N675 Week 15 Final Exam
1. CNS stimulants cause increase alertness, excitation, and sometime euphoria.
Stimulant drugs include the following:
a. Cocaine, Amphetamine and Ecstasy
2. A college student is brought to the
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N675 Week 15 Final Exam
1. CNS stimulants cause increase alertness, excitation, and sometime euphoria.
Stimulant drugs include the following:
a. Cocaine, Amphetamine and Ecstasy
2. A college student is brought to the emergency department by a roommate
who is concerned about symptoms of extreme restlessness, nausea, and
vomiting. The provider notes elevations of the pulse and blood pressure and
pupillary dilation, along with hyperactive bowel sounds. The provider
suspects withdrawal from which substance?
a. Opioids
3. A patient reports symptoms of restlessness, fatigue, and difficulty
concentrating. The provider determines that these symptoms occur in
relation to many events and concerns. What other things will the provider
question this patient about?
a. Headaches and bowel habits
4. A patient is coming to your clinic and you suspect opiate withdrawal. You
know the most common signs of opiate withdrawal include:
a. Dysphoric mood, piloerection, insomnia, weakness
5. You are seeing a 22 year old patient in your primary care clinic. The patient
complains of abdominal. You do a urine pregnancy test and it is positive. You
referred the patient to an obstetrician who will see the patient in 4 weeks.
You note that the patient also takes sertraline for depression. How should the
sertraline be managed?
a. Let the obstetricians and patient make a decision about continuing
sertraline (Sertraline is one of the best studied selective serotonin
reuptake inhibitors in pregnancy and lactation. While the health care
provider would rather this patient not taking medication while she is
pregnant, consideration must be given the severity of her depression
and her response to treatment. The risk of exposure to medication
must always be weighed against the risk of not treating this patient.
All psychotropic medications cross the placenta and so developing
fetuses are exposed to these medications.)
6. You are seeing a patient and considering serotonin syndrome as a potential
differential diagnosis. The patient is taking an SSRI. Which of the other
medications the patient is taking may cause serotonin syndrome?
a. Dextromethorphan (Necessary rind dextromethorphan can cause
serotonin syndrome. This is a potentially life-threatening condition.)
7. What characteristic is true of tension headaches, but not of cluster
headaches?
a. Tension headaches are always bilateral (Cluster headaches are always
unilateral)
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8. A 50-year-old man complains of marked scalp tenderness accompanied by a
bad headache at his left temple. He reports a sudden loss of vision in the left
eye for the past several hours. The neurological exam is normal except for
the loss of vision in the left eye. Which of the following conditions is most
likely?
a. Giant cell arteritis
9. You are examining a patient who has just been diagnosed with Bell's palsy.
Bells's palsy is characterized by all of the following except:
a. Inability to swallow
10.A patient is in the emergency department after sustaining a blow to the head
in a motor vehicle accident. The patient’s Glasgow Coma score is 14 and the
patient is drowsy. The patient has a small amount of blood in one external
auditory canal. Which is a priority in diagnosing the extent of injury in this
patient?
a. Non-enhanced computed tomography of the head
11.An 80-year-old patient becomes apathetic, with decreased alertness and a
slowing of speech several days after hip replacement surgery alternating with
long periods of lucidity. What is the most likely cause of these symptoms?
a. Delirium
12.An elderly patient is brought to the emergency department after being found
on the floor after a fall. The patient has unilateral sagging of the face, marked
slurring of the speech, and paralysis on one side of the body. The patient’s
blood pressure is 220/190 mm Hg. What is the likely treatment for this
patient?
a. Neurosurgical consultation
13.When examining a patient’s skin, a practitioner uses dermoscopy in order to
(Select all that apply.)
a. determine whether lesion borders are regular or irregular.
b. assess changes in pigmentation throughout various lesions.
c. visualize skin fissures, hair follicles, and pores in lesions.
d. accentuate changes in color of pathologic lesions by fluorescence.
e. differentiate fluid masses from cystic masses in the epidermis.
14.When collecting a specimen to determine a diagnosis of tinea corporis, the
provider will scrape which portion of the lesion?
a. The active, leading border
15.A 15-month-old who is eating and behaving normally is found to have a high
fever. After a few days, the fever resolves and the child breaks out in a
maculopapular rash. This is a description of which with the following
conditions:
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a. Roseola infantum (Roseola is caused by herpes virus 6. Signs and
symptoms including high fever for a few days with a maculopapular
rash occurring after the fever breaks.)
16.The patient has been in the sun for the past few weeks and has developed
darkened skin and numerous 3-6 mm light colored, flat lesions on his s trunk.
What is the likely etiology?
a. Tinea versicolor (Tinea versicolor typically visualized during the spring
and summer months when the patient has become darkened after sun
exposure. The areas that are infected did not tan and so become very
noticeable.)
17.A 7-year-old presents with encopresis. The NP might suspect:
a. Constipation (The underlying cause of encopresis, repetitive soiling of
stool by child was 4 years of age or older who should be potty train, is
usually chronic constipation.)
18.A 12-year-old with hip pain presents to the NP clinic. Hip pain has occurred
with activity for the past 4-6 weeks, but his pain is worse and now involves
the knee. There is no history of trauma. How should the workup be initiated?
a. Perform Trendelenburg's test in the office (There are several diagnoses
in the differential. The assessment of this child's pain should begin in
the office. Asking the child to stand on the affected leg to perform the
Trendelenburg test. If there are weak adductor muscles in the affected
hip, a pelvic tilt will be visible in the affected hip. After assessment of
the hip, knee, and gait in the office, a hip x-ray to include AP and
lateral should be ordered.)
19.A 3-year-old has been recently treated for an upper respiratory infection but
drainage from the right nostril persists. What should the NP suspect?
a. Presence of foreign body (To clinical clue should make the examiner
suspect a foreign body. First, the patient has continued drainage
despite treatment. Second, the drainage is unilateral.)
20.A 8-year-old boy with type 1 diabetes is being seen for 3 day history of
urinary frequency and nocturia. He denies flank pain and is afebrile. The
urinalysis results is negative for blood and nitrates but is positive for large
amount of leukocytes and ketones. He has a trace amount of protein. Which
is the following is best test to order initially?
a. A urine culture and sensitivity (In 8-year-old male patient with
diagnosis of diabetes has a high risk of UTIs. Urinalysis is showing
possible UTI. The urine culture would be ordered because he has high
risk of infection.)
21.A 16-year-old complains that his knee hurts. his mother states that he has
complained of knee pain for the past 2 weeks. He has a prominent tibial
tubercle. Which should be part of the differential diagnosis?
a. Osgood-Schlatter disease (Osgood Slater disease is in osteochondritis
of the tibial tubercle that can produce pain in the knees of
adolescence. pain gradually increases) over time and can become
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