The most effective treatment of non-infectious bursitis includes:

Conservative treatment includes rest, cold and heat treatments,

elevation, administration of nonsteroidal anti-inflammatory drugs
(NSAIDs), bursal aspiration, and intrabursal steroid injections

What conditions must be met for you to bill “incident to” the physician, receiving
100% reimbursement from Medicare?
The physician must be on-site and engaged in patient
care
You must initiate the plan of care for the patient

Which of the following is not a risk factor associated with the development of
syndrome X and type 2 diabetes mellitus?
The metabolic syndrome refers to the co-occurrence of several
known cardiovascular risk factors, including insulin resistance,
obesity, atherogenic dyslipidemia and hypertension.

Which of the following is not a common early sign of benign prostatic hyperplasia
(BPH)?
Strong urinary stream flow

Steve, age 69, has gastroesophageal reflux disease (GERD). When teaching him
how to reduce his lower esophageal sphincter pressure, which substances do you
recommend that he avoid?
Food that is very hot or very cold
Fatty or fried foods
Peppermint or spearmint, including flavoring
Coffee, tea, and soft drinks that contain caffeine
Spicy, highly seasoned foods
Fried food DT caffeine, chocolate and anticholinergics

A 32-year-old female patient presents with fever, chills, right flank pain, right
costovertebral angle tenderness, and hematuria. Her urinalysis is positive for
leukocytes and red blood cells. The nurse practitioner diagnoses pyelonephritis.
The most appropriate management is:
Include 500 mg of oral ciprofloxacin (Cipro) twice per day for
seven days; 1,000 mg of extended-release ciprofloxacin once per
day for seven days; or 750 mg of levofloxacin (Levaquin) once per
day for five days.

The best test to determine microalbuminuria to assist in the diagnosis of diabetic

neuropathy is to measure albumin in a spot urine sample, collected either as the first
urine in the morning or at random, for example, at the medical visit. This method is
accurate:
Early morning
What is the first symptom seen in the majority of patients with Parkinson’s disease?
Resting tremor

The most commonly recommended method for prostate cancer screening in a 55-
year-old male is:
Digital rectal exams

A patient taking levothyroxine is being over-replaced. What condition is he at risk for?

Osteoporosis

Which of the following is the most common cause of low back pain?
Lumbar disc disease

Which is the most common cause of end-stage renal disease in the United States?
Diabetes

A patient exhibits extrapyramidal side effects of antipsychotic medications. Which of

the following symptoms would lead you to look for another diagnosis?
high fever (102 to 104 degrees F), irregular pulse, accelerated
heartbeat (tachycardia), increased rate of respiration (tachypnea),
muscle rigidity, altered mental status, autonomic nervous system
dysfunction resulting in high or low blood pressure, profuse
 perspiration, and excessive sweating. Called Malignant
Hyperthermia” OR Neuroleptic malignant syndrome hallucinations.

Phalen’s test, 90°wrist flexion for 60 seconds, reproduces symptoms of:

Carpal tunnel syndrome

The most common cause of elevated liver function tests is:

Alcohol

Which of the following is a potential acquired cause of thrombophilia?

Antiphospholipid antibodies

A 75-year-old female is diagnosed with primary hyperparathyroidism and asks the

nurse practitioner what the treatment for this disorder is. The nurse practitioner
explains:
Primary hyperparathyroidism is treated with

parathyroidectomy
A 25-year-old overweight patient presents with a complaint of dull achiness in his
groin and history of a palpable lump in his scrotum that “comes and goes”. On
physical examination, the nurse practitioner does not detect a scrotal mass. There is
no tenderness, edema, or erythema of the scrotum, the scrotum does not
transilluminate. What is the most likely diagnosis?
Inguinal hernia

Dave, age 38, states that he thinks he has an ear infection because he just flew back
from a business trip and feels unusual pressure in his ear. You diagnose barotrauma.
What is your next action?
Prescribe nasal steroids and oral decongestants

The physiological explanation of syncope is:

Syncope is a transient loss of consciousness (TLOC) due to global
cerebral hypoperfusion characterized by rapid onset, short
duration and spontaneous complete recovery.

A 20-year-old male patient complains of “scrotal swelling.” He states his scrotum

feels heavy but denies pain. On examination, the nurse practitioner notes
transillumination of the scrotum. What is the most likely diagnosis?
Hydrocele

A 32-year-old male patient complains of urinary frequency and burning on urination

for 3 days. Urinalysis reveals bacteriuria. He denies any past history of urinary tract
infection. The initial treatment should be: nclude nitrofurantoin
monohydrate/macrocrystals, trimethoprim-sulfamethoxazole (TMP-SMX), or
fosfomycin.
 Trimethoprim and sulfamethoxazole

Diagnostic radiological studies are indicated for low back pain:

Diagnostic imaging is indicated for patients with low back pain only if
they have severe progressive neurologic deficits or signs or symptoms
that suggest a serious or specific underlying condition. In other patients,
evidence indicates that routine imaging is not associated with clinically
meaningful benefits but can lead to harms.

The diagnosis of human papilloma virus (HPV) infection in males is usually made by:
The diagnosis of HPV in men is made when external genital warts
are seen. The diagnosis of genital warts is made by examination of
the lesions

Which history is commonly found in a patient with glomerulonephritis?

Upper respiratory tract infection or a skin infection that was caused
by those bacteria

The most common presentation of thyroid cancer is:

is an asymptomatic thyroid mass or a nodule that can be felt in the
neck.

The obligatory criteria for diagnosis of muscular dystrophy (MD) are:

 Genetic testing to evaluate missing or repeated mutations in the
dystrophin gene. A lack of the dystrophin gene can lead to a
diagnosis of Duchenne or Becker MD. The test is important not
only to confirm the MD diagnosis in males but also to determine
whether women with a family history of Duchenne or Becker MD
may be carriers.4 The case for genetic diagnosis.
Accurate diagnosis of the muscular dystrophies is important for
patients, their families, and efficient and cost-effective use of
medical resources. (EEG.)

The diagnosis which must be considered in a patient who presents with a severe
headache of sudden onset, with neck stiffness and fever, is:
Viral meningitis

A 60-year-old male patient with multiple health problems presents with a complaint of
erectile dysfunction (ED). Of the following, which medication is most likely to be
causing the problem?
Hypertensive medication such as hydrochlorothiazides, and other
DM2 medications

A 72-year-old patient exhibits sudden onset of fluctuating restlessness, agitation,

confusion, and impaired attention. This is accompanied by visual hallucinations and
sleep disturbance. What is the most likely cause of this behavior?
Delirium
Which of the following set of symptoms should raise suspicion of a brain tumor?
Holocranial headaches present in the morning and accompanied
by projectile vomiting without nausea

The cornerstone of treatment for stress fracture of the femur or metatarsal stress
fracture is:
Relative rest-that being the cessation of the offending activity for a
period of time until the irritation is eliminated, pain is gone and the
bone is given a chance to heal

Rest the affected part of the body

- Once pain free, the person can gradually begin the sporting
activity again
- Air splinting can reduce pain and decrease the time until return to
full participation or intensity of exercise.
- NSAIDs to reduce pain and inflammation

Sally, a computer programmer, has just been given a new diagnosis of carpal tunnel
syndrome. Your next step is to:
Try neutral position wrist splinting and order an oral NSAID

Marsha presents with symptoms resembling both fibromyalgia and chronic fatigue
syndrome, which have many similarities. Which of the following is more characteristic
of fibromyalgia?
Musculoskeletal pain
Diagnostic evaluation for urinary calculi includes:
Diagnosis is based on urinalysis and radiologicimaging, usually
noncontrast helical CT.

A positive drawer sign supports a diagnosis of:

Posterior cruciate ligament injury

A 63-year-old man presents to the office with hematuria, hesitancy, and dribbling.
Digital rectal exam (DRE) reveals a moderately enlarged prostate that is smooth. The
PSA is 1.2. What is the most appropriate management strategy for you to follow at
this time?
Prescribe an alpha-adrenergic blocker

A 14-year-old female cheerleader reports gradual and progressive dull anterior knee
pain, exacerbated by kneeling. The nurse practitioner notes swelling and point
tenderness at the tibial tuberosity. X-ray is negative. What is the most likely
diagnosis?
Prepatellar bursitis?

Jack, age 55, comes to the office with a blood pressure of 144/98 mm Hg. He states
that he did not know if it was ever elevated before. When you retake his blood
pressure at the end of the exam, it remains at 144/98. What should your next action
be?
Stage 2 hypertension (lifestyle change, and medication

Successful management of a patient with attention deficit hyperactivity disorder

(ADHD) may be achieved with:
Ritalin and diet

What diabetic complications result from hyperglycemia?

1. Retinopathy
2. Hypertension resistant to treatment
3. Peripheral neuropathy
4. Accelerated atherogenesis

The most common symptoms of transient ischemic attack (TIA) include:

Common symptoms are sudden and transient, and include
unilateral paresis, speech disturbance, and monocular blindness.

clinical symptoms typically lasting less than one hour, and without
evidence of infarction on imaging

Establishment of a definitive diagnosis of osteomyelitis requires:

Bone biopsy leads to a definitive diagnosis.
Which of the following is the most common causative organism of nongonococcal
urethritis?
Chlamydia trachomatis

A 30-year-old female patient presents to the clinic with heat intolerance, tremors,
nervousness, and weight loss inconsistent with increased appetite. Which test would
be most likely to confirm the suspected diagnosis?
TSH. We also assess free thyroid hormone (FT4) and at times T3

Potential causes of hypocalcemia include which of the following?

Hypoalbuminemia is the most common cause of hypocalcemia.
Causesinclude cirrhosis, nephrosis. hypoparathyroidism, vitamin D
deficiency, and renal disease.

Which of the following is a contraindication for metformin therapy?

hypersensitity metabolic acidiosis, dehydration, sepsis,
hypoxemia, hepatic impairment, renal dysfunction

The organism most often associated with prostatitis is:

Escherichia coli
The most effective intervention(s) to prevent stroke is (are):
Aspirin is one of the most common, most effective/or lifestyle
changes

What is the most commonly abused substance?

alcohol is the #1 abused substance in America. An estimated 135.5
million people drink alcohol, but of those people, 86 million are
considered to be abusers

Prolonged PT suggests:
Abnormality in extrinsic coagulation
pathway
Deficiency of FII, FV, FX, or fibrinogen abnormalities

Diabetes screening recommendations for asymptomatic adults age 45 and over

include which of the following:
(HbA1C and 2-hour 75gram oral glucose tolerance test)

Potential side effects of levofloxacin include which of the following?

Confusion, Hypoglycemia, Achilles tendon rupture, All of the above.
Which of the following is the most common complication of the myelodysplastic
syndromes?
Bleeding

Which of the following is characteristic of a manic episode?

Grandiosity or grandiose delusions

A middle-aged female presents complaining of recent weight loss. The physical exam
reveals an enlarged painless cervical lymph node. The differential diagnosis for this
patient’s problem includes:
Infection

What is the most common cause of Cushing’s syndrome?

The long-term, high-dose use of the cortisol-like glucocorticoids
A diabetic patient is taking low dose enalapril for hypertension. A record of the
patient’s blood pressure over 4 weeks ranges from 130 to 142 mmHg systolic and 75
to 85 mmHg diastolic. How should the nurse practitioner respond?
Current guidelines recommend lowering BP to <135/80 mmHg

At what age is screening most likely to detect scoliosis?

Adolescent (age 11 and older, or from onset of puberty until
skeletal maturity).

A patient has been taking fluoxetine (Prozac) since being diagnosed with major
depression, first episode, 2 months ago. She reports considerable improvement in
her symptoms and her intention to discontinue the medication. What should be the
nurse practitioner’s recommendation?
Recommend that the patient continue the antidepressant
medication for at least 4 more months

A typical description of a tension headache is:

Mild to moderate intensity, bilateral, nonthrobbing

Which of the following is not a characteristic of type 1 diabetes mellitus?

It is generally controlled by diet and/or oral medication
The most accurate measure of diabetes control is:
hemoglobin A1c considered the most accurate measurement or
Glycosylated hemoglobin level

Microalbuminuria is a measure of:

Urinary excretion of 30-299mg/24 hours of albumin, Expressing
albumin and creatinine ratio (ACR) takes the variability into
account and normalizes the albumin in a spot specimen

A patient has HIV infection and is having a problem with massive diarrhea. You
suspect the cause is:
Cryptosporidiosis

The nurse practitioner is following a child with juvenile rheumatoid arthritis (JRA) who
has been previously diagnosed and is being managed for the disease by a pediatric
rheumatologist. The mother asks for information about the child’s long-term
prognosis. What is the most appropriate reply?
Prevent disease progression and destruction of joints, bones,
cartilage and soft tissues such as muscles, tendons and joint
capsules
 Which of the following is the most common causative organism of nongonococcal
urethritis?
Chlamydia trachomatis
1.

Which factors are associated with high risk for foot complications in a patient with
diabetes mellitus?
2. Obesity
3. Abnormal nails
4. Abnormal gait
Poorly controlled lipids

A 65-year-old patient complains of recurrent bilateral temporal headaches, malaise,

muscle aches, and low-grade fever. The headache is described as superficial
tenderness rather than deep pain. Giant cell arteritis is suspected. Appropriate
treatment is:
Refer for temporal artery biopsy and initiation of oral prednisone

The most reliable diagnostic indicator of gout is:

Elevated serum uric acid levels
A patient with HIV infection has a fever of unknown origin (FUO). Which of the following is
a possible cause of FUO in a patient with HIV?
Drug fever

Which of the following physical modalities recommended for treatment of rheumatoid

arthritis provides the most effective long-term pain relief?
Your physical therapist may use modalities, such as gentle heat
and electrical stimulation to help manage your RA symptoms.

Other than smoking cessation, which of the following slows the progression of COPD
in smokers?
Oxygen

What intervention does the American College of Rheumatology recommend as first

line therapy for osteoarthritis?
Acetaminophen should be used as first-line therapy for mild
osteoarthritis. Nonsteroidal anti-inflammatory drugs are superior to
acetaminophen for treating moderate to severe osteoarthritis
The best test to determine microalbuminuria to assist in the diagnosis of diabetic
neuropathy:
Measure albumin (microalbuminuria)

A 26-year-old female presents with elbow pain that is described as aching and
burning. There is point tenderness along the lateral aspect of the elbow and painful
passive flexion and extension. She reports she has been playing tennis almost daily
for the past month. The most likely diagnosis is:
Lateral epicondylitis (tennis elbow)