NR 511 WEEK 8 FINAL EXAM ALL ANSWERS ARE CORRECT
GRADED A Latest UPDATED 2021
NR 511 Week 8 Exam
Question 1.
The most cost-effective screening test for determining HIV status is which of the following?
A. Western blot
B. Enzyme-linked immunosorbent assay
C. Venereal Disease Research Laboratory test
D. Viral load
Answer: B. Enzyme-linked immunosorbent assay
Question 2
Which blood test is a nonspecific method and most helpful for evaluating the severity and
course of an inflammatory process?
A. Erythrocyte sedimentation rate
B. White blood cell count
C. Polymorphonuclear cells
D. C-reactive protein (CRP)
Answer: D. C-reactive protein (CRP)
Question 3
Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?
A. GABA
B. Acetylcholine
C. Dopamine
D. Serotonin
Answer: C. Dopamine
Question 4
Mrs. Thomas was seen in the office complaining of pain point tenderness in the area of her
elbow. The pain has increased following a day of gardening one week ago. A physical
finding that differentiates the diagnosis and is most consistent with lateral epicondylitis
(tennis elbow) is:
A. Ecchymosis, edema, and erythema over the lateral epicondyle
B. Pain at the elbow with resisted movements at the wrist and forearm
C. Inability to supinate and pronate the arm
D. Inability to flex or extend the elbow against resistance
Answer: B. Pain at the elbow with resisted movements at the wrist and forearm
Question 5
Which of the following statements concerning the musculoskeletal examination is true?
A. The uninvolved side should be examined initially and then compared to the involved side.
B. The part of the body that is causing the patient pain should be examined first.
C. When possible, the patient should not be asked to perform active range-of-motion (ROM)
exercises to avoid causing pain.
D. Radiographs should always be obtained prior to examination so as not to cause further
injury to the patient.
Answer: A. The uninvolved side should be examined initially and then compared to the
involved side.
Question 6
Which of the following signs or symptoms indicate an inflammatory etiology to
musculoskeletal pain?
A. Decreased C-reactive protein
B. Hyperalbuminemia
C. Morning stiffness
D. Weight gain
Answer: C. Morning stiffness
Question 7
Which causes the greatest percentage of mammalian bites?
A. Dogs
B. Cats
C. Humans
D. Rodents
Answer: A. Dogs
Question 8
A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual
periods. She is pale and states she can no longer exercise. Pelvic exam reveals a single, very
large mass. Which of the following diagnostic tests should the clinician order first?
A. Transvaginal ultrasound
B. Endometrial biopsy
C. MRI
D. Abdominal computed tomography
Answer: A. Transvaginal ultrasound
Question 9
A diabetic patient asks the clinician why he needs to check his blood sugar at home even
when he feels good. Which of the following responses would be most appropriate?
A. "Control of glucose will help postpone or delay complications."
B. "Regularly checking blood sugar will help establish a routine."
C. "Monitoring glucose will promote a sense of control."
D. All of the above
Answer: D. All of the above
Question 10
A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and
constipation for the past 3 months. On physical examination, the clinician notices a sinus
bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon
reflexes. Which of the following tests should be ordered next?
A. Serum
B. calcium TSH
C. Electrolytes
D. Urine specific
Answer: B. calcium TSH
Question 11
Which of the following medications for type 2 diabetes mellitus should not be prescribed
during pregnancy?
A. Insulin
B. Metformin
C. Glucotrol
D. Precose
Answer: C. Glucotrol
Question 12
During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer.
What physical finding should make the clinician suspicious?
A. An enlarged rubbery gland
B. A hard irregular gland
C. A tender gland
D. A boggy
Answer: A. An enlarged rubbery gland
Question 13
Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of
distress. What should be your first step?
A. Remove the insect with tweezers.
B. Immobilize the insect with 2% lidocaine.
C. Sedate Eddie with diazepam.
D. Shine a light in the ear for the insect to "find its way
Answer: B. Immobilize the insect with 2% lidocaine.
Question 14
What is the most common cause of microcytic anemia?
A. Anemia of chronic disease
B. Sideroblastic anemia
C. Iron-deficiency anemia
D. Thalassemia
Answer: C. Iron-deficiency anemia
Question 15
An 82-year-old man is seen in the primary care office with complaints of dribbling urine and
difficulty starting his stream. Which of the following should be included in the list of
differential diagnoses?
A. Benign prostatic hyperplasia (BPH)
B. Parkinson's disease
C. Prostate cancer
D. All of the above
Answer: D. All of the above
Question 16
Early rheumatoid disease is characterized by:
A. Pain and swelling in both small and large peripheral joints
B. Rigid joints with diminished range of motion
C. Joint swelling and immobility on rising
D. A cardiac rub or pulmonary friction
Answer: C. Joint swelling and immobility on rising
Question 17
A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist.
She thought she just bruised it but is worried because it has not improved. She has used
Tylenol® and ice at home, and that has helped slightly. You examine her and find she has
moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is
uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her
fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should
you do?
A. Make an immediate referral for an orthopaedic evaluation without further assessment.
B. Tell her that it takes time for these bruises to improve, so she should be patient.
C. Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint.
D. Send her to the emergency room for reduction of this obvious wrist fracture.
Answer: C. Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint.
Question 18
The criteria for diagnosing generalized anxiety disorder in the American Psychiatric
Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text
revision) state that excessive worry or apprehension must be present more days than not for at
least:
A. 1 month
B. 3 months
C. 6 months
D. 12 months
Answer: C. 6 months
Question 19
A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to
transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to
find?
A. The scrotum will be dark.
B. The scrotum will appear light pink or yellow.
C. The scrotum will appear milky white.
D. The internal structures will be clearly visible.
Answer: B. The scrotum will appear light pink or yellow.
Question 20.
According to Kübler-Ross, the stages of grief occur in which order?
A. Anger, denial, depression, bargaining, acceptance
B. Anger, denial, bargaining, acceptance, depression
C. Denial, anger, depression, bargaining, acceptance
D. Denial, anger, bargaining, depression, acceptance
Answer: D. Denial, anger, bargaining, depression, acceptance
Question 21
Reuben, age 24, has HIV and just had a routine viral load test done. The results show a
falling viral load. What does this indicate?
A. A favourable prognostic trend
B. Disease progression
C. The need to be more aggressive with Reuben's medications
D. The eradication of the HIV
Answer: A. A favourable prognostic trend
Question 22
The exanthem of Lyme disease is:
A. Erythema infectious
B. Laterothoracic exanthem
C. Erythema migrans
D. Morbilli exanthem
Answer: C. Erythema migrans
Question 23
You have detected the presence of crepitus on examination of a patient with a
musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both
active and passive movement. These findings suggest that the origin of the musculoskeletal
complaint is:
A. Articular
B. Inflammatory
C. Nonarticular
D. A and B
Answer: A. Articular
Question 24
What is the recommended daily calcium intake for adults over the age of 50 with low bone
mass?
A. 1,200 mg/day
B. 1,000 mg/day
C. 1,300 mg/day
D. 1,500 mg/day
Answer: D. 1,500 mg/day
Question 25
When assessing a woman for infertility, which of the following tests should be done first?
A. Analysis of partner's sperm
B. Magnetic resonance imaging
C. (MRI) Hysterosalpingogram
D. Estrogen level
Answer: A. Analysis of partner's sperm
Question 26
Which type of burn injury results in destruction of the epidermis with most of the dermis, yet
the epidermal cells lining hair follicles and sweat glands remain intact?
A. Superficial burns
B. Superficial partial-thickness burns
C. Deep partial-thickness burns
D. Full-thickness
Answer: B. Superficial partial-thickness burns
Question 27
A 23-year-old sexually active woman presents for her first Pap smear. Her history includes
nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the
following conditions should the clinician be particularly alert for during her examination?
A. Human papillomavirus (HPV)
B. Endometrial hyperplasia
C. Vagismus
D. Polycystic ovarian
Answer: A. Human papillomavirus (HPV)
Question 28
As a rule of thumb, the estimated level of haematocrit is how many times the value of the
haemoglobin?
A. Two
B. Three
C. Four
D. Five
Answer: B. Three
Question 29
Sam is a 25-year-old who has been diagnosed with low back strain based on his history of
localized low back pain and muscle spasm along with a normal neurological examination. As
the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the
following symptoms would alert the clinician to the more serious finding of a herniated
nucleus pulposus or ruptured disc?
A. Morning stiffness and limited mobility of the lumbar spine
B. Unilateral radicular pain symptoms that extend below the knee and are equal to or greater
than the back pain
C. Fever, chills, and elevated erythrocyte sedimentation rate
D. Pathologic fractures, severe night pain, weight loss, and fatigue
Answer: B. Unilateral radicular pain symptoms that extend below the knee and are equal to
or greater than the back pain
Question 30
A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following
laboratory tests would help establish a diagnosis?
A. Testosterone level
B. Prostate-specific
C. 4antigen
D. Nocturnal penile tumescence and rigidity Prolactin level
Answer: A. Testosterone level
Question 31
The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by
the patient would indicate that your teaching has been effective?
A. "I'll take my pill at least 30 minutes before breakfast."
B. "I'll take my Glucotrol before bedtime."
C. "It is important to take my medication right after I eat."
D. "Since I only like to eat two meals a day, I can take the pill between my meals."
Answer: A. "I'll take my pill at least 30 minutes before breakfast."
Question 32
In the United States, what is the second most common connective tissue disease and the most
destructive to the joints?
A. Osteoarthritis
B. Systemic lupus erythematosus
C. (SLE) Rheumatoid arthritis
D. Sjögren's syndrome
Answer: C. (SLE) Rheumatoid arthritis
Question 33
The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the
following neurotransmitters plays a role in anxiety?
A. Acetylcholine
B. Gamma-aminobutyric acid (GABA)
C. Dopamine
D. Serotonin
Answer: B. Gamma-aminobutyric acid (GABA)
Question 34
A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects
testicular torsion. Which of the following is the appropriate action?
A. Refer to a urologist immediately.
B. Obtain a computed tomography (CT)scan.
C. Instruct the patient to elevate the scrotum.
D. Prescribe ibuprofen.
Answer: A. Refer to a urologist immediately.
Question 35
Which of the following medications can cause hyperglycaemias?
A. Prednisone
B. Metformin
C. Synthroid
D. Cephalexin
Answer: A. Prednisone
Question 36
During treatment for anaphylaxis, what site is used for the initial injection of epinephrine?
A. IV
B. Abdomen
C. Upper lateral thigh
D. Deltoid C. Upper lateral thigh
Answer: C. Upper lateral thigh
Question 37
It is important to educate patients with depression and their family members about reporting
signs of increasing depression and suicidal thoughts. This is especially true during which time
period?
A. Before the initiation of treatment
B. 1 to 2 weeks after the initiation of treatment
C. When switching to a different medication
D. 1 to 2 weeks after tapering off medications
Answer: B. 1 to 2 weeks after the initiation of treatment
Question 38
What is the most common cause of secondary amenorrhea?
A. Pregnancy
B. Pituitary dysfunction
C. Inadequate estrogen levels
D. Genetic disorders
Answer: A. Pregnancy
Question 39
Which of the following is the only drug for bulimia approved by the U.S. Food and Drug
Administration?
A. Sertraline
B. Fluoxetine
C. Citoprolam
D. Imipramine
Answer: B. Fluoxetine
Question 40
The goals of the 15-minute hour approach include:
A. Enhance self-esteem, expand behavioral repertoire, prevent dire consequences, and
reestablish premorbid levels of functioning
B. Emerge with a higher level of functioning and commitment to long-term psychotherapy
C. Accept need for antidepressant therapy and psychiatric referral; share concerns with
primary care clinician
D. Improve family functioning and sexual performance as well as accept need for
antidepressant medication
Answer: A. Enhance self-esteem, expand behavioral repertoire, prevent dire consequences,
and reestablish premorbid levels of functioning
Question 41
John is a 16-year-old boy who presents to the emergency room after hurting his knee in a
football game. He described twisting his knee and then being unable to extend it completely.
John tells the clinician that he heard a pop when the injury occurred and has been
experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most
appropriate to assess for the presence of a meniscal tear?
A. Valgus stress test
B. McMurray circumduction test
C. Lachman test
D. Varus stress
Answer: B. McMurray circumduction test
Question 42
The cardinal subjective symptom of sickle cell crisis is which of the following?
A. Pain
B. Nausea
C. Light-headedness
D. Palpitations
Answer: A. Pain
Question 43
A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which of the
following pelvic pathologies is the most common cause of dysmenorrhea?
A. Pelvic inflammatory disease
B. Endometriosis
C. Sexually transmitted infections
D. Ovarian cyst
Answer: B. Endometriosis
Question 44
Which arthropod bite can contain cytotoxic and haemolytic toxins that may destroy tissue?
A. Tick
B. Brown recluse spider
C. Wasp
D. Stinging caterpillar
Answer: B. Brown recluse spider
Question 45
Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of
L5-S1. She is currently in the emergency room with suspicion of cauda equina compression.
Which of the following is a sign or symptom of cauda equina compression?
A. Gastrocnemius weakness
B. A reduced or absent ankle reflex
C. Numbness in the lateral foot
D. Paraesthesia of the perineum and buttocks
Answer: D. Paraesthesia of the perineum and buttocks
Question 46
A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the
following tests is essential before prescribing any oral contraceptive?
A. Pregnancy test
B. Complete blood cell count
C. Thyroid-stimulating hormone
D. Urine dip for Protein
Answer: A. Pregnancy test
Question 47
A patient with type 2 diabetes comes to the clinic after reading about metformin in a
magazine. Which of the following conditions that the patient also has would be a
contraindication to taking metformin?
A. Ketoacidosis
B. Cirrhosis
C. Hypoglycaemic episodes
D. All of the above
Answer: D. All of the above
Question 48
The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for
a patient fitting the diagnostic criteria for depression. Which of the following is not true
concerning SSRIs in comparison to tricyclic antidepressants?
A. SSRIs are more effective than TCAs.
B. SSRIs take less time to work than TCAs.
C. SSRIs have a more favourable side-effect profile than TCAs.
D. SSRIs are not lethal in overdose.
Answer: A. SSRIs are more effective than TCAs.
Question 49
Which type of bone marrow transplant is obtained from an identical twin?
A. Autogenic
B. Autologous
C. Allogeneic
D. Syngeneic
Answer: D. Syngeneic
Question 50
Pink, cherry red tissues and skin may result from which Type of poisoning?
A. Arsenic
B. Lead
C. Carbon monoxide
D. Strychnine
Answer: C. Carbon monoxide
Question 51
Basic human needs are identified as:
A. Autonomy and feeling valued by others
B. Exhilaration and productivity
C. Spirituality
D. Career success and material rewards
Answer: A. Autonomy and feeling valued by others
Question 52.
The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the
clinician classify this patient?
A. Overweight
B. Mild obesity
C. Moderate obesity
D. Morbid obesity
Answer: B. Mild obesity
Question 53
22-year-old male is seen in the clinic because he found a hard lump in his testicle when
performing testicular self- examination (TSE). Which of the following should be included in
the list of differential diagnoses?
A. Testicular cancer
B. Inguinal hernia
C. Varicocele
D. All of the above
Answer: D. All of the above
Question 54
What is the treatment of choice for a patient diagnosed with testicular cancer?
A. Radical orchidectomy
B. Lumpectomy
C. Radiation implants
D. All of the above
Answer: A. Radical orchidectomy
Question 55
Which method is used to remove heavy metals, such as lead, that are ingested as poisons?
A. Chelation
B. Dialysis
C. Gastric lavage
D. Bowel irrigation
Answer: A. Chelation
Question 56.
A 58-year-old woman presents with a breast mass. Which of the following responses by the
clinician would be most appropriate?
A. "It is probably just a cyst because that is the most common breast mass."
B. "We will order a mammogram and ultrasound to help establish a diagnosis."
C. "We will go ahead and schedule you for a biopsy because that is the only way to know for
sure."
D. "Because your lump is painful, it is most likely not cancer."
Answer: B. "We will order a mammogram and ultrasound to help establish a diagnosis."
Question 57
A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On
potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae.
Which of the following treatments would be appropriate?
A. Fluconazole
B. Estrogen vaginal
C. cream Metronidazole
D. Doxycycline
Answer: A. Fluconazole
Question 58
The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs
to manage his symptoms of pain and discomfort. Which of the following statements would be
most appropriate when teaching Sam about the use of NSAIDs?
A. "You should start with the lowest dose that is effective in managing your pain, because
long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and
haemorrhage."
B. "You should start with the lowest dose that is effective in managing your pain to avoid
developing tolerance to the medication."
C. "You should take the maximum recommended dose of NSAIDs so that you will not need
to take narcotics to control your pain."
D. "It is important to take NSAIDs on an empty stomach in order to increase absorption."
Answer: A. "You should start with the lowest dose that is effective in managing your pain,
because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers
and haemorrhage."
Question 59
A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting
of a joint, is more likely related to which musculoskeletal injury?
A. A sprain
B. A strain
C. A partial fracture
D. A fracture
Answer: B. A strain
Question 60
Which type of heat-related illness involves a core body temperature of at least 104.9°F, acute
mental status changes, absent sweat, and tachypnoea?
A. Heat cramps
B. Heat syncope
C. Heat exhaustion
D. Heat stroke
Answer: C. Heat exhaustion
Question 61
Which of the following may be used to evaluate a person's suicide risk?
A. CAGE
B. SANE
C. SAD PERSONAS
D. DIGFAST
Answer: C. SAD PERSONAS
Question 62
One of the initial steps in assessing patients with musculoskeletal complaints is to determine
whether the complaint is articular or nonarticular in origin. Which of the following is an
example of an articular structure?
A. Bone
B. Synovium
C. Tendons
D. Fascia
Answer: B. Synovium
Question 63
After returning from visiting his grandchildren in England, George, age 59, complains of a
flulike illness, including fever, chills, and myalgia. He reports having discovered a rash or red
spot that grew in size on his right leg. What disease are you considering?
A. A viral syndrome
B. Lyme disease
C. Rocky Mountain spotted fever
D. Relapsing fever
Answer: B. Lyme disease
Question 64
A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram
changes should the clinician expect as a manifestation of the disease?
A. Sinus
B. bradycardia Atrial
C. fibrillation
D. Supraventricular tachycardia U waves
Answer: A. Sinus
Question 65
Which of the following tests is essential for a 46-year-oldwoman who the clinician suspects
is perimenopausal?
A. Pregnancy
B. Estrogen level
C. Progesterone level
D. LH level
Answer: A. Pregnancy
Question 66
After 6 months of Synthroid therapy, the clinician should expect which of the following in
the repeat thyroid studies?
A. Elevated TSH
B. Normal TSH
C. Low TSH
D. Undetectable TSH
Answer: B. Normal TSH
Question 67
A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2
diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best
initial treatment?
A. No treatment at this time
B. Diet and exercise for 6-week trial
C. Diet, exercise, and oral medication
D. Diet, exercise, and exogenous insulin
Answer: B. Diet and exercise for 6-week trial
Question 68
Which of the following should be considered in a patient presenting with erectile
dysfunction?
A. Diabetes mellitus
B. Hypertension
C. Atherosclerosis
D. All of the above
Answer: D. All of the above
Question 69
Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel
syndrome. She has two young children and asks the clinician what the chances are that they
also will develop carpal tunnel syndrome. Which of the following responses would be correct
regarding the risk of developing carpal tunnel syndrome?
A. Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to
account for about one- half the risk of developing carpal tunnel.
B. Only people with occupations that require repeated flexion extension of the wrist, use of
hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for
developing carpal tunnel.
C. An underlying musculoskeletal disorder must be present for a person to develop carpal
tunnel.
D. Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.
Answer: A. Carpal tunnel syndrome commonly occurs in families. Genetic factors are
thought to account for about one- half the risk of developing carpal tunnel.
Question 70
A 20-year-old woman is seen in the clinic because her boyfriend was found to have
gonorrhoea. Which of the following is the treatment of choice for gonorrhoea?
A. Ceftriaxone
B. Doxycycline
C. Acyclovir
D. Metronidazole
Answer: A. Ceftriaxone
Question 71
Which of the following statements is true regarding the treatment of carpal tunnel syndrome?
A. The goal of treatment is to prevent flexion and extension movements of the wrist.
B. Splints are used in carpal tunnel syndrome, because they allow for free movement of the
fingers and thumb while maintaining the wrist in a neutral position.
C. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome
because of the risks for median nerve damage, scarring, and infection.
D. All of the above
Answer: D. All of the above
Question 72
Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe.
The clinician suspects acute gout. Which of the following should the clinician expect in the
initial test results for this patient?
A. Elevated uric acid level
B. Elevated blood urea nitrogen
C. Decreased urine pH
D. Decreased C-reactive protein
Answer: A. Elevated uric acid level
Question 73
Which of the following data is indicative of testicular torsion?
A. Absent cremasteric reflex
B. Pain relieved on testicular elevation
C. Testicle very low in the scrotum
D. Swollen scrotum with "red dot sign"
Answer: A. Absent cremasteric reflex
Question 74
A patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer
her, the clinician must understand that exercise has what effect on the patient with type 2
diabetes?
A. Reduces postprandial blood glucose
B. Reduces triglycerides and increases high-density lipoprotein (HDL)
C. Reduces total cholesterol
D. All of the above
Answer: D. All of the above
Question 75
A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the
following tests should be the first priority?
A. Pregnancy test
B. Pelvic ultrasound
C. Endometrial
D. biopsy Platelet count
Answer: A. Pregnancy test
Question 76
What is the most common cause of generalized musculoskeletal pain in women ages 20 to
55?
A. Chronic fatigue syndrome (CFS)
B. Anemia
C. Fibromyalgia syndrome (FMS)
D. Sports-related injuries
Answer: D. Sports-related injuries
Question 77
If the international normalized ratio (INR) result is above the therapeutic range in a patient
with atrial fibrillation on warfarin, what might the clinician do?
A. Stop the warfarin for 1 week, and then repeat the INR.
B. Withhold one or more days of anticoagulant therapy.
C. Restart therapy at a lower dose immediately.
D. The prothrombin time and INR should be reevaluated within 1 month of the dosage
adjustments.
Answer: B. Withhold one or more days of anticoagulant therapy.
Question 78
A 32-year-old woman is seen in the clinic because she has been unable to get pregnant after
12 months of unprotected sex. In order to determine the cause of the infertility, the clinician
should question her about which of these possible causes?
A. Pelvic inflammatory disease
B. Oral contraceptive use for 15 years
C. Early menarche
D. Diet high in soy protein
Answer: A. Pelvic inflammatory disease
Question 79
Which of the following statements concerning the treatment of fibromyalgia syndrome is
true?
A. There is currently no cure for the disorder; however, patients should be made aware that
symptom relief is possible.
B. Treatment is directed toward controlling discomfort, improving sleep, and maintaining
function.
C. Fibromyalgia syndrome can be difficult to manage, requiring a variety of approaches and
multiple medications.
D. All of the above
Answer: C. Fibromyalgia syndrome can be difficult to manage, requiring a variety of
approaches and multiple medications.
Question 80
The clinician should prescribe an antibiotic that covers which of these organisms for a patient
with acute prostatitis?
A. Gram-positive cocci
B. Gram-negative cocci
C. Gram-positive bacillus
D. Gram-negative bacillus
Answer: D. Gram-negative bacillus
Question 81
Which household solution should be used to clean a bathroom if sharing with a friend who
has HIV?
A. 100% bleach
B. 50% bleach and 50% vinegar
C. Nine parts H2O to one part bleach
D. The friend must have his or her own bathroom.
Answer: C. Nine parts H2O to one part bleach
Question 82
Sandra is 42 years old and has just been diagnosed with leukaemia. She is complaining of
bone and joint pain. Which type of leukaemia is most likely the culprit?
A. Acute lymphocytic leukaemia
B. Acute myelogenous leukaemia
C. Chronic myelogenous leukaemia
D. Chronic lymphocytic leukemia
Answer: B. Acute myelogenous leukemia
Question 83
Which of the following is identified as an eating disorder in which a person craves food
substitutes, such as clay, ice chips, and cotton, and is considered an objective finding
associated with severe iron deficiency?
A. Ferritin
B. Porter's syndrome
C. Hypochromia
D. Pica
Answer: D. Pica
Question 84
The clinician suspects that a client seen in the office has hyperthyroidism. Which of the
following tests should the clinician order on the initial visit?
A. High sensitivity thyroid-stimulating hormone (TSH) and free T4
B. Free T4 and serum calcium
C. Free T3 and T4
D. TSH and thyroxin antibodies
Answer: A. High sensitivity thyroid-stimulating hormone (TSH) and free T4
Question 85
The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of
the following statements by the patient would indicate that teaching has been effective?
A. "As long as I don't need glasses, I don't have to worry about going blind."
B. "I know I need to have my eyes checked every year."
C. "My optometrist checks my eyes."
D "I will see my eye doctor when my vision gets blurry."
Answer: B. "I know I need to have my eyes checked every year."
Question 86
Triggering factors for acute exacerbations of which of the following conditions include
exposure to ultraviolet (UV)- B and UV-A rays?
A. Rheumatoid arthritis
B. Scleroderma
C. SLE
D. Sjögren's syndrome
Answer: C. SLE
Question 87
Which of the following characteristics separates anaphylaxis from a vasovagal reaction?
A. Bradycardia
B. Extreme diaphoresis
C. Severe bronchoconstriction
D. Hypotension
Answer: C. Severe bronchoconstriction
Question 88
Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The clinician has
explained to Mr. Jackson that the goals for managing osteoarthritis include controlling pain,
maximizing functional independence and mobility, minimizing disability, and preserving
quality of life. Mr. Jackson explains to the clinician that his first choice would be to use
complementary therapies to control his condition and asks what therapies are most effective
in treating osteoarthritis. What would be the most appropriate response from the clinician?
A. "Complementary therapies should be considered only if surgical interventions are not
successful."
B. "I am unfamiliar with the available complementary therapies for osteoarthritis and prefer
to discuss more mainstream treatments, such as NSAIDs and physical therapy, to manage
your condition."
C. "I would be happy to discuss all the treatment options available to you. Complementary
therapies, such as acupuncture, acupressure, and tai-chi, are being studied for use in the
treatment of osteoarthritis and have shown promise when used with standard medical
therapy."
D. "It would be crazy to use complementary therapies to treat such a serious condition."
Answer: C. "I would be happy to discuss all the treatment options available to you.
Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being studied for
use in the treatment of osteoarthritis and have shown promise when used with standard
medical therapy."
Question 89
One benefit of motivational interviewing (MI) is:
A. It assumes that ambivalence is a normal part of the change process.
B. It can be utilized during routine office visits.
C. It is a therapeutic technique which is not necessarily time intensive.
D. All are benefits of MI.
Answer: D. All are benefits of MI.
Question 90
What percentage of burns is involved using the rule of nines if both front legs are burned?
A. 9%
B. 18%
C. 24%
D. 36%
Answer: B. 18%
Question 91
Women are at the highest risk for developing postpartum depression for up to how long after
childbirth?
A. 2 weeks
B. 1 month
C. 3 months
D. 6 months
Answer: D. 6 months
Question 92
Which statement about HIV postexposure prophylaxis (PEP) for health-care workers is the
most accurate?
A. PEP should be started within hours of exposure.
B. PEP should be started within 72 hours of exposure.
C. Renal and hepatic function tests should be done 6 weeks after beginning PEP.
D. PEP will prevent potential hepatitis C infection if present.
Answer: A. PEP should be started within hours of exposure.
Question 93
he clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle.
Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an xray is not always necessary for an injured ankle and that the decision to obtain radiographs is
dependent on the examination and Diane's description of her injury. Which of the following
clues in Diane's examination or history would alert the clinician to the need for obtaining
radiographs?
A. Inability to bear weight immediately after the injury
B. Development of marked ankle swelling and discoloration after the injury
C. Crepitation with palpation or movement of the ankle
D. All of the above
Answer: D. All of the above
Question 94
A vegetarian patient with gout asks the clinician about food he should avoid. The clinician
should advise the patient to avoid which of the following foods?
A. Rice
B. Carrots
C. Spinach
D. Potatoes
Answer: C. Spinach
Question 95
A patient with a basilar skull fracture may experience an impaired downward gaze or diplopia
from which affected cranial nerve?
A. CN II
B. CN III
C. CN IV
D. CN V
Answer: C. CN IV
Question 96
A patient presents to the clinician after experiencing four episodes in the last month of
sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes.
The patient is now becoming very fearful of future events and has been reluctant to leave the
house. The clinician suspects panic disorder but wants to rule out any possible medical
causes. Which of the following medical conditions can mimic the symptoms of a panic
attack?
A. Pheochromocytoma
B. Hyperthyroidism
C. Cardiac arrhythmias
D. All of the above
Answer: D. All of the above
Question 97
Which test is used to confirm a diagnosis of epididymitis?
A. Urinalysis
B. Gram stain of urethral discharge
C. Complete blood cell count with differential
D. Ultrasound of the scrotum
Answer: D. Ultrasound of the scrotum
Question 98.
Bathing the patient refers to:
A. A technique used in primary care to get the patient to accept the need for psychological or
psychiatric referral
B. A technique used to facilitate cultural understanding
C. A technique used to perform psychotherapy
D. A technique that is a quick screen for psychiatric issues and interventions for
psychological problems
Answer: D. A technique that is a quick screen for psychiatric issues and interventions for
psychological problems
Question 99
Bathing the patient is an advanced practice nursing intervention that allows the practitioner
to:
A. Develop a therapeutic relationship without "owning" the patient's problem
B. Conduct psychological counseling within the context of the primary care encounter
C. Focus on the "process" and not the assessment
D. Make the patient and family happier
Answer: A. Develop a therapeutic relationship without "owning" the patient's problem
Question 100
A 45-year-old woman is seen in the clinic with abnormal uterine bleeding and pain during
intercourse. The clinician should consider which of the following diagnoses?
A. Leiomyoma
B. Pregnancy
C. Ovarian cancer
D. All of the above
Answer: D. All of the above
