Codina Test 301-350

301.-A patient who is complaining of a new onset of severe headache is being examined. The patient is instructed to lie down on the examining table while the nurse practitioner flexes his head and neck forward to his chest. The patient reacts by quickly flexing his hip and knee. What is the name of this positive finding?. Kernig’s sign. Brudzinski’s sign. Rovsing’s sign. Drawer’s sign.

302.-A neighbor’s 14-year-old son, who is active in basketball, complains of pain and swelling on both knees. On physical exam, there is tenderness over the tibial tuberosity of both knees. Which of the following is most likely?. Chondromalacia patella. Left knee sprain. Osgood-Schlatter disease. Tear of the medial ligament.

303.-A woman at 32 weeks gestation has a positive throat culture for strep pyogenes. She denies allergies but gets very nauseated with erythromycin. Which of the following is the best choice for this pregnant patient?. Clarithromycin (Biaxin). Trimethoprim/sulfamethoxazole (Bactrim DS). Ofloxacin (Floxin). Penicillin (Pen VK).

304.-During a sports physical exam, a 16-year-old patient is noted to have a few beats of horizontal nystagmus on extreme lateral gaze that disappear when the eyes move back toward midline. Which statement best describes this clinical finding?. It is caused by occult bleeding of the retinal artery. This is a normal finding. It is a sign of a possible brain mass. This is a borderline result and requires further evaluation.

305.-An urgent care nurse practitioner is assessing a 45-year-old White woman with a BMI of 32 for complaints of intermittent right upper quadrant abdominal pain over the past few weeks that is precipitated by eating fried foods and peanut butter. On exam, the patient’s heart and lungs are normal. There is no pain over the costovertebral angle. During abdominal exam, the bowel sounds are present in all quadrants. While palpating deeply on the right upper quadrant during deep Inspiration, the patient complains of severe sharp pain to the nurse practitioner. Which of the following is best described?. Acute cholecystitis. Acute appendicitis. Acute gastroenteritis. Acute diverticulitis.

306.-Which of the following drugs is recommended by the Centers for Disease Control and Prevention (CDC) as first-line treatment for treating infections by the organism Bacillus anthracis (anthrax)?. Clindamycin (Cleocin). Fluconazole (Diflucan). Penicillin G injection. Ciprofloxacin (Cipro.

307.-A major risk factor for a Down syndrome infant is: Maternal age younger than 16 years. Maternal age older than 35 years. A positive family history of Down syndrome. A positive family history of genetic disease.

308.-A new patient who is a 40-year-old female postal worker is being evaluated for complaints of a new onset of an erythematosus rash on both her cheeks and on the bridge of the nose that is accompanied by fatigue. She reports a history of Hashimoto’s thyroiditis and is currently being treated with Synthroid 1.25 mg daily. Which of the following conditions is most likely?. Atopic dermatitis. Thyroid disease. Lupus erythematosus. Rosacea.

309.-Mary, who is 65 years of age, comes into the clinic during the first week of November for her annual wellness visit. Her last Td booster was 9 years ago. Which immunization(s) would you recommend for this visit?. Influenza vaccine. Tetanus and influenza vaccine. Pneumococcal (Pneumovax) and influenza vaccines. She does not need any vaccinations to be administered in this visit.

310.-Acute bronchitis is best characterized by: Fever and wheezing. Purulent sputum and fever. Paroxysms of coughing that is dry or productive of mucoid sputum. A gradual onset and fatigue.

311.-The nurse practitioner notices a gray ring on the edge of both irises of an 80-year old female. The patient denies visual changes or pain. She reports that she has had the “ring” for many years. Which of the following is the most likely diagnosis?. Arcus senilis. Pinguecula. Peripheral cataracts. Macular degeneration.

312.-What is the clinical significance of the above finding on a 35-year-old. The patient has a higher risk of blindness. The patient should be evaluated for Hyperlipidemia. The patient should be evaluated by an ophthalmologist. The patient should be evaluated for acute glaucoma.

313.-The cones in the retina of the eye are responsible for: Central vision. Peripheral vision. Night vision. Double vision.

314.-The nurse practitioner would refer all of the following to a physician except: Severe facial burns. Electrical burns. Burns that involve the cartilage of the ear. Second-degree burns on the lower arm.

315.-On auscultation of the chest, a split S2 is best heard at: Second intercostals space, right sternal border. Second intercostal space, left sternal border. Fifth intercostal space, midclavicular line. Fourth intercostal space, left sternal border.

316.-According to the guidelines outlined in JNC 7, the normal blood pressure should be: <140/90. <130/85. <120/80. <110/75.

317.Which of the following would be classified as a second-degree burn?. A severe sunburn with blistering. Burns that involve the subcutaneous layer of skin. A reddened finger after touching a hot iron. Burns that involve eschar.

318.-The mother of a 16-year-old boy is concerned that her son is not developing normally. On physical exam, the patient is noted to have small testes with no pubic or facial hair. What is the most appropriate statement to the mother?. Her son is developing normally. Her son’s physical development is delayed and should be evaluated by a pediatric endocrinologist. Her son should be rechecked in 3 months; if he still does not have secondary sexual characteristics, a thorough hormonal workup should be initiated. Her son’s physiological development is slower than normal but is within the lower limit of normal for his age group.

319.-The most common type of skin malignancy is: Squamous cell cancer. Basal skin cancer. Melanoma. Dysplastic nevi.

320.-The posterior fontanel should be completely closed by: 3 months. 4 months. 5 months. 6 months.

321.-Which cranial nerve is being evaluated when Rinne testing is done?. CN VII. CN VIII. CN IX and X. CN XI.

322.-Jane, a middle-aged nurse, complains of localized pain on the sole of her left foot that is located between the third and fourth toes. The pain is aggravated by weight bearing and feels like “a pebble in my shoe.” During the physical examination, the nurse practitioner palpates a tender nodule in the metatarsal interspace on the left foot. No redness or swelling is noted. Which of the following conditions is being described?. Plantar wart. Foreign body. Morton’s neuroma. Metatarsalgia.

323.-Laura, who is 18 years old, is being followed up for acne by the nurse practitioner. The facial exam reveals that papules and pustules are present mostly on the forehead and the chin areas. The patient has been using prescription topical and OTC medicated soap daily for 6 months without much improvement. Which of the following would you recommend next?. Isotretinoin (Accutane). Tetracycline (Sumycin). Clindamycin topical solution (Cleocin T). Minoxidil (Rogaine).

324.-The following statements are all true regarding herpes zoster except: It is due to reactivation of latent varicella virus. The typical lesions are bullae. It is usually more severe in immunocompromised individuals. Infection of the trigeminal nerve ophthalmic branch can cause corneal blindness.

325.-A middle-aged Black male complains of a history of outbreaks of painful large nodules and pustules on both his axillae that resolve after treatment with antibiotics. On physical examination, the nurse practitioner notices large red nodules that are tender to palpation. In addition, several pustules are present along with multiple scars on the skin. The nurse practitioner advises the patient that the condition is caused by a bacterial infection of the sweat glands in the axillae. Which of the following conditions is being described?. Hidradenitis suppurativa. Severe nodular acne. Granuloma inguinale. Cat scratch fever.

326.-A possible side effect from the use of nifedipine (Procardia XL) is: Hyperuricemia and hypoglycemia. Hyperkalemia and angioedema. Edema of the ankles and headache. Dry hacking cough.

327.-Which of the following maneuvers is contraindicated in patients with acute prostatitis?. Massaging the infected prostate. Serial urine samples. Rectal exams. Palpation of the epididymis.

328.-Erysipelas is an infection of the skin most commonly caused by which of the following class of organisms?. Streptococci. Staphylococci. Gram-negative bacteria. Fungi.

329.-What is the first-line class of antibiotics recommended by the American Thoracic Society (ATS) for patients younger than 60 years of age who are diagnosed with community-acquired pneumonia with no comorbidity?. First-generation cephalosporins. Second-generation cephalosporins. Macrolides. Beta-lactam antibiotics.

330.-All of the following are clinical eye findings found in some patients with chronic uncontrolled hypertension. Which of the following findings is not associated with this disorder?. AV nicking. Copper wire arterioles. Flame-shaped hemorrhages. Microaneurysms.

331.-While reviewing some lab reports, the nurse practitioner notes that one of her teenage male patient’s lab results is abnormal. The liver function tests are all normal except for a slight elevation in the alkaline phosphatase level. The patient is a member of a soccer team and denies any recent injury. What is the next step in this patient’s evaluation?. Order a liver ultrasound to rule out fatty liver. This is a normal finding for his age group. The patient needs to be evaluated further for pancreatic disease. Refer the patient to a pediatric rheumatologist.

332.-Which of the following would be appropriate initial management of a second-degree burn?. Irrigate with hydrogen peroxide and apply Silvadene cream BID. Irrigate with normal saline and apply Silvadene cream BID. Irrigate with tap water and apply Neosporin ointment BID. Unroof all intact blisters and apply antibiotic ointment BID.

333.-When Molluscum contagiosum is found on the genital area of children, which of the following is the best explanation?. It should raise the suspicion of child sexual abuse. It is not considered a sexually transmitted disease. It is caused by atypical bacteria. It is caused by the poxvirus and will resolve on its own.

334.-An 80-year-old woman complains about her “thin” and dry skin. Which of the following is the best explanation for her complaint?. Genetic predisposition. Loss of subcutaneous fat and lower collagen content. Loss of sebaceous glands. Damage from severe sun exposure.

335.-All of the following statements are correct regarding licensure for nurse practitioners except: It ensures a minimum level of professional competency. It grants permission for an individual to practice in a profession. It requires verification of educational training from an accredited graduate program. It reviews information via a nongovernmental agency.

336.-Which of the following is the correct statement regarding the size of the arterioles and veins on the fundi of the eye?. The veins are larger than the arterioles. The arterioles are larger than the veins. The arterioles are half the size of the veins. The veins and the arterioles are equal in size.

337.-All of the following factors have been found to increase the risk of atrial fibrillation in predisposed individuals except: Hypertension. Excessive alcohol intake in susceptible individuals. Theophylline (Theodur) and pseudoephedrine (Sudafed). Acute esophagitis.

338.-At what age can a child copy a cross and ride a bicycle?. 1 year. 2 years. 3 years. 4 years.

339.-You would associate a positive iliopsoas muscle test result with: Left cerebral vascular accident. Urinary tract infection. Heel fractures. Acute abdomen.

340.-Which cranial nerve innervates the extra ocular muscles of the eyes?. CN II, CN III, and CN VI. CN III, CN IV, and CN VI. CN IV, CN V, and CN VII. CN V, CN VI, and CN VIII.

341.-Which of the following tests would you recommend to patients to confirm the diagnosis of beta thalassemia or sickle cell anemia?. Hemoglobin electrophoresis. Bone morrow biopsy. Peripheral smear. Reticulocyte count.

342.-All of the following patients have an increased risk of developing adverse effects from Metformin (Glucophage) except: Patients with renal disease. Patients with hypoxia. Obese patients. Patients who are alcoholics.

343.-A middle-aged hypertensive male presents to a public health clinic with complaints of an acute onset of fever, chills, and cough that is productive of rusty-colored sputum. The patient reports episodes of sharp pains on the left side of his back and chest whenever he is coughing. His temperature is 102.2 degrees Fahrenheit, the pulse is 100/min, and the BP is 130/80. The urinalysis does not show leukocytes, nitrites, or blood. This finding is most consistent with: Atypical pneumonia. An upper urinary tract infection. Bacterial pneumonia. Acute pyelonephritis.

344.-Lifestyle modifications are an important aspect in the treatment of hypertension. Which of the following statements is incorrect?. Reduce intake of sodium, potassium, and calcium. Reduce intake of sodium and saturated fats. Exercise at least three to four times per week. Maintain an adequate intake of potassium, magnesium, and calcium.

345.-Which of the following classes of antihypertensive drugs should a patient be weaned off slowly to avoid the risk of severe rebound hypertension?. Diuretics. Beta-blockers. ACE inhibitors. Calcium channel blockers.

346.-A 70-year-old male with open-angle glaucoma is prescribed Betimol (timolol) ophthalmic drops. All of the following are contraindications to Betimol ophthalmic drops except: Overt heart failure or sinus bradycardia. Asthmatic patients. Second- or third-degree AV block. Migraine headaches.

347.-At what time of the day would you recommend a scotch tape test be done to evaluate for a suspected case of enterobiasis?. In the evening after dinner. At night before bed. Early in the morning. It does not matter what time of the day the test is done.

348.-At what age can a child copy a circle and ride a tricycle?. 1 year. 2 years. 3 years. 4 years.

349.-A 30-year-old male patient refuses to take his afternoon dose of pills. The nurse tells him of the possible consequences of his action, but the patient still refuses to cooperate. Which of the following is the best course for the nurse to follow?. Document in the patient’s record his behaviors and the action taken by the nurse. Reassure the patient that he will be fi ne after taking the medicine. Document only the patient behavior. Document only the nurse’s action.

350.-While performing a sports physical on a 16-year-old girl, the nurse practitioner notes a split S2 during inspiration that disappears during expiration. The girl is active and her growth and development have been uneventful. What is the best recommendation for the child’s mother?. Her daughter needs to be referred to a pediatric cardiologist. Her daughter needs to be referred for a stress EKG. Advise the mother that this is a normal finding. The child should avoid strenuous physical exertion until further evaluation.