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Question 1

Sal is a 56 y/o male who the NP has seen on many occasions in the clinic. During her physical exam of the heart, the NP notices that he has a new mitral regurgitation murmur that is described as a Grade II. She notes that his murmur is associated with which part of the cardiac cycle?

Diastolic
Systolic
A & B

 

Question 2

Artie, a 36 y/o male, comes to the clinic with chief complaint of: intermittent flank one side flank pain. The pain is an 8 on a scale of 1-10, with 10 being the worst pain he has ever felt. He states the pain lasts from 20-60 minutes and that he must either stand or walk when the pain hits. He also notes that he has blood in his urine. His most likely diagnosis is:

Acute pyelonephritis
Nephrolithiasis (kidney stone)
Bladder cancer
None of the above

Question 3

St. John’s Wart has all the following potential uses except:

 Depression
 Menopausal symptoms
 Wound healing
 HIV/AIDS

Question 4

Drew is a 13 y/o male who presents to the clinic with testicular pain, nausea, vomiting, scrotal edema, and redness. You perform a urine analysis, which is negative. What is your most likely treatment plan?

Use cold compresses on the groin area
Start on antibiotics
Give him acetaminophen and have him back in 24 hours
Send him to the ER. This is a surgical emergency.

Question 5

Mike is a 22 y/o male who comes to your clinic with a 5-day history of cough without sputum production. He states that his cough is worse in the morning and he has some hoarseness, post-nasal drip, and a low-grade fever. Mike has otherwise been healthy. Treatment for Mike’s condition would include all the following except:

Rest
Mucolytics
Antibiotics
Increased fluid intake

Question 6

The positive signs of pregnancy include all the following except:

Palpation of uterus by NP
Ultrasound and visualization of fetus
Goodell’s sign (cervical softening at 4 weeks)
Fetal heart tones

Question 7

Mary is a new mother who was tested HBsAG+ during her prenatal screening process. Upon the birth of her infant, the newborn should be given HBIG and Hep B within:

12 hours of birth
24 hours of birth
36 hours of birth
48 hours of birth

 

Question 8

Once cervical cancer screening is initiated in women, the screening interval should be:

Every 2 years
Every 3 years
Every 4 years
Every 5 years

Question 9

Joan is a 39 y/o female who presents to the clinic with a chief complaint of: 3-day history of fever (101 F degrees), chills, n & v, and flank pain. During the physical exam, the NP notices that Joan has CVA tenderness. In a urine check, the NP notes that she has many leukocytes, hematuria, WBC casts, and mild proteinuria. Pharmacological treatment for Joan could include which of the following drugs:

Fluoroquinolone
Ceftriaxone
Ciprofloxacin
All of the above
A & C only

Question 10

Which of the following glands is responsible for calcium balance in the body?

Posterior pituitary
Parathyroid glands
Thyroid gland
Pineal gland

Question 11

The preferred test for oral glucose tolerance test (OGTT) in a pregnant woman is:

100 g
75 g
50 g
25 g

Question 12

A patient with type 2 DM should have an eye exam for diabetic retinopathy every

6-12 months
12-18 months
18-24 months
24-36 months

Question 13

Joan is a 39 y/o female who presents to the clinic with a chief complaint of: 3-day history of fever (101 F degrees), chills, n & v, and flank pain. During the physical exam, the NP notices that Joan has CVA tenderness. In a urine check, the NP notes that she has many leukocytes, hematuria, WBC casts, and mild proteinuria. Patients with Joan’s diagnosis would be referred to a nephrologist under these conditions if they were:

Pregnant women
Children
Diabetic
All of the above

  

Question 14

Archie is a 19 y/o male who comes to the clinic with his significant other because of recent outbursts and then long periods of mood changes that cycle between mania and depression. His most likely diagnosis is:

Major depression
Bipolar depression
Minor depression
None of the above

Question 15

Jeremy is suffering from chronic alcohol abuse. His symptoms include mental confusion, ataxia, stupor, and hypotension. The most likely diagnosis for these symptoms is:

 Korsakoff’s syndrome
 Insomnia
 Anorexia nervosa
 Bipolar disorder

Question 16

Radioactive iodine treatment results in temporary hypothyroidism.

 True
 False

  

Question 17

Andrew is a 37 y/o male who comes to the clinic with the following symptoms: insomnia, feelings of worthlessness, and being easily fatigued. Given his symptoms the most likely diagnosis would be:

Major depression
Minor depression
Suicidal ideation
Anxiety

 

Question 18

The most common side effects of giving SSRIs to depressed patients include:

Diarrhea
Nausea and vomiting
Weight gain
Sexual dysfunction
All of the above
A, B & C only

Question 19

Kyle is a 68 y/o male who comes to the clinic for his annual checkup. His chief complaint is that for the past couple of weeks he has had severe, sharp, excruciating pain in his abdomen, flank, and back. During the physical exam, the NP notices that on palpation of the abdomen she feels a palpable mass that is greater than 3 cm in width. This could potentially be:

An acute MI
Abdominal aortic aneurysm
Infective endocarditis
Congestive heart failure

  

Question 20

Adam is a 10 y/o male who has Koplik’s spots inside the cheeks by the rear molars. The most likely diagnosis is:

Measles
Hand, foot, and mouth disease
Scarlet fever
Varicella

  

Question 21

What is the earliest age at which one would not give DTap to a child but rather would give Td or Tdap?

1 year old
2 years old
3 years old
7 years old

 

Question 22

Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some rhinitis, and low-grade fever. His likely diagnosis is:

Bronchitis
Atypical pneumonia (Walking pneumonia)
Allergic rhinitis
Community acquired bacterial pneumonia

  

Question 23

Martin is a 41 y/o male who comes to the clinic with the following symptoms: fever, chills, and malaise. On physical exam, the NP notes that he has a new murmur that was not present at his last visit and is aware that he has a prosthetic valve. He also has splinter hemorrhages on his nails, and petechiae on his palate. Additional diagnostic criteria for Martin’s presumed diagnosis would include which of the following:

Blood cultures
Echocardiography
Transesophageal echocardiography
All of the above
A & B only

 

Question 24

A pregnant women who has gestational diabetes mellitus (GDM) in the second trimester has which type of diabetes?

Type I
Type 2
Neither

Question 25

Carlos is a 64 y/o male who has previously been diagnosed as a Category A COPD patient based on Gold guidelines (2017). Treatment for Carlos would include which of the following?

Long-acting beta agonist (LABA)
Short-acting beta agonist (SABA)
Long-acting muscarinic agent (LAMA)
Referral to a pulmonologist

  

Question 26

Ann is a primigravida in her 35th week of pregnancy and presents to the clinic with severe recurrent headaches, blurred vision, pitting edema, and right upper quadrant pain. Additionally, she has oliguria, nausea, and vomiting. Her urine protein is >1+. The only treatment for Ann would be:

Delivery of fetus
Strict bedrest
Intravenous magnesium sulfate
Erythromycin

Question 27

Zina is a 34 y/o female who comes to the clinic with a chief complaint of 3 years of chronic heartburn. She states that she gets it after eating tacos and bacon. She has tried to self-medicate with OTC antacids with no improvement. In the exam, the NP notices a sour odor on Zina’s breath, thinning tooth enamel, and a chronic red throat. The most likely diagnosis is:

Halitosis
Peptic ulcer disease
Gastroesophageal reflux disease (GERD)
A or B only

Question 28

Martin is a 41 y/o male who comes to the clinic with the following symptoms: fever, chills, and malaise. On physical exam, the NP notes that he has a new murmur that was not present at his last visit and is aware that he has a prosthetic valve. He also has splinter hemorrhages on his nails, and petechiae on his palate. Based on these finding alone the NP arrives at the following presumed diagnosis:

Congestive heart failure
Infective endocarditis
Dissecting abdominal aortic aneurysm (AAA)
None of the above

Question 29

When testing an infant for developmental dysplasia of the hip, which of the following tests could be used?

Ortolani test
Barlow test
Galeazzi (Allis) sign
All of the above

Question 30

John is a 26 y/o Caucasian male who works as a landscaper for his father’s business. During the past couple of months, he has noticed a small dark popular lesion on his neck. He states that it sometimes bleeds and is a “sore that never heals.” The NP notes that he has a circumscribed 2mm lesion at the base of his neck just below the hairline. The NP’s diagnostic impression is that this is probably:

Squamous cell carcinoma
Basal cell carcinoma
Melanoma
Malar lupus
SCIENCE
HEALTH SCIENCE
NURSING

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