Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?  

Question 1. Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

Posterior dislocations are more common than anterior dislocations.
There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.
Recurrent dislocations are uncommon and would require a greater force to result in injury.
Surgery is most commonly the treatment of choice.

Question 2. In the United States, what is the second most common connective tissue disease and the most destructive to the joints?  

Osteoarthritis
Systemic lupus erythematosus (SLE)
Rheumatoid arthritis (RA)
Sjogren’s syndrome

Question 3. Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease?

Elevated thyroid-stimulating hormone (TSH)
Elevated T4
Elevated TRH
All of the above

Question 4. Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?  

Benzodiazepines
Antipsychotics
Anticonvulsants
Antidepressants

Question 5. When may confidentiality be overridden?

When personal information is available on the computer
When a clinician needs to share information with a billing company
When an insurance company wants to know the results of a breast cancer gene test
When a patient has a communicable disease

Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

Question 1: How often should the clinician examine the feet of a person with diabetes?

a. Once a year
b. Every 6 months
c. Every 3 months
d. Every visit

Question 2: Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

a. Cholinesterase inhibitors
b. Anxiolytics
c. Antidepressants
d. Atypical antipsychotics

Question 3: Most adult poisonings are:

a. intentional and self-inflicted.
b. accidental.
c. caused by someone wishing to do harm to the person.
d. not attributed to any reason.

Question 4: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

a. “It is probably just a cyst, because that is the most common breast mass.”
b. “We will order a mammogram and ultrasound to help establish a diagnosis.”
c. “We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”
d. “Because your lump is painful, it is most likely not cancer.”

Question 5: Which of the following is a specific test for multiple sclerosis (MS)?

a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test.

Question 4. Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?  

Question 1. Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

Posterior dislocations are more common than anterior dislocations.
There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.
Recurrent dislocations are uncommon and would require a greater force to result in injury.
Surgery is most commonly the treatment of choice.

Question 2. In the United States, what is the second most common connective tissue disease and the most destructive to the joints?

Osteoarthritis
Systemic lupus erythematosus (SLE)
Rheumatoid arthritis (RA)
Sjogren’s syndrome

Question 3. Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease?

Elevated thyroid-stimulating hormone (TSH)
Elevated T4
Elevated TRH
All of the above

Question 4. Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?

Benzodiazepines
Antipsychotics
Anticonvulsants
Antidepressants

Question 5. When may confidentiality be overridden?

When personal information is available on the computer
When a clinician needs to share information with a billing company
When an insurance company wants to know the results of a breast cancer gene test
When a patient has a communicable disease

Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?

Question 1:  Which of the following is a crucial element of developing a guideline?

Creating a physician expert panel
Reviewing the literature with ratings of available evidence
Conducting an external review of a guideline
Developing evidence-based tables

Question 2:  African American patients seem to have a negative reaction to which of the following asthma medications?

Inhaled corticosteroids
Long-term beta-agonist bronchodilators 

Leukotriene receptor agonist

Oral corticosteroid

Question 3:  Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?

The tumor size cannot be evaluated, the cancer has not spread to the lymph nodes, and the distant spread cannot be evaluated.
The cancer is in situ, it is spreading into the lymph nodes, but the spread otherwise cannot be evaluated.
The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.
The cancer is about 5 cm in size, nearby lymph nodes cannot be evaluated, and there is no evidence of distant spreading.

Question 4:  Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

Meclizine
Diphenhydramine
Diamox
Promethazine

Question 5:  Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a:

Filiform/digitate wart. 

Dysplastic cervical lesion. 

Condyloma accuminata.
Koilocytosis.

Question 6:  Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?

Dementia 

Alzheimer’s disease 

Parkinson’s disease 

Delirium

A disease has an incidence of 10 per 1,000 persons per year, and 80% of those affected will die within 1 year. Prior to the year 2000, only 50% of cases of the disease were detected by physician diagnosis prior to death. In the year 2000, a lab test was developed that identified 90% of cases an average of 6 months prior to symptom onset; however, the prognosis did not improve after diagnosis. Comparing the epidemiology of the disease prior to 2000 with the epidemiology of the disease after the development of the lab test, which statement is true concerning the disease in 2000?

1. 6,750 people who were free of disease X were enrolled in a cohort study in 1985 and followed with annual exams and interviews through 1995. Exposure to factor A was determined at study enrollment and the participants were followed until 1995 to observe new cases of disease X. Data from the study at the end of follow-up are shown in the following table. What is the incidence rate of disease X among persons exposed to factor A?

Exposure   to Factor A

People   with Disease X

People   without Disease X

Not   Exposed

30

3,720

Exposed

120

2,880

Select one:

a. 0.04

b. 0.19

c. 0.25

d. 4.00

e. 5.17

2. A disease has an incidence of 10 per 1,000 persons per year, and 80% of those affected will die within 1 year. Prior to the year 2000, only 50% of cases of the disease were detected by physician diagnosis prior to death. In the year 2000, a lab test was developed that identified 90% of cases an average of 6 months prior to symptom onset; however, the prognosis did not improve after diagnosis. Comparing the epidemiology of the disease prior to 2000 with the epidemiology of the disease after the development of the lab test, which statement is true concerning the disease in 2000?

Select one:

a. Incidence is higher and prevalence is higher than in 1999

b. Incidence is higher in 2000 but prevalence remains the same

c. Incidence is the same in 2000 but prevalence is higher than in 1999

d. Both incidence and prevalence remain the same as in 1999

e. Incidence is the same in 2000 but prevalence is lower than in 1999

3. A disease has an incidence of 10 per 1,000 persons per year, and 80% of those affected will die within 1 year. Prior to the year 2000, only 50% of cases of the disease were detected by physician diagnosis prior to death. In the year 2000, a lab test was developed that identified 90% of cases an average of 6 months prior to symptom onset; however, the prognosis did not improve after diagnosis. Which statement is true concerning the duration of the disease after the development of the lab test?

Select one:

a. Mean duration of a case of the disease is shorter in 2000

b. Mean duration of a case of the disease is the same in 2000

c. Mean duration of a case of the disease is longer in 2000

d. No inference about mean duration can be made since the lab test has only been available for 1 year

4. A disease has an incidence of 10 per 1,000 persons per year, and 80% of those affected will die within 1 year. Prior to the year 2000, only 50% of cases of the disease were detected by physician diagnosis prior to death. In the year 2000, a lab test was developed that identified 90% of cases an average of 6 months prior to symptom onset; however, the prognosis did not improve after diagnosis. Which statement is true concerning the disease-specific mortality rate after the development of the lab test?

Select one:

a. The mortality rate for the disease is decreased in 2000

b. The mortality rate for the disease is the same in 2000

c. The mortality rate for the disease is increased in 2000

d. No inference about the mortality rate can be made since the lab test has only been available for 1 year

5. A group of researchers are interested in conducting a clinical trial to determine whether a new cholesterol-lowering agent was useful in preventing coronary heart disease (CHD). They identified 14,327 potential participants for the trial. At the initial clinical exam, 422 were discovered to have CHD. The remaining subjects entered the trial and were divided equally into the treatment and placebo groups. Of those in the treatment group, 535 developed CHD after 5 years of follow-up while 568 developed CHD during the same period in the placebo group. What was the prevalence of CHD at the initial exam?

Select one:

a. 10.4 per 1,000 persons

b. 18.7 per 1,000 persons

c. 29.5 per 1,000 persons

d. 47.3 per 1,000 persons

e. 79.3 per 1,000 persons

If the sinoatrial (SA) node fails, then at what rate (depolarizations per minute) can the atrioventricular (AV) node depolarize?

Question 1

Hemolytic disease of the newborn (HDN) can occur if the mother:

Is Rh-positive and the fetus is Rh-negative 

Is Rh-negative and the fetus is Rh-positive 

Has type A blood and the fetus has type O 

Has type AB blood and the fetus has type B 

Question 2

Examination of the throat in a child demonstrating signs and symptoms of acute epiglottitis may contribute to which life-threatening complication?

Retropharyngeal abscess 

Laryngospasms 

Rupturing of the tonsils 

Gagging induced aspiration 

Question 3

If the sinoatrial (SA) node fails, then at what rate (depolarizations per minute) can the atrioventricular (AV) node depolarize?

60 to 70 

40 to 60 

30 to 40 

10 to 20 

Question 4

What is the ratio of coronary capillaries to cardiac muscle cells?

1:1 (one capillary per one muscle cell) 

1:2 (one capillary per two muscle cells) 

1:4 (one capillary per four muscle cells) 

1:10 (one capillary per ten muscle cells) 

Question 5

Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?

IL–1 and IL-6 

IL-2 and TNF-?

IFN and IL-12 

TNF-ß and IL-4 

Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

Question 1

Which of the following is a crucial element of developing a guideline?

Creating a physician expert panel

Reviewing the literature with ratings of available evidence 

Conducting an external review of a guideline

Developing evidence-based tables 

Question 2

African American patients seem to have a negative reaction to which of the following asthma medications?

Inhaled corticosteroids

Long-term beta-agonist bronchodilators 

Leukotriene receptor agonists

Oral corticosteroids 

Question 3

Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?

The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the distant spread cannot be evaluated.

The cancer is in situ; it is spreading into the lymph nodes,

but the spread cannot be evaluated otherwise.

The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.

The cancer is about 5 cm in size; nearby lymph nodes cannot be evaluated; and there is no evidence of distant spreading.

Question 4 

Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

Meclizine 

Diphenhydramine

Diamox 

Promethazine

Question 5

Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a:

Filiform/digitate wart

Dysplastic cervical lesion 

Condyloma acuminata 

Koilocytosis

Screening children with a known risk factor for type 2 diabetes mellitus is recommended at age 10 or at onset of puberty, and should be repeated how often?

1. The following are risk factors for hypertension in children and teens (choose all that apply):

being obese.
drinking whole milk.
being exposed to second-hand smoke.
watching 2 or more hours of television per day.

2. In evaluating a 9-year-old child with a healthy BMI during a well visit, a comprehensive cardiovascular evaluation should be conducted by the following methods (choose all that apply):

Obtain fasting lipid profile.
Screen for type 2 diabetes mellitus by measuring HbA1c.
Assess for family history of thyroid disease.
Assess diet and physical activity.

3. At what age is it appropriate to recommend dietary changes to parents if overweight or obesity is a concern?

12 months old
5 years old
10 years old
18 years old

4. The following are risk factors for type 2 diabetes mellitus in children and teens (choose all that apply):

hyperinsulinemia.
abnormal weight-to-height ratio.
onset of nonorganic failure to thrive in the toddler years.
Native American ancestry.

5. Screening children with a known risk factor for type 2 diabetes mellitus is recommended at age 10 or at onset of puberty, and should be repeated how often?

every other year.
every year.
every six months.
if child presents with a body mass index in the 85th percentile or higher.

Geriatric assessments can be challenging for the health-care provider due to delay of recognition and/or reporting of symptoms by the patient. Which of the following best describes what is used by health-care providers to address this differential?

Question 1

Geriatric assessments can be challenging for the health-care provider due to delay of recognition and/or reporting of symptoms by the patient. Which of the following best describes what is used by health-care providers to address this differential?

Clinical decision-making tools.

When symptoms were noticed.

Change in function and impact of symptoms.

Symptoms from comorbidities.

Question 2

The nurse practitioner is managing a 68 year old patient with a AAA and urgent hypertension.   What IV anti hypertensive medication should be used to rapidly and consistently lower blood pressure?

metroprolol, amiodarone, nitroglycerine

diltiazem, metoprolol,  nitroprusside

esmolol, nitroprusside, diltiazem

nicardipine, esmolol, nitroglycerine

Question 3

Which of the following terms refers to conditions that have multiple underlying factors and may involve multiple organs?

Multifaceted syndrome

Aging syndrome

CFM syndrome

Geriatric syndrome

Question 4

Oral cancer is a malignant tumor presented by a nonhealing sore in the mouth or lip that causes difficulty chewing or swallowing. Which of the following statements applies to an oral cancer diagnosis?

It cannot be prevented.

It involves unexplained lymph node swelling in the head and neck area.

It is three times more likely in women than men.

It involves unexplained lymph node swelling in the axillary area.

Question 5

Mr. Osorio is a 65-year-old male who recently retired because of a medical condition. He has good family support and is very motivated to start a wellness program to prevent worsening of his condition. These factors are an example of:

Barriers

Incentives

Positive self-efficacy

Facilitators

Select the serum assessment that is required when prescribing drugs to treat psychiatric disorders in psychosomatic patients. 

QUESTION 1 

Select the serum assessment that is required when prescribing drugs to treat psychiatric disorders in psychosomatic patients. 

A . Potassium 

B . White blood cells 

C . Liver enzymes 

D . Blood urea nitrogen 

QUESTION 2 

Select the theorist who developed the eight stages of psychosocial life cycle. 

A . Bowlb y 

B . Perls 

C . Erikson 

D . Roger s 

QUESTION 3 

Select two causes of dissociative amnesia. 

A . Sexual abuse 

B . Substance abuse 

C . Surgical pain 

D . Partner betrayal 

QUESTION 4 

Select the patient evaluation scale to be used before and during prescribing antipsychotic drugs. 

A . MMSE 

B . AIMS 

C . CAGE 

D . HAMD 

QUESTION 5 

Select the two comorbid disorders with which Pica occurs most commonly. 

A . Enuresis 

B . Encopresis 

C . Autism 

D . Intellectual disability