NR511 - midterm and final - 2018

Asked by sharpie
Dated: 4th Aug'18 08:36 PM
Bounty offered: $46.00

Question 1.Question : Which of the following is a crucial element of developing a

guideline?

Student Answer: Creating a physician expert panel

Reviewing the literature with ratings of available evidence

Conducting an external review of a guideline

Developing evidence-based tables

Points Received: 2 of 2

Comments:

Question 2.Question : African American patients seem to have a negative reaction

to which of the following asthma medications?

Student Answer: Inhaled corticosteroids

Long-term beta-agonist bronchodilators

Leukotriene receptor agonists

Oral corticosteroids

Points Received: 2 of 2

Comments:

Question 3.Question : Jolene has breast cancer that has been staged as T1, N0,

M0. What might this mean?

Student Answer: The tumor size cannot be evaluated; the cancer has not

spread to the lymph nodes; and the distant spread cannot

be evaluated.

The cancer is in situ; it is spreading into the lymph nodes,

but the spread cannot be evaluated otherwise.

The cancer is less than 2 cm in size and has not spread

to the lymph nodes or other parts of the body.

The cancer is about 5 cm in size; nearby lymph nodes

cannot be evaluated; and there is no evidence of distant

spreading.

Points Received: 2 of 2

Comments:

Question 4.Question : Sondra's peripheral vestibular disease causes dizziness and

vertigo. Which of the following medications will help to

decrease edema in the labyrinth of the ear?

Student Answer: Meclizine

Diphenhydramine

Diamox

Diamox

Promethazine

Points Received: 0 of 2

Comments:

Question 5.Question : Mandy presents with a cauliflower-like wart in her anogenital

region. You suspect it was sexually transmitted and

document this as a:

Student Answer: Filiform/digitate wart

Dysplastic cervical lesion

Condyloma acuminata

Koilocytosis

Points Received: 2 of 2

Comments:

Question 6.Question : Inattention and a sleep-wake cycle disturbance are the

hallmark symptoms of?

Student Answer: Dementia

Alzheimer's disease

Parkinson's disease

Delirium

Points Received: 2 of 2

Comments:

Question 7.Question : You have taught Jennifer, age 15, about using a flow meter

to assess how to manage her asthma exacerbations. She

calls you today because her peak expiratory flow rate is

65%. What would you tell her?

Student Answer: "Take your short-acting beta-2 agonist, remain quiet, and

call back tomorrow."

"Use your rescue inhaler, begin the prescription of oral

glucocorticoids you have, and call back tomorrow."

"Drive to the emergency room now."

"Call 911."

Points Received: 2 of 2

Comments:

Question 8.Question : A patient is seen in the clinic with hematuria confirmed on

microscopic examination. The clinician should inquire about

the ingestion of which of these substances that might be the

cause of hematuria?

Student Answer:

NSAIDs

NSAIDs

Beets

Vitamin A

Red meat

Points Received: 2 of 2

Comments:

Question 9.Question : Which of the following is an example of tertiary prevention in

a patient with chronic renal failure?

Student Answer: Fluid restriction

Hemodialysis 4 days a week

High-protein diet

Maintenance of blood pressure at 120/80

Points Received: 2 of 2

Comments:

Question 10.Question : Which of the following conditions is associated with

cigarette smoking?

Student Answer: Glaucoma

Increased sperm quality

Bladder cancer

Eczema

Points Received: 0 of 2

Comments:

Question 11.Question : A chronic cough lasts longer than:

Student Answer: 3 weeks

1 month

6 months

1 year

Points Received: 0 of 2

Comments:

Question 12.Question : The 'freezing phenomenon' is a cardinal feature of?

Student Answer: Parkinson's disease

Alzheimer's disease

A CVA

Bell's palsy

Points Received: 0 of 2

Comments:

Question 13.Question : When administered at the beginning of an attack, oxygen

therapy may help this kind of headache?

Student Answer: Tension

Migraine

Cluster

Stress

Points Received: 0 of 2

Comments:

Question 14.Question : Which ethnic group has the highest lung cancer incidence

and mortality rates?

Student Answer: African American men

Scandinavian men and women

Caucasian women

Asian men

Points Received: 0 of 2

Comments:

Question 15.Question : The most significant precipitating event leading to otitis

media with effusion is:

Student Answer: Pharyngitis

Allergies

Viral upper respiratory infection (URI)

Perforation of the eardrum

Points Received: 2 of 2

Comments:

Question 16.Question : Samuel is going to the dentist for some work and must take

endocarditis prophylaxis because of his history of:

Student Answer: Severe asthma

A common valvular lesion

Severe hypertension

A prosthetic heart valve

Points Received: 0 of 2

Comments:

Question 17.Question : A 34-year-old patient was treated for a UTI and has not

responded to antibiotic therapy. Which of the following

actions should be taken next?

Student Answer: Send a urine specimen for microscopy and evaluate for

fungal colonies.

fungal colonies.

Increase the dose of antibiotic.

Order a cytoscopy.

Order a different antibiotic.

Points Received: 0 of 2

Comments:

Question 18.Question : Which statement best describes a carotid bruit?

Student Answer: It is felt with the middle three fingers over the carotid

artery.

A bruit becomes audible when the lumen is narrowed to 1

mm or less.

A low-pitched bruit is a medical emergency.

The higher the pitch of the bruit, the higher the degree of

stenosis.

Points Received: 0 of 2

Comments:

Question 19.Question : Which statement is true regarding chloasma, the 'mask of

pregnancy'?

Student Answer: It is caused by a decrease in the melanocyte-stimulating

hormone during pregnancy.

This condition only occurs on the face.

Exposure to sunlight will even out the discoloration.

It is caused by increased levels of estrogen and

progesterone.

Points Received: 2 of 2

Comments:

Question 20.Question : Simon presents with alopecia areata with well-circumscribed

patches of hair loss on the crown of his head. How do you

respond when he asks you the cause?

Student Answer: "You must be under a lot of stress lately."

"It is hereditary. Did your father experience this also?"

"The cause is unknown, but we suspect it is due to an

immunologic mechanism."

"We'll have to do some tests."

Points Received: 0 of 2

Comments:

Question 21.Question : A blood pressure (BP) of 150/90 is considered:

Student Answer: Stage 2 hypertension

Student Answer: Stage 2 hypertension

Hypertensive

Normal in healthy older adults

Acceptable if the patient has DM

Points Received: 0 of 2

Comments:

Question 22.Question : When teaching post MI patients about their NTG tablets, the

clinician should stress that the tablets should remain in the

light-resistant bottle in which they are packaged and should

not be put in another pill box or remain in areas that are or

could become warm and humid. Once opened, the bottle

must be dated and discarded after how many months?

Student Answer: 1 month

3 months

6 months

As long as the tablets are kept in this special bottle, they

will last forever.

Points Received: 0 of 2

Comments:

Question 23.Question : Your patient has decided to try to quit smoking with Chantix.

You are discussing his quit date, and he will begin taking the

medicine tomorrow. When should he plan to quit smoking?

Student Answer: He should stop smoking today.

He should stop smoking tomorrow.

His quit date should be in 1 week.

He will be ready to quit after the first 30 days.

Points Received: 0 of 2

Comments:

Question 24.Question : 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?

Student Answer: Spores

Leukocytes

Pseudohyphae

Epithelial cells

Points Received: 0 of 2

Comments:

Question 25.Question : The hallmark of an absence seizure is:

Question 25.Question : The hallmark of an absence seizure is:

Student Answer: No activity at all

A blank stare

Urine is usually voided involuntarily

The attack usually lasts several minutes

Points Received: 0 of 2

Comments:

Question 26.Question : Which medication used for scabies is safe for children 2

months and older?

Student Answer: Permethrin cream

Lindane

Crotamiton lotion and cream

Ivermectin

Points Received: 0 of 2

Comments:

Question 27.Question : The clinician is seeing a patient complaining of red eye. The

clinician suspects conjunctivitis. The presence of

mucopurulent discharge suggests which type of

conjunctivitis?

Student Answer: Viral conjunctivitis

Keratoconjunctivitis

Bacterial conjunctivitis

Allergic conjunctivitis

Points Received: 2 of 2

Comments:

Question 28.Question : Gabby, aged 22, has Bell's palsy on the right side of her

face. Her mouth is distorted, and she is concerned about

permanent paralysis and pain. What do you tell her?

Student Answer: "Most patients have complete recovery in 3 to 6

months."

"Unfortunately, you'll probably have a small amount of

residual damage."

"Don't worry, I'll take care of everything."

"You may have a few more episodes over the course of

your lifetime but no permanent damage."

Points Received: 2 of 2

Comments:

Question 29.Question : How often should drug levels be monitored when a seizure

Question 29.Question : How often should drug levels be monitored when a seizure

medication has controlled the seizures, and the drug level is

adequate?

Student Answer: Every 3 months

Every 6 months

Annually

Whenever there is a problem

Points Received: 0 of 2

Comments:

Question 30.Question : Immunizations are an example of which type of prevention?

Student Answer: Primary

Secondary

Tertiary

Points Received: 0 of 2

Comments:

Question 31.Question : The result of the patient's 24-hour urine for protein was 4.2

g/day. The clinician should take which of the following

actions?

Student Answer: Repeat the test.

Refer to a nephrologist.

Measure the serum protein.

Obtain a blood urea nitrogen (BUN) and creatinine.

Points Received: 2 of 2

Comments:

Question 32.Question : Which cranial nerve is affected in a patient with a

cerebrovascular accident who has difficulty chewing?

Student Answer: CN V

CN VII

CN IX

CN X

Points Received: 0 of 2

Comments:

Question 33.Question : Which of the following diagnostic tests should be ordered

for a patient suspected of having bladder cancer?

Student Answer: Kidneys, ureter, bladder x-ray

Cystoscopy with biopsy

Magnetic resonance imaging

Urine tumor marker (NMP22)

Urine tumor marker (NMP22)

Points Received: 2 of 2

Comments:

Question 34.Question : The "B" in the ABCDEs of assessing skin cancer represents:

Student Answer: Biopsy

Best practice

Boundary

Border irregularity

Points Received: 2 of 2

Comments:

Question 35.Question : Which statement is true regarding driving and patients with a

seizure disorder?

Student Answer: Once diagnosed with a seizure disorder, patients must

never drive again.

After being seizure free for 6 months, patients may drive.

Each state has different laws governing driving for

individuals with a seizure disorder.

These persons may drive but never alone.

Points Received: 0 of 2

Comments:

Question 36.Question : Which high-density lipoprotein (HDL) level is considered

cardioprotective?

Student Answer: Greater than 30

Greater than 40

Greater than 50

Greater than 60

Points Received: 0 of 2

Comments:

Question 37.Question : The most common cause of CAP is?

Student Answer: Streptococcus pneumoniae

Klebsiella pneumoniae

Legionella pneumoniae

Pseudomonas aeruginosa

Points Received: 0 of 2

Comments:

Question 38.Question : Sandra has palpitations that occur with muscle twitching,

Question 38.Question : Sandra has palpitations that occur with muscle twitching,

paresthesia, and fatigue. What specific diagnostic test might

help determine the cause?

Student Answer: Serum calcium

Electrocardiogram (ECG)

Thyroid-stimulating hormone test

Complete blood cell count

Points Received: 2 of 2

Comments:

Question 39.Question : A patient presents to the clinician with a sore throat, fever of

100.7?F, and tender anterior cervical lymphadenopathy. The

clinician suspects strep throat and performs a rapid strep

test that is negative. What would the next step be?

Student Answer: The patient should be instructed to rest and increase fluid

intake as the infection is most likely viral and will resolve

without antibiotic treatment.

Because the patient does not have strep throat, the

clinician should start broad spectrum antibiotics in order to

cover the offending pathogen.

A throat culture should be performed to confirm the

results of the rapid strep test.

The patient should be treated with antibiotics for strep

throat as the rapid strep test is not very sensitive.

Points Received: 0 of 2

Comments:

Question 40.Question : Patients with acute otitis media should be referred to a

specialist in which of the following situations?

Student Answer: Concurrent vertigo or ataxia

Failed closure of a ruptured tympanic membrane

If symptoms worsen after 3 or 4 days of treatment

All of the above

Points Received: 0 of 2

Comments:

Question 41.Question : Which of the following tests is most useful in determining

renal function in a patient suspected of CRF?

Student Answer: BUN and creatinine

Electrolytes

Creatinine clearance

Urinalysis

Points Received: 0 of 2

Points Received: 0 of 2

Comments:

Question 42.Question : Marci has a wart on her hand. She says she heard

something about "silver duct tape therapy." What do you tell

her about his?

Student Answer: It is an old wives' tale.

It is used as a last resort.

Salicylic acid is more effective.

It is a simple treatment that should be tried first.

Points Received: 0 of 2

Comments:

Question 43.Question : What is the first-line recommended treatment against Group

A ?-hemolytic streptococci (GABHS), the most common

cause of bacterial pharyngitis?

Student Answer: Penicillin

Quinolone

Cephalosporin

Macrolide

Points Received: 0 of 2

Comments:

Question 44.Question : Which of the following is an example of sensorineural

hearing loss?

Student Answer: Perforation of the tympanic membrane

Otosclerosis

Cholesteatoma

Presbycusis

Points Received: 0 of 2

Comments:

Question 45.Question : Which of the following is "a linear crack extending from the

epidermis to the dermis?"

Student Answer: An ulcer

A fissure

Lichenification

An excoriation

Points Received: 2 of 2

Comments:

Question 46.Question : A 65-year-old man presents to the clinician with complaints

Question 46.Question : A 65-year-old man presents to the clinician with complaints

of increasing bilateral peripheral vision loss, poor night

vision, and frequent prescription changes that started 6

months previously. Recently, he has also been seeing halos

around lights. The clinician suspects chronic open-angle

glaucoma. Which of the following statements is true

concerning the diagnosis of chronic open-angle glaucoma?

Student Answer: The presence of increased intraocular pressure measured

by tonometry is definitive for the diagnosis of open-angle

glaucoma.

The clinician can definitively diagnosis open-angle

glaucoma based on the subjective complaints of the

patient.

Physical diagnosis relies on gonioscopic evaluation of the

angle by an ophthalmologist.

Early diagnosis is essential in order to reverse any

damage that has occurred to the optic nerve.

Points Received: 0 of 2

Comments:

Question 47.Question : The majority of HSV-1 and HSV-2 infections are

asymptomatic so that only which elevated antibody titer

shows evidence of previous infection?

Student Answer: IgA

IgE

IgG

IgM

Points Received: 0 of 2

Comments:

Question 48.Question : A patient is seen with a sudden onset of flank pain

accompanied by nausea, vomiting, and diaphoresis. In

addition to nephrolithiasis, which of the following should be

added to the list of differential diagnoses?

Student Answer: Pancreatitis

Peptic ulcer disease

Diverticulitis

All of the above

Points Received: 0 of 2

Comments:

Question 49.Question : Which of the following is abundant in the heart and rapidly

rises in the bloodstream in the presence of heart failure,

making it a good diagnostic test?

making it a good diagnostic test?

Student Answer: B-type natriuretic peptide

C-reactive protein

Serum albumin

Erythrocyte sedimentation rate

Points Received: 0 of 2

Comments:

Question 50.Question : You are doing a cerumen extraction and touch the external

meatus of your patient's ear. He winces and starts coughing.

What is the name of this reflex?

Student Answer: Baker phenomenon

Arnold reflex

Cough reflex

Tragus reflex

Points Received: 0 of 2

Comments:

* Times are displayed in (GMT-07:00) Mountain Time (US & Canada)

Question : The most cost-effective screening test for determining HIV

status is which of the following?

Student Answer: Western blot

Enzyme-linked immunosorbent assay

Venereal Disease Research Laboratory test

Viral load

Points Received: 0 of 2

Comments:

Question 2.Question : Which blood test is a nonspecific method and most helpful

for evaluating the severity and course of an inflammatory

process?

Student Answer: Erythrocyte sedimentation rate

White blood cell count

Polymorphonuclear cells

C-reactive protein (CRP)

C-reactive protein (CRP)

Points Received: 0 of 2

Comments:

Question 3.Question : Cocaine acts as a stimulant by blocking the reuptake of

which neurotransmitter?

Student Answer: GABA

Acetylcholine

Dopamine

Serotonin

Points Received: 0 of 2

Comments:

Question 4.Question : Mrs. Thomas was seen in the office complaining of pain and

point tenderness in the area of her elbow. The pain has

increased following a day of gardening one week ago. A

physical finding that differentiates the diagnosis and is most

consistent with lateral epicondylitis (tennis elbow) is:

Student Answer: Ecchymosis, edema, and erythema over the lateral

epicondyle

Pain at the elbow with resisted movements at the wrist

and forearm

Inability to supinate and pronate the arm

Inability to flex or extend the elbow against resistance

Points Received: 2 of 2

Comments:

Question 5.Question : Which of the following statements concerning the

musculoskeletal examination is true?

Student Answer: The uninvolved side should be examined initially and then

compared to the involved side.

The part of the body that is causing the patient pain

should be examined first.

When possible, the patient should not be asked to

perform active range-of-motion (ROM) exercises to avoid

causing pain.

Radiographs should always be obtained prior to

examination so as not to cause further injury to the patient.

Points Received: (not graded)

Comments:

Question 6.Question : Which of the following signs or symptoms indicate an

Question 6.Question : Which of the following signs or symptoms indicate an

inflammatory etiology to musculoskeletal pain?

Student Answer: Decreased C-reactive protein

Hyperalbuminemia

Morning stiffness

Weight gain

Points Received: (not graded)

Comments:

Question 7.Question : Which causes the greatest percentage of mammalian bites?

Student Answer: Dogs

Cats

Humans

Rodents

Points Received: (not graded)

Comments:

Question 8.Question : A 48-year-old woman is seen in the clinic with complaints of

prolonged heavy menstrual periods. She is pale and states

she can no longer exercise. Pelvic exam reveals a single,

very large mass. Which of the following diagnostic tests

should the clinician order first?

Student Answer: Transvaginal ultrasound

Endometrial biopsy

MRI

Abdominal computed tomography scan

Points Received: (not graded)

Comments:

Question 9.Question : A diabetic patient asks the clinician why he needs to check

his blood sugar at home even when he feels good. Which of

the following responses would be most appropriate?

Student Answer: "Control of glucose will help postpone or delay

complications."

"Regularly checking blood sugar will help establish a

routine."

"Monitoring glucose will promote a sense of control."

All of the above

Points Received: (not graded)

Comments:

Question 10.Question : A 25-year-old patient presents to the clinic with fatigue, cold

Question 10.Question : A 25-year-old patient presents to the clinic with fatigue, cold

intolerance, weight gain, and constipation for the past 3

months. On physical examination, the clinician notices a

sinus bradycardia; muscular stiffness; coarse, dry hair; and a

delay in relaxation in deep tendon reflexes. Which of the

following tests should be ordered next?

Student Answer: Serum calcium

TSH

Electrolytes

Urine specific gravity

Points Received: (not graded)

Comments:

Question 11.Question : Which of the following medications for type 2 diabetes

mellitus should not be prescribed during pregnancy?

Student Answer: Insulin

Metformin

Glucotrol

Precose

Points Received: (not graded)

Comments:

Question 12.Question : During a DRE on a 75-year-old man, the clinician suspects

the patient has prostate cancer. What physical finding

should make the clinician suspicious?

Student Answer: An enlarged rubbery gland

A hard irregular gland

A tender gland

A boggy gland

Points Received: (not graded)

Comments:

Question 13.Question : Eddie, age 4, presents to the ED with a live insect trapped in

his ear canal causing a lot of distress. What should be your

first step?

Student Answer: Remove the insect with tweezers.

Immobilize the insect with 2% lidocaine.

Sedate Eddie with diazepam.

Shine a light in the ear for the insect to "find its way out."

Points Received: (not graded)

Comments:

Question 14.Question : What is the most common cause of microcytic anemia?

Student Answer: Anemia of chronic disease

Sideroblastic anemia

Iron-deficiency anemia

Thalassemia

Points Received: (not graded)

Comments:

Question 15.Question : An 82-year-old man is seen in the primary care office with

complaints of dribbling urine and difficulty starting his

stream. Which of the following should be included in the list

of differential diagnoses?

Student Answer: Benign prostatic hyperplasia (BPH)

Parkinson's disease

Prostate cancer

All of the above

Points Received: (not graded)

Comments:

Question 16.Question : Early rheumatoid disease is characterized by:

Student Answer: Pain and swelling in both small and large peripheral

joints

Rigid joints with diminished range of motion

Joint swelling and immobility on rising

A cardiac rub or pulmonary friction rub

Points Received: (not graded)

Comments:

Question 17.Question : A 70-year-old female has fallen 2 weeks ago and developed

immediate pain in her left wrist. She thought she just bruised

it but is worried because it has not improved. She has used

Tylenol® and ice at home, and that has helped slightly. You

examine her and find she has moderate swelling and

ecchymosis but no overtly obvious deformity. Her ROM is

uncomfortable and severely diminished due to the pain. No

crepitus is heard or felt. Her fingers are warm; her pulse is

strong; and capillary refill is less than 2 seconds. What

should you do?

Student Answer: Make an immediate referral for an orthopedic evaluation

without further assessment.

Tell her that it takes time for these bruises to improve, so

she should be patient.

Obtain a wrist x-ray and place her wrist in a splint or

Obtain a wrist x-ray and place her wrist in a splint or

prescribe a splint.

Send her to the emergency room for reduction of this

obvious wrist fracture.

Points Received: (not graded)

Comments:

Question 18.Question : The criteria for diagnosing generalized anxiety disorder in

the American Psychiatric Association's Diagnostic and

Statistical Manual of Mental Disorders, 5th edition (text

revision) state that excessive worry or apprehension must be

present more days than not for at least:

Student Answer: 1 month

3 months

6 months

12 months

Points Received: (not graded)

Comments:

Question 19.Question : 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 expect to

find?

Student Answer: 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.

Points Received: (not graded)

Comments:

Question 20.Question : According to Kübler-Ross, the stages of grief occur in which

order?

Student Answer: Anger, denial, depression, bargaining, acceptance

Anger, denial, bargaining, acceptance, depression

Denial, anger, depression, bargaining, acceptance

Denial, anger, bargaining, depression, acceptance

Points Received: (not graded)

Comments:

Question 21.Question : Reuben, age 24, has HIV and just had a routine viral load

test done. The results show a falling viral load. What does

this indicate?

Student Answer: A favorable prognostic trend

A favorable prognostic trend

Disease progression

The need to be more aggressive with Reuben's

medications

The eradication of the HIV

Points Received: (not graded)

Comments:

Question 22.Question : The exanthem of Lyme disease is:

Student Answer: Erythema infectiosum

Laterothoracic exanthem

Erythema migrans

Morbilli exanthem

Points Received: (not graded)

Comments:

Question 23.Question : You have detected the presence of crepitus on examination

of a patient with a musculoskeletal complaint. Additionally,

there is limited range of motion (ROM) with both active and

passive movement. These findings suggest that the origin of

the musculoskeletal complaint is:

Student Answer: Articular

Inflammatory

Nonarticular

A and B

Points Received: (not graded)

Comments:

Question 24.Question : What is the recommended daily calcium intake for adults

over the age of 50 with low bone mass?

Student Answer: 1,200 mg/day

1,000 mg/day

1,300 mg/day

1,500 mg/day

Points Received: (not graded)

Comments:

Question 25.Question : When assessing a woman for infertility, which of the

following tests should be done first?

Student Answer: Analysis of partner's sperm

Magnetic resonance imaging (MRI)

Hysterosalpingogram

Estrogen level

Points Received: (not graded)

Comments:

Question 26.Question : Which type of burn injury results in destruction of the

epidermis with most of the dermis, yet the epidermal cells

lining hair follicles and sweat glands remain intact?

Student Answer: Superficial burns

Superficial partial-thickness burns

Deep partial-thickness burns

Full-thickness burns

Points Received: (not graded)

Comments:

Question 27.Question : A 23-year-old sexually active woman presents for her first

Pap smear. Her history includes nulligravida, age at first

intercourse 14, and more than 10 sexual partners. Which of

the following conditions should the clinician be particularly

alert for during her examination?

Student Answer: Human papillomavirus (HPV)

Endometrial hyperplasia

Vagismus

Polycystic ovarian syndrome

Points Received: (not graded)

Comments:

Question 28.Question : As a rule of thumb, the estimated level of hematocrit is how

many times the value of the hemoglobin?

Student Answer: Two

Three

Four

Five

Points Received: (not graded)

Comments:

Question 29.Question : Sam is a 25-year-old 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

examination. As the clinician, you explain to Sam that low

back pain is a diagnosis of exclusion. Which of the following

symptoms would alert the clinician to the more serious

finding of a herniated nucleus pulposus or ruptured disc?

Student Answer: Morning stiffness and limited mobility of the lumbar spine

Student Answer: Morning stiffness and limited mobility of the lumbar spine

Unilateral radicular pain symptoms that extend 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

Points Received: (not graded)

Comments:

Question 30.Question : A 30-year-old man is seen with a chief complaint of loss of

libido. Which of the following laboratory tests would help

establish a diagnosis?

Student Answer: Testosterone level

Prostate-specific antigen

Nocturnal penile tumescence and rigidity

Prolactin level

Points Received: (not graded)

Comments:

Question 31.Question : The clinician prescribes glipizide (Glucotrol) for a diabetic

patient. Which statement made by the patient would

indicate that your teaching has been effective?

Student Answer: "I'll take my pill at least 30 minutes before breakfast."

"I'll take my Glucotrol before bedtime."

"It is important to take my medication right after I eat."

"Since I only like to eat two meals a day, I can take the pill

between my meals."

Points Received: (not graded)

Comments:

Question 32.Question : In the United States, what is the second most common

connective tissue disease and the most destructive to the

joints?

Student Answer: Osteoarthritis

Systemic lupus erythematosus (SLE)

Rheumatoid arthritis

Sjögren's syndrome

Points Received: (not graded)

Comments:

Question 33.Question : The effectiveness of benzodiazepines in treating anxiety

Question 33.Question : The effectiveness of benzodiazepines in treating anxiety

disorders suggests that which of the following

neurotransmitters plays a role in anxiety?

Student Answer: Acetylcholine

Gamma-aminobutyric acid (GABA)

Dopamine

Serotonin

Points Received: (not graded)

Comments:

Question 34.Question : A 14-year-old male is seen with complaints of severe

testicular pain. The clinician suspects testicular torsion.

Which of the following is the appropriate action?

Student Answer: Refer to a urologist immediately.

Obtain a computed tomography (CT) scan.

Instruct the patient to elevate the scrotum.

Prescribe ibuprofen.

Points Received: (not graded)

Comments:

Question 35.Question : Which of the following medications can cause

hyperglycemia?

Student Answer: Prednisone

Metformin

Synthroid

Cephalexin

Points Received: (not graded)

Comments:

Question 36.Question : During treatment for anaphylaxis, what site is used for the

initial injection of epinephrine?

Student Answer: IV

Abdomen

Upper lateral thigh

Deltoid

Points Received: (not graded)

Comments:

Question 37.Question : It is important to educate patients with depression and their

family members about reporting signs of increasing

depression and suicidal thoughts. This is especially true

during which time period?

during which time period?

Student Answer: Before the initiation of treatment

1 to 2 weeks after the initiation of treatment

When switching to a different medication

1 to 2 weeks after tapering off medications

Points Received: (not graded)

Comments:

Question 38.Question : What is the most common cause of secondary amenorrhea?

Student Answer: Pregnancy

Pituitary dysfunction

Inadequate estrogen levels

Genetic disorders

Points Received: (not graded)

Comments:

Question 39.Question : Which of the following is the only drug for bulimia approved

by the U.S. Food and Drug Administration?

Student Answer: Sertraline

Fluoxetine

Citoprolam

Imipramine

Points Received: (not graded)

Comments:

Question 40.Question : The goals of the 15-minute hour approach include:

Student Answer: Enhance self-esteem, expand behavioral repertoire,

prevent dire consequences, and reestablish premorbid

levels of functioning

Emerge with a higher level of functioning and

commitment to long-term psychotherapy

Accept need for antidepressant therapy and psychiatric

referral; share concerns with primary care clinician

Improve family functioning and sexual performance as

well as accept need for antidepressant medication

Points Received: (not graded)

Comments:

Question 41.Question : 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 extend it

completely. John tells the clinician that he heard a pop when

completely. John tells the clinician that he heard a pop when

the injury occurred and has been experiencing localized

pain. The clinician suspects a meniscal tear. Which test

would be most appropriate to assess for the presence of a

meniscal tear?

Student Answer: Valgus stress test

McMurray circumduction test

Lachman test

Varus stress test

Points Received: (not graded)

Comments:

Question 42.Question : The cardinal subjective symptom of sickle cell crisis is which

of the following?

Student Answer: Pain

Nausea

Light-headedness

Palpitations

Points Received: (not graded)

Comments:

Question 43.Question : A 25-year-old woman is seen in the clinic complaining of

painful menstruation. Which of the following pelvic

pathologies is the most common cause of dysmenorrhea?

Student Answer: Pelvic inflammatory disease

Endometriosis

Sexually transmitted infections

Ovarian cyst

Points Received: (not graded)

Comments:

Question 44.Question : Which arthropod bite can contain cytotoxic and hemolytic

toxins that may destroy tissue?

Student Answer: Tick

Brown recluse spider

Wasp

Stinging caterpillar

Points Received: (not graded)

Comments:

Question 45.Question : Janet is a 30-year-old who has recently been diagnosed with

a herniated disc at the level of L5-S1. She is currently in the

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?

Student Answer: Gastrocnemius weakness

A reduced or absent ankle reflex

Numbness in the lateral foot

Paresthesia of the perineum and buttocks

Points Received: (not graded)

Comments:

Question 46.Question : A 21-year-old woman is seen in the clinic requesting birth

control pills. Which of the following tests is essential before

prescribing any oral contraceptive?

Student Answer: Pregnancy test

Complete blood cell count

Thyroid-stimulating hormone

Urine dip for protein

Points Received: (not graded)

Comments:

Question 47.Question : A patient with type 2 diabetes comes to the clinic after

reading about metformin in a magazine. Which of the

following conditions that the patient also has would be a

contraindication to taking metformin?

Student Answer: Ketoacidosis

Cirrhosis

Hypoglycemic episodes

All of the above

Points Received: (not graded)

Comments:

Question 48.Question : The clinician has chosen to prescribe an SSRI instead of a

tricyclic antidepressant (TCA) for a patient fitting the

diagnostic criteria for depression. Which of the following is

not true concerning SSRIs in comparison to tricyclic

antidepressants?

Student Answer: SSRIs are more effective than TCAs.

SSRIs take less time to work than TCAs.

SSRIs have a more favorable side-effect profile than

TCAs.

SSRIs are not lethal in overdose.

Points Received: (not graded)

Points Received: (not graded)

Comments:

Question 49.Question : Which type of bone marrow transplant is obtained from an

identical twin?

Student Answer: Autogenic

Autologous

Allogeneic

Syngeneic

Points Received: (not graded)

Comments:

Question 50.Question : Pink, cherry red tissues and skin may result from which type

of poisoning?

Student Answer: Arsenic

Lead

Carbon monoxide

Strychnine

Points Received: (not graded)

Comments:

Question 51.Question : Basic human needs are identified as:

Student Answer: Autonomy and feeling valued by others

Exhilaration and productivity

Spirituality

Career success and material rewards

Points Received: (not graded)

Comments:

Question 52.Question : The clinician sees a patient who is 5 feet tall and weighs 150

pounds. How would the clinician classify this patient?

Student Answer: Overweight

Mild obesity

Moderate obesity

Morbid obesity

Points Received: (not graded)

Comments:

Question 53.Question : A 22-year-old male is seen in the clinic because he found a

hard lump in his testicle when performing testicular selfexamination

(TSE). Which of the following should be

examination (TSE). Which of the following should be

included in the list of differential diagnoses?

Student Answer: Testicular cancer

Inguinal hernia

Varicocele

All of the above

Points Received: (not graded)

Comments:

Question 54.Question : What is the treatment of choice for a patient diagnosed with

testicular cancer?

Student Answer: Radical orchidectomy

Lumpectomy

Radiation implants

All of the above

Points Received: (not graded)

Comments:

Question 55.Question : Which method is used to remove heavy metals, such as

lead, that are ingested as poisons?

Student Answer: Chelation

Dialysis

Gastric lavage

Bowel irrigation

Points Received: (not graded)

Comments:

Question 56.Question : A 58-year-old woman presents with a breast mass. Which of

the following responses by the clinician would be most

appropriate?

Student Answer: "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."

Points Received: (not graded)

Comments:

Question 57.Question : A 36-year-old woman is seen with complaints of vaginal

Question 57.Question : A 36-year-old woman is seen with complaints of vaginal

itching, burning, and discharge. On potassium hydroxide

(KOH) wet mount of vaginal discharge, the clinician notices

hyphae. Which of the following treatments would be

appropriate?

Student Answer: Fluconazole

Estrogen vaginal cream

Metronidazole

Doxycycline

Points Received: (not graded)

Comments:

Question 58.Question : 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?

Student Answer: "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 to avoid developing tolerance to the

medication."

"You should take the maximum 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."

Points Received: (not graded)

Comments:

Question 59.Question : A history of overuse or excessive force, as opposed to a fall,

hyperextension, or the twisting of a joint, is more likely

related to which musculoskeletal injury?

Student Answer: A sprain

A strain

A partial fracture

A fracture

Points Received: (not graded)

Comments:

Question 60.Question : Which type of heat-related illness involves a core body

temperature of at least 104.9°F, acute mental status

temperature of at least 104.9°F, acute mental status

changes, absent sweat, and tachypnea?

Student Answer: Heat cramps

Heat syncope

Heat exhaustion

Heat stroke

Points Received: (not graded)

Comments:

Question 61.Question : Which of the following may be used to evaluate a person's

suicide risk?

Student Answer: CAGE

SANE

SAD PERSONAS

DIGFAST

Points Received: (not graded)

Comments:

Question 62.Question : One of the initial steps in assessing patients with

musculoskeletal complaints is to determine whether the

complaint is articular or nonarticular in origin. Which of the

following is an example of an articular structure?

Student Answer: Bone

Synovium

Tendons

Fascia

Points Received: (not graded)

Comments:

Question 63.Question : After returning from visiting his grandchildren in England,

George, age 59, complains of a flulike illness, including

fever, chills, and myalgia. He reports having discovered a

rash or red spot that grew in size on his right leg. What

disease are you considering?

Student Answer: A viral syndrome

Lyme disease

Rocky Mountain spotted fever

Relapsing fever

Points Received: (not graded)

Comments:

Question 64.Question : A patient is diagnosed with hypothyroidism. Which of the

Question 64.Question : A patient is diagnosed with hypothyroidism. Which of the

following electrocardiogram changes should the clinician

expect as a manifestation of the disease?

Student Answer: Sinus bradycardia

Atrial fibrillation

Supraventricular tachycardia

U waves

Points Received: (not graded)

Comments:

Question 65.Question : Which of the following tests is essential for a 46-year-old

woman who the clinician suspects is perimenopausal?

Student Answer: Pregnancy

Estrogen level

Progesterone level

LH level

Points Received: (not graded)

Comments:

Question 66.Question : After 6 months of Synthroid therapy, the clinician should

expect which of the following in the repeat thyroid studies?

Student Answer: Elevated TSH

Normal TSH

Low TSH

Undetectable TSH

Points Received: (not graded)

Comments:

Question 67.Question : A patient is 66 inches in height, weighing 200 pounds, and

newly diagnosed with type 2 diabetes mellitus (DM). Her

fasting plasma glucose level is 215 mg/dL. What is the best

initial treatment?

Student Answer: No treatment at this time

Diet and exercise for 6-week trial

Diet, exercise, and oral medication

Diet, exercise, and exogenous insulin

Points Received: (not graded)

Comments:

Question 68.Question : Which of the following should be considered in a patient

presenting with erectile dysfunction?

Student Answer: Diabetes mellitus

Student Answer: Diabetes mellitus

Hypertension

Atherosclerosis

All of the above

Points Received: (not graded)

Comments:

Question 69.Question : Mrs. Anderson is a 35-year-old woman who has been

recently diagnosed with carpal tunnel syndrome. She has

two young children and asks the clinician what the chances

are that they also will develop carpal tunnel syndrome.

Which of the following responses would be correct regarding

the risk of developing carpal tunnel syndrome?

Student Answer: Carpal tunnel syndrome commonly occurs in families.

Genetic factors are thought to account for about one-half

the risk of developing carpal tunnel.

Only people with occupations that require repeated

flexion extension of the wrist, use of hand tools that require

forceful gripping, or use of hand tools that vibrate are at risk

for developing carpal tunnel.

An underlying musculoskeletal disorder must be present

for a person to develop carpal tunnel.

Carpal tunnel syndrome only occurs in the presence of a

hormonal imbalance.

Points Received: (not graded)

Comments:

Question 70.Question : A 20-year-old woman is seen in the clinic because her

boyfriend was found to have gonorrhea. Which of the

following is the treatment of choice for gonorrhea?

Student Answer: Ceftriaxone

Doxycycline

Acyclovir

Metronidazole

Points Received: (not graded)

Comments:

Question 71.Question : Which of the following statements is true regarding the

treatment of carpal tunnel syndrome?

Student Answer: The goal of treatment is to prevent flexion and extension

movements of the wrist.

Splints are used in carpal tunnel syndrome, because they

allow for free movement of the fingers and thumb while

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

Points Received: (not graded)

Comments:

Question 72.Question : 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

expect in the initial test results for this patient?

Student Answer: Elevated uric acid level

Elevated blood urea nitrogen

Decreased urine pH

Decreased C-reactive protein

Points Received: (not graded)

Comments:

Question 73.Question : Which of the following data is indicative of testicular torsion?

Student Answer: Absent cremasteric reflex

Pain relieved on testicular elevation

Testicle very low in the scrotum

Swollen scrotum with "red dot sign"

Points Received: (not graded)

Comments:

Question 74.Question : A patient with type 2 diabetes asks the clinician why she

needs to exercise. In order to answer her, the clinician must

understand that exercise has what effect on the patient with

type 2 diabetes?

Student Answer: Reduces postprandial blood glucose

Reduces triglycerides and increases high-density

lipoprotein (HDL)

Reduces total cholesterol

All of the above

Points Received: (not graded)

Comments:

Question 75.Question : A 26-year-old woman is seen with complaints of irregular

vaginal bleeding. Which of the following tests should be the

vaginal bleeding. Which of the following tests should be the

first priority?

Student Answer: Pregnancy test

Pelvic ultrasound

Endometrial biopsy

Platelet count

Points Received: (not graded)

Comments:

Question 76.Question : What is the most common cause of generalized

musculoskeletal pain in women ages 20 to 55?

Student Answer: Chronic fatigue syndrome (CFS)

Anemia

Fibromyalgia syndrome (FMS)

Sports-related injuries

Points Received: (not graded)

Comments:

Question 77.Question : If the international normalized ratio (INR) result is above the

therapeutic range in a patient with atrial fibrillation on

warfarin, what might the clinician do?

Student Answer: Stop the warfarin for 1 week, and then repeat the INR.

Withhold one or more days of anticoagulant therapy.

Restart therapy at a lower dose immediately.

The prothrombin time and INR should be reevaluated

within 1 month of the dosage adjustments.

Points Received: (not graded)

Comments:

Question 78.Question : A 32-year-old woman is seen in the clinic because she has

been unable to get pregnant after 12 months of unprotected

sex. In order to determine the cause of the infertility, the

clinician should question her about which of these possible

causes?

Student Answer: Pelvic inflammatory disease

Oral contraceptive use for 15 years

Early menarche

Diet high in soy protein

Points Received: (not graded)

Comments:

Question 79.Question : Which of the following statements concerning the treatment

Question 79.Question : Which of the following statements concerning the treatment

of fibromyalgia syndrome is true?

Student Answer: There is currently no cure for the disorder; however,

patients should be made aware that symptom relief is

possible.

Treatment is directed toward controlling discomfort,

improving sleep, and maintaining function.

Fibromyalgia syndrome can be difficult to manage,

requiring a variety of approaches and multiple medications.

All of the above

Points Received: (not graded)

Comments:

Question 80.Question : The clinician should prescribe an antibiotic that covers

which of these organisms for a patient with acute

prostatitis?

Student Answer: Gram-positive cocci

Gram-negative cocci

Gram-positive bacillus

Gram-negative bacillus

Points Received: (not graded)

Comments:

Question 81.Question : Which household solution should be used to clean a

bathroom if sharing with a friend who has HIV?

Student Answer: 100% bleach

50% bleach and 50% vinegar

Nine parts H2O to one part bleach

The friend must have his or her own bathroom.

Points Received: (not graded)

Comments:

Question 82.Question : Sandra is 42 years old and has just been diagnosed with

leukemia. She is complaining of bone and joint pain. Which

type of leukemia is most likely the culprit?

Student Answer: Acute lymphocytic leukemia

Acute myelogenous leukemia

Chronic myelogenous leukemia

Chronic lymphocytic leukemia

Points Received: (not graded)

Comments:

Question 83.Question : Which of the following is identified as an eating disorder in

Question 83.Question : Which of the following is identified as an eating disorder in

which a person craves food substitutes, such as clay, ice

chips, and cotton, and is considered an objective finding

associated with severe iron deficiency?

Student Answer: Ferritin

Porter's syndrome

Hypochromasia

Pica

Points Received: (not graded)

Comments:

Question 84.Question : The clinician suspects that a client seen in the office has

hyperthyroidism. Which of the following tests should the

clinician order on the initial visit?

Student Answer: High sensitivity thyroid-stimulating hormone (TSH) and

free T4

Free T4 and serum calcium

Free T3 and T4

TSH and thyroxin antibodies

Points Received: (not graded)

Comments:

Question 85.Question : The clinician has been doing diabetic teaching for a patient

with type 1 diabetes. Which of the following statements by

the patient would indicate that teaching has been effective?

Student Answer: "As long as I don't need glasses, I don't have to worry

about going blind."

"I know I need to have my eyes checked every year."

"My optometrist checks my eyes."

"I will see my eye doctor when my vision gets blurry."

Points Received: (not graded)

Comments:

Question 86.Question : Triggering factors for acute exacerbations of which of the

following conditions include exposure to ultraviolet (UV)-B

and UV-A rays?

Student Answer: Rheumatoid arthritis

Scleroderma

SLE

Sjögren's syndrome

Points Received: (not graded)

Comments:

Question 87.Question : Which of the following characteristics separates anaphylaxis

from a vasovagal reaction?

Student Answer: Bradycardia

Extreme diaphoresis

Severe bronchoconstriction

Hypotension

Points Received: (not graded)

Comments:

Question 88.Question : Mr. Jackson is a 65-year-old man recently diagnosed with

osteoarthritis. The clinician has explained to Mr. Jackson

that the goals for managing osteoarthritis include controlling

pain, maximizing functional independence and mobility,

minimizing disability, and preserving quality of life. Mr.

Jackson explains to the clinician that his first choice would

be to use complementary therapies to control his condition

and asks what therapies are most effective in treating

osteoarthritis. What would be the most appropriate

response from the clinician?

Student Answer: "Complementary therapies should be considered only if

surgical interventions are not successful."

"I am unfamiliar with the available complementary

therapies for osteoarthritis and prefer to discuss more

mainstream treatments, such as NSAIDs and physical

therapy, to manage your condition."

"I would be happy to discuss all the treatment options

available to you. Complementary therapies, such as

acupuncture, acupressure, and tai-chi, are being studied for

use in the treatment of osteoarthritis and have shown

promise when used with standard medical therapy."

"It would be crazy to use complementary therapies to

treat such a serious condition."

Points Received: (not graded)

Comments:

Question 89.Question : One benefit of motivational interviewing (MI) is:

Student Answer: It assumes that ambivalence is a normal part of the

change process.

It can be utilized during routine office visits.

It is a therapeutic technique which is not necessarily time

intensive.

All are benefits of MI.

Points Received: (not graded)

Comments:

Comments:

Question 90.Question : What percentage of burns is involved using the rule of nines

if both front legs are burned?

Student Answer: 9%

18%

24%

36%

Points Received: (not graded)

Comments:

Question 91.Question : Women are at the highest risk for developing postpartum

depression for up to how long after childbirth?

Student Answer: 2 weeks

1 month

3 months

6 months

Points Received: (not graded)

Comments:

Question 92.Question : Which statement about HIV postexposure prophylaxis (PEP)

for health-care workers is the most accurate?

Student Answer: PEP should be started within hours of exposure.

PEP should be started within 72 hours of exposure.

Renal and hepatic function tests should be done 6 weeks

after beginning PEP.

PEP will prevent potential hepatitis C infection if present.

Points Received: (not graded)

Comments:

Question 93.Question : The clinician is caring for Diane, a 22-year-old woman who

presents with an injured ankle. Diane asks the clinic

NR511 midterm and final
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