsnpernminute,nandnanrespiratorynratenofn 12 nbreathsnpernminute.nWhichnofnthen followingnconditionsnisnmostnlikely? A)nAcutensinusitis B)nAcutenbronchitis C)nFevernsecondaryntonthenpreviousnviralnURIn(uppernrespiratoryninfection) D)nMunchausen'snsyndromen-nCORRECTnANSWER-A)nAcutensinusitisn Acutensinusitisnsymptomsnincludencough,nfacialnpain,nandnlow-gradenfever.
An 28 - year- oldnmalennursentellsnthenemployeenhealthnnursenpractitionernthatnhenwasntreatednfornanUTIntwicenthen previousnyear.nThenpatientndeniesnfever,nflanknpain,nornurethralndischargenduringnthenvisit.nWhichnofnt henfollowingnisnthenbestnfollow-upnfornthisnpatient? A)nRefernthenpatientntonanurologist B)nPrescribenthenpatientnofloxacinn(Floxin)nforn 2 nweeksninsteadnofn 1 nweek C)nAdvisenthenpatientnthatnhenneedsntonvoidneveryn 2 nhoursnwhennawake D)nRefernthenpatientntonthenlocalnED,nbecausenhenhasnanverynhighnrisknofnsepsisn- nCORRECTnANSWER-A)nRefernthenpatientntonanurologistn ItnisnrecommendednthatnfrequentnUTIsninnmalesnbenreferredntonanurologistnfornevaluationnandntreatm ent. An 28 - year- oldnmultiparanwhonisnatn 32 nweeksnofngestationnpresentsntonyournofficencomplainingnofnansuddennons etnofnsmallnamountsnofnbrightnrednvaginalnbleeding.nShenhasnhadnseveralnepisodesnandnappearsnanxi ous.nOnnexam,nhernuterusnisnsoftntonpalpation.nWhichnofnthenfollowingnisnmostnlikely? A)nPlacentanabruptio B)nPlacentanprevia C)nAcutencervicitis D)nMolarnpregnancyn(hydatidiformnmole)n-nCORRECTnANSWER-B)nPlacentanprevian Placentanprevianoccursnwhennabnormalnimplantationnofnthenplacentanoccurs.nAncommonnsymptomn ofnplacentanprevianisnpainless,nbrightnrednbleeding. An 28 - year- oldnstudentnisnseenninnthenschoolnhealthnclinicnwithncomplaintsnofnanhackingncoughnthatnisnproductiv enofnsmallnamountsnofnsputumnandnanrunnynnose.nHendoesnnotntakenanynmedications,ndeniesnanynall ergies,nandnhasnnonsignificantnmedicalnhistory.nPhysicalnexaminationnrevealsnanlow- gradentemperaturenofn99.9ndegreesnFahrenheit,nrespirationsnofn16/min,nanpulsenofn 90 nbeatsnpernmin ute,nandndiffusenfinencracklesninnthenbasenofnthenlungs.nAnchestnradiographn(x- ray)nshowsndiffuseninfiltratesnonnthenlowernlobenofnthenrightnlung.nThentotalnwhitenbloodncellncountnisn 10,500/uL.nWhatnisnthenmostnlikelyndiagnosis?
Atn 12 nweeksngestation,nthenfundusnofnthenuterusnshouldnbenlocatednapproximatelynatnthensymphysis npubis. An 30 - year-oldnfemalenwhonisnsexuallynactivencomplainsnofnanlargenamountnofnmilk- nlikenvaginalndischargenfornseveralnweeks.nAnmicroscopynslidenrevealsnanlargenamountnofnsquamousn epithelialncellsnthatnhavenblurrednmargins.nVerynfewnwhitenbloodncellsnarenseen.nThenvaginalnpHnisnat n6.0.nWhatnisnmostnlikely? A)nTrichomonasninfection B)nBacterialnvaginosis C)nCandidalninfection D)nAnnormalnfindingn-nCORRECTnANSWER-B)nBacterialnvaginosisn Bacterialnvaginosisnisnanbacterialninfectionnofnthenvagina.nSignsnandnsymptomsnincludencopiousnoff- whitentongrayndischargenwithnfoulnodornwithoutnvaginalnerythemanornirritation.nWetnprepnwillnshownpo sitivenforncluencells.nWhennperformingnanwetnprep,nthen"whiffntest"nwillnbenpositivenfornanstrongn"fishy "nodornwhennvaginalndischargenisnmixednwithnonendropnofnKOH. An 30 - year- oldnmalenpatientnrefusesntontakenhisnafternoonndosenofnpills.nThennursentellsnhimnofnthenpossiblencon sequencesnofnhisnaction,nbutnthenpatientnstillnrefusesntoncooperate.nWhichnofnthenfollowingnisnthenbe stncoursenfornthennursentonfollow? A)nDocumentninnthenpatient'snrecordnhisnbehaviorsnandnthenactionntakennbynthennurse B)nReassurenthenpatientnthatnhenwillnbenfinenafterntakingnthenmedicine C)nDocumentnonlynthenpatientnbehavior D)nDocumentnonlynthennurse'snactionn-nCORRECTnANSWER- A)nDocumentninnthenpatient'snrecordnhisnbehaviorsnandnthenactionntakennbynthennursen Ifnanpatientnisnnon- compliant,ndocumentationnofnthenpatientnbehaviornandnthenactionsntakennbynthennursenbothnmustnb endocumented. An 30 - year- oldnmalenwithnanhistorynofngoutnisnwalkingntonthenexaminationnroomnandnthennursenpractitionernnotic esnthatnhenisnlimping.nWhennthenpatientnsitsndown,nthennursenpractitionernnotesnthatnthenmetatarsop halangealnjointnofnthengreatntoenisnverynswollennandnisnbrightnred.nThenpatientnreportsnthatnhenwasnatt
endingnanpartynthennightnbeforenandndrank.nThenpatientnisnrequestingnanprescriptionntontreatnhisnpainf ulntoe.nThennursenpractitionernprescribesnthenpatientnindomethacinn(Indocin)n 50 nmgnTIDnPRNnandnco lchicine.nRegardingncolchicine,nwhichnofnthenfollowingninstructionsnisncorrect? A)nTaken 1 npillneverynhourntoneveryn 2 nhoursnuntilnreliefnisnobtainednornadversengastrointestinalneffectsn occur,nsuchnasnabdominalnpain,nnausea,norndiarrhea B)nTaken 1 npillneverynhournuntilnreliefnisnobtainednupnton 24 nhours C)nTaken 1 npillneveryn 4 nton 6 nhoursnuntilnthenpainnisnrelieved D)nTaken 2 nton 3 npillsnQIDnuntilnreliefnisnobtainednornadven-nCORRECTnANSWER- A)nTaken 1 npillneverynhourntoneveryn 2 nhoursnuntilnreliefnisnobtainednornadversengastrointestinalneffectsn occur,nsuchnasnabdominalnpain,nnausea,norndiarrhean Colchicinenactsnasnannanti- inflammatorynandnhelpsntonsuppressngoutynattacks.nItnisnusuallyntakennasn 1 ntabletn(0.6nmg)neveryn 1 nt on 2 nhoursnuntilnreliefnisnobtainedn(ornadversengastrointestinalneffectsnoccur,nsuchnasnabdominalnpai n,nnausea,norndiarrhea).nPrescribenthenpatientnonlyn 10 ntabletsnatnantimen(donnotnrefill)nduringnanflare- up.nThenmaximumndosenisn 6 nmg/day.nManynpatientsnwillndevelopnGInadverseneffectsnevennbeforenthe npainnisnrelieved.nColchicinencannalsonbentakenndailyninnsmallnamountsnfornprophylaxis. An 30 - year- oldnprimigravidanisndiagnosednwithnanpossiblenthreatenednabortion.nThenresultnofnthenurinenpregnan cyntestnisnpositive.nWhichnofnthenfollowingnstatementsnisntruenregardingnanthreatenednabortion? A)nVaginalnbleedingnandncrampingnarenpresent,nbutnthencervixnremainsnclosed B)nVaginalnbleedingnandncrampingnarenpresentnalongnwithnandilatedncervix C)nThenfetusnandnplacentanarenallnexpelled D)nThenproductsnofnconceptionnandnthenplacentanremainninsidenthenuterusnalong withnandilatedncervixn-nCORRECTnANSWER- A)nVaginalnbleedingnandncrampingnarenpresent,nbutnthencervixnremainsnclosedn Threatenednabortionnisndefinednasnvaginalnbleedingnandncrampingnwith- noutnthenpresencenofncervicalndilation. An 35 - year- oldnmalenhasnanhistorynofnannuppernrespiratorynviralninfectionn 4 nweeksnago.nHenreportsnthatnhenstarte dnfeelingnshortnofnbreathnandnnowncomplainsnofnsharpnpainninnthenmiddlenofnhisnchestnthatnseemsnton
