APEA PRETEST QUESTIONS – Flashcards
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The process by which a professional association confers recognition that a licensed professional has demonstrated mastery of a specialized body of knowledge and skills is termed: A. licensure. B. quality assurance. C. certification. D. policy and procedure.
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C
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1. A 46 year old female has hypertension and is well managed with propanolol (Inderal). Which of the following is a beneficial secondary effect of this drug? A. Improved glycemic control. B. Improved lipid profile C. Weight loss D. Migraine prophylaxis
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D
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What is the recommended timing for gestational diabetes screening? A. 12-16 weeks gestation B. 24-28 weeks gestation C. 30-34 weeks gestation D. 34-38 weeks gestation
answer
B
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20. Which of the following is NOT an appropriate suppression therapy for chronic bacterial prostatitis (CBP)? A. doxycycline 100 mg qd B. nitrofurantoin (Macrobid) 100 mg qd C. Bactrim DS (Sulfatrim) qd D. erythromycin qd
answer
D
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4. An 87 year old patient was placed on low dose amlodipine (Norvasc) for treatment of hypertension and angina. She takes an ASA daily, but, takes no other medications. What side effects might be expected from taking amolodipine? A. diarrhea. B. orthostatic hypotension. C. decreased heart rate. D. nocturnal cough.
answer
B. orthostatic hypotension
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Six weeks gestation is confirmed in a 23 year old, moderately overweight, patient. She asks the nurse practitioner, "Should I diet so I won't gain too much baby fat" The nurse practitioner appropriately responds: A. "It is probably a good idea to lose a few pounds in the first trimester since it will be harder to control weight gain later." B. "A weight gain of approximately 25 pounds is ideal for mother and baby." C. "It doesn't matter how much weight you gain or lose as long as you eat a well-balanced diet." D. "Just try to limit your weight gain as much as you comfortably are able."
answer
B
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A patient presents with sudden onset of "crushing chest pressure," diaphoresis, pallor, and extreme weakness. Electrocardiogram and serum enzyme changes support a diagnosis of acute myocardial infarction (AMI). The nurse practitioner would expect: A. widened QRS intervals, AV dissociation, elevated CPK-MP and LDH, and negative troponin. B. ST changes, prominent Q wave, elevated CPK-MB and LDH, and cardiac troponin I. C. prolonged PR interval, bradycardia, and increased CPK-MB and LDH. D. peaked T waves, tachycardia, and elevated CPK-MB and LDH, and cardiac Troponin I.
answer
B
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Untreated infection with human papilloma virus (HPV-16) increases the female's risk for: A. pelvic inflammatory disease. B. ovarian cancer. C. infertility D. cervical cancer.
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D
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10. Which APRN is the exception to the graduate level preparation requirement for certification for advanced practice registered nurses? A. Advanced practice registered nurses who have completed an approved educational program prior to implementation of graduate level education are considered to have met the requirements for advanced practice registered nursing. B. Advanced practice registered nurses who plan to practice in a hospital or other controlled setting are not required to have graduate education. C. Advanced practice registered nurses who can pass both the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners (AANP) certification examinations are allowed to practice without graduate level education. D. There are no exceptions to the rule requiring graduate education to practice as an advanced practice registered nurse
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A
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Strabismus is observed in a 13 month old child. The most appropriate action for the nurse practitioner to take is to: A. refer the patient to an ophthalmologist. B. patch the child's affected eye. C. follow the child closely for 2 more months. D. teach the patient and parent eye muscle exercises.
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A
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The Dubowitz Clinical Assessment is a: A. standardized scoring system for assessing gestational age of newborns. B. scale developed for rating the newborn's appearance, heart rate, reflexes, activity, and respirations. C. system for identifying children who have been sexually or physically abused. D. screening system to identify congenital anomalies.
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A
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14. The nurse practitioner examines a 6 year old who has had sore throat and fever for less than 24 hours. Based on the most common cause of pharyngitis in this age group, the most appropriate action is to? A. prescribe amoxicillin in a weight-appropriate dose. B. ask if any other family members have the same symptoms. C. encourage supportive and symptomatic care. D. prescribe an antihistamine and decongestant.
answer
C
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The nurse practitioner is counseling a young woman who desires pregnancy. She discontinued her oral ontraceptives four months ago. Her urine pregnancy test (UPT) is negative. She expresses concern that she might have an infertility problem. The nurse practitioner accurately tells her that a couple is not considered infertile until there has been unprotected intercourse without conception for what period of time? A. 4 months B. 8 months C. 1 year D. 1 ½ years
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C
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Licensure is: A. another term for certification. B. contingent on certification. C. used to establish minimal competence. D. necessary for reimbursement.
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C
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Which class of drugs increases a patient's risk for developing rhabdomyolysis? A. Anti-hypertensives B. Thiazide diuretics C. The "statins" D. Anti-coagulants
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C
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Which of the following is the best response to a woman who has just admitted she is a victim of spousal abuse? A. "What was it you did to make him angry?" B. "You must seek refuge immediately." C. "I am concerned about your safety." D. "I am going to call a shelter for you."
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C
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An example of primary prevention is: A. routine immunizations for healthy children or adults. B. screening for high blood pressure. C. cholesterol reduction in a patient with CAD. D. a PAP smear to determine degree of cervical dysplasia.
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A
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A 30 yo woman has varicose veins. These are A. due to congenital valve deformities. B. usually diagnosed on clinical presentation. C. not affected by pregnancy. D. more symptomatic during ovulation.
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B
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Which of the following is NOT true about Carpal Tunnel Syndrome? A. Symptoms present in the first 3 fingers of the affected hand. B. Symptoms are absent in the 5th finger. C. Median nerve compression can result in decreased strength and impaired fine motor coordination. D. Phalen's and Tinel's signs are negative.
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D
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Coarctation of the aorta should be suspected in newborns or infants who exhibit any of the following EXCEPT: A. upper extremity hypertension. B. lower extremity hypotension. C. diminished lower extremity pulses. D. diastolic murmurs.
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D
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26. The most reliable diagnostic indicator of gout is: A. monosodium urate (MSU) crystals in the synovial fluid. B. tophi visible over joints or in connective tissue. C. elevated serum uric acid level. D. abrupt onset of single joint inflammation and pain.
answer
A
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Primary prevention of human papilloma virus (HPV) infection requires educational efforts directed toward A. receiving annual screening examinations. B. self-examination to detect the signs of infection. C. receiving a vaccination on an annual basis. D. delaying the onset of sexual activity and using barrier methods of contraception.
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D
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Which of the following is a secondary cause of hyperlipidemia? A. Osteoporosis B. Hypothyroidism C. Recent dietary excess and weight gain D. Lack of exercise
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B
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Which of the following is NOT a risk factor for sudden infant death syndrome (SIDS)? A. Maternal age < 19 years B. Winter months C. Low birth weight D. Female gender
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D
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A patient with a past history of documented coronary arterial blockage less than 70% complains of chest pain several times per day (while at rest) which is relieved with nitroglycerin. What is the most appropriate initial action for the nurse practitioner? A. Refer to a cardiologist as soon as possible. B. Prescribe long-acting nitroglycerin. C. Order a treadmill stress test. D. Prescribe an ACE inhibitor and re-evaluate in 24 to 48 hour
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A
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34. Which symptom is NOT typical in a female during the peri-menopausal period? A. Vasomotor instability B. Paresthesias C. Increased vaginal lubrication D. Disturbed sleep patterns
answer
C
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The parents of a 2 year old report that she is not saying any words, but makes sounds, babbles, and understands simple commands from her parents. The parents are not concerned. The nurse practitioner responds? A. "Your child should be saying a few words by this time. She should be referred for further assessment." B. "Your child should be saying a few words by this time. We will wait another 3 to 6 months and observe her progress." C. "Your child's language skills are not as developmentally advanced as we would expect. She will need speech therapy." D. "Your child should be referred to an ear, nose, and throat specialist to assess her hearing."
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A
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Given appropriate patient education by the primary care provider, poor compliance with medical recommendations is most often due to? A. willful disobedience. B. vision and/or hearing deficits. C. anxiety. D. limited cognitive ability
answer
D
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44. The Patient Self-Determination Act of 1991 requires all health care agencies receiving Medicare or Medicaid funds to give patients written information about their rights to make decisions regarding their medical care. A document which declares in advance what type of medical care a person wants to be provided or withheld should he or she be unable to express his or her wishes is called? A. an advanced directive. B. a durable power of attorney. C. informed consent. D. a right to die statement.
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A
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46. The obesity associated with Type 2 diabetes mellitus is? A. a lower body (gynecoid) distribution. B. defined as BMI 30% or greater. C. defined as waist-to-hip ratio 0.5 or less. D. a truncal (android) distribution.
answer
D
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48. A 59 year old postmenopausal woman has atrophic vaginitis. She has a history of breast cancer at age 40 years. What is the appropriate initial treatment for this patient? A. Oral conjugated estrogens B. Oral medroxyprogesterone acetate C. Topical medroxyprogesterone acetate D. Topical conjugate estrogen cream
answer
D
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An 83 year old man has a resting hand tremor. What disease process is this type of tremor is most commonly associated with A. Multiple sclerosis (MS) B. Parkinson's disease C. Diabetic neuropathy D. Huntington's chorea
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B
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53. What is the most frequent cause of death in patients with anorexia nervosa? A. Renal failure B. Suicide C. Hepatic failure D. Cardiac arrest
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D
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Which of the following is NOT true regarding the diagnosis of scoliosis in children A. Scoliosis is most apparent during the pre-adolescent growth spurt. B. Scoliosis may be evidenced by unequal shoulder, scapula, or iliac crest height with the child standing. C. Kyphosis in the adolescent indicates scoliosis. D. Routine screening for scoliosis should begin at 10 to 12 years-of-age, with forward bending touching the toes, and unclothed examination of the spine.
answer
C
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Which of the following must be present for the diagnosis of bacterial vaginosis A. Presence of clue cells B. Vaginal pH < 4.0 C. Presence of pseudohyphae on HPF D. Negative amine test
answer
A
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Which of the following is appropriate to teach a patient who is using a daily nitrate agent for treatment of chronic angina A. Continuous 24-hour coverage is necessary for maximum protection. B. A daily 12-hour nitrate-free period is important to prevent tolerance. C. A daily 6-hour nitrate-free period is important to prevent tolerance. D. Nitrate-free periods present a potential for developing nitrate intolerance.
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A
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Which of the following findings would raise the nurse practitioner's suspicion of bulimia in a 17 year old female? A. Hyperkalemia B. Emaciation C. Scars on her knuckles D. Dental caries
answer
C
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62. A 25 year old overweight patient presents with a complaint of dull achiness in his groin and history of a palpable lump in his scrotum that "comes and goes." On physical examination, the nurse practitioner does not detect a scrotal mass. There is no tenderness, edema, or erythema of the scrotum and the scrotum does not transilluminate. Considering these findings, what is the most likely diagnosis? A. Testicular torsion B. Epididymitis C. Inguinal hernia D. Varicocele
answer
C
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63. The mechanism by which nurses are held accountable for practice, based on the quality of nursing care in a given situation in accordance with established standards of practice, is: A. outcome criteria. B. process criteria. C. peer review. D. quality assurance
answer
C
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64. The finding which is most consistent with a diagnosis of benign prostatic hyperplasia is digital palpation of a prostate gland that is: A. enlarged, symmetrical, semi-firm, and non-tender. B. enlarged, symmetrical, boggy, and exquisitely tender. C. asymmetrical and nodular. D. exquisitely tender with absence of median sulcus.
answer
A
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67. A 50 year old male is scheduled for his annual wellness visit. The nurse practitioner would appropriately recommend all of the following EXCEPT: A. stool for occult blood annually . B. annual digital rectal examination (DRE) and prostate specific antigen (PSA). C. monthly self-testicular examination and annual clinical testicular examination. D. annual lipid profile
answer
C
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69. The hallmark of neurofibromatosis (von Recklinghausen disease) present in almost 100% of patients is A. acoustic neuroma. B. astrocytoma of the retina. C. distinctive osseous lesions. D. cafe au lait spots.
answer
D
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A 24 year old male patient diagnosed with Hodgkin's lymphoma is concerned about long-term survival. The most accurate response by the nurse practitioner would be: A. "The 5-year survival rate is about 80% B. "Non-Hodgkin's lymphoma has a better prognosis." C. "With radiation and chemotherapy, there is almost a 100% cure rate." D. "With surgical treatment, there is a 95% cure rate."
answer
A
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81. A 12 year old has a fasting serum cholesterol of 190mg/dL (4.94 mmol/L). Her mother asks if this value is "ok." The nurse practitioner responds? A. "This is acceptable for her age and gender, although less than 200mg/dL (5.2 mmol/L) is desirable." B. "This is acceptable, but she should increase her fruit and vegetable intake." C. "This is unacceptable. The desired level is < 170 mg/dL (4.42mmol/L)." D. "This is unacceptable, but inappropriate to treat because of her age."
answer
C
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86. A 7 year old male presents with a painless limp, antalgic gait, muscle spasm, mildly restricted hip abduction and internal rotation, proximal thigh atrophy, and slightly short stature. The most likely diagnosis is A. transient monoarticular synovitis. B. slipped capital femoral epiphysis. C. congenital dysplasia of the hip. D. Legg-Calve-Perthes disease.
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D
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89. Most children who have been sexually abused have:
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No detectable genital injury
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90. Among adolescents in the U.S., the greatest known risk factor for contracting hepatitis B is: A. homosexual activity. B. injecting drug use. C. heterosexual activity. D. alcohol and designer drug use.
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C
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91. When counseling a woman who is breastfeeding her 6 month old infant, the nurse practitioner should recommend a caloric intake over her pre-pregnancy requirements of A. 200 kcal per day. B. 500 kcal per day. C. 900 kcal per day. D. 1000 kcal per day.
answer
B
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A 38 year old penicillin allergic patient has folliculitis on a bearded part of his face. The nurse practitioner prescribes erythromycin and tells the patient A. erythromycin may upset his stomach, so it should be taken with food. B. taking erythromycin should clear the infection in 3 days. C. the problem will recur unless the patient remains beardless. D. a similar allergic reaction could occur with erythromycin because he is penicillin allergic.
answer
A
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96. A 75 year old female complains that she awakens 3 to 4 times each night sensing bladder fullness, but is unable to "hold it" until she can get seated on the bathroom toilet. This type of urinary incontinence is termed: A. overflow incontinence. B. stress incontinence. C. functional incontinence. D. urge incontinence.
answer
D
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98. Which of the following patients requires radiological evaluation of a first incidence of urinary tract infection? A. A 9 year old female B. An 11 year old male C. A 13 year old female D. An 18 year old female
answer
B
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Which of the following drugs is considered safe for use during pregnancy? A. miconazole (Monistat®) cream B. isotretinoin (Accutane®) C. trimethoprim-sulfamethoxazole (Bactrim®, Sulfatrim)) D. terconazole (Terazol®) vaginal cream
answer
A
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104. Which of the following laboratory tests is useful in the diagnosis of spontaneous abortion A. Serial quantitative beta-human chorionic gonadotropin levels B. Qualitative plasma estradiol levels C. Plasma dehydroepiandrosterone sulfate (DHEA-S®) levels D. Qualitative plasma human chorionic gonadotropin levels
answer
A
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108. Which of the following should NOT be recommended to the parents of a child with asthma? A. Eliminate air conditioning in the child's room. B. Encase the child's mattress in a sealed vinyl cover. C. Remove carpeting from the child's bedroom. D. Do not allow smoking in the home.
answer
A
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109. Which finding below would be unusual in a patient with diabetic retinopathy? A. Papilledema B. Dot and blot hemorrhages C. Microaneurysms D. Cotton wool spots
answer
A
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112. The most reliable indicator(s)of neurological deficit when assessing a patient with acute low back pain is(are): A. patient reports of bladder dysfunction, saddle anesthesia, and motor weakness of limbs. B. history of significant trauma relative to the patient's age. C. decreased reflexes, strength, and sensation in the lower extremities. D. patient report of pain with the crossed straight leg raise test.
answer
C
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114. Risk factors for elder abuse do NOT include: A. dependency. B. mental impairment. C. age 65 to 70 years. D. lower socioeconomic group.
answer
C
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121. A 3 year old female with a palpable right upper quadrant abdominal mass, anemia, and fever is being evaluated for Wilms' tumor. Which of the following diagnostic tests would be most useful A. Intravenous pyelogram (IVP) B. Flat and erect x-ray of the abdomen C. Abdominal ultrasound D. Voiding cystourethrogram (VCU)
answer
C
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122. Anticipatory guidance for children 4 to 12 years-of-age should focus primarily on A. infectious disease prevention. B. discipline. C. injury prevention. D. nutrition.
answer
C
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126. Which term most accurately describes the prostate gland of a patient with prostate cancer A. Hard B. Rubbery C. Boggy D. Spongy
answer
A
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137. Which case of epistaxis should concern the nurse practitioner most A. A child under 2 years-of-age B. A teenager with allergies C. A child with fresh clots in one naris D. A teenager using a nasal decongestant
answer
A
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143. Which of the following diseases is NOT acquired transplacentally A. Rubeola B. Toxoplasmosis C. Tuberculosis D. Varicella
answer
C
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150. The process by which a professional association confers recognition that a licensed professional has demonstrated mastery of a specialized body of knowledge and skills is termed A. licensure. B. quality assurance. C. certification. D. policy and procedure.
answer
C
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10. The result of the Weber tuning fork test is lateralization of sound to the right ear. This finding indicates a A. conduction problem in the left ear. B. conduction problem in the right ear. C. sensorineural problem in the right ear. D. sensorineural problem in the left ear.
answer
B
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11. Which of the following is true about cognitive abilities in the elderly? A. Some decline occurs in the sixth decade, but persons in later decades show little change. B. Skills training and motivational incentives have no effect on memory. C. Elderly adults perform poorly in comparison to young adults on tests of verbal skills. D. Apprehension about competitive situations has little effect on performance.
answer
A
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The nurse practitioner is evaluating a 35 year old female nurse. She has a history of hospitalization for hepatitis B infection 2 years ago. Her laboratory tests demonstrate positive HBsAg. The nurse practitioner would most likely diagnose A. chronic hepatitis B infection. B. acute hepatitis B infection. C. recovered hepatitis B infection. D. recent hepatitis B vaccination
answer
A
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16. How many kilocalories below one's requirement does it take to lose one pound A. 3500 B. 2500 C. 2000 D. 1000
answer
A
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17. A nurse practitioner examines the skin of an elderly patient. Which finding below is NOT a benign variant associated with the aging process? A. Xerosis B. Cherry angiomas and senile purpura C. Senile keratoses and senile lentigines D. Dermatophytoses
answer
D
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19. A patient has laboratory studies performed which demonstrate: increased TSH, decreased free T4 and T3. Which symptoms might she complain of? A. Intolerance to heat B. Hair and nails soft and thin C. Warm, moist skin D. Hair loss
answer
D
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24. A usually very healthy 3 yo was diagnosed yesterday with acute otitis media. The NP prescribes amoxicillin. The child's caregiver called today to report that the ear pain has continued and his temperature remains at about 100F despite using ibuprofen. How should the NP respond? A. Have the caregiver alternate between ibuprofen and acetaminophen for pain relief for 24 to 48 more hours. B. Ask the caregiver to switch to a different antipyretic and call back if it remains elevated for more than 24-48 hours.
answer
A
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30. The drug of choice for acute episodes of gout is colchicine. What is the most common early sign of colchicine toxicity? A. Palpitations B. Nausea C. Diarrhea D. Headache
answer
C
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36. Patients with HIV are at increased risk for Pneumocystis carinii pneumonia (PCP) which is associated with significant morbidity and mortality. For this reason, prophylaxis is recommended. Which of the following is an appropriate drug for PCP prophylaxis? A. penicillin B. trimethoprim-sulfamethoxazole (Bactrim®) C. erythromycin D. zidovudine (Retrovir®)
answer
B
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37. The nurse practitioner assesses an asymptomatic 43 year old male and determines that he is at minimal risk for a myocardial infarction (MI). The patient asks whether he would benefit from taking aspirin 325 mg every day to prevent an MI. What should the nurse practitioner recommend A. "Take a daily aspirin because it will decrease your overall risk of death and prevent any complications from heart attack." B. "Take a daily aspirin because there are numerous studies which support that people who do not have heart symptoms benefit from one aspirin per day." C. "Do not take a daily aspirin as there is insufficient evidence at this time for primary prevention of heart attack in people without heart symptoms." D. "Do not take a daily aspirin until you reach 55 years-of-age."
answer
C
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38. Which of the following patients is at highest risk of suicide A. 65 year old female B. 70 year old male C. 35 year old white divorced male D. 42 year old single mother
answer
B
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42. A 35 year old female with a history of mitral valve prolapse is scheduled for routine dental cleaning. According to the 2007 American Heart Association's guidelines for endocarditis prophylaxis, what would you advise this patient: A. She should receive prophylaxis on the day of her dental cleaning. B. She does not need prophylaxis for any dental procedures. C. She should recieve prophylaxis on the day before, and day of her cleaning. D. She needs prophylaxis only for tooth extraction and deep dental procedures.
answer
B
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49. A 50 year old patient has abnormal vaginal bleeding with heavy periods and intermenstrual watery discharge with a small amount of blood. What is the most likely diagnosis? A. cervical cancer B. uterine fibroids C. endometrial cancer D. peri-menopausal bleeding
answer
C
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53. The NP is discussing contraception options to be used during lactation with a 24 year old pregnant patient. Which of the following methods of contraception would NOT be appropriate for use while breastfeeding? A. levonorgestrel (Norplant®) B. A low dose oral contraceptive C. An intrauterine device D. A diaphragm and spermicide
answer
B.
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56. The physiological explanation for syncope is: A. accelerated venous return and increased stroke volume resulting in deactivation of the parasympathetic nervous system. B. a cycle of inappropriate vasodilatation, bradycardia, and hypotension. C. a sudden rise in blood pressure due to overly efficient vasoconstriction. D. emotional stress resulting in hypertension, tachycardia, and increased venous return.
answer
B
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57. A patient presents with an inflamed upper eyelid margin. The conjunctiva is red and there is particulate matter along the upper eyelid. The patient complains of a sensation that "there is something in my eye." What is the diagnosis and how should it be treated? A. Hordeolum; treat with a topical antibiotics and warm compresses B. Conjunctivitis; treat with topical antibiotics and warm compresses C. Blepharitis; treat with warm compresses and gentle debridement with a cotton swab D. Chalazion; refer to an ophthalmologist for incision and drainage
answer
C
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Which immunization(s) is(are) contraindicated in an immunodeficient individual? 1. Varicella 2. IPV 3. MMR 4. HBV A. 4 B. 1, 3 C. 1, 3, 4 D. All of the above
answer
B
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64. Radiographic evaluation of talipes equinovarus must be performed: A. while weight-bearing. B. after age 4 years-of-age. C. with oblique views. D. while non-weight-bearing.
answer
A
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71. Adolescents need to be educated that HIV is usually transmitted by: A. homosexual intercourse, primarily. B. fecal-oral route. C. semen, vaginal secretions, and blood. D. saliva and tears.
answer
C
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Untreated infection with human papilloma virus (HPV-16) increases the female's risk for: A. pelvic inflammatory disease. B. ovarian cancer. C. infertility D. cervical cancer.
answer
D
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88. The leading causes of morbidity and mortality in postmenopausal American women are cardiovascular disease, osteoporosis, and cancer. What intervention has the greatest impact on prevention of these disorders? A. Hormone replacement therapy B. Early screening for hyperlipidemia C. Vitamin supplementation D. Exercise
answer
A
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95. Which of the following is NOT a goal of treatment for the patient with cystic fibrosis? A. Prevent intestinal obstruction B. Provide adequate nutrition C. Promote clearance of secretions D. Replace water-soluble vitamins
answer
D
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99. Which of the following is a microcytic hypochromic anemia? A. Folic acid deficiency anemia B. Iron deficiency anemia C. Pernicious anemia D. Anemia of chronic disease
answer
B
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100. Which of the following medication classes is considered first line therapy for patients who have chronic heart failure (CHF)? A. ACE inhibitors B. Beta-blockers C. Calcium channel blockers D. Direct vasodilators
answer
A
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104. Which case of epistaxis should concern the NP most? A. A child with fresh clots in one naris. B. A child under 2 years of age. C. A child with seasonal allergies. D. A child with red, irritated nares and old crusts.
answer
B
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105. A NP is holding a prenatal nutrition class for a group of patients. Considering knowledge about cultural variations, which of the following women may be at increased risk for inadequate calcium intake? A. A 30 year old orthodox Jew B. A 35 year old Caucasian C. A 27 year old Native American D. A 24 year old Hispanic
answer
C
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114. Which of the following physical findings is consistent with a diagnosis of beta-thalassemia major? A. Bronze skin color B. Expressionless facies C. Lymphadenopathy D. Extremity pain
answer
A
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116. Which of the following is NOT a risk factor for a transient ischemic attack (TIA)? A. Age B. Hypertension C. Common migraine headache D. Smoking
answer
C
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118. A 3 day old infant is brought into the clinic with a history of failure to pass meconium, poor feeding, vomiting, and excessive flatus. The infant was diagnosed in the nursery with trisomy 21. Which of the following would be included in the differential diagnosis? A. Omphalocele B. Hirschsprung's disease C. Duodenal atresia D. Esophageal atresia
answer
B
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119. A 17-year-old female is diagnosed with secondary amenorrhea. Findings in her history which may account for the cessation of menses include all of the following EXCEPT she: A. has undiagnosed anorexia nervosa. B. leads 1½ hour aerobic dancercise classes 10 times each week. C. frequently uses the designer drug ecstacy or smokes marijuana on the weekend with friends D. receives a Depo Provera injection every 3 months at the family planning clinic.
answer
C
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126. Which of the following scenarios in a 75 year old patient would be inappropriately managed in an outpatient setting (i. e. the patient should be referred for hospital admission)? A. Secondary hypertension B. Unstable angina C. Orthostatic hypotension D. Vasovagal syncope
answer
B
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128. A 25 year old married woman is being taught the natural family planning method (NFP) of contraception by the NP. Which of the following statements by the patient demonstrates her understanding of NFP? A. "Abstinence is required during the 14th through 16th day of my cycle." B. "Coitus is 'safe' when my basal body temperature increases." C. "Cervical mucus is clear and thin during ovulation." D. "Douching does not affect my ability to effectively practice NFP.
answer
C
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132. What disease process are Bouchard's nodes most commonly associated with? Rheumatoid arthritis Osteoarthritis
answer
Osteoarthritis
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133. Which of the following is an appropriate drug for initial treatment of gastroesophageal reflux disease (GERD) in adults? A. famotidine (Pepcid®) B. sucralfate (Carafate®) C. metoclopramide (Reglan®) D. omeprazole (Prilosec®)
answer
A
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134. According to the American Diabetes Association, what is the lowest fasting plasma glucose level which warrants a diagnosis of diabetes mellitus if confirmed on a subsequent day? A. 121 mg/dL (6.7 mmol/L) B. 126 mg/dL (7 mmol/L) C. 130 mg/dL (7.2 mmol/L) D. 140 mg/dL (7.8 mmol/L)
answer
B
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135. Treatment of acute vertigo includes: A. bedrest and an antihistamine. B. fluids and a decongestant. C. a sedative and extra fluids. D. exercise and a low sodium diet.
answer
A
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136. A young child is suspected of having pediculosis. The NP examines the hair of the child with a Wood's lamp. The NP would expect to see: A. Adult lice glowing fluorescent green. B. Nits that fluoresce white and gray
answer
B
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139. A patient with no significant medical history has varicose veins. She complains of "aching legs". The intervention that will provide the greatest relief for her complaint is to: A. wear support stockings. B. avoid prolonged sitting. C. elevate her legs periodically. D. take two aspirin for pain.
answer
C
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141. The nurse practitioner should refer the pregnant patient for ultrasound and amniocentesis when the patient: A. has a history of high risk sexual behavior. B. received a blood transfusion in 1982. C. has a history of a neural tube defect in a previous pregnancy. D. has unsensitized Rh-negative blood.
answer
C
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142. Patients with benign prostatic hyperplasia (BPH) should be taught to avoid which one of the following drug classes? A. alpha-adrenergic antagonists B. Anti-androgen agents C. Tricyclic antidepressants (TCAs) D. Sulfonamides
answer
C
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148. Which of the following medications is indicated for primary prevention of febrile seizures? A. phenobarbital B. acetaminophen (Tylenol®) C. aspirin D. phenytoin (Dilantin®)
answer
B
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149. Which of the following conditions requires partner treatment? A. Trichomonal vaginalis B. Leiomyoma C. Bacterial vaginosis D. Candida vaginitis
answer
A
question
All of the following are included in the differential diagnosis of hyperthyroidism EXCEPT: A. Plummer's disease B. Multi-nodular goiter C. Hypersomnia D. Thyrotoxicosis
answer
C
