Chapter 3 Week 1: Health promotion

1. Which of the following is a primary prevention measure for a 76-year-old man newly diagnosed with a testosterone deficiency?
2. Which of the following is an example of secondary prevention in a 50-year-old woman?
3. Which of the following is an example of tertiary prevention in a patient with chronic renal failure?
4. Immunizations are an example of which type of prevention?
5. Prevalence is the number of new cases of a particular disease.
6. The number of cases of a particular disease for the past 5 years is an example of the incidence rate.
7. There are 1,185,000 cases of HIV/AIDS in the US" is an example of morbidity rate.
8.  Endemic is the term used when the presence of an event is constant.
9. The "bird" flu of 2005 to 2006 is considered a sporadic outbreak.
10. A pandemic affects many communities in a short period of time.

Chapter 5 Week 1: Evidence- Based Practice

1. Which of the following are parts of evidence-based practice?
2. Which is the most important question to ask in nursing research?
3. Which of the following is a crucial element of developing a guideline?
4. Which of the following would be considered the research design for Level I evidence?
5. Which of the following would be considered the research design for Level II evidence?
6. Which of the following would be considered the research design for Level III evidence?
7. Which of the following would be considered the research design for Level IV evidence?
8. Which of the following would be considered the research design for Level V evidence?
9. Which of the following would be considered the research design for Level VI evidence?
10. Which of the following would be considered the research design for Level VII evidence?

CH 8 Week 2- Eyes, Ears, Nose And Throat Problems

1. The clinician is assessing a patient complaining of hearing loss. The clinician places a tuning fork over the patient's mastoid process, and when the sound fades away, the fork is placed without restriking it over the external auditory meatus. The patient is asked to let the clinician know when the sound fades away. This is an example of which type of test?
2. A patient presents to the clinician c/o ear pain. On exam, the clinician finds that the patient has tenderness on traction of the pinna as well as when applying pressure over the tragus. These findings are classic signs of which condition?
3. Otitis media is considered chronic when:
4. The most significant precipitating event leading to otitis media with effusion is:
5. Patients with acute otitis media should be referred to a specialist in which of the following situations?
6. Fluctuations and reductions in estrogen may be a contributing factor in which type of rhinitis?
7. Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than:
8. Which of the following antibiotics provides the best coverage in acute or chronic sinusitis when gram-negative organisms are suspected?
9. In which of the following situations would referral to a specialist be needed for sinusitis?
10. Which type of stomatitis results in necrotic ulceration of the oral mucous membranes?
11. The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection?
12. Heart valve damage resulting from acute rheumatic fever is a long-term sequelae resulting from infection with which of the following pathogens?
13. A patient presents with the following signs and symptoms: gradual onset of low-grade fever, marked fatigue, severe sore throat, and posterior cervical lymphadenopathy. Based on the signs and symptoms alone, which condition is most likely the cause?
14. A patient presents to the clinician with a sore throat, fever of 100.7, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?
15. Which of the following meds used in the treatment of glaucoma works by constricting the pupils to open the angle and allow aqueous fluid to escape?
16. You have a patient who is positive for strep on rapid antigen testing. You order amoxicillin after checking for drug allergies (pt has none) but he returns 3 days later, reporting that his temp has gone up, not down (101.5 in office). You also note significant adenopathy, most notably in the posterior and anterior cervical chains, some hepatomegaly, and a diffuse rash. You decide:
17. Severe pain associated with acute otitis media signifies perforation of the
18. Jill presents with symptoms of hay fever, and you assess the nasal mucosa of her turbinate’s to be pale. What diagnosis do you suspect?
19. When a practitioner places a vibrating tuning fork in the midline of a client's skull and asks if the tone sounds the same in both ears or is better in one, the examiner is performing:
20. Acute otitis media is diagnosed when there is:
21. What therapy has proved beneficial for long-term symptom relief of tinnitus?
22. Jessica, an 8-year-old third-grader, is brought to the office by her grandmother, who is the child's babysitter. She has complained of fever and sore throat for the past 2 days. Five other children in her class have been sick with sore throats. She denies difficulty swallowing and has been drinking fluids, but she has no appetite. A review of system reveals that she has clear nasal drainage, hoarseness, and a nonproductive cough. She denies vomiting but has had mild diarrhea. On examination, she has a temperature of 101.5°F; 3+ erythematous tonsils; and palpable, tender cervical lymph nodes. Based on these findings, what is the most likely diagnosis?
23. Martin, age 24, presents with an erythematous ear canal, pain, and a recent history of swimming. What do you suspect?
24. Sam, age 4, is brought into the clinic by his father. His tympanic membrane is perforated from otitis media. His father asks about repair of the eardrum. How do you respond?
25. A client complains of frequent bouts of severe, intense, disabling left-sided facial pain accompanied by excessive left eye lacrimation (tearing) and worsening anxiety. The pain wakes him at night, and he has even contemplated harming himself during these episodes due to the intensity and unrelenting nature of the pain. What kind of headache is he describing?
26. Jill states that her 5-year-old daughter continually grinds her teeth at night. You document this as:
27. Mark, age 18, has a persistent sore throat, fever, and malaise not relieved with penicillin therapy. What would you order next?
28. Nathan, age 19, is a college swimmer. He frequently gets swimmer's ear and asks if there is anything he can do to help prevent it other than wearing earplugs, which don't really work for him. What do you suggest?
29. Matthew, age 52, has allergic rhinitis and would like some medicine to relieve his symptoms. He is taking cimetidine (Tagamet) for gastroesophageal reflux disease. Which medication would you not order?

Chapter 11 Week 2: Abdominal Problems

1. A 35yo female pt is seen in the clinic c/o abdominal pain. Which of the following should be included in the history and physical exam?
2. A pt comes to the office c/o constipation. The pt lists all of the following meds. Which drug could be responsible for the constipation?
3. A pt is seen with c/o diarrhea. Which of the following should be included in the pt's differentials?
4. Mr. J. K., 38yo, is 5'8" and weighs 189lbs. He reports that he has had intermittent heartburn for several months and takes Tums with temporary relief. He has been waking during the night with a burning sensation in his chest. Which additional info would lead you to believe that GERD is the cause of the pain?
5. A 29yo Englishman is seen in the office with c/o pain in his chest and belly. He has been suffering the pain for 2 weeks and gets temporary relief from Alka-Seltzer. The burning pain wakes him at night and radiates up to his chest. Which factor favors a dx of gastric ulcer?
6. Which of the following is most effective in diagnosing appendicitis? H&P
7. Which of the following is associated with celiac disease (celiac sprue)?
8. A 45yo pt presents with a CC of generalized abd pain. Her physical exam is remarkable for LLQ tenderness. At this time, which of the following should be considered in the differential dx?  
9. A 46yo pt is seen in the clinic w/abd pain. Which of the following tests is essential for this pt?
10. A 25yo accountant is seen in the clinic c/o crampy abd pain after meals. She is often constipated and takes laxatives, which are followed by a couple of days of diarrhea. She temporarily feels better after a bowel movement. She states she is embarrassed by flatulence and has abd distention. She has had no wt loss or blood in her stool. This problem has gone on for about 6mo. What should the next step be?
11. A 28yo pt is seen in the clinic with colicky abd pain particular with meals. She has frequent constipation, flatulence, and abd distention. Which of the data make a diagnosis of diverticulitis unlikely?
12. A 28yo is seen with c/o diarrhea. Which of the following responses to the Hx questions would help the PCP establish the dx of IBS?
13. A pt is diagnosed with GERD and his endoscopic report reveals the presence of Barrett's epithelium. Which of the following should the PCP include in the explanation of the pathology report?
14. Which of the following dietary instructions should be given to a pt with?
15. The pt with GERD should be instructed to eliminate which of these activities?
16. A pt is diagnosed with giardia after a backpacking trip in the mountains. Which of the following would be an appropriate treatment?
17. A 22yo is seen c/o vague belly pain. This type of pain is seen at what point in appendicitis?
18. The NP suspects a pt has a peptic ulcer. Which of the following items on the Hx would lead the NP to this conclusion?
19. A pt is seen with dark-colored urine and the urine dipstick reveals a high level of bilirubin. Which of the following could be the cause of the problem?
20. A 21yo student presents with c/o fatigue, HA, anorexia, and a runny nose, all of which began about 2wks ago. She started taking vitamins and OTC cold preparations but she feels worse. The smell of food makes her nauseated. Her boyfriend had mono about a month ago and she wonders if she might have it also. Exam reveals cervical adenopathy and an enlarged liver and spleen. Which of the following labs would be most helpful in the differential diagnosis at this point?
21. On further questioning, the 21yo pt with c/o fatigue, HA, anorexia, and a runny nose explains that she is sexually active only with her boyfriend, does not use injectable drugs, and works as an aide in a daycare center. Which of the following tests would be most helpful in confirming your dx?
22. A pt is seen in the clinic with RUQ pain that is radiating to the middle of the back. The NP suspects acute cholelithiasis. The NP should expect which of the following lab findings?
23. A pt has acute pancreatitis with seven of the diagnostic criteria from Ranson's criteria. In order to plan care, the NP must understand that this criteria score has which of the following meanings?
24. A pt is seen in the office with c/o six to seven liquid BMs per day. Which of the following assessment findings would lead the NP to a Dx of inflammatory bowel disease?
25. Which of the following is part of the treatment plan for the pt with IBS?

Chapter 7 Week 3: Skin Problems

1. Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?
2. What is a "linear crack extending from the epidermis to the dermis"?
3. A bulla is:
4. An example of ecchymosis is:
5. When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?
6. Your patient is in her second trimester of pregnancy and has a yeast infection. What is the treatment that you usually recommend/order in nonpregnant patients, but is listed as a pregnancy category?
7. Tinea unguium is also known as:
8. Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus. The clinical presentation is pruritic, tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this?
9. Mark has necrotizing fasciitis of his left lower extremity. Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria?
10. When using the microscope for an intravaginal infection, you see something translucent and colorless. What do you suspect?
11. Marci has a wart on her hand. She says she heard something about "silver duct tape therapy." What do you tell her about his?
12. Which is the most potent and irritating dose of tretinoin? 0.05%
13. Of the following types of cellulitis, which is a streptococcal infection of the superficial layers of the skin that does not involve the subq layers?
14. Mandy presents with a cauliflower-like wart on her anogenital region. You suspect it was sexually transmitted and document it as:
15. Jeffrey has atopic dermatitis. You are prescribing a low-dose topical corticosteroid for him. Which would be a good choice?
16. Harvey has a rubbery, smooth, round mass on his chest that is compressible and has a soft-to-very firm texture. What do you diagnose this as?
17. Which of the following statements is accurate when you are removing a seborrheic keratosis lesion using liquid nitrogen?
18. The "B" in ABCDEs of assessing skin cancer represents:
19. The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?
20. Eighty percent of men have noticeable hair loss by what age?
21. Prevalence of psoriasis is highest in which group?
22. The most common precancerous skin lesion found in Caucasians is:
23. Ian, age 62, presents with a wide, diffuse area of erythematous skin on his lower left leg that is warm and tender to palpation. There is some edema involved. You suspect:
24. Josh, age 22, has tinea versicolor. Which description is most likely for his condition?
25. Tori is on systemic antifungals for a bad tinea infection. You are aware that the antigungals may cause:
26. Which scalp problem can be caused by a fever and certain drugs?
27. Why do people of African descent have a lower incidence of non-melanoma skin cancer?
28. Which statement is true regarding chloasma, the "mask of pregnancy?"
29. When instructing your elderly client about treating her xerosis, what do you tell her?
30. Which medication used for scabies is safe for children 2mo and older?
31. Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?
32. Which of the following statements about performing cryosurgery for actinic keratosis is true?
33. An example of a primary skin lesion is a/an:
34. Which statement regarding necrotizing fasciitis is true?
35. When staging a malignant melanoma using Clark's levels, which level extends into the papillary dermis?

Chapter 8 Week 3: Eyes, Ears, Nose And Throat Problems ( Eyes Only)

1. While doing a face, head, and neck examination, you note that the palpebral fissures are abnormally narrow. What are you examining?
2. When Judith, age 15, asks you to explain the 20/50 vision in her right eye, you respond:
3. The most common cause of loss of vision in the adult over 45 is:
4. You have made a diagnosis of acute sinusitis based on Martha's history and the fact that she complains of pain behind her eye. Which sinuses are affected?
5. Jim, age 49, comes to the office with a rapid-onset complete paralysis of one-half of his face. He is unable to raise his eyebrow, close his eye, whistle, or show his teeth. You suspect a lower motor neuron lesion, resulting in cranial nerve VII paralysis. What is your working diagnosis?
6. Maury, age 52, has throbbing pain in the left eye, an irregular pupil shape, marked photophobia, and redness around the iris. What is your initial diagnosis?
7. Which of the following signs of thyroid dysfunction is a sign of hyperthyroidism?
8. Your client, a 75-year-old smoker of 50 years, is at the office today for a routine physical. During your inspection of the oral mucosa, you discover a lesion that you suspect to be cancerous. You document your finding as:
9. An acutely presenting, erythematous, tender lump within the eyelid is called:
10. The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?
11. Which subtype of cataracts is characterized by significant nearsightedness and a slow indolent course?
12. Which of the following statements is true concerning the use of bilberry as a complementary therapy for cataracts?
13. A 65yo man presents to the clinician with c/o increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6mo previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma.
14. Acute angle-closure glaucoma involves a sudden severe rise in intraoccular pressure. Which of the following ranges represents normal intraoccular pressure?
15. As diabetic retinopathy progresses, the presence of "cotton wool" spots can be detected. Cotton wool spots refer to:
16. Which of the following is an example of sensorineural hearing loss?
17. You are in the park playing with your children when you see that your friend is screaming for help. Her toddler has fallen and there is a stick lodged in his eye. The child is kicking and screaming and grabbing for the stick. You:

Chapter 9 Week 3: Respiratory Problems

1. The barrel chest characteristic of emphysema is a result of:
2. Which of the following statements regarding pulmonary function is true?
3. Marta is taking TB drugs prophylactically. How do you instruct her to take them?
4. Which of the following conditions is associated with cigarette smoking?
5. Which of the following is a possible consequence of sleep apnea?
6. Which of the following pt's would you expect to have a decreased response to?
7. The most common cause of CAP is:
8. The forced vital capacity is decreased in:
9. Jason, age 62, has obstructive sleep apnea. What do you think is one of his contributing factors?
10. Which statement about adenocarcinoma of the lung is accurate?
11. You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?  
12. Which of the following statements regarding
13. Which obstructive lung dz is classified as reversible?
14. Most nosocomial pneumonias are caused by:
15. George has ….. and an 80% forced expiratory volume in 1 second. How would you classify the severity of his?
16. Your pt is on Therabid for his asthma. You want to maintain his serum levels between:
17. Joyce is taking a long-acting beta agonist for her asthma. What additional med should she be taking?
18. Cydney presents with a h/o asthma. She has not been treated for a while. She c/o daily but not continual symptoms, greater than 1 week and at nighttime. She has been using her rescue inhaler. Her FEV1 is 60-80% predicted. How would you classify her asthma severity?
19. What is the first-line recommended treatment against Group A beta-hemolytic streptococci (    ), the most common cause of bacterial pharyngitis?
20. Your pt states he has a strep throat infection. Which of the following symptoms makes you consider a viral etiology instead?
21. Which info should be included when you are teaching your pt about the use of nicotine gum?
22. Nathan, a 32yo policeman, has a 15-pack-year history of smoking and continues to smoke heavily. During every visit, he gets irate when you try to talk to him about quitting. What should you do?
23. Marci has been started on a TB regimen. Because isoniazid (INH) may cause peripheral neuropathy, you consider ordering which of the following drugs prophilactically?
24. Why do you suspect that your pt may have a decreased response to the TB test?
25. You are using the CURB-65 clinical prediction tool to decide whether Mabel, whom you have diagnosed with community-acquired pneumonia (CAP), should be hospitalized or treated at home. Her score is 3. What should you do?
26. Sam, age 78, presents to the clinic w/respiratory symptoms. His PFTs are as follows: normal total lung capacity, decreased PaO2, increased PaCO2. On assessment, you auscultate course crackles and forced expiratory wheezes. What is your dx?
27. African American pt's seems to have a negative reaction to which of the following asthma meds?
28. A pt with HTN comes in and insists that one of his new meds is causing him to cough. When looking at his list of meds, you think the cough must be from:
29. Julie has a postnasal drip along with her cough. You assess her for:
30. You are doing a cerumen extraction and touch the external meatus of your pt's ear. He winces and starts coughing. What is the name of this reflex?
31. A chronic cough lasts longer than:

Chapter 12 Week 5: Renal Problems

1. A pt is seen in the clinic with a CC of hematuria. To make a differential dx, which of the following questions should be asked?
2. The result of the pt's 24hr urine for protein was 4.2g/day. The clinician should take which of the following actions?
3. A pt is seen c/o "leaking urine when I sneeze." Which of the following actions should the clinician take first?
4. A pt is seen in the clinic w/hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
5. a 27yo female presents with a CC of burning and pain on urination. She has no previous h/o UTI. What are some additional symptoms consistent with a dx of lower… ?
6. A 30yo pt presents w/pain on urination. The urine microscopy of unspun urine greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable dx?
7. A pt presents w/CVA tenderness and several-day h/o high fever, chills, and dysuria. Which of the following dx's is most likely given the above info?
8. Which of the following info is essential before prescribing Bactrim DS to a 24yo woman w/a
9. A pt is seen in the office c/o severe flank pain. The clinician should assess this pt for which risk factor for kidney stones?
10. A pt is diagnosed w/urge incontinence. Before prescribing Detrol …, the provider should question the pt about which of these contraindications to this med?
11. A pt is diagnosed w/overactive bladder. Which of the following instructions should be given to this woman?
12. A 34yo pt was treated for a … and has not responded to antibiotic therapy. Which of the following actions should be taken next?
13. Which of the following are predisposing factors for pyelonephritis?
14. A 42yo woman is seen in the clinic with fever, chills, vomiting, and severe dysuria. She is diagnosed with acute pyelonephritis. How should this pt be managed?
15. A pt is seen with a sudden onset of flank pain accompanied by n/v and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses?
16. Which of the following instructions should be given to the pt with nephrolithiasis?
17. Which of the following patients is at risk for developing urinary tract cancer?
18. A pt is seen in the clinic and diagnosed with Stage I renal cancer. The provider should refer the pt to a nephrologist for which of these treatments?
19. An 86yo woman is seen in the clinic for recurrent hematuria. The provider suspects bladder cancer. Which of the following data from the history is considered a risk factor for this type of cancer?
20. Which of the following diagnostic tests should be ordered for a pt suspected of having bladder cancer?
21. A 78yo man is diagnosed with Stage D bladder cancer and asks the provider what that means. Which is the best response?
22. The pt is diagnosed with acute renal failure (ARF). Which of the following data obtained from the Hx should alert the provider that this is a case of prerenal azotemia?
23. The pt is diagnosed with ARF. Which of the following conditions is the most common cause?
24. An 82yo woman with renal failure is seen in the clinic. The provider should question the pt about the intake of which of these substances that can cause renal toxicity?
25. Which of the following clinical manifestations are consistent with a pt in?
26. Which of the following tests is most is most useful in determining renal function in a pt suspected of?
27. Which of the following foods should be limited in a pt with

Chapter 13 Week 5: Men’s Health

1. A 63yo man is seen in the clinic with a CC of nocturia. Which of the following should be included in the differential diagnosis?
2. A 76yo man is seen in the office for c/o urinary incontinence. The clinician should explore which of these causes of incontinence in men?
3. Which of the following would be an appropriate treatment for a pt with mild?
4. A 30yo man is seen with a chief complaint of loss of libido. Which of the following lab tests would help establish a dx?
5. A 35yo man presents with c/o painful erections, and he notices his penis is crooked when erect. What is the most likely diagnosis?
6. The pt with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6mo. The clinician should assess this pt for which of these side effects?
7. The 56yo man with chronic prostatitis should be treated with trimethoprim 80mg sulfamethoxazole 400mg (…., Bactrim) for how long?
8. A 46yo man presents with urinary hesitancy and low back pain. He has no h/o…. Digital rectal exam reveals a normal prostate, and a diagnosis of prostatodynia is made. Which is the appropriate treatment?
9. A 23yo sexually active man is seen in the clinic with unilateral painful testicular swelling, and he is diagnosed with epididymitis. In order to prescribe the correct drug, the clinician must understand that which of these is the most common causative organism?
10. Treatment for epididymitis includes which of the following?
11. A 78yo man is diagnosed with C2 prostate cancer and he asks the clinician what that means. In order to answer the pt, the clinician must have which of these understandings of the Jewett rating system?
12. A 58yo pt has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the pt about which of these side effects?
13. A pt with testicular cancer is being followed after completing treatment 1 yr ago. He has been symptom-free with no evidence of disease. How often should he have a … ?
14. Pt's treated for Neisseria gonorrhoeae also should be treated for Chlamydia trachomatis.
15. Hep A is considered an STI by the CDC.

Chapter 15 Week 5: Musculoskeletal Problems

1. You have detected the presence of crepitus on exam of a pt with a musculskeletal complaint. Additionally, there is limited … w/both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is:
2. You are performing muscle strength testing on a pt presenting w/musculoskeletal pain and find that the pt has complete ROM w/gravity eliminated. Which numeric grade of muscle strength would you give this pt, 1-5?
3. Mrs. Gray is a 55yo woman who presents with tightness, pain, and limited movement in her right shoulder. She denies any h/o trauma. Her exam reveals a 75% reduction in both active and passive ROM of the right shoulder. Mrs. Gray also is experiencing tenderness with motion and pain at the deltoid insertion. Her medical hx is significant for type 1 diabetes mellitus and HTN. Her social hx reveals that she is a secretary and that she is right-handed. Based on her examination and medical hx, you suspect adhesive capsulitis, or "frozen shoulder." Which clue in Mrs. Gray's hx supports this dx?
4. Jennifer is an 18yo who comes to the ER 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 ROM in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?
5. Which of the following statements is true concerning the management of the client with a herniated disc?
6. The clinician suspects that a client has a patellar instability. In order to test for this, the client is seated with the quadriceps relaxed, and the knee is placed in extension. Next the patella is displaced laterally, and the knee flexed to 30 degrees. If instability is present, this maneuver displaces the patella to an abnormal position on the lateral femoral condyle, and the client will perceive pain. Testing for patellar instability in this way is known as:
7. Normal estrogen function is important for preventing osteoporosis in both men and women. Estrogen works to prevent osteoporosis in which of the following ways?
8. Which of the following tests is considered the gold standard for definitively diagnosing osteoporosis?
9. What is the recommended daily calcium intake for adults over the age of 50 with low bone mass?
10. Mrs. Allen is a 60yo woman who has been diagnosed with osteoporosis. She is very concerned about the risk of breast cancer associated with hormone replacement therapy and is wondering what other treatments are available to her. The clinician explains that bisphosphonates are another class of drugs used in the prevention and treatment of osteoporosis. What teaching should the clinician give Mrs. Allen in regard to taking bisphosphonates?
11. Which stage of Paget's disease is characterized by elevated numbers of osteoblasts, resulting in abnormal increases in bone remodeling and leading to an irregular deposition of collagen fibers?
12. One of the most frequent presenting signs/symptoms of osteoporosis is:
13. Osteoarthritis is primarily a noninflammatory condition.
14. The presence of a positive rheumatoid factor is always indicative of rheumatoid arthritis.

Chapter 16 Week 5: Endocrine And Metabolic Problems

1. A pt with T1DM comes to the clinic c/o feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first.
2. A 64yo man with T2DM presents to the clinic with the complaint of "my feet feel like they're on fire." He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment?
3. After removing a tack from a … pt's heel and evaluating the site for infection, what is the best plan for this pt?
4. Joyce is seen in the clinic c/o vague symptoms of nervousness and irritability. She says that her hair will not hold a permanent wave anymore. On physical exam, the clinician finds an irregular heartbeat and brisk reflexes. The differential dx should include which of the following conditions?
5. The pt is prescribed radioactive iodine (RAI) and asks the clinician how this drug works. The clinician's response should include which of the following data?
6. Which of the following lab findings should the clinician expect in a pt with untreated Graves'?
7. How often should the clinician examine the feet of a person with diabetes?
8. Mr. W, 53yo, is seen in the clinic w/concerns about his L foot. He has a 40-yr h/o … w/"fairly good" control on twice-daily insulin. He denies injury but states that he tripped a few months ago and his foot is sore when he walks. Physical exam reveals an edematous, erythemic, and warm foot. There is a superficial ulcer on the plantar surface. Which of the following is the most likely dx?
9. Which of the following tests should you order to confirm Mr. W's dx?
10. The clinician should question the pt w/suspected gout about use of which medication?
11. The clinician finds numerous nodules on the thyroid of a 65yo woman. The clinician suspects thyroid cancer. Which of the following data would be most significant for this pt?
12. Which of the following is essential for diagnosing thyroid cancer?
13. Which of the following are common signs of …. ?
14. Which of the following is diagnostic for … ?
15. A 35yo woman presents w/symptoms of hypoglycemia. There is no h/o …. Which of the following should be included in the differential dx?
16. Metformin is the first line of pharm treatment for ….
17. Fruit juice with added sugar is the tx of choice for anyone experiencing hypoglycemia.
18. Lifestyle modification is the tx of choice for metabolic syndrome.
19. A BMI of 29 is considered obesity.
20. Urine-free cortisol is one of four diagnostic tests recommended for Cushing's syndrome.

Chapter 6 Week 6: Neurological Problems

1. Which statement about confusion is true?
2. Sondra's peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help decrease edema in the labyrinth of the ear?
3. The hallmark of an absence seizure is:
4. How often should drug levels be monitored when a seizure medication has controlled the seizures and the drug level is adequate?
5. Which of the following persons fits the classic description of a pt with multiple sclerosis?
6. Which of the following is a specific test to MS?
7. Which drug for Alzheimer's should be administered beginning at the time of diagnosis?
8. Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery?
9. Which CN is affected in a patient with a cerebrovascular accident who has difficulty chewing?
10. Which statement best describes a carotid bruit?
11. Which patient is more likely to have cluster headache?
12. Inattention and sleep-wake cycle disturbance are the hallmark symptoms of:
13. Which type of meningitis is more benign, self-limiting, and caused primarily by a virus?
14. Which is the most sensitive neuroimaging test to evaluate patients with encephalitis?
15. What is usually the