Description

The CEA Final Diagnostic Examination must be completed by Saturday at 11:59 p.m. MT in Week 8.

NR 667 Week 8 CEA Final Diagnostic Examination

1. Question: Your 51-year-old female patient has been diagnosed with a “new murmur” during a near syncopal episode workup. In evaluating this patient, during which phase of the cardiac cycle would you anticipate auscultation of an S1 heart sound?
2. Question: The initial workup for a patient with a new chief complaint of palpitations should include which of the following tests first?
3. Question: Which of the following locations is most commonly described as the best location to identify the aortic valve in a healthy adult?
4. Question: Jason, a 63-year-old male who had a cardiac drug-eluting stent placed and had an elevated troponin of 1.6, asks how long he will need to be on aspirin plus clopidogrel (Plavix). How long should Jason be on dual antiplatelet therapy after his stent?
5. Question: What illness or diagnosis would localized egophony on auscultation over the left lower lobe most likely imply?
6. Question: While assessing a 15-year-old patient for a new onset of cough, how does performing percussion of the thorax assist the provider during the physical examination?
7. Question: Which of the following patients would you expect to show a less-than-expected forced vital capacity (FVC) on pulmonary function testing?
8. Question: In obstructive lung disease, a decreased level in which of the following spirometry parameters is most suggestive of diagnosis?
9. Question: Your newly established patient developed a progressively enlarged thyroid gland (goiter) along with symptoms of anxiety, palpitations, and tremor over the last year. Which diagnosis is most likely based on these findings?
10. Question: A 32-year-old female with a diagnosis of hyperthyroidism might exhibit which of the following typical signs on exam?
11. Question: Your patient has Cushing’s disease. Which of the following would you NOT expect to find during examination?
12. Question: In a patient with Diabetes Mellitus Type 2, the evaluation for end-organ dysfunction should include which of the following?
13. Question: A patient with severe cirrhosis awaiting possible liver transplant should be evaluated with which scoring system to assess liver function and prognosis?
14. Question: You suspect mononucleosis in a 12-year-old with left upper quadrant pain and likely splenomegaly. Which examination step should be avoided over that area?
15. Question: A 21-year-old female may have a perforated gastric ulcer with peritonitis. Which type of bacteria is most likely the causative agent?
16. Question: A 22-year-old male power lifter complains his scrotum is very enlarged and fluid-like. Which diagnosis is most likely?
17. Question: A 22-year-old female has sinus pressure and congestion. Which maneuver may help reproduce sinus-related pain and support the diagnosis?
18. Question: A 49-year-old male presents with weight loss, night sweats, anhedonia, and CXR showing profoundly enlarged hilar adenopathy. Which diagnosis should be in your differential?
19. Question: Which of the following diseases is associated with vitreous detachment?
20. Question: A patient presents with a unilateral visual deficit described as loss of visual fields on the right side in both eyes. This is known as what?
21. Question: An adolescent female with microcytic, hypochromic anemia and elevated RDW most likely has iron deficiency. Which labs will you order first?
22. Question: A microcytic anemia with normal RDW is most likely which type of anemia?
23. Question: A 43-year-old male with macrocytic anemia should be evaluated for which lab level to help narrow the etiology?
24. Question: A 66-year-old female with end-stage renal disease on dialysis has labs showing high creatinine/BUN. On CBC, you’d typically see which result?
25. Question: During a routine physical, a 12-year-old with a history of Reye syndrome is noted. Which agent is most often implicated in causing Reye syndrome?
26. Question: Your patient is diagnosed with hepatitis A. Which immunoglobulin is the first to be elevated in the serum?
27. Question: A patient had new onset hepatitis B about one year ago. Which marker is most likely elevated now?
28. Question: A 24-year-old female suspected of systemic lupus erythematosus (SLE). Which useful lab aids diagnosis?
29. Question: Which glands are commonly obstructed and may require incision and drainage for abscess?
30. Question: When screening a suspicious mole for melanoma, which feature is especially concerning?
31. Question: Which dermatologic lesion is precancerous and due to UV-B exposure?
32. Question: Based on ABCDE for melanoma, which represents a suspicious finding?
33. Question: A patient actively experiencing delirium tremens after abrupt alcohol cessation is likely suffering from deficit of which neurotransmitter?
34. Question: To differentiate anxiety from hyperthyroidism, which test is most useful?
35. Question: Your schizophrenic patient says, “What is that awful smell?” This is an example of which type of hallucination?
36. Question: A 16-year-old who attempted self-harm must be evaluated for which most common co-diagnosis?
37. Question: A 23-year-old male has severe pain raising his arm overhead. Which diagnosis is most likely?
38. Question: A 16-year-old female has unilateral jaw pain and difficulty fully opening her mouth. Which diagnosis is most likely?
39. Question: Limited lumbar spine movement with inflammation over the sacroiliac joints. Which diagnosis fits best?
40. Question: You perform a sensory exam of the face and notice abnormal sensation to sharp/dull over the left cheek. Which cranial nerve is most likely involved?
41. Question: During a neurologic exam (cranial nerves), which is the most effective for assessing cranial nerve II?
42. Question: Having the patient close their eyes and identify a familiar object in their hand is known as which test?
43. Question: A patient with a damaged glossopharyngeal nerve might exhibit which clinical finding?
44. Question: A patient successfully treated for strep infection now has hematuria with RBC casts. Which diagnosis is confirmed?
45. Question: In addition to dysuria and frequency, which urinalysis finding confirms pyelonephritis?
46. Question: In assessing suspected pyelonephritis, which physical exam test may elicit a confirmatory response?
47. Question: In a diabetic hypertensive patient, which first test is used to evaluate early renal dysfunction?
48. Question: A 19-year-old female with groin pain and a recent promiscuous partner. She shuffles when walking, STI positive. Which agent most likely caused this?
49. Question: A 15-year-old with dysfunctional uterine bleeding (DUB). Which lab should be ordered first?
50. Question: A 25-year-old with malodorous vaginal discharge suspicious for bacterial vaginosis. Which test is not used to diagnose BV?
51. Question: A patient with CHF (EF 30%) has SOB only with jogging/exercise, not at rest or ADLs. Which NYHA class is this?
52. Question: A patient presents with new-onset irregularly irregular rapid HR around 100 bpm for several days. What is the first priority intervention?
53. Question: A 63-year-old male with exertional chest pressure that resolves with rest (not increasing in frequency) is diagnosed with what and gets what plan?
54. Question: A 72-year-old female with prior CABG and valve replacement now has fever, night sweats, and a new murmur. Which complication must you evaluate?
55. Question: In a 9-year-old, you hear crackles in the lower lobe that clear after coughing. What do you suspect?
56. Question: A tall, thin 15-year-old male abruptly developed SOB after a minor fall. Which diagnosis do you anticipate?
57. Question: A patient recently post-operative for appendectomy has dull percussion over the lung base. Which diagnosis is likely?
58. Question: Which of the following patients is most likely to complain of hemoptysis?
59. Question: A patient’s labs show TSH 5.9 (slightly high) and free T4 0.3 (low). Which symptom would you expect with these values?
60. Question: A 40-year-old African American female patient presents with exophthalmos on exam. Which condition is described?
61. Question: For suspected Hashimoto’s thyroiditis, which test specifically evaluates the underlying pathology of hypothyroidism?
62. Question: A 51-year-old Caucasian male hasn’t seen a provider in 20 years. He presents with nonpitting periorbital edema, coarse hair, lateral eyebrow thinning. Which finding causes this?
63. Question: Patients with flu-like symptoms, splenomegaly, and posterior cervical chain adenopathy should be screened with which test?
64. Question: A patient diagnosed with acanthosis nigricans would typically have which exam finding?
65. Question: A 39-year-old female with RUQ pain worsened by deep breathing and a positive Murphy sign. Which condition is consistent with this?
66. Question: In educating a patient about GERD management, which factor is not typically an aggravating cause?
67. Question: A 48-year-old with floaters, flashes of light, and a “curtain” coming down over the visual field. Which condition is likely?
68. Question: A patient with acute closed-angle glaucoma will show which finding on exam?
69. Question: A 52-year-old male with hearing difficulty in the right ear. Which test helps differentiate conductive vs. sensorineural loss?
70. Question: Your patient provides a research paper on a sinus infection treatment. Which study design is the highest level of evidence?
71. Question: A 16-year-old female with heavy menses, severe cramping, and possible endometriosis. Which diagnosis should you consider first in your workup?
72. Question: A patient with elevated MCV and MCH on CBC might have which condition?
73. Question: A patient’s platelet count dropped from 140,000 to 60,000 after recent cath lab procedures with heparin. Which diagnosis must be ruled out?
74. Question: A patient has elevated WBC, fever, and chills. Which of the following is not a potential cause of the elevated WBC?
75. Question: A patient had a thymectomy and was diagnosed with “whole-body weakness.” Which diagnosis is most likely?
76. Question: A 17-year-old with a bee sting to the face who now has swelling and trouble breathing. Which diagnosis is most common?
77. Question: A 28-year-old male with HIV is “well managed” if, in addition to having a good CD4 count, he also has what?
78. Question: A 22-year-old female with lab evidence of SLE might also have which classic physical finding?
79. Question: A 38-year-old male with darkened, velvety skin in neck/axilla areas is most likely which diagnosis?
80. Question: A 21-year-old sexually active female has “weird bumps” on her vulva. Which virus causes condyloma?
81. Question: A patient has a dark brown, round, “stuck on” lesion. Which lesion best fits this description?
82. Question: A 1-year-old with erythema on the face around nasolabial folds and fine dandruff. Which disease is most likely?
83. Question: A 30-year-old with cyclical extremes of euphoria and depression. Which diagnosis is likely?
84. Question: A patient in rehab after major surgery appears despondent, sleepy, unmotivated, stable vitals. Which condition does this likely represent?
85. Question: A 29-year-old veteran who must face the door at all times might have PTSD. Which medication is first-line for PTSD?
86. Question: An 8-year-old female with fear of abandonment, intense relationships, recurrent self-harm. Which diagnosis fits best?
87. Question: A 55-year-old male diabetic with exertional left lower leg pain, numbness at rest, hair loss on anterior tibia. Which diagnosis?
88. Question: A patient off diuretics for vacation gained 21 lbs, has bilateral crackles, severe generalized edema including abdomen. Which condition describes this?
89. Question: A 45-year-old male with known peripheral arterial disease (PAD) and no surgical history. Which medication should he be on if not already?
90. Question: During an oral exam, the patient’s tongue deviates to the left when protruded. Which is the correct diagnosis?
91. Question: A 56-year-old male smoker with TIA symptoms. Which medication strategy is indicated in TIA?
92. Question: A patient with difficulty forming words but intact comprehension and ability to follow commands. Which brain area?
93. Question: A 22-year-old who appears drowsy, opens eyes to respond, then drifts back to sleep. Which level of consciousness is this?
94. Question: Which condition is least suspicious for renal artery stenosis in a hypertensive patient?
95. Question: A 31-year-old female has gram-negative rods on urine culture. Which organism is least likely?
96. Question: Elevated creatinine after a period of hypotension suggests which type of renal dysfunction?
97. Question: An ESRD patient is asked about how hemodialysis works. Which explanation is most accurate?
98. Question: A G2P1 pregnant female at 28 weeks with ultrasound-confirmed placenta previa. What guidance is correct?
99. Question: The most common causes of uterine cancer include which history items?
100. Question: A 22-year-old with migraines and endometriosis on combined oral contraceptives. Which question is priority?
101. Question: A 19-year-old male with supraventricular tachycardia (SVT) at rate 220. On EKG, SVT is typically seen as what?
102. Question: A 52-year-old with HFrEF (EF 35%) needs optimal medical therapy. Which drug is generally avoided as part of first-line HFrEF management?
103. Question: A 47-year-old with COPD and coronary artery disease started a new beta-blocker and now wheezes more. Which agent is least safe?
104. Question: A 56-year-old female was started on aspirin, atorvastatin, ezetimibe, lisinopril, amlodipine, and bupropion. She now has LE edema and constipation. Which drug is most likely responsible?
105. Question: In asthma management, which drug class should never be used as monotherapy?
106. Question: A 9-year-old newly diagnosed with mild asthma. What is the first prescription typically?
107. Question: A 28-year-old female in status asthmaticus unrelieved by nebulized albuterol might benefit from which IM medication?
108. Question: A 52-year-old patient with COPD is prescribed an inhaled medication. Which agent requires mouth rinsing to prevent thrush?
109. Question: A 47-year-old newly diagnosed with T2DM is started on the most commonly prescribed first agent. A typical side effect is what?
110. Question: A 22-year-old trans female patient abruptly stopped a medication regimen. They present with hypotension, pallor, and hypothermia. Which drug is most likely the culprit?
111. Question: Per current guidelines, at which HgbA1c should a second oral anti-diabetic agent be added if control is not achieved on the first?
112. Question: A 51-year-old female with T2DM and weight gain concerns asks about a medication option that might help. Which agent is a reasonable choice?
113. Question: A 66-year-old male with gnawing abdominal pain and orthopedic overuse injuries. Which question is most useful to rule out serious GI causes?
114. Question: A 55-year-old with acute myeloid leukemia (AML). Which agent helps manage a common side effect of high cell turnover (hyperuricemia)?
115. Question: A 19-year-old with Crohn’s on Natalizumab is having a bloody flare. What medication decision is most appropriate?
116. Question: A 19-year-old female with dysuria, frequency, and UA positive for leukocytes, nitrites, and bacteria. She had C. diff 2 years ago. Best antibiotic choice?
117. Question: A 62-year-old male has tinnitus for one week. Which medication is a potential cause?
118. Question: A patient’s persistent acne not responding to standard therapies may use isotretinoin (Accutane). Which unique obligation applies?
119. Question: A 32-year-old with community-acquired pneumonia but otherwise healthy. Which first-line antibiotic is typically prescribed?
120. Question: The use of benzylpenicillin (Penicillin G) is best considered for which type of organism?
121. Question: A 16-year-old with unilateral leg swelling likely has a DVT. Which explanation about warfarin therapy is correct?
122. Question: Rivaroxaban (Xarelto) works by inhibiting which factor?
123. Question: A 51-year-old female has microcytic anemia from iron deficiency. Which vitamin taken with ferrous sulfate improves absorption?
124. Question: Which of the following is a common cause of provoked DVT?
125. Question: Treatment of a type I hypersensitivity reaction may include all but which of the following?
126. Question: Patients with autoimmune disorders often need a long-term disease-modifying therapy. Which med class is used?
127. Question: A 21-year-old college student with persistent itching and hives but no respiratory compromise. Which medication class is best for symptomatic relief?
128. Question: In a new HIV diagnosis, the patient asks about treatments. Which agents may be used?
129. Question: A 52-year-old with sun-exposed lesions and telangiectasia. Which topical agent might treat such lesions (e.g., actinic keratoses)?
130. Question: Determination of topical corticosteroid potency is largely based on the drug and which variable?
131. Question: A 19-year-old on Bactrim develops widespread painful erythema like first-degree burns on ~18% BSA. Which disease is likely?
132. Question: A 24-year-old female has facial flushing that spares the nasal bridge, triggered by foods/exercise, with visible telangiectasias. Which agent is used for chronic treatment?
133. Question: Which class of medications is first-line for PTSD and major depressive disorder?
134. Question: A patient newly on amitriptyline for chronic migraines should be warned about which common side effects?
135. Question: A patient on haloperidol for 2 days has lip smacking and facial movements. Which diagnosis is likely?
136. Question: Transitioning between antidepressants (SSRI, SNRI, MAOI) too quickly may risk which serious complication?
137. Question: A 41-year-old has back spasms aggravated by poor seating at work. Which agent is appropriate short-term for muscle spasms?
138. Question: Patients with peripheral arterial disease and intermittent claudication may benefit from which agent?
139. Question: A severe life-threatening adverse effect of HMG-CoA reductase inhibitors (statins) is what?
140. Question: Which is true of phase 1 of classic migraine management?
141. Question: A firm contraindication for combined oral contraceptives is found in which patient?
142. Question: Which concept describes how small differences in dose of a drug with a narrow margin can cause severe toxicity?
143. Question: A patient is switched from HCTZ to a loop diuretic. Which statement is most accurate about electrolyte differences?
144. Question: What effect do NSAIDs have on the kidney’s vascular supply?
145. Question: Which agent dilates the efferent arteriole, thereby reducing creatinine clearance when administered?
146. Question: ESRD patients on dialysis with anemia of chronic disease may benefit from erythropoietin. Which level would decrease first if EPO is effective?
147. Question: A hypertensive adult on lisinopril should watch for elevation in which potentially life-threatening electrolyte?
148. Question: A 22-year-old with gonorrhea and chlamydia confirmed by DNA probe. Which medication regimen is indicated?
149. Question: A 52-year-old in menopause seeking a non-prescription remedy for hot flashes. Which supplement may help?
150. Question: A female patient experienced menarche at age 8. This is considered which of the following?
     

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NR 667 Week 8 CEA Final Diagnostic Examination

1. Question: During a post-hospital discharge visit, you notice your 71 year old female patient has been diagnosed with a “new murmur” found by the hospitalist during their recent hospitalization for CHF exacerbation. In evaluating the patient, during which phase of the cardiac cycle would you anticipate auscultation of a S3 or S4 heart sound?
2. Question: The point of maximum impulse (PMI) is MOST often palpable in healthy adults when positioned in the supine or left lateral decubitus position. Which one of the following locations is most commonly described as the PMI in a healthy adult?
3. Question: The nurse practitioner assessing the patient with a rapid cardiac rhythm may assess for a pulse deficit by auscultating the patient’s heart while watching the EKG rhythm. Where would the S1 heart sounds correlate with the electrocardiographic waves?
4. Question: Michael, a 72 year old male patient who previously presented with stable cardiac-type chest pain has underwent a stress test. He presents today to review the stress test results, which show EKG findings of ST segment depression during the exam in leads V3 and V4 as well as some concurrent chest discomfort. Based on these findings, which of the following are NOT priority medical decisions?
5. Question: While examining a 53 year old female patient, you auscultate abnormal breath sounds over all fields, and now assess transmission of voice sounds by having the patient say “ee” while auscultating the chest with the diaphragm of your stethoscope. Normally, you should auscultate a muffled “e” sound, however, you hear hear a nasally “a” sound. Which one of the following will you document is present?
6. Question: While assessing the 19 year old patient for a new onset cough, the nurse practitioner may inspect, auscultate, palpate, and/or percuss. How does performing percussion of the thorax assist the provider during the physical examination?
7. Question: Your 42 year old male patient has been referred to your clinic for establishing care and on his intake survey, you note he has documented diagnosis of interstitial lung disease. You have decided to perform a diaphragmatic excursion test on the patient. Which one of the following results would you expect to see in this patient?
8. Question: Your 50 year old Caucasian male patient has not seen a primary care giver in 20+ years and is here for a history and physical examination. While examining the head and face, you see your patient has nonpitting periorbital edema, particularly underneath their eyes and very dry, thinned hair, including the lateral third of eyebrows. Which one of the following would you expect to cause this finding?
9. Question: A 40 year old, female, African American patient presents for history and physical. Upon your initial assessment, you notice she has severe exophthalmos. Which one of the following diagnoses below would be the highest on your differential diagnosis of this physical examination finding?
10. Question: Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has underwent a pulmonary function test (PFT) with spirometry. As the patient’s primary healthcare provider, you have been asked to explain the findings of the PFT to the patient in a follow-up visit at which time the patient asks what the study was evaluating. To describe the PFT to the patient in more useful terms, you state that the large inspiration of air to the furthest extent they could reasonably accomplish followed by a full exhalation is referred to as which of the following measurements during the PFT?
11. Question: Your newly established patient states in the past year, they have progressively developed a noticeable bump on their neck and when asked about symptoms, they report feeling very anxious, have developed a tremor, and are commonly feeling palpitations in their chest. On examination, you identify an enlarged thyroid gland suspicious for a goiter. Of the following diagnoses, which is most likely for the patient to develop based on these findings above?
12. Question: Your 32 year old female patient presented for a routine health exam states they have a diagnosis of hyperthyroidism by another provider a year ago. In addition to evaluation with TSH and T4 lab work, which of the following represent typical signs of hyperthyroidism expected on your exam of this patient?
13. Question: Your patient has a diagnosis of Addison’s disease. Which of the following might you expect to find during examination?
14. Question: The nurse practitioner’s evaluation of a patient with Diabetes Mellitus type 2 should include which of the following while evaluating for end organ dysfunction of the disease?
15. Question: Your patient with a diagnosis of autoimmune hepatitis is being seen in your clinic for routine liver serology and follow-up examination. Which of the following correctly identifies the normal liver span when percussing the liver of a HEALTHY adult?
16. Question: The 33 year old male patient presents with complaints of abdominal pain after a recent birthday party where other guests also suspected food borne illness and gastroenteritis. To elicit the most accurate evaluation of this patient, which is the order of assessment which should be done for the abdomen?
17. Question: The 19 year old male patient presents with acute symptoms of abdominal pain and a history of intermittent heartburn and spicy food intolerance, as well as anxiety due to his college athletic performance. You have a concern that the patient may have a perforated gastric ulcer and is experiencing peritonitis. Which of the following exam findings is NOT supportive of this diagnosis?
18. Question: Your 22 year old male patient states during his review of systems that his scrotum is very enlarged and feels like it is full of worms. He is a powerlifter and works as a trash collector. You suspect the patient likely has which of the following diagnoses?
19. Question: Your 22 year old female patient is seeing you for complaints of sinus pressure and congestion. Which one of the following sinuses should be palpated during your examination?
20. Question: Your 49 year old male patient presents with weight loss, night sweats, anhedonia, and a CXR showing profoundly enlarged hilar adenopathy. Based on these findings, a diagnosis of lymphoma would be in your working differential. Which one of the following assessment findings when palpating lymph nodes would be INCONSISTENT with this diagnosis?
21. Question: Your new patient intake history of an elderly man includes a history of Ehlers-Danlos with complications of retinal detachment treated with gas pneumopexy. In discussing this history, you recall the transparent mass of gelatinous material where the gas pneumopexy is performed can be found in which chamber(s) of the eye?
22. Question: While assessing the patient, you covered their right eye while you covered your left eye, then brought a set number of fingers or wiggling fingers into each quadrant of the patient’s visual field while you had them identify when they saw your fingers/movement. A normal exam would be documented as which of the following?
23. Question: Your late adolescent female patient presents with a history of heavy menses and pale conjunctiva. Your review of systems is fairly unremarkable other than she lives in a house built in 1965, has an unrestricted diet, and her family heredity is Italian. She denies any history of chronic health conditions. Initial CBC with differential shows a microcytic hypochromic anemia which has not yet been diagnosed or treated and the red cell distribution width (RDW) is elevated at 15%. Based on the most common cause of microcytic hypochromic anemia, which of the following labs will you order first?
24. Question: A patient of Mediterranean descent who presents with microcytic anemia with normal red cell distribution width should be evaluated using gel electrophoresis to confirm which of the following types of anemia?
25. Question: The 43 year old male patient with macrocytic anemia should be evaluated for which of the following lab levels to help narrow down the etiology?
26. Question: While assessing the complete metabolic profile of the 66 year old female patient with end stage renal disease (ESRD) on dialysis, you find a creatinine of 4.3, BUN of 62, phos of 5.2. On review of the CBC with differential, you would anticipate which of the following levels?
27. Question: During your visit with a 19 year old patient for a college health physical, your health history includes a diagnosis of angioedema. What of the following parts of the body are were likely involved?
28. Question: Your patient has just been diagnosed with Hepatitis A. Which of the following immunoglobulin are first to be elevated in the serum?
29. Question: Your patient had a history of Hepatitis A approximately one year ago. Which of the following immunoglobulin is most likely to be elevated at this time?
30. Question: Your 32 year old female patient presents with a suspected diagnosis of systemic lupus erythematosus (SLE). Which of the useful labs in making the diagnosis of SLE?
31. Question: Which one of the following sweat glands concentrated in the palms of the hands and soles of the feet and is involved in temperature regulation?
32. Question: Your 53 year old female patient with pale skin and easy freckling presents for a skin survey due to their family history of skin cancer. When screening for melanoma, which one of the following findings would be considered a suspicious feature of a mole characteristic of a possible melanoma?
33. Question: Which of the following dermatologic lesions is precancerous and likely due to prolonged exposure to UV-B?
34. Question: Based on your evaluation of ABCDE for melanoma, which of the following represents a suspicious finding?
35. Question: Your patient is complaining of hypersomnia, lack of motivation, weight gain, and anhedonia. Suspecting a diagnosis of clinical depression, you anticipate the patient will benefit from treating their underlying deficit of which of the following neurotransmitters?
36. Question: The diagnosis of anxiety in your 28-year-old male patient may be differentiated from hyperthyroidism following testing?
37. Question: Your schizophrenic patient is agitated during your exam and states “what is that awful taste?” This is an example of which of the types of hallucinations?
38. Question: Your patient has made an attempt on their own life, and has survived. In assessing them, it is important the nurse practitioner recognizes that patients with a history of self-harm need to be evaluated for which of the following underlying disease states, which is the most common co-diagnosis in patients who have made attempts of self-harm?
39. Question: You are assessing a 26-year-old male patient who complains that his arm hurts. When assessing ROM of the shoulder, you ask him to touch the opposite scapula by placing his arm up and over the back of his neck, but the patient reports tremendous pain when attempting to do this. Which one of the following would you suspect?
40. Question: The 19 year old female patient complains of jaw pain anterior and inferior to the ear bilaterally. All of the following are common symptoms of a temporomandibular joint (TMJ) disorder EXCEPT which one?
41. Question: Unequal shoulder height with a lateral and rotary curvature of the spine would be associated with which one of the following spinal deformity diagnosis?
42. Question: You perform a sensory assessment on the face and notice abnormal sensation to sharp/dull testing on the left cheek. Which one of the following cranial nerves would you expect to cause this abnormality?
43. Question: During your neurologic examination portion of your comprehensive physical of the new patient to your panel, you perform cranial nerve assessments. Which of the following represents the most effective protocol for assessment of cranial nerve I?
44. Question: While performing sensory cortex testing on your patient, you gave them close their eyes and place a familiar object such as a paper clip, key or pencil in their hand, having them manipulate it skillfully and identify it within 5 seconds. This is known as which of the following tests?
45. Question: During your physical examination of a 49 year old brain cancer patient, you notice their gag reflex is impaired during the exam. This suggests damage to which one of the following cranial nerves?
46. Question: Your 18 year old female patient has recently been diagnosed with streptococcal infection and has been successfully treated with an appropriate antimicrobial agent. They have no other noteworthy health history, chronic illness, or medications on record. They are complaining today of hematuria. RBC casts on urinalysis with microscopy have been identified during this visit. Based on this finding, you can make the diagnosis of which of the following?
47. Question: In addition to patient symptoms of painful urination and frequency, which of the following findings confirms a diagnosis of pyelonephritis?
48. Question: In assessing your patient with suspected pyelonephritis, the following test may be sensitive to elicit a confirmatory response.
49. Question: As a prudent nurse practitioner, the diabetic, hypertensive patient you are seeing should be evaluated for early evidence of renal damage from both diabetes and hypertension. Which of the following assessment tools should the nurse practitioner order first for the evaluation of early renal dysfunction secondary to diabetes or hypertension?
50. Question: Your 19 year old female patient presents with groin pain, states they were recently involved with a sexual partner who was sexually promiscuous. You notice they are walking with a shuffling gait and their STI testing was positive for Gonorrhea and Chlamydia. Which of the following evaluations should be considered if this were left untreated for a prolonged period of time?
51. Question: A patient presents with blood present in the anterior portion of their eye covering the lower half of their iris. With which of the following diagnoses is this most consistent?
52. Question: In which of the following patients is PRBC transfusion recommended?
53. Question: Which of the following patients should be evaluated for iron deficiency anemia first?
54. Question: Which of the following laboratory markers is most sensitive for early detection of iron deficiency anemia?
55. Question: A 32 year old female patient presents with generalized fatigue, brittle nails, and pallor. Which of the following is the most likely cause of these findings?
56. Question: Your patient presents with joint pain, stiffness in the morning lasting more than an hour, and swelling of multiple small joints. Which of the following diagnoses is most consistent with these findings?
57. Question: Which of the following laboratory tests is most useful to confirm a diagnosis of rheumatoid arthritis?
58. Question: Your patient presents with acute onset of unilateral red, painful eye with photophobia and decreased vision. Which of the following diagnoses is most consistent?
59. Question: A patient presents with sudden, painless loss of vision in one eye. Fundoscopic examination reveals a pale retina with a cherry-red spot at the macula. Which of the following is the most likely diagnosis?
60. Question: A patient presents with a history of recurrent headaches, nausea, and visual auras. Which of the following is the most likely diagnosis?
61. Question: Which of the following findings would be most concerning for increased intracranial pressure during a neurologic examination?
62. Question: A 45 year old male patient presents with tremors at rest, rigidity, and bradykinesia. Which of the following is the most likely diagnosis?
63. Question: Which of the following is the most appropriate initial treatment for a patient presenting with acute gout flare?
64. Question: Your patient presents with persistent fatigue, pallor, and splenomegaly. Peripheral smear reveals teardrop-shaped red blood cells. Which of the following is the most likely diagnosis?
65. Question: A patient presents with hematuria, flank pain, and a palpable mass in the abdomen. Which of the following is the most likely diagnosis?
66. Question: Your patient presents with persistent cough, hemoptysis, and weight loss. Chest imaging reveals a mass in the right upper lobe. Which of the following is the most likely diagnosis?
67. Question: Which of the following tests is most sensitive for detecting early pulmonary embolism in a patient with sudden onset shortness of breath?
68. Question: A patient presents with fever, productive cough, and pleuritic chest pain. Chest x-ray shows consolidation in the right lower lobe. Which of the following is the most likely diagnosis?
69. Question: Your patient presents with shortness of breath, orthopnea, and lower extremity edema. Which of the following findings is most consistent with congestive heart failure?
70. Question: A patient presents with sudden onset chest pain radiating to the left arm, diaphoresis, and nausea. Which of the following is the most likely diagnosis?
71. Question: Your patient presents with hypertension and proteinuria during pregnancy. Which of the following is the most likely diagnosis?
72. Question: Which of the following is the first-line treatment for a patient diagnosed with type 2 diabetes mellitus?
73. Question: A patient presents with polyuria, polydipsia, and polyphagia. Blood glucose testing confirms hyperglycemia. Which of the following is the most likely diagnosis?
74. Question: Your patient presents with fever, neck stiffness, and photophobia. Which of the following is the most likely diagnosis?
75. Question: A 6-year-old child presents with a barking cough and stridor. Which of the following is the most likely diagnosis?
76. Question: Your patient presents with sudden onset abdominal pain in the right lower quadrant, nausea, and fever. Which of the following is the most likely diagnosis?
77. Question: A patient presents with jaundice, fatigue, and right upper quadrant tenderness. Which of the following lab tests would help confirm the diagnosis of hepatitis?
78. Question: Your patient presents with chronic diarrhea, weight loss, and malabsorption. Which of the following tests is most useful for confirming celiac disease?
79. Question: A patient presents with polyuria, polydipsia, and hypokalemia. Which of the following is the most likely diagnosis?
80. Question: Your patient presents with hypertension, hypokalemia, and metabolic alkalosis. Which of the following is the most likely underlying cause?
81. Question: A patient presents with hematuria, flank pain, and hypertension. Which of the following is the most likely diagnosis?
82. Question: Your patient presents with sudden onset weakness on one side of the body, slurred speech, and facial droop. Which of the following is the most likely diagnosis?
83. Question: A patient presents with recurrent seizures and no prior history of neurological disease. Which of the following is the most appropriate first diagnostic test?
84. Question: Your patient presents with severe headache, vomiting, and neck stiffness. Which of the following is the most concerning possible complication?
85. Question: A patient presents with fatigue, pallor, and shortness of breath. CBC reveals macrocytic anemia. Which of the following is the most likely cause?
86. Question: Your patient presents with fever, productive cough, and dyspnea. Chest imaging reveals infiltrates consistent with pneumonia. Which of the following pathogens is the most likely cause?
87. Question: A patient presents with sudden onset shortness of breath and pleuritic chest pain. D-dimer is elevated. Which of the following is the next best step in management?
88. Question: Your patient presents with palpitations, dizziness, and syncope. ECG reveals atrial fibrillation. Which of the following is the most appropriate initial management?
89. Question: A patient presents with recurrent headaches, visual disturbances, and nausea. Fundoscopic exam reveals papilledema. Which of the following is the most likely underlying condition?
90. Question: Your patient presents with generalized edema, proteinuria, and hypoalbuminemia. Which of the following is the most likely diagnosis?
91. Question: A patient presents with fatigue, pallor, and jaundice. Peripheral smear reveals spherocytes. Which of the following is the most likely diagnosis?
92. Question: Your patient presents with hypotension, tachycardia, and altered mental status following trauma. Which of the following is the most likely underlying cause?
93. Question: A patient presents with dysuria, frequency, and urgency. Urinalysis reveals pyuria and bacteriuria. Which of the following is the most likely diagnosis?
94. Question: Your patient presents with fever, cough, and shortness of breath. Chest x-ray reveals lobar consolidation. Which of the following is the most likely diagnosis?
95. Question: A patient presents with rash, fever, and lymphadenopathy. Which of the following is the most likely diagnosis?
96. Question: Your patient presents with sudden onset chest pain, shortness of breath, and diaphoresis. ECG reveals ST elevation in leads II, III, and aVF. Which of the following is the most likely diagnosis?
97. Question: A patient presents with acute abdominal pain, vomiting, and inability to pass gas. Which of the following is the most likely diagnosis?
98. Question: Your patient presents with chronic cough, night sweats, and weight loss. Chest imaging reveals cavitary lesions. Which of the following is the most likely diagnosis?
99. Question: A patient presents with weakness, fatigue, and pallor. Laboratory tests reveal iron deficiency anemia. Which of the following is the most likely underlying cause?
100. Question: Your patient presents with sudden severe headache, nausea, and photophobia. Which of the following is the most concerning diagnosis?
101. Question: A patient presents with progressive shortness of breath, dry cough, and fatigue. Pulmonary function tests reveal a restrictive pattern. Which of the following is the most likely diagnosis?
102. Question: Your patient presents with chronic diarrhea, weight loss, and anemia. Which of the following tests is most useful to confirm inflammatory bowel disease?
103. Question: A patient presents with sudden onset severe headache described as “the worst headache of my life.” Which of the following is the most concerning possible diagnosis?
104. Question: Your patient presents with jaundice, abdominal pain, and dark urine. Liver function tests show elevated bilirubin and alkaline phosphatase. Which of the following is the most likely diagnosis?
105. Question: A patient presents with fever, chills, and flank pain. Urinalysis reveals pyuria and bacteriuria. Which of the following is the most likely diagnosis?
106. Question: Your patient presents with palpitations, anxiety, and weight loss. Thyroid function tests reveal elevated T3 and T4 with suppressed TSH. Which of the following is the most likely diagnosis?
107. Question: A patient presents with polyuria, polydipsia, and nocturia. Blood glucose is elevated. Which of the following is the most likely diagnosis?
108. Question: Your patient presents with persistent cough, hemoptysis, and weight loss. Chest imaging reveals a cavitary lesion in the upper lobe. Which of the following is the most likely diagnosis?
109. Question: A patient presents with syncope, palpitations, and shortness of breath. ECG reveals prolonged QT interval. Which of the following is the most likely underlying cause?
110. Question: Your patient presents with sudden onset unilateral weakness, slurred speech, and facial droop. Which of the following is the most likely diagnosis?
111. Question: A patient presents with fever, headache, and neck stiffness. Lumbar puncture shows elevated WBC with lymphocytic predominance. Which of the following is the most likely diagnosis?
112. Question: Your patient presents with chronic joint pain, morning stiffness lasting more than an hour, and symmetric swelling of small joints. Which of the following is the most likely diagnosis?
113. Question: A patient presents with generalized fatigue, pallor, and shortness of breath. Lab tests reveal microcytic anemia. Which of the following is the most likely underlying cause?
114. Question: Your patient presents with abdominal pain, nausea, and vomiting. Lab tests reveal elevated amylase and lipase. Which of the following is the most likely diagnosis?
115. Question: A patient presents with fatigue, pallor, and jaundice. Peripheral smear reveals schistocytes. Which of the following is the most likely diagnosis?
116. Question: Your patient presents with fever, cough, and purulent sputum. Chest x-ray shows lobar consolidation. Which of the following is the most likely pathogen?
117. Question: A patient presents with sudden onset chest pain radiating to the back, hypotension, and unequal pulses. Which of the following is the most likely diagnosis?
118. Question: Your patient presents with fever, night sweats, weight loss, and lymphadenopathy. Which of the following is the most likely diagnosis?
119. Question: A patient presents with sudden severe abdominal pain, vomiting, and rigid abdomen. Which of the following is the most likely diagnosis?
120. Question: Your patient presents with chronic fatigue, pallor, and spoon-shaped nails. Lab tests reveal iron deficiency anemia. Which of the following is the most likely underlying cause?
121. Question: A patient presents with acute onset shortness of breath, chest pain, and hypoxia. D-dimer is elevated. Which of the following is the next best diagnostic test?
122. Question: Your patient presents with palpitations, dizziness, and syncope. ECG shows ventricular tachycardia. Which of the following is the most appropriate initial management?
123. Question: A patient presents with progressive weakness, ptosis, and diplopia that worsens with activity. Which of the following is the most likely diagnosis?
124. Question: Your patient presents with rash, joint pain, and fever. Lab tests reveal positive ANA and anti-dsDNA antibodies. Which of the following is the most likely diagnosis?
125. Question: A patient presents with abdominal pain, diarrhea, and weight loss. Colonoscopy shows continuous colonic inflammation starting from the rectum. Which of the following is the most likely diagnosis?
126. Question: Your patient presents with abdominal pain, diarrhea, and weight loss. Colonoscopy shows skip lesions with transmural inflammation. Which of the following is the most likely diagnosis?
127. Question: A patient presents with chest pain, dyspnea, and diaphoresis. ECG reveals ST elevation in anterior leads. Which of the following is the most likely diagnosis?
128. Question: Your patient presents with painless hematuria. Which of the following is the most likely diagnosis?
129. Question: A patient presents with sudden onset back pain, lower limb weakness, and urinary retention. Which of the following is the most likely diagnosis?
130. Question: Your patient presents with fever, hypotension, and tachycardia following an infection. Which of the following is the most likely diagnosis?
131. Question: A patient presents with fatigue, pallor, and bruising. Lab tests reveal pancytopenia. Which of the following is the most likely diagnosis?
132. Question: Your patient presents with severe headache, nausea, vomiting, and blurred vision. Fundoscopy reveals papilledema. Which of the following is the most likely underlying cause?
133. Question: A patient presents with acute right upper quadrant pain, fever, and jaundice. Which of the following is the most likely diagnosis?
134. Question: Your patient presents with chronic cough, hemoptysis, and night sweats. Chest imaging shows cavitary lesions. Which of the following is the most likely diagnosis?
135. Question: A patient presents with sudden onset unilateral vision loss. Fundoscopy reveals retinal artery occlusion. Which of the following is the most likely underlying cause?
136. Question: Your patient presents with recurrent episodes of abdominal pain and diarrhea, triggered by certain foods. Which of the following is the most likely diagnosis?
137. Question: A patient presents with fatigue, pallor, and shortness of breath. Lab tests reveal vitamin B12 deficiency. Which of the following is the most likely underlying cause?
138. Question: Your patient presents with fever, cough, and purulent sputum. Chest x-ray shows patchy infiltrates. Which of the following is the most likely pathogen?
139. Question: A patient presents with chest pain, shortness of breath, and hypotension. ECG reveals ST elevation in inferior leads. Which of the following is the most likely diagnosis?
140. Question: Your patient presents with fatigue, pallor, and jaundice. Peripheral smear shows elliptocytes. Which of the following is the most likely diagnosis?
141. Question: A patient presents with acute abdominal pain, vomiting, and constipation. Abdominal x-ray reveals air-fluid levels. Which of the following is the most likely diagnosis?
142. Question: Your patient presents with severe headache, photophobia, and neck stiffness. Lumbar puncture reveals elevated WBCs with neutrophilic predominance. Which of the following is the most likely diagnosis?
143. Question: A patient presents with recurrent urinary tract infections and flank pain. Imaging reveals renal scarring. Which of the following is the most likely underlying cause?
144. Question: Your patient presents with fever, fatigue, and diffuse lymphadenopathy. Lab tests reveal elevated atypical lymphocytes. Which of the following is the most likely diagnosis?
145. Question: A patient presents with chronic diarrhea, weight loss, and abdominal bloating. Serologic testing reveals anti-tTG antibodies. Which of the following is the most likely diagnosis?
146. Question: Your patient presents with sudden onset severe chest pain radiating to the neck. ECG shows ST segment elevation. Which of the following is the most likely diagnosis?
147. Question: A patient presents with fever, cough, and purulent sputum. Chest imaging shows lobar consolidation. Which of the following is the most likely pathogen?
148. Question: Your patient presents with abdominal pain, nausea, vomiting, and diarrhea. Which of the following is the most likely cause if labs show metabolic acidosis?
149. Question: A patient presents with persistent headache, nausea, and vomiting. MRI reveals a mass lesion in the posterior fossa. Which of the following is the most likely diagnosis?
150. Question: Your patient presents with sudden onset weakness, slurred speech, and facial droop. CT scan shows hypodensity in the middle cerebral artery territory. Which of the following is the most likely diagnosis?