NSG6020 3P’s Exam – When performing a visual acuity test the nurse

3P’s EXAM

1.            When performing a visual acuity test the nurse practitioner notes 20/30 in the left eye and 20/40 in the right eye using the Snellen eye chart. This means:

a)            have the patient returning in two weeks for a follow up vision screen

b)            dilated the eye and retest

c)            refer the patient to an ophthalmologist

d)            document this as a normal finding

2.            The American psychiatric association’s diagnostic and statistical manual of mental disorder defines Munchausen Syndrome By Proxy

a)            a self-inflicted injury to gain attention

b)            a caregiver making up or causing an illness or injury in a person under his or her care

c)            an abusive behavior that does not involve the caregiver

d)            a situation in which the abuser is often inattentive and uncaring toward the victim

3.            Symptoms of depression are a side effect of which neurotransmitter medication?

a)            dopamine           serotonin, norepinephrine

b)            gabapentin

c)            mil

d)            cortisol

4.            Which lesion is dark raised and asymmetric with irregular border? Quizlet Bates Chapter 20

a)            Nevus

b)            Actinic keratosis

c)            Keratoacanthoma

d)            Melanoma

5.            A 32 years old woman presents with dull puffiness of the ayes pronounced not pitting periorbital edema this finding is suggestive of this condition? APEA

a)            Nephrotic syndrome

b)            Myxedema

c)            Cushing syndrome

d)            Sinusitis

6.            A 42 years old woman with a past medical history of migraine headaches is requesting prophylactic medication treatment. Which medication should the Nurse practitioner prescribe?

a)            Sumatriptan (Imitrex)

b)            Amitriptyline (Elavil)

c)            Verapamil (verelan)

d)            Metoprolol (Lopressor)

7.            A pediatric patient has areas of scaling on the scalp with round patches of alopecia. This clinical finding is consistent with:

a)            Tinea capitis

b)            Seborrheic dermatitis

c)            Trichotillomania

d)            Alopecia areata

8.            What is the appropriate prophylactic medication for an 18 years old woman with a past medical history of migraine headaches?

a)            Sumatriptan (Imitrex)

b) Propanolol (Inderal)

c)            Ibuprofeno (motrin)

d)            Dihydroergotamine (DHE)

9.            Why would a combined hormonal contraceptive be contraindicated in a 36 year old patient with a past medical history of type 2 diabetes, obesity, chronic smoking and sedentary life

a)            She is obese

b)            She has type 2 diabetes mellitus

c)            Her age and tobacco use

d)            She leads a sedentary lifestyle

10.          During the breast examination of a perimenopausal woman the NP detects a bloody spontaneous discharge from the right nipple. This indicates further evaluation.

a)            Fibroadenoma

b)            Polycystic breast disease Generalized breast pain or tenderness. Green or dark brown nonbloody nipple discharge that tends to leak without pressure or squeezing

c)            An intraductal papilloma

d)            Pituitary prolactinoma

11.          Rh negative women should receive Rho (D) immunoglobulin at what gestational time?

a)            6 weeks

b)            12 weeks

c)            28 weeks

d)            35 weeks

What happens is the client is Rh negative and has a negative antibody screen?

12.          When interpreting a complete blood count (CBC) lab report which of the following results describes the size of the RBCs?

a)            Hemoglobin

b)            Mean corpuscular volume (MCV)

c)            Red cell distribution width (RDw)

d)            Hematocrit

13.          What medication should be avoided when prescribe prophylactic therapy for headache

a)            Verapamil

b)            Propranolol

c)            Venlataxin (Effexor)

d)            Nimodipine

14.          What is the mechanism of action of prostaglandin E1 (PG1) in a patient with transposition of the great arteries

a)            To maintain equal pressure in the ventricles

b)            To maintain patency of the great arteries

c)            To produce vasodilation on …………….

d)            To prevent cyanotic episodes by trapping blood in the lower …………

15.                          Which of the following complaints best describes lower extremity calf pain associated with peripheral artery disease

a)            A sharp stabbing pains

b)            A dull pain or cramp

c)            An electric shock

d)            A pulsating pain

16.          Which of the following conditions is NOT a typical finding of hyperprolactinemia in a 47- year-old premenopausal woman?

a)            Hirsutism

b)            Gynecomastia

c)            Oligomenorrhea

d)            Acne

17.          When treating a patient with asthma who is experiencing acute wheezing which medication should be given to relieve the symptom?

a)            Short acting bronchodilator

b)            Long acting bronchodilator

c)            Inhaled corticosteroid

d)            Combination of methylxanthine and long acting bronchodilator

18.          Which immunization reduces a patient’s risk for infection with the virus that causes painful localized blistering rash?

a)            Smallpox vaccine

b)            Varicella vaccine (chicken Pox)

c)            Shingles (herpes zoster) vaccine

d)            Meningococcal vaccine

19.          Headache warning signs that need prompt investigation include all of the following EXCEPT:

a)            new onset after age 50

b)            aggravated or relieved by change of position

c)            precipitated by Valsalva maneuver

d)            Headache relieved with mild infrequent use of analgesics

20.          The client with iron deficiency anemia should be advised to take the iron supplement

a)            With milk to avoid stomach upset

b)            With milk of magnesia at bedtime to avoid constipation

c)            On an empty stomach between meals

 d)           For 30 days to 5 weeks

21.          Which one of the following statements is true of Munchausen syndrome by proxy?

a)            The injury is self-inflicted as the patient is seeking attention from others

b)            Under the supervision of adults other than the abuser, the patient does not exhibit symptoms

c)            The caregiver is usually not involver in the abusive behavior

d)            The abuser is often inattentive and uncaring towards the victim

22.          Which of the following is the most common presenting sign of substance abuse in adolescents?

a)            Poor school performance

b)            change in sleep habits

c)            increased blood pressure

d)            changes in behavior

23.          A woman is 11 weeks pregnant and has a maternity history of one full term vaginal delivery, a set of premature triplets delivered vaginally, and a first trimester abortion. Using her TPAL system to document her maternal status

a)            Gravida 4 para 1114

b)            Gravida 4, para 1314 4 is the number of living children GTPAL

c. Gravida 3, para 1114

d)            Gravida 3, para 1112

24.          The nurse practitioner palpates an enlarged right epitrochlear lymph node in a 30 years old patient. The Nurse Practitioner should asses the patents

a)            Throat, face, and right ear

b)            Neck and supraclavicular region

c)            Right forearm and hand

d)            Right groin and abdomen

25.          Anticholinergics are indicated for the treatment of

a)            Asymptomatic bacteriuria

b)            Renal insufficiency

 c)           Urge incontinence

d)            Overflow incontinence

26.          A patient presents with signs of chest pain, the nurse practitioner observes jugular venous distention. Their finding is consistent with

a)            Hypertension

b)            Heart failure

c)            Asthma

d)            Pneumonia

27.          On examination of the neck, a dome shaped lesion in the dermis forming a benign closed firm sac attached to the epidermis is noted on the right lateral side of the neck. The type of lesion is known as

a)            Keloid

b)            Tophi

c)            A cutaneous cyst

d)            Chondrodermatitis

28.          Symptoms of heartburn and regurgitation are associated with:

a)            Hiatal hernia

b)            Gastroesophageal reflux

c)            Peptic ulcer disease

d)            Esophageal cancer

29.          A 70 years old man walks 20 minutes most days of the week. He has begun to complain of pain of his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 20 minutes walks without stopping to rest. What choice best describes the pain associated with peripheral artery disease?

a)            A sharp, stabbing pain

b)            A dull pain and cramp

c)            An electric shock

d)            A pulsating pain

30.          Papilledema is a cause for concern because it is suggestive of

a)            Optic atrophy

b)            Microaneurysms

c)            Increased intracranial pressure

d)            Retinal hemorrhage

31.          A 38-year-old patient with a history of abdominal pain presents to the nurse practitioner. Findings reveal superficial edema and bruising in the subcutaneous fatty tissue around the umbilicus. Hemorrhagic pancreatic is suspected because of which finding?

a)            A positive Gray Turner’s sign

b)            A positive Cullen’s sign

c)            Kaposi’s sarcoma

d)            Petechiae

32.          A 57 years old post-menopausal female presents with a complaint of vaginal burning, pruritus and painful intercourse. On examination, the nurse practitioner would be most concern with the findings

 a)           A thin, pale, dry vaginal mucosa

b)            Absence of rugae

c)            A friable cervix

d)            Raised yellowish cervical lesion

33.          What intervention does the American College of Rheumatology recommend as first line therapy for Osteoarthritis, rheumatoid arthritis or something else

a)            Diagnostic workup to rule out rheumatic arthritis

b)            NSAID use at lowest effective dose

c)            Acetaminophen use up to 4 grams/day

d)            Exercise and weight loss

34.          Which of the following drugs is not contraindicated for concurrent use with warfarin (Coumadin)?

a)            Amoxicillin (Amoxil)

b)            Trimethroprim/sulfamethaxazole (Bactrim)

c)            Cirpofloxacin (Cipro)

d)            Clarithromycin (Biaxin)

35.          The lymphatic ducts drain into the (APEA)

a)            arterial system

b)            venous system

c)            vertebral bodies of the spine

d)            shoulder

36.          Which of the following is the most appropriate treatment for trichomoniasis in a non- pregnant woman?

a)            Metronidazole (flagyl)

b)            Doxycycline (Vibramycin)

c)            Clindamycin (Cleocin)

d)            Clotrimazole (lotrimin)

37.          Osteosarcoma in a pediatric patient is most often diagnosed when there is:

a)            Pain in the affected bone

 b)           Pathologic fracture

c)            Repeat fracture

d)            Apophyseal avulsion

38.          In a patient who has a history of migraine headaches, which characteristics is most common?

a)            Focal deficits

b)            Family history

c)            Weakness

d)            Initial onset after age 35

39.          Symptoms associated with small bowel obstruction usually include:

a)            Nausea and diarrhea

b)            Vomiting and pain

c)            Hematemesis and bloody stool

d)            Indigestion and anorexia

40.          Unilateral rhinitis could be caused by all of the following except

a)            A foreign body in the nasal canal

b)            A nasal polyp

c)            Drug induced rhinitis

d)            A deviated sputum

41.          A 7 years old child has been diagnosed with acute sinusitis. The drug class that should be avoided is:

a)            Antihistamines

b)            Expectorants

c)            Decongestants

d)            Nasal steroids

42.          A patient present with an elongated head with bony prominence of the forehead, nose and lower jaw. These facial features could be suggestive of:

a)            Nephrotic syndrome

b)            Acromegaly

c)            Cushing’s syndrome

d)            Parkinson’s disease

 

43.          Why would a child diagnosed with beta thalassemia and hemosiderosis receive deferoxamine (desferal)?

a)            To prevent blood transfusion reactions

b)            To simulate red blood cell production

c)            To improve the oxygen carrying capacity of RBCs

d)            To eliminate excessive iron and prevent organ damage

44.          A patient has newly diagnosed hypothyroidism. What are the patients TSH level expected to be?

a)            Higher than normal

b)            Lower than normal

c)            Within normal range

d)            TSH is not used to diagnose hypothyroidism Suggest that the provider lower the dose.

45.          Which of the following symptoms would be a clinical manifestation noted during the secondary stage of syphilis?

a)            Absence of symptoms

b)            Single painless lesion, chancre on the genital area.

c)            Rash marked by red or reddish-brown, penny-sized lesions over the palms and soles

d)            Poor muscle coordination

46.          An 84-year-old male with prostatic hypertrophy is at increased risk of:

a)            Constipation

b)            Fecal incontinence

c)            Urinary tract infections

d)            Prostate cancer

47.          A characteristic lesion observed in a male with primary syphilis is a:

A) Group of small scattered vesicles

B) Chancre

C)            Papule of many shapes

D)           Non-tender penile indurated nodule

48.          During an acute attack of gout, the nurse practitioner knows NOT to prescribe

a)            Colchicine (Colcrys)

b)            Allopurinol (zyloprim)

c)            Steroids

d)            NSAIDS

49.          What two vitamins and minerals should be included in oral multivitamins in women

a)            Folic Acid and Vitamin C

b)            Iron and Vitamin B12

c)            Vitamin D and Iron

d)            Folic Acid and Iron

50.          In a patient with bacterial meningitis, the most common reason for finding of headaches:

a)            Meningeal erythema

b)            Increased intracranial pressure

c)            Meningeal irritation

d)            Swelling of the spinal cord

51.          Janeway lesions, petechiae and Oster nodes are associated with:

a)            Gonococcemia

b)            Infective endocarditis

c)            Hyperthyroidism

d)            Peripheral vascular disease

52.          A patient present with decreased hearing related to antibiotic use. Which class of antibiotics is this?

 a)           Aminoglycosides

b)            Beta-lactams

c)            Cephalosporins

d)            Macrolides

53.          Which antihypertensive would be appropriate to prescribe for a hypertensive patient (B/P 150/95) that is in her third trimester?

a)            Candesartan

b)            Lisinopril

c)            Methyldopa

d)            Furosemide

54.          A 40-year-old admits to multiple sex partners presents with several lesions over his body. Finding reveals hemorrhagic vesiculopustular lesions over the hands and feet. These lesions are most likely associated with:

a)            Gonococcemia

b)            Infective endocarditis

c)            Hyperthyroidism

d)            Peripheral vascular disease

55.          Which agent is NOT useful in prophylactic treatment of migraine headaches?

a)            Sumatriptan (Imitrex)

b)            Amitriptyline (elavi