NURS 6531 Advanced Practice Care of Adults Across the Lifespan

1. Question: An adult presents with tinea corporis. Which item below is a risk factor for its development?
2. Question: Which of the following best describes hypertrophic cardiomyopathy?
3. Question: A patient presents to the primary care provider complaining of a rash on his right forehead that started yesterday and is burning and painful. The physical exam reveals an erythematous, maculopapular rash that extends over the patient’s right eye to his upper right forehead. Based on the history and examination, the most likely cause of this patient’s symptoms is:
4. Question: Marvin, age 56, is a smoker with diabetes. He has just been diagnosed as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis?
5. Question: The National Cholesterol Education Program’s Adult Treatment Panel III recommends that the goal for low density lipoproteins in high risk patients be less than:
6. Question: The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The least likely diagnosis for this patient is:
7. Question: In the initial evaluation of a patient with new onset hypertension, the nurse practitioner should:
8. Question: A 70 year old patient presents with a slightly raised, scaly, erythematous patch on her forehead. She admits to having been a “sun worshiper.” The nurse practitioner suspects actinic keratosis. This lesion is a precursor to:
9. Question: A 55 year old patient has a work-up for hypertension and is noted to have elevated BUN and creatinine. Which of the following should the nurse practitioner suspect?
10. Question: A 58-year-old man is diagnosed with Barrett’s esophagus after an endoscopy. He has no known allergies. Which of the following medications is MOST appropriate to treat this patient’s disorder?
11. Question: The nurse practitioner is reviewing a patient’s lab report who completed the hepatitis B series 3 months ago. Which of the following lab results would you expect to see in this patient?
12. Question: Which antibiotic would be the most e"ective in treating community acquired pneumonia (CAP) in a young adult without any comorbid conditions?
13. Question: A 40 year old female with history of frequent sun exposure presents with a multicolored lesion on her back. It has irregular borders and is about 11mm in diameter. What should the nurse practitioner suspect?
14. Question: Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized?
15. Question: Which choice below is least e"ective for alleviating symptoms of the common cold?
16. Question: What prophylactic medication is commonly recommended for the patient under 35 years of age with a positive PPD?
17. Question: Which of the following dermatologic vehicles are the most e"ective in absorbing moisture and decreasing friction?
18. Question: A 76-year-old male complains of weight loss, nausea, vomiting, abdominal cramping and pain. Physical findings include an abdominal mass and stool positive for occult blood. The nurse practitioner pain suspects a tumor in the small intestine. The best diagnostic test for this patient is:
19. Question: Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations a"ect her activities and they occur at least twice weekly and may last for days. She is a"ected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in?
20. Question: An 18-year-old female presents to the urgent care center complaining of severe pruritus in both eyes that started 2 days ago. Associated symptoms include a headache and fatigue. On examination, the nurse practitioner notes some clear discharge from both eyes and some erythema of the eyelids and surrounding skin. Which of the following is the most likely cause of this patient’s symptoms?
21. Question: Sheila, age 78, presents with a chief complaint of waking up during the night coughing. You examine her and find an S3 heart sound, pulmonary crackles that do not clear with coughing, and peripheral edema. What do you suspect?
22. Question: An active 65-year-old man under your care has known acquired valvular aortic stenosis and mitral regurgitation. He also has a history of infectious endocarditis. He has recently been told he needs elective replacement of his aortic valve. When he comes into the office you discover that he has 10 remaining teeth in poor repair. Your recommendation would be to:
23. Question: When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action?
24. Question: An 18 year old complains that his “throat hurts” with swallowing. His voice is very “throaty” and he is hyperextending his neck to talk. Examination reveals asymmetrical swelling of his tonsils. His uvula is deviated to the left. What is the most likely diagnosis?
25. Question: Treatment of acute vertigo includes:
26. Question: A patient presents with an inflamed upper eyelid margin. The conjunctiva is red and there is particulate matter along the upper eyelid. The patient complains of a sensation that “there is something in my eye.” What is the diagnosis and how should it be treated?
27. Question: A patient presents with classic symptoms of gastroesophageal reflux disease (GERD). He is instructed on life style modifications and drug therapy for 8 weeks. Three months later he returns, reporting that he was “fine” as long as he took the medication. The most appropriate next step is:
28. Question: A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe?
29. Question: What is the Gold standard for the diagnosis of asthma?
30. Question: A 58 year old complains of tightness in his chest while cutting firewood. It disappears quickly if he stops chopping. He denies shortness of breath, his total cholesterol level is less than 200 mg/dL, and he is a non-smoker. What is the most appropriate action for the nurse practitioner to take with this patient?
31. Question: A false-positive result with the fecal occult blood test can result from:
32. Question: A 70 year old man who walks 2 miles every day complains of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 2 mile walk. What question asked during the history, if answered affirmatively, would suggest a diagnosis of arteriosclerosis obliterans?
33. Question: Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?
34. Question: A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most e"ective in keeping him symptom-free?
35. Question: Martha had a less than 7% value on her Schilling test. What medication do you anticipate she might need?
36. Question: A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed?
37. Question: Your 31-year-old patient, whose varicella rash just erupted yesterday, asks you when she can go back to work. What do you tell her?
38. Question: Acute rheumatic fever is an inflammatory disease which can follow infection with:
39. Question: Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order?
40. Question: Your well-nourished 75-year-old patient has come into the office for a physical exam and states that she recently had two nosebleeds. She does not take any anticoagulants, and you have ruled out any coagulopathies. The most likely cause of these nosebleeds is:
41. Question: Your patient Jerry has gout. What do you suggest?
42. Question: A middle-aged male presents to urgent care complaining of fever, dysphagia, and shortness of breath. The nurse practitioner notes the patient leaning forward in a tripod position and drooling. The clinical presentation of this patient suggests:
43. Question: A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with:
44. Question: Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes?
45. Question: Which of the following is not a goal of treatment for the patient with cystic fibrosis?
46. Question: Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by:
47. Question: An 80-year-old male admits to difficulty swallowing during the review of systems. The nurse practitioner recognizes the di"erential diagnosis for this patient’s dysphagia is:
48. Question: Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect?
49. Question: Mort is hypertensive. Which of the following factors influenced your choice of using an alpha blocker as the antihypertensive medication?
50. Question: A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory?
51. Question: Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is:
52. Question: Which of the following heart murmurs warrants the greatest concern?
53. Question: Which of the following are classic features of ulcerative colitis?
54. Question: Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect?
55. Question: What condition is associated with mucus production greater than 3 months per year for at least 2 consecutive years?
56. Question: A patient reports “something flew in my eye” about an hour ago while he was splitting logs. If there were a foreign body in his eye, the nurse practitioner would expect to find all except:
57. Question: Which of the following can result from chronic inflammation of a meibomian gland?
58. Question: What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery?
59. Question: A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him:
60. Question: The most common cancer found on the auricle is:
61. Question: Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication?
62. Question: A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough?
63. Question: Mark has just been given a diagnosis of congestive heart failure. Which of his medications should be discontinued?
64. Question: What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?
65. Question: An AST that is more than twice the level of ALT is suggestive of:
66. Question: A patient with elevated lipids has been started on lovastatin. After 3 weeks of therapy, he calls to report generalized muscle aches. The nurse practitioner should suspect:
67. Question: A 70 year old patient presents with left lower quadrant (LLQ) abdominal pain, a markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition?
68. Question: John, age 33, has a total cholesterol level of 188 mg/dL. How often should he be screened for hypercholesterolemia?
69. Question: Treatment of H.pylori includes which of the following?
70. Question: Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to:
71. Question: In order to decrease deaths from lung cancer:
72. Question: Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis?
73. Question: Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?
74. Question: A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent care with new onset left lower quadrant pain. Her current medications include omeprazole 20 milligrams po daily, lisinopril 20 milligrams po daily, simvastatin 20 milligrams po daily, and prednisone 12 milligrams po daily. The nurse practitioner suspects acute diverticulitis and possibly an abscess. The most appropriate diagnostic test for this patient at this time is:
75. Question: Jennifer, age 49, who has a history of hyperlipidemia, has symptoms that lead you to suspect unstable angina. Your next action would be to:
76. Question: A 45 year old with diabetes has had itching and burning lesions between her toes for 2 months. Scrapings of the lesions confirm the diagnosis tinea pedis. What is the best initial treatment option for this patient?
77. Question: A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect:
78. Question: Shirley, age 58, has been a diabetic for 7 years. Her blood pressure is normal. Other than her diabetes medications, what would you prescribe today during her routine office visit?
79. Question: A 47 year old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On examination, external hemorrhoids are noted. How should the nurse practitioner proceed?
80. Question: After thorough history, physical examination, and laboratory tests, a patient is diagnosed with irritable bowel syndrome (IBS). Which of the following initial treatment plans is currently considered most e"ective?
81. Question: Which of the following is a predisposing condition for furunculosis?
82. Question: The di"erential diagnosis for a patient complaining of a sore throat includes which of the following?
83. Question: Amaurosis fugax is described as a:
84. Question: A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 di"erent thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect:
85. Question: Which statement below is correct about pertussis?
86. Question: A 40 year old presents with a hordeolum. The nurse practitioner teaches the patient to:
87. Question: John, age 59, presents with recurrent, sharply circumscribed red papules and plaques with a powdery white scale on the extensor aspect of his elbows and knees. What do you suspect?
88. Question: Impetigo and folliculitis are usually successfully treated with:
89. Question: A cashier complains of dull ache and pressure sensation in her lower legs. It is relieved by leg elevation. She occasionally has edema in her lower legs at the end of the day. What is the most likely cause of these problems?
90. Question: Appropriate therapy for peptic ulcer disease (PUD) is:
91. Question: The American Cancer Society recommends a flexible sigmoidoscopy for colorectal cancer screening in persons at average risk every:
92. Question: When teaching a patient with hypertension about restricting sodium, you would include which of the following instructions?
93. Question: Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg daily, and Calcium 1500 mg daily. At today’s visit. Her blood pressure is 170/89. According to JNC VIII guidelines, what should you do next to control Harriet’s blood pressure?
94. Question: Risk factors for acute arterial insufficiency include which of the following?
95. Question: A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is:
96. Question: An elderly patient is being seen in the clinic for complaint of “weak spells” relieved by sitting or lying down. How should the nurse practitioner proceed with the physical examination?
97. Question: Which of the following patient characteristics are associated with chronic bronchitis?
98. Question: Which of the following is the most appropriate therapeutic regimen for an adult patient with no known allergies diagnosed with group A B-hemolytic strep?
99. Question: Risk factors for acute otitis media (AOM) include all of the following except:
100. Question: A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is:
101. Question: When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?