Quizlet e - Lecture PDF

Preview

Summary

Lecture...

Description

FNP 2 exam 1 practice questions Study online at quizlet.com/_4e8y7h 1.

The bacterium responsible for the highest mortality in pts with CAP is:

Streptococcus pneumoniae

6.

A. Strep Pneumo B. Mycoplasma pneumo C. Moraxella catarrhalis D. Haemophilus influenzae 2.

When initially treating adults for bronchitis, which would the NP be least likely to order?

3.

4.

What is the least common pathogen C. Pseudomonas: is found in community-acquired atypical an uncommon cause pneumonia? of CAP but is very difficult bacteria to A. Moxarella catarrhalis treat B. Strep Pneumo C. Pseudomonas aeruginosa D. Mycoplasma Pneumonia Which of the following is recommended for erythema migrans treatment in early stages of lyme disease? A. Doxycyline (Vibramycin) 100mg PO BID X21 days B. Ciprofloxacin (Cipro) 250 mg PO BID X14 days C. Erythromycin (E-mycin) 333mg PO TID X10 days D. Dixoxacillin 500mg PO BID X 10 days

5.

28 y.o. student presents with "hacking cough." Productive with small amounts sputum, runny nose. Doesn't take any meds, no allergies, no significant PMH. Temp: 99.9F, Resp: 16/min, HR: 90 BPM, diffuse fine crackles. CXR shows diffuse infiltrates in lower lobe of right lung. CBC shows WBC count 10,500. What is most likely diagnosis? A. Strep pneumo B. Mycoplasma pneumo C. Acute Bronchitis D. Legionnaires disease

A. Perform thorough History B. Prescribe PO antihistamine such as benadryl 25mg PO QD C. IM Epinephrine 1:1000 STAT D. Call 911

B. Antibiotics

A. Expectorants B. Antibiotics C. Bronchodilators D. Antitussives

30 y.o. c/o pruritic hives over chest/ arms but denies SOB, difficulty swallowing. Reports family hx allergic rhinitis, & asthma. Which of the following interventions is most appropriate?

A. Take a thorough history prior to prescribing medications: find cause of rash. No airway difficulty/ swallowing so no need for 911

7.

Which of the following is associated D. Tingling and numbness in both feet: with Vitamin B-12 anemia? B12 can cause nerve A. Spoon shaped nails and Pica damage if left B. An abnormal neuro exam untreated, also C. Vegan diet dementia, memory D. Tingling/ numbness in both feet loss, difficulty walking, mood changes, depression also

8.

A 70 y.o male c/o bright red spot in his left eye for 2 days. He denies pain, visual changes, or headaches. New onset cough from recent viral illness. The only med he was on was Bayer Aspirin 1 tablet daily. Which of the following is most likely?

A. Doxycyline 100mg PO BID X21 daysRecommended by the CDC as gold standard treatment

D: Subconjunctival hemorrhage: caused by increased intraocular pressure due to straining, coughing, heavy lifting etc. Self limiting- disappears in 1-3 weeks

A. Corneal Abraison B. Acute bacterial conjunctivitis C. Acute uveitis D. Subconjunctival hemorrhage 9.

B. Mycoplasma: most commonly seen in children and young adults. spread through droplets, sneezing and coughing at close distance. DX made through sx and CXR showing infiltrate to lower lobes

RMSF is caused by bite of:

B: Tick with parasite Rickettsia rickettsii

A. Mosquito B. Tick C. Insect D. Flea 10.

4 y.o. female comes in after just starting pre school complaining of burning/ itching in both eyes along with runny nose. Child's eyes appear injected bilaterally, the throat is red and her inferior nasal turbinates are swollen. Which is most likely? A. Herpes Keratitis B. Corneal Ulcer C. Viral Conjunctivitis D. Bacterial conjunctivitis

C: Viral- no signs of infection but pts often complain of red/ itchy/ swollen eyes

11.

What test would you use on a 7 y.o. to screen for color blindness?

B: Ishihara chart

16.

A. Snellen chart B. Ishihara chart C. Cover/uncover test D. Red Reflex 12.

Koplik's spots are associated with: A. Poxvirus infections B. Measles C. Kawasaki's disease D. Reye's syndrome

13.

An elderly pt with productive cough + fever diagnosed with pneumonia. All of the following organisms are capable of causing CAP except:

B. Measles: S/S of the measles includes 3 C's! Cough, coryza, conjunctivitis, rash, fever over 101F and Koplik's spots in buccal mucosa C. Treponema pallidum is a spirochete that causes syphilis

You would advise an 18 y.o. at the student health clinic who just got an MMR booster which of the following: A. She may have low grade fever over next 24-48 hrs B. Not to get pregnant within the next 4 weeks C. Her arm will be very sore for the next 48 hrs at injection site D. Her arm will have some induration at IM site for 48 hrs

15.

An NP is giving dietary counseling to an alcoholic male who has been recently diagnosed with folic acid deficiency anemia. Which of the following foods should the NP recommend? A. Tomatoes, oranges, bananas B. Cheese, yogurt, milk C. Lettuce, beef, dairy products. D. Spinach, liver, and whole wheat bread

B. Women should not get MMR while pregnant, and need at least 28 days between vaccination and conception, preferrably at least 4 weeks

B: COPD: results in polycythemia (Increased Hematocrit) due to chronic hypoxia. Also you may note digital clubbing, dyspnea on exertion, accessory muscle use

A. Bronchogenic carcinoma B. COPD C. Chronic bronchitis D. CHF 17.

A. Haemophilus influenzae B. Mycoplasma pneumoniae C. Treponema pallidum D. Strep Pneumo 14.

67 y.o female presents to the clinic with 50 pk year hx of smoking for physical. C/o being easily short of breath/ frequent fatigue. Physical reveals diminished breath sounds, hyperresonance and hypertrophied resp muscles. Her CBC shows that her hematocrit level is slightly elevated. Her pulmonary function test shows increased total lung capacity. What is most likely DX for this pt?

a 28 y.o. male nurse of Hispanic descent reports hx of a cold that resolved two weeks ago except for a dry cough, and pain in his cheek that worsens when he bends down. Pt denies fever, tells NP he is very allergic to keflex and erythromycin. Vitals: Temp 99.2F, HR: 72, and RR: 12 breaths/min. Which of the following is most likely?

A. Acute Sinusitis: acute sinusitis sx include facial pain, cough, and low grade fever

A. Acute sinusitis B. Acute bronchitis C. Fever 2ndary to recent URI D. Munchausen's syndrome 18.

All of the following are implicated in causing chronic cough except: A. Chronic bronchitis B. Allergic rhinitis C. Acute viral URI D. GERD

D: Spinach liver and whole wheat

19.

Which of the following viral infections is associated with occasional abnormal forms of lymphocytes during an acute infection? A. Cytomegalovirus (CMV) B. Epstein-Barr virus (EBV) C. HPV D. Coxsackie Virus

C Acute viral URI: The key in this question is where it says what causes "CHRONIC COUGH." An acute viral illness will resolve, while chronic bronchitis, GERD, and allergic rhinitis can all cause chronic coughs. B: Epstein Barr Virus (EBV)

20.

A high school teacher complains of cough X6 weeks. Worse when lying down. He has episodes of heartburn, which he treats with OTC TUMS. He chews mints for his "bad breath" which is most likely causing his cough?

GERD: Common cause of chronic cough, worse when lying down because acid splashes up into upper esophagus

25.

A. A mild macrocytic anemia B. Normocytic anemia C. Microcytic anemia D. A mild hemolytic anemia

A. Asthma B. Gastroesophageal Reflux C. Pneumonia D. Chronic Post nasal drip 21.

All of the following are factors important in determining the peak flow rate except:

Weight 26.

A. Weight B. Height C. Age D. Gender 22.

A small abscess on a hair follicle on the eyelid is called: A. Hordeolum B. Aortic Stenosis C. Pinguecula D. Ptosis

23.

Beta thalassemia minor is considered a: A. Macrocytic anemia B. Normocytic anemia C. Microcytic anemia D. Hemolytic anemia

24.

Which of the following findings are seen in a patient with folate deficiency anemia? A. Microcytic and Hypochromic RBCs B. Microcytic and normochromic RBCs C. Normal size and color RBCs D. Macrocytic and Normocytic RBCs

27.

D: Macrocytic and Normocytic RBCs are found in Folate deficiency anemia

All of the following are associated with an increased risk for normocytic anemia except:

C: Microcytic anemia: Lead poisoning can cause microcytic anemia. Causes anemia by mimicking healthful minerals such as Calcium, iron and zinc. Is absorbed by the bones where it disrupts the formation of RBCs.

D: Pregnancy, during pregnancy women at risk to develop microcytic, hypochromic anemia due to dilutional effect of increased blood volume in pregnancy.

A. Rheumatoid arthritis B. Lupus C. Chronic immune disorders. D. Pregnancy

Hordeolum- painful acute bacterial infection of a hair follicle on the eyelid

C; Microcytic anemia: Beta thalassemia is a genetic disorder in which the bone marrow makes small pale RBCs (microcytic hypochromic), and microcytic anemia occurs.

Lead poisoning can cause which type of anemia?

An infant who does not have a history of reactive airway disease and allergy has both insiratory and expiratory wheezing accompanied by fever and profuse clear nasal discharge, which of the following are most likely? A. Tracheobronchitis B. Bronchiolitis C. Croup D. A small foreign body that is lodged in the left main bronchus

B: Bronchiolitis: Tracheobronchitis include prominent dry, non productive cough; later coughing up sputum is common. Bronchiolitis is a viral infection caused by RSV that is commonly seen during the winter/ spring months in infants & young children. Typical S/S include fever/ inspiratory/ expiratory wheezing, with clear drainage. Croup is viral infection with classic "barking" cough; the pt may have runny nose but no fever with croup. Foreign body ruled out due to fever and runny nose

28.

Asthmatics may have all of the following symptoms during an asthma exacerbation except:

Chronic coughing

33.

A. Rapid Pulse B. Wheezing C. Chronic coughing D. Tachypnea 29.

10 y.o. male who was recently accepted to his school's soccer team has a hx of exercise induced astnma and he wants to know when he should take his albuterol inhaler. The NP should advise him:

A: Premedicate 20 min prior to starting exercise

12 y.o. complaining of 2 week history of facial pressure, that worsens when she bends over. She c/o tooth pain in her upper molars on the right side of her face. On physical exam, her lung and heart sounds are normal. Which of the following is the most likely DX?

What is the best procedure for evaluating corneal abrasion?

34.

35.

C; Acute sinusitis: s/s include facial pressure, headache, pain that worsens when bending over, eye/ear pain, aching in upper jaw/ teeth, reduced smell/ taste and cough.

A. An acute dental abscess B. Chronic sinusitis C. Acute sinusitis D. Severe allergic rhinitis 31.

A. Bacterial pneumonia B. Acute bronchitis C. COPD D. Atypical pneumonia

A 12 y.o. male's peak inspiratory flow rate results show 60-80% of the predicted range. How would you classify his asthma? A. Mild intermittent B. Mild Persistent C. Moderate persistent D. Severe asthma

The mother of an 8 y.o. boy reports presence of round red rash on the child's left lower leg. It appeared 1 week after the child returned from his grandparents house in Massachusets. During the skin exam, the NP notes a maculopapular rash with areas of clearing making it resemble a large target. Which of the following is best described?

36.

B. Fluorescein stain

Acute Bronchitis is best characterized by: A. Fever and wheezing B. Purulent Sputum and fever C. Paroxysms of coughing that is dry or with productive of mucoid sputum D. A gradual onset and fatigue

C moderate persistent- 60-80% peak flow tests is moderate persistent and anything less than 60% is severe

A; Bacterial pneumonia: Consolidation is not seen on CXR in the other three options

A Lymphocytosis and/ or atypical lymphocytesMono caused by virus not infection. More likely to see EBV titers, elevated LFTs, and BUN CT elevation A; Erythema Migrans: "Bulls eye rash" seen in Lyme disease. Needs immediate treatmemt with ABX, seen in NE region of USA

A. Erythema Migrans B. Rockey Mountain spotted fever C. Meningococcemia D. Larva Migrans

A. Tonometry B. Fluorescein stain C. Visual Field test D. Funduscopy 32.

The following abnormal lab result may be seen in patients with acute mononucleosis except: A. Lymphocytosis and/ or atypical lymphocytes B. Positive EBV titers for (Ig) M and Ig G C. Elevated liver function tests D. Elevated BUN and Ct

A. Premedicate himself 20 min before starting exercise B. Wait until he starts to exercise to use the inhaler Premedicate 60 min prior to starting exercise D. Wait until he finishes his exercise to use inhaler 30.

A chest radiograph shows an area of consolidation on the lower lobe. Which of the following conditions is the most likely?

37.

What is the first line class of ABX recommended by the American Thoracic Society for patients younger than 60 with CAP with no co morbidities? A. First gen cephalosporins B. Second Gen cephalosporins C. Macrolides D. Beta Lactam antibiotics

C: Paroxysms of coughing: Bronchitis is characterized by intermittent cough that is either dry or productive with mucous C. Macrolides

38.

When Molluscum Contagiosum is found in the genital area of children, which of the following is the best explanation?

A. It should raise concern for sexual abuse: Molluscum Contagiosum is spread by skin to skin contact, if found in the genital area it should raise concern for sexual abuse

A. It should raise suspicion of sexual abuse B. It is not considered an STI C. It is caused by Atypical bacteria D. It is caused by the poxvirus and will resolve on it's own 39.

41.

Which of the following tests would you recommend to patients to confirm DX of beta thalassemia or sickle cell anemia? A.Hemoglobin Electrophoresis B. Bone Marrow Biopsy C. Peripheral Smear D. Reticulocyte count

Orchitis is caused by which of the following? A. Mumps virus B. Measles virus C. Chlamydia Trachomatis D. Chronic UTIs that are not correctly treated

43.

A. Veins are larger than arterioles B. The arterioles are larger than veins C. The arterioles are half the size of the veins D. The veins and the arterioles are equal in size 40.

D: Hypertension

A. Alcoholism B. Very young age or the elderly C. Multiple lobar involvement D. Hypertension 42.

Which of the following is A: The veins are larger than the the correct statement arterioles- this should be regarding the size of the apparent on a fundoscopic exam arterioles and veins on the fundi of the eye?

All of the following factors increase risk of mortality for patients diagnosed with bacterial pneumonia except:

A: Mumps: Orchitis (or inflammation of one or both of the testicles) occurs with the mumps

A cauliflower like growth C: Cholesteatoma with fowl smelling discharge is seen in an otoscopic exam of the left ear of an 8 y.o. boy with a hx of chronic otitis media. No tympanic membrane, ossicles, are visible and the pt seems to have difficulty hearing out of the affected ear. Which condition is the best described? A. Chronic perforation of TM with secondary bacterial infetcion B. Chronic Mastoiditis C. Cholesteatoma D. Cancer of the middle ear

A. Hemoglobin Electrophoresis

44.

Which of the following is associated with having 3 stages of rashes? A. Fifth disease B. Erythema infectiosum C. Varicella D. Rocky mountain spotted fever

A: Fifth disease: (Prodromal phase) begins with sx of URI such as fever, malaise, headache, and chills. Second stage: Rash begins on the cheeks known as the "slapped cheek" usually resolves in 2-3 days. Third stage: rash moves to arms and legs and appears "lacey" that is flat and purple in appearance. May last 3-4 weeks

45.

A 15 m.o. child who is eating and behaving normally is found to have a high fever. A few days after, the fever resolves and the infant breaks into a maculopapular rash. This is a description of which of the following? A. Erythema infectiosum B. Roseola Infantum C, Fifth disease D. Scarlet fever

46.

New patient who recently visited relative in north carolina c/o a new onset fever, and red rashes that started 2 days ago. First rash appeared on wrists and ankles, and included palms of hands. Pt reports the rash is spreading to his trunk. His eyes are not injected, and no enlarged nodes are palpated on his neck. There is no desquamation of the skin. Which of the following is most likely?

B. Roseola Infantum (Also known as fifth disease). Slapped cheek appearance. The happy rash, kids don't seem sick

A 13 y.o. pt has a throat culture that is positive for strep throat. She reports that her younger brother was recently diagnosed with strep and was treated. The pt has a severe allergy to penicillin and reports erythromycin makes her very nauseated. Which of the following ABX is the best choice? A. Azythromycin B Cephalexin (keflex) C. Cefuroxime axetil (Ceftin) D. Levofloxacin (Levaquin)

A 62 y.o. male with COPD complains to his NP that his ipratropium bromide (Atrovent ) is not working. He reports he still feels SOB after using it 4X per day for 3 months. Which of the following actions is the next step for the NP?

C: COntinue atrovent and add albuterol. The plan of care is always start with an anticholinergic (Atrovent) and then add short acting beta agonist

A. Increase pt's dose to 3 inhalations QID B. Continue the atrovent and start the pt on O2 via NC C. Continue the atrovent and add albuterol 2 inhalations QID D. Start the pt on O2 at night time abd PRN during the day

C. Rocky Mountain Spotted fever: given recent travel, rash location. Tick born illness 49.

What structure of the eye is responsible for 20/20 vision?

D. Fovea and Macula

A. Rods B. Cones C. Optic disc D. Fovea and macula

A. Kawasaki's disease B. Meningococcemia C. Rocky Mountain spotted fever D. Measles 47.

48.

50.

A. Azythromycin: Don't use Levaquin in kids, 10% cross reactivity between penicillin and Keflex, Erythromycin commonly has nausea as side effect but not allergy, azythromycin better tolerated.

A new patient is being interviewed by an NP, and states she had a gastrectomy procedure 5 years ago. The NP knows that this patient is at risk for which of the following? A. Folate deficiency anemia B. b12 deficiency anemia C. Iron deficiency anemia D. Normocytic anemia

51.

What bacteria most commonly causes otitis externa? A. Pseudomonas aeroginosa B. Strep pyogens C. Haemophilis influenza D. Maraxella catarrhalis

B. B12 deficiency anemia: intrinsic factor is made by parietal cells in fundus of the stomach. IF is needed to sufficiently absorb B12. Gastrectomy pts have damaged fundus usually so they are at risk.

A. Pseudomonas aeroginosa is the most common. Staphylococcus is the second most common seen in otitis ex...