APEA 3P Actual Exam Test Bank (APEA Question Bank)
(Mostly Resourceful)
APEA
1. When performing a visual acuity test the nurse practitioner notes 20/30 in the left eye and
20/40 in the right eye using the Snellen eye chart. This means:
a) have the patient returning in two weeks for a follow up vision screen
b) dilated the eye and retest
c) refer the patient to an ophthalmologist
d) document this as a normal finding
Answer: c) refer the patient to an ophthalmologist
2. The American psychiatric as so diagnostic and statistical manual of mental disorder defines
Munchausen Syndrome By Proxy
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
Rationale:
Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a
child, most often a mother, either makes up fake symptoms or causes real symptoms to make it
look like the child is sick.
3. Symptoms of depression are a side effect of which neurotransmitter medication?
a) dopamine serotonin, norepinephrine
b) gabapentin
c) mil
d) cortisol
Answer: a) dopamine serotonin, norepinephrine
4. Which lesion is dark raised and asymmetric with irregular border? Quizlet Bates Chapter 20
a) Nevus
b) Actinic keratosis
c) Keratoacanthoma
d) Melanoma
Answer: d) Melanoma
5. A 32 years old woman presents with dull puffiness of the ayes pronounced not pitting
periorbital edema this finding is suggestive of this condition? APEA
a) Nephrotic syndrome
b) Myxedema
c) Cushing syndrome
d) Sinusitis
Answer: b) Myxedema
Rationale:
Myxedema is a deposition of mucopolysaccarides in the dermis. Is commonly found if patients
with advanced hypothyroidism. The classic skin changes are: swelling of face, lips, eyelids, and
tongue or swelling and thickening of skin anywhere on the body, especially in the lower legs.
Myxedema is the hallmark of Grave’s disease, an autoimmune form of hyperthyroidism.
Myxedema can also occur in Hashimoto’s thyroiditis a form of hypothyroidism.
6. A 42 years old woman with a past medical history of migraine headaches is requesting
prophylactic medication treatment. Which medication should the Nurse practitioner prescribe?
a) Sumatriptan (Imitrex)
b) Amitriptyline (Elavil)
c) Verapamil (verelan)
d) Metoprolol (Lopressor)
Answer: b) Amitriptyline (Elavil)
Rationale:
Amitriptyline (Elavil) is a tricyclic antidepressant and is considered off label use for prophylactic
treatment of migraine. Sumatriptan (Imitrex) Is a Triptans used to abort migraine
7. A paediatric patient has areas of scaling on the scalp with round patches of alopecia This
clinical finding is consistent with:
a) Tinea capitis
b) Seborrheic dermatitis
c) Trichotillomania
d) Alopecia areata
Answer: a) Tinea capitis
8. What is the appropriate prophylactic medication for an 18 years old woman with a past
medical history of migraine headaches?
a) Sumatriptan (Imitrex)
b) Propranolol (Inderal)
c) Ibuprofen (Motrin)
d) Dihydroergotamine (DHE)
Answer: b) Propranolol (Inderal)
9. Why would a combined hormonal contraceptive be contraindicated in a 36 year old patient
with a past medical history of type 2 diabetes, obesity, chronic smoking and sedentary life
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
Rationale:
Combined oral contraceptive is contraindicated in women older than 45, breastfeeding, smoking,
HTN, diabetes or hx of stroke
10. During the breast examination of a perimenopausal woman the NP detects a bloody
spontaneous discharge from the right nipple. This indicates further evaluation.
a) Fibroadenoma
b) Polycystic breast disease Generalized breast pain or tenderness. Green or dark brown
nonblood nipple discharge that tends to leak without pressure or squeezing
c) An intraductal papilloma
d) Pituitary prolactinoma
Answer: c) An intraductal papilloma
Rationale:
Intraductal papilloma’s are usually solitary and smaller than 1 cm. They are located in large
lactiferous sinuses or ducts and have a tendency to bleed. Quizlet Nipple Discharge
11. Rh negative women should receive Rho (D) immunoglobulin at what gestational time?
a) 6 weeks
b) 12 weeks
c) 28 Weeks
d) 35 weeks
Answer: C) 28 Weeks
Rationale:
What happens is the client is Rh negative and has a negative antibody screen?
She will need repeat antibody screens and should receive Rho(D) immune globulin (RhoGAM)
at 28 weeks' gestation (Quizlet Antepartum Diagnostic Testing Saunders)
12. When interpreting a complete blood count (CBC) lab report which of the following results
describes the size of the RBCs?
a) Haemoglobin
b) Mean corpuscular volume (MCV)
c) Red cell distribution width (RDw)
d) Haematocrit
Answer: b) Mean corpuscular volume (MCV)
Rationale:
Th mean corpuscle (cell) volume (MCV) is a measurement of the average size of the RBCs.
Small-sized RBCs result in a lower MCV, while larger RBCs result in a higher MCV.
13. What medication should be avoided when prescribe prophylactic therapy for headache
a) Verapamil
b) Propranolol
c) Venlataxin (Effexor)
d) Nimodipine
Answer: c) Venlataxin (Effexor)
Rationale:
Serotonin Norepinephrine Reuptake inhibitor have the most serious side effect. Patients should
have drug free period for 3-4 weeks after every 6 months of treatment (pharmacology book page
1047)
14. What is the mechanism of action of 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 on
d) To prevent cyanotic episodes by trapping blood in the lower
Answer: c) To produce vasodilation on
15. Which of the following complaints best describes lower extremity calf pain associated with
peripheral artery disease
a) A sharp stabbing pains
b) A dull pain or cramp
c) An electric shock
d) A pulsating pain
Answer: b) A dull pain or cramp
Rationale:
Peripheral artery disease signs and symptoms include: Painful cramping in one or both of your
hips, thighs or calf muscles after certain activities, such as walking or climbing stairs
(claudication) Leg numbness or weakness. Coldness in your lower leg or foot, especially when
compared with the other side. (Mayoclinic)
16. Which of the following conditions is NOT a typical finding of hyperprolactinemia in 47year-old premenopausal woman?
a) Hirsutism
b) Gynecomastia
c) Oligomenorrhea
d) Acne
Answer: b) Gynecomastia
Rationale:
Hyperprolactinemia causes typical symptoms in premenopausal women and in men, but not in
postmenopausal women. Premenopausal women — Hyperprolactinemia in premenopausal
women causes hypogonadism, with symptoms that include infertility, oligomenorrhea, or
amenorrhea and less often galactorrhoea. (uptodate.com/clinical-manifestations)
17. 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
Rationale:
Short-Acting Beta Agonist (SABA) inhalers; used for acute asthma attacks; quickly reduce
airway constriction & restore normal airflow; agonists/stimulators of adrenergic receptors in SNS
(sympathomimetics); albuterol (Ventolin), levalburterol (Xopenex), pirbuterol (Maxair),
terbutaline (Brethine), metaproterenol (Alupent). (Quizlet Pharm Ch 37 Respiratory drugs)
18. 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
Rationale:
Shingles (herpes zoster) is an extremely painful skin rash caused by the varicella zoster virus, the
same virus that causes chickenpox. In people who have had chickenpox, the virus is never fully
cleared from the body; instead, it remains dormant in the nerve tissues. (medicinet.com/shingles)
19. Headache warning signs that need prompt investigation include all of the following
EXCEPT:
a) new onset after age 50
b) aggravated or relieved by change of position
c) precipitated by Valsalva maneuver
d) Headache relieved with mild infrequent use of analgesics
Answer: d) Headache relieved with mild infrequent use of analgesics
20. The client with iron deficiency anaemia should be advised to take the iron supplement
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 5 weeks
Answer: c) On an empty stomach between meals
Rationale:
Because iron is best absorbed on an empty stomach, patients should be advised to take the
supplement an hour before meals. Most patients can use the less expensive, more standard forms
of ferrous sulphate (Quizlet Haematology Cht 33)
21. Which one of the following statements is true of Munchausen syndrome by proxy?
a) The injury is self-inflicted as the patient is seeking attention from others
b) Under the supervision of adults other than the abuser, the patient does not exhibit symptoms
c) The caregiver is usually not involved in the abusive behavior
d) The abuser is often inattentive and uncaring towards the victim
Answer: b) Under the supervision of adults other than the abuser, the patient does not exhibit
symptoms
Rationale:
Munchausen syndrome by proxy (MSP) is a mental illness. It is also a form of child abuse. It
affects caregivers, especially caregivers of children. It is also known as factitious disorder by
proxy. Mothers of small children are most often affected by this condition. Fathers or other
caregivers can have it as well.
22. Which of the following is the most common presenting sign of substance abuse in
adolescents?
a) Poor school performance
b) change in sleep habits
c) increased blood pressure
d) changes in behavior
Answer: d) changes in behavior
23. A woman is 11 weeks pregnant and has a maternity history of one full term vaginal delivery,
a set of premature triplets delivered vaginally, and a first trimester abortion. Using her TPAL
system to document her maternal status
a) Gravida 4 para 1114
b) Gravida 4, para 1314 4 is the number of living children GTPAL
c). Gravida 3, para 1114
d) Gravida 3, para 1112
Answer: a) Gravida 4 para 1114
Rationale:
Gravida, Term babies, Preterm babies, Abort and Living child
24. The nurse practitioner palpates an enlarged right epitrochlear lymph node in a 30 years old
patient. The Nurse Practitioner should asses the patents
a) Throat, face, and right ear
b) Neck and supraclavicular region
c) Right forearm and hand
d) Right groin and abdomen
Answer: c) Right forearm and hand
Rationale:
Lower arm and hand for erythema and swelling
25. Anticholinergics are indicated for the treatment of
a) Asymptomatic bacteriuria
b) Renal insufficiency
c) Urge incontinence
d) Overflow incontinence
Answer: c) Urge incontinence
Rationale:
Anticholinergics are drugs that block the action of acetylcholine . Anticholinergics can treat a
variety of conditions, including: urinary incontinence , overactive bladder , COPD , They also
help block involuntary muscle movements associated with certain diseases such as Parkinson’s
disease .
26. A patient presents with signs of chest pain; the nurse practitioner observes jugular venous
distention. Their finding is consistent with
a) Hypertension
b) Heart failure
c) Asthma
d) Pneumonia
Answer: b) Heart failure
Rationale:
Heart failure causes decreased cardiac output when the heart fails as a pump and the circulation
becomes backed up and congested. Signs and symptoms: dyspnoea, orthopnoea, paroxysmal
nocturnal dyspnoea, decreased blood pressure, dependent, pitting edema; anxiety; confusion;
jugular vein distention; fatigue. The S3 may be the earliest sign of heart failure.(Study blue)
27. On examination of the neck, a dome shaped lesion in the dermis forming a benign closed
firm sac attached to the epidermis is noted on the right lateral side of the neck. The type of lesion
is known as
a) Keloid
b) Tophi
c) A cutaneous cyst
d) Chondrodermatitis
Answer: c) A cutaneous cyst
Rationale:
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. Usually either an Epidermoid cyst (common
on face/neck) or pilar (trichilemmal) cyst (common in the scalp). Both may become inflamed.
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28. Symptoms of heartburn and regurgitation are associated with:
a) Hiatal hernia
b) Gastroesophageal reflux
c) Peptic ulcer disease
d) Esophageal cancer
Answer: b) Gastroesophageal reflux
Rationale:
Classic GERD symptoms are: Heartburn, Regurgitation: bitter, acidic fluid in the mouth when
lying down or bending over
29. A 70 years old man walks 20 minutes most days of the week. He has begun to complain of
pain of his left calf when he is walking. The problem has gotten gradually worse and now he is
unable to complete his 20 minutes walks without stopping to rest. What choice best describes the
pain associated with peripheral artery disease?
a) A sharp, stabbing pain
b) A dull pain and cramp
c) An electric shock
d) A pulsating pain
Answer: b) A dull pain and cramp
Rationale:
Peripheral Artery disease signs and symptoms include: Painful cramping after certain activities,
such as walking or climbing stairs (claudication), Leg numbness or weakness, Coldness in leg or
foot, especially when compared with the other side, Sores on toes, feet or legs that won't heal, A
change in the color , Hair loss or slower hair growth, Shiny skin, No pulse or a weak pulse in
legs or feet
30. Papilledema is a cause for concern because it is suggestive of
a) Optic atrophy
b) Microaneurysms
c) Increased intracranial pressure
d) Retinal hemorrhage
Answer: c) Increased intracranial pressure
Rationale:
Papilledema is the swelling of the optic disc caused by increased intracranial pressure.
31. A 38-year-old patient with a history of abdominal pain presents to the nurse practitioner.
Findings reveal superficial edema and bruising in the subcutaneous fatty tissue around the
umbilicus. Haemorrhagic pancreatic is suspected because of which finding?
a) A positive Gray Turner’s sign
b) A positive Cullen’s sign
c) Kaposi’s sarcoma
d) Petechiae
Answer: b) A positive Cullen’s sign
32. A 57 years old post-menopausal female presents with a complaint of vaginal burning, pruritus
and painful intercourse. On examination, the nurse practitioner would be most concern with the
findings
a) A thin, pale, dry vaginal mucosa
b) Absence of rugae
c) A friable cervix
d) Raised yellowish cervical lesion
Answer: c) A friable cervix
Rationale:
The term "friable" refers to tissue that is easily irritated, which makes it more prone to
inflammation, bleeding, or tearing. Vaginal rugae disappear in those with an estrogen deficiency
and those women who are older. Nabothian cysts (also called epithelial cyst ) are common and
benign and are considered a normal feature of the adult cervix. They may be translucent or
opaque, whitish to yellow. Atrophic vaginitis is a vaginal disorder that usually happens after
menopause appearing as thin, pale and dry.
33. What intervention does the American College of Rheumatology recommend as first line
therapy for Osteoarthritis, rheumatoid arthritis or something else
a) Diagnostic workup to rule out rheumatic arthritis
b) NSAID use at lowest effective dose
c) Acetaminophen use up to 4 grams/day
d) Exercise and weight loss
Answer: d) Exercise and weight loss
Rationale:
Weight loss and exercise are useful in OA. Excess weight puts stress on knee joints and hips and
low back. For every 10 pounds of weight lost over 10 years, reduces the chance of developing
knee OA by up to 50 %. Exercise can improve muscle strength, decrease joint pain and stiffness,
and lower the chance of disability due to OA.
34. Which of the following drugs is not contraindicated for concurrent use with warfarin
(Coumadin)?
a) Amoxicillin (Amoxil)
b) Trimethoprim/sulfamethoxazole (Bactrim)
c) Ciprofloxacin (Cipro)
d) Clarithromycin (Biaxin)
Answer: a) Amoxicillin (Amoxil)
35. The lymphatic ducts drain into the (APEA)
a) arterial system
b) venous system
c) vertebral bodies of the spine
d) shoulder
Answer: b) venous system
36. Which of the following is the most appropriate treatment for trichomoniasis in a nonpregnant woman?
a) Metronidazole (flagyl)
b) Doxycycline (Vibramycin)
c) Clindamycin (Cleocin)
d) Clotrimazole (lotrimin)
Answer: a) Metronidazole (flagyl)
37. Osteosarcoma in a paediatric patient is most often diagnosed when there is:
a) Pain in the affected bone
b) Pathologic fracture
c) Repeat fracture
d) Apophyseal avulsion
Answer: a) Pain in the affected bone
Rationale:
Osteosarcoma is the most common type of bone cancer in children and teens. Bone pain and
tenderness the most common symptom. It arises most often in the wide ends of long bones, such
as the femur and tibia in the upper and lower leg, and the humerus in the upper arm.
38. In a patient who has a history of migraine headaches, which characteristics is most common?
a) Focal deficits
b) Family history
c) Weakness
d) Initial onset after age 35
Answer: b) Family history
39. Symptoms associated with small bowel obstruction usually include:
a) Nausea and diarrhoea
b) Vomiting and pain
c) Hematemesis and bloody stool
d) Indigestion and anorexia
Answer: b) Vomiting and pain
Rationale:
Symptoms of a small bowel obstruction include vomiting from vagal nerve stimulation, pain
from bowel wall distention, and abdominal distension from accumulation of chyme or ascites.
(Quizlet Patho GI System)
40. Unilateral rhinitis could be caused by all of the following except
a) A foreign body in the nasal canal
b) A nasal polyp
c) Drug induced rhinitis
d) A deviated sputum
Answer: c) Drug induced rhinitis
41. A 7 years old child has been diagnosed with acute sinusitis. The drug class that should be
avoided is:
a) Antihistamines
b) Expectorants
c) Decongestants
d) Nasal steroids
Answer: a) Antihistamines
42. A patient present with an elongated head with bony prominence of the forehead, nose and
lower jaw. These facial features could be suggestive of:
a) Nephrotic syndrome
b) Acromegaly
c) Cushing’s syndrome
d) Parkinson’s disease
Answer: b) Acromegaly
Rationale:
Increased growth hormone produces enlargement of bone and soft tissues. Head elongated with
bony prominence of forehead nose, and lower jaw. Soft tissues enlarge. Coarsened features.
(Quizlet HEENT Abnormality Tables)
43. Why would a child diagnosed with beta thalassemia and hemosiderosis receive deferoxamine
(desferal)?
a) To prevent blood transfusion reactions
b) To simulate red blood cell production
c) To improve the oxygen carrying capacity of RBCs
d) To eliminate excessive iron and prevent organ damage
Answer: d) To eliminate excessive iron and prevent organ damage
Rationale:
given SQ by pump overnight to prevent free iron released with RBC destruction from building
up in tissues; binds the free iron so it doesn't do damage in tissues (Quizlet Haematology and
Oncology Unit 6)
44. A patient has newly diagnosed hypothyroidism. What are the patients TSH level expected to
be?
a) Higher than normal
b) Lower than normal
c) Within normal range
d) TSH is not used to diagnose hypothyroidism
Answer: a) Higher than normal
Rationale:
Suggest that the provider lower the dose.
45. Which of the following symptoms would be a clinical manifestation noted during the
secondary stage of syphilis?
a) Absence of symptoms
b) Single painless lesion, chancre on the genital area.
c) Rash marked by red or reddish-brown, penny-sized lesions over the palms and soles
d) Poor muscle coordination
Answer: c) Rash marked by red or reddish-brown, penny-sized lesions over the palms and soles
Rationale:
Other symptoms of secondary syphilis include: sore throat. fever. swollen lymph glands.
headaches. fatigue. muscle aches. wart-like patches around skin folds or genitals.
46. An 84-year-old male with prostatic hypertrophy is at increased risk of:
a) Constipation
b) Fecal incontinence
c) Urinary tract infections
d) Prostate cancer
Answer: c) Urinary tract infections
Rationale:
BPH increases the risk of: Acute urinary retention , UTI and Sepsis.
47. A characteristic lesion observed in a male with primary syphilis is a:
a) Group of small scattered vesicles
b) Chancre
c) Papule of many shapes
d) Non-tender penile indurated nodule
Answer: b) Chancre
Rationale:
Primary syphilis typically presents as a solitary, painless chancre, whereas secondary syphilis can
have a wide variety of symptoms, especially fever, lymphadenopathy, rash, and genital or
perineal condyloma latum.
48. During an acute attack of gout, the nurse practitioner knows NOT to prescribe
a) Colchicine (Colcrys)
b) Allopurinol (Zyloprim)
c) Steroids
d) NSAIDS
Answer: b) Allopurinol (Zyloprim)
Rationale:
Colchicine has two distinct applications in gout. First, it can be used to treat an acute gouty
attack. Second, it can help prevent attacks in chronic gout
49. What two vitamins and minerals should be included in oral multivitamins in women
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
50. In a patient with bacterial meningitis, the most common reason for finding of headaches:
a) Meningeal erythema
b) Increased intracranial pressure
c) Meningeal irritation
d) Swelling of the spinal cord
Answer: b) Increased intracranial pressure
51. Janeway lesions, petechiae and Oster nodes are associated with:
a) Gonococcemia
b) Infective endocarditis
c) Hyperthyroidism
d) Peripheral vascular disease
Answer: b) Infective endocarditis
52. A patient present with decreased hearing related to antibiotic use. Which class of antibiotics
is this?
a) Aminoglycosides
b) Beta-lactams
c) Cephalosporins
d) Macrolides
Answer: a) Aminoglycosides
Rationale:
Aminoglycosides antibiotics, vancomycin and aspirin are some medication that can cause
hearing loss.
53. Which antihypertensive would be appropriate to prescribe for a hypertensive patient (B/P
150/95) that is in her third trimester?
a) Candesartan
b) Lisinopril
c) Methyldopa
d) Furosemide
Answer: c) Methyldopa
Rationale:
Oral methyldopa has been assigned to pregnancy category B. Methyldopa is a drug of first
choice for control of mild to moderate hypertension in pregnancy and is the most widely
prescribed antihypertensive
54. A 40-year-old admits to multiple sex partners presents with several lesions over his body.
Finding reveals haemorrhagic vesiculopustular lesions over the hands and feet. These lesions are
most likely associated with:
a) Gonococcemia
b) Infective endocarditis
c) Hyperthyroidism
d) Peripheral vascular disease
Answer: a) Gonococcemia
55. Which agent is NOT useful in prophylactic treatment of migraine headaches?
a) Sumatriptan (Imitrex)
b) Amitriptyline (elavil)
c) Verapamil (verelant)
d) Metropolol (lopresor)
Answer: a) Sumatriptan (Imitrex)
Rationale:
Sumatriptan is used to treat migraines (not to prevent it). It helps to relieve headache, pain, and
other migraine symptoms (including nausea, vomiting, sensitivity to light/sound).
56. The right lymph duct drains lymphatic fluid from all the following expect the (APEA)
a) Right side of the heard
b) Right upper thorax
c) Right arm
d) Right leg
Answer: d) Right leg
57. Acute lymphocytic leukemia is usually diagnosed by:
a) A completed blood count
b) Magnetic resonance imaging
c) A nuclear bone scans
d) A bone marrow examination
Answer: d) A bone marrow examination
58. The medication that blocks the transportation of glucose across the intestines into the blood
stream to target prandial blood glucose is:
a) Metformin (Glucophage XR)
b) Acarbose (Precose)
c) Rosiglitazone (Avandia)
d) Glipizide (Glucotrol XL)
Answer: b) Acarbose (Precose)
Rationale:
Acarbose inhibits enzymes (glycoside hydrolases) needed to digest carbohydrates, specifically,
alpha-glucosidase enzymes in the brush border of the small intestines, and pancreatic alphaamylase.
59. Prostate pain is usually located in the:
a) Supra pubic area
b) Back
c) Perineum
d) In the glans penis
Answer: c) Perineum
Rationale:
Prostate pain is usually lo acted in the lower abdomen, back, or groin
60. A nurse practitioner examines the skin of an elderly patient which finding below is NOT
benign lesion associated with the aging process?
a) Xerosis
b) Cherry angiomas and senile purpura
c) Senile keratosis and senile lentigines
d) Dermatophytosis
Answer: d) Dermatophytosis
Rationale:
Dermatophytosis, also known as ringworm, is a fungal infection of the skin. Typically it results
in a red, itchy, scaly, circular rash.
61. A 65-year-old male presents with findings of symmetric thorax with moderate kyphosis and
anterior diameter. Chest expansion is decreased and the diaphragm descending 2 cm bilaterally.
These findings relate to:
a) Pneumothorax
b) Plural effusion
c) A fractured rib
d) Chronic obstructive pulmonary disease
Answer: d) Chronic obstructive pulmonary disease
62. Phenazopyridine (Pyridium) is recommended for very short-term use in patients with urinary
tract infections (UTIs) because:
a) Possible resistance
b) Occurrence of hemolytic anaemia
c) Gastritis
d) Cost
Answer: b) Occurrence of haemolytic anaemia
Rationale:
Headache, rash, pruritus and occasional gastrointestinal disturbance. An anaphylactoid-like
reaction has been described. Methemoglobinemia, haemolytic anaemia , renal and hepatic
toxicity have been reported, usually at overdosage levels
63. Estrogen-progestin contraceptives should be avoided in women with:
a) Tension headaches
b) Migraines with aura
c) Unilateral headaches
d) Cluster headaches
Answer: b) Migraines with aura
Rationale:
Combine contraceptives is a good choice for patients childbearing age younger than 35 with NO
aura migraine (hollier video part 1)
64. The addition of benzoyl peroxide to erythromycin for the topical treatment of acne:
a) Improve the efficacy of erythromycin
b) Decrease 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 efficacy of erythromycin
65. An elderly male with benign prostate hyperplasia (BPH) should be advised to avoid
antihistamines. What is the reason for this?
a) Urinary incontinence
b) Constipation
c) Orthostatic hypotension
d) Urinary retention
Answer: d) Urinary retention
66. Examination of the hair reveals a fine silky appearance. This finding may be seen in patients
that have:
a) Hypothyroidism
b) Hyperthyroidism
c) Type 2 diabetes
d) Celiac disease
Answer: b) Hyperthyroidism
67. A patient develops a cough secondary to an angiotensin-converting-enzyme (ACE). The most
appropriate statement related to ACE-I cough is that the cough typically:
a) Resolves within a week after stopping the ACE inhibitor
b) Resolves with splitting the daily dose to twice daily dosing
c) Occurs with an angiotensin- II receptor blocker (ARB)
d) Affects men more than women
Answer: a) Resolves within a week after stopping the ACE inhibitor
Rationale:
A dry hacking cough usually begins 1-2 weeks of starting ACE, but may occur up to 6 months
later. Typically resolves 1-4 days of discontinuation of therapy, buy may linger up to 4 weeks
68. A patient with a diagnosis of giardiasis is being treated with metronidazole (flagyl). What
information would be important to obtain before prescribing this medication?
a) If the patient allergic to sulfa
b) If the patient has peptic ulcer disease
c) If the patient is at least 18 year of age
d) If the patient drinks alcohol
Answer: d) If the patient drinks alcohol
69. A 20 years old male living in the college dorm, complains of a dry cough for the past month.
Assessment finding associated with an atypical, community acquired pneumonia would include:
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 1010 F, sore throat, and diminished breath sounds on auscultation
d) Temperature of 1020 F, dyspnea, and diminished lung sounds on auscultation
Answer: a) A low-grade fever, malaise, and clear lung fields on auscultation
70. The most appropriate medication indicated for reversing the anticoagulated effects of
dabigatran etexilate (Pradaxa)
a) Idarucizumab (Praxbind)
b) Vitamin K
c) Protamine sulfate
d) Fondaparinux (Arixtra)
Answer: a) Idarucizumab (Praxbind)
71. A common pathological finding in patient with asthma
a) Necrosis of small airway
b) Absence of goblet cells
c) Absence of ciliary regeneration
d) Hypertrophy of smooth muscle
Answer: d) Hypertrophy of smooth muscle
72. Which cranial nerves are responsible for eye movement?
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
Rationale:
oculomotor (III) nerve, trochlear (IV) nerve and the abducen (VI) nerve.
73. The typical presentation of severe acute aortic regurgitation (AR) includes sudden severe
shortness of breath rapidly developing heart failure, and:
a) Dry cough
b) Chest pain
c) Decreased blood pressure
d) Systolic murmur
Answer: c) Decreased blood pressure
74. Disorders in the kidneys and the ureters may cause pain in all of the following areas except
the:
a) Flank
b) Abdomen
c) Back
d) Suprapubic
Answer: d) Suprapubic
Rationale:
Renal and urethral pain is usually located in the flank area, abdomen or groin.
75. When palpating the prostate gland during the rectal exam, the prostate feels tender, swollen,
boggy and warm. This finding 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
Rationale:
A boggy prostate describes a gland that is edematous and tender such as in patients with bacterial
prostatitis.
76. This contagious disease causes fever, headache, stiff neck, photophobia, nausea, vomiting,
and altered mental status. What immunization prevents this?
a) Meningococcal vaccine
b) Pneumococcal vaccine
c) Measles, Mumps, and Rubella (MMR) vaccine
d) Varicella vaccine
Answer: a) Meningococcal vaccine
77. Headache warning signs that need prompt investigation include all of the following
a) New onset after 50
b) Aggravated or relieved by change or position
c) Precipitated by Valsalva maneuver
d) Headaches relieved with mild recurrent use of analgesics
Answer: a) New onset after 50
b) Aggravated or relieved by change or position
c) Precipitated by Valsalva maneuver
78. Serotonin Syndrome is a potentially life-threatening condition associated with:
a) Depression
b) Anxiety
c) Increased levels of serotonin
d) Chlylothorax
Answer: c) Increased levels of serotonin
79. Which one of the following statements about treating scabies with lindane (Kewell) is
correct? Know that Nix is the treatment.
a) Lindane is safe to use in pregnant women, babies, children, and the elderly
b) Lindane lotion and/or shampoo in not considered first-line therapy
c) Repeated applications of lindane can be used if there has been a twelve-hour interval
d) Lindane can be used in patient with a history of seizures.
Answer: b) Lindane lotion and/or shampoo in not considered first-line therapy
Rationale:
Lindane is used to treat lice and scabies, but it may cause serious side effects. Safer medications
are available to treat these conditions. You should only use lindane if there is some reason you
cannot use the other medications
80. Symptoms consistent with later stage human deficiency disease (HIV) typically include all of
the following except,
a) Night sweats
b) Lymphadenopathy for more than 3 months
c) Persistent vomiting
d) Persistent, unexplained fatigue
Answer: c) Persistent vomiting
Rationale:
This is the late stage of HIV infection: symptoms include: Rapid weight loss, Recurring fever or
profuse night sweats, Extreme and unexplained tiredness, Prolonged swelling of the lymph
glands in the armpits, groin, or neck, Diarrhea that lasts for more than a week, Sores of the
mouth, anus, or genitals, Pneumonia, Red, brown, pink, or purplish blotches on or under the skin
or inside the mouth, nose, or eyelids, Memory loss, depression, and other neurologic disorders
81. The earliest clinical manifestation of diabetic nephropathy is:
a) An elevation in blood urea nitrogen (BUN)
b) An elevation in blood urea nitrogen (BUN) and creatinine (CR)
c) A decreased glomerular filtration rate
d) Microalbuminuria
Answer: d) Microalbuminuria
82. When fluid accumulates between the visceral and parietal pleural spaces, the term used is:
a) Pericardial effusion
b) Pleural effusion
c) Pleural empyema
Answer: b) Pleural effusion
83. Children born with down syndrome often have other anomalies. They especially require
evaluation of what body system?
a) Orthopedic
b) Gastrointestinal
c) Cardiac
d) Endocrine
Answer: c) Cardiac
84. What finding is typical in a patient with a meniscal tear? (APEA)
a) Positive McMurray’s test
b) Positive anterior drawer test
c) Audible click at the join line
d) Fixed patellar subluxation
Answer: a) Positive McMurray’s test
85. The nurse practitioner diagnoses a female patient with trichomoniasis. A common chief
complaint of a patient whit trichomoniasis is:
a) Painless, ulcerated vulvar lesion with vaginal discharged
b) Fever, papules, and vaginal discharged with burning
c)Vaginal discharge
d) Dyspareunia and upper abdominal pain
Answer: c)Vaginal discharge
86. When deciding on an initial treatment option for an acute flare of atopic dermatitis,
unresponsive to emollient therapy, the next best choice for treatment is:
a) Oral corticosteroids (prednisone)
b) Betamethasone dipropionate 0.05% (betanate)
c) Desonide 0.5%
d) Pimecrolimus 1% cream (Elidel)
Answer: c) Desonide 0.5%
87. When examining the breast, the “tail of Spence” would be located
a) In the upper inner quadrant
b) In the lower inner quadrant
c) In the lower outer quadrant
d) Laterally across the anterior axillary fold
Answer: d) Laterally across the anterior axillary fold
88. Headaches with symptoms of nausea and vomiting may be associated with all of the
following, EXCEPT:
a) Migraine headache
b) Brain tumors
c) Subarachnoid hemorrhage
d) Tension headache
Answer: d) Tension headache
89. Which of the following finding could indicate a need for further evaluation of the cardiac
patient?
a) Hematocrit 42%
b) Potassium 4.2 mg/dl
c) Sodium 140 mEq/dl
d) Low density lipoprotein of 190 mg/dl
Answer: d) Low density lipoprotein of 190 mg/dl
90. Alpha-adrenergic blocker increases urine outflow in males by:
a) Improving detrusor muscle stability
b) Shrinking the prostate gland
c) Relaxing prostate smooth muscle
d) Dilating the urethral vasculature
Answer: c) Relaxing prostate smooth muscle
91. The scoliosis patient who would cause the greatest concern for the nurse practitioner is a:
a) 13 y/o female with a 1000 curve
b) 17 y/o female with a 100 curve
c) 12 y/o female with a 50 curve
d) 18 y/o female with a 50 curve
Answer: a) 13 y/o female with a 1000 curve
92. Which finding bellow would be unusual in a patient with diabetic retinopathy?
a) Papilledema
b) Dot and blot hemorrhages
c) Microaneurysms
d) Cotton wool spots
Answer: a) Papilledema
93. Where should the uterine fundus be palpable at 12 weeks?
a) At the level of the umbilicus
b) At the level of the symphysis pubis
c) Midway between the symphysis and umbilicus
d) Bellow the symphysis pubis
Answer: b) At the level of the symphysis pubis
94. Ophthalmoscopic examination of a 40 years old carpenter reveals a triangular thickening of
the bulbar conjunctiva across the outer surface of the cornea. This condition is termed:
a) Corneal arcus
b) Corneal scar
c) Pterygium
d) Cataract
Answer: c) Pterygium
Rationale:
A pterygium is a growth of the conjunctiva (triangular thickening) that covers the cornea.
95. A patient calls the nurse practitioner, and states that he missed his morning daily dose of
warfarin, 5 mg yesterday and today. The nurse practitioner instructs the patient to:
a) Wait until tomorrow and resume daily dosing of warfarin 5 mg.
b) Take warfarin 10 mg now
c) Take warfarin 5 mg now, warfarin 5 mg at 5 pm, today and resume the daily warfarin 5 mg
dose in the morning as schedule
d) take warfarin 5 mg now and resume the warfarin 5 mg daily dose in the morning as schedule.
Answer: d) take warfarin 5 mg now and resume the warfarin 5 mg daily dose in the morning as
schedule.
96. What common clinical finding is present in a patient who has croup?
a) Barking cough
b) Sudden onset of symptoms
c) Nighttime symptoms
d) Shortness of breath
Answer: a) Barking cough
97. A type of breast cancer that begins with erythema and swelling of the breast and progresses
rapidly is termed:
a) Paget’s disease
b) Invasive ductal carcinoma
c) Inflammatory breast cancer
d) Invasive locular carcinoma
Answer: c) Inflammatory breast cancer
98. Salmeterol (servant) in combination with an inhaled steroid is prescribed for a patient with
moderate persistent asthma. What is the most important teaching point about salmeterol?
a) It is not effective during an acute asthma attack
b) It may take 2 to 3 weeks to begin working
c) The drug works within 10 minutes
d) The drug may be used bay patients 6 years older.
Answer: a) It is not effective during an acute asthma attack
99. A 50 years old male has a non-tender, enlarged scrotum. The nurse practitioner suspects
which of the following conditions:
a) Orchitis
b) Epididymitis
c) Hydrocele
d) Prostatitis
Answer: c) Hydrocele
Rationale:
Hydrocele is produced by fluid in the sac which normally surrounds the testicle. It often presents
as painless swelling in the scrotum
100. Risk factors associated with breast cancer include all of the following except:
a) Personal family history of breast cancer
b) Use of hormone replacement therapy
c) Post-menopausal obesity
d) Low socioeconomic status.
Answer: d) Low socioeconomic status.
101. A patient who has a sulpha allergy can safely take:
a) A sumatriptan (Imitrex)
b) Celecoxib (Celebrex)
c) Glimepiride (amaryl)
d) Silver sulfadiazine (Silvadene)
Answer: c) Glimepiride (amaryl)
102. Which group of lymph nodes are locating on the medial surface of the arm approximately 3
cm above the elbow?
a) Lateral axillary nodes
b) Infraclavicular nodes
c) Epitrochlear nodes
d) Submental nodes
Answer: c) Epitrochlear nodes
Rationale:
The epitrochlear lymph nodes, also known as the cubital or supraepitrochlear lymph nodes, are
part of the superficial lymphatic system of the upper limb. The epitrochlear nodes are in the
subcutaneous connective tissue on the medial aspect of the elbow, about 4–5 cm above the
humeral epitrochlear.
103. An elderly patient has been diagnosed with a cataract. What structure in the eye has become
diseased?
a) Retina
b) Cornea
c) Lens
d) Optic nerve
Answer: c) Lens
Rationale:
A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to
aging.
104. A patient presents with pain in the shoulder. The nurse practitioner knows that there are four
rotator cuff muscles. The muscle that initiates abduction movement at the shoulder is known as
the:
a) Supraspinatus
b) Infraspinatus
c) Levator scapulae muscle
d) Subscapularis
Answer: a) Supraspinatus
Rationale:
Muscles: supraspinatus (initiates abduction - first 15 degrees), deltoid (up to 90 degrees),
trapezius and serratus anterior (scapular rotation, for abduction beyond 90 degrees). The deltoid
muscle abducts the arm, but at 90 degrees the humerus bumps into the acromion.
105. A patient with bulimia is likely to be:
a) Very overweight
b) Very underweight
c) Of average weight
d) Not concerned with weigh
Answer: c) Of average weight
106. Chronic bloody diarrhoea could be suggestive of:
a) Irritable bowel syndrome
b) Crohn’s disease
c) Hepatitis A
d) Celiac disease
Answer: b) Crohn’s disease
107. On examination a patient is noted to have a “mask-like” face with decreased blinking and a
characteristic stare. These features may be characteristic of:
a) Nephrotic syndrome
b) Myxedema
c) Cushing’s syndrome
d) Parkinson disease
Answer: d) Parkinson disease
108. An appropriate initial treatment for benign positional vertigo is: (APEA)
a) Hydrochlorothiazide
b)Meclizine (Antivert)
c) pseudoephedrine (Sudafed)
d) promethazine (Phenergan)
Answer: b)Meclizine (Antivert)
109. Conductive and sensorineural phases are necessary for hearing to take place. The
sensorineural phase of hearing pathways involves the:
a) cochlea and the cochlear nerve
b) external ear canal and the middle ear
c) ossicles and the inner ear
d) transfer of sounds from the external environment into de external auditory canal.
Answer: a) cochlea and the cochlear nerve
Rationale:
Involve the cochlea and the cochlear nerve
110. A 65 years old has a history of one kidney with early renal insufficiency. He is diagnosed
with pneumonia and will require:
a) Shorter course of antibiotics
b) Longer course of antibiotics
c) Lower dose of antibiotics
d) A higher dose of antibiotic
Answer: c) Lower dose of antibiotics
111. A 44 years old male presents to the nurse practitioner for an employment physical and is
concerned about testing positive for amphetamines on a drug screen, even though he is not taking
amphetamines. His current medication list includes metformin, lisinopril, glyburide and
bupropion. The most likely medication cause for a false positive result for amphetamines would
be:
a) Metformin
b) Lisinopril
c) Glyburide
d) Bupropion
Answer: d) Bupropion
Rationale:
Bupropion is a commonly prescribed, monocyclic antidepressant often used as an aid for
smoking cessation. Several case reports have described false positive amphetamine urine drug
screens (UDS) associated with bupropion
112. Desmopressin acetate (DDAVP) nasal spray has been found to be useful in the management
of enuresis in children. In which of the following situations is the drug especially beneficial?
a) Daytime incontinence
b) Hypertensive children with enuresis
c) Secondary enuresis
d) Sleepovers
Answer: d) Sleepovers
Rationale:
DDAVP Nasal Spray is indicated for the management of primary nocturnal enuresis. It may be
used alone or adjunctive to behavioral conditioning or other nonpharmacological intervention
113. Rapid Human Immunodeficiency virus (HIV) testing would be appropriate for a patient
with complains of
a) painful bower movement, anal itching, and painful or swollen testicles or abnormal menstrual
bleeding.
b) Painful urination, dyspareunia, and vaginal or penile discharge
c) Fever, headache, and lymphadenopathy
Answer: b) Painful urination, dyspareunia, and vaginal or penile discharge
Rationale:
Indicative for patients presenting symptoms of acute HIV infection such as rash, fever, headache,
sore throat.
114. which of the following condition is NOT associated with the symptoms of haemoptysis?
a) Pulmonary emboli
b) Chronic bronchitis
c) Viral pneumonia
d) Neoplasm of the lung
Answer: c) Viral pneumonia
115. which condition is associated with end-stage renal disease in paediatric patients and requires
recombinant erythropoietin treatment?
a) Osteodystrophy
b) Hyperkalaemia
c) Hypertension
d) Anaemia
Answer: d) Anaemia
116. when evaluating a 17 y/o girl with infrequent menstrual periods, which findings suggest
probable hyperandronism?
a) High pitch voice
b) Hirsutism
c) Polycystic ovaries
d) Obesity
Answer: b) Hirsutism
117. which form of urinary incontinence is present in a patient with Alzheimer’s disease who is
unable to reach the toilet in time? (APEA)
a) Functional incontinence
b) Overflow incontinence
c) Urge incontinence
d) Stress incontinence
Answer: a) Functional incontinence
Rationale:
Possible causes of functional incontinence include: poor vision, psychological issues,
environmental barriers to using the restroom, cognitive issues, including forms of dementia,
delirium , and intellectual disabilities, neurological or muscular limitations, such as arthritis
118. A 27y/o male patient presents with a painless chancre on the shaft of his penis and regional
lymphadenopathy. He is diagnosed with primary syphilis. The best initial treatment is:
a) Ceftriaxone (Rocephin)
b) Clindamycin (cleocin)
c) Metronidazole (flagyl)
d) Benzathine penicillin G (Bicillin L.A)
Answer: d) Benzathine penicillin G (Bicillin L.A)
119. An 80 y/o man is being evaluated for 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 their
symptoms ?
a) Cimetidine (Tagamet)
b) Warfarin (coumadin)
c) Ramipril (altace)
d) Vitamin b12
Answer: a) Cimetidine (tagamet)
120. When ordering an oral diabetes medication for a 72 y/o patient with a recent hx of
decreased appetite and ongoing risk of hypoglycaemia. The NP should Rx.
a) Tolbutamide (orinase)
b) Glipizide (Glucotol XL)
c) Metformin (Glucophage)
d) Chlorpropamide (diabinese)
Answer: c) Metformin (Glucophage)
121. to increases urine outflow in men with BPH, the NP should prescribe
a) An alpha blocker
b) An alpha agonist
c) A calcium channel blocker
d) A diuretic
Answer: a) An alpha blocker
122. A 64 y/o man c/o leg pain and occasional numbness that worsens with ambulation and
improves with lumbar flexion. The symptoms are consistent with:
a) Ankylosing spondylitis
b) Spinal stenosis
c) Bursitis
d) Cauda equina syndrome
Answer: b) Spinal stenosis
Rationale:
Spinal stenosis or pseudo claudication refer to pain in the back or legs when the patient walks but
improves with rest, lumbar flexion or both.
123. which is a true statement about varicose veins?
a) They are due to congenital valve deformities
b) They are usually dx on clinical presentation
c) They are not affected by pregnancy
d) They are more symptomatic during ovulation
Answer: d) They are more symptomatic during ovulation
Rationale:
Varicose veins are most often diagnosed with a physical exam, including examining your legs
while you are standing. A weakened valve allows backflow of blood to the previous valve in a
vein
124. A 17 y/o is dx. With mild bronchospasm. Which of the following would provide relief?
a) Inhaled mometasone ( Asmanex)
b) Inhaled levalbuterol (Xopenex)
c) Oral mentelukast (Singulair)
d) Oral dextromethorphan/guaifenesin product
Answer: b) Inhaled levalbuterol (Xopenex)
125. A common cause of decrease libido in men is due to?
a) Decrease blood flow in the hypogastric arterial system
b) Endocrine dysfunction
c) Neurologic deficit
d) Impaired neural innervation
Answer: b) Endocrine dysfunction
126. what should be included in the initial tx of bacterial epididymitis in a sexually active 22 y/0
male?
a) Doxycycline and ceftriaxone
b) Ceftriaxone and metronidazole
c) Ciprofloxacin and fluconazole
d) Levofloxacin and cephalexin
Answer: a) Doxycycline and ceftriaxone
Rationale:
In young men the usual cause is a sexually transmitted microorganism
127. which assessment findings are NOT associated with pyloric stenosis in a 2 month old
infant?
a) Projectile vomiting
b) Severe dehydration as demonstrated by sunken eyeballs and depressed anterior fontanelle
c) A bloated and tense tympanic abdomen
d) A palpable mass the size and shape of an olive, located in the right upper quadrant of the
abdomen
Answer: c) A bloated and tense tympanic abdomen
128. hyperkalaemia is associated with
a) Increase BP
b) Alpha-blockers
c) Diminished renal function
d) Loop diuretics
Answer: c) Diminished renal function
Rationale:
chronic renal failure, hypoaldosteronism, and massive tissue breakdown as in rhabdomyolysis,
are typical conditions leading to hyperkalaemia.
129. the assessment of a 72 y/o male causes the NP to have concerns that the pt. is a suicide risk.
Risk factors for suicide in the elderly do NOT include
a) Chronic pain
b) Comorbid physical illness
c) Family hx of suicide
d) Retirement
Answer: d) Retirement
130. A pregnant pt presents for a routine 16 week prenatal visit. Her BP has decreased from
119/78 mm/Hg at her 12 week visit to 110/69 mmHg. What hemodynamic for the decrease BP?
a) Decrease preload
b) Decrease in stroke volume
c) Decrease cardiac output
d) Decrease in systemic vascular resistance
Answer: d) Decrease in systemic vascular resistance
Rationale:
The increase cardiac output and slight decrease in DP during pregnancy is associated with a
marked reduction in systemic vascular resistance
131. the most common treatment for Helicobacter pylori is a triple therapy, interpreted as:
a) 2 antibiotics and proton pump inhibitor for 7-14 days
b) 3 different antibiotics for 7-20 days
c) 3 rounds of the same antibiotic over 3 weeks
d) 2 proton pump inhibitors and 1 antibiotic for 7-14 days
Answer: a) 2 antibiotics and proton pump inhibitor for 7-14 days
132. Patients with psoriasis frequently have
a) Pruritus, positive auspitz sign, and pitted nails
b) Pruritus, pitted nails and satellite lesions
c) Pitted nails and plaques
d) Dermatomal rash and satellite lesions
Answer: c) Pitted nails and plaques
133. which condition is best treated using alpha adrenergic antagonist?
a) Functional incontinence
b) Renal insufficiency
c) Urge incontinence
d) Overflow incontinence
Answer: d) Overflow incontinence
134. A patient who is taking an oral glococorticosteroid should be advice to
a) Crush it in applesauce
b) Chew it prior to a high fat meal
c) Take it on an empty stomach
d) Take it with food
Answer: d) Take it with food
Rationale:
Corticosteroids are recommended to take with food to prevent stomach upset
135. which of the following drug classes is not indicated for the treatment of depression?
a) Buspirone (Buspar)
b) Selective Serotonin reuptake inhibitor (SSRI)
c) Tricyclic antidepressant (TCA)
d) Bupropion (Wellbutrin)
Answer: a) Buspirone (Buspar)
Rationale:
Buspirone is an anti-anxiety medicine
136. A Hispanic woman who is 26 weeks pregnant states that she recently began eating ice chips
between meals.
a) Have the patient checked for diabetes
b) Asses the patient for iron deficiency anaemia
c) Encourage the patient to eat more at meal times
d) Tell the patient that this cultural practice can be harmful
Answer: b)Asses the patient for iron deficiency anaemia
137. Snellen chart evaluation indicated that the patient 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 20 feet
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
138. which of the following is NOT a common symptom of Vit b12 deficiency
a) Sore tongue
b) Fatigue
c) Constipation
d) Vomiting
Answer: d) Vomiting
139. during a migraine, the cerebral arteries
a) Constrict
b) Dilate
c) Pulsate
d) vibrate
Answer: b) Dilate
140. which is the appropriate medication for a 31 y/o pregnant diagnosed with UTI
a) Cefuroxime (Zina fed) or nitrofurantoin (Macrobid)
b) Nitrofurantoin (Macrobid) or Ciprofloxacin (cipro)
c) Ciprofloxacin (cipro) or tetracycline (Sumycin)
d) tetracycline (Sumycin) or amoxicillin (Amoxil)
Answer: a) Cefuroxime (Zinafed) or nitrofurantoin (Macrobid)
Rationale:
The safest choices are amoxicillin (moxatag), cefuroxime (Zinafed), cephalexin (Keflex) and
Nitrofurantoin (Macrobid)
141. which of the following medication is not indicated for the treatment of muscle spasms?
a) Baclofen (lioresal)
b) Tizanidine (Zanaflex)
c) Cyclobenzaprine (Flexeril)
d) Carisoprodol (Soma)
Answer: a) Baclofen (lioresal)
Rationale:
Antispastics are used to treat muscle spasticity. They should NOT be used to treat muscle
spasms. Baclofen is used to relieve spasticity caused by MS.
142. during an abdominal examination the NP percusses the bulging area of the abdomen. Which
sounds suggest the presence
a) Tympanic
b) Dullness
c) Hyper resonant sounds
d) Normal resonance
Answer: b) Dullness
143. which pathogen is associated with common urinary tract infections?
a) E.coli
b) klebsiella
c) streptococcus
d) proteus mirabilis
Answer: a) E.coli
144. which condition is caused by an insufficient production of intrinsic factor by gastric mucosa
and vitamin B insufficiency?
a) Diarrhoea
b) Pernicious anaemia
c) Osteoporosis
d) Muscle weakness
Answer: b) Pernicious anaemia
145. A multiparous pregnant patient presents at 24 weeks gestation with complain of painless
vaginal bleeding. This presentation is consistent with:
a) Placenta accreta
b) Placenta previa
c) Placenta percreta
d) Placental abruption
Answer: b) Placenta previa
Rationale:
Placenta accreta poses a major risk of severe vaginal bleeding (haemorrhage) after delivery.
Placenta previa vary, but the most common symptom is painless bleeding during the third
trimester.
146. when measuring the fundal high of a pregnant female at 32 weeks gestation, which
measurement would the NP suspect fetal growth
a) 29 cm
b) 30cm
c) 31cm
d) 32 cm
Answer: d) 32 cm
Rationale:
Fundal height is generally defined as the distance from the pubic bone to the top of the uterus
measured in centimetres. After 20 weeks of pregnancy, your fundal height measurement often
matches the number of weeks you've been pregnant.
147. A 40 y/o female, the overall texture of the breast is soft, with an uneven contour bilaterally.
The NP informs the patient that:
a) Warrants a mammogram
b) Is considered normal
c) May be suggestive of fibroadenoma
d) May indicate cystic breast
Answer: a) Warrants a mammogram
148. A 74 y/o man who recently lost his spouse of 50 years in an auto accident tells the NP that“
he has no purpose in this life”
a) Have you told your family how you feel?
b) Have you thought about hurting yourself?
c) Are you taking your medication?
d) Do you have any friends?
Answer: b) Have you thought about hurting yourself?
149. A 67 y/o woman with Hx of A-fib and an ejection fraction of 48% has had normal digoxin
levels. Which can cause a decrease of digoxin level?
a) Decrease creatinine clearance
b) Weight loss
c) Increase exercise
d) Regular use of antacid
Answer: d) Regular use of antacid
150. 5-alpha reductase inhibitor work to improve symptoms of benign prostatic hyperplasia by?
a) Decreasing the size of the prostate
b) Increasing blood flow to the prostate
c) Relaxing smooth muscle in the bladder neck
d) Relaxing smooth muscle in the prostate capsule
Answer: a) Decreasing the size of the prostate
Rationale:
alpha reductase such as finasteride reduced amount of dihydrotestosterone in the prostate causing
it to shrink. This helps you to pass urine more easily.
151. which medication is indicated for patients with generalized anxiety disorder?
a) Buspirone (Buspar)
b) Citalopram (Celexa)
c) Imipramine (Tofranil)
d) Bupropion HCL (Welbutrin)
Answer: a) Buspirone (Buspar)
Rationale:
Buspirone (Buspar) is an ant anxiolytic, the other choices are antidepressants
152. pregnant women are evaluated for syphilis with serology testing because:
a) Syphilis during pregnancy predisposes the fetus to spontaneously abort or the newborn to have
congenital syphilis
b) Hormonal changes associated with pregnancy may trigger activation of latent syphilis
c) Syphilis may be passed to the fetus beginning in the third trimester
d) Untreated syphilis can cause neonatal respiratory distress
Answer: a) Syphilis during pregnancy predisposes the fetus to spontaneously abort or the
newborn to have congenital syphilis
Rationale:
Syphilis can seriously complicate pregnancy and result in spontaneous abortion, stillborn, nonimmune hydrops, intrauterine growth restriction and perinatal death, as well as liveborn infected
children
153. when treating a patient with asthma who is experiencing acute wheezing, which medication
should be given to relieve the symptoms?
a) Short acting bronchodilator
b) Long acting bronchodilator
c) Inhaled corticosteroid
d) Combination of methylaxanthine and long acting bronchodilator
Answer: a) Short acting bronchodilator
154. Recommended combination therapy for uncomplicated anorectal and pharyngeal gonorrhea
is?
a) Ceftriaxone and benzathine penicillin
b) benzathine penicillin and doxycycline
c) Doxycycline and ciprofloxacin
d) Ceftriaxone and azithromycin
Answer: d) Ceftriaxone and azithromycin
155. An example of synovial joints would be
a) Vertebrate bodies of the spine
b) Scalp
c) Shoulder
d) Pubic symphysis of the pelvis
Answer: c) Shoulder
