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-Jeremy is suffering from chronic alcohol abuse. His symptoms

include mental confusion, ataxia, stupor, and hypotension. The most likely cause of Jeremy's disease is:
 Vitamin D deficiency

 Thiamine deficiency

 Vitamin C deficiency

 Vitamin E deficiency
1 points  
QUESTION 2

-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
1 points  
QUESTION 3

-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. Medications to assist Zina would include all the following except:
Zantac

Pepcid

NSAIDS

Prevacid
 
QUESTION 4

-The diagnosis of a subclinical hypothyroidism would be identified by which lab test results?
Increased TSH and normal free T4

Decreased TSH and normal free T4

Increased TSH and increased free T4

Decreased TSH and decreased free T4
1 points  
QUESTION 5

-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. Potential organisms that might have caused Sam's condition include which of the following:
Mycoplasma pneumoniae

Chlamydia pneumoniae

Legionella pneumonia

All of the above

None of the above
1 points  
QUESTION 6

-Maria is a 26 y/o female in her third trimester of pregnancy. She has a sudden onset of vaginal bleeding and has a hypertonic uterus. She has a history of hypertension secondary to previous cocaine use. Her most likely diagnosis would be:
Placental abruption

Placenta previa

Severe preeclampsia

Uterine rupture
 
QUESTION 7

-Sara is a 38 y/o multipara who is in her 6th-7th month of pregnancy with her fourth child. She has a new onset of vaginal bleeding that is worsened by intercourse. On external physical exam, you note that her uterus is soft and non-tender to palpation. Knowing that her cervix is not dilated, the most appropriate treatment would be:
An emergency room visit

Strict bedrest

Hospitalization

All of the above
1 points  
QUESTION 8

-All of the following are characteristic of the S4 heart sound except
Normal finding in some healthy elderly

Occurs during systole

Best heard at apex of the heart

Best heard with bell of stethoscope
1 points  
QUESTION 9

-Susan is a 29 y/o female who comes to the clinic with a 3-day history of fever, chills, nausea, vomiting, and flank pain. During the visit, the NP does a urine dipstick and discover that Susan is positive for nitrites, leukocytes, and >10 WBCs. The physical exam reveals a CVA tenderness. Her most likely diagnosis is:
Lower urinary tract infection

Abdominal virus

Upper urinary tract infection

Sexually transmitted disease
 
QUESTION 10

-Diagnostic studies for Type II diabetes mellitus would include which of the following?
HbA1C (>6.5%)

Fasting plasma glucose (= to or >126 mg/dL)

Random plasma glucose (>200 mg/dL)

All of the above

None of the above
1 points  
QUESTION 11

-Continuous antibiotic prophylaxis with which antibiotic is the most effective mode of treating UTIs:
TMP-SMX

Nitrofurantoin

Cephalexin

Ciprofloxacin
1 points  
QUESTION 12

-According to the CDC, an infant can start receiving live attenuated vaccine at 6 months of age. True
 False
1 points  
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. The most likely diagnosis is:
Acute pyelonephritis

Nephrolithiasis

Simple UTI

None of the above
 

-The most common method of contraception is:
IUDs

Sterilization

Condoms

Birth control pills
1 points  
QUESTION 15

-To perform the psoas sign, the NP would do which of the following?
With patient supine, have pt. raise right leg against NPs hand. Positive if pain is elicited.

With patient on left side, extend patients right leg at hip. Positive if pain is elicited.

Pain during left-sided pressure in LLQ is positive sign.

Flex patient's right thigh at hip with knee bent and rotate leg internally at the hip. Positive if pain elicited.

A & B only

None of the above
1 points  
QUESTION 16

-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
1 points  
QUESTION 17

-Judy, a 28 y/o, presents to the clinic with a fever, vaginal discharge, and pain in the lower abdomen, pelvis, and lower back. These symptoms are accompanied by chills, nausea, and vomiting. Treatment for Judy's condition would include all the following drugs except:
Cefotan

Amoxicillin

Ceftriaxone

Metronidazole
 
 
 
 
QUESTION 18

-Which vaccine is required at birth of a newborn?
Hepatitis A

Hepatitis B

DTAP

Tdap
1 points  
QUESTION 19

-Amanda was out hiking with her boyfriend in the woods. When she gets home, she notices that she has an inflammatory skin reaction caused by something she picked up in the woods. The next day she sees bright red pruritic lesions on her lower extremities that are moist and painful. Treatment for Amanda's condition would include which of the following?
Topical steroids

Triamcinolone

Calamine lotion

Oatmeal baths (Aveeno)

All of the above

All of the above except D
1 points  
QUESTION 20

-Angela is a 15-year-old who has a distorted perception of her body shape and size. She is currently down to 96 lbs. with a BMI of 17. Your physical exam and history note that she has lanugo, has not had a menses in 4 months, and has a daily history of vomiting and taking laxatives. Complications of Angela's disease include which of the following?
 Osteopenia

 Peripheral edema

 Cardiac complications

 All of the above

 B & C only
QUESTION 21

-Osteoporosis is defined as having a T-score of _____ or less than the standard deviation of a healthy individual.
1

-1.5

-2.5

-3.5
1 points  
QUESTION 22

-Acanthosis nigricans is associated with all the following except:
Diabetes

Metabolic syndrome

Obesity

Cancer of bladder
1 points  
QUESTION 23

-In pulsus paradoxus, even if the pulse cannot be palpated, it can still be heard by using a BP cuff and stethoscope. True
 False
1 points  
QUESTION 24

-Mickey is a 23 y/o male who comes to the clinic with the following complaints: abdominal pain, chest pain, and seizures. In reviewing his record, the NP notices that this is his 20th visit this year. Furthermore, he has had six exploratory surgeries that have discovered nothing of consequence. His most likely diagnosis is:
 Munchausen syndrome

 Schizophrenia

 Posttraumatic syndrome

 Anorexia nervosa
QUESTION 25

-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
1 points  
QUESTION 26

-All of the following are pharmacological treatments for osteoporosis except:
Biphosphates

Thyroid stimulating hormone

Tamoxifen

Parathyroid hormone analog
1 points  
QUESTION 27

-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 the most likely diagnosis?
Testicular cancer

Testicular torsion

Hodgkin lymphoma

None of the above
1 points  
QUESTION 28

-Juan, an 82 y/o male, is brought to the clinic by his daughter with sudden LLQ pain, nausea, vomiting, diarrhea, or constipation.  The patient has a temperature of 100.4 and reports blood in stool. Juan's most likely diagnosis is:
PUD

Acute diverticulitis

Acute pancreatitis

Hepatitis
QUESTION 29

-Treatment for H. pylori-negative ulcers includes all the following except:
Stop NSAIDS

Stop smoking

Prilosec for 4-8 weeks

Triple therapy including Biaxin, Flagyl, and amoxicillin
1 points  
QUESTION 30

-A 32 y/o female comes to the clinic for what she describes as "a dark-colored urine." During the exam, the NP uses a urine dipstick to test for blood in the urine. Since the result had so many false negative and false positive indicators, the next step would be:
Urinalysis with microscopy

Urine culture

Referral to urologist

Cystoscopic examination of bladder

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