An adult has upper respiratory symptoms and cough for the past 14 days. What should be considered?
Mycoplasma pneumoniae is:
Which medication below is contraindicated in an asthma patient because it may increase risk of sudden death if used alone?
A 75-year-old female with emphysema who has been treated with inhaled steroids for many years should:
A patient received the pneumonia immunization at age 60 years. He is 65 years old and presents to your clinic today. What recommendation should be made about the pneumococcal immunization?
Which of the following medications should be used cautiously in a patient who has asthma?
The most common symptom associated with acute bronchitis is:
Mild persistent asthma is characterized by:
The chest circumference of a 12 month-old is:
A patient with cough and fever is found to have infiltrates on chest x-ray. What is his likely diagnosis?
An uncommon symptom associated with acute bronchitis is:
Patients who have cough-variant asthma:
The most common cause of atypical pneumonia in adults is:
Which patient might be expected to have the worst FEV1?
Ipratropium is very widely used in the treatment of COPD. Which of the following statements about ipratropium is correct?
An 80-year-old has Stage 3 COPD. He is most likely to have concomitant:
A 6-year-old child who has moderate persistent asthma is diagnosed with pneumonia after chest X-ray and laboratory studies. He developed a sudden onset of fever with chills. He is in no distress. What is the preferred treatment for him?
What disease is usually managed with a short-acting or long-acting inhaled anticholinergic medication?
A patient with pneumonia reports that he has rust-colored sputum. What pathogen should the nurse practitioner suspect?
A 44-year-old nonsmoker is diagnosed with pneumonia. He is otherwise healthy and does not need hospitalization at this time. Which antibiotic can be used for empirical treatment of pneumonia according to the most recent Infectious Diseases Society of America/American Thoracic Society guidelines?
The gold standard for diagnosing pneumonia on chest X-ray is the presence of:
An 83-year-old healthy adult is diagnosed with pneumonia. He is febrile but in no distress. What is the preferred treatment for him?
The pneumococcal immunization in infants has:
A 78-year-old adult who has a 50 pack year smoking habit asks the nurse practitioner about the benefits of quitting “at my age.” What should the nurse practitioner reply?
M. pneumoniae and C. pneumoniae are respiratory pathogens that:
An 18-month-old child is diagnosed with bronchiolitis. His respiratory rate is 28 breaths per minute. Which choice below is most appropriate for patient management?
How should a 20-year-old college age student who presents with cough, night sweats, and weight loss be screened for TB?
How should a 20-year-old college age student who presents with cough, night sweats, and weight loss be screened for TB?
A patient with asthma uses one puff twice daily of fluticasone and has an albuterol inhaler for PRN use. He requests a refill on his albuterol inhaler. His last prescription was filled 5 weeks ago. What action by the NP is appropriate?
Patients with asthma:
A 26-year-old being treated for community-acquired pneumonia (CAP) has been taking azithromycin (standard dose) in therapeutic doses for 72 hours. His temperature has gone from 102° F to 101° F. What should be done?
A 60-year-old patient newly diagnosed with COPD presents to your office. He would like to get the influenza immunization. He has no evidence of having had the pneumococcal immunization. What statement is correct?
Which of the following is NOT part of the differential for a patient who complains of cough?
A 65-year-old has been diagnosed with asthma. Older patients who have newly diagnosed asthma:
A 67-year-old patient with COPD presents an immunization record that reflects having last received the pneumococcal immunization (PPSV23) when he was 60 years old. Which statement below reflects the current standard of practice recommended by CDC for this patient?
A 24-year-old college student who does not smoke is diagnosed with pneumonia. He is otherwise healthy and does not need hospitalization at this time. What antibiotic represents the best choice for treatment for him?
What does a peak flow meter measure?
The major laboratory abnormality noted in patients who have pneumococcal pneumonia is:
Which drug class is never used to treat chronic obstructive pulmonary disease (COPD)?
A patient who has asthma presents with chest tightness, wheezing, coughing, and fever. He has wheezing and diminished breath sounds in the upper right lobe. His cough is non-productive, and he denies nasal symptoms. Which symptom is most likely related to pneumonia?
A patient with COPD has been using albuterol with good relief for shortness of breath. He is using it 3-4 times daily over the past 4 weeks. How should the NP manage this?
Which of the following may be used to diagnose COPD?
A patient with acute bronchitis was diagnosed at an urgent care center 10 days ago. He reports that he received an antitussive for nighttime cough, a steroid injection and oral steroids, and an antibiotic. Which of these interventions was of greatest benefit in resolution of his symptoms?
A 65-year-old patient has COPD. She receives a prescription for an albuterol inhaler. What medication information should be provided to this patient?
A patient presents with symptoms of influenza during influenza season. He has not received the immunization against influenza. What should be used to help diagnose influenza in him?
The most common cause of pneumonia in people of all ages is:
A patient recently received levofloxacin for 7 days to treat pneumonia. His respiratory symptoms have resolved, but today he calls the office. He reports having severe watery diarrhea, abdominal cramping, and low-grade fever. What should be done?
A 20-year-old college age student has a positive TB skin test. Which choice listed below provides definitive diagnosis of tuberculosis?
A patient has cough, pharyngitis, nasal discharge, and fever. He has been diagnosed with acute bronchitis. Which symptom is least likely in the first 3 days of this illness?
Which of the following characteristics is always present in a patient with COPD?
“Good control” of asthma is measured by the number of times weekly a patient uses a rescue inhaler. What choice below indicates “good control”?
Mr. Smith has smoked for 45 years. Which of the following medications may worsen one of his diseases?
The most common sequela of influenza in older adults is:
A healthy 7-year-old child is diagnosed with atypical pneumonia. He is febrile but not in distress. What is the preferred treatment for him?
A 30-year-old patient with intermittent asthma is using his “rescue” medication once daily. How should this be managed? He should receive a prescription for a(n):
Which choice below most appropriately differentiates acute bronchitis from pneumonia in a patient who has a productive cough?
The most common cause of pneumonia in an otherwise healthy 3-year-old child is:
Which medication below should be avoided in a patient with stage 3 COPD?
A patient with acute bronchitis and cough for 5 days calls to report that his cough is productive of discolored sputum. He has no other new symptoms. How should the nurse practitioner manage this?
A patient has received a prescription for lisinopril. Which side effect most commonly occurs with this medication?
A 24-year-old presents with fever, rhinorrhea, and paroxysmal, high-pitched cough. This is:
A 60-year-old patient reports chronic cough and sputum production. He has a long history of exposure to secondhand cigarette smoke from his wife. What diagnosis is most likely?
A patient is diagnosed with asthma. Which question is most important to ask when deciding on medication management?
Breath sounds auscultated over the periphery of the lung fields are quiet and wispy during the inspiratory phase followed by a short, almost silent expiratory phase. These breath sounds are considered:
The two tests that can indicate current infection with hepatitis B are:
A mother of a 4-week-old infant visits your office. She states that her baby is vomiting after feeding and then cries as if he is hungry again. What should the nurse practitioner assess?
A patient has the following laboratory value. (anti-HAV IgG: positive). What is the clinical interpretation?
The early signs and symptoms of appendicitis in an adult:
A 70-year-old presents to the nurse practitioner’s office for a well exam today. What medication probably has no effect on screening for occult blood in the stool?
Symptoms of uncomplicated reflux disease in older adults should be treated:
Which symptom is INCONSISTENT with irritable bowel syndrome in older adults?
A 20-year-old female patient presents with tenderness at McBurney’s point. Appendicitis is considered. What laboratory test should be done initially to determine the etiology of this patient’s abdominal pain?
A patient with a suspected inguinal hernia should be examined:
A healthcare provider (“the HCP”) was stuck with a needle from a patient suspected to be infected with HIV (“the patient”). A rapid HIV test was performed on the patient and found to be positive. This means that:
A patient has had right upper quadrant pain that has lasted for the past 3 days, but the pain has become acute in the past 12 hours. He has low-grade fever. Which lab test(s) will be elevated if he has pancreatitis?
A patient presents with complaints of bright red stools over the past week. This symptom could be consistent with:
A 24-year-old female presents with pain and tenderness in the right lower abdominal quadrant. Her pelvic exam and urinalysis are within normal limits. Her WBC is elevated and her urine pregnancy test is negative. What is part of the differential diagnosis
What medication used to treat patients who have GERD provides the fastest relief of heartburn symptoms?
A patient with gall bladder disease has classic symptoms. Which symptom below is NOT classic of gallbladder disease?
Most patients who have acute hepatitis B infection:
A patient has been diagnosed with hepatitis A. The most common reported risk factor is:
A 6-week-old male infant is brought to the nurse practitioner because of vomiting. The mother describes vomiting after feeding and feeling a “knot” in his abdomen especially after he vomits. The child appears adequately nourished. What is the likely etiology?
Which of the following is NOT a risk factor for developing hepatitis B?
An 83-year-old patient is diagnosed with diverticulitis. The most common complaint is:
Which medication listed below can exacerbate the symptoms of GERD?
Choose the number on the image that most closely approximates the location of a direct inguinal hernia.
A 70-year-old patient states that he had some bright red blood on the toilet tissue this morning after a bowel movement. He denies pain. What is the LEAST likely cause in this patient?
GERD (gastroesophageal reflux disease) and physiologic reflux have similar characteristics. However, physiologic reflux:
A 56-year-old male patient has been diagnosed with an inguinal hernia. What symptom would make the nurse practitioner suspect an incarcerated hernia?
A 48-year-old patient has the following laboratory values. (anti-HCV: reactive, HCV RNA: detectable). How should they be interpreted?
Choose the number on the image that most closely approximates the location of an indirect inguinal hernia?
A patient presents with right upper quadrant and upper abdominal pain. Acute cholecystitis is suspected because the pain radiates to the:
A 63-year-old male has been your patient for several years. He is a former smoker who takes simvastatin, ramipril, and an aspirin daily. His blood pressure and lipids are well controlled. He presents to your clinic with complaints of fatigue and “just not feeling well” for the last few days. His vital signs and exam are normal, but his liver enzymes are elevated. His hepatitis panel is negative for infectious hepatitis. What is the most likely cause of his elevated liver enzymes?
What is the simplest screen for nutritional adequacy in elderly patients?
A 31-year-old patient is suspected of having hepatitis C. He reports possible exposure about a month ago. (anti-HCV: nonreactive, HCV RNA: not detectable).How should the nurse practitioner interpret his laboratory results?
A patient has been diagnosed with viral gastroenteritis. He has nausea and vomiting, and has started having lower abdominal cramps. What is the most effective intervention for him?
A 35-year-old patient has the following laboratory values. How should they be interpreted? (HBsAG: negative, Anti-HBc: negative, Anti-HBs: negative)
An 85-year-old adult has chronic constipation. How should this be managed initially?
Which is NOT an effective strategy for helping older adults gain weight?
The relationship between duodenal ulcer disease and H. pylori infection is:
A 37-year-old has routine blood work performed during an annual exam. On exam he has a tender, enlarged liver. How should the nurse practitioner proceed?
A 19-year-old female presents with lower abdominal pain that began about 12 hours ago. She denies vaginal discharge. Which choice below is the least likely cause of her symptoms?
A 40-year-old patient has the following laboratory values. How should they be interpreted? HBsAG: negative, anti-HBs: positive, anti-HBc: negative
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