Deck 1: Adult Nurse Practioner Practice: Medical Conditions and Disorders

Question 1

A 35-year-old woman complaining of lower back pain is suspected of herniated nucleus pulposus. Vertebral herniation is most likely found in which areas?

A)L1-L2; L4-L5
B)L2-L3; L3-L4
C)L4-L5; L5-S1
D)S1-S2; S2-S3

Answer 1

L4-L5; L5-S1

Question 2

A patient with multiple myeloma is demonstrating signs of hypercalcemia by which of the following?

A)Diarrhea
B)Twitches
C)Hyperactive deep tendon reflexes
D)Decreased motility of the gastrointestinal tract

Answer 2

Decreased motility of the gastrointestinal tract

Question 3

Which is not a correct definition of each classification of fracture?

A)Complete: bone bends but does not break
B)Greenstick: bone cracks through one side only
C)Comminuted: bone is crushed into many pieces
D)Open: bone pierces skin

Answer 3

Complete: bone bends but does not break

Question 4

A patient is suspected to have Von Willebrand disease. The statements below are characteristics of the disease. Which of the following is incorrect?

A)It is a qualitative platelet defect.
B)vWF allows adhesion of platelets to a glycoprotein Ib-IX.
C)The deficiency is only moderate.
D)vWF functions independent of factor VIII.

Question 5

A 20-year-old female sustained multiple long bone fractures after a motorcycle accident. The patient is at risk for fat emboli, a serious complication. Which of the following signs and symptoms indicate fat emboli?

A)Tachypnea, tachycardia, elevated temperature, shortness of breath
B)Tachypnea, tachycardia, confusion, shortness of breath
C)Bradypnea, bradycardia, confusion, shortness of breath
D)Bradypnea, bradycardia, decreased temperature, shortness of breath

Question 6

Of the following lab values, which would be true in a case of iron deficiency anemia?

A)Decreased MCV and an increased RDW
B)Decreased MCV and an decreased RDW
C)Increased MCV and an increased RDW
D)Decreased MCV and an increased MCHC

Question 7

A patient who sustained a spinal cord injury 48 hours ago presents with diaphoresis, flushed face and neck, and severe headache. Further assessment reveals bradycardia and severe hypertension. The patient is most likely experiencing:

A)Autonomic dysreflexia
B)Pulmonary embolism
C)Malignant hypertension
D)Spinal shock

Question 8

A nurse determines that the following clients are contraindicated to receive the measles, mumps, and rubella vaccine except:

A)A female client at 12 weeks gestation
B)A school-age child with HIV
C)A female client with a history of hypersensitive reactions to neomycin
D)A female client with HIV who is admitted for Pneumocystis carinii pneumonia

Question 9

A patient is taken in due to a motorcycle accident. Which of the following is not a warning sign of internal bleeding?

A)Hematomas
B)Board-like abdomen
C)Deformed extremities
D)Vomiting of bile

Question 10

A nurse is assessing a patient for signs and symptoms of severe anemia. Besides the lab values and vital signs what observations in the physical assessment would give indication that the patient is severely anemic?

A)A bluish color over the abdomen.
B)Pedal edema.
C)Abnormalities in the patient's nails.
D)A jerking of the wrist and arm when the blood pressure cuff is applied.

Question 11

A 35-year-old white female tested positive for antinuclear antibody after demonstrating signs of systemic lupus erythematosus. What is the next step?

A)Prescribe ibuprofen
B)Prescribe prednisone or another glucocorticoid
C)Order for an Anti-DS DNA
D)Order for Anti-citrullinated cyclic peptide

Question 12

A 27 year old man had a tonic-clonic seizure and fell down. While admitted, the patient had a recurrent episode of seizure. Which of the following is a priority during this event?

A)Diazepam at bedside
B)Oxygen at bedside
C)Tongue depressor at bedside
D)Restrain immediately

Question 13

When managing a patient with septic shock, it is important to remember that:

A)Due to exotoxin release
B)Causes vasodilation
C)Caused by gram-positive bacteria
D)Caused by injury to the CNS

Question 14

A woman was recently diagnosed with osteoarthritis. During patient education, the woman is informed that the following conditions or actions can cause or worsen primary osteoarthritis:

A)Diabetes mellitus, a congenital abnormality, obesity
B)Overuse of joints, obesity, diabetes mellitus
C)Overuse of joints, obesity, aging
D)Overuse of joints, obesity, a congenital abnormality

Question 15

An 18-year-old who had a recent fracture in the left leg is suspected of having compartment syndrome. Assessment findings would include the following signs and symptoms:

A)Pain with active movement, inability to perform passive movements, pallor
B)Pain with passive movement, inability to perform active movement, weakness
C)Pain with active movement, inability to perform passive movements, weakness
D)Pain with passive movement, inability to perform active movements, decreased sensation

Question 16

You are beginning treatment on a patient with HIV. Besides drugs that are specifically targeted at HIV, what other group of medications would the patient be started on to avoid common complications of HIV?

A)Empiric antibiotics
B)Anti fungal medications
C)Non steroidal anti-inflammatory medications
D)Pain medication

Question 17

A 20-year-old man comes to the clinic complaining of anorexia, vomiting, and myalgia. On assessment, maculopapular and petechial rash are found on the ankles and wrists. The patient says he remembers getting bitten by a tick about 2 weeks ago. Based on the physical findings and history, the patient is most likely diagnosed with:

A)Rocky mountain spotted fever
B)Infectious mononucleosis
C)Rubella
D)Diphtheria

Question 18

A 69-year-old man is taken in for diagnostic tests. The findings showed reversible airway obstruction secondary to bronchial hyperreactivity, airway inflammation, mucus plugging, and smooth muscle hypertrophy. What is his likely diagnosis?

A)Emphysema
B)Pneumonia
C)Pulmonary edema
D)Asthma

Question 19

On assessment, small to large wart-like growths on the woman's genitals are observed and noted. Some eruptions appear fungating, others appear cauliflower-like. Which of the following is a severe complication of this sexually transmitted disease?

A)Mental deterioration
B)Ophthalmia neonatorum
C)Pelvic inflammatory disease
D)Cervical malignancy

Question 20

Which of the following statements describes decorticate posturing?

A)One or both arms are flexed onto the chest and the legs may extend rigidly.
B)One or both arms are rigidly extended and the legs may extend rigidly as well.
C)The ankle and great toe dorsiflexes with fanning of the other toes.
D)No motor response is observed in any extremity.

Question 21

Which of the following is not a clinical feature of Sturge-Weber syndrome?

A)It is congenital neurological and skin disorder
B)It initially manifests as seizure.
C)It rarely affect body organs
D)Anticonvulsants are the drug of choice

Question 22

Which of the following disorders are not commonly treated with antidepressants?

A)Obsessive-compulsive disorder
B)Eating disorders
C)Bipolar disorder
D)Post-traumatic stress disorder

Question 23

Which of the following are atypical antipsychotic drugs?

A)Seroquel, Risperdal, Olanzapine
B)Haloperidol, Chlorpromazine, Fluphenazine
C)Alpralozam, Chlordiazepoxide, Lorazepam
D)Valproic acid, Carbamazepine, Sodium Valproate

Question 24

Which of the following is true about expressive aphasia?

A)The damage occurs in Wernicke's area.
B)Patients are not able to understand spoken and written words, but are able to produce sounds, phrases, and word sequences.
C)Patients are not able to use an object correctly.
D)Patients understand what is said, but are unable to communicate verbally.

Question 25

Hemoptysis is not a clinical symptom of:

A)Pneumonia
B)Tuberculosis
C)Emphysema
D)Bronchitis

Question 26

A 55-year-old man who works in a long-term health facility comes to the office complaining of cough, afternoon fever, night sweats, and easy fatigability. Tuberculosis is the initial diagnosis. Which of the following diagnostic tests is the most definitive for tuberculosis?

A)Chest x-ray
B)Sputum culture
C)Mantoux test
D)Tuberculin test

Question 27

Which of the following characteristics would be expected of the asthma of a patient with severe persistent asthma?

A)Asthma attacks are brief of varied intensity, occurring no more than twice a week. Normal peak expiratory flow rate is maintained between attacks. Nighttime symptoms are no more than twice a month.
B)Exacerbations of symptoms affect activity, occurring more than twice a week. Daily short-acting bronchodilator use is prescribed. Nighttime symptoms are more than twice a month.
C)Continual symptoms of asthma that limit physical activities. Frequent exacerbations do not quickly respond to treatments.
D)An acute exacerbation of asthma that does not respond to routine therapies like bronchodilators.

Question 28

A woman who is 20 weeks gestation has a risk to have which condition if she has a history of hypertension?

A)Anemia
B)Abruptio placenta
C)Placenta previa
D)Spontaneous abortion

Question 29

A female patient suspected of having a neurological deficit is contraindicated for magnetic resonance imaging if she has a history of:

A)Claustrophobia
B)Uncontrolled hypertension
C)Implanted defibrillator
D)Craniotomy

Question 30

Lumbar puncture is contraindicated in patients with:

A)Low back pain
B)Increased intracranial pressure
C)Increased bone fragility
D)Decreased cardiac output

Question 31

A woman at 18 weeks gestation is pregnant for the seventh time. She had three elective abortions, the first at 12 weeks gestation, second at 21 weeks gestation, and third at 10 weeks gestation. She has a daughter born at 42 weeks gestation, a son born at 41 weeks gestation, and a set of twin boys born at 37 weeks gestation. What is the woman's GP-TPAL

A)G7P4 -T2P2A3L4
B)G7P3-T2P2A3L4
C)G7P4-T2P1A3L4
D)G7P5-T1P2A3L4

Question 32

A 69-year-old man comes to the office complaining of severe bone pain in the left leg. On assessment, a bowing deformity is noticed in the left leg, causing gait abnormalities. Tingling and weakness of the affected leg is also reported. Which of the following is the best initial test for suspected Paget's disease?

A)Alkaline phosphatase
B)X-ray
C)Urinary hydroxyproline
D)Bone scan

Question 33

A woman at 24 weeks gestation is administered with a ritodrine (Yutopar) to stop premature labor. Which of the following is an adverse reaction of this medication?

A)Hypotension
B)Uterine rupture
C)Pulmonary edema
D)Water intoxication

Question 34

A woman at 28 weeks gestation is administered with magnesium sulfate to control severe hypertension. The following findings indicate that the patient is experiencing magnesium sulfate toxicity except:

A)Blood pressure reading of 70/40
B)Respiratory rate of 10 breaths per minute
C)Knee jerk reflex +1
D)Seizures

Question 35

A patient comes to the office with extremely pale skin. Which condition is least likely to be indicated by pale skin?

A)Late stages of carbon monoxide poisoning
B)Blood loss and associated blood vessel constriction
C)Shock
D)Decreased blood pressure
E)Emotional distress

Question 36

A 35-year-old patient is diagnosed with essential hypertension. Upon evaluation, the patient needs further teaching when he states that __________ is a chronic complication of essential hypertension?

A)Diabetes
B)Renal failure
C)Neuropathy
D)Asthma

Question 37

A man is suspected of chronic glaucoma. Which of the following examinations should be ordered to determine the diagnosis?

A)Slit lamp
B)Tonometry
C)Fluorescein angiography
D)Computed tomography

Question 38

Which of the following names layers of the skin from most superficial to deepest?

A)Epidermis, dermis, subcutaneous fatty tissue
B)Dermis, epidermis, subcutaneous fatty tissue
C)Epidermis, subcutaneous fatty tissue, dermis
D)Dermis, subcutaneous fatty tissue, epidermis

Question 39

An 80-year-old Hispanic woman attached to the ECG is diagnosed with myocardial infarction. Utilizing the ECG, an infarct is located on the base of the left ventricle. Which of the following arteries has been occluded?

A)Lateral branch of the circumflex artery
B)Marginal branch of the circumflex artery
C)Left anterior descending artery
D)Right coronary artery

Question 40

Secondary hypertension refers to increased blood pressure caused by an existing condition. Each of these following endocrine disorders can contribute to secondary hypertension, except:

A)Cushing syndrome
B)Diabetes
C)Pheochromocytoma
D)Hypoaldosteronism

Question 41

Where are fungal infections usually found?

A)Blood
B)Skin
C)Organs
D)All of the above

Question 42

A patient administered with pilocarpine hydrochloride (Isopto Carpine) is demonstrating the toxic effects of the drug if the following signs and symptoms are seen except:

A)Vertigo
B)Tremors
C)Hypertension
D)Bradycardia

Question 43

A 35-year-old man is suspected of a cataract in its early stage. Which of the following manifestations is considered as the main indicator of cataract formation?

A)Blurred vision
B)Eye pain
C)Floaters
D)Diplopia

Question 44

A 75-year-old female client comes to the office complaining of severe angina unresolved by nitroglycerin, which started 2 hours earlier. Physical examination reveals hypotension, clear lung fields, and elevated jugular pressure. A deep and labored breathing pattern is noted. Infarct in the right ventricle is diagnosed.
Which of the following 12-lead ECG findings is the single most powerful predictor of right ventricular infarction involvement within 10 hours of the onset of symptoms?

A)ST-segment elevation in lead V_4R
B)ST-segment elevation in lead V₁
C)ST-segment depression in lead V_3R
D)ST-segment elevation in lead V_3R

Question 45

A pregnant woman is diagnosed with bacterial vaginosis. Which of the following findings is consistent with the diagnosis?

A)Gray and thin discharge with a strong fish-like odor
B)Mucoid and purulent discharge
C)Thick, white, cottage cheese-like discharge
D)Frothy, foamy, yellow-green vaginal discharge

Question 46

A patient scheduled for cataract surgery is administered with cyclopentolate hydrochloride (Cyclogyl) eye drops. This medication is used to:

A)Constrict the pupil and contract the ciliary muscles
B)Corneal anesthesia
C)Add moisture to the eyes
D)Dilate the pupil and relax the ciliary muscles

Question 47

Which of the following diagnostic tests is ordered to obtain a detailed imaging and recording of ocular circulation?

A)Computed tomography
B)Slit lamp
C)Corneal staining
D)Fluorescein angiography

Question 48

An immobile patient presents with a decubitus ulcer in an area in which the top layer of the skin is missing. The ulcer is shallow with a pink to red base. These signs and symptoms describe an ulcer at stage ________ :

A)Stage I
B)Stage II
C)Stage III
D)Stage IV

Question 49

A 43-year-old woman presents with difficulty breathing and distended neck veins. Pulsus paradoxus is recognized on assessment. No pulse is detected on palpation of the femoral artery. Other significant findings include muffled heart sounds, dyspnea, and tachycardia. What is the most likely diagnosis?

A)Pericardial effusion
B)Cardiac tamponade
C)Pericarditis
D)Chronic constrictive pericarditis

Question 50

Which of the following statements is true about the electrophysiologic properties of the cardiac cells?

A)Myocardial muscles do not respond in an all-or-nothing manner.
B)When one cell is stimulated, the impulse does not spread throughout the heart muscle.
C)Myocardial cells do not possess the ability to initiate an electrical impulse.
D)Automaticity, excitability and conductivity are classified as mechanical properties, whereas contractility is classified as electrical.

Question 51

An elderly patient who complains of chest pain, dizziness, and shortness of breath is about to be connected to a cardiac monitor. To monitor lead III:

A)Place the positive electrode on the patient's left leg; the negative electrode on the patient's right leg.
B)Place the positive electrode on the left leg; the negative electrode on the left arm.
C)Place the positive electrode on the left arm; the negative electrode is placed on the right arm.
D)Place the positive electrode on the left side of the chest; the negative electrode is placed on the right arm.

Question 52

Which of the following problems is most likely associated with the left bundle branch block (LBBB)?

A)Congenital heart disease
B)Severe aortic valve disease
C)Atrial Septal Defect (ASD)
D)VSD

Question 53

A 70-year-old woman is scheduled to have a colonoscopy in the next three days. Pre-procedure instructions and actions would include:

A)A clear liquid diet started after midnight on the day before the test
B)Adequate cleansing of the colon is not necessary
C)NPO at least 6 hours before the procedure
D)The patient is positioned lying on the left side with the knees drawn up to the chest

Question 54

A 45-year-old man is on chronic hemodialysis. Which of the following conditions is not linked to dialysis?

A)Infection of vascular access
B)Thrombosis
C)Steal syndrome
D)Hepatitis A

Question 55

Which of the following medications are not administered during the active phase of peptic ulcer disease?

A)Anti-cholinergics
B)Prostaglandins
C)Non-steroidal anti-inflammatories
D)Antacids

Question 56

A woman with pancreatitis is noted to have bluish discoloration of the periumbilical area on physical examination. This finding is called:

A)Turner's sign
B)Cullen's sign
C)Murphy's sign
D)Spider angioma

Question 57

An 18-year-old female has been diagnosed with hepatitis A. Which of the following assessment findings indicates that she is in the icteric stage of hepatitis?

A)Flu-like symptoms
B)Increased energy levels
C)Pruritus.
D)Serum bilirubin and enzymes are elevated

Question 58

Which of the following groups of individuals has the greatest risk for celiac disease?

A)Asian
B)Native American
C)African Americans
D)Caucasians of European descent

Question 59

While assisting a physician in the diagnosis of Cushing's syndrome, the following symptoms should be considered:

A)Weight loss, hirsutism, purple striae
B)Renal calculi, dysmenorrhea and polydipsia
C)Hypotension, osteoporosis, hypernatremia
D)Hypokalemia, hyperglycemia, truncal obesity, buffalo hump

Question 60

During assessment, the nurse touches the client's cornea with a wisp of cotton. Which of the following cranial nerves is the nurse assessing?

A)Cranial nerve II
B)Cranial nerve IV
C)Cranial nerve V
D)Cranial nerve VI

Question 61

Which procedure is most helpful in screening for impotence?

A)Sexual history and physical examination
B)Serum testosterone
C)Penile blood pressure studies
D)Gonadotropin assay

Question 62

The Bartholin gland is responsible for secreting mucus to lubricate the vagina. Where is it specifically located?

A)Anterior wall of the vagina
B)Above the urethral and vaginal opening
C)Below and to the left and right of the vaginal opening
D)Extends from the vulva to the cervix

Question 63

A patient has a known case of congestive heart failure. Upon assessment, the patient presents with oliguria, asterixis, confustion, and orthostatic blood pressure. The diagnosis was azotemia. What type of azotemia is the patient under?

A)Pre-renal
B)Renal
C)Postrenal
D)None of the above

Question 64

Which is the most significant procedure in screening for benign prostatic hypertrophy?

A)PSA
B)DRE
C)TRU
D)Prostate biopsy

Question 65

A patient is diagnosed with diabetes insipidus after a series of diagnostic tests. Which of the following signs and symptoms is indicative of this disorder?

A)Polydipsia
B)Weight gain
C)Hypertension
D)Changes in level of consciousness

Question 66

You suspect a patient has Type I Diabetes. The following statements are true about Type I Diabetes except:

A)May be linked to autoimmunity
B)Onset usually prior to age 20
C)Beta islet cells destroyed
D)Does not require insulin injections

Question 67

A female patient complains of an enlarged thyroid gland, and protruding eye ball. Further evaluation reveals that the patient has hypertension, nervousness, and fine tremors of the hands. Which of the following medications should be ordered for the patient?

A)Propylthiouracil (PTU)
B)Levothyroxine (Synthroid)
C)Liotrix (Thyrolar)
D)Liothyronine (Cytomel)

Question 68

A newly diagnosed client is prescribed with insulin. The patient is taught to rotate injection sites when administering insulin to prevent which of the following reasons complications?

A)Increased resistance to insulin
B)Insulin lipodystrophy
C)Hypersensitivity
D)Increased bleeding and bruises

Question 69

The following statements are true regarding Burkitt's lymphoma, except:

A)Close association with Epstein Barr virus
B)High-grade T-cell malignancy
C)Cytogenic chromosomal change is seen
D)It is a form of non-Hodgkin lymphoma

Question 70

The following are characteristics of nephrogenic diabetes insipidus, except:

A)Sensitized kidney tubules to ADH
B)A genetic (sex-linked) predilection in men
C)Normal ADH production and secretion
D)Large volumes of dilute urine are produced