NR511 MIDTERM EXAM MARCH 2020

Question 1.         Which of the following is a crucial element of developing a

guideline?

                Creating a physician expert panel

Reviewing the literature with ratings of available evidence Conducting an external review of a guideline

Developing evidence-based tables         

 

 

Question 2.         African American patients seem to have a negative reaction

to which of the following asthma medications?

                Inhaled corticosteroids

Long-term beta-agonist bronchodilators Leukotriene receptor agonists

Oral corticosteroids        

 

 

Question 3. Jolene has breast cancer that has been staged as T1, N0,

M0. What might this mean?

                                The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the distant spread cannot be evaluated.

The cancer is in situ; it is spreading into the lymph nodes,

but the spread cannot be evaluated otherwise.

   The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.

   The cancer is about 5 cm in size; nearby lymph nodes cannot be evaluated; and there is no evidence of distant spreading.

               

 

 

Question 4.         Sondra's peripheral vestibular disease causes dizziness and

vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

                Meclizine Diphenhydramine

 

 

Diamox Promethazine

               

 

 

Question 5.         Mandy presents with a cauliflower-like wart in her anogenital

region. You suspect it was sexually transmitted and document this as a:

                Filiform/digitate wart

Dysplastic cervical lesion Condyloma acuminata Koilocytosis

               

 

 

Question 6. Inattention and a sleep-wake cycle disturbance are the

hallmark symptoms of?

           Dementia

   Alzheimer's disease   Parkinson's disease   Delirium

               

 

 

Question 7.         You have taught Jennifer, age 15, about using a flow meter

to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?

                                  "Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow."

"Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow."

"Drive to the emergency room now."

"Call 911."

               

 

 

Question 8. A patient is seen in the clinic with hematuria confirmed on

microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?

 

 

   NSAIDs

Beets Vitamin A Red meat

               

 

 

Question 9.         Which of the following is an example of tertiary prevention in a patient with chronic renal failure?

                Fluid restriction Hemodialysis 4 days a week High-protein diet

Maintenance of blood pressure at 120/80           

 

 

Question 10.      Which of the following conditions is associated with

cigarette smoking?

                  Glaucoma

   Increased sperm quality   Bladder cancer

   Eczema               

Question 11.      A chronic cough lasts longer than:                            3 weeks

1 month

6 months

1 year

               

 

 

Question 12.      The 'freezing phenomenon' is a cardinal feature of?

                Parkinson's disease

Alzheimer's disease A CVA

Bell's palsy           

 

Question 13.      When administered at the beginning of an attack, oxygen

therapy may help this kind of headache?

                                  Tension  Migraine  Cluster  Stress

               

 

 

Question 14.      Which ethnic group has the highest lung cancer incidence

and mortality rates?

                African American men

Scandinavian men and women Caucasian women

Asian men            

Question 15.      The most significant precipitating event leading to otitis

media with e?usion is:

                Pharyngitis Allergies

Viral upper respiratory infection (URI) Perforation of the eardrum

               

 

 

Question 16.      Samuel is going to the dentist for some work and must take

endocarditis prophylaxis because of his history of:

                Severe asthma

A common valvular lesion Severe hypertension

A prosthetic heart valve               

 

 

Question 17.      A 34-year-old patient was treated for a UTI and has not

responded to antibiotic therapy. Which of the following actions should be taken next?

                Send a urine specimen for microscopy and evaluate for

 

fungal colonies.

Increase the dose of antibiotic. Order a cytoscopy.

Order a di?erent antibiotic.

 

               

 

 

Question 18.      Which statement best describes a carotid bruit?

                                It is felt with the middle three fingers over the carotid artery.

A bruit becomes audible when the lumen is narrowed to 1

mm or less.

   A low-pitched bruit is a medical emergency.

   The higher the pitch of the bruit, the higher the degree of stenosis.

               

 

 

Question 19.      Which statement is true regarding chloasma, the 'mask of

pregnancy'?

                                  It is caused by a decrease in the melanocyte-stimulating hormone during pregnancy.

This condition only occurs on the face.

Exposure to sunlight will even out the discoloration.

It is caused by increased levels of estrogen and progesterone.

               

 

 

Question 20.      Simon presents with alopecia areata with well-circumscribed

patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

                "You must be under a lot of stress lately."

"It is hereditary. Did your father experience this also?" "The cause is unknown, but we suspect it is due to an

immunologic mechanism."

   "We'll have to do some tests."               

 

 

Question 21.      A blood pressure (BP) of 150/90 is considered:

 

 

                Stage 2 hypertension

Hypertensive

Normal in healthy older adults Acceptable if the patient has DM

               

 

 

Question 22.      When teaching post MI patients about their NTG tablets, the

clinician should stress that the tablets should remain in the light-resistant bottle in which they are packaged and should not be put in another pill box or remain in areas that are or could become warm and humid. Once opened, the bottle must be dated and discarded after how many months?

                1 month 3 months

6 months

As long as the tablets are kept in this special bottle, they will last forever.

               

 

 

Question 23.      Your patient has decided to try to quit smoking with Chantix.

You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?

                He should stop smoking today.

He should stop smoking tomorrow. His quit date should be in 1 week.

He will be ready to quit after the first 30 days.

               

 

 

Question 24.      When looking under the microscope to diagnose an

intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

                Spores Leukocytes Pseudohyphae Epithelial cells

               

 

 

Question 25.      The hallmark of an absence seizure is:                    No activity at all

A blank stare

Urine is usually voided involuntarily

The attack usually lasts several minutes                

 

 

Question 26.      Which medication used for scabies is safe for children 2

months and older?

                Permethrin cream Lindane

Crotamiton lotion and cream Ivermectin

               

 

 

Question 27.      The clinician is seeing a patient complaining of red eye. The

clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?

                Viral conjunctivitis Keratoconjunctivitis Bacterial conjunctivitis Allergic conjunctivitis

               

 

 

Question 28.      Gabby, aged 22, has Bell's palsy on the right side of her

face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?

                "Most patients have complete recovery in 3 to 6

months."

"Unfortunately, you'll probably have a small amount of residual damage."

"Don't worry, I'll take care of everything."

"You may have a few more episodes over the course of your lifetime but no permanent damage."

               

 

 

Question 29. How often should drug levels be monitored when a seizure

medication has controlled the seizures, and the drug level is adequate?

                Every 3 months Every 6 months Annually

Whenever there is a problem  

 

 

Question 30.      Immunizations are an example of which type of prevention?

                  Primary

   Secondary  Tertiary

               

 

 

Question 31.      The result of the patient's 24-hour urine for protein was 4.2

g/day. The clinician should take which of the following actions?

                  Repeat the test.

   Refer to a nephrologist.

   Measure the serum protein.

   Obtain a blood urea nitrogen (BUN) and creatinine.

               

 

 

Question 32.      Which cranial nerve is a?ected in a patient with a

cerebrovascular accident who has di?culty chewing?

                CN V CN VII CN IX CN X

               

 

 

Question 33.      Which of the following diagnostic tests should be ordered

for a patient suspected of having bladder cancer?

                Kidneys, ureter, bladder x-ray

Cystoscopy with biopsy Magnetic resonance imaging

 

 

Urine tumor marker (NMP22)   

 

 

Question 34.      The "B" in the ABCDEs of assessing skin cancer represents:                          Biopsy

Best practice Boundary

Border irregularity          

 

 

Question 35.      Which statement is true regarding driving and patients with a

seizure disorder?

                                  Once diagnosed with a seizure disorder, patients must never drive again.

After being seizure free for 6 months, patients may drive.

Each state has di?erent laws governing driving for individuals with a seizure disorder.

   These persons may drive but never alone.

               

 

 

Question 36.      Which high-density lipoprotein (HDL) level is considered

cardioprotective?

                Greater than 30 Greater than 40

Greater than 50

Greater than 60

               

 

 

Question 37.      The most common cause of CAP is?

                  Streptococcus pneumoniae

   Klebsiella pneumoniae   Legionella pneumoniae

   Pseudomonas aeruginosa        

 

 

Question 38.      Sandra has palpitations that occur with muscle twitching,

paresthesia, and fatigue. What specific diagnostic test might help determine the cause?

                Serum calcium Electrocardiogram (ECG)

Thyroid-stimulating hormone test Complete blood cell count

               

 

 

Question 39.      A patient presents to the clinician with a sore throat, fever of

100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?

                                The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.

   Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the o?ending pathogen.

A throat culture should be performed to confirm the results of the rapid strep test.

The patient should be treated with antibiotics for strep

throat as the rapid strep test is not very sensitive.

               

 

 

Question 40.      Patients with acute otitis media should be referred to a

specialist in which of the following situations?

                Concurrent vertigo or ataxia

Failed closure of a ruptured tympanic membrane If symptoms worsen after 3 or 4 days of treatment All of the above

               

 

 

Question 41.      Which of the following tests is most useful in determining

renal function in a patient suspected of CRF?

                BUN and creatinine Electrolytes Creatinine clearance Urinalysis

               

 

 

 

Question 42.      Marci has a wart on her hand. She says she heard

something about "silver duct tape therapy." What do you tell her about his?

                  It is an old wives' tale.

   It is used as a last resort.

   Salicylic acid is more e?ective.

   It is a simple treatment that should be tried first.

               

 

 

Question 43.      What is the first-line recommended treatment against Group

A ?-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?

                                  Penicillin  Quinolone

   Cephalosporin  Macrolide

               

 

 

Question 44.      Which of the following is an example of sensorineural

hearing loss?

                Perforation of the tympanic membrane Otosclerosis

Cholesteatoma Presbycusis

               

 

 

Question 45.      Which of the following is "a linear crack extending from the

epidermis to the dermis?"

                An ulcer A fissure

Lichenification An excoriation

               

 

 

Question 46.      A 65-year-old man presents to the clinician with complaints

 

of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?

                                The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.

   The clinician can definitively diagnosis open-angle

glaucoma based on the subjective complaints of the patient.

Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist.

Early diagnosis is essential in order to reverse any

damage that has occurred to the optic nerve.

               

 

 

Question 47. The majority of HSV-1 and HSV-2 infections are

asymptomatic so that only which elevated antibody titer shows evidence of previous infection?

                IgA IgE IgG IgM

               

 

 

Question 48.      A patient is seen with a sudden onset of flank pain

accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of di?erential diagnoses?

                  Pancreatitis

   Peptic ulcer disease   Diverticulitis

   All of the above              

Question 49.      Which of the following is abundant in the heart and rapidly

rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?

 

                  B-type natriuretic peptide

   C-reactive protein   Serum albumin

   Erythrocyte sedimentation rate            

 

 

Question 50.      You are doing a cerumen extraction and touch the external

meatus of your patient's ear. He winces and starts coughing. What is the name of this reflex?

                                  Baker phenomenon   Arnold reflex

   Cough reflex   Tragus reflex