Final Exam
Question 1
Which of the
following is an oral antimicrobial option for the treatment of a
community-acquired methicillin-resistant S. aureus cutaneous infection?
Question
options:
Amoxicillin.
Dicloxacillin.
Cephalexin.
Trimethoprim-sulfamethoxazole.
Question 2
The most
common renal stones are composed of:
Question
options:
calcium.
uric acid.
sodium.
iron.
Question 3
At which of
the following ages should screening begin for a child who has significant risk
of lead poisoning?
Question
options:
3 months.
6 months.
1 year.
2 years.
Question 4
An 18-year-old
high school senior presents, asking for a letter stating that he should not
participate in gym class because he has asthma. The most appropriate action is
to:
Question
options:
write the
note because gym class participation could trigger asthma symptoms.
excuse him
from outdoor activities only to avoid pollen exposure.
assess his
level of asthma control and make changes in his treatment plan if needed so he
can participate.
write a note
excusing him from gym until his follow-up exam in 2 months.
Question 5
Sam is a
4-year-old boy who presents with a 1-week history of intermittent fever, rash,
and watery, red eyes. Clinical presentation is of an alert child who is
cooperative with examination but irritable, with a temperature of 38° C(100.4°
F), pulse rate of 132 bpm, and respiratory rate of 38/min. Physical examination
findings include nasal crusting; dry, erythematous, cracked lips; red, enlarged
tonsils without exudate; and elevated tongue papillae. The diagnosis of
Kawasaki disease is being considered. Additional findings are likely to
include:
Question
options:
vesicular-form
rash.
purulent
conjunctivitis.
peeling
hands.
occipital
lymphadenopathy.
Question 6
Acanthosis
nigricans is commonly noted in all of the following areas except:
Question
options:
groin folds.
axilla.
nape of the
neck.
face.
Question 7
To obtain
the most accurate hydration status in a child with acute gastroenteritis, the
NP should ask about:
Question
options:
the time of
last urination.
thirst.
quantity of
liquids taken.
number of
episodes of vomiting and diarrhea.
Question 8
In a
13-year-old female patient with mild acne and who experiences an inadequate
response to benzoyl peroxide treatment, an appropriate treatment option would
be to:
Question
options:
add a
topical retinoid.
add an oral
antibiotic.
consider
isotretinoin.
consider
hormonal therapy.
Question 9
A mother
brings to the clinic her 3-year-old daughter, who presents with dry red patches
on her face around the eyes. The mother has observed her daughter constantly
rubbing the area, which has caused swelling around the eyes. Physical
examination is consistent with atopic dermatitis. The NP considers this is a
diagnosis that:
Question
options:
requires a
skin culture to confirm contributing bacterial organisms.
should be
supported by a biopsy of the affected area.
necessitates
obtaining peripheral blood eosinophil level
is usually
made by clinical assessment alone.
Question 10
A 6-year-old
boy has a 1-year history of moderate persistent asthma that is normally well
controlled with budesonide via dry powder inhaler (DPI) twice a day and the use
of albuterol once or twice a week as needed for wheezing. Three days ago, he
developed a sore throat, clear nasal discharge, and a dry cough. In the past 24
hours, he has had intermittent wheezing, necessitating the use of albuterol two
puffs with use of an age-appropriate spacer every 3 hours, with partial relief.
Your next most appropriate action is to obtain:
Question
options:
a chest
radiograph.
an oxygen
saturation measurement.
a peak
expiratory flow (PEF) measurement.
a sputum
smear for WBCs.
Question 11
Worldwide,
which of the following is the most common type of anemia?
Question
options:
Pernicious
anemia.
Folate-deficiency
anemia.
Anemia of
chronic disease.
Iron-deficiency
anemia.
Question 12
Celeste is a
9-year-old girl with moderate persistent asthma. She is not taking a prescribed
inhaled corticosteroid but is using albuterol PRN to relieve her cough and
wheeze. According to her mother, she currently uses about six albuterol doses
per day, in particular for cough and wheeze after active play. You consider
that:
Question
options:
albuterol
use can continue at this level.
excessive
albuterol use is a risk factor for asthma death.
she should
also use salmeterol (Serevent) to reduce her albuterol use.
active play
should be limited to avoid triggering cough and wheeze
Question 13
In medical
coding, the abbreviation CPT stands for:
Question
options:
current
pricing tier.
current
procedural terminology.
clinical
practice terminology.
compendium
of procedures and therapy.
Question 14
First-line
treatment of impetigo with less than 5 lesions of 1–2 centimeters in diameter
on the legs in a 9-year-old girl is:
Question
options:
topical
mupirocin.
topical
neomycin.
oral
cefixime.
oral
doxycycline.
Question 15
After
inhaled corticosteroid is initiated, improvement in control is usually seen:
Question
options:
on the first
day of use.
within 2–8
days.
in about 3–4
weeks.
in about 1–2
months.
Question 16
Which
precursor of vitamin D is the form that is commonly measured in laboratory
tests to determine vitamin D status?
Question
options:
Vitamin D2.
25-hydroxyvitamin
D.
Vitamin D3.
1,
25-dihydroxyvitamin D.
Question 17
When
compared with children with private insurance, those with Medicaid and CHIP
are:
Question
options:
comparable
in access to health care and meeting several core measures in preventive care.
more
deficient in several core measures of preventive care.
less likely
to see primary care providers.
more likely
to receive mandatory immunizations.
Question 18
Which of the
following best describes asthma?
Question
options:
Intermittent
airway inflammation with occasional bronchospasm.
A disease of
bronchospasm that leads to airway inflammation.
Chronic
airway inflammation with superimposed bronchospasm.
Relatively
fixed airway constriction.
Question 19
During an
outbreak of meningococcal meningitis, all of the following can be used as
chemoprophylaxis except:
Question
options:
a single
dose of ceftriaxone.
multiple
doses of rifampin.
multiple
doses of amoxicillin.
a single
dose of meningococcal conjugate vaccine (MCV4 or Menactra).
Question 20
The
clinician anticipates that a child with mongolian spots will cry out because of
discomfort when the area is pressed or palpated.
Question
options:
True
False
Question 21
A
14-year-old male presents with acne consisting of 25 comedones and 20
inflammatory lesions with no nodules. This patient can be classified as having:
Question
options:
mild acne.
moderate
acne.
severe acne.
very severe
acne.
Question 22
Which of the
following is consistent with the NAEPP comment on the use of inhaled
corticosteroids (ICS) for a child with asthma?
Question options:
The
potential but small risk of delayed growth with ICS is well balanced by their
effectiveness.
ICS should
be used only if leukotriene modifiers fail to control asthma.
Permanent
growth stunting is consistently noted in children using ICS.
Leukotriene
modifiers are equal in therapeutic effect to the use of a long-acting
beta2-agonist.
Question 23
A potential
adverse effect from ICS use is:
Question
options:
oral
candidiasis.
tachycardia.
gastrointestinal
upset.
insomnia.
Question 24
A Still
murmur:
Question
options:
is an
indication to restrict sports participation selectively.
has a
buzzing quality.
is usually
heard in patients who experience dizziness when exercising.
is a sign of
cardiac structural abnormality.
Question 25
In medical
coding, the abbreviation ICD stands for:
Question
options:
insurance
code for diagnoses.
integrated
clinical dilemmas.
international
classification of diseases.
initial
classification of the diagnosis.
Question 26
A common
site for atopic dermatitis in an infant is:
Question
options:
the diaper
area.
the face.
the neck.
the
posterior trunk.
Question 27
When
counseling the family of an otherwise healthy 2-year-old child who just had a
febrile seizure, you consider which of the following regarding whether the
child is at risk for future febrile seizures?
Question
options:
The
occurrence of one febrile seizure is predictive of having another.
Intermittent
depakote can be used prophylactically during febrile illness to reduce risk of
recurrence.
A milder
temperature elevation in a child with a history of a febrile seizure poses
significant risk for future recurrent febrile and nonfebrile seizures.
Consistent
use of antipyretics during a febrile illness will significantly reduce the risk
of a future febrile seizure.
Question 28
In
counseling a patient with scabies, the NP recommends all of the following
methods to eliminate the mite from bedclothes and other items except:
Question
options:
wash items
in hot water.
run items
through the clothes dryer for a normal cycle.
soak items
in cold water for at least 1 hour.
place items
in a plastic storage bag for at least 1 week.
Question 29
You are
seeing 17-year-old Cynthia. As part of the visit, you consider her risk factors
for type 2 DM would likely include all of the following except:
Question
options:
obesity.
Native
American ancestry.
family
history of type 1 DM.
personal
history of polycystic ovary syndrome.
Question 30
When billing
commercial insurance, NPs get the authority to bill for their services from:
Question
options:
state law
only.
federal law
only.
state law
and/or the commercial payers.
federal law
and/or commercial payers.
Question 31
Skin lesions
infected by community-acquired MRSA (CA-MRSA) often occur spontaneously on
intact skin.
Question
options:
True
False
Question 32
In children,
which of the following conditions can contribute to bladder instability and
increase the risk of a UTI?
Question
options:
Constipation.
Upper
respiratory tract infection.
Chronic
diarrhea.
Efficient
bladder emptying.
Question 33
An
18-year-old college freshman is brought to the student health center with a
chief complaint of a 3-day history of progressive headache and intermittent
fever. On physical examination, he has positive Kernig and Brudzinski signs.
The most likely diagnosis is:
Question
options:
viral
encephalitis.
bacterial
meningitis.
acute
subarachnoid hemorrhage.
epidural
hematoma.
Question 34
Which of the
following describes the Kernig sign?
Question
options:
Neck pain
occurs with passive flexion of one hip and knee, which causes flexion of the
contralateral leg.
Passive neck
flexion in a supine patient results in flexion of the knees and hips.
Elicited
with the patient lying supine and the hip flexed 90 degrees, it is present when
extension of the knee from this position elicits resistance or pain in the
lower back or posterior thigh.
Headache
worsens when the patient is supine.
Question 35
DSM-5
criteria for anorexia nervosa include all of the following except:
Question
options:
refusal to
maintain body weight at or above the minimum normal weight for age and height.
intense fear
of gaining weight or becoming fat despite being underweight.
distorted
experience and significance of body weight and shape.
absence of
at least three consecutive menstrual cycles.
Question 36
Serious
allergic reactions caused by the use of TMP-SMX include all of the following
except:
Question
options:
anaphylaxis.
Stevens-Johnson
syndrome.
toxic
epidermal necrolysis.
fixed drug
eruptions.
Question 37
A risk
factor for mitral valve prolapse (MVP) includes a history of:
Question
options:
rheumatic
fever.
rheumatoid
arthritis.
Kawasaki
disease.
Marfan
syndrome.
Question 38
Girls
typically grow to their adult height by:
Question
options:
menarche.
1 year
before menarche.
1 year after
onset of menstruation.
age 16.
Question 39
NSAIDs cause
gastric injury primarily by:
Question
options:
direct
irritative effect.
slowing
gastrointestinal motility.
thinning of
the protective gastrointestinal mucosa.
enhancing
prostaglandin synthesis.
Question 40
Acne
neonatorum treatment options include which of the following?
Question
options:
No special
skin care is needed because these lesions are self-resolving.
Topical
retinoids.
Oral
antibiotic.
High-dose
benzoyl peroxide.
Question 41
The most
common reason for precocious puberty in girls is:
Question
options:
ovarian
tumor.
adrenal
tumor.
exogenous
estrogen.
early onset
of normal puberty.
Question 42
When billing
Medicaid, NPs get the authority to bill for their services from:
Question
options:
state law
only.
federal law
only.
state and
federal law.
neither
state nor federal law.
Question 43
You have
initiated therapy for an 18-year-old man with acne vulgaris and have prescribed
doxycycline. He returns in 3 weeks, complaining that his skin is “no better.”
Your next action is to:
Question
options:
counsel him
that 6–8 weeks of treatment is often needed before significant improvement is
achieved.
discontinue
the doxycycline and initiate minocycline therapy.
advise him
that antibiotics are likely not an effective treatment for him and should not
be continued.
add a second
antimicrobial agent such trimethoprim-sulfamethoxazole.
Question 44
For a Grade
I ankle sprain, weight-bearing should be avoided for at least:
Question
options:
24 hours.
72 hours.
1 week.
until full
ROM is restored.
Question 45
Hemoglobin
A1c best provides information on glucose control over the past:
Question
options:
1–29 days.
21–47 days.
48–63 days.
64–90 days.
Question 46
Type I
hypersensitivity reactions, such as atopic dermatitis, involve the action of
which antibodies binding to receptor sites on mast cells?
Question
options:
IgG.
IgM.
IgE.
IgA.
Question 47
Which of the
following children is most likely to have lead poisoning?
Question
options:
A
developmentally disabled 5-year-old child who lives in a 15-year-old house in
poor repair.
An infant
who lives in a 5-year-old home with copper plumbing.
A toddler
who lives in an 85-year-old home.
A
preschooler who lives nears an electric generating plant.
Question 48
Which of the
following represents the most accurate patient information when using
permethrin (Elimite) for treating scabies?
Question
options:
To avoid
systemic absorption, the medication should be applied over the body and rinsed
off within 1 hour.
The patient
should notice a marked reduction in pruritus within 48 hours of using the
product.
Itch often
persists for a few weeks after successful treatment.
It is a
second-line product in the treatment of scabies.
Question 49
Increased
risks for fatal reactions from anaphylaxis include all of the following except:
Question
options:
personal
history of asthma.
delay in
administering epinephrine.
age in the
teen years.
delay in
administering antihistamines.
Question 50
Clinical
findings characteristic of asthma include all of the following except:
Question
options:
a recurrent
spasmodic cough that is worse at night.
recurrent
shortness of breath and chest tightness with exercise.
a congested
cough that is worse during the day.
wheezing
with and without associated respiratory infections.