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ANCC TEST REVIEW
TEST WITH A+ GRADES
Avpatientvwithvtype1vdiabetesvmellitusvwhovisvNPHvandvregularvinsulinvsplitvdosingvp resentvwithvcomplainsvofvearlyvmorningvrisevfinger- stickvbloodvglucose.vAvreviewvofvanvat- homevglucosevtestvrevealsvincreasedvmorningvlevels.vAftervanvincreasevinvtheveveni ngvinsulinvdose,vthevproblemvworsens.vThisvisvmostvlikelyvanvexamplevof: a)vInsulinvResistance b)vInsulinvAllergy c)vThevSomogyivEffect d)vHyperglycemia-inducedvhypoglycemia.v-vcorrectvanswer-a)vThevSomogyivEffect Av25-years- oldvpresentvwithvavchiefvcomplaintvofvdecreasedvmobilityvandvpainvofvthevrightvshoul dervexacerbatedvbyvmovements.vThevpatientvreportsvthatvhevparticipatedvinvextensiv evhousevpaintingv 24 vhoursvpriorvtovthevonsetvofvpain.vHevdeniesvanyvtrauma.vPassiv evROMvisvintact.vNovrednessvorvecchymosisvisvpresent.vWhatvisvthevnextvstepvtovbev takenvinvordervtovmakevavDiagnosis?
a)vPalpatevthevstructurevaroundvthevshoulder b)vObtainvanvMIRvtovevaluatevthevshoulder c)vOrdervandvX-Rayvofvthevshoulder d)vRequestvanvEMG ApplyvSOAPEv-vcorrectvanswer-a)vPalpatevthevstructurevaroundvthevshoulder ApplyvSOAPE Av 65 vyears- oldvmalevpresentsvtovhisvclinicvcomplainingvofvincreasingvfatigue,vdyspneavonvexertio nv,andvanklevedemavduringvthevday.vHevhasvavhistoryvofvmildvhypertension,vforvwhic hvhevsawvhisvphysicianvyearsvago.vThevphysicianvadvisedvthevpatientvtovdecreasevhi svsaltvintakev.Onvphysicianvexaminationvthevpatientvisvtachycardiavpositivevforvjugula rvvenousvdistension,vandvpositivevforvS3vwithvavsystolicvmurmurvchestvX- rayvrevealsvcardiomegalyvwithvvascularvredistributionv.Thevnursevpractitionervdiagno sisvisv: a)vMyocardialvinfarction b)vPneumonia c)vCongestivevheartvfailure d)vPleuralveffusionv-vcorrectvanswer-c)vCongestivevheartvfailure Av67- yearvoldvpatientvwithvtypev 2 vDM,vcongestivevheartvfailurev(CHF),vandvavmildvarteryvdi seasevisvcurrentlyvtakingvdailyvhydrochlorothiazidev 25 vmgvdaily,vglipizidev 10 vmgvdail y;vandvatorvastatinv(Lipitor),v 20 vmgvh.s.vWhichvofvthevfollowingvisvanvaccuratevstate mentvregardingvthisvregimen? a)vThevglipizidevwillvincreasevthevriskvofvpotassiumvdepletion.... b)vThevdigoxinvwillvincreasevthevriskvofvhypoglycemia. c)vThevhydrochlorothiazidevwillvpredisposevthevpatientvtovdigoxinvtoxicity d)vThevatorvastinvwillvworsenvthevdiabetesv-vcorrectvanswer- c)vThevhydrochlorothiazidevwillvpredisposevthevpatientvtovdigoxinvtoxicity Av 14 vyear- oldvwhovfellvonvhervoutstretchedvhandvcomplainsvofvproximalvforearmvpainvX- rayvrevealsvavpositivevfatvpadvsignv,andvthevfullyvextendvthevelbow.vNovdefinitivevbon yvchangesvarevseenvonvX-ray.vThevmostvlikelyvworkingvdiagnosisvis: a)vUppervextremelyvsprain. b)vLateralvepiconditis. c)vRadialvheadvfracture d)vOlecranonvbursitisv-vcorrectvanswer-c)vRadialvheadvfracture Av 17 vyear- oldvfemalevisvsuspectedvtovhavevavPolycysticvOvaryvSyndrome.vInvadditionvtovtestost eronevthevmostvappropriatevdiagnosticvtestvwillvbe: a)vBUN,vcreatinine,velectrolytes,vandvdenydroeplandrosteronev(DHEA). b)vCompletevbloodvcountv(BUN)v,creatininevandvestrone
d)vFibromyalgiav-vcorrectvanswer-c)vPolymyalgiavrheumatic Av 17 vyear- oldvfemalevhasvnevervhadvhervmenses.vShevisvatvtannervstagevIIIvofvsexualvdevelop ment.vHervphysicalvandvhervweightvisvappropriatevforvhervagevandvheight.vWhatvisvth evmostvlikelyvdiagnosis? a)vSecondaryvamenorrhea b)vPrimaryvamenorrhea c)vDysmenorrhea d)vOvarianvdigenesisv-vcorrectvanswer-b)vPrimaryvamenorrhea Avnursevpractitionervisvsuturingvavsimplevlacerationvonvav11- yearvoldvpatient.vThevusevofvlidocainevwithvepinephrinevisvnotvusedvinvthevfollowingva reasvexceptvthe: a)vScalp b)vNose c)vFingers d)vEarlobev-vcorrectvanswer-a)vScalp Whichvofvthevfollowingvisvnotvanvindicationvofvpreeclampsia? a)vVisualvdisturbance b)vGlycosuria c)vEdemavofvfacevandvhands d)vHeadachesv-vcorrectvanswer-b)vGlycosuria Av10-vmonth- oldvpresentsvwithvavrash,vrunnyvnose,vandvcough.vExaminationvrevealsvavclustervofvti nyvofvwhitevpapulesvwithvanverythematousvavbuccalvmucosa.vWhatvdoesvthisvsugges t? a)vScarletvFever b)vRubella c)vErythemavinfectious d)vMeaslesv-vcorrectvanswer-d)vMeasles (DescriptionvofvthevKoplik'svSpot")Smallvwhitevroundvspotsvonvthevbasevofvthevbucca lvmucosavbyvthevrearvmolars) Whichvofvthevfollowingvwet- mountvresultsvconfirmsvavpreliminaryvdiagnosisvofvbacterialvvaginosis? a)vSquamousvepithelialvcellsvwithvstipplingvappearancevandvindistinctvborders,vnovla ctobacillusvrods,vmanyvwhitevbloodvcells b)vSquamousvepithelialvcellsvwithvclearvcytoplasmvandvdistinctvborders,vmanyvlactob acillusvrods,voccasionalvwhitevbloodvcells c)vOrganismvaboutvthevsizevofvwhitevbloodvcellsvwithvundulatingvflagellum,voccasion alvlactobacillusvrods,vmanyvwhitevbloodvcells
d)vHyphaevandvspores,vfewvlactobacillusvrods,voccasionalvwhitevbloodvcells.v- vcorrectvanswer- a)vSquamousvepithelialvcellsvwithvstipplingvappearancevandvindistinctvborders,vnovla ctobacillusvrods,vmanyvwhitevbloodvcells Whichvofvthevfollowingsvisvtypicallyvavsignvofvacutevappendicitis? a)vPeriumbilicalvecchymosis b)vReboundvtendernessvatvMcBurneysvpoint. c)vAvnegativevRovsing'svsign d)vPusvandvmucusvinvstoolv-vcorrectvanswer- b)vReboundvtendernessvatvMcBurneysvpoint Whichvofvthevfollowingvcriteriavdifferentiatesvavtransientvischemicvattackv(TIA)vfromva vCVA? a)vFocalvsymptoms b)vAmnesiavofvincident c)vSlownessvofvonset d)vAbsencevofvresidualvsymptomsv-vcorrectvanswer- d)vAbsencevofvresidualvsymptoms (TIAv<24vhourvrecoveryvwithoutvneurologicvdeficit/vnovbrainvdamage) (CVAv>v 24 vhoursvwithvneurologicvdeficit) Assessmentvfindingsvthatvwouldvsupportvavdiagnosisvofvmitralvregurgitationvinclude: a)vDiastolicvmurmurvwithvsplitvS b)vLoudvhighvpitchedvpansystolicvmurmur c)vAtrialvfibrillationvwithvsummationvgallop d)vEarlyvdiastolicvmurmurvwithvanvS3vwavev-vcorrectvanswer- b)vLoudvhighvpitchedvpansystolicvmurmur Whichvofvthevfollowingvisvthevleadingvcausevofvcancerv-relatedvdeathsvinvwoman? a)vCervicalvcancer b)vOvarianvcancer c)vBreastvcancer d)vLungvcancerv-vcorrectvanswer-d)vLungvcancer Whichvofvthevfollowingvwouldvbevmostvappropriatevtovperformvinvthevinitialvevaluation vofvavpatientvwithvsymptomsvofvavpatientvwithvsymptomvofvacutevprostatitis? a)vUrinalysisvandvurinevculture b)vScrotalvpalpitationvandvurinevculture c)vProstate-specificvantigenv(PSA) d)vCompletevbloodvcountv(CBC)vwithvdifferentialv-vcorrectvanswer- a)vUrinalysisvandvurinevculture Av 29 vyear-oldvmalevwithvnoncomplicatedvChlamydiavinfectionvmayvexhibit:
c)vTovcountvbackwardvfromv 100 vbyv 7 d)vTovspellvavwordvbackwardv-vcorrectvanswer- a)vThevmeaningvofvavcommonvproverb Av70-year- oldvmalevpresentsvwithvparesthesiavofvthevlowervextremitiesv.Onvexamination,vthevpa tientvappearsvpalevandvshowsvavdecreasedvvibratoryvsense.vLaboratoryvtestsvrevealv elevatedvindirectvbilirubinvHCT=30%vmeanvcorpuscularvvolumev(MCV)v=v 120 vμL3v(n ormal=87-103vμL3).Thevmostvlikelyvdiagnosisvis: a)vPerniciousvanemia b)vAnemiavofvchronicvdisease c)vFolicvacidvdeficiency d)vIronvdeficiencyvanemiav-vcorrectvanswer-a)vPerniciousvanemia Av50-year- oldvpresentsvavchiefvcomplaintvofvmalaise.vFurthervquestioningvrevealsvthatvhisvprim aryvconcernvwasvthevsexualvdysfunction.vHevisvcurrentlyvtakingvthevfollowingvmedica tions:vAtenololv(Tenormin),v 50 vmgvdaily;vParoxetinev(Paxil),v 20 vmgvdaily,vLoratadine, vHydrochlorothiazidev(HCTZ)v 25 vmgvdaily.vThevmostvlikelyvcausevofvthevpatient'svco ncernvwouldvbe: a)vLoratadinev(Claritin) b)vHydrochlorothiazidev(HCTZ) c)vAtenololv(Tenormin) d)vParoxetinev(Paxil)v-vcorrectvanswer-d)vParoxetinev(Paxil) Anv88-year-oldvpresentsvwithvright- sidedvweaknessvaftervbeingvunablevtovrisevunassistedvfollowingvavfallvtovthevbathvan dvnoncompliancevwithvavhypertensionvmedicationvregimen.vWhatvisvthevmostvlikelyvd iagnosis? a)vSeizure b)vRight-sidedvCVA c)vLeft-sidedvCVA d)vTransientvischemicvattackv-vcorrectvanswer-c)vLeft-sidedvCVA Officevspirometryvperformedvwithvanvalbuterolvnebulizervtreatmentvcanvconfirmvavdia gnosisvofvasthmavbecausevitvindicates: a)vOxygenvsaturation b)vIfvairwayvobstructionvisvfromvpulmonaryvfibrosis c)vChronicvcarbonvdioxidevretention d)vIfvavpatientvhasvreversiblevairwayvobstructionv-vcorrectvanswer- d)vIfvavpatientvhasvreversiblevairwayvobstruction Whichvofvthevfollowingvbestvdescribesvpsoriaticvlesionsvinvanvelderlyvpatient? a)vLocalizedverythematousvvesicles b)vRed,vsharplyvdefinedvplaquesvwithvsilveryvscales
c)vShinyv,purple,vsmoothvlesions d)vErythematousvplaquesvwithvcentralvclearingv-vcorrectvanswer- b)vRed,vsharplyvdefinedvplaquesvwithvsilveryvscales Anv85-year- oldvmalevrelatesvthatvonvthevwayvtovhisvannualvphysicalvexamination,vhevsufferedvav suddenvlossvofvvisionvinvhisvrightveyevcharacterizedvbyv"avbunchvofvlights"vandvavfeel ingvthatv"avcurtainvcamevdown"vThevmostvlikelyvdiagnosisvis: a)vVitrealvHemorrhage b)vOpticvnervevlesion c)vCentralvretinalvnervevocclusion d)vRetinalvdetachmentv-vcorrectvanswer-d)vRetinalvdetachment Thevbestvlaboratoryvtestvtovdistinguishvironvdeficiencyvanemiavfromvothervanemiavis: a)vSerumvferritinvlevel b)vMeanvcorpuscularvhemoglobinvconcentration c)vMeanvcorpuscularvvolume d)vTransferrinvsaturationv-vcorrectvanswer-a)vSerumvferritinvlevel Anv88-year- oldvpatientvhasvhadvavgradualvonsetvofvhearingvlossvinvthevleftvear.vExaminationvsho wsvavlargevaccumulationvofvcerumenvinvthevauditoryvcanal.vAssumingvtherevisvnovne uralvloss,vyouvwouldvexpectvthevWebervtestvto: a)vLateralizevtovthevleft. b)vLateralizevtovthevright c)vBevinconclusive d)vNotvlateralizev-vcorrectvanswer-a)vLateralizevtovthevleft Whichvofvthevfollowingvisvassociatedvwithvnormalvaging? a)vDecreasevproductionvofvgastricvacid b)vIncreasevsalivation c)vDecreasevincidencevofvgallstones d)vIncreasedvesophagealvemptyingv-vcorrectvanswer- a)vDecreasevproductionvofvgastricvacid Whichvclassvofvantihypertensivevhasvbeenvassociatedvwithvacutevrenalvfailure,vandvi svabsolutelyvCONTRAINDICATEDvinvpatientsvwithvbilateralvrenalvarteryvstenosis? a)vCalciumvchannelvblockers b)vThiazidevdiuretics c)vPotassium-vsparingvdiuretics d)vAngiotensin-convertingvenzyme(ACE)vinhibitorsv-vcorrectvanswer-d)vAngiotensin- convertingvenzyme(ACE)vinhibitors Av66-year- oldvpatientvpresentsvwithvbilateralvotitisvmediavwithveffusionv(OME)vandvwhitevpatche
a)vObtainvanvEKG. b)vObtainvanvechocardiogram. c)vReevaluatevthevpatientvinv 10 vdays????? d)vRefervthevpatientvtovavcardiologist.v-vcorrectvanswer- c)vReevaluatevthevpatientvinv 10 vdays????? Thevfollow-upvexaminationvofvav12-month- oldvtreatedv 2 vweeksvagovforvbacterialvotitisvmediavrevealsvavnormalvleftvtympanicvme mbranevandvrightvtympanicvmembranevwithvavvisiblevserousvfluidvlevelsvandvdecreas edvmobility.vAnvappropriatevplanvincludesva: a)vConsultationvwithvanvaudiologist b)vPrescriptionvofvanvoralvdecongestant c)vFollow-upvevaluationvofvthevearsvinv 2 vmonths???? v(Dovnotvprescribevoralvdecongestantvtovavchild) d)vReferralvtovanvENTvspecialistvforvsurgicalvconsultv-vcorrectvanswer-c)vFollow- upvevaluationvofvthevearsvinv 2 vmonths???? v(Dovnotvprescribevoralvdecongestantvtovavchild) AccordingvtovthevAmericanvDiabetesvAssociation,vthevnewestvstandardvforvdetermini ngvthevpresencevofvdiabetesvmellitusvbasedvonvfastingvplasmavGlucosevlevelvisvavval uevequalvtovorvgreatervthan: a)v 126 vmg/dl b)v 140 vmg/dl c)v 145 vmg/dl d)v 160 vmg/dlv-vcorrectvanswer-a)v 126 vmg/dl Av 32 vyear- oldvpatientvreportsvav 6 vmonthsvhistoryvofvintermittentvsymmetricalvswellingvofvthevwri stsvandvdailyvmorningvstiffnessvlastingv 1 vhourvorvmorevimprovingvthevstiffnessvandvth evpainvaroundvothervjoints.vWhichvofvthevfollowingvisvmostvlikelyvdiagnosis? a)vRheumatoidvarthritisv(RAv>v 15 vmin,vsymmetricvvsvOAv<v 15 vminutesvasymmetric) b)vOsteoarthritis c)vGoutyvarthritis d)vReiter'svsyndromev-vcorrectvanswer- a)vRheumatoidvarthritisv(RAv>v 15 vmin,vsymmetricvvsvOAv<v 15 vminutesvasymmetric) Av39-year- oldvpatientvwasvdiagnosingvwithvacutevbronchitisvinvthevemergencyvdepartment.vHev wasvtreatedvwithvacetaminophen,vdextromethorphan,vandvmetaproterenolv(Alupent).v Thevpatient'svhistoryvrevealsvavsmokingvhabitvofv 1 vpackvpervday.vHevnowvpresentsvt ovyourvofficevwithvavfevervofv101.2vFv(39.4vC),vandvavcoughvproductivevofvthick,vyello w-green,vfoul- smellingvsputum.vYouvwouldvencouragevsmokingvcessationvandvprescribe: a)vTheophylline b)vAvpenicillinvantibiotic
c)vAnvinhalablevcorticosteroid d)vAvmacrolidevantibioticv-vcorrectvanswer-d)vAvmacrolidevantibiotic Trigeminalvneuralgiavmanifestsvitselfvprimarilyvwith: a)vElectric-shockvunilateralvfacialvpain b)vunilateralvfacialvasymmetry c)vBurningvbilateralvfacialvpain d)vJawvpainvextendingvtovthevneckv-vcorrectvanswer-a)vElectric- shockvunilateralvfacialvpain Av4-year-oldvgirlvwithvavhistoryvofvrecurrentvurinaryvtractvinfectionvcomesvforvavfollow- upvaftervdiagnosisvofvthevmostvrecentvinfection.vDuringvhervphysicalvexamination,vthe v4-year- oldvtellsvthevnursevthatvhervbrothervsometimesvliesvonvtopvofvhervandvrubsvhisvpenisv nearvhervpubicvarea.vAftervcompletingvthevphysicalvexamination,vthevnursevpractition ervmust: a)vDiscussvthevchild'svreportvwithvthevmother b)vReportvsuspicionsvtovthevappropriatevchildvprotectivevservicesvagency c)vRefervthevcasevtovavphysician d)vSuggestvpsychological;vcounselingv-vcorrectvanswer- b)vReportvsuspicionsvtovthevappropriatevchildvprotectivevservicesvagency (Codinavpagev 537 vQ:v606) Avpatientvwithvmacularvdegenerationvhasvdifficultyvseeingvobjects: a)vFromvavdistance b)vInvthevcentervofvthevvisualvfield c)vAtvreadingvdistance d)vInvthevperipheralvfieldsv-vcorrectvanswer-b)vInvthevcentervofvthevvisualvfield Whichvofvthevfollowingvpharmacotherapeuticsvwouldvbevimportantvtovadministervtovav patientvwhovhasvcornealvabrasion? a)vOlopatadinev(Patanol) b)vCromolynvophthalmicv(Crolom) c)vTimololv(Timoptic). d)vGentamicinvophthalmicv(Genoptic)v-vcorrectvanswer- d)vGentamicinvophthalmicv(Genoptic) Whichvofvthevfollowingvsigns/ symptomsvarevoftenvassociatedvwithvheadachesvduevtovanvintracranialvtumor? a)vPainvworsevinvsupinevposition;vfocalvneurologicalvsigns b)vHyperreflexia,vpersonalityvchanges c)vAcutevonset;vincreasingvpainvovervhoursvtovdays d)vPupillaryvconstriction;vstuporv-vcorrectvanswer- a)vPainvworsevinvsupinevposition;vfocalvneurologicalvsigns
a)vAzithromycinv(Zithromax) b)vCephalexinv(Keflex) c)vAmoxicillin d)vClindamycinv(Cleocin)v-vcorrectvanswer-a)vAzithromycinv(Zithromax) Av68-year-oldvfemalevpresentsvwithvavnewvonsetvofvleft- sidedvthrobbingvheadache.vShevhasvnoticedvsomevspotsvinvhervvisualvfieldsvthatvco mevandvgo.vShevisvbeingvtreatedvwithvanvNSAIDvforvarthritis.vSedimentationvratevisve xtremelyvelevated;vothervlaboratoryvvaluesvarevwithinvnormalvlimits.vThevheadachevis vmostvlikelyvduevto: a)vAvtransientvischemicvattach b)vTemporalvarteritis c)vAnvNSAIDvheadache d)vGlaucomav-vcorrectvanswer-b)vTemporalvarteritis Av40-year-oldvmalevpresentsvwithvav2- weekvhistoryvofvrectalvpainvandvhevreportsvpastvhistoryvofvconstipationvandvfindingvs potsvofvbrightvredvbloodvonvtoiletvpapervseveralvtimesvavweekv.Rectalvexaminationvre vealsvavtender,vswollen,vbluishv,ovoidvmass.vThevstoolvgualacvtestvisvnegative.vWhic hvofvthevfollowingvactionsvshouldvthevnursevpractitionervtake? a)vRefervthevpatientvtovavgastroenterologistvforvavmalignancyvworkup. b)vSchedulevavcolonoscopyvtovrulevoutvcolonvcancer. c)vRepeatvthevgualac-formingvagentsvandvobtainvavcompletevbloodvcountv(CBC) d)vPrescribevbulk-formingvagentsvandvhydrocortisonevsuppositoriesv- vcorrectvanswer-d)vPrescribevbulk-formingvagentsvandvhydrocortisonevsuppositories (Thevstoolvguaiacvtestvorvguaiacvfecalvoccultvbloodvtestv(gFOBT)visvonevofvseveralvm ethodsvthatvdetectvthevpresencevofvfecalvoccultvbloodv(FOB) Anv18-year- oldvpatientvpresentsvwithvcomplaintsvofvmaxillaryvpainvandvyellowvnasalvdischargevfo rv 14 vdays.vWhatvisvthevappropriatevinitialvpharmacologicvintervention? a)vAmoxicillin b)vDiphenhydramine c)vDoxycycline d)vErythromycinv-vcorrectvanswer-a)vAmoxicillin Avnursevpractitionervordersvpulmonaryvrehabilitationvforvav56-year- oldvwithvCOPD.vExpectedvoutcomesvofvthisvprogramvincludevallvofvthevfollowingvEXC EPT: a)venhancedvqualityvofvlife b)vincreasedvlungvcapacity c)vdecreasedvin-patientvhospitalizations d)vImprovedvexercisevcapacityv-vcorrectvanswer-b)vincreasedvlungvcapacity
AvPtvwithvavdiagnosisvofvdiverticulosisvpresentsvwithvlocalizedvLLQvdiscomfort,vavpal pablevmass,vmildvleukocytosis,vandvT=100vFv(37.8C).vThevpatientvdoesvnotvappearvt oxicvandvcanvtoleratevfluids.vAnvappropriatevplanvshouldvinclude. a)vBariumvenemavandvnothingvbyvmouth b)vClearvliquidsvandvoralvantibioticsv???? c)vLow-fibervdietvandvreferralvtovavgastroenterologist d)vHospitalvadmissionvforvIVvantibioticsv-vcorrectvanswer- b)vClearvliquidsvandvoralvantibioticsv???? (BestvDxvmethodvisvCTvofvabdomenvwithvorvwithoutvcontras.vTx:vUncomplicatedvcas es:vCiprofloxacinv 500 vmgvBIDvPLUSvMetronidazolev(Flagyl)v 500 vmgvTIDvxv 10 vdays)v (Rovsing'svSignv+)vCodinavpage- Youvarevevaluatingvav40-year- oldvpatientvsuspectedvofvhavingvavpulmonaryvembolismv(PE);vthevpatientvcomplainsv ofvanxietyvandvcough.vAvstatvchestvX-rayvisvnormalv.Thevnextvtestvshouldvbe: a)vSpirometry b)vMagneticvresonancevimagingv(MRI) c)vContrastvvenography d)vHelicalvCTvpulmonaryvangiographyv-vcorrectvanswer- d)vHelicalvCTvpulmonaryvangiography Av14-year- oldvmalevwithvbronchitisvisvbeingvtreatedvwithvfluidsvandvexpectorants.vHevreturnsvtov thevclinicvwithvavfevervofv 103 vFv(39.4vC),vrightvpleuriticvchestvpain,vandvgreenvsputu m.vWhichvofvthevfollowingvexaminationvshouldvbevexpected? a)vRightvlowervlobevcrackles b)vDecreasevfremitus c)vBilateralvwheezing d)vNormalvpercussionv-vcorrectvanswer-a)vRightvlowervlobevcrackles Anv18-year- oldvcollegevstudentvpresentsvforvanvathleticvphysicalv.Whenvaskingvaboutvcurrentvme dications.vShevmentionsvshevtakesv"somevherb"vshevboughtvatvthevhealthvfoodvstore vforvmigrainesvandvmenstrualvcramps.vWhichvofvthevfollowingvherbalvremediesvhasvb eenvcommonlyvusedvforvthesevconditions? a)vEphedrav(Allergies:vAsthma,vrhinitis,vandvcold) b)vEchinaceav(commonvcold) c)vFeverfewv(2ndvlinevpreventionvofvmigrainevheadache) d)vGinkgovbilobav(PMSvSymptoms,vmemoryvinvADv&vPD,v) e)vStvJohn'svWorth:vAntidepressantv(InteractionvwithvG.vAnesthetic,vPaxil,vBirthvcontr olvpills,vTryptophan) f)vBlackvCohorsh,vsoy,v&vYamv(MenopausevS/S) g)vValerianv&vKavavKavav(insomniavorvanxiety)v-vcorrectvanswer- c)vFeverfewv(2ndvlinevpreventionvofvmigrainevheadache)
Afterv3-weekvcampingvtrip,vanv11-year- oldvisvseenvforvavtargetvlesionvwithvcentralvclearing,vLocatedvinvthevinguinalvarea.vTh evpatientvhasvhadvavseverevheadache,vmalaise,vfatigue,vandvgeneralizedvmusculosk eletalvpainvforvseveralvdays.vPharmacologicvmanagementvofvthisvconditionvincludes: a)vTrimethoprim-Sulfamethoxazolev(Bactrim) b)vAzithromycinv(Zithromax) c)vMetronidazolev(Flagyl) d)vDoxycyclinev(Doryx)v-vcorrectvanswer-d)vDoxycyclinev(Doryx) (Accordingvtovthevexpertsvafterv8-year-old,vthevpatientvcanvtakevTetracycline) Av2-months- oldvinfantvisvpresentedvforvexaminationvandvimmunizations.vHistoryvincludesvanvunco mplicatedvfull- termvdeliveryvandvhepatitisvBvvirusvimmunizationvshortlyvaftervbirth.vExaminationvisvu nremarkablevexceptvforvavdiffuselyverythematousv(non-beet- red)vmacularvrashvinvthevdiapervarea,vsparingvthevinguinalvfolds.vNovsatellitevlesionsv arevnotedv.Thevinfant'svdiapervrashvisvmostvlikelyvcausedvby: a)vCandidavalbicansvinfectionv(Satellitevlesionsvarevnoted) b)vEczema c)vSeborrheicvdermatitis d)vContactvdermatitisv-vcorrectvanswer-d)vContactvdermatitis (Thevfactvthatvtherevarevnovsatellitevlesionvr/ovcandidavalbicanvinfections) Avroutinevlaboratoryvassessmentvofvav12-year- oldvboyvwithvavfamilyvhistoryvofvthalassemiavandvanemiavrevealsvTannervstagevIIvpre sentation.vThevHctv=v35%.vInvadditionvtovavcompletevbloodvcountv(CBC)vthevNPvprac titionervwillvordervwhichvofvthevfollowing? a)vHemoglobinvelectrophoresis b)vVitaminvB12vlevel c)vSerumvfolicvacid d)v24-hourvurinevcreatininev-vcorrectvanswer-a)vHemoglobinvelectrophoresis Av15-year- oldvpatientvreturnsvforvavcontraceptivevservicesv 2 vwetvmountvwithvavdiagnosisvofvtric homonasvvaginitis,vandvtreatmentvwithv 2 vgvofvmetronidazolev(Flagyl).vShevreportsvth atvdischargevandvitchingvarevgone,vbutvshevreportedvincreasevinvurinaryvfrequently,va ccompaniedvwithvavlotvofvburning.vPatientvhasvnotvresumedvsexualvactivityvandvhasv menstruatedvsincevhervlastvvisit.vExaminationvrevealsvmildvsuprapubicvtenderness,vn ovleucorrhea,vandvavnormalvwetvmount.vGonococcalvculturevandvChlamydiavtestsvar evnegative.vWhichvdiagnosisvtestvshouldvbevperformedvimmediately? a)vUrinevpregnancyvtest b)vMicroscopyvexaminationvofvurine c)vHerpesvsimplexvculture d)vRepeatvchlamydiavtestv-vcorrectvanswer-b)vMicroscopyvexaminationvofvurine
Thevparentvofvav13-year- oldvdiagnosedvwithvseizurevdisordervcallsvtovreportvthatvthevchildvisvexhibitingvsympt omsvofvavcold,vbutvhasvnotvfever.vThevnursevpractitionervshouldvadvisevthevparentvth atvthevdevelopmentvofvfevervmay: a)vHavevnoveffectvonvthevseizurevthreshold b)vLowervthevseizurevthreshold c)vMakevthevseizurevmedicationvlessveffective. d)vIncreasevthevseizurevthresholdv-vcorrectvanswer-b)vLowervthevseizurevthreshold Whatvisvsensitivity?v-vcorrectvanswer-positive/vhavevthevdisease Oldvguyvasksvaboutvavresearchvhevreadvonvthevinternetvwhatvshouldvthevnursevknow vaboutvit?v-vcorrectvanswer-Itvwasvweirdvjustvreadvitvandvgetvthevbest Whichvcharacterizesvmigrainevheadaches? a.vItvhappensv 1 vdailyvandvcomesvwithvnauseavandvvomiting b.vItvlastsvfromv4-72vhours.v-vcorrectvanswer- a.vItvhappensv 1 vdailyvandvcomesvwithvnauseavandvvomiting RecognizevClustervheadaches?v-vcorrectvanswer- a.vUnilateralveyevpainvandvnosevdischarge OldvmanvwithvhistoryvofvstrokevandvMIvandvisvnowvgettingvforgetful?v- vcorrectvanswer-a.vVascularvdementia Patientvwithvtrigeminalvneuralgiavonvgabapentinvbutvnotvworking?v-vcorrectvanswer- a.vTegretol Oldvladyvthatvalwaysvpreparesvdinnervforvfamilyvandvnowvisvforgettingvstuffvandvleftvt urkeyvinvthevsink,vwhatvisvshevloosing?v-vcorrectvanswer-a.vExecutivevFunction WhatvisvKorsikoffvsyndromevrelatedvto?v-vcorrectvanswer- a.vAlcoholvandvthiaminev(VITvB1) Prodromalvsignsvofvgenitalvherpes?v-vcorrectvanswer-a.vTingling,vburningvandvpain Teenvbroughtvinvbyvhisvparentsvwithvgrandiosevdelusionvandvlackvofvsleep? vWhatvisvit?v-vcorrectvanswer-a.vBipolar Mothervcallsvnursevandvtellsvthatvthevchildvhasvavcoldvbutvnovfevervatvthisvtimevthevn ursevtellsvthevmothervthevfever:v-vcorrectvanswer-a.vDecreasesvseizurevthreshold PatientvwithvparesthesiavandvHGBvisv9.0vMCVvisv129.vWhatvwillvyouvcheck?v- vcorrectvanswer-a.vVitaminvB Avnursevisvdoingvavfundoscopicvexamvandvseevveinsvovervgoingvarterioles.vWhatvsh ouldvthevnursevcheckvfor?v-vcorrectvanswer-a.vHypertension
ChildvbroughtvinvbyvhisvmothervwithvconjunctivitisvbutvalsovhasvOM.vThevnursevtellsvt hevmothervthevfirstvlinevofvtreatmentvis?v-vcorrectvanswer- a.vAmoxixillinv(Ivdidn'tvseeverythromycin) (Lookvitvup) WhatvisvnormalvinvMenieresvdisease?v-vcorrectvanswer- a.vRhinevtestvACvisvdoublevthanvBC OldvmanvcomesvwithvlostvofvhearingvofvhighvpitchedvsoundsvandvbilaterallyvBCvandv ACvhasvdiminished?vWhatvisvit? a.vSensoryvneuralvhearingvlossv b.vOtosclerosis c.vCerumenvImpactiioinv-vcorrectvanswer-a.vSensoryvneuralvhearingvloss ObesevguyvwithvplantarvfasciitisvandvisvbeenvtreatedvwithvNSAIDSvalready.vWhatvisvt hevnextvstepvtovfollow?v-vcorrectvanswer- a.vContinuevwithvNSAIDS,vapplyvandvstretchingvplantarvboot,vandvtellvthevptvtovloose vweight Bestvexercisevforvosteoporosisvinvwomen?v-vcorrectvanswer-a.vWalking HowvdovyouvdiagnosevOsgoodvSchlattervdisease?v-vcorrectvanswer- a.vPainvovervtibialvtuberosity Patientvwantsvtovplayvbasketballvandvwantsvclearancevhevisv95thvonvheightvandv75th vonvweightvwhatvshouldvyouvcheckvfor?v-vcorrectvanswer-a.vMarfanvsyndrome Childvcomesvwithvdiarrheavwhatvshouldvbevthevpriorityvforvreassurance?v- vcorrectvanswer-a.vCheckvforvgrowthvchart Allvisvnormalvinvinfantsvexcept?v-vcorrectvanswer-a.vSymmetricalvneckvtone Howvdovyouvassessvdehydrationvonvavchildvbest? a.vCheckvskinvfoldv b.vUrinevpH c.vPosteriorvfontanelv-vcorrectvanswer-a.vCheckvskinvfold Whatvarevyouvcheckingvwhenvyouvpressvdownvonvavpatient'svhead?v- vcorrectvanswer-a.vHerniatedvdiskvatvL Patientvcomplainsvofvshouldervpainvradiatingvtovforearm.vAftervcheckingvshouldervma neuversveverythingvisvnegative.vWhatvisvcausingvthevpain?v-vcorrectvanswer- a.vCervicalvradiculopathy Guyvcomesvwithvlowervbackvpainvaftervbeenvtreatedvforv 3 vweeksvwithvnovrelief? vWhatvwillvyouvordervnext?v-vcorrectvanswer-a.vX- rayvandvMRIv(vThevothersvwerevlikevelectricvexams)
Whatvisvnotvavriskvfactorvforvosteoporosis?v-vcorrectvanswer-a.vObesity Ladyvonvestrogenvandvisvnowvdiagnosedvwithvosteoporosis.vWhatvwouldvyouvprescri bevnext? a.vMethylprednisolone b.vDepovprovera c.vRisedronatev-vcorrectvanswer-c.vRisedronatev?? Youngvmanvwithvkneevpainvandvyouvdovanteriorvdrawervtestvtovcheckvfor?v- vcorrectvanswer-a.vACL Youngvguyvfallvonvwristvandvyouvappliedvicevandvelevated,vX- rayvisvnegativevforvnavicularvfracture,vwhatvwillvyouvdovnext?v-vcorrectvanswer- a.vAppliedvcastvwithvthumbvincludedvandvrepeatvx-rayvinv 2 vweeks Guyvwithvgoutvcomesvinvseverevpain.vHevstoppedvtakingvAllopurinolvandvstartedvtaki ngvitvagainvaftervthevpainvstartedvbutvisvnotvgettingvrelief.vWhatvwillvyouvordersvnext? a.vStartvonvProbenecidvandvdecreasevallopurinol b.vStartvshortvtreatmentvwithvsteroidsv-vcorrectvanswer- b.vStartvshortvtreatmentvwithvsteroids WhatvarevthevbestvmedsvtovtreatvGERD?v-vcorrectvanswer-a.vPPIs Ptvthatvinsurancevdroppedvhimvandvcomesvtovyouvforvthevfirstvtimevforvmedsvrefill.vHi svlastvEndoscopyvwasvpositivevforvBarrett'svesophagus.vWhatvwillvthevnursevdovfirst? a.vOrdervPPIsvlongvterm b.vObtainvmorevdetailedvinformationvbeforevprescribingvanyvmedicine c.vRefervtovOncologyv-vcorrectvanswer- b.vObtainvmorevdetailedvinformationvbeforevprescribingvanyvmedicine Whatvtestvwillvyouvdovtovr/ovGERDvexcept?v-vcorrectvanswer-a.vERCP Patientvhavingvconstipationvandvdiarrheavavnoticedvsomevbloodvinvstoolvwhatvtovdo? v-vcorrectvanswer-a.vColonoscopy Youngvgirlvwithvmultiplevpartnersvaskvyouvaboutvpostponingvhervpapvsmearvtoday.vT hevnursevknowsvthatvthevACOGvrecommends? a.vAfterv 40 vyearsvold b.vAftervhavingvsexualvintercourse c.vAfterv 21 vyearsvoldv-vcorrectvanswer-c.vAfterv 21 vyearsvoldv?? ThevnursevfindsvSquamousvintraepithelialvlesionvonvthevpapvsmearvwhatvshouldvdov next?v-vcorrectvanswer-a.vRefervforvcolposcopy Avteenvurinevsamplevcomesvbackvwithvepithelialvcellsvandvbacteriavwhatvdoesvthisvm ean? a.vHPV
