NURS 6531N Midterm Exam (100 Q/A) / NURS6531N Midterm Exam (Latest 2020): Walden University

NURS 6531N Midterm Exam (100 Q/A) / NURS6531N Midterm Exam (Latest 2020): Walden University

·         Question 1

When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

Yes

No

·         Question 2

The most common cancer found on the auricle is:

Actinic keratosis

Basal cell carcinoma

Squamous cell carcinoma

Acral-lentiginous melanoma

·         Question 3

Which of the following medication classes should be avoided in patients with acute or chronic bronchitis because it will contribute to ventilation-perfusion mismatch in the patient?

Xanthines

Antihistimines

Steroids

Anticholinergics

·         Question 4

A 47 year old male patient presents to the clinic with a single episode of a moderate amount of bright red rectal bleeding. On examination, external hemorrhoids are noted. How should the nurse practitioner proceed?

Instruct the patient on measures to prevent hemorrhoids such as bowel habits and diet. 

Order a topical hemorrhoid cream along with a stool softener.

Refer the patient for a barium enema and sigmoidoscopy.
 

Refer the patient for a surgical hemorrhoidectomy.

·         Question 5

Which of the following patient characteristics are associated with chronic bronchitis?

Overweight, cyanosis, and normal or slightly increased respiratory rate
 

Underweight, pink skin, and increased respiratory rate
 

Overweight, pink skin, and normal or slightly increased respiratory rate
 

Normal weight, cyanosis, and greatly increased respiratory rate

·         Question 6

 A 65-year-old female with a past medical history of hypertension, hyperlipidemia, and polymyalgia rheumatica presents to urgent care with new onset left lower quadrant pain. Her current medications include omeprazole 20 milligrams po daily, lisinopril 20 milligrams po daily, simvastatin 20 milligrams po daily, and prednisone 12 milligrams po daily. The nurse practitioner suspects acute diverticulitis and possibly an abscess. The most appropriate diagnostic test for this patient at this time is:

CBCdiff
 

Erythrocyte sedimentation rate
 

Abdominal ultrasound
 

CT scan

·         Question 7

A patient reports “something flew in my eye” about an hour ago while he was splitting logs. If there were a foreign body in his eye, the nurse practitioner would expect to find all except:

Purulent drainage
 

Tearing
 

Photophobia
 

A positive fluorescein stain

·         Question 8

A 21 year old college student presents to the student health center with copious, markedly purulent discharge from her left eye. The nurse practitioner student should suspect:

Viral conjunctivitis
 

Common pink eye
 

Gonococcal conjunctivitis
 

Allergic conjunctivitis

·         Question 9

 A 35 year old man presents with radicular pain followed by the appearance of grouped vesicles consisting of about 15 lesions across 3 different thoracic dermatomes. He complains of pain, burning, and itching. The nurse practitioner should suspect:

A common case of shingles and prescribe an analgesic and an antiviral agent
 

A complicated case of shingles and prescribe acyclovir, an analgesic, and a topical cortisone cream
 

Herpes zoster and consider that this patient may be immunocompromised
 

A recurrence of chickenpox and treat the patient’s symptoms

·         Question 10

Which type of lung cancer has the poorest prognosis?

Adenocarcinoma
 

Epidermoid carcinoma
 

Small cell carcinoma
 

Large cell carcinoma

·         Question 11

 An 83-year-old female presents to the office complaining of diarrhea for several days. She explains she has even had fecal incontinence one time. She describes loose stools 3–4 times a day for several weeks and denies fever, chills, pain, recent antibiotic use. The history suggests that the patient has:

Acute diarrhea
 

Chronic diarrhea
 

Irritable bowel
 

Functional bowel disease

·         Question 12

Margaret, age 32, comes into the office with painful joints and a distinctive rash in a butterfly distribution on her face. The rash has red papules and plaques with a fine scale. What do you suspect?

An allergic reaction
 

Relapsing polychondritis
 

Lymphocytoma cutis
 

Systemic lupus erythematosus

·         Question 13

Antibiotic administration has been demonstrated to be of little benefit to the treatment of which of the following disease processes?

Chronic sinusitis

Acute bronchitis
 

Bacterial pneumonia
 

Acute exacerbation of chronic bronchitis

·         Question 14

Lisa, age 49, has daily symptoms of asthma. She uses her inhaled short-acting beta-2 agonist daily. Her exacerbations affect her activities and they occur at least twice weekly and may last for days. She is affected more than once weekly during the night with an exacerbation. Which category of asthma severity is Lisa in?

Mild intermittent
 

Mild persistent
 

Moderate persistent

·         Question 15

Which of the following is the most appropriate therapeutic regimen for an adult patient with no known allergies diagnosed with group A B-hemolytic strep?

Penicillin V 500 milligrams PO every 8 hours for 10 days
 

Ampicillin 250 milligrams PO twice a day for 10 days
 

Clarithromycin 500 milligrams po daily for 7 days

None of the above

·         Question 16

A cashier complains of dull ache and pressure sensation in her lower legs. It is relieved by leg elevation. She occasionally has edema in her lower legs at the end of the day. What is the most likely cause of these problems?

Congestive heart failure
 

Varicose veins

Deep vein thrombosis

Arterial insufficiency

·         Question 17

Which statement below is correct about pertussis?

It is also called whooping cough
 

It begins with symptoms like strep throat
 

It lasts about 3 weeks
 

It occurs most commonly in toddlers and young children

·         Question 18

Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis?

Pneumonia
 

Asthma
 

Sinusitis
 

Pertussis

·         Question 19

A 70 year old patient presents with left lower quadrant (LLQ) abdominal pain, a markedly tender palpable abdominal wall, fever, and leukocytosis. Of the following terms, which correctly describes the suspected condition?

Diverticulosis
 

Diverticula

Diverticulitis
 

Diverticulum

·         Question 20

Sylvia, age 83, presents with a 3 day history of pain and burning in the left forehead. This morning she noticed a rash with erythematous papules in that site. What do you suspect?

Varicella

Herpes zoster

Syphilis

Rubella

·         Question 21

A 33-year-old female is admitted with acute pancreatitis. The nurse practitioner knows that the most common cause of pancreatitis is:

Alcohol
 

Gallstones
 

Medications
 

Pregnancy

·         Question 22

When a patient presents with symptoms of acute gallbladder disease, what is the appropriate nurse practitioner action?

Order abdominal x-rays
 

Order an abdominal ultrasound
 

Refer the patient to a surgeon for evaluation
 

Prescribe pain medication

·         Question 23

A false-positive result with the fecal occult blood test can result from:

ingestion of large amounts of vitamin C
 

a high dietary intake of rare cooked beef
 

a colonic neoplasm that is not bleeding
 

stool that has been stored before testing

·         Question 24

 A 76-year-old male complains of weight loss, nausea, vomiting, abdominal cramping and pain. Physical findings include an abdominal mass and stool positive for occult blood. The nurse practitioner pain suspects a tumor in the small intestine. The best diagnostic test for this patient is:

Colonoscopy
 

Small bowel follow-through
 

Barium enema
 

CT abdomen

·         Question 25

A patient presents to urgent care complaining of dyspnea, fatigue, and lower extremity edema. The echocardiogram reveals and ejection fraction of 38%. The nurse practitioner knows that these findings are consistent with:

Mitral regurgitation
 

Systolic heart failure
 

Cardiac myxoma
 

Diastolic heart failure

·         Question 26

Maxine, Age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that she should be hospitalized?

Multilobar involvement on chest x-ray with the inability to take oral medications
 

Alert and oriented, slightly high but stable vital signs, and no one to take care of her at home
 

Sputum and gram positive organisms
 

A complete blood count showing leukocytosis

·         Question 27

A 55 year old man is diagnosed with basal cell carcinoma. The nurse practitioner correctly tells him:

“It is the most common cause of death in patients with skin cancer.”
 

“It can be cured with surgical excision or radiation therapy.”
 

“It is a slow growing skin cancer that rarely undergoes malignant changes.”
 

“It can be cured using 5-flurouracil cream twice daily for 2 to 4 weeks.”

·         Question 28

Expected spirometry readings when the patient has chronic emphysema include:

Decreased residual volume (RV)
 

Increased vital capacity (VC)
 

Increased forced expiratory volume (FEV-1)
 

Increased total lung capacity (TLC)

·         Question 29

 An 80-year-old male admits to difficulty swallowing during the review of systems. The nurse practitioner recognizes the differential diagnosis for this patient’s dysphagia is:

Esophageal cancer
 

Chest pain
 

GERD
 

A and C
 

All of the above

·         Question 30

A 40 year old female with history of frequent sun exposure presents with a multicolored lesion on her back. It has irregular borders and is about 11mm in diameter. What should the nurse practitioner suspect?

Squamous cell carcinoma
 

Malignant melanoma
 

A common nevus
 

Basal cell carcinoma

·         Question 31

Which of the following is not a goal of treatment for the patient with cystic fibrosis?

Prevent intestinal obstruction
 

Provide adequate nutrition
 

Promote clearance of secretions
 

Replace water-soluble vitamins

·         Question 32

The nurse practitioner is performing a physical exam on a middle-aged African-American man. Which of the following areas is a common site for melanomas in African-Americans and other dark-skinned individuals?

Scalp
 

Nails
 

Feet
 

B and C
 

All of the above

·         Question 33

An adult presents with tinea corporis. Which item below is a risk factor for its development?

Topical steroid use
 

Topical antibiotic use
 

A recent laceration 
 

Cold climates

·         Question 34

A patient has experienced nausea and vomiting, headache, malaise, low grade fever, abdominal cramps, and watery diarrhea for 72 hours. His white count is elevated with a shift to the left. He is requesting medication for diarrhea. What is the most appropriate response?

Prescribe loperamide (Immodium) or atropine-diphenoxylate (Lomotil) and a clear liquid diet for 24 hours. 
 

Prescribe a broad-spectrum antibiotic such as ciprofloxacin (Cipro), and symptom management.
 

Offer an anti-emetic medication such as ondansetron (Zofran) and provide oral fluid and electrolyte replacement instruction.
 

Order stool cultures.

·         Question 35

Janine, age 29, has numerous transient lesions that come and go, and she is diagnosed with urticaria. What do you order?

Aspirin

NSAIDs

Opioids

Antihistamines

·         Question 36

 Of the following signs and symptoms of congestive heart failure (CHF), the earliest clinical manifestation is:

Peripheral edema
 

Weight gain
 

Shortness of breath
 

Nocturnal dyspnea

·         Question 37

A 16 year old male presents with mild sore throat, fever, fatigue, posterior cervical adenopathy, and palatine petechiae. Without a definitive diagnosis for this patient, what drug would be least appropriate to prescribe?

Ibuprofen

Erythromycin

Amoxicillin

Acetaminophen

·         Question 38

A 70 year old man who walks 2 miles every day complains of pain in his left calf when he is walking. The problem has gotten gradually worse and now he is unable to complete his 2 mile walk. What question asked during the history, if answered affirmatively, would suggest a diagnosis of arteriosclerosis obliterans?

“Are you wearing your usual shoes?” 
 

“Do you also have chest pain when you have leg pain?”
 

“Is your leg pain relieved by rest?”
 

“Do you ever have the same pain in the other leg?”

·         Question 39

Which of the following statements about malignant melanomas is true?

They usually occur in older adult males

The patient has no family history of melanoma

They are common in blacks

The prognosis is directly related to the thickness of the lesion

·         Question 40

Sheila, age 78, presents with a chief complaint of waking up during the night coughing. You examine her and find an S3 heart sound, pulmonary crackles that do not clear with coughing, and peripheral edema. What do you suspect?

Asthma

Nocturnal allergies
 

Valvular disease
 

Heart failure

·         Question 41

Which antibiotic would be the most effective in treating community acquired pneumonia (CAP) in a young adult without any comorbid conditions? 

Erythromycin
 

Clarithromycin (Biaxin)
 

Doxycycline (Vibramycin)
 

Penicillin

·         Question 42

Which of the following dermatologic vehicles are the most effective in absorbing moisture and decreasing friction?

Powders
 

Gels
 

Creams
 

Lotion

·         Question 43

A 70 year old patient presents with a slightly raised, scaly, erythematous patch on her forehead. She admits to having been a “sun worshiper.” The nurse practitioner suspects actinic keratosis. This lesion is a precursor to:

Squamous cell carcinoma
 

Basal cell carcinoma
 

Malignant melanoma
 

Acne vulgaris

·         Question 44

An elderly patient is being seen in the clinic for complaint of “weak spells” relieved by sitting or lying down. How should the nurse practitioner proceed with the physical examination? 

Assist the patient to a standing position and take her blood pressure. 
 

Assess the patient’s cranial nerves. 
 

Compare the patient’s blood pressure lying first, then sitting, and then standing. 
 

Compare the amplitude of the patient’s radial and pedal pulses.

·         Question 45

What oral medication might be used to treat chronic cholethiasis in a patient who is a poor candidate for surgery?

  Ursodiol
 

  Ibuprofen
 

Prednisone
 

  Surgery is the only answer

·         Question 46

A 46-year-old female with a past medical history of diabetes presents with a swollen, erythematous right auricle and is diagnosed with malignant otitis externa. The nurse practitioner knows that the most likely causative organism for this patient’s problem is:

Staphylococcus aureus
 

Group A beta hemolytic streptococcus
 

Haemophilus influenza
 

Pseudomonas aeruginosa

·         Question 47

Which of the following is not a symptom of irritable bowel syndrome?

Painful diarrhea

Painful constipation

Cramping and abdominal pain

Weight loss

·         Question 48

A patient comes in complaining of 1 week of pain in the posterior neck with difficulty turning the head to the right. What additional history is needed?

Any recent trauma

Difficulty swallowing

  Stiffness in the right shoulder

Change in sleeping habits

·         Question 49

Marvin, age 56, is a smoker with diabetes. He has just been diagnosed as hypertensive. Which of the following drugs has the potential to cause the development of bronchial asthma and inhibit gluconeogenesis?

ACE Inhibitor
 

Beta Blocker
 

Calcium channel blocker
 

Diuretic

·         Question 50

The differential diagnosis for a patient complaining of a sore throat includes which of the following?

Gonococcal infection
 

Thrush
 

Leukoplakia
 

B only
 

A, B, and C

·         Question 51

A patient presents to the primary care provider complaining of a rash on his right forehead that started yesterday and is burning and painful. The physical exam reveals an erythematous, maculopapular rash that extends over the patient’s right eye to his upper right forehead. Based on the history and examination, the most likely cause of this patient’s symptoms is:

Rhus dermatitis
 

Ophthalmic zoster
 

Chemosis
 

Optic neuritis

·         Question 52

Before initiating an HMG CoA-reductase inhibitor for hyperlipidemia, the nurse practitioner orders liver function studies. The patient’s aminotransferase (ALT) is elevated. What laboratory test(s) should be ordered?

Serologic markers for hepatitis
 

Serum bilirubin
 

Serum cholesterol with HDL and LDL
 

A liver biopsy

·         Question 53

A patient with elevated lipids has been started on lovastatin. After 3 weeks of therapy, he calls to report generalized muscle aches. The nurse practitioner should suspect:

A drug interaction

Hepatic dysfunction
 

Hypersensitivity to lovastatin

Rhabdomyolysis

·         Question 54

Treatment of acute vertigo includes:

Bedrest and an antihistamine
 

Fluids and a decongestant
 

A sedative and decongestant
 

Rest and a low sodium diet

·         Question 55

Treatment of H.pylori includes which of the following?

Proton pump inhibitor
 

Antibiotic therapy
 

Bismuth subsalicylate
 

A and B
 

A, B, and C

·         Question 56

Carl, age 78, is brought to the office by his son, who states that his father has been unable to see clearly since last night. Carl reports that his vision is “like looking through a veil.” He also sees floaters and flashing lights but is not having any pain. What do you suspect?

Cataracts
 

Glaucoma
 

Retinal detachment
 

Iritis

·         Question 57

In order to decrease deaths from lung cancer:

All smokers should be screened annually
 

All patients should be screened annually
 

Only high risk patients should be screened routinely
 

Patients should be counseled to quit smoking

·         Question 58

John, age 33, has a total cholesterol level of 188 mgdL. How often should he be screened for hypercholesterolemia?

  Every 5 years
 

Every 2 years
 

 Every year
 

Whenever blood work is done

·         Question 59

Mort is hypertensive. Which of the following factors influenced your choice of using an alpha blocker as the antihypertensive medication?

Mort is black
 

Mort also has congestive heart failure
 

  Mort has benign prostatic hyperplasia
 

  Mort has frequent migraine headaches

·         Question 60

John, age 59, presents with recurrent, sharply circumscribed red papules and plaques with a powdery white scale on the extensor aspect of his elbows and knees. What do you suspect?

Actinic keratosis

Eczema

Psoriasis

Seborrheic dermatitis

·         Question 61

Harriet, a 79-year-old woman, comes to your office every 3 months for follow up on her hypertension. Her medications include one baby aspirin daily, Lisinopril 5mg daily, and Calcium 1500 mg daily. At today’s visit. Her blood pressure is 17089. According to JNC VIII guidelines, what should you do next to control Harriet’s blood pressure?

Increase her Lisinopril to 20mg daily 
 

Add a thiazide diuretic to the Lisinopril 5mg daily
 

Discontinue the Lisinopril and start a combination of ACE Inhibitor and calcium channel blocker
 

Discontinue the Lisinopril and start a diuretic

·         Question 62

An active 65-year-old man under your care has known acquired valvular aortic stenosis and mitral regurgitation. He also has a history of infectious endocarditis. He has recently been told he needs elective replacement of his aortic valve. When he comes into the office you discover that he has 10 remaining teeth in poor repair. Your recommendation would be to:

defer any further dental work until his valve replacement is completed

instruct him to have dental extraction done cautiously, having no more than 2 teeth per visit removed.

suggest he consult with his oral surgeon about having all the teeth removed at once and receiving appropriate antibiotic prophylaxis

coordinate with his cardiac and oral surgeons to have the tooth extractions and valve replacement done at the same time to reduce the risk of anesthetic complications.

·         Question 63

Appropriate therapy for peptic ulcer disease (PUD) is:

Primarily by eradication of infection
 

Based on etiology
 

Aimed at diminishing prostaglandin synthesis
 

Dependent on cessation of NSAID use

·         Question 64

Shirley, age 58, has been a diabetic for 7 years. Her blood pressure is normal. Other than her diabetes medications, what would you prescribe today during her routine office visit?

A calcium channel blocker
 

A beta blocker
 

An ACE Inhibitor
 

No hypertension medication   

·         Question 65

Medicare is a federal program administered by the Centers for Medicare and Medicaid Services (CMS). The CMS has developed guidelines for Evaluation and Management coding, which all providers are expected to follow when coding patient visits for reimbursement. Which of the following is an important consideration regarding billing practices?

It is important to “undercode” so that one does not get charged with Medicare fraud

The practice of “overcoding” is essential in this age of decreasing reimbursements

Failing to bill for billable services will lead to unnecessarily low revenues

Time spent with the patient is a very important determinant of billing

·         Question 66

A 2 year old presents with a white pupillary reflex. What is the most likely cause of this finding?

Viral conjunctivitis

Glaucoma

Corneal abrasion

Retinoblastoma

·         Question 67

Harvey has had Meniere’s disease for several years. He has some hearing loss but now has persistent vertigo. What treatment might be instituted to relieve the vertigo?

Pharmacological therapy
 

A labyrinthectomy
 

A vestibular neurectomy
 

Wearing an earplug in the ear with the most hearing loss

·         Question 68

Which of the following is not a risk factor for coronary arterial insufficiency?

Hyperhomocysteinemia
 

Smoking
 

Genetic factors
 

Alcohol ingestion

·         Question 69

An 18-year-old female presents to the urgent care center complaining of severe pruritus in both eyes that started 2 days ago. Associated symptoms include a headache and fatigue. On examination, the nurse practitioner notes some clear discharge from both eyes and some erythema of the eyelids and surrounding skin. Which of the following is the most likely cause of this patient’s symptoms?

Allergic conjunctivitis
 

Bacterial conjunctivitis
 

Gonococcal conjunctivitis
 

Viral conjunctivitis

·         Question 70

A 20 year old is diagnosed with mild persistent asthma. What drug combination would be most effective in keeping him symptom-free?

A long-acting bronchodilator

An inhaled corticosteroid and cromolyn
 

Theophylline and a short acting bronchodilator
 

A bronchodilator PRN and an inhaled corticosteroid

·         Question 71

Acute rheumatic fever is an inflammatory disease which can follow infection with:

Group A Streptococcus
 

Staphlococcus areus
 

Β-hemolytic Streptococcus
 

Streptococcus pyogenes

·         Question 72

A 60 year old male diabetic patient presents with redness, tenderness, and edema of the left lateral aspect of his face. His left eyelid is grossly edematous. He reports history of a toothache in the past week which “is better.” His temperature is 100°F and pulse is 102 bpm. The most appropriate initial action is to:

Start an oral antibiotic, refer the patient to a dentist immediately, and follow up within 3 days
 

Order mandibular x-rays and question the patient about physical abuse
 

Start an oral antibiotic, mouth swishes with an oral anti-infective, and an analgesic
 

Initiate a parenteral antibiotic and consider hospital admission

·         Question 73

If a patient presents with a deep aching, red eye and there is no discharge, you should suspect:

Iritis
 

Allergic conjunctivitis
 

Viral conjunctivitis

Bacterial conjunctivitis

·         Question 74

The National Cholesterol Education Program’s Adult Treatment Panel III recommends that the goal for low density lipoproteins in high risk patients be less than:

160 mgdL
 

130 mgdL
 

100 mgdL
 

70 mgdL

·         Question 75

 A patient presents with classic symptoms of gastroesophageal reflux disease (GERD). He is instructed on life style modifications and drug therapy for 8 weeks. Three months later he returns, reporting that he was “fine” as long as he took the medication. The most appropriate next step is:

Referral for surgical intervention such as a partial or complete fundoplication
 

Dependent upon how sever the practitioner believes the condition
 

To repeat the 8 week course of drug therapy while continuing lifestyle modifications
 

Investigation with endoscopy, manometry, andor pH testing

·         Question 76

Group A β-hemolytic streptococcal (GABHS) pharyngitis is most common in which age group?

Under 3 years of age
 

Preschool children
 

6 to 12 years of age
 

Adolescents

·         Question 77

The most appropriate treatment for a child with mild croup is:

A bronchodilator
 

An antibiotic
 

A decongestant 
 

A cool mist vaporizer

·         Question 78

A child complains that his “throat hurts” with swallowing. His voice is very “throaty” and he is hyperextending his neck to talk. Examination reveals asymmetrical swelling of his tonsils. His uvula is deviated to the left. What is the most likely diagnosis?

Peritonsillar abscess
 

Thyroiditis
 

Mononucleosis
 

Epiglottitis

·         Question 79

Salmeterol (Servent) is prescribed for a patient with asthma. What is the most important teaching point about this medication?

It is not effective during an acute asthma attack.
 

It may take 2 to 3 days to begin working. 
 

This drug works within 10 minutes. 
 

This drug may be used by patients 6 years and older.

·         Question 80

Which intervention listed below is safe for long term use by an adult with constipation?

Bulk-forming agents
 

Stool softeners
 

Laxatives
 

Osmotic agents

·         Question 81

A 40 year old presents with a hordeolum. The nurse practitioner teaches the patient to:

Apply a topical antibiotic and warm compresses. 
 

Apply cool compresses and avoid touching the hordeolum. 
 

Use an oral antibiotic and eye flushes. 
 

Apply light palpation to facilitate drainage.

·         Question 82

Sarah has allergic rhinitis and is currently being bothered by nasal congestion. Which of the following meds ordered for allergic rhinitis would be most appropriate?

An antihistamine intranasal spray

A decongestant nasal spray
 

Ipratropium
 

Omalizumab

·         Question 83

What is the Gold standard for the diagnosis of asthma?

Patient’s perception of clogged airways
 

Validated quality-of-life questionnaires

  Bronchoscopy
 

Spirometry

·         Question 84

A patient complains of “an aggravating cough for the past 6 weeks.” There is no physiological cause for the cough. Which medication is most likely causing the cough?

Methyldopa
 

Enalapril 
 

Amlodipine
 

Hydrochlorothiazide

·         Question 85

Stacy, age 27, states that she has painless, white, slightly raised patches in her mouth. They are probably caused by:

Herpes simplex
 

Aphthous ulcers
 

Candidiasis
 

Oral cancer

·         Question 86

Risk factors for acute otitis media (AOM) include all of the following except:

Household cigarette smoke
 

Group daycare attendance
 

Sibling history of acute otitis media
 

African-American ethnicity
 

·         Question 87

Which of the following can result from chronic inflammation of a meibomian gland?

A chalazion
 

Uveitis
 

Keratitis
 

A pterygium

·         Question 88

What conditions must be met for you to bill “incident to” the physician, receiving 100% reimbursement from Medicare?

You must initiate the plan of care for the patient

The physician must be on-site and engaged in patient care

You must be employed as an independent contractor

You must be the main health care provider who sees the patient

·         Question 89

Of the following choices, the least likely cause of cough is:

Asthma
 

Gastroesophageal reflux
 

Acute pharyngitis

Allergic rhinitis

·         Question 90

The most common correlate(s) with chronic bronchitis and emphysema is(are):

Familial and genetic factors
 

Cigarette smoking
 

Air pollution
 

Occupational environment

·         Question 91

Which choice below is least effective for alleviating symptoms of the common cold?

Antihistamines

Oral decongestants

Topical decongestants

Antipyretics

·         Question 92

When teaching a patient with hypertension about restricting sodium, you would include which of the following instructions?

Diets with markedly reduced intakes of sodium may be associated with other beneficial effects beyond blood pressure control    
 

Sodium restriction can cause serious adverse effects
 

A goal of 3 g of sodium chloride or 1.2 g of sodium per day is easily achievable
 

Seventy-five of sodium intake is derived from processed foods

·         Question 93

Which of the following heart murmurs warrants the greatest concern?

Systolic murmur
 

Venous hum murmur
 

Diastolic murmur
 

Flow murmur

·         Question 94

A patient presents with an inflamed upper eyelid margin. The conjunctiva is red and there is particulate matter along the upper eyelid. The patient complains of a sensation that “there is something in my eye.” What is the diagnosis and how should it be treated?

Hordeolum; treat with a topical antibiotic and warm compress
 

Conjunctivitis; treat with topical antibiotic and warm compresses
 

Blepharitis; treat with warm compresses and gentle debridement with a cotton swab
 

Chalazion; refer to an ophthalmologist for incision and drainage

·         Question 95

A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory?

Inferior wall
 

Anterior wall
 

Apical wall
 

Lateral wall

·         Question 96

The nurse practitioner observes a tympanic membrane that is opaque, has decreased mobility, and is without bulging or inflammation. The least likely diagnosis for this patient is: 
 

Acute otitis media (AOM)
 

Otitis media with effusion
 

Mucoid otitis media
 

Serous otitis media

·         Question 97

Alan, age 54, notices a bulge in his midline every time he rises from bed in the morning. You tell him it is a ventral hernia, also known as:

inguinal hernia

epigastric hernia
 

umbilical hernia
 

incisional hernia   

·         Question 98

A 58-year-old man is diagnosed with Barrett’s esophagus after an endoscopy. He has no known allergies. Which of the following medications is MOST appropriate to treat this patient’s disorder?

Omeprazole
 

Ranitidine
 

An antacid
 

None of the above

·         Question 99

Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to:

Quit smoking
 

Maintain aggressive hypertension therapy
 

Stick to a low-fat, low-sodium diet
 

Continue with his exercise program

·         Question 100

Risk factors for acute arterial insufficiency include which of the following?

Recent myocardial infarction
 

Atrial fibrillation
 

Atherosclerosis
 

All of the above

·         Question 101

Impetigo and folliculitis are usually successfully treated with:

Systemic antibiotics
 

Topical antibiotics
 

Topical steroid creams
 

Cleansing and debridement