Description

1. Question: An example of secondary prevention for a diagnosis of coronary artery disease includes which of the following?
2. Question: Your patient is complaining of paroxysmal atrial fibrillation. Which medical procedure is commonly used to treat this condition?
3. Question: A patient presenting with symptoms of hypotension, narrowed pulse pressures, muffled heart tones, and jugular venous distention is most likely experiencing which of the following life-threatening conditions?
4. Question: A 55 year-old female patient with no previous cardiac history and no family history of hyperlipidemia with an acute myocardial infarction is treated successfully with a drug-eluting stent during a recent hospitalization. As their long-term care provider, you anticipate they were most likely to be also started on which of the following lipid- lowering agents at discharge?
5. Question: A 45-year-old man presents with intermittent chest discomfort and shortness of breath that occurs during physical activity and resolves with rest. He has a history of hypertension. Which diagnostic test is most appropriate to evaluate his cardiac function and assess for possible structural heart disease?
6. Question: The most important diagnostic factor in evaluating angina pectoris is the patient’s:
7. Question: Your 53 year-old female patient is experiencing shortness of breath and has a diagnosis of pulmonary arterial hypertension. Which ventricle is directly experiencing increased afterload from this disease state?
8. Question: Which of the following medical exam requires the patient to be sedated?
9. Question: The patient you just saw in your office is being hospitalized for sepsis. Which does not represent an evidence of poor end-organ function?
10. Question: A patient has been complaining of palpitations for the past week and presents to you at an urgent care clinic for evaluation. You perform a 12 lead EKG and identify atrial fibrillation with a hear rate of 122 beats per minute. What is your next order?
11. Question: Which of the following is the most common cause of Cushing’s Syndrome?
12. Question: An adult male who has managed type 2 diabetes mellitus well for many years presents for a 6-month follow up. His Hgb A1c has risen from 7% to 9% over the interval. All other laboratory values are normal and his BMI is still 25. His psychiatrist recently added olanzapine (Zypreza) to the medical regimen. The nurse practitioner will most likely:
13. Question: A patient has a 2 cm pituitary adenoma on MRI. Deficiency of one of the pituitary hormones can cause immediate hemodynamic instability and has a risk of death. Which is the most critical hormone deficiency to rule out?
14. Question: Which of the following is true of HHS?
15. Question: A 18-year-old woman presents with increased thirst, frequent urination, and unexplained weight loss. Her fasting plasma glucose level is 200 mg/dL. What is the most likely diagnosis?
16. Question: A 27-year-old woman presents with frequent headaches, galactorrhea, and amenorrhea. MRI of the brain reveals a pituitary adenoma. What is the most appropriate initial treatment?
17. Question: Patients on levothyroxine should be monitored for signs of:
18. Question: A 39-year-old male with type 1 DM is seen in the urgent care after a recent hospitalization for DKA. Treated with IV fluids, IV insulin, and potassium correction, His BS decreases to 120 mg/dL and is transitioned from IV insulin to Sub Q. After 6 hours he begins vomiting and ABG is done: pH 7.19, CO2 13, K+ 5.5, glucose 180. Which of the following is the most likely reason for persistent acidosis?
19. Question: A 60-year-old woman presents for a routine check-up. She has a history of hypertension, type 2 diabetes mellitus, and hyperlipidemia. She is currently on lisinopril, metformin, and atorvastatin. She has no new complaints. On examination, her blood pressure is 135/80 mmHg, heart rate is 72 beats per minute, and BMI is 32 kg/m². Recent laboratory tests reveal HbA1c of 7.5%, LDL cholesterol of 110 mg/dL, and creatinine of 1.1 mg/dL. What is the most appropriate management plan to optimize her care?
20. Question: Classic findings in a patient with a pheochromocytoma include which of the following?
21. Question: The management of COPD in the elderly is best guided by:
22. Question: Which of the following gastrointestinal changes is associated with normal aging?
23. Question: A frail elderly patient presents with constipation. Which of the following normal physiologic changes seen with aging is the most likely cause?
24. Question: An elderly patient diagnosed with end-stage lung cancer has been refusing meals, opting instead for ice cream only. The family is concerned about the patient not getting enough nutrition. The NP:
25. Question: An elderly patient is being admitted to the skilled nursing facility and is being screened for the risk of falling. Which of the following information would trigger a complete falls assessment?
26. Question: An adult female with rheumatoid arthritis presents to the office for a follow up. She is currently taking methotrexate and over the counter Ibuprofen. Today she complains of severe stomach pain and intense abdominal cramping. After the nurse practitioner makes appropriate adjustments to the patient’s medication regimen, the patient still complains of abdominal discomfort and reports dark stools. The practitioner suspects:
27. Question: A 63-year-old male presents with a suspected lower GI bleed. He reports passing frank small amounts of blood several times today. He denies use of NSAID’s or blood thinners. What questions would be important to ask to further differentiate your diagnosis?
28. Question: A patient with alcohol-induced liver disease presents with a sudden change in personality and loss of concentration and judgement after ingesting a meal high in protein. The nurse practitioner should plan to reduce the elevated level of which toxin in the blood?
29. Question: A 59-year-old male presents with symptoms of abdominal pain, jaundice, and weight loss which he has not been trying to lose weight. What would be a malignancy associated with these symptoms?
30. Question: A 54-year-old male who is 30 pounds overweight states that he awakens at night with heartburn and the taste of hot acid in his mouth. Stress makes his condition worse, yet baking soda seems to provide some relief. Findings on examination are normal and the stool for occult blood is negative. The preliminary diagnosis should be:
31. Question: A 42-year-old male with past medical history significant for right chronic right shoulder pain, CAD, ETOH abuse, and hypertension presents with several episodes of hematemesis. He reports he only takes Ibuprofen 200mg 3 times daily. He reports he has been on this regimen for 6 months now due to his pain. What medical history would be significant for risk factors of PUD in this patient?
32. Question: A 64-year-old female with a past medical history significant for hepatitis C and Cirrhosis presents to your office with abdominal pain and distention. Exam reveals tense ascites. Which is indicated for treatment?
33. Question: A patient states that his girlfriend was recently diagnosed with hepatitis, and he tests positive for hepatitis C. He expresses fear of the diagnosis because his father died after a liver transplantation. Which existing information in the patient’s history is the most significant factor in the progression of liver failure?
34. Question: A 42-year-old female presents with large watery frequent stools. She also reports abdominal pain and cramping, bloating and gas. The likely anatomical source of her diarrhea is where?
35. Question: A 29-year-old male presents with severe abdominal pain, he has a history of alcohol abuse, and recurrent pancreatitis. Patient’s Lipase is elevated, and he has nausea and vomiting as well. Abdominal CT shows inflammatory changes around the pancreas. What is the most important intervention to consider in the acute phase?
36. Question: Evidence based health screening is utilized with an understanding of the limits of interpreting the results. In this context, the term sensitivity refers to the ability of a test to:
37. Question: Which of the following risks of patient use of convenient/urgent care may increase the risk of a nurse practitioner to miss subtle changes in the patient’s condition over time?
38. Question: Multimodal analgesia involves the use of multiple agents to avoid reliance on which particular class of medication?
39. Question: A 65-year-old man presents for follow-up of his well-controlled hypertension and expresses concerns about maintaining bone health. He is a smoker and has a sedentary lifestyle. What is the most appropriate initial recommendation to reduce his risk of osteoporosis?
40. Question: A patient states they do not want to have any further medical care and wishes to leave against medical advice. Unknown to you, the healthcare tech then held their arm down to get an IV catheter placed against their will. The healthcare tech is at risk of being charged with which of the following:
41. Question: An adult patient presents with complaints of acute-onset unilateral right eye pain, visual changes, seeing halos around lights, abdominal pain, and intermittent nausea. Physical findings include an erythematous right eye without discharge, a cloudy cornea, and a moderately dilated right pupil that is non-reactive to light. The nurse practitioner should immediately:
42. Question: An older adult female reports nasal congestion, clear nasal secretions, and a post-nasal drip since going through menopause. After a thorough examination reveals no significant abnormalities, the nurse practitioner diagnoses the patient with:
43. Question: The patient you just saw in urgent care is being admitted for strep viridans endocarditis. Which of the following does the prudent nurse practitioner considered the most possible source of the illness?
44. Question: Your patient presents with unilateral eye pain after a workplace exposure to a caustic substance. Which of the following techniques is useful to assist in removal of the agent?
45. Question: Which antibiotic is appropriate for initial treatment of sinusitis?
46. Question: Which of the following bacteria are more commonly associated with pharyngitis?
47. Question: The medical term for nosebleed is which of the following?
48. Question: An adult male presents with a 1-week history of headache and nasal congestion; assessment reveals T=103 degrees F (39.4 degrees C), periorbital swelling, and proptosis. Which is the most appropriate action?
49. Question: An elderly patient has throbbing pain in the left eye, blurred vision, marked photophobia, and redness around the iris. What is the nurse practitioner’s initial diagnosis?
50. Question: Your patient has a Le Fort III fracture and is admitted for close monitoring. Which of the following represent a potential complication of this type of fracture?
51. Question: An example of secondary prevention for a diagnosis of coronary artery disease includes which of the following?
52. Question: Your patient is complaining of paroxysmal atrial fibrillation. Which medical procedure is commonly used to treat this condition?
53. Question: A patient presenting with symptoms of hypotension, narrowed pulse pressures, muffled heart tones, and jugular venous distention is most likely experiencing which of the following life-threatening conditions?
54. Question: A 55 year-old female patient with no previous cardiac history and no family history of hyperlipidemia with an acute myocardial infarction is treated successfully with a drug-eluting stent during a recent hospitalization. As their long-term care provider, you anticipate they were most likely to be also started on which of the following lipid- lowering agents at discharge?
55. Question: A 45-year-old man presents with intermittent chest discomfort and shortness of breath that occurs during physical activity and resolves with rest. He has a history of hypertension. Which diagnostic test is most appropriate to evaluate his cardiac function and assess for possible structural heart disease?
56. Question: The most important diagnostic factor in evaluating angina pectoris is the patient’s:
57. Question: Your 53 year-old female patient is experiencing shortness of breath and has a diagnosis of pulmonary arterial hypertension. Which ventricle is directly experiencing increased afterload from this disease state?
58. Question: Which of the following medical exam requires the patient to be sedated?
59. Question: The patient you just saw in your office is being hospitalized for sepsis. Which does not represent an evidence of poor end-organ function?
60. Question: A patient has been complaining of palpitations for the past week and presents to you at an urgent care clinic for evaluation. You perform a 12 lead EKG and identify atrial fibrillation with a hear rate of 122 beats per minute. What is your next order?
61. Question: Which of the following is the most common cause of Cushing’s Syndrome?
62. Question: An adult male who has managed type 2 diabetes mellitus well for many years presents for a 6-month follow up. His Hgb A1c has risen from 7% to 9% over the interval. All other laboratory values are normal and his BMI is still 25. His psychiatrist recently added olanzapine (Zypreza) to the medical regimen. The nurse practitioner will most likely:
63. Question: A patient has a 2 cm pituitary adenoma on MRI. Deficiency of one of the pituitary hormones can cause immediate hemodynamic instability and has a risk of death. Which is the most critical hormone deficiency to rule out?
64. Question: Which of the following is true of HHS?
65. Question: A 18-year-old woman presents with increased thirst, frequent urination, and unexplained weight loss. Her fasting plasma glucose level is 200 mg/dL. What is the most likely diagnosis?
66. Question: A 27-year-old woman presents with frequent headaches, galactorrhea, and amenorrhea. MRI of the brain reveals a pituitary adenoma. What is the most appropriate initial treatment?
67. Question: Patients on levothyroxine should be monitored for signs of:
68. Question: A 39-year-old male with type 1 DM is seen in the urgent care after a recent hospitalization for DKA. Treated with IV fluids, IV insulin, and potassium correction, His BS decreases to 120 mg/dL and is transitioned from IV insulin to Sub Q. After 6 hours he begins vomiting and ABG is done: pH 7.19, CO2 13, K+ 5.5, glucose 180. Which of the following is the most likely reason for persistent acidosis?
69. Question: A 60-year-old woman presents for a routine check-up. She has a history of hypertension, type 2 diabetes mellitus, and hyperlipidemia. She is currently on lisinopril, metformin, and atorvastatin. She has no new complaints. On examination, her blood pressure is 135/80 mmHg, heart rate is 72 beats per minute, and BMI is 32 kg/m². Recent laboratory tests reveal HbA1c of 7.5%, LDL cholesterol of 110 mg/dL, and creatinine of 1.1 mg/dL. What is the most appropriate management plan to optimize her care?
70. Question: Classic findings in a patient with a pheochromocytoma include which of the following?
71. Question: The management of COPD in the elderly is best guided by:
72. Question: Which of the following gastrointestinal changes is associated with normal aging?
73. Question: A frail elderly patient presents with constipation. Which of the following normal physiologic changes seen with aging is the most likely cause?
74. Question: An elderly patient diagnosed with end-stage lung cancer has been refusing meals, opting instead for ice cream only. The family is concerned about the patient not getting enough nutrition. The NP:
75. Question: An elderly patient is being admitted to the skilled nursing facility and is being screened for the risk of falling. Which of the following information would trigger a complete falls assessment?
76. Question: An adult female with rheumatoid arthritis presents to the office for a follow up. She is currently taking methotrexate and over the counter Ibuprofen. Today she complains of severe stomach pain and intense abdominal cramping. After the nurse practitioner makes appropriate adjustments to the patient’s medication regimen, the patient still complains of abdominal discomfort and reports dark stools. The practitioner suspects:
77. Question: A 63-year-old male presents with a suspected lower GI bleed. He reports passing frank small amounts of blood several times today. He denies use of NSAID’s or blood thinners. What questions would be important to ask to further differentiate your diagnosis?
78. Question: A patient with alcohol-induced liver disease presents with a sudden change in personality and loss of concentration and judgement after ingesting a meal high in protein. The nurse practitioner should plan to reduce the elevated level of which toxin in the blood?
79. Question: A 59-year-old male presents with symptoms of abdominal pain, jaundice, and weight loss which he has not been trying to lose weight. What would be a malignancy associated with these symptoms?
80. Question: A 54-year-old male who is 30 pounds overweight states that he awakens at night with heartburn and the taste of hot acid in his mouth. Stress makes his condition worse, yet baking soda seems to provide some relief. Findings on examination are normal and the stool for occult blood is negative. The preliminary diagnosis should be:
81. Question: Elevated calcium levels may suggest which of the following?
82. Question: Which of the following behaviors is likely to elicit rhabdomyolysis?
83. Question: A 65-year-old woman with osteoporosis presents with acute onset of severe back pain after lifting a heavy object. What is the most likely diagnosis?
84. Question: Patients who present with decreased joint space of a lumbar vertebrae on x-ray are likely diagnosed with which of the following chronic disease states?
85. Question: An adolescent athlete presents with shoulder pain and inability to raise the arm above the shoulder. The most likely diagnosis is:
86. Question: Which of the following distinguishes plantar fasciitis from other common foot problems?
87. Question: Patients who have been in a multi-car pileup should be evaluated for which of the following elements of the secondary survey?
88. Question: Which of the following is a urate lowering drug that may be used in conjunction with NSAIDs in treating gouty arthritis?
89. Question: A 50-year-old man with a history of osteoarthritis presents with knee pain that is interfering with his daily activities. What is the most appropriate initial non-pharmacological management?
90. Question: Your patient has presented with an acute GI bleed. In working up potential causes, which of the following scenarios is most probable as a reason for the bleed?
91. Question: A male adult patient presents to the clinic with sudden onset of painful hematuria. The most likely diagnosis is:
92. Question: Your ESRD patient on hemodialysis has missed therapy two separate times this week. What potentially life-threatening lab finding would you anticipate to be acutely elevated?
93. Question: An 80-year-old man with a history of chronic kidney disease (CKD) presents with increased fatigue, pruritus, and swelling in his lower extremities. Which of the following lab tests would be most important to assess the progression of his CKD?
94. Question: A 25-year-old woman presents with dysuria, frequency, and urgency. She reports chronic pelvic pain that worsens as the bladder fills and improves after voiding. Urinalysis is unremarkable with no evidence of infection. What is the most likely diagnosis?
95. Question: Inability to reach the bathroom before urinating is a feature consistent with which of the following diagnoses?
96. Question: Which nationality is four times as likely as Caucasians to be diagnosed with kidney disease?
97. Question: Your patient presents to the Urgent Care with periorbital and peripheral edema and has evidence of macroalbuminuria. Which state is described by this clinical presentation?
98. Question: The patient you are caring for has experienced a low blood pressure for a period of 2 hours before treatment with a fluid bolus. Which type acute renal dysfunction is being described in this scenario?
99. Question: Which portion of the renin-angiotensin-aldosterone mechanism is inhibited by lisinopril?
100. Question: An older adult with diabetes mellitus, COPD, hypertension, and osteoarthritis develops chronic kidney disease. The most likely cause is:
101. Question: A patient who presents to your clinic with an acute change in facial symmetry, inability to speak clearly and unilateral muscular weakness should be transported for evaluation immediately as treatment for embolic stroke with tPA within which timeframe?
102. Question: In treating a pregnant female with migraine headaches, which of the following drugs would be contraindicated?
103. Question: Which of the following constellations of symptoms, lasting more than 3 months, is most common in fibromyalgia?
104. Question: An elderly female is being treated with gabapentin (Neurontin) for neuropathic pain. Six months ago, she was started on a dose of 600 mg at HS. She states that she feels much better now, but that she becomes very dizzy when she gets up. Which of the following would be the best approach now?
105. Question: An adult female presents with the following symptoms: clear nasal discharge, nasal obstruction and tenderness over the antrum, throbbing facial pain referred to the supraorbital area and worsened by head movements or stooping for 15 days. Which antibiotic is appropriate for initial treatment of sinusitis?
106. Question: The patient with urine output of 450 ml/hr for 6 hours straight despite only 100ml/hr of IV fluid after being intubated for a head trauma with increased intracranial pressure should be treated for which condition?
107. Question: Your patient has been noticing progressively worsening muscular weakness over the past 15 months to the point he is not able to stand and is effectively wheelchair bound. Which of the following diagnoses can reasonably be excluded?
108. Question: An adolescent male college freshman presents to the student health office with concerns about not succeeding in school. He is in his second semester and is on academic probation because of poor grades. He states that he has always struggled in school but managed to graduate from high school with a 3.5 grade point average because his parents monitored and controlled his studying. He wonders if he has a learning disability or other disorder. The nurse practitioner should respond by:
109. Question: Which of the following is characteristic of Lewy body dementia?
110. Question: Which of the following cranial nerves is responsible for shoulder shrug?
111. Question: A 7-year-old boy presents with recurrent abdominal pain, diarrhea, and weight loss. What is the most appropriate initial test?
112. Question: The 16-year-old mother of a 2-month-old presents the infant, reporting that the child is very irritable and does not feed well. During physical examination, the child’s head drops back and the child exhibits sudden flexing of the extremities. As the flexing stops, the child cries uncontrollably. Funduscopic examination reveals retinal hemorrhages. Which of the following diagnostic tests should be ordered?
113. Question: A 5-year-old girl presents with fever, rash, hacking cough, and swollen, tender lymph nodes. The rash started on her face and has spread to the rest of her body. What is the most likely diagnosis?
114. Question: A 5-year-old boy presents with a sore throat, fever, and a sandpaper-like rash. What is the most likely diagnosis?
115. Question: A pediatric male is present with his mother, who states that he is extremely restless at night and constantly scratches his anal area. Which diagnostic procedure would confirm a diagnosis of pinworm infestation?
116. Question: A late adolescent is brought to the nurse practitioner’s office by her mother, who is concerned about her daughter’s recent weight loss and the potential of purging herself after meals. The daughter denies any self-induced vomiting, starvation or excessive activity. History reveals that the daughter was consistently in the 50th percentile for weight but is now in the 10th percentile. She does state that she jogs 5 miles a day and is in good condition. In addition to a complete blood count with differential, which of the following laboratory tests will be most helpful for further assessment?
117. Question: A healthy unvaccinated child is exposed to Hepatitis A. The best option for therapy is:
118. Question: A nurse practitioner is evaluating an infant for possible colic. Which of the following could indicate the need for a more extensive evaluation?
119. Question: A 13-year-old is concerned because she has not yet begun to menstruate. Physical examination indicates that the patient is at Sexual Maturity Rating IV and is of average height and weight. Which of the following would be the most appropriate response to this patient?
120. Question: Which of the following treatments is best for children under 9 years of age who are diagnosed with early Lyme disease?
121. Question: A patient presents to the clinic for a 2-week follow-up after increase of escitalopram (Lexapro) to 20 mg oral daily for major depressive disorder. The patient reports taking the medication daily as prescribed but is concerned there has been no improvement. Which of the following is the nurse practitioner’s best course of action?
122. Question: A 30-year-old woman presents with a 6-month history of persistent sadness, loss of interest in activities she once enjoyed, fatigue, and difficulty concentrating. She also reports changes in appetite and sleep patterns. What is the most likely diagnosis?
123. Question: A 25-year-old woman presents with a 2-year history of fluctuating mood states, including periods of mild depression and hypomania. These symptoms have not been severe enough to meet the criteria for major depressive or manic episodes. What is the most likely diagnosis?
124. Question: An adult G0P0 patient presents with reports of breast discharge for several months. The discharge is thin, milky, and non-odorous. The patient denies any pain, masses, or skin changes of either breast. She has a history of seizures and bipolar disorder and has had a recent normal MRI. She is taking divalproex (Depakote), risperidone (Risperdal), clonazepam (Klonopin), and conjugated estrogens (Premarin Vaginal Cream). Which medication should the nurse practitioner consider changing?
125. Question: Which of the following is a common physical sign of bulimia nervosa?
126. Question: Which of the following represent extrapyramidal symptoms?
127. Question: An adult female was treated for postpartum depression with selective serotonin reuptake inhibitors (SSRIs) by another healthcare provider. The patient reports continuing lethargy and depression. Before the dose of SSRIs is increased, it is most important to obtain:
128. Question: Which of the following represent precipitating factors for excited delirium?
129. Question: Patients who overdose on amitriptyline should be treated with which of the following agents?
130. Question: An older patient with diabetes and multiple comorbidities presents for follow up after a recent hospitalization for an acute MI. He is not checking his blood glucose levels and has not been eating regularly. The nurse practitioner’s most important action is to:
131. Question: An adult female has a lump in the upper outer aspect of her right breast. She had a mammogram when she first found the lump, and it was negative. Physical examination finds that the lump is a hard, nodular mass of about 5-10 mm in diameter. The nurse practitioner’s most appropriate course of action at this time is to:
132. Question: A 28-year-old woman in her first trimester of pregnancy presents with nausea and vomiting. What is the most appropriate initial management?
133. Question: A 41-year-old female enters the clinic with concerns of a lump in her breast. On examination, the nurse practitioner finds a palpable mass in the left outer quadrant that is mobile. A mammogram reveals a hypoechoic mass. The next step the nurse practitioner would take is to order a:
134. Question: A male presents with a painless penile lesion which has been present for 4 weeks. There is no urethral discharge. He is sexually active with multiple partners and does not use a condom. The initial diagnosis is:
135. Question: A 45-year-old woman, visits your clinic for her annual exam. During the breast examination, the provider notices a firm, irregularly shaped lump in her left breast that is not tender. The patient reports that she first noticed the lump about a month ago but thought it was related to her menstrual cycle. There are no changes in skin texture or nipple discharge. Given these findings, what is the most appropriate next step in care?
136. Question: A patient is 28 weeks pregnant and presents with a single episode of vaginal bleeding. Prenatal progress is normal, and the patient denies pain, vaginal itching, or discharge. Which of the following is the most appropriate to determine a diagnosis?
137. Question: The symptoms of benign prostatic hypertrophy are often overlooked because the older male:
138. Question: The preferred treatment for early syphilis is:
139. Question: A female patient was sexually assaulted within the past 120 hours and is concerned about unwanted pregnancy. The correct prescription would be:
140. Question: An adult male presents with general malaise and concerns about delayed ejaculation. His medication regimen consists of quinapril (Accupril) 20 mg daily; paroxetine (Paxil) 20 mg daily; loratadine (Claritin) 10 mg daily; hydrochlorothiazide (HCTZ) 25 mg daily. The delayed ejaculation is most likely caused by the:
141. Question: A 55-year-old woman with a history of smoking presents with a chronic cough and shortness of breath. What is the most likely diagnosis?
142. Question: An adult male presents for re-evaluation of his asthma control. Last month, his asthma regimen was increased to a low dose inhaled corticosteroid and short acting beta agonist as needed. He states that he uses his rescue inhaler one time a week and has awoken with asthma symptoms once in the last month. His peak flow is in the green zone. The most appropriate plan for this patient is to:
143. Question: Which of the following scenarios suggest a high risk of metabolic acidosis?
144. Question: A 40-year-old man presents with chronic cough, night sweats, and unintentional weight loss. He has a history of recent travel to a country with a high prevalence of tuberculosis. On physical examination, he has dullness to percussion and decreased breath sounds in the right upper lobe. What is the most appropriate initial test to confirm the diagnosis?
145. Question: An adult presents for a 3-month follow-up visit for intermittent asthma. The patient’s current treatment plan is albuterol (Ventolin HFA) as needed. The patient reports coughing, wheezing, and chest tightness that require inhaler use 3 days a week. The patient also reports nighttime coughing about once per week in the last month. What is the nurse practitioner’s BEST plan of care?
146. Question: Your patient with a family history of lung disease presents to urgent care with a diagnosis of shortness of breath. Which screening test is commonly used to evaluate the lung for nodules?
147. Question: A geriatric female presents with 48 hours of regional burning pain on the right side of the ribs. The nurse practitioner starts drug treatment with:
148. Question: The following are side effects of albuterol use except which of the following?
149. Question: A 57-year-old man presents with a persistent, non-productive cough and weight loss. Chest X-ray reveals a mass in the lung apex. What is the most appropriate next step in diagnosis?
150. Question: An adult patient presents with a 2-day history of intermittent stabbing chest pain that worsens with deep breaths. The patient reports a nonproductive cough and no fever for several days, and denies trauma, palpitations, or GI symptoms. T = 98.7°F (37°C), P = 86, R = 20/min, BP = 112/60 mm Hg, O2 Sat = 97%. Lungs are clear to auscultation, and heart sounds are normal S1 and S2 without murmurs, clicks, or rubs. Physical examination reveals localized chest wall tenderness at the costal margin. An EKG shows normal sinus rhythm. Chest X-ray is normal. The most likely diagnosis is: