Barkley 3P
You are auscultating Jon's chest. When he sits up and leans ahead, you may hear a high
pitched, blowing murmur at S2. What does this kind of murmur maximum possibly suggest?
A. Mitral stenosis
b. Aortic Stenosis
c. Mitral regurgitation
d. Aortic regurgitation - ANSd. Aortic regurgitation
Aortic regurg is smooth, high pitched, blowing diastolic decrescendo that first-rate heard at
the 3rd left interspace at base. Murmur initiated w/ S2 and heard while Pt sits up and leans
forward. Mitral Stenosis= low pitched diastolic rumble & does not radiate. Best heard in apex
whilst in left lateral function. Aortic stenosis= loud, harsh murmur midsystole, radiated down
the facet of neck and down apex. Mitral regurg= loud blowing murmur heard at apex and is
pansystolic.
Which of the following is the most not unusual clinical manifestation of osteoporosis?
A. Bone deformity
b. Bone pain
c. Pathologic fracture
d. Fat embolism - ANSa. Bone deformity
maximum common metabolic bone sickness, is continual, revolutionary, & systemic; Low
bone mass and deterioration of bone tissue, = results in elevated skeletal fragility &
deformity. Osteoporosis generally now not obvious till AFTER a fracture; 2/three of vertebral
fractures are painless. Fat embolism from fats obstruction d/t damage or trauma & not not
unusual in osteoporosis.
A male patient requests a phosphodiesterase inhibitor to deal with erectile dysfunction.
Which of the following is suitable?
A. Tadalafil (Cialis) can be used at a dose of 2.5 mg each day if sexual pastime will take
area or more times according to week.
B. Vardenafil (Levitra), 5 mg, can be thinking about a excessive-fats meal four hours before
sexual activity
c. Sildenafil (Viagra), 50 mg, may be taken one hour earlier than sexual pastime as long as
the patient has a resting blood pressure below a hundred and seventy/110 mm Hg
d. Avanafil (Stendra) is suggested at 50 mg for all sufferers, and may be taken 30 minutes
before sexual pastime. - ANSa. Tadalafil (Cialis) can be used at a dose of 2.Five mg each
day if sexual hobby will take place or more instances per week.
Which of the subsequent is NOT part of Virchow's Triad?
A. Hypercoagulability
,b. Damage to endothelial cells
c. Sympathetic tone
d. Turbulent blood drift - ANSc. Sympathetic tone
Virchow's triad is a method of describing the 3 most important factors that lead to a
thrombosis -- sympathetic tone isn't one of those and doesn't affect blood clotting.
Hypercoagulability does lead to clotting, consisting of malignancy, trauma, sepsis, and
thrombophilia. Endothelial cellular harm is part of Virchow's triad bc it causes blood to clot by
way of promoting platelet adherence to the wall of the vessels; vascular wall injury is the
second one issue of Virchow's triad. Lastly, turbulent blood glide is a constituent of
circulatory stasis the 1/3 factor of the triad, which can be because of atrial traumatic
inflammation, venous obstruction, and ventricular disorder
A patient with kidney stones also offers with hypercalcemia and mental confusion. The
practitioner should compare the affected person for which of the following?
A. Cushing Syndrome
b. Conn's Syndrome
c. Hyperparathyroidism
d. Addison's sickness - ANSc. Hyperparathyroidism
Which of the subsequent statements is genuine concerning contraceptives?
A. Because oral contraceptives may additionally cause damage to the fetus, they're
pregnancy category X pills in being pregnant.
B. Oral contraceptives are connected to the promoting of ovarian, endometrial, and breast
cancer.
C. By growing angiotensin and aldosterone, oral contraceptives may additionally boom blood
strain.
D. Oral contraceptives can also lessen the consequences of theophylline, benzodiazepines,
and tricyclic antidepressants - ANSc. By growing angiotensin and aldosterone, oral
contraceptives may additionally growth blood pressure.
Estrogen promotes aldosterone production= sodium retention & HTN. Also believed
stimulates hepatic production of angiotensinogen, affecting renal machine through increased
angiotensin & BP. OCP are category X, however due to the fact serve little need, lower
occurrence of ovarian and endometrial ca and don't growth risk of breast ca. OCP containing
progestin may beautify results of theophylline, benzos, and tricyclic antidepressants by way
of decreasing clearance.
Upon percussion of the chest, you observe hyperresonance. Of the following selections
which could most in all likelihood be the reason?
A. Atelectasis
b. Normal Lung
c. Pneumothorax
d. Pulmonary embolism - ANSc. Pneumothorax
What is the proper order of steps to accurately perform the Ortolani maneuver?
A. Extend the legs, adduct the legs, and abduct the knees
, b. Flex the knees, abduct the knees, and adduct the legs
c. Flex the knees, adduct the legs, and abduct the legs
d. Extend the knees, abduct the legs, and adduct the knees - ANSb. Flex the knees, abduct
the knees, and adduct the legs
performed on supine little one, flex knees even as preserving thighs. Adduct legs till thumbs
contact, observe with abduct knees until lateral part of knee contact table.
You have four sufferers who all have a family history of growing coronary coronary heart
disorder at an early age. According to their blood take a look at outcomes, which patient
would maximum in all likelihood increase coronary heart sickness first?
A. Cholesterol: a hundred and seventy; LDL: a hundred and twenty; Triglycerides: a hundred
and twenty; HDL: 45
b. Cholesterol: 195; LDL: a hundred and ten; Triglycerides: 135; HDL: 30
c. Cholesterol: 170; LDL: 100; Triglycerides: 140; HDL: 20
d. Cholesterol: a hundred ninety; LDL: a hundred and forty; Triglycerides: 151; HDL: 50 -
ANSd. Cholesterol: 190; LDL: a hundred and forty; Triglycerides: 151; HDL: 50
3 of the 4 measurements are above what ought to be; HDL <40 in guys & 50 in ladies growth
danger, LDL purpose is <130, Chol > 2 hundred & trig >a hundred and fifty attributed to
growth risk coronary heart sickness.
This low-molecular-weight heparin is indicated to be used with warfarin for the remedy of
acute symptomatic deep vein thrombosis, either with or without pulmonary embolism:
a. Nadroparin
b. Dalteparin
c. Tinzaparin
d. Fondaparinux - ANSc. Tinzaparin-
can be combined with warfarin for DVT, aids warfarin in inhibiting clotting of blood.
Nadroparin & Dalteparin don't use w/ warfarin, use independently. Fondaparinux is a Xa
inhibitor NOT LMWH.
He predominant cause for discontinuance of implanted etonogestrel (Nexplanon) is:
a. Weight benefit
b. Pregnancy
c. Breast tenderness
d. Irregular bleeding - ANSd. Irregular bleeding
For the treatment of relapsing-remitting more than one sclerosis, the nurse practitioner is
aware of that:
a. First-line remedy usually entails an immunomodulator
b. Natalizumab is one of the safest capsules to apply as initial therapy
c. A affected person using interferon-beta products would should have renal characteristic
monitored.
D. Fingolimod is given intravenously for patients with resistant remitting-relapsing a couple of
sclerosis. - ANSa. First-line therapy normally involves an immune modulator