Codina Test 101-150

101.-All of the following measures has been found to help lower the risk of osteoporosis except: Drinking organic juice. Eating low-fat dairy foods. Performing weight-bearing exercises. Vitamin D supplementation.

102.-A 28-year-old male nurse of Hispanic descent reports a history of a cold that resolved 2 weeks ago except for a dry cough and pain over his right cheek that worsens when he bends down. The patient denies fever. He tells the employee health nurse practitioner that he is very allergic to both cephalexin (Keflex) and erythromycin. The vital signs show that the patient’s temperature is 99.2 degrees Fahrenheit, a pulse of 72 beats per minute, and a respiratory rate of 12 breaths per minute. Which of the following conditions is most likely?. Acute sinusitis. Acute bronchitis. Fever secondary to the previous viral URI (upper respiratory infection). Munchausen’s syndrome.

103.-A 38-year-old multigravida who is at 32 weeks of gestation calls the family nurse Practitioner complaining of bright red vaginal bleeding. There is no watery discharge. She complains that her uterus feels hard and is very painful. Which of the following conditions is most likely?. Placenta previa. Placenta abruption. A molar pregnancy. An ectopic pregnancy.

104.-The Jarisch-Herxheimer reaction is best described as: An immune-mediated reaction precipitated by the destruction of a large number of spirochetes due to an antibiotic injection. Severe chills and elevated blood pressure. Caused by infection with either Chlamydia trachomatis or gonorrheal infection of the liver capsule. Associated with certain viral illnesses.

105.-During a breast exam of a 30-year-old nulliparous female, the nurse practitioner palpates several rubbery mobile areas of breast tissue. They are slightly tender to palpation. Both breasts have symmetrical findings. There are no skin changes or any nipple discharge. The patient is expecting her menstrual period in 5 days. Which of the following would you recommend?. Referral to a gynecologist for further evaluation. Tell her to return 1 week after her period so her breasts can be rechecked. Advise the patient to return in 6 months to have her breasts rechecked. Schedule the patient for a mammogram.

106.-When evaluating the blood pressure on both the arms and legs of an infant who has a diagnosis of coarctation of the aorta, which of the following is the correct finding?. The blood pressure is higher in the arms than in the legs. Only the diastolic blood pressure is higher in the legs than in the arms. The blood pressure is higher in the legs than the arms. The blood pressure is lower in both arms than in the legs.

107.-Which of the following should you expect to find on a wet-mount slide of a patient diagnosed with bacterial vaginosis?. Tzanck cells. A large amount of leukocytes and epithelial cells. A large amount of bacteria coating the squamous cells and very few leukocytes. Epithelial cells and a small amount of blood.

108.-A 40-year-old woman is in the office complaining of palpitations and some light headedness for the past 6 months. These are random episodes. The nurse practitioner notices a midsystolic click with a late systolic murmur that is best heard in the apical area during auscultation of the chest. The NP would suspect: Atrial fibrillation. Sinus arrhythmia. Mitral stenosis. Mitral valve prolapse.

109.-Your 35-year-old patient is being worked up for microscopic hematuria. All of the following are differential diagnoses of microscopic hematuria except: Kidney stones. Bladder cancer. Renal stenosis. Renal stenosis.

110.-During a routine physical exam of an elderly woman, a triangular thickening of the bulbar conjunctiva on the temporal side is noted to be encroaching on the cornea. She denies any eye pain or visual changes. Which of the following is most likely?. Corneal arcus. Pterygium. Pinguecula. Chalazion.

111.-Mr. Jones, who has been on pravastatin (Pravachol) 20 mg at bedtime for the past few months, complains of lately feeling extremely fatigued. The patient also noticed that his urine has been a darker color during the past 2 weeks. Which of the following is the best treatment plan to follow?. Discontinue his pravastatin and order a liver function profile. Continue the pravastatin but on half the dose. Schedule him for a complete physical exam. Schedule him for a liver function profile.

112.-Jane, a young primigravida, reports to you that she is starting to feel the baby’s movements in her uterus. This is considered to be which of the following?. Presumptive sign. Probable sign. Positive sign. Possible sign.

113.-A 14-year-old teen is worried that she has not started to menstruate like most of her friends. During the gynecological examination, the nurse practitioner tells the mother, who is in the room with the patient, that her daughter is starting Tanner Stage II. What are the physical exam findings during this stage?. Breast buds and some straight pubic hair. Fully developed breasts and curly pubic hair. Breast tissue with the areola on a separate mound with curly pubic hair. No breast tissue and no pubic hair.

114.-The Phalen test is used to evaluate: Inflammation of the median nerve. Rheumatoid arthritis. Degenerative joint changes. Chronic tenosynovitis.

115.-Physiologic anemia of pregnancy is due to: An increase in the cardiac output at the end of the second trimester. A physiologic decrease in the production of RBCs in pregnant women. An increase of up to 50% of the plasma volume in pregnant women. An increase in the need for dietary iron in pregnancy.

116.-All of the following are implicated in causing chronic cough except: Chronic bronchitis. Allergic rhinitis. Acute viral upper respiratory infection. Gastroesophageal reflux disease.

117.-Which of the following is a true statement regarding the effect of aspirin on platelet function?. The effect on platelets is reversible. The effect on platelets is reversible and lasts only 1 week. It has a minimal effect on platelet function. The effect on platelet function is irreversible and lasts 15 to 20 days.

118.-All of the following agents are used to control the inflammatory changes seen in the lungs of asthmatics, except: Albuterol inhaler (Proventil). Triamcinolone (Azmacort) ??. Montelukast (Singulair). Cromolyn sodium inhaler (Intal).

119.-Rovsing’s sign is associated with which of the following?. An acute abdomen, such as during a ruptured appendix. Knee instability. Damage to the meniscus of the knee. Acute cholelithiasis.

120.-Which of the following is contraindicated in the care of pregnant women with placenta previa?. Echocardiogram. Intravaginal ultrasound. Abdominal ultrasound. Pelvic ultrasound.

121.-A patient is positive for anti-HCV (hepatitis C virus antibody). What is the next step to further evaluate this patient?. Refer the patient to a gastroenterologist. Order a hepatitis C PCR (polymerase chain reaction) test. Order a hepatitis B comprehensive panel. The patient is immune to hepatitis C and no further testing is indicated.

122.-A 62-year-old female complains of chronic severe low back pain. She also reports mild episodes of fecal incontinence and numbness to her lower legs over the past week. You would suspect which of the following?. Fracture of the lower spine. A herniated disc. Cauda equina syndrome. Ankylosing spondylitis.

123.-A 40-year-old White female with a BMI (body mass index) of 32 complains of colicky pain in the right upper quadrant of her abdomen that gets worse if she eats fried food. During the physical exam, the nurse practitioner presses deeply on the left lower quadrant of the abdomen. After releasing her hand, the patient complains of pain on the right side of the lower abdomen. What is the name of this finding?. Rebound tenderness. Rovsing’s sign. Murphy’s sign. Psoas test.

124.-Which of the following viral infections is associated with occasional abnormal forms of lymphocytes during an acute infection?. Cytomegalovirus (CMV). Epstein-Barr virus (EBV). Human papilloma virus (HPV). Coxsackie virus.

125.-A faun tail nevus is a sign of which of the following?. Down syndrome. Infantile scoliosis. Congenital heart disease. Spina bifida.

126.-Jenny, a 21-year-old, complains to you of a 1-week episode of dysuria, frequency, and a strong odor to her urine. This is her second episode of the year. What is the most appropriate follow-up for this patient?. Order a urinalysis and urine for culture and sensitivity (C&S) and treat the patient with antibiotics. Order a urine C&S and hold treatment until you get the results from the lab. Treat the patient with a 7-day course of antibiotics and order urine for culture and sensitivity (urine C&S) now and after she completes her antibiotics. Treat the patient with a stronger drug such as ofloxacin (Floxin) for 10 days.

127.-Café-au-lait spots look like tan-to-light brown stains that have irregular borders. They can be located anywhere on the body. Which of the following is a correct statement?. They are associated with neurofibromatosis or von Recklinghausen’s disease. They may be considered as precancerous after a biopsy. They are more common in darker-skinned children. They are associated with Wilson’s disease.

128.-During the eye exam of a 50-year-old hypertensive patient who is complaining of an onset of a severe headache, you find that the borders of the disc margins on both eyes are blurred. What is the name of this clinical finding?. Normal optic disc. Optic neuropathy. Papilledema. Hypertensive retinopathy.

129.-A high school teacher complains of a dry cough for the past 6 weeks. It worsens when he is supine. He has episodes of heartburn, which he self-treats with an overthe-counter (OTC) antacid. He chews mints for his “bad breath.” Which of the following is a possible cause for this patient’s cough?. Asthma. Gastroesophageal reflux. Pneumonia. Chronic postnasal drip.

130.-The red reflex is elicited by shining a light in the eyes of the infant at an angle with the light about 15 in. away. The nurse practitioner is screening for?. Cataracts. Strabismus. Blindness. The blinking response.

131.-A 44-year-old patient with Down syndrome starts to develop impaired memory and difficulty with his usual daily life routines. He is having problems functioning at the job that he has done for the past 10 years. The physical exam and routine labs are all negative. The vital signs are normal. His appetite is normal. The most likely diagnosis is: Tic douloureux. A stroke. Alzheimer’s disease. Delirium.

132.-Which of the following findings is associated with the chronic use of chewing tobacco?. Cheilosis and xerostomia. Glossitis. A geographic tongue. Leukoplakia and oral cancer.

133.-Which of the following is recommended treatment for erythema migrans or early Lyme disease?. Doxycycline (Vibramycin) 100 mg PO BID x 21 days. Ciprofloxacin (Cipro) 250 mg PO BID x 14 days. Erythromycin (E-mycin) 333 mg PO TID x 10 days. Dicloxacillin 500 mg PO BID x 10 days.

134.-Nurse practitioners and clinical nurse specialists derive their legal right to practice from: The Nurse Practice Act of the state where they practice. The laws of the state where they practice. The Medicare statute. The Board of Nursing in the state where they practice.

135.-You are checking a 75-year-old woman’s breast during an annual gynecological exam. The left nipple and areola are scaly and reddened. The patient denies pain and pruritis. She has noticed this scaliness on her left nipple for the past 8 months. Her dermatologist gave her a potent topical steroid, which she used twice a day for 1 month. The patient never went back for the follow-up. She still has the rash and wants an evaluation. Which of the following is the best intervention for this patient?. Prescribe another potent topical steroid and tell the patient to use it twice a day for 4 weeks. Order a mammogram and refer the patient to a breast surgeon. Advise her to stop using soap on both breasts when she bathes to avoid drying up the skin on her areola and nipples. Order a sonogram and fine-needle biopsy of the breast.

136.-The following children are considered at higher risk for tuberculosis (TB) except: A child who has recently been diagnosed with leukemia. An infant whose family is homeless. A child who was born in Japan. A Hispanic child with asthma who is using a steroid inhaler.

137.-During a sports physical exam of a 14-year-old high school athlete, the nurse practitioner notices a split of the S2 component of the heart sound during deep inspiration. She notes that it disappears upon expiration. The heart rate is regular and no murmurs are auscultated. Which of the following is correct?. This is an abnormal finding and should be evaluated further by a cardiologist. A stress test should be ordered. This is a normal finding in some young athletes. An echocardiogram should be ordered.

138.-Mrs. J. L. is a 55-year-old female with a body mass index (BMI) of 24 and a history of asthma. She has hypertension that has been under control with hydrochlorothiazide 12.5 mg PO daily. Her total cholesterol is 230 g/dl. How many risk factors for coronary heart disease (CAD) does she have?. 1 risk factor. 2 risk factors. 3 risk factors. 4 risk factors.

139.-A common side effect of metformin (Glucophage) therapy is: Weight gain. Lactic acidosis. Hypoglycemic episodes. Gastrointestinal problems.

140.-While doing a cardiac exam on a 45-year-old male, you note an irregular rhythm with a pulse rate of 110 beats per minute. The patient is alert and is not in distress. What is the most likely diagnosis?. Atrial fibrillation. Ventricular fibrillation. Cardiac arrhythmia. First-degree right bundle branch block.

141.-The following are patients who are at high risk for complications due to urinary tract infections. Who does not belong in this category?. A 38-year-old diabetic patient with a HbA1C of 7.5%. A woman with a history of rheumatoid arthritis who is currently being treated with a regimen of methotrexate and low-dose steroids. A 21-year-old woman who is under treatment for 2 sexually transmitted infections. Pregnant women.

142.-A 68-year-old woman with her near for a dry cough that worsens at night when she lies in bed. She has shortness of breath, which worsens when she exerts herself. The patient’s pulse rate is 90/min and regular. The patient has gained 6 lbs over the past 2 months. She is on a nitroglycerine patch and furosemide daily. The best explanation for her symptoms is: Kidney failure. Congestive heart failure. ACE inhibitor-induced coughing. Thyroid disease.

143.-A nurse practitioner is doing a funduscopic exam on a 35-year-old female during a routine physical exam. He notices that she has sharp disc margins and a yellowishorange color in the macular area. The ratio of veins to arteries is 3:2. What is the next most appropriate action?. Advise the patient that she had a normal exam. Advise the patient that she had an abnormal exam. Refer the patient to the emergency room. Refer the patient to an ophthalmologist.

144.-During a sports physical, you note that the vision of an 18-year-old male athlete is 20/30 in both eyes. Which of the following statements is true?. The patient can see at 20 ft what a person with normal vision can see at 30 ft. The patient can see at 30 ft what a person with normal vision can see at 20 ft. The patient cannot engage in contact sports. The patient needs to be referred to an ophthalmologist.

145.-Carol, a 30-year-old type 2 diabetic, is on regular insulin and lente insulin in the morning and in the evening. She denies changes in her diet or any illness, but recently started attending aerobic classes in the afternoon. Because of her workouts, her blood sugars have dipped below 50 mg/ dL very early in the morning. Her fasting blood sugar before breakfast is now elevated and higher than normal. Which of the following is best described?. Somogyi phenomenon. Dawn phenomenon. Raynaud’s phenomenon. Insulin resistance.

146.-A 40-year-old female is positive for anti-hepatitis C virus (HCV). Which test is appropriate for follow-up?. HCV RNA. HCV antibodies. HCV core antigen. Hepatitis C surface antigen.

147.-When the nurse practitioner is evaluating a patient for intermittent claudication, he/she would first: Order a venogram. Order T.E.D. anti-embolism stockings. Check the ankle and brachial blood pressure before and after exercise. Check the pedal and posterior tibial pulses.

148.-All of the following drugs can interact with Theophylline (Theo-24) except: Erythromycin. Montelukast (Singulair). Phenytoin sodium (Dilantin). Cimetidine (Tagamet).

149.-You note a high-pitched and blowing pansystolic murmur in a 70-year-old male. It is Grade II/VI and is best heard at the apical area. Which of the following is most likely?. Ventricular septal defect. Tricuspid regurgitation. Mitral regurgitation. Mitral stenosis.

150.-The cover/uncover test is a screening tool for: Color blindness. Strabismus. Visual acuity. Cataracts.