01 Oct Mrs. Green, age 45, is complaining of generalized morning stiffness, especially in both her wrist and hands.
207. Mrs. Green, age 45, is complaining of generalized morning stiffness, especially in both her wrist and hands. It is much worse in the morning and lasts for a few hours. She also complains of fatigue and generalized body aches that have been present for the past few months. Which of the following is most likely?
A) Osteoporosis
B) Rheumatoidarthritis
C) Osteoarthritis
D) Gout
207. B) Rheumatoid arthritis Signs and symptoms of rheumatoid arthritis include symmetrical joint stiffness, swelling, and pain in the hands, wrists, elbows, ankles, and shoulders. Other common complaints include fatigue, malaise, fever, and generalized body aches.
210. The complications of untreated gout include:
A) Loss of joint mobility and renalfailure
B) Loss of joint mobility and liverfailure
C) An increased risk of urinary tractinfections
D) Bladdercancer
212. You note bony nodules located at the proximal interphalangeal joints on both the hands of your 65-year-old female patient. Which of the following is most likely?
A) Bouchard’snode
B) Heberden’snode
C) Osteoarthriticnodules
D) Tophi deposits
40. All of the following factors are associated witha higher risk of osteopenia and osteoporosisexcept:
a) Excessive alcohol intake and cigarettesmoking b)Asian or Caucasianancestry
c) Obesity
d) Older age
41. What type of cast is used to stabilize a fracture of the scaphoidbone?
a) Long armcast
b) Thumb spicacast
c) Short legcast
d) Leg cylinder cast
42. A patient with chronic obstructive pulmonary disease (COPD) is referred for pulmonary function testing. All of the following results are characteristic ofpulmonary function tests in patients with COPD except:
a) Increase in the TLC (total lungcapacity)
b) Dyspnea
c) Increase in the RV (residualvolume)
d) Reduction of the FEV1 (forced expiratory volume in 1second)
43. What is the first-line class of antibiotics recommended by the American Thoracic Society(ATS) for patients younger than 60 years of age who are diagnosed with community-acquired pneumonia with nocomorbidity?
a) First-generationcephalosporins
b) Second-generationcephalosporins
c) Macrolides
d) Beta-lactamantibiotics
hematol
234. Aoll ogf thiecfoollowing conditions are associated with an increased risk for normocytic anemia except:
A) Rheumatoidarthritis
B) Lupus
C) Chronic autoimmunedisorders
D) Pregnancy
58. Folic acid supplementation is recommended for women who are planning preg- nancy in order to:
A) Prevent renalagenesis
B) Preventanencephaly
C) Prevent kidneydefects
D) Prevent heartdefects
226. Lead poisoning can cause which type of anemia?
A) A mild macrocyticanemia
B) Normocyticanemia
C) Microcyticanemia
D) A mild hemolyticanemia
90. A nurse practitioner is giving dietary counseling to a male alcoholic who has recently been diagnosed with folic acid deficiency anemia. Which of the following foods should the nurse practitioner recommend to this patient?
A) Tomatoes, oranges, andbananas
B) Cheese, yogurt, andmilk
C) Lettuce, beef, and dairyproducts
D) Spinach, liver, and whole wheatbread
184. The red blood cells in pernicious anemia will show:
A) Microcytic and hypochromiccells
B) Microcytic and normochromiccells
C) Macrocytic and normochromiccells
D) Macrocytic and hypochromiccells
184. C) Macrocytic and normochromic cells The blood cells in pernicious anemia will display macrocytic, normochromic cells. RBCs in iron-deficiency anemia are microcytic and hypochromic.
192. Beta thalassemia minor is considered a:
A) Macrocytic anemia B) Normocytic anemia C) Microcytic anemia D) Hemolytic anemia
205. Which of the following findings are seen in a patient with folate-deficiency anemia?
A) Microcytic and hypochromicRBCs
B) Microcytic and normochromicRBCs
C) Normal size and color of theRBCs
D) Macrocytic and normocyticRBCs
205. D) Macrocytic and normocytic RBCs Folate-deficiency anemia is diagnosed by macrocytic, normocytic red blood cell.
1. Koilonychia is associated with which of the followingconditions? Leadpoisoning
Beta thalassemia trait B12 deficiency anemia Iron-deficiency anemia
Koilonychia is also known as spoon-shaped nails. The finger nails are thin and have a concave shape. Koilonychia is associated with severe iron-deficiency anemia.
2. The nurse practitioner suspects that a middle-aged woman may have systemic lupus erythematosus (SLE). Which of the following laboratory tests is most specific forthis disease?
13. Which of the following symptoms is associated with B12 deficiency anemia?
A) Spoon-shaped nails andpica
B) An abnormal neurologicalexam
C) A vegandiet
D) Tingling and numbness of bothfeet
13. D) Tingling and numbness of both feet Vitamin B12 deficiency anemia can cause nerve cell damage if not treated. Symptoms of B12 deficiency anemia may include tingling or numbness in fingers and toes, difficulty walking, mood changes or depression, memoryloss, disorientation, anddementia.
3. Which of the following individuals is more likely to beaffected by alpha thalassemia anemia?
a) 53-year-old Greekpatient
b) 25-year-old Chinesepatient
c) 62-year-old Russianpatient
d) 38-year-old African Americanpatient
4. What is themedian?
Select All That Apply
a) It is the number that occurs mostfrequently
b) It is the middle number in a group ofnumbers
c) It is the average number in a group ofnumbers
d) It is a measure of centraltendency
5. What is the name of the physiologically active compound that is derived fromsoybeans?
a) Isoflavones
b) Estrogen
c) Progesterone
d) Resveratrol
13. Which of the following symptoms is associated with B12 deficiency anemia?
A) Spoon-shaped nails andpica
B) An abnormal neurologicalexam
C) A vegandiet
D) Tingling and numbness of bothfeet
6.The red blood cells in pernicious anemia will show: a)Microcytic and hypochromic cells
b) Microcytic and normochromiccells
c) Macrocytic and normochromiccells
d) Macrocytic and hypochromiccells
.A 13-year-old boy’s peak expiratory flow results indicate 60% to 80% of the predicted range. How would you classify his asthma?
a) Mild intermittentasthma
b) Mild persistentasthma
c) Moderate persistentasthma
d) Severeasthma
2. An asthmatic exacerbation is characterized by all of the following symptomsexcept:
a) Tachycardia
b) Severewheezing
c) Chroniccoughing
d) Tachypnea
3. Auscultation of normal breath sounds of the chestwill reveal:
a)Bronchial breath sounds heard at the lower bases b)High-pitched vesicular breath sounds heard over the
upper lobes
c) Vesicular breath sounds heard over thetrachea
d) Vesicular breath sounds in the lowerlobe
4. An infant who does not have a history of reactive airway disease and allergy has both inspiratory and expiratory wheezing accompanied by fever and profuse clear nasal discharge. Which of the followingis mostlikely?
a) Tracheobronchitis
b) Bronchiolitis
c) Croup
d) A small foreign body is lodged on the leftmain bronchus
5. During the physical exam of a 60-year-old adult, the nurse practitioner performs an abdominal exam. The nurse practitioner is checking the left upper quadrant of the abdomen. During percussion, an area of dullness is noted beneath the lower left ribcage.Which of the following is a true statement regarding the spleen?
a) The spleen is not palpable in the majority ofhealthy adults
b) The spleen is 8 to 10 cm in the left midaxillary lineat its longestaxis
c) Thespleenis2to6 cm betweenthe 9thand 11thribs on the left midaxillaryline
d) The splenic size varies depending on thepatient’s gender
6. When initially treating an adult for acute bronchitis, which of the following should the nurse practitionerbe least likely toorder?
a)Expectorants
b)Antibiotics
c)Bronchodilators
d)Antitussives
1. An asthmatic 20-year-old woman who was seen for a viral upper respiratoryinfection 2 weeks ago presents to the nurse practitioner’s office complaining of a recent onset of shortness of breath, inspiratory and expiratory wheezing, and chest tightness. She has been using her albuterol inhaler four to six times a day with poor relief. She is unable to speak in full sentences. When the nurse practitioner quickly evaluates the patient, she notices that the patient is pale, diaphoretic, fatigued, and using her sternocleidomastoid accessory muscles for respiration. Her respiratory rate is 32 breaths/min and pulse is 130 beats/min. Which of the following interventions is not indicated?
a) Administer oxygen by nasalcannula
b) Give the patient a nebulized short-acting beta 2agonist
c) Quickly assess the patient with the pulse oximeter and check breathsounds
d) Initiate cardiopulmonary resuscitation (CPR)immediately
2. All of the following are associated with emphysemaexcept: A barrel-shapedchest
Pursed-lip breathing
A chest radiograph result with infiltrates and flattening of the costovertebral angle
Dyspnea when at rest
Emphysema is characterized by having a barrel-shaped chest, pursed-lip breathing, and
dyspnea when at rest. Infiltrates on an x-ray indicate bacterial infection, such as pneumonia.
3. An elderly patient with a productive cough and fever is diagnosed withpneumonia. All of the following organisms are capable of causing community-acquired pneumoniaexcept:
a) Haemophilusinfluenzae
b) Mycoplasma pneumoniae
c) Treponemapallidum
d) Streptococcuspneumoniae
4. A 10-year-old boy who was recently accepted onto his school’s soccer team hasa history of exercise-induced asthma. He wants to know when he should use his albuterol inhaler.The nurse practitioner would advise the patientto:
a) Premedicate 10 to 15 minutes before startingexercise
b) Wait until he starts to exercise before using theinhaler
c) Premedicate 30 minutes before startingexercise
d) Wait until he finishes his exercise before using his inhaler
Exercise-induced asthma is best controlled by using the Proventil inhaler (bronchodilator) approximately 10 to 15 minutes before exercise, to prevent vasospasm of the bronchioles and shortness of breath with exercise. The effects of these bronchodilators usually last approximately 4 hours. They also work quickly to open up the bronchioles if an acute attack/shortness of breath occurs.
5. All of the following are considered overarching goals in Healthy People 2020except:
Todos los siguientes se consideran objetivos generales en Healthy People 2020, excepto:
a) Achieve health equity, eliminate health disparities, and improve health of allgroups
b) Create social and physical environments that promote good health forall
c) Promote quality of life, healthy development, and healthy behaviors across alllife stages
d) Encourage sexual abstinence and condomuse
6.A 28-year-old student is seen in the school health clinic with complaints of a hacking nonproductive cough, rhinorrhea, pharyngitis, and malaise for the past 2 weeks. He does not take any medications, denies any allergies, and has no significant medical history. Physical examination reveals a low-grade temperature of 99.9°F, respirations of 16breaths/min, pulse of 90 beats/min, and scattered rales and wheezing of the lungs. The patient does not appear toxic. The total white blood cell count is 10,500/μL. What is the most likely diagnosis?
a) Bacterialpneumonia
b) Atypicalpneumonia
c) Acutebronchitis
d)Pertussis
