Codina Test 351-400

351.-Patients who are considered mentally competent have a right to consent or refuse medical treatment. What is the legal term for this right?. Informed consent. Durable power of attorney. Competence. Advance directives.

352.-The following statements are true about Wilm’s tumor except: The most frequent clinical sign is a palpable abdominal mass. It is a congenital tumor of the kidney. Microscopic or gross hematuria is sometimes present. The tumor commonly crosses the midline of the abdomen when it is discovered.

353-At what level of prevention would you classify screening for lung cancer?. Primary prevention. Secondary prevention. Tertiary prevention. Screening for lung cancer is not currently recommended.

354.-Which of the following T-scores is indicative of osteoporosis?. T-score of 0 to –1.0. T-score of –1.0 to –2.0. T-score of –2.5 or less. The diagnosis of osteoporosis is based on an x-ray series of the spine.

355.-Which of the following methods is used to diagnose gonorrheal pharyngitis or proctitis?. Serum chlamydia titer. Gen-Probe. Thayer-Martin culture. Culture and sensitivity of the purulent discharge.

356.-The first nurse practitioner program was started by: Alfred Bandura. President John F. Kennedy. Federal government. Loretta Ford, PhD.

357.-Terazosin (Hytrin), an alpha-blocker, is used to treat which of the following conditions?. Benign prostatic hypertrophy and hypertension. Chronic prostatitis and atrial fibrillation. Urinary tract infections and arrhythmias. Benign prostatic hypertrophy and chronic prostatitis.

358.-A concerned new mother reports to you that her son, who is 3 years of age, is not toilet trained yet. Which of the following is an appropriate reply?. Recommend a referral to a pediatric urologist. Advise the mother that her child is developing normally. Recommend a bed-wetting alarm. Recommend a voiding cystogram.

359.-Which of the following clinical findings can mimic a case of testicular torsion but is not considered an emergent condition?. The “blue dot” sign. One swollen testicle with yellow-colored penile discharge. An acute onset of dysuria and frequency. A varicocele.

360. Which of the following classes of drugs is implicated with blunting the signs and symptoms of hypoglycemia in diabetics?. Calcium channel blockers. Diuretics. Beta-blockers. ARBs (angiotensin receptor blockers).

361.-All of the following factors increase the risk of mortality for patients diagnosed with bacterial pneumonia except: Alcoholism. Very young age or the elderly. Multiple lobar involvements. Hypertension.

362.-The bacterium responsible for the highest mortality in patients with community acquired pneumonia is: Streptococcus pneumoniae. Mycoplasma pneumoniae. Moraxella catarrhalis. Haemophilus influenzae.

363.-Mr. R. J. is a 40-year-old asthmatic male with hypertension. For the past 6 months, he has been following a low-fat, low-sodium diet and walking 3 times a week. His BP readings from the past 2 visits were 160/95 and 170/100. On this visit, it is 160/90. What is the most appropriate action for the nurse practitioner to follow at this visit?. Continue the lifestyle modifications and recheck his blood pressure again in 4 weeks. Initiate a prescription of hydrochlorothiazide 12.5 mg PO daily. Initiate a prescription of Atenolol (Tenormin) 25 mg PO daily. Refer the patient to a cardiologist for a stress EKG.

364.-When initially treating an adult for acute bronchitis, which of the following should the nurse practitioner be least likely to order?. Expectorants. Antibiotics. Bronchodilators. Antitussives.

365.-All of the following describes normal behavior for a 3-year-old child except: Speaks in 3- to 4-word sentences that are understood by most strangers. Can draw a cross. Can draw a circle. Can ride a tricycle.

366.-Mary, who has recently been diagnosed with lupus, complains that her hands and feet always feel cold even in the summertime. Sometimes her fingertips become numb and turn a blue color. The fingertips eventually turn to a dark red color. Which of the following is most likely?. Chronic arterial insufficiency. This is a normal reaction when one feels very cold. Peripheral vascular disease. Raynaud’s syndrome.

367.-Mrs. Nottam, who has a BMI of 29, has a 20-year history of primary hypertension. She has been on hydrochlorothiazide 25 mg PO daily with excellent results. On this visit, she is complaining of feeling thirsty all the time even though she drinks more than 10 glasses of water per day. She reports to the nurse practitioner that she has been having this problem for about 6 months. Upon reading the chart, the nurse practitioner notes that the last two fasting blood glucose levels have been 140 mg/dL and 168 mg/dL. Random blood glucose is at 210 mg/dL. Which of the following is the best treatment plan to follow at this visit?. Order another random blood sugar test in 2 weeks. Initiate a prescription of metformin (Glucophage) 500 mg PO BID. Order a 3-hour glucose tolerance test. Order a HgbA1c level.

368.-A newly diagnosed middle-aged type 2 diabetic wants to start an exercise program. All of the following statements are true: except: If the patient is unable to eat due to illness, antidiabetic agents can be continued with frequent glucose monitoring. Strenuous exercise is contraindicated for type 2 diabetics because of a higher risk of hypoglycemic episodes. Exercise increases the body’s ability to metabolize glucose D). Patients who exercise vigorously in the afternoon may have hypoglycemic episodes in the evening or at night if they do not eat.

369.-What is the least common pathogen found in community-acquired atypical pneumonia?. Moxarella catarrhalis. Streptococcus pneumoniae. Pseudomonas aeruginosa. Mycoplasma pneumonia.

370.-All of the following are true about strawberry hemangiomas found in infants except: Most will involute spontaneously by the age of 18 to 24 months. Watchful waiting is the most useful strategy. Hemangiomas should be treated with laser therapy if they have not resolved by the age of 12 months. Strawberry hemangiomas are benign.

371.-A 56-year-old mechanic is brought to your office complaining of heavy pressure in the substernal area of his chest that is radiating to his jaw. The pain began while he was lifting up a tire. He now appears pale and is diaphoretic. His blood pressure is 100/60 mm Hg, and his pulse rate 50. What is the most appropriate action?. Perform a 12-lead EKG. Dial 9-1-1. Administer a morphine injection for pain. Observe the patient in the office.

372.-Which of the following is indicated for initial treatment of an uncomplicated case of Helicobacter pylori negative peptic ulcer disease?. Omeprazole (Prilosec). Misoprostol (Cytotec). Ranitidine (Zantac). Pepto-Bismol tablets.

373.-Erythromycin inhibits the cytochrome P-450 system. The following drugs should be avoided because of a potential for a drug interaction except: Theophylline (Theo-Dur). Warfarin (Coumadin). Diazepam (Valium). Furosemide (Lasix).

374.-If left untreated, Zollinger-Ellison syndrome can cause which of the following?. Severe ulceration of the stomach or duodenum. Toxic megacolon. Chronic diarrhea. Malabsorption of fat-soluble vitamins.

375.-All of the following are considered Category X drugs except: Misoprostol (Cytotec). Isotretinoin (Accutane). Finasteride (Proscar). Meperidine (Demerol).

376.-You note, during a physical exam on a 6-year-old child, some pitting on the finger nails. This finding is correlated with: Iron-deficiency anemia. Psoriasis. Onychomycosis. Vitamin C deficiency.

377.-Which of the following is correct regarding the best site to listen for mitral Regurgitation?. The apical area during S2. It is best heard at the base at S1. It is best heard at the apex at S1. It is best heard at the base at S2.

378.-Extreme tenderness and involuntary guarding at McBurney’s point is a significant finding for possible: Acute cholecystitis. Acute appendicitis. Acute gastroenteritis. Acute diverticulitis.

379.-All of the following may help relieve the symptom(s) of GERD except: Losing weight. Stopping caffeine intake. Chewing breath mints. Stopping alcohol intake.

380.-An 18-year-old waitress is diagnosed with pelvic inflammatory disease (PID). The cervical Gen-Probe result is positive for Neisseria gonorrhoeae and negative for Chlamydia trachomatis. All of the following statements are. This patient should be treated for chlamydia even though the Gen-Probe for chlamydia is negative. Ceftriaxone 250 mg IM and doxycycline 100 mg PO BID x 14 days are appropriate treatment for this patient. Advise the patient to return to the clinic for a repeat pelvic exam in 48 hours. Repeat the Gen-Probe test for Chlamydia trachomatis to ensure that the previous test was not a false- negative result.

381.-What Tanner stage is a girl at when her breasts form a secondary mound?. Tanner Stage II. Tanner Stage III. Tanner Stage IV. Tanner Stage V.

382.-A 35-year-old smoker is being evaluated for birth control choices. The patient has a history of PID along with an embolic episode after her last pregnancy. Which of the following methods of birth control would you recommend?. Condoms and the vaginal sponge (Today Sponge). Estrogen patches. Intrauterine device. Depo-Provera (depot medroxyprogesterone).

383.-A 21-year-old woman complains of left-sided pelvic pain accompanied by dyspareunia. During the gynecological exam, the nurse practitioner notices green cervical discharge. The patient mentions a new onset of a painful and swollen left knee and denies a history of trauma. This best describes: Septic arthritis. Reiter’s syndrome. Chondromalacia of the patella. Disseminated gonorrheal infection.

384.-You would recommend the pneumococcal vaccine (Pneumovax) to patients with all of the following conditions except: Sickle cell anemia. Splenectomy. Patients infected with HIV. G6PD deficiency anemia.

385.-A 40-year-old cashier complains of periods of dizziness and palpitations that have a sudden onset. The EKG shows P waves before each QRS complex and a heart rate of 170 beats/minute. A carotid massage decreases the heart rate to 80 beats/min. These best describe: Ventricular tachycardia. Paroxysmal atrial tachycardia. Atrial fibrillation. Ventricular fibrillation.

386.-A 25-year-old woman complains of dysuria, severe vaginal pruritis, and a malodorous vaginal discharge. Pelvic examination reveals a strawberry-colored cervix and frothy yellow discharge. Microscopic exam of the discharge reveals mobile organisms that have flagella. The correct pharmacologic therapy for the condition is: Metronidazole (Flagyl). Ceftriaxone sodium (Rocephin). Doxycycline hyclate (Vibramycin). Clotrimazole (Gyne-Lotrimin).

387.-A new mother reports to you that her 6-month-old infant has a cold and has a fever of 99.8 degrees Fahrenheit. The infant is not irritable and is feeding well without problems. The mother wants to know whether it is okay for him to be immunized at this time. Which of the following statements is true?. The infant should not be immunized until he is afebrile. An infant with a cold can be immunized at any time. An infant with a cold can be immunized as long as the infant’s temperature is no higher than 100.4 degrees Fahrenheit. Because immunization is so important, it should be given to the infant as scheduled.

388.-Metronidazole (Flagyl) produces the disulfiram (Antabuse) effect when combined with alcoholic drinks or medicine. You would educate the patient to avoid: Alcoholic drinks during the time she takes the medicine. Alcoholic drinks 1 day before, during therapy, and a few days after therapy. Alcoholic drinks after she takes the medicine. There is no need to avoid any food or drink.

389.-The treatment plan of patients with AIDS who have CD4 counts of < 200/mm should emphasize: Administering an MMR vaccine. Preventive therapy for toxoplasmosis. Preventive therapy for Pneumocystis carinii pneumonia. Evaluation of the home environment.

390.-A positive obturator sign might signify which of the following conditions?. Acute appendicitis. Acute pancreatitis. Acute cholecystitis. Acute hepatitis.

391.-Spermatogenesis occurs at the: Vas deferens. Seminal vesicles. Testes. Epididymis.

392. Prophylaxis for Pneumocystis carinii. pneumonia includes all of the following drugs except: Trimethoprim-sulfamethoxazole. Dapsone. Aerosolized pentamidine. Aerosolized albuterol sulfate (Ventolin).

393.-Mrs. Brands complain of dizziness when she moves her head. You suspect benign paroxysmal positional vertigo. The diagnosis is supported by the presence of: Tinnitus. Horizontal nystagmus with rapid head movement. New onset of hearing loss. Duration of greater than 2 years.

394.-While performing a routine physical exam on a 60-year-old male, the nurse practitioner notices a soft bruit over the carotid area on the left side of the neck. The patient has a history of hypertension. The patient is at higher risk for: Temporal arteritis and brain aneurysms. Dizziness and headaches. Abdominal aneurysm and congestive heart failure. Stroke and coronary heart disease.

395.-A kindergarten teacher is diagnosed with acute pharyngitis. On exam, the throat is a bright red color with no tonsillar exudate, and clear mucus is seen on the lower nasal turbinates. The result of her urinalysis shows a large amount of white blood cells and is positive for nitrites. The patient has a sulfa allergy and thinks she is also allergic to penicillins. Which of the following is the best treatment choice?. Amoxicillin/clavulanic acid (Augmentin) 500 mg PO BID. Levoquinolone (Levaquin) 250 mg PO daily. Trimethoprim sulfamethoxazole (Bactrim DS) 1 tablet PO BID. Clarithromycin (Biaxin) 500 mg PO BID.

396.-All of the following drugs interferes with the metabolism of oral contraceptives except: Tetracycline. Rifampin. Phenytoin (Dilantin). Ciprofloxacin (Cipro).

397.-When starting an elderly patient on a new prescription of levothyroxine (Synthroid), the nurse practitioner should keep in mind that the rationale for starting an elderly patient on a lower dose is which of the following?. Due to its central nervous system effects. Due to its cardiac effects. Due to its renal effects. Due to its hepatic effects.

398.-Women who are pregnant during the winter months are recommended to have which of the following?. Increased intake of Vitamin C and folate. Vaccination against the influenza virus. Increased caloric intake of fruits and vegetables. Heavier winter clothes to avoid chilling the fetus.

399- The earliest age that an MMR can be administered is at: 4 months. 6 months. 8 months. 12 months.

400.-Which of the following is a CDC-recommended treatment for a case of uncomplicated gonorrheal and chlamydial infection?. Metronidazole (Flagyl) 250 mg PO TID x 7 days. Valacyclovir (Valtrex) 500 mg PO BID x 10 days. Azithromycin 1 g orally OR doxycycline 100 mg orally twice a day for 7 days. 1 dose of oral fluconazole (Diflucan) 150 mg.