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When performing a visual acuity test the nurse practitioner notes 20/30 in the left eye and 20/ in the right eye using the Snellen eye chart. This means: ✔✔Refer the patient to an ophthalmologist The American psychiatric association's diagnostic and statistical manual of mental disorder defines Munchausen Syndrome by proxy: ✔✔a caregiver making up or causing an illness or injury in a person under his or her care Symptoms of depression are a side effect of which neurotransmitter medication? ✔✔dopamine Which lesion is dark, raised, and asymmetric with irregular border? ✔✔Melanoma A 32-year-old woman presents with dull puffiness of the eyes pronounced not pitting periorbital edema this finding is suggestive of this condition? ✔✔Myxedema A 42-year-old woman with a past medical history of migraine headaches is requesting prophylactic medication treatment. Which medication should the Nurse Practitioner prescribe? ✔✔Amitriptyline (Elavil) A pediatric has areas of scaling on the scalp with round patches of alopecia. this clinical finding is consistent with: ✔✔Tinea Capitis What is the appropriate prophylactic medication for an 18-year-old woman with a past medical history of migraine headaches? ✔✔Propanolol (Inderal)
Why would a combined hormonal contraceptive be contraindicated in a 36-year-old patient with a past medical history of type 2 diabetes, obesity, chronic smoking, and sedentary life: ✔✔Her age and tobacco use During the breast examination of a perimenopausal woman, the NP detects a bloody spontaneous discharge from the right nipple. This indicates further evaluation. ✔✔An intraductal papilloma Intraductal papilloma are usually solitary and smaller than 1 cm. They are located in large lactiferous sinuses or ducts and have a tendency to bleed. Rh negative women should receive Rho(D) immunoglobulin at what gestational time? ✔✔ 28 weeks When interpreting a complete blood count (CBC) lab report which of the following results describes the size of the RBCs? ✔✔Mean corpuscular volume (MVC) What medication should be avoided when prescribing prophylactic therapy for headaches? ✔✔Venlataxin (Effexor) What is the mechanism of action of prostaglandin E1 (PG1) in a patient with transposition of the great arteries? ✔✔To produce vasodilation and adequate oxygen saturation Which of the following complaints best describes lower extremity calf pain associated with peripheral artery disease: ✔✔A dull pain or cramp Which of the following conditions is NOT a typical finding of hyperprolactinemia in a 47-year- old premenopausal woman? ✔✔Gynecomastia When treating a patient with asthma who is experiencing acute wheezing which medication should be given to relieve the symptom? ✔✔Short acting bronchodilator
On examination of the neck, a dome shaped lesion in the dermis forming a benign closed firm sac attached to the epidermis is noted on a right lateral side of the neck. The type of lesion is known as : ✔✔a cutaneous cyst A dark dot (black-head) may be visible on its usually either an epidermoid cyst, common on the face and neck, or pilar cyst, common in the scalp. Both may be come inflamed. BATES: pg Symptoms of heartburn and regurgitation are associated with: ✔✔Gastroesophageal reflux A 70-years-old man walks 20- minutes most days of the week. He has begun to complain of pain of his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 20 minutes walks without stopping to rest. What choice best describes the pain associated with peripheral artery disease? ✔✔a dull pain and cramp Papilledema is cause for concern because it is suggestive of: ✔✔Increased intracranial pressure BATES: pg. 280 A 38-year-old patient with a history of abdominal pain presents to the nurse practitioner. Findings reveal superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. Hemorrhagic pancreatic is suspected because of which finding? ✔✔A positive Cullen's sign BATES: pg. 208 A 57-year-old post-menopausal female presents with a complaint of vaginal burning, pruritus, and painful intercourse. On examination, the nurse practitioner would be most concern with the findings: ✔✔A friable cervix
When intervention does the American College of Rheumatology recommend as first line therapy for Osteoarthritis, rheumatoid arthritis or something else: ✔✔Exercise and weight loss Which of the following drugs is not contraindicated for concurrent use with warfarin (Coumadin)? ✔✔Amoxicillin (Amoxil) The lymphatic ducts drain into the: ✔✔Venous system Which of the following is the most appropriate treatment for trichomoniasis in a non-pregnant woman? ✔✔Metronidazole (Flagyl) Osteosarcoma in a pediatric patient is most often diagnosed when there is: ✔✔pain in the affected bone In a patient who has a history of migraine headaches, which characteristics is most common? ✔✔Family history Symptoms associated with small bowel obstruction usually include: ✔✔Vomiting and pain Unilateral rhinitis could be caused by all of the following except: ✔✔Drug induced rhinitis A 7-year-old child has been diagnosed with acute sinusitis. The drug class that should be avoided is: ✔✔antihistamines A patient present with a elongated head with bony prominence of the forehead, nose, and lower jaw. These facial features could be suggestive of: ✔✔Acomegaly Why would a child diagnosed with beat thalassemia and hemosiderosis received deferoxamine (Desferal)? ✔✔To eliminate excessive iron and prevent organ damage
BATES: pg. 219 Which antihypertensive would be appropriate to prescribe for a hypertensive patient (B/P) 150/95) that is in her third trimester? ✔✔Methyldopa Category B for pregnancy Pharm book: pg. A 40-year-old admits to multiple sex partners presents with several lesions over his body Findings reveals hemorrhagic vesiculopustular lesions over the hands and feet. These lesions are most likely associated with: ✔✔Gonococcemia BATES: pg. Purple to grey macules, papules or hemorrhagic pustules distributed over acral and periarticular surfaces Which agent os NOT useful in prophylactic treatment of migraine headaches? ✔✔Sumatriptan (Imitrex) The right lymph duct drains lymphatic fluid from all the following expect the ✔✔Right leg Acute lymphocytic leukemia is usually diagnosed by: ✔✔A bone marrow examination The medication that blocks the transportation of glucose across the intestines into the blood stream to target prandial blood glucose is: ✔✔Acarbose (Precose) Alpha-Glucosidase Inhibitors Prostate pain is usually located in the: ✔✔Perineum
A nurse practitioner examines the skin of an elderly patient which finding below is NOT benign lesion associated with the aging process? ✔✔Dermatophytosis also known as ringworm, is a fungal infection of the skin. Typically it results in a red, itchy, scaly, circular rash. A 65-year-old male presents with findings of symmetric thorax with moderate kyphosis and anterior diameter. Chest expansion is decreased and the diaphragm descending 2 cm bilaterally. These findings related to: ✔✔chronic obstructive pulmonary disease Phenazopyridine (Pyridium) is recommended for very short-term use in patients with urinary tract infections (UTIs) because: ✔✔Occurrence of hemolytic anemia Estrogen-progestin contraceptives should be avoided in women with: ✔✔Migraines with aura Combine contraceptives is a good choice for patients childbearing age younger than 35 with NO aura migraine The addition of benzoyl peroxide to erythromycin for the topical treatment of acne: ✔✔Improve the efficacy of erythromycin An elderly male with benign prostate hyperplasia (BPH) should be advised to avoid antihistamines. What is the reason for this? ✔✔Urinary retention Examination of the hair reveals a fine silky appearance. This finding may be seen in patients that have: ✔✔Hyperthyroidism A patient develops a cough secondary to an angiotensin-converting-enzyme (ACE). The most appropriate statement related to ACE-I cough is that the cough typically: ✔✔Resolves within a week after stopping the ACE inhibitor
Headache warning signs that need prompt investigation include all the following: ✔✔New onset after 50 Aggravated or relieved by change or position Precipitated by Vasalva maneuver Serotonin Syndrome is a potentially life-threatening condition associated with: ✔✔Increased levels of serotonin Which one of the following statements about treating scabies with lindane (Kewell) is correct? ✔✔(NIX is the treatment ) Lindane lotion and/or shampoo is not considered first-line therapy Symptoms consistent with later stage human deficiency disease (HIV) typically include all the following EXCEPT: ✔✔Persistent vomiting The earliest clinical manifestation of diabetic nephropathy is: ✔✔Micoalbuminuria When fluid accumulates between the visceral and parietal pleural spaces, the term used is: ✔✔Pleural effusion Children born with down syndrome often have other anomalies. They especially require evaluation of what body system? ✔✔Cardiac What finding is typical in a patient with a meniscal tear? ✔✔Positive McMurray's Test The nurse practitioner diagnoses a female patient with trichomoniasis. A common chief complaint of a patient with trichomoniasis is: ✔✔vaginal discharge
When deciding on an initial treatment option for an acute flare of atopic dermatitis, unresponsive to emollient therapy, the next best choice for treatment is: ✔✔Desonide 0/5% When examining the breast, the "tail of Spence" would be located ✔✔laterally across the anterior axillary fold Headaches with symptoms of nausea and vomiting may be associate with all the following EXCEPT: ✔✔Tension headache Which of the following finding could indicate a need for further evaluation of the cardiac patient: ✔✔Low density lipoprotein of 190 mg/dL Alpha-adrenergic blocker increases urine outflow in males by: ✔✔Relaxing prostate smooth muscle The scoliosis patient who would cause the greatest concern for the nurse practitioner is a: ✔✔ 13 y/o female a 10 degree curve Which finding bellow would be unusual in a patient with diabetic retinopathy? ✔✔Papilledema Where should the uterine fundus be palpable at 12 weeks? ✔✔At the level of the symphysis pubis Ophthalmoscopic examination of 40 years old carpenter reveals a triangular thickening of the bulbar conjunctiva across the outer surface of the cornea. This condition in termed: ✔✔Pterygium A growth of the conjunctiva (triangular thickening) that covers the cornea
A patient with bulimia is likely to be: ✔✔Of average weight Chronic bloody diarrhea could be suggestive of: ✔✔Crohn's disease On examination a patient is noted to have a "mask-life" fave with decreased blinking and a characteristic stare. ✔✔Parkinson disease An appropriate initial treatment for benign positional vertigo is: ✔✔Meclizine (Antivert) Conductive and sensorineural phases are necessary for hearing to take place. The sensorineural phase of hearing pathways involves the: ✔✔cochlea and the cochlear nerve A 65 year year old has a history of one kidney with early renal insufficiency. He is diagnosed with pneumonia and will require: ✔✔Lower dose of antibiotics A 44 year old presents to the nurse practitioner for an employment physical and is concerned about testing positive for amphetamines on a drug screen, even though he is not taking amphetamines. His current medication list includes metformin, lisinopril, glyburide and bupropion. The most likely medication cause for a false positive result for amphetamines would be: ✔✔Bupropion Desmopressin is a commonly nasal spray has been fund to be useful in the management of enuresis in children. In which of the following situation is the drug especially beneficial? ✔✔Sleepovers Rapid Human Immunodeficiency virus (HIV) testing would be appropriate for a patient with complaints of: ✔✔Painful urination, dyspareunia, and vaginal or penile discharge Which of the following condition is NOT associated with the symptoms of hemoptysis? ✔✔Viral pneumonia
Which condition is associated with end-stage renal disease in pediatric patients and requires recombinant erythropoietin treatment? ✔✔Anemia When evaluating a 17-year-old girl with infrequent menstrual periods, which findings suggest probable hyperandrogenism? ✔✔Hirsutism Thick hair growth- on the face particularly the beard and moustache area, limbs, underarm, and pubic area. Which form of urinary incontinence is present in a patient with Alzheimer's disease who is unable to reach the toilet in time? ✔✔Functional incontinence Occurs when some obstacle or disability makes it hard for you to reach or use a toilet in time to urinate A 27-year old male patient presents with a painless chancre on the shaft of his penis and regional lymphadenopathy. He is diagnosed with primary syphilis. The best initial treatment is: ✔✔Benzathine penicillin G (Bicillin L.A.) CDC.gov A 80-year-old man is being evaluated for recent episodes of incontinence and confusion. His family states that he is usually independent with no altered mental issues, but has become forgetful within the last two weeks. Which medication is most likely associated with the symptoms? ✔✔Cimetidine (tagamet) When ordering an oral diabetes medication for a 72 year old patient with a recent history of decreased appetite and ongoing risk of hypoglycemia. The NP should order: ✔✔Metformin To increase urine outflow in men with BPH, the NP should prescribe: ✔✔An alpha blocker
Patients with psoriasis frequently have ✔✔pitted nails and plaque Which condition is best treated using alpha adrenergic antagonist? ✔✔Overflow incontinence A patient who is taking an oral glococorticosteroid should be advised to: ✔✔take it with food Which of the following drug classes is not indicated for the treatment of depression? ✔✔Buspirone (Buspar) A hispanic woman who is 26 weeks pregnant states that she recently began eating ice chips between meals ✔✔Assess the patient for iron deficiency anemia Snellen chart evaluation indicated that the patient's vision is 20/30. What is the proper description of this result? ✔✔At 20 ft, this patient can see what a person with normal can see at 30 ft. Which of the following is NOT a common symptom of Vitamin B12 deficiency? ✔✔Vomiting During a Migraine, the cerebral arteries: ✔✔dilate Which is the appropriate medication for a 31 year old pregnant diagnosed with a UTI ✔✔Cefuroxime (Zinafed) or Nitrofurantoin (Macrobid) Which of the following medication is note indicated for the treatment of muscle spasms? ✔✔Baclofen During an abdominal examination the NP percusses the bulging area of the abdomen. Which sounds suggest the presence: ✔✔Dullness
Which pathogen is associated with common UTI? ✔✔E. Coli Which condition is caused by an insufficient production of intrinsic facto by gastric mucosa and Vitamin B insufficiency? ✔✔Pernicious anemia A multiparous pregnant patient presents at 24 weeks gestation with complain of painless vaginal bleeding. This presentation is consistent with: ✔✔placenta previa When measuring the fundal height of a pregnant female at 32 weeks gestation, which measurement would the NP suspect fetal growth: ✔✔32 cm A 40 year old female, the overall texture of the breast is soft, with an uneven contour bilaterally, the NP informs the patient that ✔✔warrants a mammogram A 74 year old man who recently lost his spouse of 50 years in an auto accident tells the NP that " he has no purpose in this life" ✔✔Have you thought about hurting yourself? A 67 year old woman with hx. of A.fib and an ejection fraction of 48% has had normal digoxin levels. Which can cause a decrease in digoxin levels? ✔✔Regular use of antacide 5 - alpha reductase inhibitor work to improve symptoms of BPH by: ✔✔Decreasing the size of the prostate Which medication is indicated for patients with generalized anxiety disorder? ✔✔Buspirone (Buspar) Pregnant women are evaluated for syphilis with serology testing because: ✔✔Syphilis during pregnancy predisposes the fetus to spontaneously abort or the newborn to have congenital syphilis
