Codina 51-100

51.-A mother brings in her 4-year-old daughter who just started attending preschool. She tells the nurse practitioner that her child is complaining of burning and itching in both eyes along with a runny nose. During the physical exam, the child’s eyes appear injected bilaterally. The throat is red and her inferior nasal turbinate are swollen. Which of the following is most likely?. Herpes keratitis. Corneal ulcer. Viral conjunctivitis. Bacterial conjunctivitis.

52.-A sexually active woman is complaining of amenorrhea and vaginal spotting. On exam, her left adnexa is tender and cervical motion tenderness is positive. Which test should the nurse practitioner initially order?. Flat plate of the abdomen. Complete blood count (CBC) with white cell differentials. Urine pregnancy test. Pelvic ultrasound.

53.-A toddler with congenital heart disease is seen for a 1-week history of facial and lower-extremity edema accompanied by shortness of breath. The child’s mother reports that the child’s appetite has been poor. The chest x-ray reveals that the child has congestive heart failure (CHF). Which of the following heart sounds are found in these patients?. S1 and S2. S1, S2, and S3. S1, S2, and S4. Still’s murmur and S4.

54.-A 53-year-old crossing guard complains of twisting his right knee while working that morning. The knee is swollen and tender to palpation. The nurse practitioner diagnoses a Grade II sprain. The initial treatment plan includes which of the following?. Application of cold packs the first 24 hours followed by applications of low heat at bedtime. Elevation of the affected limb and intermittent applications of cold packs for the next 48 hours. Rechecking the knee in 24 hours and isometric exercises. The application of an Ace bandage to the affected knee.

55.-Erythromycin 200 mg with sulfi soxazole 600 mg suspension (Pediazole) is contraindicated in which of the following conditions. G6PD deficiency anemia. Lead poisoning. Beta thalassemia minor. B12 deficiency anemia.

56.-The mother of an 11-year-old boy with sickle cell anemia calls on the phone complaining that her son woke up because of a painful penile erection that will not go away. The nurse practitioner’s most appropriate intervention is: Insert a Foley catheter and measure the child’s intake and output for the next 24 hours. Insert a Foley catheter to obtain a specimen for a urinalysis and urine for C&S (culture and sensitivity). Recommend an increase in the child’s fluid intake. Recommend immediate referral to the ER.

57-A positive Coombs test on an Rh-negative pregnant woman means: The mother has autoantibodies against Rh-positive red blood cells (RBCs). The fetus has autoantibodies against maternal RBCs. The mother does not have Rh factor against fetal RBCs. The fetus does not have RBC autoantibodies.

58.-Folic acid supplementation is recommended for women who are planning pregnancy in order to: Prevent renal agenesis. Prevent anencephaly. Prevent kidney defects. Prevent heart defects.

59.-All of the following are possible causes for secondary hypertension except: Acute pyelonephritis. Pheochromocytoma. Renovascular stenosis. Coarctation of the aorta.

60.-Fitz-Hugh-Curtis syndrome is associated with which following infection?. Syphilis. Chlamydia trachomatis. Herpes genitalis. Lymphogranuloma venereum.

61.-A nursing home resident reports to his physician that his previous roommate was recently started on tuberculosis treatment. A Mantoux test and chest x-ray are ordered for the patient. What is the minimum size of induration considered positive for this patient?. 3 mm. 5 mm. 10 mm. 15 mm.

62.-In small children with acquired immunodeficiency syndrome (AIDS), which of the following vaccines is contraindicated?. Diphtheria and tetanus (Td). Hepatitis B and mumps. Varicella. Td and oral polio.

63.-A 44-year-old female who is undergoing treatment for infertility complains of not having a menstrual period for a few months. The night before, she started spotting and is now having cramp-type pains in her pelvic area. Her blood pressure (BP) is 160/80, the pulse rate is 110, and she is afebrile. Her labs reveal a mild anemia with mild leukocytosis. On pelvic exam, the uterine fundus is found above the symphysis pubis. The cervical os is dilated at 3 cm. Which of the following is most likely?. Inevitable abortion. Threatened abortion. Incomplete abortion. Acute pelvic inflammatory disease.

64.-A 14-year-old female who is sexually active is brought in by her mother for an immunization update. According to the mother, her daughter had 1 dose of hepatitis B vaccine. Which of the following vaccines would you administer at this visit?. Td and hepatitis B. DTaP (diphtheria, tetanus, acellular pertussis) and hepatitis B. Hepatitis B only. MMR (measles, mumps, rubella) and Td.

65.-An Rh-negative pregnant woman with negative rubella titers should be vaccinated at what time period in pregnancy?. She can be vaccinated at any time in her pregnancy. During the second trimester. During the third trimester. During the postpartum period.

66.-Medicare Part B will pay for all of the following services except: Outpatient physician visits that are medically necessary. Durable medical equipment. Outpatient laboratory and radiology tests. Eyeglasses and routine dental care.

67.-Which of the following is used to screen for color blindness in a 7-year-old boy?. Snellen chart. Ishihara chart. Cover/uncover test. Red reflex.

68.-A 67-year-old retired clerk presents with complaints of shortness of breath and weight gain over a 2-week period. A nonproductive cough accompanies her symptoms. The lung exam is positive for fi ne crackles in the lower lobes with no wheezing. The exam is positive for egophony. Which of the following conditions is most likely?. Acute exacerbation of asthma. Left-heart failure. Right-heart failure. Chronic obstructive pulmonary disease.

69.-Which of the following drugs is most likely to relieve the patient’s symptoms?. Atenolol (Tenormin). Trimethoprim/sulfamethoxazole (Bactrim DS). Furosemide (Lasix). Hydrocodone/guaifenesin syrup (Hycotuss).

70.-A patient has recently been diagnosed with migraine headache with aura. She wants advice on what she should eliminate from her diet to reduce her risk of headaches. The best response is to advise this patient to avoid: Foods with aspartame (Equal) because they can trigger migraines. Foods with monosodium glutamate because they promote diuresis. Foods with garlic because they promote hypertension. Foods with nitrates because they do not induce flushing.

71.-A patient with a history of mitral valve prolapse (MVP) is requesting prophylaxis before her dental surgery. Which of the following would you prescribe this patient?. Amoxicillin a half hour before and 2 hours after the procedure. Amoxicillin 1 hour before the procedure. Amoxicillin 1 hour before and 3 hours after the procedure. Prophylaxis is not recommended for this patient.

72.-Koplik’s spots are associated with: Poxvirus infections. Measles. Kawasaki’s disease. Reye’s syndrome.

73.-Stella, a new mother, complains to you that she has been feeling irritable and jittery almost daily for the past few months. She complains of frequent palpitations and more frequent bowel movements along with weight loss. Her BP is 160/70, her pulse is 110, and she is afebrile. All of the following conditions should be considered in the differential diagnosis for this patient except: Mitral regurgitation. Graves’ disease. Generalized anxiety disorder. Illicit drug use.

74.-An elderly patient with a productive cough and fever is diagnosed with pneumonia. All of the following organisms are capable of causing community-acquired pneumonia except: Haemophilus influenzae. Mycoplasma pneumonia. Treponema pallidum. Streptococcus pneumoniae.

75.-Human chorionic gonadotropin (HCG) is produced by the: Placenta. Hypothalamus. Anterior pituitary. Ovaries.

76.-The majority of serum alpha fetoprotein is produced by the: Fetal liver. Mother’s liver. Placenta. Fetal neural tube.

77.-Stella works in the housekeeping department of a hospital. She presents to the employee health clinic with a complaint of a needlestick to her left thumb. The needle was in one of the garbage bags from the emergency room. The patient had a little bleeding that stopped spontaneously. Which of the following is the next step?. Order an enzyme-linked immunosorbent assay (ELISA) test as soon as possible. Recommend a tetanus booster in 1 week. Offer the patient hepatitis B immunoglobulin. Order a chest x-ray.

78.-An elderly woman has been on digoxin (Lanoxin) for 10 years. Her electrocardiograph (EKG) is showing a new onset of atrial fibrillation. Her pulse is 64/min. She denies syncope and dizziness. Which of the following interventions is most appropriate?. Order an electrolyte panel and a digoxin level. Order a serum thyroid-stimulating hormone (TSH), digoxin level, and an electrolyte panel. Order a serum digoxin level and decrease her digoxin dose by half while waiting for results. Discontinue the digoxin and order another 12-lead EKG.

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80.-The nurse practitioner who suspects that one of her hypertensive patients has Cushing’s syndrome would expect to find which of the following laboratory results?. Hyponatremia. Hypoglycemia. Elevated serum cortisol levels. Decreased urine 17-ketosteroids.

81.-The first teeth to erupt during infancy are which of the following?. First molars. Second molars. Incisors. Canines.

82.-The positive signs of pregnancy include: Palpation of the fetus and auscultation of the fetal heart tones by the nurse practitioner. Palpation of the fetus and a positive quantitative serum pregnancy test. Fetal heart tones and a positive quantitative serum pregnancy test. Fetal heart tones and feeling of movement of the baby by the mother.

83.-Chadwick’s sign is characterized by: Softening of the cervix. Blue coloration of the cervix and vagina. Softening of the uterine isthmus. Nausea and vomiting during the first trimester of pregnancy.

84.-A college student has recently been informed that he has an HPV (human papilloma virus) infection on the shaft of his penis. Which of the following may reveal subclinical lesions on the penile skin?. Perform a KOH (potassium hydroxide) exam. Scrape off some of the affected skin and send it for a culture and sensitivity. Apply acetic acid to the penile shaft and look for acetowhite changes. Order a serum herpes virus titer.

85.-Carol M. is a 40-year-old bank teller who has recently been diagnosed with obsessive-compulsive disorder by her therapist. Her symptoms would include: Ritualistic behaviors that the patient feels compelled to repeat. Attempts to ignore or suppress the repetitive behaviors, which increase anxiety. Frequent intrusive and repetitive thoughts and impulses. All of the above.

86.-Which of the following medications is indicated for the treatment of obsessive-compulsive disorder?. Paroxetine (Paxil CR. Haldoperidol (Haldol). Lorazepam (Xanax). Imipramine (Elavil).

87. You would advise an 18-year-old female student who has been given a booster dose of MMR at the college health clinic that: She might have a low-grade fever during the first 24 to 48 hours. She should not get pregnant within the next 4 weeks. Her arm will be very sore on the injection site for 24 to 48 hours. Her arm will have some induration on the injection site in 24 to 48 hours.

88.-Jean, a 68-year-old female, is suspected of having Alzheimer’s disease. Which of the following is the best initial method for assessing the condition?. Computed tomography scan of the brain. Mini Mental Status Exam. Obtain the history from the patient, friends, and family members. EEG (electroencephalography).

89.-A 55-year-old woman who has type 2 diabetes is concerned about her kidneys. She has a history of 3 urinary tract infections within the past 8 months. She denies dysuria and frequency at this visit. Which of the following is the best initial course to follow?. Recheck the patient’s urine and order urine for culture and sensitivity. Order an IVP (intravenous pyelogram). Advise the patient to follow up with a urologist. Evaluate the patient for a possible kidney infection.

90.-A nurse practitioner is giving dietary counseling to a male alcoholic who has recently been diagnosed with folic acid deficiency anemia. Which of the following foods should the nurse practitioner recommend to this patient?. Tomatoes, oranges, and bananas. Cheese, yogurt, and milk. Lettuce, beef, and dairy products. Spinach, liver, and whole wheat bread.

91.-The ELISA and Western Blot tests are both used to test for HIV. Which of the following statements is correct?. It is a test to detect viral RNA. A positive ELISA screening does not mean the person has HIV infection. It is a test to detect viruses. It is a diagnostic test for the AIDS virus.

92.-Hegar’s sign is considered a: Positive sign of pregnancy. Probable sign of pregnancy. Presumptive sign of pregnancy. Problem in pregnancy.

93.-When palpating a woman who is at 20 weeks of gestation, the nurse practitioner should be able to feel the uterine fundus at what level?. Just rising above the level of the pubic symphysis. Between the pubic symphysis and the umbilicus. At the level of the umbilicus. Above the level of the umbilicus.

94.-A 67-year-old female with a 50 pack/year history of smoking presents for a routine annual physical examination. She complains of being easily short of breath and is frequently fatigued. Physical examination reveals diminished breath sounds, hyperresonance, and hypertrophied respiratory accessory muscles. Her CBC results reveal that her hematocrit level is slightly elevated. Her pulmonary function test (PFT) results show increased total lung capacity. What is the most likely diagnosis for this patient?. Bronchogenic carcinoma. COPD (chronic obstructive pulmonary disease). Chronic bronchitis. Congestive heart failure.

95.-Your patient of 10 years, Mrs. Leman, is concerned about her most recent diagnosis. She was told by her dermatologist that she has an advanced case of actinic keratosis. Which of the following is the best explanation for this patient?. It is a benign condition. It is a precancerous lesion and should be followed up with her dermatologist. Apply hydrocortisone cream 1% BID for 2 weeks and most of it will go away. It is important for her to follow up with an oncologist.

96.-Patient confidentiality is breached when: Medical information is given to a spouse. Records are subpoenaed. Reports are sent to the Public Health Department. Records are released to insurance companies.

97.-A 25 -year-old woman’s last menstrual period was 6 weeks ago. She is complaining of nausea with vomiting in the morning and fatigue. Her breasts feel bloated. The nurse practitioner suspects that she is pregnant. Her symptoms would be considered: Positive signs of pregnancy. Probable signs of pregnancy. Presumptive signs of pregnancy. Possible signs of pregnancy.

98.-A 55-year-old male patient describes to you an episode of chest tightness in his substernal area that radiated to his back while he was jogging. It was relieved immediately when he stopped. Which of the following conditions does this best describe?. Angina pectoris. Acute myocardial infarction. Gastro esophageal reflux disease. Acute costochondritis.

99.-Which of the following would you recommend to this 55-year-old patient?. Start an exercise program by starting with walking instead of jogging. Consult with a cardiologist for further evaluation. Consult with a gastroenterologist to rule out acute cholecystitis. Take ibuprofen (Advil) 600 mg for pain every 4 to 6 hours PRN.

100.-Carol, a 73-year-old patient, complains of episodic vertigo, slight confusion, weakness that last nearly an hour each time. Movement does not worsen the vertigo. She “rests” and her symptoms subside, but she is puzzled because the weakness “jumps from side to side,” sometimes on the right and sometimes on the left of her body. Her symptoms suggest: Benign paroxysmal positional vertigo. Ménière’s disease. TIA (transient ischemic attack). CVA (cerebrovascular accident).