1. Symptoms of depression are a side effect of which neurotransmitter
medication?
A- Dopamine
B- Gabapentin
C- Mu
D- Cortisol
2. Which of the following is considered a synovial joint?
A- -Vertebral bodies of the spine
B- – Skull
C- -Shoulder
D- – Pubic symphysis of the pelvis
3. The most common sign associated with substance abuse in an
adolescent is:
A- – Poor school performance
B- – Change in sleep habits
C- – Increased blood pressure
D- – Changes in behavior
4. Which pathogen is associated with common urinary tract infections?
A- E. coli
B- Klebsiella
C- Streptococcus
D- Proteus mirabilis
5. Which medication can cause a false positive result for amphetamines
in a urine drug screen?
A- Metformin
B- Lisinopril
C- Glyburide
D- Bupropion
6. Pregnant women are evaluated for syphilis with serology testing
because:
A- Syphilis during pregnancy predisposes the fetus to spontaneously
abortion or the newborn to have syphilis
B- Hormonal changes associated with pregnancy may trigger
activation of latent syphilis
C- Syphilis may be passed to the fetus beginning in the third
trimester
D- Untreated syphilis can cause neonatal respiratory distress
7. Heartburn and regurgitation are symptoms associated with:
A- Hiatal hernia
B- Gastroesophageal reflux= GERD
C- Peptic ulcer disease
D- Esophageal cancer
8. Which patient causes the greatest concern for complications related
to scoliosis?
A- 13-year-old girl with a 10° curve
B- 17-year-old girl with a 10° curve
C- 12-year-old boy with a 5° curve
D- 18-year-old boy with a 5° curve
9. Which medication is contraindicated during an acute attack of gout?
A- Colchicine (for acute attack)
B- Allopurinol = prophylaxis, preventive, meds patient drinks everyday
C- A steroid
D- NSAIDs
10. A cloudy opacity of the eye is noted on ophthalmoscopic
examination. This is suggestive of:
A- Corneal arcus
B- A corneal scar
C- A pterygium
D- A cataract
11. Which medication is the first-line treatment for chronic bacterial
prostatitis (CBP)?
A- Erythromycin 4 times daily for 7 to 10 days
B- Doxycycline (Vibramycin) twice daily for 14 days
C- Macrobid (Nitrofurantoin) twice daily for 6 weeks
D- Sulfamethoxazole/trimethoprim (Bactrim DS) twice daily for 4 to
12 weeks
12. Which medication is initially used for patients with benign
positional vertigo?
A- Hydrochlorothiazide
B- Meclizine (Antivert) = or Dimenhydrinate (dramamine) avestibular
suppressant
C- Pseudoephedrine (Sudafed)
D- Promethazine (Phenergan)which immunization
13. Which of the following conditions is associated with chronic
bloody diarrhea?
A- Irritable bowel syndrome
B- Crohn’s disease
C- Hepatitis A
D- Celiac disease
14. What is the initial treatment for a patient with premenstrual
syndrome who is experiencing acute pain?
A- Black cohosh
B- B vitamins
C- Antidepressant agents
D- Heat applied to the lower abdomen
15. Why would a combined hormonal contraceptive be contraindicated
in a 36-year-old patient with a past medical history of diabetes,
obesity, current smoking and sedentary lifestyle?
A- She is obese
B- She has type 2 diabetes mellitus
C- Her age and tobacco use = risk for blood clots
D- She leads a sedentary lifestyle
16. A 53-year-old man might be experiencing symptoms of a small
bowel obstruction because he complains of:
A- Nausea and diarrhea
B- Vomiting and pain
C- Hematemesis and bloody stool
D- Indigestion and anorexia
17. Which of the following is a typical finding in a patient with a
meniscal tear?
A- Positive McMurray’s test = a test used to determine the presence of a
meniscal tear within the knee B- Positive anterior drawer test
C-Audible click at the joint line
D- Fixed patellar subluxation
18. When performing acuity test, the nurse practitioner notes 20/30 in
the left eye and 20/60 in the right eye. The next step is to:
A- Have the patient return in 2 weeks for a follow-up vision screen
B- Dilate the eyes and re-test
C- Refer the patient to an ophthalmologist
D- Document this is a normal finding
19. The medication that targets postprandial blood glucose by blocking
the transport of glucose across the intestine into the bloodstream is:
A- Metformin (Glucophage XR)
B- Acarbose (Precose) = this helps prevent sugars from passing through your
small intestine into your blood.
C- Rosiglitazone (Avandia)
D- Glipizide (Glucotrol XL)
20. A pediatric patient diagnosed with croup most likely presents with
which clinical finding?
A- Barking cough
B- Sudden onset of symptoms
C- Nighttime symptoms
D- Shortness of breath
21. What assessment finding suggests osteosarcoma in a pediatric
patient?
A- Pain in the affected bone
B- Pathologic fracture
C- Repeat fracture
D- Apophyseal avulsion
22. Which of the following is NOT a cause of unilateral rhinitis?
A- A foreign body in the nasal canal
B- A nasal polyp
C- Drug induced rhinitis
D- A deviated septum
23. A 64-year-old man complains of leg pain and occasional numbness
that worsens with ambulation and improves with lumbar flexion.
These symptoms are consistent with:
A- ankylosing spondylitis
B- spinal stenosis
C- bursitis Document continues below
Discover more from:
Pathophysiology and Pharmacology for Accelerated BSN Students I (NURS 316A )(NURS 316A )
49 documentsGo to course
- 7Sensory Case Study Pathophysiology and Pharmacology for Accelerated BSN Students I100% (6)
- 603p Answers Nisha – APEA Pathophysiology and Pharmacology for Accelerated BSN Students I80% (5)
- 5Unit 5glass fracture lab Pathophysiology and Pharmacology for Accelerated BSN Students INone
- 1Humans obtain energy to thrive and work from the food they eat Pathophysiology and Pharmacology for Accelerated BSN Students INone
- 53 Critical Concepts – NURS 180 Example – Updated Remediation Document Pathophysiology and Pharmacology for Accelerated BSN Students INone
- 2Nervous System Pathophysiology and Pharmacology for Accelerated BSN Students INone
D- cauda equina syndrome
24. What symptom would lead the nurse practitioner to suspect
atypical community-acquired pneumonia in an 18-year-old living in
a college dorm?
A- A low-grade fever, malaise, and clear lung fields on auscultation
B- A low-grade fever, malaise, and crackles audible throughout the
lung fields
C- Temperature of 101°F, sore throat, and diminished breath sounds
of auscultation
D- Temperature of 102°F, dyspnea, and diminished lung sounds of
auscultation
26. A 23-year-old baseball player is evaluated for left shoulder pain
secondary to a sports injury. Which of the four rotator cuff muscles
is affected if the patient has a pain with abduction movement of the
shoulder?
A- Supraspinatus = the supraspinatus can be tested by having the patient
abduct the shoulders to 90 degrees in forward flexion with the thumbs
pointing downward. The patient then attempts to elevate the arms against
examiner resistance. This is often referred to as the “empty can” test.
B- Infraspinatus
C- Levator scapulae muscle
D- Subscapularis
27. What is the mechanism of action of an alpha-adrenergic blocker in
patients with benign prostatic hyperplasia (BPH)?
A- To improve detrusor muscle stability
B- To reduce the size of the prostate gland
C- To relax the prostate smooth muscle = these medications, relax the
muscle of the prostate and bladder neck, which allows urine to flow more
easily. There are at least five medications in this category: terazosin (Hytrin),
doxazosin (Cardura), tamsulosin (Flomax), alfuzosin (Uroxatral), and
silodosin (Rapaflo).
D- To dilate the urethral vasculature
28. The nurse practitioner performs a breast exam and documents a
small fixed circular nodule at the “tail of Spence”. This is located:
A- In the upper inner quadrant
B- In the lower inner quadrant
C- In the lower outer quadrant
D- Laterally across the anterior axillary fold
29. Which lesion is dark, raised and asymmetric with irregular borders?
A- Nevus
B- Actinic keratosis
C- Keratoacanthoma
D- Melanoma
30. The secondary stage of syphilis is associated with which clinical
manifestation?
A- Absence of symptoms = (latent syphilis)
B- A single painless lesion (chancre) on the genital area = (primary
syphilis)
C- Rash marked by red or reddish-brown, penny-sizes lesions over
the palms and soles = does not itch, multiple painless lesions D- Poor
muscle coordination = (tertiary syphilis)
31. A 67-year-old woman with a history of arterial fibrillation and an
ejection fraction of 48% has had normal digoxin levels of 0.8-2
ng/dL for the past 9 months. Today the result was 0.4 ng/dL. What
could be the cause of this decrease in digoxin levels?
A- Decreased creatine clearance
B- Weight loss
C- Increased exercise
D- Regular use of an antacid
32. Short bands of tough, flexible, ropelike collagen fibrils that connect
two bones is called:
A- Tendons (connect muscle and bone)
B- Fibrous connective tissue
C- Ligaments = connect 2 bones
D- Cartilage (rubber like padding covers and protects the ends of long bone at
the joints), an fasciae (connect muscle to other muscle)
33. What is the drug of choice for a pediatric patient diagnosed with
scabies?
A- Clotrimazole (Lotrimin) lotion
B- Permethrin (Nix) cream
C- Lindane (Kwell)
D- Selenium sulfide (Selsun)
34. Which of the following complaints best describes lower extremity
calf pain associated with peripheral artery disease?
A- A sharp, stabbing pain
B- A dull pain or cramp
C- An electric shock
D- A pulsating pain
35. Which of the following warning signs of a headache do NOT warrant
an immediate investigation?
A- New onset after age 50
B- Aggravated or relieved by change of position
C- Precipitated by Valsalva maneuver
D- Relieved with use of common analgesics
36. A 77-year-old patient is diagnosed with new onset anemia. This
finding should prompt follow-up assessment for:
A- Constipation
B- Malignancy
C- Medication reaction
D- Associated fatigue
37. A patient with an acute presentation of acute aortic regurgitation
(AR) typically presents with sudden sever sharp lower extremity
edema, a rapid heartbeat, and:
A- Dry cough
B- Chest pain
C- Decreased blood pressure
D- – Systolic murmur (diastolic)
38. When assessing bilateral eye movement, the nurse practitioner is
assessing which cranial nerve?
A- CN II, III, IV
B- CN III, IV, VI = 3, 4, 6, Cranial nerves III (oculomotor), CN IV (trochlear), and
CVI (abducens) control the position of the eyeballs.
C- CN II, IV, VI
D- CN III, IV, VII
39. Before the nurse practitioner prescribes metronidazole (Flagyl) for a
patient with giardiasis it is important to inquire:
A- The presence of an allergy to sulfa
B- A past medical history of peptic ulcer disease
C- Whether the patient is at least 18 years old
D- Whether the patient drinks alcohol
Giardiasis is an infection in small intestine. It’s caused by a microscopic parasite
called Giardia lamblia. Giardiasis spreads through contact with infected people.
And you can get giardiasis by eating contaminated food or drinking contaminated
water. Pet dogs and cats also frequently contract giardia.
40. Which medication class is contraindicated in a pediatric patient
diagnosed with acute sinusitis?
A- Antihistamines
B- Expectorant
C- Decongestants
D- Nasal steroids
41. Which medication is used as an anticoagulant reversal agent for
dabigatran etexilate (Pradaxa)?
A- Idarucizumab (Praxbind)
B – Vitamin K – (warfarin coumadin)
C – Protamine sulfate – (heparin)
D – Fondaparinux (Arixtra) –
42. A prostate gland is found to be tender, swollen, boggy, and
warm on a digital rectal exam is consistent with:
A- A normal prostate gland
B- Acute bacterial prostatitis = bacterial prostatitis is an acute infection of
the prostate gland that causes pelvic pain and urinary tract symptoms, such
as dysuria, urinary frequency, and urinary retention, and may lead to
systemic symptoms, such as fevers, chills, nausea, emesis, and malaise.
C- Benign prostatic hyperplasia
D- Carcinoma of the prostate
43. Which of the following is the single-dose treatment for a patient
with diagnosed chlamydia?
A- Doxycycline (Vibramycin) 200 mg orally
B- Azithromycin (Zithromax) 1 gram orally
C- Metronidazole (Flagyl) 2 grams orally = trichomonas
D- Ceftriaxone (Rocephin) 250 mg intramuscular
44. What class of antibiotics can cause decreased hearing?
A- Aminoglycosides = vancomycin, streptomycin, gentamycin
B- Bata lactams
C- Cephalosporins
D- Macrolides
45. Findings of a nontender, enlarged scrotum in a 48-year-old man
suggests a concern for which condition?
A- Orchitis
B- Epididymitis
C- Hydrocele
D- Prostatitis
46. A 17-year-old is diagnosed with mild bronchospasm. Which if the
following would provide relief?
A- Inhaled mometasone (Asmanex)
B- Inhaled levalbuterol (Xopenex) = a quick relief drug (bronchodilators)
C- Oral montelukast (Singulair)
D- Oral dextromethorphan/guaifenesin product
47. What condition presents with facial features of an elongated
head and body prominence of the forehead, nose and lower
extremities?
A- Nephrotic syndrome
B- Acromegaly
C- Cushing’s syndrome
D- Parkinson’s disease
48. Which statement is true about varicose veins?
A- They are due to congenital valve deformities
B- They are usually diagnosed on clinical presentation
C- They are not affected by pregnancy
D- They are more symptomatic during ovulation
49. What is the mechanism of action for prostaglandin E1 (PG1) in a
patient with transposition of the great arteries?
A- To maintain equal pressure in the ventricles
B- To maintain patency of the great arteries
C- To produce vasodilation and adequate oxygen saturation
D- To prevent cyanotic episodes by trapping blood in the lower
extremities
50. The right lymphatic ducts drain into what part of the circulatory
system?
A- Arterial
B- Venous = subclavian veins, venous circulation
C- Arteriovenous system
D- Capillary bed
51. A 70-year-old woman is seen in the office for complains of
mouth soreness that deters eating. During the assessment,
findings include a glossy, smooth, beefy-red tongue. This suggests:
A- Pernicious anemia due to insufficient intrinsic factor = pernicious
anemia caused by Vit. B12 deficiency result in megaloblastic anemia may
represent glossitis
B- Secondary hypothyroidism
C- Cheilosis, a serious disease of the mouth and oropharynx D- A
neurological disorder such as Parkinson’s disease.
52. How would a condylomata acuminate lesion in a man be
described in the medical record?
A- A group of small scattered vesicles
B- A chancre
C- Multiple papular lesions with verrucous appearance
D- A red, nontender, enlarging indurated nodule on the penis
Condyloma acuminatum is a single genital wart
Condylomata is multiple popular lesions/genital warts (cauliflower like)
verrucous appearance
3.
53. Based on the mechanism of hearing, sensorineural loss in an
adult involves the:
A – Cochlea and the cochlear nerve = cochlea and vestibulocochlear
nerve CN VIII
B – External ear canal and the middle ear
C – Ossicles and the inner ear
D – Transfer of sounds from the external environment into the external
auditory canal
54. Which of the following is commonly associated with increased
risk for prostatic hypertrophy?
A- Constipation
B- Fecal incontinence
C- Urinary tract infections
D- Prostate cancer
55. Which of the following risk factors is NOT associated with breast
cancer?
A- Personal family history of breast cancer
B- Use of hormone replacement therapy
C- Postmenopausal obesity
D- Low socioeconomic status
56. Which area of the body should be assessed if an enlarged right
epitrochlear lymph node is palpated?
A- Throat, face and right ear
B- Neck and supraclavicular region
C- Right forearm and hand
D- Right groin and abdomen
57. A child with a history of enuresis (involuntary urination, especially
by children at night) should be treated with desmopressin acetate
(DDAVP) nasal spray for:
A- Daytime incontinence
B- Urinary pain
C- Secondary enuresis
D- Nocturnal enuresis
58. What diagnostic test is performed to diagnose acute
lymphocytic leukemia (ALL)?
A- A complete blood count with differential
B- Magnetic resonance imaging
C- A nuclear bone scans
D- A bone marrow examination = bone marrow biopsy
59. When evaluating a 17-year-old girl with infrequent menstrual
periods, which finding suggests probable hyperandrogenism?
A- High pitched voice
B- Hirsutism
C- Polycystic ovaries Obesity
60. The American Psychiatric Association’s Diagnostic and Statistical
Manual of Mental Disorders, Fifth Edition (DSM-5) describes
Munchausen syndrome by proxy is:
A- A self-inflicted injury to gain attention
B- A caregiver making up or causing an illness or injury in a person
under his or her care
C- An abusive behavior that does not involve the caregiver
D- A situation in which the abuser is often inattentive and uncaring
toward the victim
61. A woman who is 30 weeks pregnant has a blood pressure of
155/92 mmHg. Which of the following is the most appropriate
antihypertensive medication for her?
A- Candesartan
B- Lisinopril
C- Methyldopa = labetalol, nifedipine
D- Furosemide
62. Finding of a firm, nodular hypertrophic mass of scar tissue on
the posterior surface of a pierced ear lobe is documented as:
A- a keloid
B- a tophi = a deposit of crystalline uric acid (gout)
C- a cutaneous cyst
D- chondrodermatitus
D-
63. Physical assessment of a child with Down syndrome should
focus on what body system for further evaluation?
A- Orthopedic
B- Gastrointestinal
C- Cardiac = especially in first 12 mos. of life D- Endocrine
64. Rh-negative women should receive Rho (D) immune globulin at
what gestational time?
A- 6 weeks
B- 12 weeks
C- 28 weeks = of pregnancy then again w/in 72 hrs. after delivery, not
administered before 28th week D- 35 weeks
65. Patients with asthma have a pathological finding of:
A- Necrosis of small airways
B- Absence of goblet cells
C- Absence of ciliary regeneration
D- Hypertrophy of smooth muscle
66. A 52-year-old man who takes warfarin for a deep vein
thrombosis (DVT) missed his morning dose of warfarin 5mg
yesterday and today. The patient should be instructed to:
A- Wait until tomorrow and resume dosing of warfarin 5mg
B- Take warfarin 10mg now
C- Take warfarin 5mg now, warfarin 5mg at 5pm today and resume
the daily warfarin 5mg dose in the morning scheduled. Take
warfarin 5mg now and resume the warfarin 5mg daily doze in the
morning as scheduled
67. Which immunization is recommended during adolescence for
the prevention of a common sexually transmitted viral infection?
A-Shingles (herpes zoster) vaccine
B- Human papillomavirus (HPV) vaccine
C- Hepatitis A vaccine
D- Chlamydia vaccine
68. Fine, silky appearance of the hair is a common finding in:
A- Hypothyroidism
B- Hyperthyroidism
C- Type 2 diabetes
D- Celiac disease
69. Which of the following hematology findings suggests need for
further evaluation in a patient with a history of cardiac disease?
A- Hematocrit 42% (normal male 38.5 – 50%, female 34.9 – 44.55%)
B- Potassium 4.2 mg/dL (normal 3.5 – 5.5 mg/dl)
C- Sodium 140 mEq/dL (normal 135 – 145 mg/dl)
D- Low density lipoprotein of 190 mg/dL = (LDLbad cholesterol,
elevated, normal is 100 – 129mg/dl)
HDL = is good cholesterol, H means “Happy”
70. What clinical emergency is associated with findings of
papilledema?
D-
A- Optic atrophy
B- Microaneurysms
C- Increased intercranial pressure = underlying brain mass
D- Retinal hemorrhages
71. A 74-year-old man who recently lost his spouse of 50 years in an
auto accident tells the nurse practitioner that he “has no purpose
in this life.” The next most appropriate question for the nurse
practitioner to ask is:
A- “Have you told your family how you feel?”
B- “Have you thought about hurting yourself?”
C- “Are you taking your medications?”
D- “Do you have any friends?”
72. A 45-year-old carpenter complains of a foreign body sensation in
is left eye with tearing and itching. During the ophthalmoscopic
exam, a triangular thickening of the bulbar conjunctiva is found at
the outer surface of the cornea. This finding is consistent with:
A- Corneal arcus
B- Corneal scar
C- Pterygium
D- Cataract
73. Patients with Parkinson’s disease exhibit sustained resistance to
passive movement throughout the range of motion, with no
fluctuations. This muscle tone is referred to as:
A- Spasticity
B- “lead-pipe” rigidity
C- Flaccidity
Paratonia
74. Which of the conditions is NOT a typical finding of
hyperprolactinemia in a 47-year-old premenopausal woman?
A – Hirsutism (facial hair growth)
B – Gynecomastia = should be milky discharge from the breasts (galactorrhea)
when not pregnant or breast-feeding.
C – Oligomenorrhea (irregular menstrual periods (oligomenorrhea) or no
menstrual periods (amenorrhea)
D – Acne (acne and excessive body hair)
75. Patients with bacterial meningitis experience headache symptoms
due to:
A- Meningeal erythema
B- Increased intracranial pressure
C- Meningeal irritation = swelling from meninges
D- Swelling of the spinal cord
76. Which medication is indicated for patients with generalized
anxiety disorder (GAD)?
A- Buspirone (BuSpar)
B- Citalopram (Celexa)= SSRI’s
C- Imipramine (Tofranil) – (tricyclic antidepressant)
D-
D- Bupropion HCI (Wellbutrin)
77. Why is phenazopyridine (Pyridium) prescribed for short-term use
only in patients with urinary tract infections?
A- Possible resistance
B- Occurrence of hemolytic anemia = hepatotoxicity, impaired liver
function, nephrotoxicity)
C- Gastritis
D- Cost
Phenazopyridine is used to treat urinary symptoms such as pain or burning,
increased urination, and increased urge to urinate. These symptoms can be
caused by infection, injury, surgery, catheter, or other conditions that irritate the
bladder.
4.
78. How would a condylomata acuminata lesion in a man be described
in the medical record?
A- A group of small scattered vesicles
B- A chancre
C- Multiple papular lesions with verrucous appearance
D- A red, nontender, enlarging indurated nodule on the penis
79. Which medication is used as an anticoagulant reversal agent for
dabigatran etexilate (Pradaxa)? A- Idarucizumab (Praxbind)
B- Vitamin (coumadin)
C- Protamine sulfate (heparin)
D- Fondaparinux (Arixtra)
80. The immunization that protects against the contagious disease that
causes fever, headache, stiff neck, photophobia, and altered mental
status is?
A- Meningococcal vaccine
B- Pneumococcal vaccine
C- Measles, mumps, and rubella (MMR) vaccine. D- Varicella vaccine
81. Which pathogen is the most common cause of gastroenteritis?
A- Helicobacter pylori
B- Escherichia coli
C- Norovirus (and campylobacter in adult, and in children rotavirus) D-
Vibrio cholera
82. Primary syphilis is characterized by what type of lesion?
A- A cluster of scattered vesicles
B- Chancre = a small painless open sore
C- Papule of many shapes
D- Nontender indurated penile nodule
83. A nonpregnant woman is diagnosed with trichomoniasis should be
treated with:
A- Metronidazole (Flagyl) = 2g PO single dose
B- Doxycycline (Vibramycin)
C- Clindamycin (Cleocin)
D- Clotrimazole (Lotrimin)
84. Which of the following conditions is NOT a typical finding of
hyperprolactinemia in a 47-year-old premenopausal woman?
A-Hirsutism
B- Gynecomastia
C- Oligomenorrhea
D- Acne
85. Which form of urinary incontinence is present in a patient with
Alzheimer’s disease who is unable to reach the toilet in time?
A- Functional incontinence
B- Overflow incontinence
C-Urge incontinence = The most common type of urinary incontinence in
patients with Alzheimer’s disease is urge urinary incontinence.
D-Stress incontinence
Functional incontinence is characterized by involuntary urine loss due to
factors outside the lower urinary tract. For example, if a patient has no stress or
urge symptoms or a high postvoid residual but is incontinent because he or she
cannot reach the bathroom in a timely manner, it may be termed functional
incontinence.
Functional incontinence is related to impaired cognitive functioning and
mobility. With functional incontinence, lower urinary tract function is intact, but
decreased cognitive functioning prevents individuals from recognizing the need to
use the restroom, or decreased mobility affects the ability to reach the restroom
in time.
86. A 34-year-old man presents with complaints of abdominal pain. The
nurse practitioner suspects hemorrhagic pancreatitis due to findings of
superficial edema, bruising around the umbilicus(Cullen’s sign), and what
other assessment finding?
A- A positive Gray Turner’s sign = ecchymosis of the flank
B- A positive Cullen’s sign (ecchymosis and edema in the subcutaneous
tissue around the umbilicus)
C- Kaposi’s sarcoma
D- Petechiae
87. Which of the following breast mass findings does NOT suggest
possible malignant breast lesions?
A- Solitary with irregular borders (cancer – irregular in shape)
B- Movable and “rope-like”
C- Hard and attached to adjacent tissue (cancer – firm, solid, fixed to the
tissue)
D- Ipsilateral and nontender (cancer- painless)
88. A 42-year-old woman with a past medical history of migraine
headaches is requesting prophylactic medication treatment. Which
medication should NOT be prescribed?
A- Sumatriptan (Imitrex)
B- Amitriptyline (Elavil)
C- Verapamil (Verelan)
D- Metoprolol (Lopressor)
Prophylaxis: preventive
Beta Blocker
Elavil
Topamax
Abortive: acute attack
Triptan family
Fioricet (meds with caffeine)
89. To increase urine outflow in men with benign prostatic hyperplasia
(BPH), the nurse practitioner should prescribe:
A- An alpha blocker = an antagonist and anti-androgens or a combination of
two, relax smooth muscle including bladder outlet muscles Ex. “sin ending”
alfuzosin, prazosin, terazosin, doxazosin, silodosin, tamsulosin.
B- An alpha agonist
C- A calcium channel blocker
D- A diuretic
90. A pediatric patient has areas of scaling on the scalp, with round
patches of alopecia. This clinical finding is consistent with:
A- Tinea capitis = also known as “Ringworm” of the scalp is a fungal
infection, itchy, scaly, bald patches on the head
B- Seborrheic dermatitis (red, itchy rash on your scalp that has flaky scale)
C- Trichotillomania – (normal scalp appearance without inflammation but
has patchy hair loss)
D- Alopecia areata – (normal scalp appearance without scales and erythema
but has single or multiple hair patches)
91. Which diagnostic test is ordered to measure the renal function in a
patient with suspected insufficiency?
A- Blood urea nitrogen (BUN)
B- Serum creatine = most sensitive test for kidney function
C- A 24-hour creatine clearance
D- Serum uric acid
92. A ‘mask-like” facial appearance, a characteristic stare and
decreased blinking are features of:
A- Nephrotic syndrome
B- Myxedema
C- Cushing syndrome
D- Parkinson disease
93. Which medication prescribed is appropriate for a woman with a
history of sphincter incompetence and stress incontinence?
A- Prazosin (Minipress)
B- Bethanechol (Urecholine, Myotonachol)
C- Pseudoephedrine = alpha adrenergic agonist (strengthen the muscle that
opens and closes the urinary sphincter does treat stress incontinence)
D- Flavoxate (Urispas) = is a synthetic urinary tract spasmolytic used to treat
bladder symptoms such as frequent or urgent urination, increased
nighttime urination, bladder pain, and incontinence (urine leakage).
94. The proper TPAL documentation for a woman with a maternity
history of an uncomplicated vaginal delivery at 38 weeks, cesarean
section for premature triplets, and an elective abortion at 8 weeks
is documented as:
A- Gravida 4, para 1114
B- Gravida 4, para 1314
C- Gravida 3, para 1114 = Term, Premature birth, Abortion, Living D-
Gravida 3, para 1112
Gravida = total number of pregnancies (a woman who is pregnant now or has
been pregnant)
Term = born at 37 to 41 weeks
Premature = born between 20 to 36 weeks
Abortion = happened or born before 20 weeks
Living = currently living
95. Which finding suggests possible serotonin syndrome in a patient
currently taking nortriptyline?
A- Depression
B- Anxiety, manic behavior
C- Rapid heart rate, high blood pressure
D- Decreased levels of serotonin
Nortriptyline is a tricyclic antidepressant. It affects chemicals in the brain that
may be unbalanced in people with depression. Nortriptyline is used to treat
symptoms of depression. Nortriptyline may also be used for purposes not
listed in this medication guide.
96. What is the first-line treatment for a patient with newly diagnosed
osteoarthritis?
A- Diagnostic workup to rule out rheumatoid arthritis
B- NSID use at lowest effective dose
C- Acetaminophen use up to 4 grams daily
D- Exercise and weight loss
97. What is the initial treatment for a patient with premenstrual
syndrome who is experiencing acute pain?
A- Black cohosh
B- B vitamins
C- Antidepressant agents (first line SSRI’s)
D- Heat applied to the lower abdomen
98. Which one of the following risk factors is NOT associated with
breast cancer?
A- Personal family history of breast cancer
B- Use of hormone replacement herapy
C- Postmenopausal obesity
E- Low socioeconomic status
99. The finding of a dome-shaped lesion in the dermis that forms a
benign, close, firm sac attached to the epidermis?
A- A keloid
B- A tophi
C- A cutaneous cyst
D- Chondrodermatitis
100. When educating a patient with moderate persistent asthma about
fluticasone/salmeterol (Advair), the nurse practitioner should
explain that:
A- It is not effective during an acute asthma attack = will not stop
asthma attack once one has started.
B- It may take 2 to 3 weeks to be effective
C- This drug works within 10 minutes
D- This drug may be used my patients 6 years and older
101. Which of the following is NOT a location of pain associated with
kidney and ureter disorders?
A- Flank
B- Abdominal (lower)
C- Back
D- Suprapubic
102. Which clinical condition is treated with anticholinergic (anti
spasmodic) medications?
A- Asymptomatic bacteriuria
B- Renal insufficiency
C- Urge incontinence = and stress incontinence Ex. Detrol, Ditropan, Uripas,
Enablex, Oxytrol, Vesicare
D- Overflow incontinence
103. A 21-year-old woman with bulimia is likely to be:
A- Very overweight
B- Very underweight
C- Of average weight
D- Not concerned with weight
104. A 65-year-old patient with a history of deep vein thrombosis (DVT)
is being treated for a dental abscess. Which antibiotic is safe to use
with Warfarin (Coumadin)?
A- Amoxicillin (Amoxil)
B- Trimethoprim/sulfamethoxazole (Bactrim)
C- Ciprofloxacin (Cipro)
D- Clarithromycin (Biaxin)
105. A 3-year-old child has enterobiasis. When should the dose of
mebendazole (Vermox) be repeated?
A- In 3 days
B- In 1 week
C- In 2 weeks
D- In 3 weeks
7.
106 Vitamins prescribed for pregnant woman should contain what two
components?
A- Folic acid and vitamin C
B- Iron and vitamin B12
C- Vitamin D and iron
D- Folic acid and iron
107. A 62-year-old man is being treated for tinea capitis (ringworm ) that
he contracted from his cat. He is currently taking griseofulvin (Grifulvin
V) 500mg BID (treatment of choice) as directed for 3 weeks and only
has marginal improvements to the site. The next step is to:
A- Add 2.5% selenium sulfide shampoo twice weekly to the
treatment regimen
B- Have the patient shave his head and warn him that hair regrowth
will be slow (not necessary)
C- Initiate a short course of oral steroids to reduce inflammation and
prevent scaring.
D- Continue the current therapy for a total of 6-8 weeks = treatment
usually 4 to 6 weeks
108. Pregnant woman are evaluated for syphilis with serology testing
because:
.
A- Syphilis during pregnancy predisposes the fetus to spontaneously
abortion or the newborn to have congenital syphilis
B- Hormonal changes associated with pregnancy may trigger
activation of latent syphilis
C- Syphilis may be passed to the fetus beginning in the third
trimester
D- Untreated syphilis can cause neonatal respiratory distress
109. Rapid immunodeficiency virus (HIV) testing would be appropriate
for a patient with complaints of:
A- Painful bowel movements, anal itching, and painful or swollen
testicles or abdominal menstrual bleeding
B- Painful urination, dyspareunia, and vaginal or penile discharge
C- Painful urination, lower abdominal pain, and dyspareunia
D- Fever, headache, and lymphadenopathy = Lymphadenopathy or
adenopathy is disease of the lymph nodes, in which they are abnormal in
size, number, or consistency
110. Which of the following skin assessment is NOT a normal finding
associated with the aging process?
A- Xerosis(dry skin)
B- Cherry angiomas and senile purpura (common in aging)
C- Senile keratoses and senile lentigines (Seborrheic keratosis is one of
the most common noncancerous skin growths in older adults and Senile
lentigo or age spots are hyperpigmented macules of skin that occur in
irregular shapes, appearing most commonly in the sun-exposed areas of the
skin such as on the face and back of the hands) D- Dermatophytosis =
ringworm
111 What medication should be avoided when prescribing prophylactic
therapy for headaches in a patient with a history of asthma (and COPD)
and chronic migraines?
A- Verapamil
B- Propranolol = Beta-adrenergic blocking agent, non-cardio selective with
history of asthma and COPD can cause acute bronchospasm and severe
asthma exacerbation)
C- Venlafaxine
D- Nimodipine
112. A 32-year-old presents with dull puffiness of the eyes with
pronounced non -pitting periorbital edema . This finding is
suggestive of what condition?
A- Nephrotic syndrome
B- Myxedema = severe hypothyroidism
C- Cushing’s syndrome
D- Sinusitis
113. A 26-year-old woman complains of acute right lower abdominal
pain. Which of the following conditions is NOT associated with this
symptom?
A- Ectopic pregnancy
B- Pelvic inflammatory disease
C- Irritable bowel syndrome = Abdominal/stomach pain, cramping or
bloating that is typically relieved or partially relieved by passing a bowel
movement
D- Ruptured ovarian follicle
.
114. A common cause of decreased libido in men is due to:
A- Decreased blood flow in the hypogastric arterial system B-
Endocrine dysfunction = DM, higher than normal prolactin level
(hyperprolactinemia), low testosterone level which cause decrease libido
and secondary erectile dysfunction
C- Neurologic deficits
D- Impaired neural innervation
115. A clouding opacity of the eye is noted on ophthalmoscopic
examination. This is suggestive of:
A- – corneal arcus
B- – a corneal scar
C- – a pterygium
D- – a cataract
Corneal Arcus, sometimes referred to as Arcus Senilis in an older patient, is a
greyish or yellowish opaque colored ring or arc around the peripheral cornea of
both eyes. The corneal arcus ring consists of lipid/cholesterol deposits in the
periphery of the cornea stromal layer.
Corneal Scar may be caused by injury to the cornea (abrasion, laceration, burns,
or disease); depending on the degree of scarring, vision can range from a blur to
total blindness Surface abrasions, although extremely painful, heal transparently
(do not leave scars).
Pterygium, the main symptom of surfer’s eye, or pterygium is a growth of pink,
fleshy tissue on the conjunctiva, the clear tissue that lines your eyelids and covers
your eyeball. It usually forms on the side closest to your nose and grows toward
the pupil area.
116 Which immunization protects against the virus that is transmitted
via blood and body fluid and can lead to chronic liver disease?
A- Hepatitis C vaccine (vaccine not currently available, transmitted via
blood)
B- Hepatitis A vaccine (vaccine is available, but transmitted primarily by the
fecal-oral route)
C- Hepatitis B vaccine = vaccine available, transmitted via blood and body
fluid
D- Typhoid fever vaccine (vaccine available, but it is a bacterial infection)
117. Osler nodes, Janeway lesions, and petechiae are symptoms found
in patients with:
A- Gonococcemia
B- Infective endocarditis
C- Hyperthyroidism
D- Peripheral vascular disease
Bacterial endocarditis is an infection of the lining of the heart caused by various
bacteria. It most often affects the heart valves. The bacteria gain access to the
heart via the bloodstream; an infection elsewhere in the body may or may not be
apparent. While some bacteria can cause infection in normal heart valves,
bacterial endocarditis more commonly affects patients with abnormal valves as a
result of previous rheumatic fever , valve surgery/replacement, or congenital
abnormalities.
The responsible bacteria include various species of staphylococcus ,
streptococcus , pseudomonas , bartonella and several other organisms.
.
Bacterial endocarditis is often divided into ‘acute’ and ‘subacute’ varieties
depending on the speed that it progresses. The symptoms may include fever,
lethargy, shortness of breath, chest pain or palpitations. These symptoms require
prompt assessment and investigation by a physician.
Osler nodes
Osler nodes are red-purple, slightly raised , tender lumps, often with a pale center .
Pain often precedes the development of the visible lesion by up to 24 hours. They
are typically found on the fingers and/or toes. They can occur at any time during
endocarditis (usually subacute) and last from hours to several days.
Janeway lesions
In contrast to Osler nodes, Janeway lesions are non-tender , often hemorrhagic
(bleeding into the skin), and occur mostly on the palms and soles including the
thenar and hypothenar eminences (at the base of the thumb and little finger
respectively). They tend to last days to weeks before healing totally. They are
more commonly seen in acute endocarditis, when bacteria such as
Staphylococcus aureus may be cultured from them. The histology is usually
consistent with septic micro-embolism (i.e. bacteria may be found within the
blood vessels).
118. During an abdominal examination, the nurse practitioner
percusses the bulging area of the abdomen. Which sound suggests the
presence of ascitic fluid (ascites)?
A- Tympany (drum-like sounds heard over air/gas filled structure)
B- Dullness = dull sounds that occur when a solid structure (e.g. liver) or fluid
(e.g. ascites) lies beneath the region being examined
C- Hyperresonant sounds (pneumothorax, said to sound similar to percussion
of puffed up cheeks)
D- Normal resonance (resonant, the sound produced by percussing a normal
chest)
119. When interpreting a complete blood count (CBC) lab report, which
of the following results describes the size of the RBC’s?
A- Hemoglobin (is a protein in red blood cells that carries oxygen throughout
the body)
B- Mean corpuscular volume (MCV) (is a measure of the average volume of
red blood cell)
C- Red cell distribution width (RDW) = measures the range in the volume and
size of your red blood cells (erythrocytes)
D- Hematocrit (the ratio of the volume of red blood cells to the total volume of
blood)
120. Which condition is associated with end-stage renal disease in
pediatric patients and requires recombinant erythropoietin treatment?
A- Osteodystrophy
B- Hyperkalemia
C- Hypertension
D- Anemia
121. Which is the appropriate medication of choice for a 31-year-old
pregnant patient diagnosed with a urinary tract infection?
A- Cefuroxime (Zinacef) or Nitrofurantoin (Macrobid)
B- Nitrofurantoin (Macrobid) or Ciprofloxacin (Cipro)
C- Ciprofloxacin (Cipro) or Tetracycline (Sumycin)
D- – Tetracycline (Sumycin) or Amoxicillin (Amoxil)
122. Which immunization reduces a patient’s risk for infection with the
virus that causes painful, localized, blistering rash.
A – Smallpox vaccine
B – Varicella vaccine (chicken pox)
C – Shingles (herpes zoster) vaccine
D – Meningoococcal vaccine
123. Which of the following if used during pregnancy, increases the risk
of hepatitis C and HIV in a mother as well as birth defects, prematurity
and stillbirth in the infants?
A – IV narcotic drug
B – Alcohol
C – Tobacco
D – Benzodiazepine
124. The nurse practitioner prescribes deferoxamine (Desferal) for a
pediatric patient with beta thalassemia hemosiderosis because the
medication:
A- – prevents blood transfusion reaction
B- – stimulates red blood cell production
C- – improves the oxygen-carrying capacity of RBC’s
D- – eliminates excessive iron and prevents organ damage. =
Deferoxamine is used to treat iron overload caused by blood transfusions in
adults and children at least 3 years old. Deferoxamine binds to iron and removes it
from the blood stream.
125. A 42-year old woman has erythema and swelling of the left breast
that has progressed rapidly. These symptoms are associated with which
type of breast cancer?
A- – Paget’s disease
B- -Invasive ductal carcinoma
C- -Inflammatory breast cancer
D- – Invasive lobular carcinoma
126. A 52-year old woman is inquiring about estrogen replacement
therapy for symptoms of menopausal which of the following is a
contraindicated?
A- – History of phlebitis
B- – Prior or present migraine headaches
C- – Family history of lung cancer
D- – Prior breast or uterine carcinoma
127. Which of the following conditions is NOT associated with the
symptoms of hemoptysis? A – Pulmonary emboli
B – Chronic bronchitis
C – Viral pneumonia
D – Neoplasm of the lung
Bacterial pneumonia can cause hemoptysis but not viral
128. Which of the following are NOT associated with pyloric stenosis in
a 2-month old infant?
A- – Projectile vomiting
B- – Severe dehydration as demonstrated by sunken eyeballs and
depressed anterior fontanelle
C- – A bloated and tense, tympanic abdomen
D- – A palpable mass the size and shape of an olive, located in the right
upper quadrant of the abdomen
129. A pediatric patient has area of scaling on the scalp, with round
patches of alopecia. This clinical finding is consistent with:
A- – tinea capitis = scalp “ring worm”, a fungal infection
B- – seborrheic dermatitis
C- – trichotillomania
D- – alopecia areata
130. A 61-year old man’s chest X-ray result indicates left lower lobe
pneumonia. He has a past medical history of a right nephrectomy. He
should be treated with:
A – a shorter course of antibiotics
B – a longer course of antibiotics
C – a lower dose of antibiotics
D – a higher dose of antibiotics
131. Which of the following is NOT a common symptom of Vitamin B12
deficiency?
A- Sore Tongue
B- Fatigue
C- Constipation
D- Vomiting
132. What clinical condition is treated with anticholinergic medication?
A- – Asymptomatic bacteriuria
B- – Renal insufficiency
C- Urge incontinence = Ex. Oxybutynin, Tolterodine
D- – Overflow incontinence
133. Assessment findings of a swan neck and boutonniere deformity are
typically associated with which diagnosis?
A- Gouty arthritis
B- Rheumatoid arthritis
C- Turner’s syndrome
D- – Osteoarthritis
134. The most common chief complaint of a woman diagnosed with
trichomoniasis is:
A- A Painless, ulcerated vulvar lesion with vaginal discharge.
B- Fever, papules, and vaginal discharge with burning
C- A vaginal discharge
D- Dyspareunia and upper abdominal pain
135. A 63-year-old man has decreased chest expansion, symmetric
thorax with moderate kyphosis, and bilateral diaphragm distention
of 2 cm. Which diagnosis is likely?
A- Pneumothorax
B- Pleural effusion
C- A fractured rib
D- Chronic obstructive pulmonary disease = (COPD)
136. Which answer best describes a presentation that is common in
men with cancer?
A- A group of small scattered vesicles
B- A chancre
C- Papules with a variety of shapes
D- A nontender indurated penile nodule
137. A condition in which pus gathers in the area between the lungs
and the inner surface of the chest wall is called:
A- Pericardial effusion (water or fluid) B- Pleural effusion (water on the
lung)
C- Pleural empyema = pus
D- Chylothorax (lymphatic fluid leaks)
138. What is the mechanism of action of prostaglandin E1 (PG1) in a
patient with transposition of the great arteries? A – To maintain
equal pressure in the ventricles
B – To maintain patency of the great arteries
C – To produce vasodilation and adequate oxygen saturation D – To
prevent cyanotic episodes by trapping blood in the lower
extremities
139. Patients with psoriasis frequently have:
A- Pruritus, positive Auspitz sign, and pitted nails
B- Pruritus, pitted nails, and satellite lesions
C- Pitted nails and plaques
D- Dermatomal rash and satellite lesions
140. Hyper kalemia is associated with:
A- increased blood pressure
B- alpha blockers
C- diminished renal function
D- loop diuretics (potassium wasting diuretics, can cause hypokalemia)
141. Which condition is caused by an insufficiency of intrinsic factor by
the gastric mucosa and vitamin B deficiency?
A- Diarrhea
B- Pernicious anemia
C- Osteoporosis
D- Muscle weakness
142. When performing a visual acuity test, the nurse practitioner notes
20/30 in the left eye and 20/60 in the right eye. The next step is to:
A- Have the patient return in two weeks for a follow-up vision screen.
B- Dilate the eyes and retest
C- Refer the patient to an ophthalmologist
D- Document this as a normal finding
Explanation:
20/30 right eye = means your right eye can read at 20 feet , but people with
normal vision can read at 30 feet.
20/60 left eye = means your left eye can read at 20 feet, but people with normal
vision can read at 60 feet.
143. Which of the following symptoms is NOT typically experienced by a
patient with later stage human immunodeficiency virus (HIV)
disease? A- Night sweats
B- Lymphadenopathy (swelling of the lymph nodes for more than 3 months)
C- Persistent vomiting
D- Persistent, unexplained fatigue
144. Emollient therapy is being used for a patient with an acute flare of
atopic dermatitis. After insufficient response to this therapy, what
is the next basic choice of treatment?
A- Oral corticosteroids (Prednisone)
B- – Betamethasone dipropionate 0.05% (Betanate)
Betamethasone topical = is a topical steroid, used to treat the inflammation and itching
caused by a number of skin conditions such as eczema or psoriasis )
C- – Desonide 0.5% (Desonate)
D- – Pimecrolimus 1% cream (Elidel)
Emollient is the first line treatment, emollients are a safe, effective treatment to
moisturize, lubricate and soothe dry skin but are often underused. They are
essential for successful treatment of any dry skin condition such as eczema,
psoriasis or ichthyosis. With regular and correct use some patients may be able to
reduce the amount of topical steroid used and possibly maintain their skin with
emollients alone.
145. Which finding is associated with early clinical development of
diabetic nephropathy?
A- An elevation in blood urea nitrogen (BUN)
B- An elevation in blood urea nitrogen (BUN) and creatinine (Cr)
C- A decreased glomerular filtration rate
D- Microalbuminuria = protein in urine, urine albumin
146. Which assessment findings are NOT associated with pyloric
stenosis in a 2-month-old infant?
A- Projective vomiting
B- Severe dehydration as demonstrated by sunken eyeballs and
decreased anterior fontanelle
C- A bloated and tense tympanic abdomen
D- A palpable mass the size and shape of an olive, located in the right
upper quadrant of the abdomen
147. What is the area of fundal height palpation on a woman who is 12
weeks pregnant?
A- At the level of umbilicus (20 weeks)
B- At the level of the symphysis pubis = 12 weeks
C- Midway between the symphysis and umbilicus (16 weeks) D- Below
the symphysis pubis (below 10 weeks)
148. A patient has a left pulmonary embolism (PE). Which medication
inhibits blood coagulation by selectively blocking the active Factor
Xa?
A- Enoxaparin (Lovenox)
B- Apixaban (Eliquis)
C- Warfarin (Coumadin)
D- – Dabigatran etexilate (Pradaxa)
149. Jugular venous distention that accompanies chest pain is often
associated with:
A- hypertension
B- heart failure
C- asthma
D- pneumonia
150. Recommended combination therapy for uncomplicated anorectal
and pharyngeal gonorrhea is:
A- Ceftriaxone and benzathine penicillin
B- Benzathine penicillin and doxycycline
C- Doxycycline and ciprofloxacin
D- Ceftriaxone and azithromycin = (ceftriaxone 250mg IM once and
azithromycin 1g orally once, administered together on the same day)
151. Rapid human immunodeficiency virus (HIV) testing would be
appropriate for a patient with complaints of:
A- Painful bowel movements, anal itching, and painful or swollen
testicles or abdominal menstrual bleeding.
B- Painful urination, dyspareunia, and vaginal or penile discharge
C- Painful urination, lower abdominal pain, and dyspareunia
D – Fever, headache, and lymphadenopathy
152. An 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
forgetting within the last few weeks. Which medication is most
likely associated with these symptoms?
A- Cimetidine (Tagamet)
B- Warfarin (Coumadin)
C- Ramipril (Altace)
D- Vitamin B12
153. During the breast examination of a perimenopausal woman, the
NP detects a bloody spontaneous discharge from the right nipple.
This indicates further ….. ??????
A- Fibroadenoma
B- Polycystic breast disease
C- An intraductal papilloma
D- Pituitary prolactinoma
154. Why should anticholinergic medications be avoided in patients
with a past medical history of benign prostatic hyperplasia (BPH)?
A- It causes urinary incontinence
B- It causes constipation
C- It causes orthostatic hypotension
D- It causes urinary retention
155. Which is a TRUE statement about varicose veins?
A- – They are due to congenital valve deformities
B- -They are usually diagnosed on clinical presentation
C- – They are not affected by pregnancy
D- – They are more symptomatic during ovulation
*** 156. A 48-year-old male diagnosed with hypertension. He has a
history of gout which medication should be avoided in this patient?
A- Amiodarone (Norvasc)
B- Hydrochlorothiazide (Microzide)= diuretic can cause build-up of uric
acid, increase urination C- Propranolol (Inderal)
D- Losartan (Cozaar)
157. Hispanic woman who is 26 weeks pregnant states that she
recently began eating ice chips between meals. The nurse practitioner
should.
A- Have the patient checked for diabetes.
B- Assess the patient for iron deficiency anemia.
C- Encourage the patient to eat more at meal times.
D- Tell the patient that this cultural practice can be harmful.
Pica = is a condition in which pregnant women compulsively eat nonfood items
(over the course of at least a month) that don’t have any nutritional value, like dirt
and clay.
158. A 42-year-old man states that he has been experiencing bouts of
fever and arthralgia. He has also developed several hemorrhagic
vesiculopustular eruption lesions over his hands and feet. The nurse
practitioner suspects.
A- Gonococcemia
B- Infective endocarditis
C- Hyperthyroidism
D- Peripheral vascular disease
Gonococcemia = also known as “Arthritis–dermatosis syndrome” and
“Disseminated gonococcal infection”, is a condition characterized by a
hemorrhagic vesiculopustular eruption, bouts of fever , and arthralgia or actual
arthritis of one or several joints
Gonococcemia = is defined as the presence of N gonorrhoeae in the bloodstream,
which can lead to the development of disseminated gonococcal infection (DGI).
Gonococcemia occurs in about 0.5-3% of patients with gonorrhea.
The clinical manifestations of this process are biphasic, with an early bacteremic
phase consisting of tenosynovitis, arthralgias, and dermatitis, followed by a
localized phase consisting of localized septic arthritis. Other potentially severe
clinical complications include osteomyelitis, meningitis, endocarditis, adult
respiratory distress syndrome (ARDS), [and fatal septic shock. Polymyositis is also a
rare complication of gonococcemia.
159. A 16-year old patient has been diagnosed with primary
dysmenorrhea. nonpharmacological treatments have not provided
adequate relief. How should this initially be managed?
A- Combination of hormonal contraceptive
B- Acetaminophen at onset of menses
C- NSAID’s at onset of menses
D- Tramadol and NSAID’s
160. Which of the following is NOT associated with assessment findings
in a patient with diabetic retinopathy?
A- Papilledema
B- Dot and blot hemorrhage
C- Microaneurysms
D- Cotton wool spots
Signs and symptoms of diabetic retinopathy
In the initial stages of diabetic retinopathy, patients are generally asymptomatic;
in the more advanced stages of the disease, however, patients may experience
symptoms that include floaters, blurred vision, distortion, and progressive visual
acuity loss. Signs of diabetic retinopathy include the following:
•Microaneurysms: The earliest clinical sign of diabetic retinopathy; these
occur secondary to capillary wall outpouching due to pericyte loss; they
appear as small, red dots in the superficial retinal layers
•Dot and blot hemorrhages: Appear similar to microaneurysms if they are
small; they occur as microaneurysms rupture in the deeper layers of the
retina, such as the inner nuclear and outer plexiform layers
•Flame-shaped hemorrhages: Splinter hemorrhages that occur in the more
superficial nerve fiber layer
•Retinal edema and hard exudates: Caused by the breakdown of the
bloodretina barrier, allowing leakage of serum proteins, lipids, and protein
from the vessels
•Cotton-wool spots: Nerve fiber layer infarctions from occlusion of
precapillary arterioles; they are frequently bordered by microaneurysms and
vascular hyperpermeability
•Venous loops and venous beading: Frequently occur adjacent to areas of
nonperfusion; they reflect increasing retinal ischemia, and their occurrence is
the most significant predictor of progression to proliferative diabetic
retinopathy (PDR).
•Intraretinal microvascular abnormalities: Remodeled capillary beds without
proliferative changes; can usually be found on the borders of the
nonperfused retina
•Macular edema: Leading cause of visual impairment in patients with diabetes
161. What is the most common characteristic found in patient with
Migraine headaches?
A- Focal deficits
B- Family history
C-Weakness
D- Initial after age 35
162. Which immunization reduces a patient’s risk for infection with the
virus that causes painful, localized, blistering rash?
A- Smallpox vaccine
B- Varicella vaccine (chicken Pox)
C- Shingles (herpes zoster) vaccine
D-Meningococcal vaccine
163. 5- alpha reductase inhibitors work to improve symptoms of benign
prostatic hyperplasia by:
A- Decreasing the size of the prostate
B- Increasing blood flow to the prostate
C- Relaxing smooth muscle in the bladder neck
D- Relaxing smooth muscle in the prostate capsule
164. The assessment of a 72-year old male causes the nurse practitioner
to have concerns that the patient is a suicide risk. Risk factor for
suicide in the elderly do NOT include.
A- chronic pain
B- comorbid physical illness
C- family history of suicide
D- retirement
165. The patient at highest risk of contacting TB would be the one who:
A- had recent contact with an infected patient
B- is low income immigrant
C- lives in a nursing home
D- smokes 2 packs of cigarettes per day
166. Excess fluid that accumulates in the pleural cavity between the
visceral and parietal spaces is termed;
A- pericardial effusion
B- pleural effusion
C- pleural empyema
D- chylothorax
167. Which of the following neurological conditions dos NOT cause
headaches with nausea and vomiting?
A- Migraine headaches
B- Brain tumors
C- Subarachnoid hemorrhage
D- Tension headaches
168. When measuring the fundal height of a pregnant female at 32
weeks gestation, which measurement would prompt to suspect
fetal growth restriction?
A- 29 cm
B- 30 cm
C- 31 cm
D- 32 cm
169. Which of the following medications is NOT indicated for the
treatment of muscle spasm?
A- Baclofen (Lioresal) = antispastic
B- Tizanidine (Zanaflex) = antispasmodic
C- Cyclobenzaprine (Flxeril) = antispasmodic
D- Carisoprodol (Soma) = antispasmodic
Antispasmodics = arecentrally acting skeletal muscle relaxants (SMRs)
Antispastics = are used to treat muscle spasticity. They should not be used to treat
muscle spasms. These drugs include:
Baclofen: Baclofen (Lioresal) is used to relieve spasticity caused by MS. It’s not
fully understood how it works, but it seems to block nerve signals from the spinal
cord that cause muscles to spasm. Side effects can include drowsiness, dizziness,
weakness, and fatigue
170. Which gynecological finding is concerning for a postmenopausal
patient with complaints of pruritus, painful intercourse, and
vaginal burning?
A- A thin pale, dry vaginal mucosa
B- Absence of rugae
C- A friable cervix
D- Raised yellowish cervical lesions
171. During a migraine headache, the cerebral arteries:
A- constrict
B- dilate
C- pulsate
D- vibrate
172. A 26-year old male patient presents with a painless chancre
(primary syphilis) on the shaft of his penis and regional
lymphadenopathy. He is diagnosed with syphilis. The best initial
treatment is:
A- ceftriaxone (Rocephin)
B- clindamycin (Cleocin)
C- metronidazole (Flagyl)
D- benzathine penicillin G (Bicillin L-A)
173. In a 40-year-old female, the overall texture of the breasts is soft,
with an uneven contour bilaterally. The nurse practitioner informs
the patient that this condition
A- warrants a mammogram
B- is considered normal
C- may be suggestive of fibroadenoma
D- may indicate cystic breasts
174. Which of the following medications is NOT usually associated with
hearing loss?
A- Furosemide
B- Gentamicin = aminoglycoside
C- Cephalexin
D- Aspirin
175. The nurse practitioner is prescribing insulin for an older adult with
a history of diabetes. To reduce the risk of nocturnal hypoglycemia
which type of insulin should be prescribed?
A- Immediate – acting
B- Regular
C- NPH
D- Long-acting
176. A risk factor for tinea corporis is:
A- elevated blood sugar = If the individual has a weak immune system or
diabetes, there is a greater susceptibility to fungal infections, such as Tinea
Corporis Infection.
B- infrequent bathing
C- frequent sun exposure
D- inactivity
177. A 24-year-old woman states that she has used lindane (Kwell) for
the treatment of scabies. The nurse practitioner informs her the
medication:
A- Is safe to use in pregnant woman, babies, children, and older
adults.
B- Lotion and/or shampoo is not considered first-line therapy.
C- Needs to be repeated following at 12 – hour intervals. D- Can be
used in patients with a history of seizures.
** Iron (ferrous sulfate) = best taken on empty stomach**