A 72 year old female patient reports a 6 month history of gradually progressive swollen and painful distal interphalangeal (DIP) joints of one hand. She has no systemic symptoms but the erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), and rheumatoid factor (RF) are all minimally elevated. What is the most likely diagnosis?
· Question 28
A patient taking levothyroxine is being over-replaced. What condition is he at risk for?
· Question 29
Which of the following is the most common cause of low back pain?
Lumbar disc disease
· Question 30
Which is the most common cause of end-stage renal disease in the United States?
· Question 31
A 77-year-old female presents to the office complaining a sudden swelling on her right elbow. She denies fever, chills, trauma, or pain. The physical exam reveals a non-tender area of swelling over the extensor surface over the right elbow with evidence of trauma or irritation. The nurse practitioner suspects:
· Question 32
A 60 year old female patient complains of sudden onset unilateral, stabbing, surface pain in the lower part of her face lasting a few minutes, subsiding, and then returning. The pain is triggered by touch or temperature extremes. Physical examination is normal. Which of the following is the most likely diagnosis?
· Question 33
Beth, age 49, comes in with low back pain. An x-ray of the lumbosacral spine is within normal limits. Which of the following diagnoses do you explore further?
· Question 34
A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of the following symptoms would lead you to look for another diagnosis?
· Question 35
Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of:
· Question 36
Jennifer says that she has heard that caffeine can cause osteoporosis and asks you why. How do you respond?
· Question 37
The most common cause of elevated liver function tests is:
· Question 38
Reed-Sternberg B lymphocytes are associated with which of the following disorders:
Non Hodgkin’s lymphoma
· Question 39
Which of the following is a potential acquired cause of thrombophilia?
Protein C deficiency
Factor V Leiden
· Question 41
A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the nurse practitioner what the treatment for this disorder is. The nurse practitioner explains:
Primary hyperparathyroidism is treated with Vitamin D restriction
Primary hyperparathyroidism is treated with parathyroidectomy
Primary hyperparathyroidism is treated with daily magnesium
Primary hyperparathyroidism is treated with parenteral parathyroid hormone (PTH)
· Question 42
Diagnostic confirmation of acute leukemia is based on:
· Question 43
A 25 year old overweight patient presents with a complaint of dull achiness in his groin and history of a palpable lump in his scrotum that “comes and goes”. On physical examination, the nurse practitioner does not detect a scrotal mass. There is no tenderness, edema, or erythema of the scrotum, the scrotum does not transilluminate. What is the most likely diagnosis?
A. Testicular torsion
C. Inguinal hernia
· Question 44
Dave, age 38, states that he thinks he has an ear infection because he just flew back from a business trip and feels unusual pressure in his ear. You diagnose barotrauma. What is your next action?
A. Prescribe nasal steroids and oral decongestants
B. Prescribe antibiotic eardrops
C. Prescribe systemic eardrops
D. Refer David to an ear, nose, and throat specialist
· Question 45
Which of the following antibiotics should not be prescribed for a pregnant woman in the 3rd trimester?
· Question 46
The physiological explanation of syncope is:
· Question 47
A 20 year old male patient complains of “scrotal swelling.” He states his scrotum feels heavy, but denies pain. On examination, the nurse practitioner notes transillumination of the scrotum. What is the most likely diagnosis?
· Question 48
A 32 year old male patient complains of urinary frequency and burning on urination for 3 days. Urinalysis reveals bacteriuria. He denies any past history of urinary tract infection. The initial treatment should be: nclude nitrofurantoin monohydrate/macrocrystals, trimethoprim-sulfamethoxazole (TMP-SMX), or fosfomycin.