507 Exam 4: Leik Practice Questions
A 30-year-old chef complains of pruritic hives over her chest and arms, but denies difficulty swallowing
or breathing. She reports a family history of allergic rhinitis and asthma. Which of the following
interventions is most appropriate?
A) Obtain a complete and thorough history
B) Recommend an oral antihistamine such as diphenhydramine 25 mg PO QID
C) Give an injection of epinephrine 1:1000 intramuscularly stat
D) Call 911 - Answer-A) Obtain a complete and thorough history
Before prescribing medications, a thorough history must be obtained to determine possible causes of
hives. The patient denied difficulty with swallowing and breathing, so there was no medical emergency
that would require calling 911.
Patients who are diagnosed with gonorrhea should also be treated for which of the following infections?
A) Chancroid
B) Chlamydia trachomatis
C) Herpes genitalis
D) Pelvic inflammatory disease (PID) - Answer-B) Chlamydia trachomatis
When diagnosed with gonorrhea, the patient should also be treated for Chlamydia trachomatis.
All of the following are infections that affect mostly the labia and vagina except:
,A) Bacterial vaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis - Answer-D) Chlamydia trachomatis
Infections that commonly affect the labia and vagina include bacterial vaginosis, candidiasis, and
trichomoniasis. Chlamydia trachomatis commonly affects the cervix, endometrial lining, fallopian tubes,
and pelvic cavity
The nurse practitioner would test the obturator and iliopsoas muscle to evaluate for:
A) Cholecystitis
B) Acute appendicitis
C) Inguinal hernia
D) Gastric ulcer - Answer-B) Acute appendicitis
Signs and symptoms of an acute abdomen include involuntary guarding, rebound tenderness, boardlike
abdomen, and a positive obturator and psoas sign. A positive obturator sign occurs when pain is elicted
by internal rotation of the right hip from 90 degrees hip/knee flexion. The psoas sign is positive when
pain occurs with passive extension of the thigh while the patient is lying on his or her side with knees
extended, or when pain occurs with active flexion of the thigh at the hip
A 30-year-old woman who is sexually active complains of a large amount of milk-like vaginal discharge
for several weeks. A microscopy slide reveals a large number of squamous epithelial cells that have
blurred margins. Very few white blood cells are seen. The vaginal pH is at 6.0. What is most likely?
A) Trichomonas infection
B) Bacterial vaginosis
C) Candidal infection
,D) A normal finding - Answer-B) Bacterial vaginosis
In bacterial vaginosis (BV), the normal hydrogen peroxideproducing lactobacilli are replaced by an
overgrowth of anaerobic bacteria. BV is a vaginosis (does not cause inflammation) rather than a
vaginitis. No symptoms may be present or the patient's history may include strong vaginal odor ("fishy"
odor) and increased vaginal discharge (milky white, thin, adherent discharge or dull gray discharge).
Findings include alkaline pH greater than 4.5, the presence of clue cells (wet smear using microscopy),
and positive "whiff test" (a strong "fishy" odor when vaginal discharge is mixed with one drop of
potassium hydroxide [KOH]). Clue cells are squamous epithelial cells dotted with large numbers of
bacteria that obscure borders.
Fetal TORCH infections can cause microcephaly, mental retardation, hepatosplenomegaly, and
intrauterine growth retardation. The acronym TORCH stands for:
A) Toxoplasma gondii, other infections, rubella, cytomegalovirus, and herpes
B) Toxic shock syndrome, ocular infections, rubella, cytomegalovirus, and herpes zoster
C) Tetanus, ophthalmic infections, roseola, cancer, and head abnormalities
D) Toxins, other infections, roseola, candidiasis, and head abnormalities - Answer-A) Toxoplasma gondii,
other infections, rubella, cytomegalovirus, and herpes
The acronym TORCH stands for Toxoplasma gondii, other infections, rubella, cytomegalovirus, and
herpes. Although several of the conditions listed in the other answer options can also cause fetal
problems, they do not comprise the TORCH disorders.
Human papillomavirus (HPV) infection of the larynx has been associated with:
A) Laryngeal cancer
B) Esophageal stricture
C) Cervical cancer
D) Metaplasia of the squamous cells - Answer-A) Laryngeal cancer
, Human papillomavirus (HPV) exposure is a risk factor in laryngeal cancer. HPV DNA transforms the moist
membranes of epithelial cells (cervix, anus, mouth, and throat). The juvenile type is related to vertical
transmission and the adult type to orogenital contact. HPV subtype 16 accounts for the majority of oral
tumors, oropharynx cancers, and laryngeal cases.
What does a positive posterior drawer sign in a 10-year-old soccer player signify?
A) Normal knee
B) Instability of the knee
C) Swelling on the knee
D) Injury to the meniscus - Answer-B) Instability of the knee
The drawer test is used to identify mediolateral or anteroposterior plane instability of the knee. The test
is performed on the unaffected and affected knee for comparison. The anterior drawer test evaluates
the anterior cruciate ligament (ACL). To perform the test, the patient lies supine and the knee is placed
at 90-degree flexion. Grasp the posterior aspect of the tibia over the upper calf muscle; then, with a
steady force, try to push the lower leg forward and backward. Anterior or posterior movement of the
knee is positive. With the leg extended, stabilize the femur with one hand and the ankle with the other.
Try to abduct and adduct the knee. There should be no medial or lateral movement.
Which of the following is a true statement regarding acute gastritis?
A) Chronic intake of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause the disorder
B) Chronic lack of dietary fiber is the main cause of the disorder
C) The screening test for the disorder is the barium swallow test
D) The gold standard to evaluate the disorder is a colonoscopy - Answer-A) Chronic intake of
nonsteroidal anti-inflammatory drugs (NSAIDs) can cause the disorder
A 30-year-old chef complains of pruritic hives over her chest and arms, but denies difficulty swallowing
or breathing. She reports a family history of allergic rhinitis and asthma. Which of the following
interventions is most appropriate?
A) Obtain a complete and thorough history
B) Recommend an oral antihistamine such as diphenhydramine 25 mg PO QID
C) Give an injection of epinephrine 1:1000 intramuscularly stat
D) Call 911 - Answer-A) Obtain a complete and thorough history
Before prescribing medications, a thorough history must be obtained to determine possible causes of
hives. The patient denied difficulty with swallowing and breathing, so there was no medical emergency
that would require calling 911.
Patients who are diagnosed with gonorrhea should also be treated for which of the following infections?
A) Chancroid
B) Chlamydia trachomatis
C) Herpes genitalis
D) Pelvic inflammatory disease (PID) - Answer-B) Chlamydia trachomatis
When diagnosed with gonorrhea, the patient should also be treated for Chlamydia trachomatis.
All of the following are infections that affect mostly the labia and vagina except:
,A) Bacterial vaginosis
B) Candidiasis
C) Trichomoniasis
D) Chlamydia trachomatis - Answer-D) Chlamydia trachomatis
Infections that commonly affect the labia and vagina include bacterial vaginosis, candidiasis, and
trichomoniasis. Chlamydia trachomatis commonly affects the cervix, endometrial lining, fallopian tubes,
and pelvic cavity
The nurse practitioner would test the obturator and iliopsoas muscle to evaluate for:
A) Cholecystitis
B) Acute appendicitis
C) Inguinal hernia
D) Gastric ulcer - Answer-B) Acute appendicitis
Signs and symptoms of an acute abdomen include involuntary guarding, rebound tenderness, boardlike
abdomen, and a positive obturator and psoas sign. A positive obturator sign occurs when pain is elicted
by internal rotation of the right hip from 90 degrees hip/knee flexion. The psoas sign is positive when
pain occurs with passive extension of the thigh while the patient is lying on his or her side with knees
extended, or when pain occurs with active flexion of the thigh at the hip
A 30-year-old woman who is sexually active complains of a large amount of milk-like vaginal discharge
for several weeks. A microscopy slide reveals a large number of squamous epithelial cells that have
blurred margins. Very few white blood cells are seen. The vaginal pH is at 6.0. What is most likely?
A) Trichomonas infection
B) Bacterial vaginosis
C) Candidal infection
,D) A normal finding - Answer-B) Bacterial vaginosis
In bacterial vaginosis (BV), the normal hydrogen peroxideproducing lactobacilli are replaced by an
overgrowth of anaerobic bacteria. BV is a vaginosis (does not cause inflammation) rather than a
vaginitis. No symptoms may be present or the patient's history may include strong vaginal odor ("fishy"
odor) and increased vaginal discharge (milky white, thin, adherent discharge or dull gray discharge).
Findings include alkaline pH greater than 4.5, the presence of clue cells (wet smear using microscopy),
and positive "whiff test" (a strong "fishy" odor when vaginal discharge is mixed with one drop of
potassium hydroxide [KOH]). Clue cells are squamous epithelial cells dotted with large numbers of
bacteria that obscure borders.
Fetal TORCH infections can cause microcephaly, mental retardation, hepatosplenomegaly, and
intrauterine growth retardation. The acronym TORCH stands for:
A) Toxoplasma gondii, other infections, rubella, cytomegalovirus, and herpes
B) Toxic shock syndrome, ocular infections, rubella, cytomegalovirus, and herpes zoster
C) Tetanus, ophthalmic infections, roseola, cancer, and head abnormalities
D) Toxins, other infections, roseola, candidiasis, and head abnormalities - Answer-A) Toxoplasma gondii,
other infections, rubella, cytomegalovirus, and herpes
The acronym TORCH stands for Toxoplasma gondii, other infections, rubella, cytomegalovirus, and
herpes. Although several of the conditions listed in the other answer options can also cause fetal
problems, they do not comprise the TORCH disorders.
Human papillomavirus (HPV) infection of the larynx has been associated with:
A) Laryngeal cancer
B) Esophageal stricture
C) Cervical cancer
D) Metaplasia of the squamous cells - Answer-A) Laryngeal cancer
, Human papillomavirus (HPV) exposure is a risk factor in laryngeal cancer. HPV DNA transforms the moist
membranes of epithelial cells (cervix, anus, mouth, and throat). The juvenile type is related to vertical
transmission and the adult type to orogenital contact. HPV subtype 16 accounts for the majority of oral
tumors, oropharynx cancers, and laryngeal cases.
What does a positive posterior drawer sign in a 10-year-old soccer player signify?
A) Normal knee
B) Instability of the knee
C) Swelling on the knee
D) Injury to the meniscus - Answer-B) Instability of the knee
The drawer test is used to identify mediolateral or anteroposterior plane instability of the knee. The test
is performed on the unaffected and affected knee for comparison. The anterior drawer test evaluates
the anterior cruciate ligament (ACL). To perform the test, the patient lies supine and the knee is placed
at 90-degree flexion. Grasp the posterior aspect of the tibia over the upper calf muscle; then, with a
steady force, try to push the lower leg forward and backward. Anterior or posterior movement of the
knee is positive. With the leg extended, stabilize the femur with one hand and the ankle with the other.
Try to abduct and adduct the knee. There should be no medial or lateral movement.
Which of the following is a true statement regarding acute gastritis?
A) Chronic intake of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause the disorder
B) Chronic lack of dietary fiber is the main cause of the disorder
C) The screening test for the disorder is the barium swallow test
D) The gold standard to evaluate the disorder is a colonoscopy - Answer-A) Chronic intake of
nonsteroidal anti-inflammatory drugs (NSAIDs) can cause the disorder
