Expert answer:A 60 year old female present to clinic for follow-

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Question
1. 1.A 60 year
old female present to clinic for follow- up of COPD. Which of the
following should be included in the plan of care as a secondary
prevention strategy for this patient? (Points : 2)

Administering herpes zoster
vaccine
Checking stool for occult blood
Education for use of inhalers
Lifestyle modifications

Question
2. 2.You are
conducting an educational session in a community health center to
increase awareness of risk factors to chronic diseases. Based on your
knowledge of community health, which of the following statements are
true?(Points : 2)

Tertiary prevention focuses on
education and screenings.
Health promotion activities are related to cure of
illnesses .
Building healthy communities is the key to
population-based health.
Community-based care focuses on aggregate groups.

Question
3. 3.You are
conducting a health history of a 19 Y/O male and notice that he is not
responding to your questions appropriately. Which of the following
questions would help you obtain pertinent information?(Points : 2)

Where do you live?
How often do you visit family members?
What type of car do you drive?
How often do you have someone help you read medical
pamphlets or instruction sheets?

Question
4. 4.An 18 Y/O
AAF inquires about having a PAP at her next visit to the clinic. Based on
the American Cancer Society recommendation, you would respond by stating: (Points : 2)

You will not need a PAP until
you are 25 years of age.
It is recommended that you get an initial PAP at age 21
or approximately 3 years after the first sexual encounter.
You do not need a PAP until after you start having sex.
We can discuss this at your next visit.

Question
5. 5.You are
preparing to begin work at a college health clinic and plan to review
most common concerns and recommended screenings for this population.
Which of the following statements are true?(Points : 2)

All students should be screened
for STDs.
All students should be observed for eating disorders.
You should inquire about sexual assault of all female
patients.
18 year old students will need parental consent to be
treated at the clinic.

Question
6. 6.You are
caring for a 38 Y/O CF with diagnosis of hypertension and high
cholesterol.
You have discussed diet and exercise as a part of the treatment
plan. Which of the following diagnostic tests should be considered as a
precautionary measure?(Points
: 2)

Echocardiogram
kidney ultrasound
Stress ECG
CXRAY

Question
7. 7.You are
educating postmenopausal women on the importance of adequate calcium
intake to promote bone health. What is the recommended dose of calcium
for postmenopausal women?(Points
: 2)

800 mg Daily
1000mg Daily
1200-1500mg Daily
2000mg Daily

Question
8. 8.Which of
the following activities promote cardiac health due to strengthening of
heart muscles?(Points
: 2)

Jogging
High paced walking
Aerobic activity
Vigorous exercise for 60 minutes daily

Question
9. 9.The most
common symptoms experienced with sudden cessation of nicotine are:(Points : 2)

Tachycardia
Bradycardia
Tremors
Dysphoria and difficulty thinking

Question
10. 10.A
mother brings her 3 Y/O female toddler in for an annual physical exam.
Which of the following screenings should be included in the annual exam?(Points : 2)

Vision screening
Fecal occult blood test
Cholesterol screening
Blood sugar screening

Question
11. 11.A
19 Y/O female presents with red tender “knot” on her left eye lid. Upon
examination, the APN noticed an erythematous pustule on the lateral
border of the left eyelid margin. The most likely diagnosis is:(Points : 2)

Blepharitis
Conjunctivitis
Hordeolum
Chalazion

Question
12. 12.What
is the imagining modality of choice in evaluating head and neck tumors?(Points : 2)

CT
MRI
Angiogram
XRAY

Question
13. 13.When
assessing the corneal light reflex, an abnormal finding indicates:(Points : 2)

Possible use of eye medications
A neurologic problem
Improper alignment of the eyes
Strasbismus

Question
14. 14.A
cerumen impaction may result in:(Points : 2)

deductive hearing loss
Conductive hearing loss
Otitis media
Otitis externa

Question
15. 15.A
5 Y/O female toddler present to the clinic with history of chronic ear
infections with ear tube placement x 2 years ago. Upon exam, you notice a
white mass behind the TM. You suspect:(Points : 2)

Ear tubes
Cholesteatoma
Serous otitis media
Granuloma

Question
16. 16.What
is a common cause of hearing loss in aging adults?(Points : 2)

Otitis media
Conductive
Otosclerosis
Medications

Question
17. 17.A
35 Y/O male has otitis externa. Likely causative pathogens include all of
the following except:(Points
: 2)

Pseudomonas aeruginosa
Staphylococcus
Moraxella catarrhalis
Candida

Question
18. 18.A
55 Y/O present to the clinic with a papular rash in palms of hands x 3
weeks with HA, body aches, nasal congestion and erosion, runny nose of
clear drainage and tiredness. Afebrile at home, no meds taken or topical
meds applied to rash site. You suspect:(Points : 2)

Allergic rhinitis
Eczema
sinusitis
syphilis

Question
19. 19.Anterior
epistaxis is usually caused by:(Points : 2)

Hypertension
allergic rhinitis
Foreign bodies
Localized nasal mucosa trauma or irritation

Question
20. 20.Which
of the following medications is most appropriate for allergic rhinitis
therapy in an acutely symptomatic 24-year-old male?(Points : 2)

Fluticasone
Benadryl
Loratidine
Nasonex

Question
21. 21.A
25 Y/O male present with acute sinusitis. Based on your knowledge, the
most likely causative organisms include all of the following except:(Points : 2)

Streptococcue pneumonia
Legionarraire
Haemophilus influenza
Moraxella catarrhalis

Question
22. 22.A
32 Y/O female present to the clinic with 2 week H/O stabbing jaw pain
8/10 with lightening-like sensation along the eye and over the forehead.
No meds taken for relief, afebrile at home, no facial trauma or head
injuries in past. Upon examination, you palpate crepitus in the TMJ area
with opening and closing of mouth. The most likely diagnosis is:(Points : 2)

Dental abscess
Migraine HA
Temporal arteritis
Trigeminal neuralgia

Question
23. 23.A
definitive diagnosis of epiglottis is made by:(Points : 2)

Lateral neck film with
thumbprint sign
Indirect laryngoscopy
CXRAY
Strider upon inspiration

Question
24. 24.A
23 Y/O AAM present to the clinic with temp of 102.4, chills, fatigue,
malaise, foul breath and odynophagia x 2 days. Upon exam you observe
drooling, right tonsillar pillar with downward displacement, exudate,
erythematous and edematous soft palate and uvula, tender cervical
adenopathy and HR of 110. The most likely diagnosis is:(Points : 2)

Acute tonsillitis
Peritonsillar abscess
Pharyngitis
Parotitis

Question
25. 25.You
have diagnosed a 45 year old female with bronchitis. She is a current
smoker of 1PPD. All of the following statements are appropriate except:(Points : 2)

Get plenty of rest and increase
fluids
Use humidifier
Start smoking cessation strategies
Return to clinic if cough not resolved in 3 days

Question
26. 26.A
40 Y/O CM present with asthma also needs antihypertensive therapy. Which
product would you avoid prescribing?(Points : 2)

Micardis
Norvasc
Propanolol
Hydrochlorthiazide

Question
27. 27.You
have examined a 24 Y/O female who has acute asthma flare-ups. She is
using fluticasone and albuterol as directed and continues to have
difficulty with coughing and wheezing. Her peak expiratory flow is 55% of
predicted. Which of the following medications should be added to the
treatment regimen?(Points
: 2)

Servent
Prednisone
Accolate
Flonase nasal spray

Question
28. 28.You
examine a 60 Y/O female with CHF and dilated cardiomyopathy. On
examination, you expect to find all of the following except:(Points : 2)

Juglar vein distention
Point of maximum impulse at the 5th intercostal space
Lower extremity edema
Tenderness on left upper abdominal quadrant palpation

Question
29. 29.You
examine an elderly man with long-standing, poorly controlled HTN. When
evaluating her for hypertensive end-organ damage, you look for evidence
of:(Points : 2)

LV hypertropy
Hyperlipidemia
Clotting disorders
Hyperinsulinemia

Question
30. 30.You
are examining a 50 Y/O female and ausculate a middle to late systolic
murmur with a midsystolic click. You suspect:(Points : 2)

Aortic stenosis
Mitral valve prolapse
CHF
Physiologic murmur

Question
31. 31.Upon
examination of an elderly man, you ausculatate a grade 3/6
cresendo-decresendo systolic murmur with radiation to the neck. The most
likely cause is:(Points
: 2)

Anemia
Mitral stenosis
Aortic stenosis
Aortic regurgitation

Question
32. 32.A
55 Y/O present with chronic cough x4 months despite antitussives, require
referral to specialist if the symptoms are accompanied by:(Points : 2)

Yellow sputum and fever
Hemoptysis and weight loss
Rib soreness and pain
Sleep interruption

Question
33. 33.You
have diagnosed a 55 Y/O CM with COPD. What are effective first line
therapy?(Points
: 2)

Bronchodilators
Anticholingergics
B2 adrenergic agonist
Theophylline

Question
34. 34.A
20 Y/O female has a chief complaint of cough and body aches. Otherwise
her history shows nothing unusual. You conclude that she has atypical
pneumonia. Assuming she has no other significant history, you prescribe:(Points : 2)

Clarithromycin
Cefpodoxime
Bactrim DB
Penicillin

Question
35. 35.What
is the mode of action of decongestants?(Points : 2)

Inflammatory response
Peripheral vasodilation
Vasoconstriction
Action on the H1 receptor sites

Question
36. 36.Which
of the following should be considered for hypertensive therapy in a 60
Y/O man with CHF?(Points
: 2)

Verapimil
HCTZ
hytrin
Fosinopril

Question
37. 37.Typically,
the earliest sign of venous insufficiency is:(Points : 2)

Altered pigmentation
Shiny skin
Skin atrophy
Edema

Question
38. 38.A
42 Y/O woman presents with a 3 month H/O progressive fatigue and memory
problems. Her physical examination reveals delayed relaxation phase of
the reflexes and coarse, dry skin. You consider a diagnosis of:(Points : 2)

Major depression
Hypothyroidism
Myxedema
Multiple sclerosis

Question
39. 39.Folate
deficiency anemia causes which of the following changes in the RBC
indices?(Points
: 2)

Microcytic, normochromic
Macrocytic, normochromic
Normocytic, normochromic
Microcytic, hypochromic

Question
40. 40.Imaging
features of sinusitis include all of the following except:(Points : 2)

Erosion of the bony wall of the
sinus
Acute fluid collection of the sinus cavity
Mucosa transdensity
Mucosal thickening

Question
41. 41.You
examine a 30 Y/O male who has emigrated from a South American country. He
has documentation of receiving bacilli Calmette-Guerin (BCG) vaccine as a
child. Based on this information, which statement is true? (Points : 2)

She will always have a positive
tuberculin skin test. (TST)
Biannual chest radiographs are needed to accurately
assess her health status.
TST-10mm or more induration should be considered a
positive result.
Isoniazid therapy should be given for 6 months before
TST is undertaken .

Question
42. 42.Physical
exam findings of a 65 Y/O male reveals increased tactile fremitus and
dullness to percussion at the right base. These findings are consistent
with:(Points : 2)

A lung mass
Pneumothorax
Consolidation
Cavitation

Question
43. 43.You
are performing a skin assessment on a 75 year old female, based on your
knowledge of structural and functional changes of the skin, all of the
following statements are true except:(Points : 2)

Decrease in the thickness of the
dermis
Decreased vascularity and increased fragility of
existing capillaries
Increase in the number of sweat glands
Decreased inflammatory response

Question
44. 44.A
31 Y/O male present with C/O left ear discomfort with itching and
drainage x 1 week. Upon examination you notice white adherent malodorous
plaques with edema. The most likely diagnosis is:(Points : 2)

Otitis externa
Otitis media
Middle ear effusion
Otomycosis

Question
45. 45.A
21 Y/O female patient present with 4 day H/O right 4th finger nail bed
with throbbing pain, redness, and swelling. Upon examination, you notice
nail bed with surrounding erythema, edema with tenderness, finger nail
intact in nail bed. The most likely diagnosis is:(Points : 2)

Paronychia
Tinea manuum
Onychomycosis
Onychauxis

Question
46. 46.What
lab tests should be monitored for individuals taking Ace Inhibitors?(Points : 2)

Calcium
Hematocrit
Albumin
BUN & creatinine

Question
47. 47.The
following are risk factors for peptic ulcer disease except:(Points : 2)

Caffeine Ingestion
NSAID use
Cigarette smoking
Antihistamine use

Question
48. 48.Gram
stain of the urethral discharge of a 30 Y/O man with dysuria reveals gram
negative cocci. The most likely diagnosis is:(Points : 2)

Chlamydia
Trichomonas
N. gonorrhoeae
E. coli

Question
49. 49.In
assessing the head and neck, you palpate for lymphadenopathy. Which of
the following sites for lymph node enlargement indicates the most serious
problem?(Points
: 2)

Epitrochlear
Deep cervical chain
Supraclavicular
Posterior auricular

Question
50. 50.Which
statement below is true concerning weight loss?(Points : 2)

Unintentional weight loss of 5%
of body weight in 1 year warrants further investigation.
Unintentional weight loss of 10% within a year warrants
further evaluation.
Weight lost in elders has been associated with decreased
hip fractures.
Unintentional weight loss of 5% within 1 year warrants
further evaluation.

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