FITZGERALD PRACTICE TEST
Terms in this set (75)
One site for atopic dermatitis usually only noted during infancy is the:
A 75 yo man with symptomatic benign prostatic hyperplasia should not be prescribed:
A first time father brings in his 1 month old infant for evaluation. He is concerned that she "throws up all of the time". The child has an appropriate weight gain since the last office visit at age 1 week and appears well today. The NP knows that the most common cause of frequent spit-up and vomiting in a young infant is:
GI tract immaturity allowing reflux
Allergy or intolerance to a component of infant formula
A new patient presents for a check-up. He has no complaints, but admits that he's been smoking 2 packs a day for 40 years. Spirometric assessment reveals an FEV1/FVC ratio of 67%. Which additional finding would be consistent with a diagnosis of COPD?
Markedly increased chest AP diameter
Pleuritic chest pain
FEV1/FVC ratio < .70
FEV1 improving by 50% after SABA treatment
The process of absorption, distribution, metabolism, and elimination of a drug is known as:
Drug interactions study
A 52 yo female of European ancestry with a BMI=24 is diagnosed with new onset HTN. She has no significant medical history, no concomitant health problems, and takes no medications. Along with therapeutic lifestyle changes, therapy should begin with which of the following classes of drug?
Calcium channel blocker
Actinic keratosis can be described as:
Hyperpigmented macules on sun exposed areas
Vesicular lesions along a dermatomal distribution
Ulcerating lesions in groin folds
Slightly rough, pink or flesh colored lesions on the face
Which of the following is an absolute contraindication to post-menopausal hormone therapy?
Unexplained vaginal bleeding
Medicare Part B coverage includes:
Healthcare for individuals over age 65 with limited income
Hospitalization for citizens over age 65
Reimbursement for outpatient services
Payment for inpatient medications
2 weeks ago, the NP saw a 2 yo in clinic. The child has not had a well-child checkup since he was 4 months old and received a number of catch up vaccines at the visit. Today, his mother calls to report he has a flat, pink rash all over his body but appears otherwise well. The NP suspects that this is a normal reaction to which of the following vaccines?
A 27 yo woman presents for care. She reports a 3 day history of intense vaginal itch, burning with urination, and white, clumping discharge. She denies foul odor but says it does smell a little musty. Which of the following history findings supports your diagnosis?
New sexual partner
Swimming in a local lake
Recent antibiotic use
Recent insertion of levonorgesteral-releasing IUD
Your neighbor asks you to refill her high blood pressure medication as she could not make her last office visit to her provider due to a family emergency. You are aware that she is going through a difficult time personally and agree to call in the prescription. As a result:
A healthcare provider-patient relationship has been formed.
The Good Samaritan Act will protect you from liability.
You should charge your neighbor for an office visit in order to maintain a professional relationship.
You realize this action is acceptable as her medication is not a controlled substance.
One week into sertraline therapy, a 34 yo woman c/o recurrent dull frontal HA that is relieved with acetaminophen. You advise her that:
This is a common, transient SE of SSRI therapy
Diazepam should be substituted
Desipramine should be added
She should discontinue the medication
Actinic keratosis can be a precursor to:
Basal cell carcinoma
Squamous cell carcinoma
Which of the following is most consistent with the diagnosis of depression?
Recurrent diarrhea and cramping
Difficulty initiating sleep
Diminished cognitive ability
Consistent early morning wakening
The NP is beginning pharmacologic management of dyslipidemia in a 47 yo male patient whose labs are as follows:
Total cholesterol 249
The appropriate class of agent is:
Omega 3 fatty acid
Fibric acid derivative
Cholesterol absorption inhibitor
HMG-CoA reductase inhibitor
Your patient has been on oral contraceptives for 4 years and is now ready to start a family. She asks how long she should wait after stopping her pills. You advise her that it is safe to conceive:
After 1-2 months
After 3-4 months
After 2 normal menstrual cycles
COC use is not advise (category 4) in which of the following?
An otherwise well woman over 35 yo
a 19 yo cigarette smoker
A 32 yo with hepatic adenoma
a 35 yo with well controlled HTN
You see a 14 yo girl at Tanner stage 2-3 with c/o being the shortest in her class. You advise:
Referral to the endocrinologist.
That she is likely near her adult height.
That her growth spurt will start soon.
That bone age be determined.
While reviewing the records of a 3 yo patient who is new to your practice, you learn that she has a Still's murmur. As a result you anticipate which of the following findings?
An audible systolic murmur auscultated at the base of the heart.
Height and weight in the bottom 25% of the growth chart.
A hyperdynamic PMI.
Joint laxity and hyperextension.
A 22 yo man presents with new onset pain and swelling in the feet and ankles as well as conjuncitivitis, oral lesions, and dysuria. The most important test to obtain is:
A distraught female patient presents to you the day after a condom break. She is very concerned that she might be pregnant and is asking about emergency contraception. Appropriate counseling about the use of hormonal emergency contraception includes all of the following except:
An established pregnancy will not be interrupted.
There is about a 50% reduction in pregnancy risk with properly timed use.
There is no increased risk of birth defect if pregnancy occurs.
Nausea is a common side effect but is usually transient.
Clinical evaluation management of a 43 you man with BMI=42 who presents with recurrent genital Candida albicans infection should include all of the following except:
Treatment with oral/topical antifungal
Offering testing for HIV
Avoidance of soap on genitals
Screening for DM
Physical examination of a patient with symptomatic Graves disease will likely reveal:
Blunted pupil response
The NP is providing FU care for a patient being managed with a statin. Lab assessment should include an initial measurement of:
A 61 yo woman see you in FU after being d/c form the hospital. She recently had an inferior wall MI and is asking about supervised cardiac rehab. She is shocked that she had a heart attack and says she never knew that her cholesterol was so high. She has not seen a provider in 27 years. Tertiary prevention strategies for this patient include:
Referral for mammogram
Lipid lowering therapy with a statin
Influenze and pneumococcal vaccination
Screening for diabetes
CPT is an acronym for:
clinical practice template
current procedureal terminology
current practice terms
clinical procedure testing
T2DM is best described as:
A hereditary autoimmune process
A consequence of obesity
A condition largely dictated by environmental factors
A disorder of IR with eventual insulin deficiency
Which of the following is most consistent with the diagnosis of herpes zoster?
Papules in a dermatomal distrubition
Low grade fever and malaise prior to eruption
Presence of pustules and honey crusted lesion
a 1-2 day prodrome of pain prior to lesions erupting
An 18 yo male presents with profound scrotal pain Which of the following findings supports the diagnosis of testicular torsion?
Positive Prehns sign
Loss of cremasteric reflex
The primary complaint of a patient with BV is usually:
Profound vaginal odor
The NP is evaluating a 34 you man who reports a 3 month hx of epigastric pain that he describes as intermittent, burning, and occurring 2-3 hours after meals. The leading differential dx is:
A newly diagnosed T2DM patient who has an A1C=8.2 will most likely begin with a medication from which of the following drug classes?
Alpha glucosidase inhibitor
A 15 week old infant presents with fever=100.5 and bilateral erythematous TMs. The infant is alert with excellent skin turgor, no difficulty breathing, acknowledges her mothers face and has a wet diaper. Her parents report she is nursing q 3hrs without vomiting or diarrhea. Appropriate management would be:
Counsel mother to observe for 72 hours and RTC if no improvement.
Start topical therapy with otic abx drops.
Initiate sepsis workup.
Begin a systemic abx regimen.
Which of the following is most consistent with the diagnosis of depression?
Recurrent diarrhea and cramping
Difficulty initiating sleep
Dimished cognitive ability
Consistent early morning awakeniing
A 20 yo man c/o being very fatigued for the past week. The PE is significant for anterior and posterior cervical adenopathy and R and L UQ abdominal tenderness. A WBC differential is significant for lymphocytosis with reactive forms. Which of following additional findings does the NP anticipate?
Pharyngitis with exudate
Diffuse maculopapular rash
Marked sinus tenderness
A 27 yo woman presents with c/o of L lower abdominal and groin pain. She admits she has had a light period everyday for nearly 3 weeks. The presumptive diagnosis of ectopic pregnancy is supported by which of the following?
Positive urine HCG
A 29 yo well woman of Mediterannean ancestry presents for her first healthcare visit in many years. She relocated to North America from Italy after marrying a member of the armed forces. A routine CBC is significant for the following:
RBC=5.9 These findings are most consistent with:
Acute blood loss
Beta thalassemia minor
The notation of impaired glucose tolerance will produce which lab abnormality?
FBG of 109
1 hour PPG of 98
Random glucose of 134
2 hour PPG of 152
A 47 yo man presents for evaluation of erythematous popular lesions on his forehead an dchin. Which is the most likely DDX?
The report of a recurrent nocturnal severe HA of 1 hour duration accompanied by lacrimation and nasal discharge is most consistent with:
Acute neurological event
All of the following ar examples of environmentatl control for a patient with allergic rhinitis except:
keepin gpets out of the bedroom
laundering sheets in hot water
encasing pillows in plastic covers
keeping bedroom window open in the early morning
In a woman taking a COC theh reduction in free androgens can yield an improvement in
A 75 yo man with symptomatic BPH should not be prescribed
A 51 yo woman presents with a 1 day history of fever pain and vomiting. The diagnosis of acute cholecystitis would be confirmed by
elevated amylase and lipase
RUQ abdominal US
abdominal planin films
The ethical principle of veracity mandates that the healthcare provider:
allocate resources so that the best is done for the rgreatest number of people
treat all people in the same fair manner
be trughtful and avoid deception is faithful to commitments made to self and others
Normal physical findings in an elderly woman include all of the following excetp
puckering of the skin over breast tissue
reduced saliva production
A new patient presents for a check up. He has no complaints
A 75 yo man with symptomatic BPH should not be prescribed:
A prostate cancer lesion detectable by DRE will likely by described as:
A hard, immobile induration
A bilateral enlargement
A painful flocculent lesion
A rubbery gland with central depression
Which diagnosis should be considered when there is a report of a "cold spot
on a thyroid scan?
All of the following are examples of primary prevention strategies for a 65 yo man with COPD except:
Annual influenza vaccine
Ensuring adequate illumination at home
Using a condom with new sex partners
Prophylactic treatment options for migraine include:
The nurse practitioner is counseling a patient who is new to insulin therapy. The patient is advised that when injecting short acting, rapid onset formulation such as insulin aspart, the peak risk time for hypoglycemia is:
15-60 minutes after injection
1-3 hours after injection
3-4 hours after injection
4-5 hours after injection
When counseling patients to promote hepatitis C prevention the nurse practitioner realizes the most important measure from the list below is:
Safe sex practices
Using single use injection drug paraphernalia
Avoidance of raw seafood ingestion
Medicare Part A coverage includes:
Limited care in SNF
Outpatient care with a PCP
120 days in SNF
Outpatient medication prescriptions
Which of the following describes the ethical principle of beneficence?
The right of the competent person to choose a personal plan of life and action.
The obligation of the PCP to help people in need.
The responsibility of the PCP to treat all in the same fair manner.
The duty of the PCP to do no harm.
When evaluating a patient with low back pain without radiculopathy, the NP will most likely identify:
Discomfort to direct palpation of paraspinal muscles
A positive SLR
Recent history of strain
Pain relief with lumbar flexion
Sulfonylureas and meglitinides are characterized by their impact on:
Insulin receptor site activity
Hepatic glucose production
Renal glucose excretion
Which of the following is true for tension type HA?
The pain is typically describes as nonpulsating in quality
Photophobia is seldom reported
The HA is usually unilateral
Rhinorrhea and lacrimation are commonly reported during the HA
During a 12 month WCC, the NP notices that the child is not walking independently. The mother is very concerned and insists that her other 3 children were all walking by age 1. The most appropriate action would be to:
Tell the mother that while on average children are walking by 1 yo, many children do so later; schedule a FU in 1-2 months to assess progress.
Reassure the mother that children with older siblings often do not start walking until later in life; schedule the next routine WCC in 3 months.
Counsel the mother that while there is no need to panic, this does represent a developmental delay and the child should be seen by a pediatric orthopedic specialist.
Request a radiographic assessment of the spinal cord, pelvis, and femurs to rule out structural bony anomalies that frequently delay walking.
The preferred therapeutic option in Graves disease is:
Surgical resection of hyperfunctioning nodule
Radioactive ablation of overactive thyroid tissue
Levothyroxine suppression therapy
While reviewing the records of a 3 yo patient who is new to your practice, you learn that she has a Still's murmur. As a result you anticipate which of the following?
An audible systolic murmur auscultated at the base of the heart
Height and weight in the bottom 25% of the growth chart
A hyperdynamic PMI
Joint laxity and hyperextension
The preferred pharmacologic management of persistent cough in a 25 yo woman with acute uncomplicated bronchitis would most likely include:
Antibiotic therapy to cover atypical pathogens
An inhaled anticholinergic
An inhaled corticosteroid
A dextromethorphan based cough suppressant
Which of the following medications provides the best relief from acute nasal congestion?
Anticholinergic nasal spray
Decongestant nasal spray
Corticosteroid nasal spray
Saline nasal spray
A 76 yo woman is treated for OA diagnosed by DEXA scan. When counseling the patient about proper use of bisphosphonate therapy, the NP advises that:
The medication should be taken at bedtime.
A parental form of the medication is the preferred, first line agent.
Oral medication must be taken with at least 8 oz of water
The use of the medication can produce a metallic taste
To reduce the incidence of flushing when starting a patient on niacin, the NP should advise pretreatment with:
The mechanism of action of nasal cromolyn is:
Mast cell stabilizer
The murmur of mitral valve insufficiency is best described as:
Mid-late systole with a snap
Diastolic and generalized across the precordium
Diastolic with radiation to the neck
Systolic with radiation to the axillae
Which of the following medication used to treat depression can be most dangerous when taken inappropriately?
According to WHO precautions for OCP, which of the following clinical scenarios describes a Category 2 situation?
Family history of lipid disorders
Personal history of factor V Leiden mutation
Undiagnosed vaginal bleeding
A 52 yo woman presents to your office as a new patient. She reports a long history of HTN and admits she does not regularly take her medication. Which of the following is an anticipated fundoscopic finding?
Narrowing of vessels
Increased cup:disc ration
Cotton wool spots
For an individual to demonstrate the capability to make an informed healthcare decision, all of the following must be present except:
Ability to understand the nature of the clinical condition
Can interpret the information presented
Able to give a reason for the choice
Does not need to be able to communicate preference
Of the total daily pancreatic insulin release, how much is basal?
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