Solution
An 88-year-old presents with right-side weakness after being unable to rise unassisted following a fall
to the bathroom floor. History includes aphasia and noncompliance with hypertension medication
regimen. What is the most likely diagnosis?
Left-sided or right-sided CVA? Correct Answer: LEFT-SIDED CVA
Which of the following signs/symtpoms are often associated with headahces due to intracranial
tumor?
1) pain worse laying down, focal neurological signs
2) Hyperflexia, personality change
3) acute onset: hours to days
4) pupillary constriction; stupor Correct Answer: 1) pain worse laying down, focal neurological signs
Which of the following pharmacotherapeutics would be most important to administer to a patient who
has a corneal abrasion?
1) Timolol
2) Gentamicin ophthalmic
3) Cromolyn optha
4) Olopatadine Correct Answer: 2) Gentamicin ophthalmic (Genoptic)
A 25-year-old presents with the chief complaint of decreased mobility and pain of the right shoulder
exacerbated by movement. The patient reports that he participated in extensive house painting 24
hours prior to the onset of pain. He denies any trauma. Passive ROM is intact. No redness or
ecchymosis is present. What is the next step to be taken in order to make a diagnosis?
1) Xray of shoulder
2) Palpate structures around the shoulder.
3) MRI of shoulder
4) EMG Correct Answer: 2) palpate structures
A 16-year-old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle spotting.
She has not missed any doses and uses no other medication. Which of the following is appropriate?
1) Changing to Ortho-Novum 1/35
2) Discontinue use
3) Providing reassurance
4) Double dose-for two days Correct Answer: 3) provide reassurance
According to the Report of the U.S. Preventive Services Task Force, which of the following is NOT a
current recommendation guideline for preventive care in elderly female patients?
1) Mammogram and clinical breast exams
,2) Fecal Occult blood test and/or sig
3) Rubella serology or vaccination history
4) Pnuemo and influenza vaccines Correct Answer: 3) Rubella serology or vaccination history
87 y/o NH patient is drowsy and barely responsive. Temp 95, BP: 110/70, Pulse 60, R 10. The best
action is to:
1) initiate passive warming
2) apply a rebreather
3) Perform fluid replacement
4) initiate active warming Correct Answer: 1) initiate passive rewarming
A patient is referred with DM, HTN and CAD. He is on insulin and a beta blocker. How would you
educate this patient on recognizing the signs and symptoms of hypoglycemia?
1) Edema
2) Tachycardia
3) palpitations
4) sweating Correct Answer: 4) sweating
A 65-year-old overweight patient is diagnosed with plantar fasciitis. Initial therapy of NSAIDs,
stretching, ice, and rest has proven ineffective after 3 weeks. The best follow-up plan of care would
be to:
1) stop NSAID, apply a heel cup and encourage exercise and wt loss.
2) continue NSAID, apply an arch support and encourage wt loss and exercise
3) continue NSAID, xray and add a short-leg night splint
4) COntinue NSAID, xray and add a metatarsal bar Correct Answer: 2) continue NSAID, apply an
arch support and encourage wt loss and exercise
Fundoscopic exam of Hypertensive patient.
1) nicking of arteriols and viens, and small retinol hemorrages
2) drusen bodies and pale retina
3) pale macula and swollen disk margins
4) microaneurysms and optic disc cupping Correct Answer: 1) nicking of arteriols and viens, and
small retinol hemorrages
Which of the following is a common presenting feature of hyperthyroidism in the elderly?
1) elevated TSH
2) Thyroid enlargement
3) atrial fibrillation
4) abnormal T3 suppression Correct Answer: 3) atrial fibrillation
A 35-year-old lawn maintenance worker presents reporting "something in my eye" since the previous
day. The eye was rinsed with over-the-counter eyewash, without relief. The patient denies visual
disturbances or drainage. In formulating a plan of care, the nurse practitioner would FIRST:
1) send to ophthalmologists
, 2) florescreen staining
3) test visual field
4) prescribe eyedrops Correct Answer: 3) test visual field
A 72-year-old patient presents with dry, itchy eyes. During the course of the physical examination, the
nurse practitioner notes the presence of a gray band of opacity in the cornea that encircles the iris.
The band is 1.0-1.5 mm wide. This finding is most consistent with a diagnosis of a/an:
1. corneal abrasion
2. arcus senilis
3. corneal ulcer
4. herpetic infection of the eye Correct Answer: 2) arcus senilis
A 26-year-old presents with reports of anorexia, fatigue, weight loss, malaise, fever, night sweats,
and a cough that has been present for 4 weeks. The diagnostic study to perform first would be:
1) xray
2) pulmonary function test
3) bronchoscopy
4) H & H Correct Answer: 1) xray (tb-night sweats)
A 44-year-old female is complaining of frequent anxiety attacks with chest discomfort and fatigue. On
physical examination, her lungs are clear bilaterally. There are a midsystolic click and a grade II/VI
systolic murmur at the apex. Further evaluation would include which of the following?
1) EKG, flat plate of the abdomen, lipid profile
2) Echocardiogram, Doppler, EKG
3) Labs and benzo's
4) EEG, Anxiety Scale, and electrolytes Correct Answer: 2) Echocardiogram, Doppler, EKG
A healthy 84 y/o would like to start an exercise program, what would you do before this takes place?
1) physical exam
2) EKG
3) knee xrays
4) PT Stress test Correct Answer: 1) Physical Exam
29 y/o has uncomplicated Chlamydia infection will exhibit:
1) green penile discharge
2) uticartia
3) unremarkable symtpoms
4) penile ulcer Correct Answer: 3) unremarkable symptoms
37 has suspected PE. c/o anxiety and cough, CXR normal, the next test should be:
1) spirometry
2) MRI
3) COntract venogra[hy