Question

Question 1. 1. Women are at the highest risk for developing postpartum depression for up to how long after childbirth? (Points : 2)

2 weeks

1 month

3 months

6 months

Question 2. 2. CPT coding offers the uniformed language used for reporting medical services and procedures performed by physician and nonphysician practitioners. Clinicians are paid based on calculated resource costs that are calculated based on practice components. Which of the following are part of the components used to calculate the per CPT code payment rate? (Points : 2)

Clinician education loans

Clinician practice liability and malpractice epense

Clinician reported cost reduction efforts

Clinician volume of patients treated

Question 3. 3. Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? (Points : 2)

Gastrocnemius weakness

A reduced or absent ankle refle

Numbness in the lateral foot

Paresthesia of the perineum and buttocks

Question 4. 4. A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment? (Points : 2)

Conjugated estrogen 0.625 mg/day oral

Estradiol 7.5 mcg/24 hr vaginal ring

Medroyprogesterone 10 mg/day oral

Conjugated estrogen 0.3 mg + medroyprogesterone 1.5 mg/day oral

Question 5. 5. Which of the following is a specific test for multiple sclerosis (MS)? (Points : 2)

Magnetic resonance imaging (MRI)

Computed tomography (CT) scan

A lumbar puncture

There is no specific test.

Question 6. 6. Most adult poisonings are: (Points : 2)

intentional and self-inflicted.

accidental.

caused by someone wishing to do harm to the person.

not attributed to any reason.

Question 7. 7. A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician epect to find? (Points : 2)

The scrotum will be dark.

The scrotum will appear light pink or yellow.

The scrotum will appear milky white.

The internal structures will be clearly visible.

Question 8. 8. Which clinical feature is the first to be affected in increased intracranial pressure (ICP)? (Points : 2)

Decrease in level of consciousness (LOC)

Headache

Nausea

Widening pulse pressure

Question 9. 9. Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician suspect in the initial test results for this patient? (Points : 2)

Elevated uric acid level

Elevated blood urea nitrogen (BUN)

Decreased urine pH

Decreased C-reactive protein (CRP)

Question 10. 10. Which solution should be used when irrigating lacerated tissue over a wound on the arm? (Points : 2)

Dilute povidone-iodine solution

Hydrogen peroide (H2O2)

Saline solution infused with an antibiotic

Saline irrigation or soapy water

Question 11. 11. Which ethical principle reflects respect for all persons and their self-determination? (Points : 2)

Autonomy

Beneficence

Justice

Veracity

Question 12. 12. During a digital rectal eam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious? (Points : 2)

An enlarged rubbery gland

A hard irregular gland

A tender gland

A boggy gland

Question 13. 13. How often should the clinician eamine the feet of a person with diabetes? (Points : 2)

Once a year

Every 6 months

Every 3 months

Every visit

Question 14. 14. Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain? (Points : 2)

Decreased C-reactive protein

Hyperalbuminemia

Morning stiffness

Weight gain

Question 15. 15. Which of the following medications is the treatment of choice for trichomonas? (Points: 2)

Metronidazole

Ceftriaone

Diflucan

Doycycline

Question 16. 16. Immunizations are an eample of which type of prevention? (Points: 2)

Primary

Secondary

Tertiary

Question 17. 17. What is the treatment of choice for a patient diagnosed with testicular cancer? (Points : 2)

Radical orchidectomy

Lumpectomy

Radiation implants

All of the above

Question 18. 18. George, aged 59, complains of a flulike illness, including fever, chills, and myalgia after returning from visiting his grandchildren in New England. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering? (Points : 2)

A viral syndromes

Lyme disease

Rocky Mountain spotted fever

Relapsing fever

Question 19. 19. A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What seually transmitted disease (STD) has she most probably been eposed to? (Points : 2)

Gonorrhea

Human papillomavirus (HPV)

Chlamydia

Trichomonas

Question 20. 20. What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster? (Points : 2)

A stabbing type of pain on one small area of the body

A vesicular skin lesion on one side of the body

A pain that is worse upon awakening

A lesion on the eterior ear canal

Question 21. 21. Which drug commonly prescribed for burns is active against a wide spectrum of microbial pathogens and is the most frequently used agent for partial- and full-thickness thermal injuries? (Points : 2)

Clotrimazole cream (Lotrimen)

Mafenide acetate (Sulfamylon)

Silver nitrate

Silver sulfadiazine (Silvadene)

Question 22. 22. Which of the following is a role of the advanced practice nurse in palliative cancer care? (Points : 2)

Detecting cancer in asymptomatic patients or those with specific symptoms

Arranging for follow-up care, including psychosocial and spiritual support

Identifying and managing complications of care

All of the above

Question 23. 23. Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact? (Points : 2)

Superficial burns

Superficial partial-thickness burns

Deep partial-thickness burns

Full-thickness burns

Question 24. 24. The criteria for diagnosing generalized aniety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (tet revision) (DSM-IV-TR) state that ecessive worry or apprehension must be present more days than not for at least: (Points : 2)

1 month.

3 months.

6 months.

12 months.

Question 25. 25. In the United States, what is the second most common connective tissue disease and the most destructive to the joints? (Points : 2)

Osteoarthritis

Systemic lupus erythematosus (SLE)

Rheumatoid arthritis (RA)

Sjogren’s syndrome

Question 26. 26. A sunscreen with a sun-protection factor (SPF) of at least what number will block most harmful ultraviolet (UV) radiation? (Points : 2)

4

8

10

15

Question 27. 27. The hallmark of an absence seizure is: (Points : 2)

No activity at all.

A blank stare.

Urine is usually voided involuntarily.

The attack usually lasts several minutes.

Question 28. 28. The effectiveness of benzodiazepines in treating aniety disorders suggests that which of the following neurotransmitters plays a role in aniety? (Points : 2)

Acetylcholine

Gamma-aminobutyric acid (GABA)

Dopamine

Serotonin

Question 29. 29. Which characteristic of delirium helps to distinguish delirium from dementia? (Points : 2)

Abrupt onset

Impaired attention

Affective changes

Delusions

Question 30. 30. A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority? (Points : 2)

Pregnancy test

Pelvic ultrasound

Endometrial biopsy

Platelet count

Question 31. 31. The clinician should question the patient with suspected gout about use of which of these medications that may be a risk factor? (Points : 2)

Low-dose aspirin

Thiazide diuretics

Ethambutol

All of the above

Question 32. 32. A bulla is: (Points : 2)

A vesicle larger than 1 cm in diameter.

An elevated solid mass with a hard teture, and the shape and borders can be regular or irregular.

A superficial elevated lesion filled with purulent fluid.

Thinning of the skin (epidermis and dermis) that appears white or translucent.

Question 33. 33. Sam is a 25-year-old man who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological eamination. As the clinician, you eplain to Sam that low back pain is a diagnosis of eclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc? (Points: 2)

Morning stiffness and limited mobility of the lumbar spine

Unilateral radicular pain symptoms that etend below the knee and are equal to or greater than the back pain

Fever, chills, and elevated erythrocyte sedimentation rate

Pathologic fractures, severe night pain, weight loss, and fatigue

Question 34. 34. Which of the following statements is true concerning the musculoskeletal eam? (Points : 2)

The uninvolved side should be eamined initially and compared to the involved side.

The part of the body that is causing the patient pain should be eamined first.

The patient should not be asked to perform active range-of-motion (ROM) eercises whenever possible to avoid causing pain.

Radiographs should always be obtained prior to eamination so as not to cause further injury to the patient.

Question 35. 35. The current goal of treatment for a patient with HIV infection is which of the following? (Points : 2)

Viral suppression of HIV to undetectable levels in the peripheral blood

Compete eradication of the virus

Encouraging the person to have no contact with uninfected individuals

Complete abstinence

Question 36. 36. Which of the following classes of drugs should be used as first-line therapy for treatment of delirium? (Points : 2)

Benzodiazepines

Antipsychotic

Anticonvulsants

Antidepressants

Question 37. 37. After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient? (Points : 2)

Suggest she use a heating pad to improve circulation

Refer to a podiatrist for a foot care treatment plan

Send her for acupuncture treatments

All of the above

Question 38. 38. Which of the following statements is true concerning the management of the client with a herniated disc? (Points : 2)

Muscle relaants and narcotics can be used to control moderate pain but should be discontinued after 3 weeks of use.

An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred.

Intolerable pain for more than a 3-month period is an indication for surgical intervention.

All of the above

Question 39. 39. Which patient is more likely to have a cluster headache? (Points : 2)

A female in her reproductive years

A 40-year-old African American male

A 55-year-old female who drinks 10 cups of coffee daily

A 45-year-old male awakened at night

Question 40. 40. The main mechanism for avoiding a lawsuit involves: (Points : 2)

Good liability insurance

A collaborating physician

Good documentation

Open communication skills

Question 41. 41. A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding? (Points : 2)

Trichomonas

Bacterial vaginosis

Human papillomavirus (HPV)

Herpes simple virus (HSV)

Question 42. 42. Which of the following laboratory findings should the clinician epect in a patient with untreated Graves’ disease? (Points : 2)

Elevated thyroid-stimulating hormone (TSH)

Elevated T4

Elevated TRH

All of the above

Question 43. 43. A 23-year-old seually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 seual partners. Which of the following conditions should the clinician be particularly alert for during her eam? (Points : 2)

Human papillomavirus (HPV)

Endometrial hyperplasia

Vagismus

Polycystic ovarian syndrome

Question 44. 44. When may confidentiality be overridden? (Points : 2)

When personal information is available on the computer

When a clinician needs to share information with a billing company

When an insurance company wants to know the results of a breast cancer gene test

When a patient has a communicable disease

Question 45. 45. A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician epect as a manifestation of the disease? (Points : 2)

Sinus bradycardia

Atrial fibrillation

Supraventricular tachycardia

U waves

Question 46. 46. The most cost-effective screening test to determine HIV status is which of the following? (Points : 2)

Western Blot

Enzyme-linked immunosorbent assay (ELISA)

Venereal Disease Research Laboratory (VDRL) test

Viral load

Question 47. 47. After 6 months of synthroid therapy, the clinician should epect which of the following in the repeat thyroid studies? (Points : 2)

Elevated thyroid-stimulating hormone (TSH)

Normal TSH

Low TSH

Undetectable TSH

Question 48. 48. The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods? (Points : 2)

Rice

Carrots

Spinach

Potatoes

Question 49. 49. A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles refle, and a tack embedded in his left heel. Which of the following would be an appropriate treatment? (Points : 2)

Tricyclic antidepressants

Capsacin cream

Vitamin B12 injections

Insulin

Question 50. 50. In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the “C” of LACE represents? (Points : 2)

Commitment

Consensus

Certification

Collaboration

Question 51. 51. In an outpatient setting, what is the most common reason for a malpractice suit? (Points : 2)

Failure to treat a condition

Failure to diagnose correctly

Ordering the wrong medication

Failure to manage care

Question 52. 52. Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis? (Points : 2)

Cholinesterase inhibitors

Aniolytics

Antidepressants

Atypical antipsychotics

Question 53. 53. A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate? (Points : 2)

“It is probably just a cyst, because that is the most common breast mass.”

“We will order a mammogram and ultrasound to help establish a diagnosis.”

“We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”

“Because your lump is painful, it is most likely not cancer.”

Question 54. 54. Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer eplains that she fell on her left side and kept her arm out straight to break her fall. She has been eperiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation? (Points : 2)

Posterior dislocations are more common than anterior dislocations.

There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.

Recurrent dislocations are uncommon and would require a greater force to result in injury.

Surgery is most commonly the treatment of choice.

Question 55. 55. The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient? (Points : 2)

Overweight

Mild obesity

Moderate obesity

Morbid obesity

Question 56. 56. Which of the following statements is true regarding the treatment of carpal tunnel syndrome? (Points : 2)

The goal of treatment is to prevent fleion and etension movements of the wrist.

Splints are used in carpal tunnel syndrome because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position.

Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.

All of the above

Question 57. 57. Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him: (Points : 2)

“L-dopa is neuroprotective.”

“The primary goal of therapy is to replace depleted stores of dopamine.”

“This is the only drug that can provide symptomatic benefit.”

“This is the initial monotherapy drug.”

Question 58.58. When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are? (Points : 2)

Spores

Leukocytes

zPseudohyphae

Epithelial cells

Question 59. 59. A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-eamination (TSE). Which of the following should be included in the list of differential diagnoses? (Points : 2)

Testicular cancer

Inguinal hernia

Varicocele

All of the above

Question 60. 60. Patients with a spontaneous pneumothora should be counseled that up to what percentage may eperience a reoccurrence at some point? (Points : 2)

10%

20%

30%

50%

Question 61. 61. John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to etend it completely. John tells the clinician that he heard a pop when the injury occurred and has been eperiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear? (Points : 2)

Valgus stress test

McMurray circumduction test

Lachman test

Varus stress test

Question 62. 62. The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs to manage his pain? (Points : 2)

You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.

You should start with the lowest dose that is effective in managing your pain in order to avoid developing tolerance to the medication.

You should take the maimum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.

It is important to take NSAIDs on an empty stomach in order to increase absorption.

Question 63. 63. If a previously frostbitten area becomes frostbitten again after it has healed, what might occur? (Points : 2)

Permanent tissue damage may occur, resulting in necrosis to that body part.

The area will be super sensitive.

The area is prone to a repeat frostbite.

The area is as susceptible as any other area.

Question 64. 64. Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines? (Points : 2)

Propranolol

Timolol

Ergotamine

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