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A middle-aged hypertensive male presents to a public health clinic with
complaints of an acute onset of fever, chills, and cough that is productive of rusty-
colored sputum. The patient reports episodes of sharp pains on the left side of his
back and chest whenever he is coughing. His temperature is 102.2 degrees
Fahrenheit, the pulse is 100/min, and the BP is 130/80. The urinalysis does not show
leukocytes, nitrites, or blood. This finding is most consistent with:
A) Atypical pneumonia
B) An upper urinary tract infection
C) Bacterial pneumonia
D) Acute pyelonephritis
C) Bacterial pneumonia
Symptoms of bacterial pneumonia include high fever, chills, productive cough,
and pain in back/chest area with deep inspiration and cough.
,Which of the following classes of antihypertensive drugs should a patient be
weaned off slowly to avoid the risk of severe rebound hypertension?
A) Diuretics
B) Beta-blockers
C) ACE inhibitors
D) Calcium channel blockers
A) Beta-blockers
Reverse rebound hypertension can occur if beta-blockers are abruptly stopped.
Recommendations include weaning off the beta-blockers when changing medications.
A 70-year-old male with open-angle glaucoma is prescribed Betimol (timolol)
ophthalmic drops. All of the following are contraindications to Betimol ophthalmic
drops except:
A) Overt heart failure or sinus bradycardia
B) Asthmatic patients
C) Second- or third-degree AV block
D) Migraine headaches
D) Migraine headaches
Contraindications with Betimol (timolol) include heart failure or sinus
bradycardia, asthmatic patients, and second- or third-degree AV block
,At what time of the day would you recommend a scotch tape test be done to
evaluate for a suspected case of enterobiasis?
A) In the evening after dinner
B) At night before bed
C) Early in the morning
D) It does not matter what time of the day the test is done
B) Early in the morning
The scotch tape test is best done in the morning for several days in a row. The
females do not lay eggs every day and therefore testing for several days will be
more accurate.
At what age can a child copy a circle and ride a tricycle?
A) 1 year
B) 2 years
C) 3 years
D) 4 years
C) 3 years
Developmental stages in children include the following: 1 year: walk; 2 years:
walks up steps with the same foot; 3 years: pedals a tricycle and copies a circle; 4
years: rides a bicycle and copies a cross and draws a person with 2 parts.
, A 30-year-old male patient refuses to take his afternoon dose of pills. The nurse
tells him of the possible consequences of his action, but the patient still refuses
to cooperate.
Which of the following is the best course for the nurse to follow?
A) Document in the patient's record his behaviors and the action taken by the nurse
B) Reassure the patient that he will be fine after taking the medicine
C) Document only the patient behavior
D) Document only the nurse's action
A) Document in the patient's record his behaviors and the action taken by the nurse
If a patient is non-compliant, documentation of the patient behavior and the
actions taken by the nurse both must be documented.
While performing a sports physical on a 16-year-old girl, the nurse practitioner
notes a split S2 during inspiration that disappears during expiration. The girl is
active and her growth and development have been uneventful. What is the best
recommendation for the child's mother?
A) Her daughter needs to be referred to a pediatric cardiologist
B) Her daughter needs to be referred for a stress EKG
C) Advise the mother that this is a normal finding
D) The child should avoid strenuous physical exertion until
further evaluation
C) Advise the mother that this is a normal finding
Explain to the mother that in healthy adolescents, a split S2 during
inspiration that disappears during expira- tion is a normal variation.