Codina Test 251-300

251.-A new mother who is on her fourth day of breastfeeding complains to the nurse Practitioner of very sore breasts. The nurse practitioner would: Recommend a decrease in the number of times she breastfeeds her infant per day. Recommend that she stop breastfeeding and use infant formula for the next 48 hours. Educate the mother that this is normal during the first week or 2 of breastfeeding and the soreness will eventually go away. Recommend that she purchase plastic nipple pads for her nursing bra and use them daily.

252.-A 12-year-old male’s peak expiratory flow results indicate 60 to 80% of the predicted range. How would you classify his asthma?. Mild intermittent asthma. Mild persistent asthma. Moderate persistent asthma. Severe asthma.

253.-Which of the following conditions is associated with a positive Auspitz sign?. Contact dermatitis. Seborrhea dermatitis. Systemic lupus erythematosus. Psoriasis.

254.-Which of the following is used to confirm a diagnosis of Hashimoto’s thyroiditis?. Serum TSH. Free T4 test. Antimicrosomal antibody test. Any of the above.

255.-A first-grader presents to a school nurse practitioner with a few blisters on one arm and on the face. The child keeps scratching the affected areas. Some of the lesions have ruptured with yellow serous fluid that crust easily. This best describes: Acute cellulitis. Herpes zoster. Bullous impetigo. Erysipelas.

256.-All of the following statements reflect inadequate breast milk production except: Full-term infant is at birth weight by the second week of life. Less than 6 wet diapers per day or less than 4 stools per day. Infant is nursing fewer than 8 times per 24-hour period. Weight loss of > 10% of birth weight.

257.-The best screening test for detecting and monitoring both hyperthyroidism and hypothyroidism is: The total T3–4. Thyroid-stimulating hormone (TSH). Thyroid profile. Palpation of the thyroid gland.

258.-A patient who recently returned from a vacation in Latin America complains of a severe headache and stiff neck that are accompanied by a high fever for the past 12 hours. While examining the patient, the nurse practitioner flexes both the patient’s hips and legs and then tells the patient to straighten them against resistance. The name of this test is: Kernig’s maneuver. Brudzinski’s maneuver. Murphy’s sign. Homan’s sign.

259.-Which of the following groups has been recommended to be screened for thyroid disease?. Women 50 years or older. Adolescent females. Elderly males. School-age children.

260.-A 65-year-old Hispanic woman has a history of type 2 diabetes. A routine urinalysis reveals a few epithelial cells and is negative for leukocytes, nitrites, and protein. Which of the following would you recommend next?. Order urine for C&S. Order a 24-hour urine for microalbumin. Because it is negative, no further tests are necessary. Recommend a screening IVP (intravenous pyelogram).

261.-RhoGAM’s mechanism of action is: The destruction of Rh-positive fetal RBCs that are present in the mother’s circulatory system. The destruction of maternal antibodies against Rh-positive fetal RBCs. The stimulation of maternal antibodies so that there is a decreased risk of hemolysis. The destruction of maternal antibodies against fetal RBCs.

262.-A chest radiograph shows an area of consolidation on the lower lobe. Which of the following conditions is most likely?. Bacterial pneumonia. Acute bronchitis. COPD. Atypical pneumonia.

263.-What type of breath sounds are best heard over the base of the lungs?. Fine breath sounds. Vesicular breath sounds. Bronchial sounds. Tracheal breath sounds.

264.-The most current recommendation from the Joint National Commission on the Evaluation and Treatment of High Blood Pressure in Adults (JNC 7) for the blood pressure goal in diabetics is: <140/90. <130/85. <130/80. <125/75.

265.-All of the following pharmacologic agents are used to treat inflammation in the lungs of asthmatics except: Nedocromil sodium (Tilade) two sprays QID. Cromolyn sodium inhaler (Intal) two puffs QID. A long-acting oral theophylline (Theo-Dur) 200 mg every 12 hours. Fluticasone inhaler (Flovent) two puffs BID.

266.- All of the following clinical finding are considered benign oral finding except: A patch of leukoplakia. Fordyce spots. Torus palatinus. Fishtail uvula.

267.-The nurse practitioner examines a 4-week-old boy whose mother reports that he has cried for at least 3 hours a day at the same time of day since birth. What is the main goal in the clinical evaluation of this infant?. Rule out any physiologic cause for the crying spells. Make sure that the infant is well clothed. Evaluate the environment. Order laboratory and diagnostic testing.

268.-During a routine physical exam of a 90-year-old woman, a low-pitched diastolic murmur Grade II/VI is auscultated. It is located on the fifth ICS on the left side of the midclavicularline. Which of the following is the correct diagnosis?. Aortic regurgitation. Mitral stenosis. Mitral regurgitation. Tricuspid regurgitation.

269.-Which of the following situations is considered emergent?. A laceration on the lower leg of a patient on aspirin (Bayer) 81 mg every other day. Rapid breathing and tachycardia in a patient with a fever. An elderly man with abdominal pain whose vital signs appear stable. A 37-year-old male biker with a concussion due to a fall who appears slightly agitated and does not appear to understand instructions given by the medical assistant checking his vital signs.

270.-Which of the following is considered an objective finding in patients who have a case of suppurative otitis media?. Erythema of the tympanic membrane. Decreased mobility of the tympanic membrane as measured by tympanogram. Displacement of the light reflex. Bulging of the tympanic membrane.

271.-Pulsus paradoxus is more likely to be associated with: Sarcoidosis. Acute bronchitis. Status asthmaticus. Bacterial pneumonia.

272.-A 17-year-old boy reports feeling something on his left scrotum. On palpation, soft and movable blood vessels that feel like a “bag of worms” are noted underneath the scrotal skin. It is not swollen or reddened. The most likely diagnosis is: Chronic orchitis. Chronic epididymitis. Testicular torsion. Varicocele.

273.-All of the following are true statements regarding elder abuse except: Those aged 80 years or older are at the highest risk for abuse. A delay in medical care is a common finding. A new onset of an STD in an elderly patient may signal sexual abuse. Decreased anxiety and depression are common symptoms of abuse in the elderly.

274.-The S1 heart sound is caused by: Closure of the atrioventricular valves. Closure of the semilunar valves. Opening of the atrioventricular valves. Opening of the semilunar valves.

275.-Patients with Down syndrome are at higher risk for all of the following except: Atlantoaxial instability. Congenital heart disease. Early onset of Alzheimer’s disease. Melanoma.

276.-Duvall and Miller used developmental theory to describe the family. Which of the following statements is true?. Each family is developmentally unique in comparison to other families. Families demonstrate common forms of membership across developmental stages. Families complete each developmental task separately. Families change over time because of the influence of environmental factors.

277.-The following abnormal lab results may be seen in patients with acute mononucleosis except: Lymphocytosis and/or atypical lymphocytes. Positive EBV titers for immunoglobulin (Ig) M and Ig G. Elevated liver function tests. Elevated creatinine and BUN.

278.-Which of the following is considered an abnormal result on a Weber test?. Lateralization to one ear. No lateralization in either ear. Air conduction lasts longer than bone conduction. Bone conduction lasts longer than air conduction.

279.-All of the following are considered benign physiologic variants except: Internal tibial torsion. Supernumerary nipples. Split uvula. Cheilosis.

280.-A 65-year-old woman’s bone density result shows severe demineralization of cortical bone. All of the following pharmacologic agents are useful in treating this condition except: Raloxifene (Evista). Calcitonin (Miacalcin). Medroxyprogesterone (Depo-Provera). Calcium with Vitamin D.

281.-A fracture on the navicular area of the wrist is usually caused by falling forward and landing on the hands. The affected wrist is hyperextended to break the fall. The nurse practitioner is aware that all of the following statements are true except: It has higher rate of nonunion compared with the other bones in the wrist when it is fractured. The fracture frequently does not show up on an x-ray fi lm when it is taken immediately after the injury. The x-ray fi lm will show the fracture if the film is repeated in 2 weeks. These fractures always require surgical intervention to stabilize the joint.

282.-John, a 10-year-old boy, has type 1 diabetes. His late afternoon blood sugars over the past 2 weeks have ranged between 210 mg/dL and 230 mg/ldL. He is currently on 10 units of regular insulin and 25 units of NPH in the morning and 15 units of regular insulin and 10 units of NPH insulin in the evening. Which of the following is the best treatment plan for this patient?. Increase both types of the morning dose. Increase only the NPH insulin in the morning. Decrease the afternoon dose of NPH insulin. Decrease both NPH and regular insulin doses in the morning.

283.-The mother of a 13-year-old male with Down syndrome is in the family nurse practitioner’s office and wants a sports physical done for her son. She reports that he wants to join the football team in his school. You would tell the mother that her son: Can play a regular football game as long as he wears maximum protective football gear. Cannot play some contact sports because of an increased risk of cervical spine injury. Can play certain contact sports after he has been checked for cervical instability. None of the above.

284.-The mother of an 8-year-old boy reports the presence of a round red rash on the child’s left lower leg. It appeared 1 week after the child returned from visiting his grandparents, who live in Massachusetts. During the skin exam, the maculopapular rash is noted to have areas of central clearing making it resemble a round target. Which of the following is best described?. Erythema migrans. Rocky Mountain spotted fever. Meningococcemia. Larva migrans.

285.-Some pharmacologic agents may cause confusion in the elderly. Which of the following pharmacologic agents is most likely to cause confusion in this population?. Cimetidine (Tagamet), digoxin (Lanoxin), diphenhydramine (Benadryl). Acetaminophen (Tylenol), aspirin (Bayer), indomethacin (Indocin). Sucralfate (Carafate), docusate sodium (Surfak), psyllium (Metamucil). Cephalexin (Keflex), amoxicillin (Amoxil), clarithromycin (Biaxin).

286.-A 55-year-old female with a history of migraine headaches has recently been diagnosed with Stage II hypertension. Her EKG strips reveal second-degree heart block. The chest x-ray is normal. Which of the following drugs should this patient avoid?. ACE inhibitors. Angiotensin receptor blockers. Diuretics. Calcium channel blockers.

287.-Which of the following cranial nerves is evaluated when a wisp of cotton is lightly brushed against the corner of the eye?. CN II. CN III. CN IV. CN V.

288.-When a patient is suspected of having acute pancreatitis, initial testing should include all of the following except: Electrolyte panel. Serum amylase level. Serum lipase level. A barium swallow.

289.-Which of the following is a true statement regarding pes planus in an infant?. Pes planus should be evaluated by a pediatric orthopedist if it does not spontaneously correct itself by the age of 12 months. The fat pads on an infant’s feet can mimic pes planus. It is always corrected by wearing special orthotic shoes. It is also called talipes equinovarus.

290.-All of the following statements are false regarding the rehabilitation of alcoholics except: Al-Anon is not designed for family members of alcoholics. Disulfiram (Antabuse) is always effective. Alcoholics Anonymous is not an effective method for treating this condition. Avoid foods or drinks that contain alcohol, such as cough syrups.

291.-A mother of a 7-year-old boy tells the family nurse practitioner that his teacher has complained to her of her son’s frequent episodes of daydreaming. While the child is at home, the mother reports that sometimes her son seems not to hear her. The child “blacks out” for a short period of time. Which of the following is most likely?. A partial seizure. An absence seizure (petit mal seizure). A grand mal seizure. A Jacksonian seizure.

292.-All of the following are correct statements regarding the Healthy People 2020 objectives except: The document’s objectives are not only applicable nationally, but also internationally. One of the objectives of the document is to help people achieve physical health. The document’s objectives are applicable only to people of the United States of America. The document is formulated by a special committee formed by an alliance of all the state health departments.

293.-The Pap smear result for a 20-year-old sexually active college student who used Condoms inconsistently reveals a large number of white blood cells and blood along with inflammatory changes. During the speculum exam, the nurse practitioner who examined the patient noticed that the patient’s cervix bled very easily (friable) and a small amount of purulent discharge was present on the cervical surface. No cervical motion tenderness was noted during the bimanual vaginal exam. What is the next step in the management of this patient?. The NP needs to do cervical cultures to verify gonorrhea. Prescribe metronidazole vaginal cream for the patient over the phone. Call the patient and tell her she needs a repeat Pap smear in 6 months. Advise her to use a Betadine douche at bedtime x 3 days.

294.-A 30-year-old female complains of having no period for the last 12 weeks. She is sexually active and has been using condoms inconsistently. The patient has a history of irregular menstrual cycles and severe dysmenorrhea. The urine pregnancy test result is positive. Which of the following is a true statement regarding this pregnancy?. The fundus of the uterus should be at the level of the symphysis pubis. The cervix should be dilated about 0.5 in. at this time of gestation. “Quickening” starts during this period. Hegar’s sign is present during this period of pregnancy.

295.-A newborn infant who is small for gestational age is noted to have shortened palpebral fissures and microcephaly with a small jaw. This infant is most likely to be diagnosed with: Down syndrome. Fetal alcohol syndrome. Growth retardation. Hydrocephalus.

296.-Which of the following is the most common cause of cancer deaths for women in the United States?. Breast cancer. Lung cancer. Colon cancer. Heart disease.

297.-Human papilloma virus infection in women has been associated with the development of: Ectopic pregnancy. Infertility. Cervical cancer. Pelvic inflammatory disease.

298.-All of the following are included in the criteria used to diagnose patients with AIDS except: Profound fatigue. Thrush. Kaposi’s sarcoma. Hairy leukoplakia of the tongue.

299.-Which of the following conditions is the most common cause of sudden death among athletes?. Brain aneurysm. Hypertrophic cardiomyopathy. Left ventricular hypertrophy. Aortic stenosis.

300.-The span of the normal adult liver is: 15 to 18 cm in the midclavicular line. 12 to 16 cm in the right midclavicular line. 2 to 6 cm in the midsternal line. 4 to 8 cm in the midsternal line.