2021 NSG6001 APEA South University 3P Exam
Question 1
When performing a visual acuity test, the nurse practitioner notes 20/30 in the left eye and 20/60
in the right eye. The next step is to
A. Have the patient return in 2 weeks for a follow-up vision screen
B. Dilate the eyes and retest
C. Refer the patient to an ophthalmologist
D. Document this as a normal finding.
Answer: C. Refer the patient to an ophthalmologist
Question 2
The American Psychiatric Association’s Diagnostic and Statistical Manual Disorder fifth edition
(DMS-5) describes Munchausen Syndrome by proxy as
A. A self-inflicted injury to gain attention
B. A caregiver making up or causing an illness or injury in a person under his or her care
C. An abusive behavior that does not involve the caregiver
D. A situation in which the abuser is often inattentive and uncaring toward the victim
Answer: B. A caregiver making up or causing an illness or injury in a person under his or her
care
Question 3
Symptoms of depression are a side effect of which neurotransmitter medication? [There are 3
categories of neurotransmitters in the brain: small molecules for fast action/excitatory
transmission = glutamate & GABA; small molecules for slower modulation of activity =
dopamine & serotonin; Peptides = endorphins, cannabindoids, oxytocin)
A. Dopamine
B. Gabapentin
C. Mu
D. Cortisol
Answer: A. Dopamine
Question 4
The right lymphatic ducts drain into what part of the circulatory system? (There are two lymph
ducts, the right lymphatic duct and the thoracic duct. The right drains lymph from the right upper
limb, the right side of thorax, and the right halves of head and neck. The thoracic duct drains
lymph into the circulatory system between the left subclavian and the left internal jugular veins)
A. Arterial
B. Venous
C. Arteriovenous system
D. Capillary bed
Answer: B. Venous
Question 5
Which lesion is dark, raised and asymmetric with irregular borders?
A. Nevus (the medical term for a mole. Nevi are very common. Most people have between 10
and 40. Common nevi are harmless collections of colored cells. They typically appear as small
brown, tan, or pink spots)
B. Actinic (a rough, scaly patch on your skin that develops from years of exposure to the sun. It's
most commonly found on your face, lips, ears, back of your hands, forearms, scalp or neck)
C. Keratoacanthoma (a dome-shaped lump or tumor that grows on your skin)
D. Melanoma (the most serious type of skin cancer, develops in the cells (melanocytes) that
produce melanin — the pigment that gives your skin its color. Melanoma is asymmetric,
irregular border, change in color, change in diameter, and evolved over time [ABCDE])
Answer: D. Melanoma (the most serious type of skin cancer, develops in the cells (melanocytes)
that produce melanin — the pigment that gives your skin its color. Melanoma is asymmetric,
irregular border, change in color, change in diameter, and evolved over time [ABCDE])
Question 6
A pediatric patient has areas of scaling on the scalp, with round patches of alopecia. This clinical
finding is consistent with
A. Tinea capitis (Ringworm of the scalp is not really a worm, but a fungal infection. It gets the
name ringworm because the fungus makes circular marks on the skin, often with flat centers and
raised borders. Also called Tinea capitis, this infection affects your scalp and hair shafts, causing
small patches of itchy, scaly skin)
B. Seborrheic dermatitis (a common skin condition that mainly affects your scalp. It causes scaly
patches, red skin and stubborn dandruff. Seborrheic dermatitis can also affect oily areas of the
body, such as the face, sides of the nose, eyebrows, ears, eyelids and chest. For infants, the
condition is known as cradle cap and causes crusty, scaly patches on the scalp.)
C. Trichotillomania (hair-pulling disorder, is a mental disorder that involves recurrent, irresistible
urges to pull out hair from your scalp, eyebrows or other areas of your body, despite trying to
stop)
D. Alopecia areata (a condition that causes hair to fall out in small patches, which can be
unnoticeable. These patches may connect, however, and then become noticeable. The condition
develops when the immune system attacks the hair follicles, resulting in hair loss)
Answer: A. Tinea capitis (Ringworm of the scalp is not really a worm, but a fungal infection. It
gets the name ringworm because the fungus makes circular marks on the skin, often with flat
centers and raised borders. Also called Tinea capitis, this infection affects your scalp and hair
shafts, causing small patches of itchy, scaly skin)
Question 7
A patient with an acute presentation of acute aortic regurgitation (AR) typically presents with
sudden severe shortness of breath, lower extremity edema, a rapid heartbeat, and
A. Dry mouth
B. Chest pain
C. Decreased blood pressure
E. Systolic murmur
Answer: B. Chest pain
Question 8
Which of the following conditions is associated with chronic bloody diarrhea?
A. Irritable bowel syndrome (a common disorder that affects the large intestine. Signs and
symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both.
IBS is a chronic condition that you'll need to manage long term)
B. Crohn’s disease (an inflammatory bowel disease (IBD). It causes inflammation of your
digestive tract, which can lead to abdominal pain, severe diarrhea, blood in stool, fatigue, weight
loss and malnutrition)
C. Hepatitis A (Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus.
You're most likely to get hepatitis A from contaminated food or water or from close contact with
a person or object that's infected. signs and symptoms can include: Fatigue, Sudden nausea and
vomiting, Abdominal pain or discomfort, especially on the upper right side beneath your lower
ribs (by your liver), Clay-colored bowel movements, Loss of appetite, Low-grade fever, Dark
urine, Joint pain, Yellowing of the skin and the whites of your eyes (jaundice),
Intense itching)
D. Celiac disease (an immune reaction to eating gluten, a protein found in wheat, barley and rye.
Over time, this reaction damages your small intestine's lining and prevents it from absorbing
some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight
loss, bloating and anemia, and can lead to serious complications)
Answer: B. Crohn’s disease (an inflammatory bowel disease (IBD). It causes inflammation of
your digestive tract, which can lead to abdominal pain, severe diarrhea, blood in stool, fatigue,
weight loss and malnutrition)
Question 9
Which condition is caused by an insufficient production of intrinsic factor by the gastric mucosa
and vitamin B insufficiency?
A. Diarrhea
B. Pernicious anemia (When your body can’t make enough healthy red blood cells because it
lacks vitamin B-12)
C. Osteoporosis
D. Muscle weakness
Answer: B. Pernicious anemia (When your body can’t make enough healthy red blood cells
because it lacks vitamin B-12)
Question 10
A 32-year old woman presents with dull puffiness of the eyes with pronounced non-pitting
periorbital edema. This finding is suggestive of what condition?
A. Nephrotic syndrome (a kidney disorder that causes your body to pass too much protein in
your urine. Nephrotic syndrome is usually caused by damage to the clusters of small blood
vessels in your kidneys that filter waste and excess water from your blood. The condition causes
swelling, particularly in your feet and ankles, and increases the risk of other health problems)
B. Myxedema (severely advanced hypothyroidism. This is a condition that occurs when your
body doesn’t produce enough thyroid hormone. The classic skin changes are: swelling of your
face, which can include your lips, eyelids, and tongue, swelling and thickening of skin anywhere
on your body, especially in your lower legs)
C. Cushing’s syndrome (when your body is exposed to high levels of the hormone cortisol for a
long time. Cushing syndrome, sometimes called hypercortisolism, may be caused by the use of
oral corticosteroid medication. The condition can also occur when your body makes too much
cortisol on its own. Too much cortisol can produce some of the hallmark signs of Cushing
syndrome — a fatty hump between your shoulders, a rounded face, and pink or purple stretch
marks on your skin. Cushing syndrome can also result in high blood pressure, bone loss and, on
occasion, type 2 diabetes)
D. Sinusitis (You may feel pressure around your eyes, cheeks and forehead. Perhaps your head
throbs. Sinusitis usually occurs after a viral upper respiratory infection or cold and includes
thick, discolored nasal mucus, decreased sense of smell, and pain in one cheek or upper teeth)
Answer: B. Myxedema (severely advanced hypothyroidism. This is a condition that occurs when
your body doesn’t produce enough thyroid hormone. The classic skin changes are: swelling of
your face, which can include your lips, eyelids, and tongue, swelling and thickening of skin
anywhere on your body, especially in your lower legs)
Rationale:
Myxedematous coma, which is manifested by coma, hypothermia, severe fluid and electrolyte
imbalances, and cardiovascular collapse, is a life-threatening, end-stage expression of
hypothyroidism.
• Hyperthyroidism has an effect opposite to that of hypothyroidism. It produces an increase in
metabolic rate and oxygen consumption, increased use of metabolic fuels, and increased
sympathetic nervous system responsiveness. Manifestations include nervousness, irritability, a
fine muscle tremor, weight loss despite an increased appetite, excessive sweating, muscle
cramps, and heat intolerance. Graves’ disease is characterized by the triad of hyperthyroidism,
goiter, and ophthalmopathy (exophthalmos or protruding eyeballs) or dermopathy (pretibial
myxedema).
• Thyroid storm or crisis, which is manifested by a very high fever, extreme cardiovascular
effects (tachycardia, congestive failure, and angina), and severe central nervous system effects
(agitation, restlessness, and delirium), is an extreme and life-threatening form of thyrotoxicosis.
Question 11
A 52-year-old woman is inquiring about estrogen replacement therapy for symptoms of
menopause. Which of the following is a contraindication?
A. History of phlebitis
B. Prior or present migraine headaches
C. Family history of lung cancer
D. Prior breast or uterine carcinoma
Answer: D. Prior breast or uterine carcinoma
Question 12
Patient with asthma have a pathological finding of:
A. Necrosis of small airways
B. Absence of goblet cells
C. Absence of ciliary regeneration
D. Hypertrophy of smooth muscle (Epithelial to mesenchymal transition plays an important role
in airway remodeling. These epithelial and mesenchymal cells cause persistence of the
inflammatory infiltration and induce histological changes in the airway wall, increasing thickness
of the basement membrane, collagen deposition and smooth muscle hypertrophy and
hyperplasia. Resulting of airway inflammation, airway remodeling leads to the airway wall
thickening and induces increased airway smooth muscle mass, which generate asthmatic
symptoms)
Answer: D. Hypertrophy of smooth muscle (Epithelial to mesenchymal transition plays an
important role in airway remodeling. These epithelial and mesenchymal cells cause persistence
of the inflammatory infiltration and induce histological changes in the airway wall, increasing
thickness of the basement membrane, collagen deposition and smooth muscle hypertrophy and
hyperplasia. Resulting of airway inflammation, airway remodeling leads to the airway wall
thickening and induces increased airway smooth muscle mass, which generate asthmatic
symptoms)
Question 13
A 65-year-old patient with a history of a deep vein thrombosis (DVT) is being treated for a dental
abscess. Which antibiotics is safe to use with warfarin (Coumadin). [Some antibiotics, such as
penicillins, quinolones, metronidazole and cephalosporins can cause unwanted side effects in
warfarin users or decrease warfarin's effectiveness]
A. Amoxicillin (Amoxil) ----[Penicillin abx]
B. Trimethoprim/ sulfamethoxazole (Bactrim)----[known as a co-trimoxazole antibiotic used to
treat a variety of bacterial infections]
C. Ciprofloxacin (Cipro) -----[a fluoroquinolone antibiotic used for bacterial infections]
D. Clarithromycin (Biaxin) -----[a macrolide antibiotic that fights bacteria infections that affect
the skin and respiratory system. Also used to treat stomach ulcers caused by H. pylori]
Answer: A. Amoxicillin (Amoxil) ----[Penicillin abx]
Question 14
Primary syphilis is characterized by what type of lesion [Primary syphilis: The first sign of
syphilis is a small sore, called a chancre (SHANG-kur). The sore appears at the spot where the
bacteria entered your body. While most people infected with syphilis develop only one chancre,
some people develop several of them. The chancre usually develops about three weeks after
exposure. Many people who have syphilis don't notice the chancre because it's usually painless,
and it may be hidden within the vagina or rectum. The chancre will heal on its own within three
to six weeks. Secondary syphilis: Within a few weeks of the original chancre healing, you may
experience a rash that begins on your trunk but eventually covers your entire body — even the
palms of your hands and the soles of your feet. This rash is usually not itchy and may be
accompanied by wart-like sores in your mouth or genital area. Some people also experience hair
loss, muscle aches, a fever, a sore throat and swollen lymph nodes. These signs and symptoms
may disappear within a few weeks or repeatedly come and go for as long as a year. Latent
syphilis: If you aren't treated for syphilis, the disease moves from the secondary stage to the
hidden (latent) stage, when you have no symptoms. The latent stage can last for years. Signs and
symptoms may never return, or the disease may progress to the third (tertiary) stage. Tertiary
syphilis: About 15% to 30% of people infected with syphilis who don't get treatment will
develop complications known as late (tertiary) syphilis. In the late stage, the disease may damage
your brain, nerves, eyes, heart, blood vessels, liver, bones and joints. These problems may occur
many years after the original, untreated infection. Neurosyphilis: At any stage, syphilis can
spread and, among other damage, cause damage to the brain and nervous system (neurosyphilis)
and the eye (ocular syphilis). Congenital syphilis: Babies born to women who have syphilis can
become infected through the placenta or during birth. Most newborns with congenital syphilis
have no symptoms, although some experience a rash on the palms of their hands and the soles of
their feet. Later signs and symptoms may include deafness, teeth deformities and saddle nose —
where the bridge of the nose collapses. However, babies born with syphilis can also be born too
early, be born dead (stillborn) or die after birth.
A. A cluster of scattered vesicles
B. Chancre
C. Papule of many shapes
D. Nontender indurated penile nodule
Answer: B. Chancre
Question 15
What is the area of fundal height palpation on a woman who is 12 weeks pregnant? [Fundal
Height during Pregnancy: The fundus will be found above the symphysis pubis at 12 weeks. The
fundus will be found at the belly button (umbilicus) at 20 weeks. As mentioned above, after
about 20-36 weeks the fundal height measurement should almost match the gestational age give
or take 2 cm]
A. At the level of the umbilicus (20 weeks)
B. At the level of the symphysis pubis (12 weeks)
C. Midway between the symphysis and umbilicus (16-19 weeks)
D. Below the symphysis pubis (less than 12 weeks)
Answer: B. At the level of the symphysis pubis (12 weeks)
Question 16
Which of the following is NOT associated with assessment finding in a patient diabetic
retinopathy? [a diabetes complication that affects eyes. It's caused by damage to the blood
vessels of the light-sensitive tissue at the back of the eye (retina). At first, diabetic retinopathy
may cause no symptoms or only mild vision problems. Eventually, it can cause blindness.
diabetic retinopathy symptoms may include: Spots or dark strings floating in your vision
(floaters), Blurred vision, Fluctuating vision, Impaired color vision, Dark or empty areas in your
vision, Vision loss]
A. Papilledema (swelling of the optic nerve---optic disk)
B. Dot and blot hemorrhages (microaneurysms rupture in the deeper layers of the retina, such as
the inner nuclear and outer plexiform layers)
C. Microaneurysms (a tiny area of blood protruding from an artery or vein in the back of the eye.
These protrusions may open and leak blood into the retinal tissue surrounding it)
D. Cotton wool spots (an abnormal finding on funduscopic exam of the retina of the eye. They
appear as fluffy white patches on the retina. They are caused by damage to nerve fibers and are a
result of accumulations of axoplasmic material within the nerve fiber layer)
Answer: A. Papilledema (swelling of the optic nerve---optic disk)
Question 17
A 3-year-old child has enterobiasis(PINWORM). When should the dose of mebendazole
(Vermox) be repeated? [The medications used for the treatment of pinworm are either
mebendazole, pyrantel pamoate, or albendazole. Any of these drugs are given in one dose
initially, and then another single dose of the same drug two weeks later. The second dose is to
prevent re-infection by adult worms that hatch from any eggs not killed by the first treatment]
A. In 3 days
B. In 1 week
C. In 2 weeks
D. In 3 weeks
Answer: C. In 2 weeks
Question 18
Which area does not allow lymphatic fluid to be drained from the right lymph duct? [The right
lymphatic duct, also called the right thoracic duct, is about 1.25 cm long. It drains lymphatic
fluid from the right thoracic cavity (this is the section of the trunk on the upper right side), the
right arm, and from the right side of the neck and the head. In some people, it also drains lymph
from the left lung’s lower lobe]
A. The right side of the head
B. The right upper thorax
C. The right arm
D. The right leg
Answer: D. The right leg
Question 19
Snellen chart evaluation indicates that a patient’s vision is 20/30. What is the proper description
of this result?
A. At 20 feet, this patient can see what a person with normal vision can see at 30 feet
B. At 30 feet, this patient can see what a person with normal vision can see at 30feet
C. At 20 feet, this patient can see what few people can see at 30 feet
D. This patient has sight abilities that are worse than a patient with 20/40 vision
Answer: A. At 20 feet, this patient can see what a person with normal vision can see at 30 feet
Question 20
Based on the mechanism of hearing, sensorineural loss in an adult involves the [The majority of
acquired hearing loss, including presbycusis, is caused by irreversible damage to the
sensorineural tissues of the cochlea]
A. Cochlea and the cochlea nerve
B. External ear canal and the middle ear
C. Ossicles and the inner ear
D. Transfer of sounds from the external environment into the external auditory canal
Answer: A. Cochlea and the cochlea nerve
Question 21
Which of the appropriate medication choice for a 31-year-old pregnant patient diagnosed with a
urinary tract infection?
A. Cefuroxime (Zinacef) [used to treat HEENT and Respiratory infections] or
Nitrofurantoin (Macrobid)
B. Nitrofurantoin (Macrobid) or Ciprofloxacin (Cipro)
C. Ciprofloxacin (Cipro) or Tetracycline (Sumycin) [not recommended in PG]
D. Tetracycline (Sumycin) [Not recommended/unsafe in PG] or Amoxicillin (Amoxil)
Answer: B. Nitrofurantoin (Macrobid) or Ciprofloxacin (Cipro)
Question 22
Pregnant women are evaluated for syphilis with serology testing because
A. Syphilis during pregnancy predisposes the fetus to spontaneously abortor the newborn to have
congenital syphilis.
B. Hormonal changes associated with pregnancy may trigger activation of talent syphilis
C. Syphilis may be passed to the fetus beginning in the third trimester
D. Untreated syphilis can cause neonatal respiratory distress
E. Penicillin G benzathine (bicillin L-A) given as 3 intramuscular doses over 2 weeks.
Answer: A. Syphilis during pregnancy predisposes the fetus to spontaneously abortor the
newborn to have congenital syphilis.
Question 23
Which of the following is a typical finding in a patient with a meniscal tear?
A. A positive McMurray’s test (The McMurray test, also known as the McMurray circumduction
test is used to evaluate individuals for tears in the meniscus of the knee)
B. Positive anterior drawer test (commonly used in orthopedic examinations to test for anterior
cruciate ligament (ACL) integrity)
C. Audible click at the joint line (usually occurs at the hip)
D. Fixed patellar subluxation (a partial dislocation of the kneecap)
Answer: A. A positive McMurray’s test (The McMurray test, also known as the McMurray
circumduction test is used to evaluate individuals for tears in the meniscus of the knee)
Question 24
Hyperkalemia is associated with:
A. Increased blood pressure
B. Alpha blockers
C. Diminished renal function
D. Loop diuretics
Answer: C. Diminished renal function
Question 25
Short bands of tough, flexible, ropelike, collagen fibrils that connect two bones is called:
A. Tendons (Type of tissue that connects muscle to bone)
B. Fibrous connective tissue (Irregularly-arranged fibrous connective tissues are found in areas
of the body where stress occurs from all directions, such as the dermis of the skin)
C. Ligaments (bands of tough elastic tissue around your joints. They connect bone to bone, give
your joints support, and limit their movement. A short band of tough, flexible, fibrous connective
tissue that connects two bones or cartilages or holds together a joint (Quizlet))
D. Cartilage (Resilient and smooth elastic tissue, rubber-like padding that covers and protects the
ends of long bones at the joints)
Answer: C. Ligaments (bands of tough elastic tissue around your joints. They connect bone to
bone, give your joints support, and limit their movement. A short band of tough, flexible, fibrous
connective tissue that connects two bones or cartilages or holds together a joint (Quizlet))
Question 26
The finding of a dome-shaped lesion in the dermis that forms a benign closed, firm sac attached
to the epidermis
A. A keloid (extra scar tissue of smooth, hard growth)
B. A tophi (when crystals of the compound known as sodium urate monohydrate, or uric acid,
builds up around your joints. Tophi often look like swollen, bulbous growths on your joints just
under your skin)
C. a cutaneous cyst (Formerly called a sebaceous cyst, a dome - shaped lump in the dermis forms
a benign closed firm sac attached to the epidermis. A dark dot (blackhead) may be visible on its
surface)
D. chondrodermatistis (a skin condition that affects the cartilage of the ear. It’s a painful nodule,
which may or may not have a scab on it, that grows over a period of time)
Answer: C. a cutaneous cyst (Formerly called a sebaceous cyst, a dome - shaped lump in the
dermis forms a benign closed firm sac attached to the epidermis. A dark dot (blackhead) may be
visible on its surface)
Question 27
What symptoms would lead the nurse practitioner to suspected atypical community acquired
pneumonia in an 18-year-old living in ...
A. a low-grade fever, malaise, and clear lung fields on auscultation
B. a low-grade fever, malaise, and crackles audible throughout the lung fields
C. temperature of 101 f, sore throat, and diminished breath sounds on auscultation
D. temperature of 102 f, dyspnea, and diminished lung sounds on auscultation
Answer: C. temperature of 101 f, sore throat, and diminished breath sounds on auscultation
Question 28
Vitamins prescribed for pregnant women should contain what two components?
A. Folic acid and vitamin C
B. Iron and vitamin B12
C. Vitamin D and Iron
D. Folic acid and Iron
Answer: D. Folic acid and Iron
Question 29
Which medication is indicated for patients with generalized anxiety disorder (GAD)?
A. Buspirone (Buspar)
B. Citalopram (Celexa)
C. Imipramine (Toframil)
D. Bupropion HCL (Wellbutrin)
Answer: A. Buspirone (Buspar)
Question 30
A prostate gland that is found to be tender, swollen, boggy, and warm on a digital rectal exam is
consistent with:
A. A normal prostate gland
B. Acute bacterial prostatitis
C. Benign prostatic hyperplasia
D. Carcinoma of the prostate
Answer: B. Acute bacterial prostatitis
Question 31
Which medication can cause a false positive result for amphetamines in a urine drug screen?
A. Metformin
B. Lisinopril
C. Glyburide
D. Bupropion
Answer: D. Bupropion
Question 32
Fine, silky appearance of the hair is a common finding in:
A. Hypothyroidism
B. Hyperthyroidism
C. Type 2 diabetes
D. Celiac disease
Answer: B. Hyperthyroidism
Question 33
Which of the following is commonly associated with increased risk for prostatic hypertrophy?
A. Constipation
B. Fecal incontinence
C. Urinary tract infections
D. Prostate cancer
Answer: C. Urinary tract infections
Question 34
Patients with bacterial meningitis experience headache symptoms due to:
A. Meningeal erythema
B. Increased intracranial pressure
C. Meningeal irritation
D. Swelling of the spinal cord
Answer: B. Increased intracranial pressure
Question 35
A 42-year-old woman with a past medical history of migraine headaches is requesting
prophylactic medication treatment. Which medication should not be ...
A. Sumatriptan (Limitrex)
B. Amitriptyline (Elavil)
C. Verapamil (Verelan)
D. Metoprolol (Lopressor)
Answer: A. Sumatriptan (Limitrex)
Question 36
What diagnostic test is performed to diagnose acute lymphocytic leukemia (ALL)?
A. A complete blood count with differential
B. Magnetic resonance imaging
C. A nuclear bone scan
D. A bone marrow examination
Answer: D. A bone marrow examination
Question 37
Which of the following medications should NOT be prescribed during an acute gout flare?
A. Colchicine (Colcrys)
B. Allopurinol (Zyloprim)
C. Steroids
D. NSAIDs
Answer: B. Allopurinol (Zyloprim)
Question 38
A 42-year-old woman with a past medical history of migraine headaches is requesting
prophylactic medication treatment which medication is NOT be prescribed?
A. Sumatriptan (Imitrex)
B. Amitriptyline (Elavil)
C. Verapamil (Verelan)
D. Metoprolol (Lopressor)
Answer: A. Sumatriptan (Imitrex)
Rationale:
In most cases, preventative treatment must be taken daily for months to years. First-line agents
include β-adrenergic blocking medications (e.g., propranolol, atenolol), anti- depressants
(amitriptyline), and antiseizure medications (e.g., divalproex, valproic acid).
A medication is used to treat the acute symptoms of migraine headache. First-line agents include
aspirin and other NSAIDs (e.g., naproxen sodium, ibuprofen), combinations of acetaminophen,
acetylsalicylic acid, and caffeine; serotonin (5-HT1) receptor agonists (e.g., sumatriptan);
ergotamine derivatives (e.g., dihydroergot- amine); and antiemetic medications (e.g.,
ondansetron, metoclopramide). Non-oral routes of administration may be preferred in individuals
who develop severe pain rapidly or on awakening, or in those with severe nausea and vomiting.
Both sumatriptan and dihydroergota mine have been approved for intranasal administration. For
intractable migraine headache, dihydroergotamine may be administered parenterally with an
antiemetic or opioid analgesic.49 Frequent use of abortive headache medications may cause
rebound headache. Because of the risk of coronary vasospasm, the 5-HT1 receptor agonists
should not be given to persons with coronary artery disease. Ergotamine preparations can cause
uterine contractions and should not be given to pregnant women. They also can cause vasospasm
and should be used with caution in persons with peripheral arterial disease.
Question 39
A pediatric patient has areas of scaling on the scalp, with round patches alopecia. This clinical
finding is consistent with:
A. Tinea capitis
B. Seborrheic dermatitis
C. Trichotillomania
D. Alopecia areata
Answer: A. Tinea capitis
Question 40
What is the appropriate prophylactic medication for an 18-year-old woman with a past medical
history of migraine headache?
A. Sumatriptan (Imitrex)
B. Propranolol (Inderal)
C. Ibuprofen (Motrin)
D. Dihydroergotamine (DHE)
Answer: B. Propranolol (Inderal)
Question 41
Which of the following is the single dose treatment for a patient with diagnose chlamydia?
A. Doxycycline (Vibramycin) 200mg orally
B. Azithromycin (Zithromax) 1 gram orally
C. Metronidazole (Flagyl) 2 gram orally
D. Ceftriaxone (Rocephin) 250 mg intramuscular
Answer: B. Azithromycin (Zithromax) 1 gram orally
Question 42
The nurse practitioner prescribes deferoxamine (Desferal) for a pediatric patient with beta
thalassemia and hemosiderosis because the medication:
A. Prevent blood transfusion reactions
B. Stimulates red blood cell production
C. Improves the oxygen-carrying capacity of RBCs
D. Eliminates excessive iron and prevent organ damage.
Answer: D. Eliminates excessive iron and prevent organ damage.
Question 43
The combination of benzoyl peroxide and erythromycin is prescribed for acne because benzoyl
peroxide:
A. Improves the efficacy of erythromycin
B. Decreases the risk of desquamation
C. Decreases the risk of resistance to erythromycin
D. Increases the time patient can be exposed to sunlight.
Answer: C. Decreases the risk of resistance to erythromycin
Question 44
Which of the following conditions is NOT associated with the symptom of hemoptysis?
A. Pulmonary emboli
B. Chronic bronchitis
C. Viral pneumonia
D. Neoplasm of the lung
Answer: C. Viral pneumonia
Question 45
Rh-negative women should receive Rho (D) immune globulin at what gestational time?
A. 6 weeks
B. 12 weeks
C. 28 weeks
D. 35 weeks
Answer: C. 28 weeks
Question 46
Why would a combined hormonal contraceptive be contraindicated in a 36-yearold patient with a
past medical history of Type 2 diabetes, obesity, current smoking and sedentary lifestyle?
A. She is obese
B. She has type 2 diabetes mellitus
C. Her age and tobacco use
D. She leads a sedentary lifestyle.
Answer: C. Her age and tobacco use
Question 47
The nurse practitioner prescribes deferoxamine (Desferal) for a pediatric patient with beta
thalassemia and hemosiderosis because the medication:
A. Prevents blood transfusion reactions
B. Stimulates red blood cell production
C. Improves the oxygen-carrying capacity of RBCs
D. Eliminates excessive iron and prevents organ damage
Answer: D. Eliminates excessive iron and prevents organ damage
Question 48
During the breast examination of a perimenopausal woman. The NP detects a bloody
spontaneous discharge from the right nipple. This indicates further evaluation for:
A. Fibroadenoma (feel firm, smooth, rubbery or hard and has a well-defined shape. Usually
painless, it might feel like a marble in your breast, moving easily under your skin when
examined)
B. Polycystic breast disease (breasts feel lumpy. Fibrocystic breasts aren’t harmful or dangerous,
but may be bothersome or uncomfortable for some women)
C. An intraductal papilloma (a small, benign tumor that forms in a milk ductin the breast)
D. Pituitary prolactinoma (a noncancerous tumor (adenoma) of the pituitary glandin your brain
overproduces the hormone prolactin)
Answer: C. An intraductal papilloma (a small, benign tumor that forms in a milk ductin the
breast)
Question 49
A 26-year-old woman complains of acute right lower abdominal pain. Which of the following
conditions is NOT associated with this symptom?
A. Ectopic pregnancy
B. Pelvic inflammatory disease
C. Irritable bowel syndrome
D. Rupture ovarian follicle
Answer: C. Irritable bowel syndrome
Question 50
Which of the following is the single-dose treatment for a patient with diagnosis of Chlamydia?
A. Doxycycline (Vibramycin) 200 mg orally
B. Azithromycin (Zithromax) 1 gram orally
C. Metronidazole (Flagyl) 2 grams orally
D. Ceftriaxone (Rocephin) 250 mg intramuscular
Answer: B. Azithromycin (Zithromax) 1 gram orally
Question 51
What is the appropriate prophylactic medication for an 18-year-old woman with a past medical
history of migraine headache?
A. Sumatriptan (Imitrex)
B. Propranolol (Inderal)
C. Ibuprofen (Motrin)
D. Dihydroergotamine (DHE)
Answer: B. Propranolol (Inderal)
Question 52
The combination of benzoyl peroxide and erythromycin is prescribed for acne because benzoyl
peroxide:
A. Improve the efficacity of erythromycin
B. Decreases the risk of desquamation
C. Decreases the risk of resistance to erythromycin
D. Increases the time patient can be exposed to sunlight
Answer: A. Improve the efficacity of erythromycin
Question 55
During an abdominal examination, the nurse practitioner percusses the bulging area of the
abdomen. Which sound suggest the presence of ascitic fluid?
A. Tympany
B. Dullness
C. Hyperresonance
D. Normal resonance
Answer: B. Dullness
Question 56
What is the drug of choice for the pediatric patient diagnosed with scabies?
A. Clotrimazole (Lotrimin) lotion
B. Permethrin (Nix) cream
C. Lindane (Kwell)
D. Selenium sulfide (Selsun)
Answer: B. Permethrin (Nix) cream
Question 57
When interpreting a complete blood count (CBC) lab report which of the following results
describes the size of the RBC’s?
A. Hemoglobin [the protein molecule in red blood cells that carries oxygen from the lungs to the
body's tissues and returns carbon dioxide from the tissues back to the lungs]
B. Mean corpuscular volume (MCV) [An MCV blood test measures the average size of your red
blood cells, also known as erythrocytes]
C. Red cell distribution width (RDW) [a measurement of the range in the volume and size of
your red blood cells (erythrocytes)]
D. Hematocrit [the proportion, by volume, of the blood that consists of red blood cells]
Answer: B. Mean corpuscular volume (MCV) [An MCV blood test measures the average size of
your red blood cells, also known as erythrocytes]
Question 58
A patient with an acute presentation of acute aortic regurgitation (AR) typically presents with
sudden severe shortness of breath, lower extremity edema, a rapid heartbeat and:
A. Dry cough
B. Chest pain
C. Decrease blood pressure
D. Systolic murmur
Answer: B. Chest pain
Question 59
An 80-year-old man is being evaluated to recent episodes of incontinence and confusion. His
family states that he is usually independent with no altered mental issues but has become
forgetful within the last 2 weeks. Which medication is most likely associated with these
symptoms?
A. Cimetidine (Tagamet) [gynecomastia, headaches, diarrhea, dizziness, drowsiness]
B. Warfarin (Coumadin) [abdominal pain, bloating, nose bleeds, HA, GI bleed]
C. Ramipril (Altace) [headache, cough, malaise, drowsiness, stomach pain, vertigo]
D. Vitamin B12 [swelling, weight gain, diarrhea, itching, rash]
Answer: A. Cimetidine (Tagamet) [gynecomastia, headaches, diarrhea, dizziness, drowsiness]
Question 60
When assessing bilateral eye movement, the nurse practitioner is assessing which cranial nerve?
A. CN II, III, IV
B. CN III, IV, VI
C. CN II, IV, VI
D. CN III, IV, VII
Answer: B. CN III, IV, VI
Question 61
What medication should be avoided when prescribing prophylactic therapy for headache in a
patient with a past history of asthma and chronic migraines?
A. Verapamil
B. Propranolol
C. Venlafaxine
D. Nimodipine
Answer: B. Propranolol
Question 62
A nonpregnant woman diagnosed with trichomoniasis should be treated with:
A. Metronidazole (Flagyl)
B. Doxycycline (Vibramycin)
C. Clindamycin (Cleocin)
D. Clotrimazole (Lotrimin)
Answer: A. Metronidazole (Flagyl)
Question 63
A 17-year-old is diagnosed with mild bronchospasm. Which of the following would provide
relief?
A. Inhaled mometasone (Asmanex)
B. Inhaled levalbuterol (Xopenex)
C. Oral Montelukast (Singulair)
D. Oral dextromethorphan/ guaifenesin product
Answer: B. Inhaled levalbuterol (Xopenex)
Question 64
What is the mechanism of action for prostaglandin E1 (PG1) in a patient with transposition of the
great arteries?
A. To maintain equal pressure in the ventricles
B. To maintain patency of the great arteries
C. To produce vasodilation and adequate oxygen saturation
D. To prevent cyanotic episodes by trapping blood in the extremities.
Answer: C. To produce vasodilation and adequate oxygen saturation
Question 65
Which patient causes the greatest concern for complication related to scoliosis?
A. 13-year-old girl with a 10 degree curve
B. 17-year-old girl with a 10 degree curve
C. 12-year-old boy with a 5 degree curve
D. 18-year-old boy with a 5 degree curve
Answer: B. 17-year-old girl with a 10 degree curve
Question 67
Which of the following complaints best describes lower extremity calf pain associated with
peripheral artery disease?
A. A sharp, stabbing pain
B. A dull pain or cramp
C. An electric shock
D. A pulsating pain
Answer: B. A dull pain or cramp
Question 68
The immunization that protect against the contagious disease that cause fever, headache, stiff
neck, photophobia, and altered mental status is:
A. Meningococcal vaccine
B. Pneumococcal vaccine
C. Measles, mumps, and rubella (MMR) vaccine
D. Varicella vaccine
Answer: A. Meningococcal vaccine
Question 69
A 60-year-old man is experiencing prostatic pain when he states that the pain localized in which
location?
A. The suprapubic area
B. The back
C. The perineum
D. The glans penis
Answer: C. The perineum
Question 70
Which of the following is NOT a symptom of late-stage human immunodeficiency disease (HIV)
infection?
A. Night sweats
B. Lymphadenopathy
C. Persistent vomiting
D. Extreme unexplained fatigue
Answer: C. Persistent vomiting
Question 71
A 75-year-old man who recently lost his spouse of 50 year in an auto accident tells the nurse
practitioner that he “has no purpose in this life”. The next most appropriate question for the nurse
practitioner to ask is:
A. “Have you told your family how you feel?’
B. “Have you thought about hurting yourself?”
C. “Are you taking your medications?”
D. “Do have any friends?”
Answer: B. “Have you thought about hurting yourself?”
Question 72
Which of the following conditions is NOT a typical finding of hyperprolactinemia in a 47-yearold premenopausal woman?
A. Hirsutism
B. Gynecomastia
C. Oligomenorrhea
D. Acne
Answer: B. Gynecomastia
Question 73
When treating a patient with asthma who is experiencing acute wheezing which medication
should be given to relieve the symptom?
A. Short-acting bronchodilator
B. Long-acting bronchodilator
C. Inhaled corticosteroid
D. Combination of methylxanthine and long-acting bronchodilator
Answer: A. Short-acting bronchodilator
Question 74
Before the nurse practitioner prescribes metronidazole (Flagyl) for a patient with giardiasis, it is
important to inquire about:
A. The presence of an allergy to sulfa
B. A past medical history of peptic ulcer disease
C. Whether the patient is at least 18 years old
D. Whether the patient drinks alcohol
Answer: D. Whether the patient drinks alcohol
Question 75
The most common chief complaint of a woman diagnosed with trichomoniasis is:
A. A painless ulcerated vulval lesion with vaginal discharge.
B. Fever, papules, and vaginal discharge with burning
C. A vaginal discharge.
D. Dyspareunia and upper abdominal pain.
Answer: C. A vaginal discharge.
Question 76
Which structure in the eye is affected by cataract disease?
A. The retina
B. The cornea
C. The lens
D. The optic nerve
Answer: C. The lens
Question 77
Finding of a firm, nodular hypertrophic mass of scar tissue on the posterior surface of a pierced
ear lobe is documented as:
A. keloid
B. A tophi
C. A cutaneous cyst
D. Chondrodermatitis.
Answer: A. keloid
Question 78
Which medication is used as an anticoagulant reversal agent for dabigatran etexilate (Pradaxa)?
A. Idarucizumab (Praxbind)
B. Vitamin K
C. Protamine sulfate
D. Fondaparinux (Arixtra)
Answer: A. Idarucizumab (Praxbind)
Question 79
Which immunization reduces a patient’s risk for infection with the virus that causes painful,
localized, blistering rash?
A. Smallpox vaccine
B. Varicella vaccine (Chicken Pox)
C. Shingles (herpes zoster) vaccine
D. Meningococcal vaccine
Answer: C. Shingles (herpes zoster) vaccine
Question 80
A 34-year-old man presents with complaints of abdominal pain. The nurse practitioner suspects
hemorrhagic pancreatitis due to finding of superficial edema, bruising around the umbilicus, and
what other assessment finding?
A. A positive Gray Turner’s sign
B. A positive Cullen’s sign (Cullen's sign is superficial edema and bruising in the subcutaneous
fatty tissue around the umbilicus)
C. Kaposi’s sarcoma
D. Petechiae
Answer: B. A positive Cullen’s sign (Cullen's sign is superficial edema and bruising in the
subcutaneous fatty tissue around the umbilicus)
Question 81
A 24-year-old pregnant woman with a history of iron deficiency anemia should be educated that
she should take iron supplements
A. With milk to avoid stomach upset
B. With milk of magnesia at bedtime to avoid constipation
C. On an empty stomach between meals.
D. For 30 days to 6 weeks.
Answer: C. On an empty stomach between meals.
