APEA QBank AANP Review Latest 2022

Gestational diabetes screening occurs between what weeks gestation? Correct answer-
24-48

When you ask the patient to take a deep breath in and then palpate over the RUQ
abdomen. Positive when pain is elicited. This is a sign of ___________. Correct
answer- Murphy's sign; cholecystitis

What are names of LABA medications? Correct answer- salmeterol

What is encopresis in children? Correct answer- stool incontinence after the age of
being toilet trained

The medical term for being cross-eyed Correct answer- strabismus

What is atopic dermatitis? Correct answer- eczema

Tests used to diagnose developmental hip dysplasia Correct answer- Barlow and
Ortolani maneuvers

What is the female athlete triad? Correct answer- disordered eating, amenorrhea,
osteoporosis

How do patients with aortic regurgitation typically present? Correct answer- they will
have a long asymptomatic period followed by exercise intolerance, then dyspnea at
rest. The left ventricle eventually fails unless the aortic valve is replaced.

What does the rash of fifth disease (a viral exanthem) look like? Correct answer-
maculopapular rash that blanches easily and may be accompanied by joint aches

What cardiac abnormalities are expected to be heard on auscultation of a pregnant

patient? Correct answer- a venous hum murmur and an S3

When a headache accompanies a stroke, is this most often hemorrhagic or ischemic?

Correct answer- hemorrhagic

AV nicking is most commonly seen on retinal exam of which chronic condition? Correct
answer- hypertension

Within 6 months of being started on a TCA or SSRI, what is a common side effect that
occurs? Correct answer- weight gain
When does otitis media with effusion usually occur? Correct answer- either before or
after an episode of acute otitis media. This effusion is not infected fluid but it is
considered a breeding ground for bacteria. This should not be treated with antibiotics.

The medical term for jock itch Correct answer- tinea cruris

Tinea cruris "jock itch" is a common __________ infection and should be treated with
what? Correct answer- fungal; OTC antifungal cream

What are teaching points for males to avoid contracting tinea cruris? Correct answer-
dry off after swimming and don't stay in a wet bathing suit

Tinea cruris can affect the inner thighs but never what else? Correct answer- the penis
or scrotum

On microscopic exam, what is most likely to be seen in the presence of a bacterial

infection? Correct answer- cocci and rods

On microscopic exam, what is most likely to be seen in the presence of a candidal

infection? Correct answer- yeasts

What are dermatophytes? Correct answer- fungi

On microscopic exam, what is most likely to be seen in the presence of a dermatophytic

(fungal) infection? Correct answer- hyphae that are long, thin, and branching (such as in
the case of tinea pedis, tinea cruris, and tinea corporis)

The medical term for ringworm Correct answer- tinea corporis

What is the most common cause of viral pneumonia in peds? Correct answer- RSV

Viral pneumonia is the most common type of pneumonia in children of what ages?
Correct answer- 6 months to 5 years

What is the simplest way to screen for nutritional adequacy in older adults? Correct
answer- measure their weight

How are scabies treated? Correct answer- via permethrin and good hygiene

What are common side effects of NSAIDs? Correct answer- renal impairment, acute
renal failure, gastritis

What is the most common cause of pernicious anemias? Correct answer- vitamin B12
deficiency
How should oral iron supplements be taken? Correct answer- on an empty stomach
with something acidic and high in calcium such as orange juice

Group A strep pharyngitis can be accompanied by what symptoms other than the
classic Centor criteria? Correct answer- abdominal pain, nausea, and vomiting

A stool specimen that is positive for WBCs is a sign of what? Correct answer- a viral or
bacterial infection

The only type of incontinence that would not benefit from pelvic floor therapy is what?
Correct answer- overflow incontinence

What do the skin manifestations of a penicillin allergy look like? Correct answer- hives

What are symptoms that someone will experience as soon as they are started on a
SSRI and when will this resolve? Correct answer- headache, nausea, insomnia,
restlessness, agitation; will resolve in 2 weeks

What causes the dry cough in people taking an ACEI? Correct answer- the buildup of
bradykinin which is usually degraded by ACE

ACEI induced coughs usually begin how soon after starting the medication? Correct
answer- within 2 weeks

COPD is often associated with what sequelae? Correct answer- anxiety and depression

When should an antiviral be started in a patient with shingles? Correct answer- within
72 hours of the onset of symptoms

What is the drug of choice for treating UTIs in male patients? Correct answer- bactrim
for 7-10 days

What is the leading cause of CKD and ESRD in the united states? Correct answer-
diabetes

What is the usual recommendation about administering MMR and varicella

immunizations? Correct answer- they should be given on the same day or at least one
month apart

What are the classic symptoms of an atopic pregnancy? Correct answer- amenorrhea,
vaginal bleeding, abdominal pain

What is sideroblastic anemia? Correct answer- when the bone marrow is unable to
incorporate iron into hemoglobin. This may be either inherited or acquired.

Can a pregnant woman get the MMR vaccine while pregnant? Correct answer- yes
Why are the carotid arteries auscultated for bruits? Correct answer- this is indicative of
generalized atherosclerosis

What is roseola? Correct answer- a viral exanthem characterized by a high fever for 3
days then abrupt stopping of the fever and a maculopapular rash that blanches. also
known as exanthem subitum.

What are signs indicative of a meningitis infection? Correct answer- Kernig and
Brudzinski's signs

Cancer in the bone marrow that results in skeletal destruction Correct answer- multiple
myeloma

What is the average age of diagnosis of multiple myeloma? Correct answer- 65

a skin disorder that causes the nose to enlarge and become red, bumpy, and bulbous
Correct answer- rhinophyma

What are physical exam findings common in alcohol abuse? Correct answer- tremors,
macrocytosis (due to vitamin B12 and folate deficiencies common in alcoholics),
hypertension, rhinophyma, peripheral neuropathy, teleangectasia, hepatosplenomegaly

What is the first sign of sexual maturation in a male? Correct answer- an increase in
testicular size (tanner stage 2)

The inability to name a familiar object Correct answer- anomia

What happens to a womans vital signs when she is in her second trimester of
pregnancy? Correct answer- her blood pressure decreases

What is the most common cause of acute pharyngitis in children? Correct answer-
respiratory viruses

A depressed patient is started on an SSRI. When should another antidepressant be

tried if there is no response? Correct answer- 8-12 weeks

If the number of bacteria on a urinalysis are greater than ____________________, this

is indicative of a UTI. Correct answer- 100,000

What are signs of a ruptured TM other than the obviously ruptured TM? Correct answer-
muffled hearing and bright red blood in the canal

Osgood Schlatter disease produces pain where? Correct answer- in the knees

Growing pains usually occur when? Correct answer- at nighttime

Children with complaints of midbone pain should be worked for what MNM differential?
Correct answer- acute lymphocytic leukemia

NSAIDs should be used in caution with what patient population? Correct answer-
anyone with hypertension because they cause sodium retention and increase blood
pressure

What is the most common cause of secondary dysmenorrhea? Correct answer-

endometriosis; symptoms include spotting in between periods, cervical stenosis or
displacement, nodular or tender uterosacral ligaments

When should AAA screening be performed via US? Correct answer- once for all males
age 65-75 who have ever smoked

What is responsible for the transmission of poison ivy? Correct answer- the oils from the
plant itself. So the only way someone can pass it on to another person is if they still
have oil from the plant on their skin (like if they haven't bathed). Note that the fluid inside
the blisters is not contagious

Actinic keratosis is a precursor for what? Correct answer- squamos cell carcinoma

What is papilledema? Correct answer- swelling of the optic nerve and disc secondary to
increased ICP. Often co-occurring with a headache

Is sexual activity safe during pregnancy? Correct answer- it can expose someone to
STDs and it can also stimulate preterm labor due to stimulation of the lower uterine
segment and release of oxtocin

A report of "knee locking" is a classic complaint of what? Correct answer- a meniscal

tear

Can a pregnant woman be on levothyroxine during pregnancy? Correct answer- yes,

she should continue it and have TSH checked monthly because she may need a higher
dose as thyroid hormone needs increase during pregnancy

What characterizes mild persistent asthma? Correct answer- asthma where symptoms
occur more than twice weekly

People who do not have a spleen (asplenic) are at a greater risk of what? Correct
answer- more susceptible to bacterial infections

What 2 things put someone at the highest risk of developing pancreatitis? Correct
answer- gallstones and alcohol abuse. Hypertriglyceridemia can also cause it.
What are the RF for GI bleeding? Correct answer- age 75 or older, warfarin use, daily
NSAID use, chronic steroid use, PMHx of GI bleed

When two or more RF for a GI bleed are present, we should not start a patient on
aspirin without what? Correct answer- a daily PPI

What medication is first line for the treatment of asymptomatic bacteriuria or UTI in
pregnancy? Correct answer- nitrofurantoin

Athletic amenorrhea increases one's risk of developing what? Correct answer-

osteoporosis; this is because there is a loss of body fat and body fat is what produces
estrogen so estrogen levels decline

An intervention being performed to prevent the occurrence of the same event

happening again is an example of ___________ prevention. Give an example. Correct
answer- secondary; taking a daily aspirin to prevent another stroke after already having
one

What is Strattera (atomoxetine) used for? Correct answer- ADHD; side effect includes
increased BP and HR so monitor closely

What is the drug Danazol and what is it used for? Correct answer- an androgen used in
the treatment of endometriosis and fibrocystic breast disease

Danazol, an androgen, has what potential side effects? Correct answer- edema,
hirsutism, hair loss, vocal changes

The Mirena (Levonorgestrol) IUD stays in for how long? Correct answer- 5 years

What is the most common reason for persistent gonorrhea infections? Correct answer-
failure of the patient to abstain from unprotected sexual intercourse

What class of drug is theophylline? What does it do? Correct answer- methylxanthine;
it's a bronchodilator

Beta blockers are contraindicated in which cardiovascular condition? Correct answer-

variant (prinzmetal) angina bc they may induce coronary vasospasm from unopposed
alpha receptor activity

What class of drug is Ropinirole (requip) and what is it used for? Correct answer-
dopamine agonist; restless leg syndrome

Are males or females more likely to commit suicide? Correct answer- males
How do depression vs. anxiety differ in the way that they affect sleep? Correct answer-
anxiety usually causes people to have problems falling asleep whereas depression
causes early morning wakening

What is the most common cause of pneumonia in all ages? Correct answer- strep
pneumo

What is the most common cause of hemorrhagic stroke? Correct answer- hypertension

What helps prevent infection by maintaining the acidic environment of the ear canal?
Correct answer- cerumen

Mortality associated with Kawasaki disease is most likely related to what? Correct
answer- coronary artery aneurysm

What is Kawasaki disease? Correct answer- an acute febrile illness of early childhood
characterized by vasculitis of the medium sized arteries, most noticeable in the coronary
vessels

Serial echos must be performed in a patient with Kawasaki disease in order to rule out
coronary artery aneurysms. When should these occur? Correct answer- at the time of
diagnosis, 1-2 weeks after onset of illness, 5-6 weeks after onset of illness

What is the most common cause of croup? Correct answer- parainfluenza virus

What are the two subsets of impetigo? Correct answer- bullous (fluid filled) or
nonbullous (honey crusts)

Which protein is an important mediator of the inflammatory response and serves as a

messenger at the site of antigen (allergen) invasion? Correct answer- cytokines; they
are released by mast cells in response to an invading antigen and recruit leukocytes
and eosinophils

Paroxysmal events associated with abnormal electrical discharges of neurons in the

brain Correct answer- seizures

What is HELLP syndrome in pregnancy? Correct answer- stands for hemolysis,

elevated liver enzymes, and low platelets; is characterized by thrombocytopenia,
hemolytic anemia, and liver dysfunction

HELLP syndrome in pregnancy is due to what? Correct answer- endothelial dysfunction

Patients with acute coronary syndrome typically have plaque erosion caused by what?
Correct answer- accumulation of hyaluronan and neutrophils
Which diagnostic study is most helpful for differentiating Alzheimer's disease from
dementia with Lewy bodies? Correct answer- PET scan

ADHD is a risk factor for both depression and what else? Correct answer- substance
abuse

Epididymitis with orchitis is commonly related to what? Correct answer- genitourinary

infections

Mycoplasma genitalium is most commonly associated with which disease presentation

in men? Correct answer- urethritis, especially if persistent or recurrent

C. trachomatis stands for what common type of bacteria infection? Correct answer-
chlamydia

Chlamydia passed from a mother to a newborn can result in which problems for the
newborn? Correct answer- conjunctivitis and pneumonia

In a patient with patent ductus arteriosus, where is the murmur best heard? Correct
answer- localized at the left clavicle and is both systolic and diastolic

What is the ductus arteriosus? Correct answer- provides the fetus with a pathway from
the pulmonary artery to the aorta in utero in order to skip the lungs

What are examples of some conditions that have multifactorial inheritance? Correct
answer- diabetes, obesity, arthritis, cancer, Alzheimers

Seborrheic dermatitis is basically the same thing as what? Correct answer- eczema of
the scalp

The flow of air coming in and out of the lungs in one inhalation and one exhalation
Correct answer- peak expiratory flow

What does an incentive spirometer measure? Correct answer- peak expiratory flow

What happens in the luteal phase of the menstrual cycle? Correct answer- LH and FSH
decrease, the ruptured follicle closes after an egg has been released and forms the
corpus luteum, which produces progesterone. Estrogen and progesterone remain high
and it is those two things that cause the lining of the uterus to thicken further in
preparation for fertilization

What is a sign of the initial appearance of measurable histamines in a patient with

allergic rhinitis? Correct answer- sneezing

The bacteria responsible for syphilis is called what? Correct answer- treponema
pallidum
The STI, chancroid, is caused by what responsible bacteria? Correct answer-
haemophilus ducreyi

What is the most common cause of septic arthritis? Correct answer- staph aureus

The STI, mycoplasma genitalium, is unique in what way? Correct answer- it lacks a cell
wall and has a terminal tip-like structure which allows it to attach to and enter other
cells. It then modulates the host's immune response

What are the 3 secondary causes of type 2 diabetes? Correct answer- prolonged
physical or emotional stress, pregnancy, drugs such as steroids and hormonal
contraceptives

How does hyperinsulinemia in PCOS work? Correct answer- insulin resistance occurs in
all places except for the ovary which remains sensitive to insulin. This insulin
upregulates androgen production.

Which drug classes are responsible for causing urinary retention? Correct answer-
antihistamines, TCAs, antispasmodics, bronchodilators, antipsychotics, carbidopa
levodopa

A 75 year old patient is experiencing progressive confusion and memory deterioration.

Which condition mimics dementia that this patient should be tested for? Correct answer-
neurosyphilis

Which hormones in late pregnancy can block insulin and cause gestational diabetes?
Correct answer- cortisol, estrogen, and placental lactogen

Target shaped skin lesions as a result of a hypersensitivity reaction to certain infections

and drugs Correct answer- erythema multiforme

An abnormal growth of squamos epithelium in the middle ear and mastoid Correct
answer- cholesteatoma

The cremasteric reflex is assessed in infants for what purpose? Correct answer- to
assess for retractile testicles; this occurs when the reflex is too strong and it pulls the
testicle out of the body and into the groin; this is normal and should go away by puberty

Patient populations who may present atypically when having a MI include who? Correct
answer- diabetics, females, elderly

A disorder that results in the destruction of platelets due to an autoimmune response

Correct answer- idiopathic thrombocytopenia purpura
Pelvic inflammatory disease is most commonly caused by what? Correct answer-
chlamydia and gonorrhea

A protruding abdominal mass after bending over, lifting, or coughing, and is painful with
coughing, is often what in adults? Correct answer- inguinal hernia

Hiatal hernias cause what type of symptoms? Correct answer- GERD

What is the name of an immature female gamete? Correct answer- oocyte

The fused ovum and sperm once fertilization has occurred Correct answer- zygote

What are conditions that are often co-occurring with alopecia areata? Correct answer-
atopic dermatitis, vitiligo, thyroid disease, collagen-vascular diseases, Down syndrome

The medical term for eczema Correct answer- atopic dermatitis

The leading cause of death in infants under the age of 1 Correct answer- sudden
unexplained infant death

How is varicella zoster transmitted? Correct answer- via the respiratory tract

The presence of pruritic papules, macules, and vesicles in various stages of healing
Correct answer- varicella zoster

What is presbycusis? Correct answer- age related hearing loss

Age is the most common cause of presbycusis, but what other conditions may play a
role in quickening the onset of this? Correct answer- white, infections, smoking,
hypertenson, diabetes, vascular disease, immune disorders, hormonal factors

The fascia layer of the male anatomy that the anterior 2/3s of the testicle resides in
Correct answer- tunica vaginalis

A subtype of strabismus that describes an inward turning of the eye Correct answer-
esotropia

The abducens nerve (CN VI) is responsible for what? Correct answer- lateral movement
of the eye outward

The trochlear nerve is responsible for what extraocular movement? Correct answer-
down and inward movement

Why is primary open-angle glaucoma considered a chronic glaucoma? Correct answer-

there is a SLOW rise in intraocular pressure
A benign epidermal tumor that is a well-demarcated, coin-like, pigmented lesion with a
stuck on appearance Correct answer- seborrheic keratosis

The most common precancerous skin lesion that results from years of repeated sun
exposure Correct answer- actinic keratosis

What happens during the follicular phase of the menstrual cycle? Correct answer- FSH
and LH increase which stimulate the production of estrogen. Ultimately, it is estrogen
that prepares the uterus for ovum fertilization

A superficial dermatophyte/fungal infection of the skin of the scalp, eyebrows, and

eyelashes Correct answer- tinea capitis

Bacterial invasion of the renal parenchyma Correct answer- pyelonephritis

What is phimosis vs. paraphimosis? Correct answer- phimosis is tightening of the

foreskin over the glans that prevents retraction; paraphimosis is when you can retract
the foreskin but you can't pull it back up

What is a common characteristic of a person with Graves disease? Correct answer-

ophthalmopathy causing lymphocytes to infiltrate the extraocular muscle, resulting in
paralysis of EOMs, involvement of the optic nerve, and corneal ulcers

Which phase of the menstrual cycle begins with a surge in LH and FSH? Correct
answer- ovulatory phase

What is the pathophys of HIV? Correct answer- causes destruction of the CD4 T cells
resulting in eventual immune suppression

Cells within the epidermis that are primarily responsible for protecting the skin from UV
rays in sunlight Correct answer- melanocytes

Body lice primarily live where? Correct answer- on bedding and clothing, not people

Body lice are vectors for which diseases? Correct answer- epidemic typhus, trench
fever, relapsing fever

Fifth disease is spread via how? Correct answer- respiratory droplets

What are other names of fifth disease? Correct answer- parvovirus, slapped cheek
disease

What is the life span of lice? Correct answer- 30 days

The hypersensitivity and pain crescendo experienced in conjunction with a migraine is

thought to be related to the release of what? Correct answer- substance P; a
neurotransmitter which functions as the pain transmitter of the dorsal horn and is
responsible for causing nausea, vomiting, stress, and anxiety

Where is the location of the tricuspid valve? Correct answer- separates the right atrium
and ventricle

What does a tricuspid regurgitation murmur sound like? Correct answer- best heard at
the left sternal border, on both systole and diastole. Increases with inspiration

When can you hear the murmur associated with pulmonic stenosis? Correct answer-
mid-late systolic murmur

When can you hear the murmur associated with aortic regurg? Correct answer- diastole
only

When can you hear the murmur associated with mitral valve stenosis? Correct answer-
diastole only

What EKG changes may be present during episodes of angina? Correct answer-
transient ST elevation, T wave changes such as inversions, ST depressionals, Q waves

Children and teens present with depression most commonly how? Correct answer-
irritability

Are the sickling of RBCS in sickle cell anemia reversible? Correct answer- initially, yes
they are reversible with oxygenation. But repeated episodes cause the cells to become
irreversibly sickled.

When the brain is exposed to something rewarding, it responds by increasing the

release of what? Correct answer- dopamine

Where are T cells produced? Correct answer- in the thymus

Where are B cells produced? Correct answer- in the bone marrow

What is the pathophys behind a thyrotoxic crisis (aka thyroid storm)? Correct answer-
T3 and T4 are overproduced which leads to increased production of epinephrine and
severe hypermetabolism

What causes a reduction in the number of RBCs in pregnancy? Correct answer- iron
deficiency anemia due to blood volume expansion and a decrease in hemoglobin levels
so the iron stores are depleted because they are needed to be used for the expanded
blood volume

When should the ductus arteriosus close in an infant? Correct answer- within the first 1-
2 days of birth
The minimum arterial pressure exerted during relaxation and dilation of the ventricles
Correct answer- diastole

Lyme disease is caused by what spirochete present on ticks? Correct answer- borrelia
burgdorfei

What are the potential sequelae of strep pharyngitis? Correct answer- acute
glomerulonephritis, peritonsillar abscess, toxic shock disease, rheumatic heart disease
(although rare)

The medical term for pubic lice aka crabs Correct answer- phthirus pubis

Petechiae noted on the cervix during a pelvic exam is a sign of what disease process?
Correct answer- trichomoniasis; also called "strawberry cervix"

What is the difference between a folliculitis and a furuncle? Correct answer- folliculitis is
an inflammation of the follice whereas a furuncle is an abscess that results from
folliculitis

Urea is eliminated by the kidneys, but where does it come from originally? Correct
answer- from the liver as a byproduct of protein metabolism

What are the 5 primary structures of the immune system? Correct answer- lymph
nodes, thymus, tonsils, spleen, bone marrow

Bacteria most commonly responsible for pyelonephritis Correct answer- e coli

What causes back pain in pregnancy? Correct answer- curvature of the lumbosacral
vertebrae

What is dacrocystitis? Correct answer- inflammation of the nasolacrimal duct due to

duct obstruction or infection

What are potential causes of blepharitis? Correct answer- bacterial infection, dry eyes,
rosacea

What are s/s of croup? Correct answer- hoarseness, cough, inspiratory stridor, possible
respiratory distress due to narrowing of the larynx

Women who become pregnant later in life have an increased risk of what? Correct
answer- breast cancer

What are things women can do to decrease their risk of breast cancer? Correct answer-
regular physical activity, breastfeeding
Does an increase or decrease in blood pH affect the rate and degree of sickling in sickle
cell anemia? Correct answer- a decrease in blood pH increases the rate

What is the difference between Prinzmetals and stable (classic angina)? Correct
answer- Prinzmetals may occur randomly and while at rest, whereas stable angina is
usually only with physical activity

Why may infection of the palatine tonsils become serious very quickly? Correct answer-
the area is composed of loose connective tissue

What are cutaneous xanthomas? Correct answer- localized lipid deposits caused by
elevated lipids or LDL

Uterine prolpase is caused by stretching of the uterine ____________ Correct answer-

ligaments

What causes bacterial vaginosis? Correct answer- a decrease in lactobacillus species

within the vagina

Where is acanthosis nigricans most likely to occur? Correct answer- axillae, neck, groin

What causes subjective tinnitus? Correct answer- abnormal neuronal activity

HIV produces cellular immunity deficiency by depleting what? Correct answer- helper T
cells

What is the function of B cells in the immune system? Correct answer- development of
antibodies

When does the male fetus begin to produce testosterone and how? Correct answer-
around 9 weeks gestation due to the Leydig cells

What is the pathophys of Addison's disease? Correct answer- causes decreased or

absent aldosterone levels resulting in increased excretion of sodium and water by the
kidneys, and hyperkalemia

What is the most serious complication of Addison's disease? Correct answer- acute
adrenal insufficiency or adrenal crisis

What are the 4 heart defects of Tetralogy of Fallot? Correct answer- VSD, right
ventricular hypertrophy, overriding aorta, pulmonary stenosis

What are the s/s of Kawasaki disease? Correct answer- think CREAM; conjunctivitis,
rash, erythema of hands and soles of feet, adenopathy (cervical), mucous membranes
(strawberry tongue)
A palpable softening of the cervical isthmus during pregnancy Correct answer- Hegar's
sign

A bluish tint to the vagina and cervix due to increased vascularity during pregnancy
Correct answer- Chadwick's sign

What is Paget's disease? Correct answer- where there is abnormal bone destruction or
growth of bone. It is also a malignant disease of the breast.

Does Meniere's disease result in hearing loss? Correct answer- yes, gradual but
progressive sensorineural hearing loss

What is another term for chronic bladder pain syndrome? Correct answer- interstitial
cystitis

What classifies someone as having "prediabetes"? Correct answer- hgba1c between

5.7 and 6.4

What classifies someone as having diabetes? Correct answer- hgba1c 6.5 or greater

A reduction in vision in one or both eyes causing loss of binocular vision Correct
answer- amblyopia

What is Brudzinski's sign? Correct answer- the patient lies supine and the NP flexes the
patients neck forward. If both hips and knees flex at the same time, this is indicative of
meningitis

A child presents with erythematous papules and vesicles, that are weeping, oozing, and
crusty. They are located all over the forehead, wrists, elbows, and backs of knees. What
is this most likely to be? Correct answer- atopic dermatitis

In older adults, what is an audible S3 sound usually a sign of? Correct answer- left
ventricular hypertrophy from heart failure, or cardiomyopathy

How is cervical radiculopathy different from cervical myelopathy? Correct answer- in

radiculopathy, there is nerve root compression that results in burning pain and n/t in the
neck and one arm. In myelopathy, there is pain with bilateral weakness and n/t in both
the upper and lower extremities

Other than scratching the medial aspect of the thigh, how else can we elicit the
cremasteric reflex in a child? Correct answer- have them sit cross legged and blow into
a balloon. This will increase intraabdominal pressure and stimulate the reflex.

What is the Lachman's test and what does it identify? Correct answer- used to assess
for ACL tear; the knee is held passively at 30 degrees flexed and then one hand
stabilizes the femur while the other applies a gentle anterior force to the proximal tibia. If
it moves beyond it's normal ROM, there may be an ACL tear

When should the testicles fully descend into the scrotum by in an infant? Correct
answer- 6 months of age. If not descended by this time, then refer to Urology at 6
months although surgical correction (orchipexy) may not be performed until 1 year

What is another name for the moro reflex? Correct answer- the startle reflex; both arms
should extend outwards when this is positive

If a moro reflex in an infant is only positive in one arm, then what do you need to
consider? Correct answer- examine the clavicle for a potential fracture

Which model is used to designate risk factors for melanoma? Correct answer- think
HARMM; history, age, regular dermatologist absent, mole changing, male gender

What is a sign of an ankle fracture on physical exam? Correct answer- point tenderness
over the posterior malleolus with an inability to bear weight after 4 or more steps

What is an acoustic neuroma? Correct answer- something pressing, likely a tumor, on

the acoustic nerve that results in dizziness, loss of balance, facial numbness, hearing
loss, and tinnitus

The axillary lymph nodes drain lymphatic fluid from where? Correct answer- breast,
upper abdomen, upper back, pectoral region, and upper limbs

International travelers to endemic areas are at a risk for what form of hepatitis? Correct
answer- hepatitis A because it can be transmitted through contaminated food or drink

Adrenarche is the early presence of pubic hair in girls aged __________ Correct
answer- 5-8 years old

A condition that presents with symptomatic limb ischemia upon exertion is termed:
Correct answer- atherosclerotic peripheral arterial disease

The largest salivary gland is the parotid gland, and where does it drain to? Correct
answer- Stensen's duct which has an opening on the buccal mucosa opposite the
second molar

The varus stress test assesses for a tear in which part of the lower extremities? Correct
answer- lateral meniscus

The valgus stress test assesses for a tear in which part of the lower extremities?
Correct answer- medical meniscus
To evaluate the uterus during a bimanual exam, the examiner would lubricate the index
and middle fingers of one hand and insert them into the vagina. The other hand would
be placed on the abdomen where? Correct answer- about midway betwee the umbilicus
and symphysis pubis while elevating the cervix and uterus with the other hand

A feeling of constantly needing to pass stool Correct answer- tenesmus

Severe constipation resulting from intestinal obstruction Correct answer- obstipation

What does the vaginal discharge associated with trich look like? Correct answer-
profuse, yellowish green that is malodorous

What does the discharge associated with bacterial vaginosis look like? Correct answer-
gray or white, thin, malodorous (fishy) and not profuse

The nurse practitioner instructs the patient to place on hand behind his back and touch
his shoulder blade. This shoulder movement elicits what? Correct answer- internal
rotation

How do we test for flexion and extension of the shoulder? Correct answer- extension is
asking the patient to move their arm behind themself. Flexion is asking the patient to
move their arm in front of the body

Symptoms related to Shaken Baby Syndrome are due to what? Correct answer-
uncontrollable cerebral edema and hypoxia

What are the symptoms of Shaken Baby Syndrome? Correct answer- blindness,
inability to perform previously learned milestones, flaccid muscle tone

Koplik's spots are indicative of what disease? Correct answer- measles (rubeola)

The medical term for measles Correct answer- rubeola

What do Koplik's spots of measles look like? Correct answer- small white specks that
resemble grains of salt on a red background

Round or oval shaped lesions surrounded by erythematous mucosa found anywhere on

the oral mucosa Correct answer- aphthous ulcers

Excessive or prolonged menstrual flow occurring at regular intervals Correct answer-

menorrhagia

Intermenstrual bleeding (aka spotting in between periods) Correct answer- metrorrhagia

Polymenorrhea is when there are fewer than ________ between periods Correct
answer- 21 days
Oligomenorrhea is when there are more than _______ between periods; or only 4-9
menstrual cycles per year Correct answer- 35 days

Retraction of the nipple and areola are suggestive of what? Correct answer- an
underlying breast mass; this is never considered normal

What is the straight leg raise test? Correct answer- used to evaluate for sciatica; the NP
raises the straight leg while flexing the hip and then dorsiflexes the foot. Positive if pain
is elicited.

What is Tinel's sign? Correct answer- positive for carpal tunnel; the NP taps over the
median nerve and is positive if n/t is felt

What is Phalen's sign? Correct answer- positive for carpal tunnel; patient holds their
wrists together to form right angles for 60 seconds and is positive if n/t is felt

Test used to identify de Quervain's tenosynovitis Correct answer- Finkelsteins test

Test of thumb movement by instructing the patient to place his thumb in the palm and
then move the wrist toward the midline in ulnar deviation Correct answer- Finkelsteins
test

What does the murmur associated with mitral regurg sound like? Correct answer-
pansystolic, harsh murmur heard loudest at the apex with radiation toward the left axilla

When auscultating the apex of the heart in a child older than 7, the bell of the
stethoscope should be placed where? Correct answer- fifth intercostal space to the left
of the midclavicular line; if younger than 7, it is best heard at the third or fourth
intercostal space

What is the main sign of Kaposi's sarcoma? Correct answer- raised or flat deep purple
lesions in the mouth

Where do lesions of Kaposi's sarcoma usually manifest? Correct answer- in the mouth,
GI tract, or lungs

A patient is experiencing a dull achy pain in the epigastric area with eating. This type of
pain is consistent with what? Correct answer- a gastric ulcer

How is the pain of a gastric ulcer vs. a duodenal ulcer different? Correct answer- the
pain is worsened with eating with a gastric ulcer but improved with eating in a duodenal
ulcer

What are s/s of glaucoma? Correct answer- loss of peripheral vision, halos around
lights, difficulty focusing on near objects
Higher level functioning, such as using the telephone, doing laundry, taking medicine,
etc. are considered to be called what? Correct answer- instrumental activities of daily
living

An inability to extend the knee is a sign of what? Correct answer- a partial or complete
patellar tendon tear

Which part of the spine controls the ankle DTRs? Correct answer- sacral nerve 1

Which part of the spine controls the knee DTRs? Correct answer- lumbar nerves 2, 3, 4

Which part of the spine controls the biceps DTRs? Correct answer- cervical nerves 5
and 6

Which part of the spine controls the triceps DTRs? Correct answer- cervical nerves 6
and 7

What are s/s of carpal tunnel syndrome? Correct answer- dropping objects, unable to
twist lids off of jars, aching at the wrist or forearm, numbness of the first 3 digits of the
hand

Which movement indicates a nuchal rigidity sign when working a patient up for
meningitis? Correct answer- neck stiffness and resistance when flexing the neck
forward

What is Kernig's sign? Correct answer- flex the patients leg at both the hip and the
knee, then straighten the knee. Pain and resistance to extension of the knee are
positive for meningitis.

A patient who is unable to touch his left scapula with his right hand likely has what?
Correct answer- a rotator cuff tear

A widened pulse pressure greater than or equal to 60 in an older adult is a risk factor for
what? Correct answer- cardiovascular disease, stroke, renal disease

The ethmoidal sinuses are located where? Correct answer- between the eyes

Where do the sphenoid sinuses lie? Correct answer- just behind the ethmoid sinuses

Where do the maxillary sinuses lie? Correct answer- around the nasal cavity

What describes a stage III pressure ulcer? Correct answer- full thickness tissue loss
and subcutanous fat may be present, but bone, tendon, or muscle are not exposed
Dislocation of the elbow joint caused by the sudden pull on the extended pronated
forearm Correct answer- nursemaid's elbow

Localized tenderness over the ankle joint is a sign of what? Correct answer- a
ligamentous injury; point tenderness and inability to bear weight is more of a sign of an
ankle fracture

Describe renal adaptation of the newborn Correct answer- the kidneys are structurally
complete but physiologically immature. the infant is at increased risk of metabolic
acidosis due to the kidneys inability to concentrate urine and adapt to fluid and
electrolyte stress

Where is the best place to locate the twelfth rib? Correct answer- between the spine
and lateral chest

What is biliary colic? Correct answer- pain in the epigastric region or RUQ that radiates
to the right scapula or shoulder; indicative of cholecystitis

Costochondritis occurs when there is inflammation of the cartilage where? Correct

answer- that connects the ribs to the sternum

What aggravates costochondritis? Correct answer- movement of the chest, trunk, and
arms

Which segments of the spine control the plantar reflexes? Correct answer- lumbar 5 and
sacral 1

A softening of the skin at the angles of the mouth which may be due to nutritional
deficiency Correct answer- angular cheilitis

Angular cheilitis can be caused by what? Correct answer- nutritional deficiency

What causes actinic cheilitis? Correct answer- excessive exposure to sunlight; most
often affects the lower lip

Intention tremors appear with movement and worsen when? Correct answer- as the
target gets closer

Nausea, diaphoresis, and pallor triggered by a fearful or unpleasant event Correct

answer- vasovagal syncope

Which conditions are known to cause polyuria? Correct answer- lithium toxicity,
uncontrolled diabetes, disorders of the posterior pituitary and hypothalamus
(hypogonadism), and hypokalemic nephropathy
Breath sounds heard over the periphery of the lung fields are what? Correct answer-
vesicular; they are quiet and wispy

What do bronchovesicular breath sounds sound like? Correct answer- full inspiratory
phase with a shortened and quieter expiratory phase

Thenar atrophy suggests what? Correct answer- a median nerve disorder

Does the ulnar nerve innervate the pinky or the thumb? Correct answer- pinky

The pregnant woman who has a BMI of less than 18.5 should gain how many pounds in
pregnancy? Correct answer- 28-40 pounds

The pregnant woman who has a BMI of 18.5-24.9 (normal) should gain how many
pounds in pregnancy? Correct answer- 25-35 pounds

The pregnant woman who has a BMI of 25-29.9 (overweight) should gain how many
pounds in pregnancy? Correct answer- 15-25 pounds

The pregnant woman with a BMI over 30 should gain how many pounds in pregnancy?
Correct answer- 11-20 pounds

A BMI of less than _____ is considered underweight Correct answer- 18.5

The term used to refer to skin that is peeling Correct answer- exfoliation

What will a basal cell carcinoma on the eyelid look like? Correct answer- papule with an
ulcerated center, most often on the lower lid and medial canthus

What is Rovsing's sign? Correct answer- positive for appendicitis; palpation on the LLQ
elicits pain in the RLQ

What causes plantar warts? Correct answer- human papillomavirus; usually occur on
the sole of the foot

In second degree uterine prolapse, where is the cervix located? Correct answer- at the
introitus

In third degree uterine prolapse, where is the cervix located? Correct answer- both the
cervix and vagina are outside the introitus

The anterior cervical lymph node chain is located where? Correct answer- anterior and
superficial to the sternocleidomastoid muscle

How do we diagnose a migraine headache? Correct answer- if 3 of the 5 POUND

symptoms are present: pulsatile or throbbing, one day duration or 4-72 hours if left
untreated, unilateral, nausea or vomiting, disabiling or intense causing interruption of
daily activity

What causes the S4 sound? Correct answer- the atrium forcefully contracting against a
stiffened ventricle

During the vaginal exam of a pregnant woman in her first trimester, an adnexal mass
with tenderness is palpated. This is consistent with what? Correct answer- an ectopic
pregnancy

Stridor indicates a partial or complete obstruction of the _________ and is best heard
where? Correct answer- larynx; neck

When assessing an african american person, black, dusky mucous membranes are
related to what Correct answer- cyanosis

Persistent, sharp, and knife-like chest pain is indicative of what? Correct answer-
pericarditis or pleuritic chest pain

Thin, pencil-like stool can be associated with what? Correct answer- a lesion in the
sigmoid colon

An acute viral illness that presents with a burning retrosternal discomfort and a dry
cough is suggestive of what? Correct answer- tracheobronchitis

The shiny, pink area located around the cervical os is known as what? Correct answer-
squamos epithelium

Tenderness of the posterior medial malleolus may be a sign of what? Correct answer-
tibial tendinitis

When performing a rectal exam on a female, a hard nodular rectal "shelf" is palpable at
the tip of the examiner's finger. What is this suggestive of? Correct answer- metastatic
tissue in the rectouterine pouch