Your 22 year old male patient states during his review of systems thathis scrotum is very en-
larged and feels like it is full a powerlifter and works as a trash collector. You suspect the pa-
tient likely has which of the following diagnoses?
A -Varicocele
B -Meningocele
C -Rectocele
D -Hydrocele - ANSWER A -Varicocele
The point of maximum impulse (PMI) is MOST often palpable in healthy adults when posi-
tioned in the supine or left lateral decubitus position. Which one of the following locations is
most commonly described as the PMI in a healthy adult?
A -Left 2nd intercostal space, midaxillary line
B -Left 5th intercostal space, midclavicular line
C -Right 4th intercostal space, midaxillary line
D -Right 2nd intercostal space, midclavicular line - ANSWER B -Left 5th intercostal space,
midclavicular line
A40 year old, female, African American patient presents for history and physical. Upon your
initial assessment, you notice she has severe exophthalmos as pictured below. Which one of
the following diagnoses below would be the highest on your differential diagnose of this
physical examination finding?
A -Bilateral conjunctivitis
B -Hyperthyroidism
C -hypothyroidism
D -Myexedma - ANSWER B -Hyperthyroidism
1
,Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has un-
derwent a pulmonary function test (PFT) with spirometry. As the patient's primary
healthcare provider, you have been asked to explain the findings of the PFT to the patient in
afollow-up visit at which time the patient asks what the study was evaluating. To describe
the PFT to the patient in more useful terms, you state that the large inspiration of air to the
furthest extent they could reasonably accomplish followed by a full exhalation is referred to
as which of the following measurements during the PFT?
A -Forced Expiratory Volume over 1 second (FEV1)
B -Functional Reserve Capacity
C -Inspiratory Reserve
D -Forced Vital Capacity - ANSWER D -Forced vital capacity
Your patient has a diagnosis of Addison's disease. Which of the following might you expect
to find during examination?
A -Abdominal striae
B -Dowager hump
C -Low body temperature
D -Moon face - ANSWER B -Dowager hump
The nurse practitioner's evaluation of a patient with Diabetes Mellitus type 2 should include
which of the following while evaluating for end organ dysfunction of the disease?
A -Renal function panel
B -Urinalysis
C -Non-dilated eye exam
D -All of these are appropriate options - ANSWER D -All of these are appropriate options
During your visit with a 19 year old patient for a college health physical, your health history
includes a diagnosis of angioedema. What of the following parts of the body are were likely
involved?
A -Isolated to the colon
B -Anywhere in the enteral tract
2
,C -Chest
D -Face and Lips - ANSWER D -Face and Lips
Which of the following dermatologic lesions is precancerous and likely due to prolonged ex-
posure to UV-B?
A -Actinic Keratosis
B -Basal cell carcinoma
C -Verucca
D -Seborrheic dermatitis - ANSWER A -Actinic Keratosis
Based on your evaluation of ABCDE for melanoma, which of the following represents a sus-
picous finding?
A -Irregular borders
B -Symmetrical nature
C -Brown color
D -Diameter of 0.4 cm - ANSWER A -Irregular borders
Your patient is complaining of hypersomnia, lack of motivation, weight gain, and anhedonia.
Suspecting a diagnosis of clinical depression, you anticipate the patient will benefit from
treating their underlying deficit of which of the following neurotransmitters?
A -GABA
B -Serotonin
C -Dobutamine
D -Glutamate - ANSWER B -Serotonin
As a prudent nurse practitioner, the diabetic, hypertensive patient you are seeing should be
evaluated for early evidence of renal damage from both diabetes and hypertension. Which
of the following assessment tools should the nurse practitioner order first for the evaluation
of early renal dysfunction secondary to diabetes or hypertension?
A -BUN/creatinine ratio
3
, B -Urinalysis with micro/macro albumin
C -Renal biopsy
D -Urine sodium - ANSWER B -Urinalysis with micro/macro albumin
While evaluating a patient in your clinic for a routine health visit, you auscultate crackles in
the poster left lower lobe, have the patient cough, with follow-up auscultation revealing
clear breath sounds. Which one of the following would you suspect?
A -Congestive heart failure
B -Atelectasis
C -Laryngospasm
D -Bronchiactasis. - ANSWER B -Atelectasis
Your 39 year old patient who has recently been hospitalized for an appendectomy and is be-
ing seen in your clinic for post-operative follow-up with primary care. On assessment, the
patient complains of some incisional pain and otherwise examination is normal, with the ex-
ception of dull percussion sounds noted on the thorax over lung tissue. Which of the follow-
ing diagnoses would be explained by this finding in post-operative patient?
A -Left-sided heart failure
B -Chronic bronchitis
C -Atelectasis
D -Healthy patient with no coexising disease - ANSWER C -Atelectasis
You are evaluating a 41 year old female patient in your clinic with symptoms of right upper
quadrant pain which worsens with deep breathing. The patient exhibits a positive Murphy
sign. These findings are most consistent which one of the following?
A -Appendicitis
B -Cholecystitis
C -Crohn's flare
D -Pancreatitis - ANSWER B -Cholecystitis
4
larged and feels like it is full a powerlifter and works as a trash collector. You suspect the pa-
tient likely has which of the following diagnoses?
A -Varicocele
B -Meningocele
C -Rectocele
D -Hydrocele - ANSWER A -Varicocele
The point of maximum impulse (PMI) is MOST often palpable in healthy adults when posi-
tioned in the supine or left lateral decubitus position. Which one of the following locations is
most commonly described as the PMI in a healthy adult?
A -Left 2nd intercostal space, midaxillary line
B -Left 5th intercostal space, midclavicular line
C -Right 4th intercostal space, midaxillary line
D -Right 2nd intercostal space, midclavicular line - ANSWER B -Left 5th intercostal space,
midclavicular line
A40 year old, female, African American patient presents for history and physical. Upon your
initial assessment, you notice she has severe exophthalmos as pictured below. Which one of
the following diagnoses below would be the highest on your differential diagnose of this
physical examination finding?
A -Bilateral conjunctivitis
B -Hyperthyroidism
C -hypothyroidism
D -Myexedma - ANSWER B -Hyperthyroidism
1
,Your patient with a suspected diagnosis of COPD has been seen by pulmonology and has un-
derwent a pulmonary function test (PFT) with spirometry. As the patient's primary
healthcare provider, you have been asked to explain the findings of the PFT to the patient in
afollow-up visit at which time the patient asks what the study was evaluating. To describe
the PFT to the patient in more useful terms, you state that the large inspiration of air to the
furthest extent they could reasonably accomplish followed by a full exhalation is referred to
as which of the following measurements during the PFT?
A -Forced Expiratory Volume over 1 second (FEV1)
B -Functional Reserve Capacity
C -Inspiratory Reserve
D -Forced Vital Capacity - ANSWER D -Forced vital capacity
Your patient has a diagnosis of Addison's disease. Which of the following might you expect
to find during examination?
A -Abdominal striae
B -Dowager hump
C -Low body temperature
D -Moon face - ANSWER B -Dowager hump
The nurse practitioner's evaluation of a patient with Diabetes Mellitus type 2 should include
which of the following while evaluating for end organ dysfunction of the disease?
A -Renal function panel
B -Urinalysis
C -Non-dilated eye exam
D -All of these are appropriate options - ANSWER D -All of these are appropriate options
During your visit with a 19 year old patient for a college health physical, your health history
includes a diagnosis of angioedema. What of the following parts of the body are were likely
involved?
A -Isolated to the colon
B -Anywhere in the enteral tract
2
,C -Chest
D -Face and Lips - ANSWER D -Face and Lips
Which of the following dermatologic lesions is precancerous and likely due to prolonged ex-
posure to UV-B?
A -Actinic Keratosis
B -Basal cell carcinoma
C -Verucca
D -Seborrheic dermatitis - ANSWER A -Actinic Keratosis
Based on your evaluation of ABCDE for melanoma, which of the following represents a sus-
picous finding?
A -Irregular borders
B -Symmetrical nature
C -Brown color
D -Diameter of 0.4 cm - ANSWER A -Irregular borders
Your patient is complaining of hypersomnia, lack of motivation, weight gain, and anhedonia.
Suspecting a diagnosis of clinical depression, you anticipate the patient will benefit from
treating their underlying deficit of which of the following neurotransmitters?
A -GABA
B -Serotonin
C -Dobutamine
D -Glutamate - ANSWER B -Serotonin
As a prudent nurse practitioner, the diabetic, hypertensive patient you are seeing should be
evaluated for early evidence of renal damage from both diabetes and hypertension. Which
of the following assessment tools should the nurse practitioner order first for the evaluation
of early renal dysfunction secondary to diabetes or hypertension?
A -BUN/creatinine ratio
3
, B -Urinalysis with micro/macro albumin
C -Renal biopsy
D -Urine sodium - ANSWER B -Urinalysis with micro/macro albumin
While evaluating a patient in your clinic for a routine health visit, you auscultate crackles in
the poster left lower lobe, have the patient cough, with follow-up auscultation revealing
clear breath sounds. Which one of the following would you suspect?
A -Congestive heart failure
B -Atelectasis
C -Laryngospasm
D -Bronchiactasis. - ANSWER B -Atelectasis
Your 39 year old patient who has recently been hospitalized for an appendectomy and is be-
ing seen in your clinic for post-operative follow-up with primary care. On assessment, the
patient complains of some incisional pain and otherwise examination is normal, with the ex-
ception of dull percussion sounds noted on the thorax over lung tissue. Which of the follow-
ing diagnoses would be explained by this finding in post-operative patient?
A -Left-sided heart failure
B -Chronic bronchitis
C -Atelectasis
D -Healthy patient with no coexising disease - ANSWER C -Atelectasis
You are evaluating a 41 year old female patient in your clinic with symptoms of right upper
quadrant pain which worsens with deep breathing. The patient exhibits a positive Murphy
sign. These findings are most consistent which one of the following?
A -Appendicitis
B -Cholecystitis
C -Crohn's flare
D -Pancreatitis - ANSWER B -Cholecystitis
4
