• Question 1 When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
Answers:
Yes
No
• Question 2 The most common cancer found on the auricle is:
Answers: Actinic keratosis
Basal cell carcinoma
Squamous cell carcinoma
Acral-lentiginous melanoma
• Question 3 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?
Answers: Xanthines
Antihistimines
Steroids
Anticholinergics
• Question 4 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?
Answers: Instruct the patient on measures to prevent hemorrhoids such as bowel habits and diet.
Order a topical hemorrhoid cream along with a stool softener.
Refer the patient for a barium enema and sigmoidoscopy.
Refer the patient for a surgical hemorrhoidectomy.
• Question 5 Which of the following patient characteristics are associated with chronic bronchitis?
Answers:
Overweight, cyanosis, and normal or slightly increased respiratory rate
Underweight, pink skin, and increased respiratory rate
Overweight, pink skin, and normal or slightly increased respiratory rate
Normal weight, cyanosis, and greatly increased respiratory rate
• Question 6 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:
Answers: CBC/diff
Erythrocyte sedimentation rate
Abdominal ultrasound
CT scan
• Question 7 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:
Answers:
Purulent drainage
Tearing
Photophobia
A positive fluorescein stain
• Question 8 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:
Answers: Viral conjunctivitis
Common pink eye
Gonococcal conjunctivitis
Allergic conjunctivitis
• Question 9 A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 different thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect:
Answers: A common case of shingles and prescribe an analgesic and an antiviral agent
A complicated case of shingles and prescribe acyclovir, an analgesic, and a topical cortisone cream
Herpes zoster and consider that this patient may be immunocompromised
A recurrence of chickenpox and treat the patient’s symptoms
• Question 10 Which type of lung cancer has the poorest prognosis?
Answers: Adenocarcinoma
Epidermoid carcinoma
Small cell carcinoma
Large cell carcinoma
• Question 11 An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3–4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has:
Answers: Acute diarrhea
Chronic diarrhea
Irritable bowel
Functional bowel disease
• Question 12 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?
Answers: An allergic reaction
Relapsing polychondritis
Lymphocytoma cutis
Systemic lupus erythematosus
• Question 13 Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes?
Answers: Chronic sinusitis
Acute bronchitis
Bacterial pneumonia
Acute exacerbation of chronic bronchitis
• Question 14 Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in?
Answers: Mild intermittent
Mild persistent
Moderate persistent
• Question 15 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?
Answers:
Penicillin V 500 milligrams PO every 8 hours for 10 days
Ampicillin 250 milligrams PO twice a day for 10 days
Clarithromycin 500 milligrams po daily for 7 days
None of the above
• Question 16 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?
Answers: Congestive heart failure
Varicose veins
Deep vein thrombosis
Arterial insufficiency
• Question 17 Which statement below is correct about pertussis?
Answers:
It is also called whooping cough
It begins with symptoms like strep throat
It lasts about 3 weeks
It occurs most commonly in toddlers and young children
• Question 18 Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis?
Answers:
Pneumonia
Asthma
Sinusitis
Pertussis
• Question 19 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?
Answers: Diverticulosis
Diverticula
Diverticulitis
Diverticulum
• Question 20 Sylvia, age 83, presents with a 3 day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect?
Answers: Varicella
Herpes zoster
Syphilis
Rubella
• Question 21 A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is:
Answers: Alcohol
Gallstones
Medications
Pregnancy
• Question 22 When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action?
Answers: Order abdominal x-rays
Order an abdominal ultrasound
Refer the patient to a surgeon for evaluation
Prescribe pain medication
• Question 23 A false-positive result with the fecal occult blood test can result from:
Answers: ingestion of large amounts of vitamin C
a high dietary intake of rare cooked beef
a colonic neoplasm that is not bleeding
stool that has been stored before testing
• Question 24 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:
Answers: Colonoscopy
Small bowel follow-through
Barium enema
CT abdomen
• Question 25 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:
Answers: Mitral regurgitation
Systolic heart failure
Cardiac myxoma
Diastolic heart failure
• Question 26 Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized?
Answers:
Multilobar involvement on chest x-ray with the inability to take oral medications
Alert and oriented, slightly high but stable vital signs, and no one to take care of her at home
Sputum and gram positive organisms
A complete blood count showing leukocytosis
• Question 27 A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him:
Answers: “It is the most common cause of death in patients with skin cancer.”
“It can be cured with surgical excision or radiation therapy.”
“It is a slow growing skin cancer that rarely undergoes malignant changes.”
“It can be cured using 5-flurouracil cream twice daily for 2 to 4 weeks.”
• Question 28 Expected spirometry readings when the patient has chronic emphysema include:
Answers: Decreased residual volume (RV)
Increased vital capacity (VC)
Increased forced expiratory volume (FEV-1)
Increased total lung capacity (TLC)
• Question 29 An 80-year-old male admits to difficulty swallowing during the review of systems. The nurse practitioner recognizes the differential diagnosis for this patient’s dysphagia is:
Answers: Esophageal cancer
Chest pain
GERD
A and C
All of the above
• Question 30 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?
Answers: Squamous cell carcinoma
Malignant melanoma
A common nevus
Basal cell carcinoma
• Question 31 Which of the following is not a goal of treatment for the patient with cystic fibrosis?
Answers: Prevent intestinal obstruction
Provide adequate nutrition
Promote clearance of secretions
Replace water-soluble vitamins
• Question 32 The nurse practitioner is performing a physical exam on a middle-aged African-American man. Which of the following areas is a common site for melanomas in African-Americans and other dark-skinned individuals?
Answers: Scalp
Nails
Feet
B and C
All of the above
• Question 33 An adult presents with tinea corporis. Which item below is a risk factor for its development?
Answers:
Topical steroid use
Topical antibiotic use
A recent laceration
Cold climates
• Question 34 A patient has experienced nausea and vomiting, headache, malaise, low grade fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is elevated with a shift to the left. He is requesting medication for diarrhea. What is the most appropriate response?
Answers: Prescribe loperamide (Immodium) or atropine-diphenoxylate (Lomotil) and a clear liquid diet for 24 hours.
Prescribe a broad-spectrum antibiotic such as ciprofloxacin (Cipro), and symptom management.
Offer an anti-emetic medication such as ondansetron (Zofran) and provide oral fluid and electrolyte replacement instruction.
Order stool cultures.
• Question 35 Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order?
Answers: Aspirin
NSAIDs
Opioids
Antihistamines
• Question 36 Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is:
Answers: Peripheral edema
Weight gain
Shortness of breath
Nocturnal dyspnea
• Question 37 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?
Answers: Ibuprofen
Erythromycin
Amoxicillin
Acetaminophen
• Question 38 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?
Answers: “Are you wearing your usual shoes?”
“Do you also have chest pain when you have leg pain?”
“Is your leg pain relieved by rest?”
“Do you ever have the same pain in the other leg?”
• Question 39 Which of the following statements about malignant melanomas is true?
Answers: They usually occur in older adult males
The patient has no family history of melanoma
They are common in blacks
The prognosis is directly related to the thickness of the lesion
• Question 40 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?
Answers: Asthma
Nocturnal allergies
Valvular disease
Heart failure
• Question 41 Which antibiotic would be the most effective in treating community acquired pneumonia (CAP) in a young adult without any comorbid conditions?
Answers: Erythromycin
Clarithromycin (Biaxin)
Doxycycline (Vibramycin)
Penicillin
• Question 42 Which of the following dermatologic vehicles are the most effective in absorbing moisture and decreasing friction?
Answers:
Powders
Gels
Creams
Lotion
• Question 43 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:
Answers:
Squamous cell carcinoma
Basal cell carcinoma
Malignant melanoma
Acne vulgaris
• Question 44 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?
Answers: Assist the patient to a standing position and take her blood pressure.
Assess the patient’s cranial nerves.
Compare the patient’s blood pressure lying first, then sitting, and then standing.
Compare the amplitude of the patient’s radial and pedal pulses.
• Question 45 What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery?
Answers:
Ursodiol
Ibuprofen
Prednisone
Surgery is the only answer
• Question 46 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:
Answers: Staphylococcus aureus
Group A beta hemolytic streptococcus
Haemophilus influenza
Pseudomonas aeruginosa
• Question 47 Which of the following is not a symptom of irritable bowel syndrome?
Answers: Painful diarrhea
Painful constipation
Cramping and abdominal pain
Weight loss
• Question 48 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?
Answers:
Any recent trauma
Difficulty swallowing
Stiffness in the right shoulder
Change in sleeping habits
• Question 49
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?
Answers: ACE Inhibitor
Beta Blocker
Calcium channel blocker
Diuretic
• Question 50 The differential diagnosis for a patient complaining of a sore throat includes which of the following?
Answers: Gonococcal infection
Thrush
Leukoplakia
B only
A, B, and C
