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Question 1 Sal is a 56 y/o male who the NP has seen on many...

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?

  1. Diastolic
  2. Systolic
  3. 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:

  1. Acute pyelonephritis
  2. Nephrolithiasis (kidney stone)
  3. Bladder cancer
  4. None of the above


Question 3

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

  1.  Depression
  2.  Menopausal symptoms
  3.  Wound healing
  4.  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?

  1. Use cold compresses on the groin area
  2. Start on antibiotics
  3. Give him acetaminophen and have him back in 24 hours
  4. 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:

  1. Rest
  2. Mucolytics
  3. Antibiotics
  4. Increased fluid intake


Question 6

The positive signs of pregnancy include all the following except:

  1. Palpation of uterus by NP
  2. Ultrasound and visualization of fetus
  3. Goodell's sign (cervical softening at 4 weeks)
  4. 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:

  1. 12 hours of birth
  2. 24 hours of birth
  3. 36 hours of birth
  4. 48 hours of birth

 

Question 8

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

  1. Every 2 years
  2. Every 3 years
  3. Every 4 years
  4. 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:

  1. Fluoroquinolone
  2. Ceftriaxone
  3. Ciprofloxacin
  4. All of the above
  5. A & C only


Question 10

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

  1. Posterior pituitary
  2. Parathyroid glands
  3. Thyroid gland
  4. Pineal gland


Question 11

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

  1. 100 g
  2. 75 g
  3. 50 g
  4. 25 g


Question 12

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

  1. 6-12 months
  2. 12-18 months
  3. 18-24 months
  4. 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:

  1. Pregnant women
  2. Children
  3. Diabetic
  4. 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:

  1. Major depression
  2. Bipolar depression
  3. Minor depression
  4. 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:

  1.  Korsakoff's syndrome
  2.  Insomnia
  3.  Anorexia nervosa
  4.  Bipolar disorder


Question 16

Radioactive iodine treatment results in temporary hypothyroidism.

  1.  True
  2.  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:

  1. Major depression
  2. Minor depression
  3. Suicidal ideation
  4. Anxiety


 

Question 18

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

  1. Diarrhea
  2. Nausea and vomiting
  3. Weight gain
  4. Sexual dysfunction
  5. All of the above
  6. 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:

  1. An acute MI
  2. Abdominal aortic aneurysm
  3. Infective endocarditis
  4. 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:

  1. Measles
  2. Hand, foot, and mouth disease
  3. Scarlet fever
  4. 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. 1 year old
  2. 2 years old
  3. 3 years old
  4. 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:

  1. Bronchitis
  2. Atypical pneumonia (Walking pneumonia)
  3. Allergic rhinitis
  4. 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:

  1. Blood cultures
  2. Echocardiography
  3. Transesophageal echocardiography
  4. All of the above
  5. A & B only

 

Question 24

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

  1. Type I
  2. Type 2
  3. 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?

  1. Long-acting beta agonist (LABA)
  2. Short-acting beta agonist (SABA)
  3. Long-acting muscarinic agent (LAMA)
  4. 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:

  1. Delivery of fetus
  2. Strict bedrest
  3. Intravenous magnesium sulfate
  4. 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:

  1. Halitosis
  2. Peptic ulcer disease
  3. Gastroesophageal reflux disease (GERD)
  4. 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:

  1. Congestive heart failure
  2. Infective endocarditis
  3. Dissecting abdominal aortic aneurysm (AAA)
  4. None of the above


Question 29

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

  1. Ortolani test
  2. Barlow test
  3. Galeazzi (Allis) sign
  4. 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:

  1. Squamous cell carcinoma
  2. Basal cell carcinoma
  3. Melanoma
  4. Malar lupus

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