A 75 year old female presents in the office complaining that her heart "keeps skipping beats and
goes very fast". The patient also reports dizziness and shortness of breath, especially with
activity. Her pulse is 120 beats/minute and irregular. The NP orders a 12-lead EKG and
considers an echocardiogram. The NP will likely prescribe:
a. chlorthalidone 12.mg daily
b. warfarin (Coumadin) 5 mg daily
c. warfarin (Coumadin) 2.5 mg daily
d. chlorthalidone 25 mg daily
c. warfarin (Coumadin) 2.5 mg daily
A young adult male visits the urgent care clinic after falling and landing on his buttock. He
complaints of feeling electrical impulses traveling down both legs and inability to urinate. Upon
physical exam, the NP notes decreased lower extremity strength and reflexes. Which diagnosis
is most likely?
A. cauda equina syndrome
B. lumbar stenosis
C. fibromyalgia
D. Paget's disease
A. cauda equina syndrome
A 35 y/o patient is being worked up for microscopic hematuria. All of the following are
differentials for microscopy hematuria except:
A. kidney stones
B. bladder cancer
C. acute pyelonephritis
D. renal artery stenosis
D. renal artery stenosis
A 22 y/o female presents to urgent care with signs of a broken arm, stating that she fell at home.
Upon assessment, the NP observes numerous bruises in various stages of healing, and the
patients live-in boyfriend response aggressively to all questions posed to the patient. which of
the following intervention is most appropriate?
A. call security and have the boyfriend removed from the exam room
B. ask the boyfriend why he will not let the patient answer the questions
C. inform the boyfriend that the rest of the exam must be private, show him to the waiting room,
and tell him you will retrieve him as soon as you finish.
D. state your suspicions to the couple and ask them to provide a truthful answer to the injuries
,C. inform the boyfriend that the rest of the exam must be private, show him to the waiting room,
and tell him you will retrieve him as soon as you finish.
The NP is assessing a 13 y/o male who presents with back pain and nausea/vomiting x 24
hours. He reports feeling dull pain and muscle spasm in his back after a direct hit to the side
during football practice. BP 140/84, tempe 99.1, HR 98, RR 26. What is most likely diagnosis?
A. appendicitis
B. bruised kidney
C. cholecystitis
D. ruptured vertebral disk
B. bruised kidney
Which of the following is a first-line medication for tinea unguium?
A. oral terbinafine (lamisil)
B. efinaconazole 10% solution
C. azeliac acid
D. metronidazole topical get
A. oral terbinafine (lamisil)
An elderly patient was burned when a large pot of boiling water fell off the stove. According to
Lund-Browder chart, the patient has reddened skin and several bullae on approx 4% of the
abdominal area. The patient is allergic to sulfa products. Which of the following intervention is
most appropriate?
A. treat with benzocaine spray
B. gentle rupture blisters
C. treat with silver sulfadiazine
D. treat with bacitracin zinc
D. treat with bacitracin zinc
An asian mother presents with her newborn. Upon exam, the NP notes black-colored patches
on the newborns lumboscaral area. How will the NP document these findings?
A. milia
B. erythema toxic neonatorum
C. Mongolian spots
D. port wine stain
C. Mongolian spots
Which antipsychotic medication is most likely to produce extrapyramidal effects?
A. Sertraline
, B. Citalopram
C. Aripiprazole
D. Haloperidol
D. Haloperidol
A toddler with congenital heart disease is seen for a 1-week history of facial and lower-extremity
edema accompanied by shortness of breath. The child's mother reports that the child's appetite
has been poor. The chest x-ray reveals that the child has congestive heart failure (CHF). Which
of the following heart sounds are found in these patients?
A) S1 and S2
B) S1, S2, and S3
C) S1, S2, and S4
D) Still's murmur and S4
B) S1, S2, and S3
A 14 year old male patient presents with acute pain in his left testicle radiating to the lower
abdomen lasting 2 hours. Which of the following if the best intervention?
A. manual detorsion
B. radioisotope scrotal scanning
C. referral for immediate surgery
D. color Doppler US
D. color Doppler US
A 67 y/o female complains of progressive dyspnea, minimal cough, and a 10# weight loss over
the last 3 months. The NP notes decreased posterior breath sounds, the use of accessory
muscles to breathe, temp of 98.8, and RR 24. the NP suspects?
A. emphysema
B. chronic bronchitis
C. respiratory infection
D. pneumonia
A. emphysema
A middle-aged male with a history of cluster headaches arrives that the primary care office for
treatment. Which of the following interventions is included in the acute treatment plan?
A. ice pack on forehead
B. acetaminophen
C. intranasal 4% lidocaine
D. phenytoin
C. intranasal 4% lidocaine
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