Question 1 Bronchiolitis tends to occur during the first ye


Question 45 What congenital malformation is commonly linked to acute leukemia in children?                 Down syndrome                                     Wilms tumor                                           Retinoblastoma                                       Neuroblastoma uestion 46 A man reports to the healthcare professional that he had a sudden onset of malaise, low back pain, and perineal pain with high fever and chills, dysuria, nocturia, and urinary retention. What action by the healthcare professional is most appropriate?                 Assess the man’s recent sexual history.                 Recommend heat and acetaminophen for back pain.                 Prepare the man for prostatic massage.                 Assist the man in obtaining a urine sample. Question 47 A child has scoliosis with a 40-degree curvature of the spine, and the parent is worried about pulmonary involvement. What statement by the healthcare professional is most appropriate?                 Scoliosis is a bone disorder and does not affect the lungs.                            Yes, we should obtain pulmonary function studies soon.                 Scoliosis severe enough to involve the lungs would be fatal.                        The lungs aren’t affected until the curvature is over 80 degrees. 1           Question 48 A patient is in status epilepticus. In addition to giving medication to stop the seizures, what would the healthcare professional place highest priority on?                 Facilitating a CT scan of the head                                Providing oxygen                                   Assessing for brain death                       Assessing for drug overdose  Question 49 Which statement by the healthcare professional accurately describes childhood asthma?                 An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation                                              A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging                               A pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens                                 An obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency                  Question 50 A child has cystic fibrosis (CF). Which medication does the healthcare professional teach the parents about?                 Salt tablets                                              Pancreatic enzymes                                Antihypertensives                                   Antibiotics                              Question 52 This region of the brain is responsible for sensory, touch, spatial awareness, and navigation.                 Occipital                 Frontal                 Temporal                 Parietal uestion 53 The myelin in the brain and spinal cords are formed by:                 Neurons                 Neurons and astrocytes                 Astrocytes and microglia                 Oligodendrocytes Question 54 A healthcare professional is reviewing a patient’s laboratory results and sees that the patient has a low reticulocyte count and a high iron level. Which type of anemia does the professional associate these findings with?                 Folate deficiency anemia                         Iron deficiency anemia                           Hemolytic anemia                                   Anemia of chronic disease     Question 55 A woman attempting to conceive tells the healthcare professional that she and her partner have intercourse when her basal body temperature (BBT) is around 37?C (98?F) without getting pregnant. What information does the professional give the woman?                 Maybe you need a fertility workup.                 That’s a normal temperature, but during ovulation BBT decreases.                 Temperature alone is not the most accurate way to predict ovulation.                 BBT rises consistently above 37.8″1eC (100″1eF) with ovulation. Question 56 A child has Duchenne muscular dystrophy and the parents want to know how this occurred. Which statement by the healthcare professional is most accurate?                 X-linked recessive inheritance                 Common SMN1 gene abnormality                               Autosomal dominant inheritance                                 Inheritance is not well defined                    Question 57 What directly causes ovulation during the menstrual cycle?                 Gradual decrease in estrogen levels                             Sudden increase of LH                          Sharp rise in progesterone levels                                  Gradual increase in estrogen levels              Question 58 Obsessive compulsive disorder is characterized by what types of thoughts and behaviors?                 disorganized irrational thoughts and disorganized behavior                 constant  irrational thoughts and constant behavior                 repetitive irrational thoughts and ritualized behavior                 repetitive irrational thoughts and disorganized behavior Question 59 A student asks the professor to explain the jaundice that accompanies hemolytic anemia. Which statement is by the professor is most accurate?                 Erythrocytes are destroyed in the spleen.                 Heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin.                 The patient has elevations in aspartate transaminase (AST) and alanine transaminase (ALT).                 The erythrocytes are coated with an immunoglobulin. Question 60 A person has been diagnosed with primary dysmenorrhea and wants to know why ibuprofen is a good choice for pain control. What response by the health care professional is best?                 It inhibits the release of leukotrienes in your system.                        It reduces the production of prostaglandins in your body.                 It enhances the effects of bradykinin release.                                    It contributes to a higher C reactive protein in your blood.            Question 61 A patient has ankylosing spondylitis. Which description of this condition by the health care professional is most accurate?                 Chronic inflammatory disease with stiffening and fusion of the spine and sacroiliac joint                 Chronic systemic inflammatory disease that affects many tissues and organs                      State of abnormal and excessive bone resorption and formation                  Wide-spread and deep chronic muscle pain, fatigue, and tender points   Question 62 Which immunoglobulin (Ig) is present in childhood asthma?                 IgM                    IgG                    IgE                     IgA uestion 63 What is the consequence of a splenectomy?                 The level of iron in circulation increases.                 Antibody production increases to improve immune function.                 The number of defective cells in circulation increases.                 The number of clotting factors increases. uestion 64 52-year-old female presents to the clinic with dysuria, urgency and frequency. She reports symptoms have been present for the past week. She also has nausea, vomiting, flank pain and an elevated temperature of 100.7. Patient has a history of Diabetes Mellitus and Overactive Bladder. She reports intermittent gross hematuria for the past week. Further evaluation by urinalysis with micro, identifies microhematuria, with greater than 100 RBC/HPF present. What are the likely differential diagnoses to consider?                 Urinary calculi                 Atrophic Vaginitis                 Pyelonephritis                 Urinary Tract Infection Question 65 A patient is in the Emergency Department with heat stroke. What finding does the healthcare provider associate with this condition?                 Core temperatures usually reaching approximately 39.5″1eC (103.1″1eF)                 Absence of sweating despite a high core temperature                       A rapidly decreasing core temperature as heat loss from the evaporation of sweat ceases                 Symptoms caused by the loss of sodium and prolonged sweating           Question 66 A 9-year-old child has a blood pressure of 112/72 mmHg in the school nurse’s office. What action by the school nurse is most appropriate?                 Inform the parents the child might be dehydrated.                 Note the normal finding in the child’s records.                 Calculate the child’s Body Mass Index.                 Refer the child for medication. Question 67 The healthcare professor states that a patient has reached pain tolerance. What further information from the professor is most accurate?                 The patient cannot endure a higher level of pain intensity at this point.                   The patient’s pain tolerance is much lower because of consuming too much alcohol.                       The patient’s pain in one place is higher because pain in multiple other sites.                       The patient now recognizes what is being felt is actually pain.     Question 68 A professor explains to a class that the reason lymph nodes enlarge and become tender during infection is because of what reason?                 B lymphocytes proliferate.                 The nodes are inflamed.                 The nodes fill with purulent exudate.                 The nodes are not properly functioning. Question 69 In order to help prevent a preadolescent girl from developing later cervical cancer, which virus does the healthcare professional recommend vaccination against to the parent?                 Human papillomavirus (HPV)                 Epstein-Barr virus (EBV)                       Herpes simplex II virus (HSV)                                     Cytomegalovirus (CMV)       Question 70 A healthcare professional is trying to lower a patient’s body temperature by convection. What action by the professional will accomplish this?                 Lower the temperature in the patient’s room.                 Place the patient in a cooling blanket.                 Obtain a fan and set it to blow over the patient.                 Place cold moist towels over the patient. Question 71 A healthcare professional is teaching a community group about inherited disorders. What pattern of inheritance does the professional describe for sickle cell disease?                 Inherited X-linked recessive disorder                          Inherited autosomal recessive disorder                        Disorder initiated by hypoxemia and acidosis                                   Disorder that is diagnosed equally in men and women     Question 72 Mr. Smith, 58 years old, presents to the urology office with complaints of gross hematuria which have been present for five days. He also expresses difficulty with urination and episodes of dysuria. He is experiencing flank pain, which radiates into the abdomen and groin. Mr. Smith has had nausea and vomiting. He does not drink many fluids, but when he does his fluid intake usually caffeinated beverages. The NP knows that:                 The lumen of the prostatic urethra narrows and lengthens, resulting in progressive urine flow obstruction. This process occurs when there is growth of the glandular-epithelial and stromal/muscle tissue of the prostate.                 Acute pain can result from renal colic, which occurs when the smooth muscle of the ureter contracts to move a kidney stone.                 Renal tubule dysfunction and atrophy can result from renal tissue fibrosis, which includes transforming growth factor and angiotensin II in the process. Question 73 Which nerve control might likely be affected in a patient that has incontinence of the bowel and bladder?                 L2-L5, S1-S5 and the coccygeal nerves                 T10-T11, T11 L1-L2, and the coccygeal nerves                 L2-4 and L4-L5                 T10-T11 and the cauda equina Question 74 A man has balanitis. What action by the healthcare professional is most appropriate?                 Educate the man on the side effects of chemotherapy.                 Perform a finger stick for a blood glucose reading.                 Administer pain medication before retracting the foreskin.                 Prepare the man for a needle aspiration of the corpus. Which statement is likely true regarding children being treated for cancer with radiation therapy?                 They will most likely have a successful remission of tumor growth.                 They seldom require follow-up maintenance treatments.                 They are prone to experience severe developmental delays.                 They are at increased risk for developing childhood cancers. Question 76 An infant has gluten-sensitive enteropathy and the parents ask the healthcare professional to explain why the baby bruises so easily. The professional explains that the baby has which deficit?                 Vitamin K deficiency from fat malabsorption                                   Bone marrow function depression                               Iron, folate, and B12 deficiency anemias                    Prescribed daily warfarin       Question 77 What is the effect of low plasma albumin?                 Clotting factors decrease, thus increasing the chance of prolonged bleeding.                        Fewer immunoglobulins are synthesized, thus impairing the immune function.                 Less iron is stored, thus increasing the incidence of iron deficiency anemia.                 Osmotic pressure decreases; thus water moves from the capillaries to the interstitium. Question 78 To quickly assess a patient’s nervous system for dysfunction, what assessment should the healthcare professional perform as the priority?                 Size and reactivity of pupils                   Pattern of breathing                               Motor response                                       Level of consciousness           Question 79 A baby is born with a myelomeningocele and needs urgent surgery to repair the defect. The parents want to take the baby home instead. What does the healthcare professional tell the parents about the purpose of this surgery?                 1cSurgery is much easier on a tiny infant than on a larger, older baby. 1d                           1cIf your baby has surgery this young, he/she cannot feel pain. 1d                          1cAdditional nervous system damage will occur the longer we wait. 1d                 1cPrompt surgery is needed to prevent total paralysis later on. 1d           Question 80  The neurobiology of depression is believed to be related to the atrophy of neurons in the:                 hypothalmus                 hippocampus                 thalmus                 amygdala Question 81 A student studying osteomyelitis and asks for an explanation of the term sequestrum. What response by the professor is best?                 An area of devascularized and devitalized bone                               An enzyme that phagocytizes necrotic bone                 A subperiosteal abscess                          A layer of new bone surrounding the infected bone         Question 82 A hospitalized patient’s lab work is as follows: WBC 2000, bands 14.8%, and segmented neutrophils 5. The healthcare professional calculates the patient’s absolute neutrophil count (ANC). What action does the professional take next?                 Implements protocols to prevent life-threatening infections                         Encourages the patient to limit any visitors for the present time                   Does nothing; this is a normal ANC for the white cell count                        Holds the patient’s medications until the ANC returns to normal Question 83 A patient has pernicious anemia and asks the healthcare professional to explain the disease. Which statement by the professional is most accurate?                 The lack of certain foods in your diet                          Your body cannot absorb vitamin B 12.                 You are not getting enough vitamin C.                 Your bone marrow has stopped working. Question 84 The APRN is treating a patient with bipolar 1 disorder.  The major focus of treatment is on:                 mania                 depression                 anxiety                 panic attacks Question 85 Which condition is considered a clinical cause of amenorrhea?                 Disorder in the endometrium                 Obstruction of the fallopian tubes                               Lack of physical exercise                       Failure to ovulate                   Question 86 What is the most abundant class of plasma protein?                 Globulin                                                  Albumin                                                 Clotting factors                                      Complement proteins             uestion 87 A severely malnourished patient is in the hospital to improve nutrition. On the second day, the patient reports palpitations and difficulty breathing. After placing the patient on a cardiac monitor, what action does the health care professional take next?                 Take the patient’s temperature.                 Have lab drawn for electrolyte levels.                 Cancel the patient’s next meal.                 Facilitate a chest x-ray. Question 88 A 65-year-old male presents with hesitancy, intermittency and terminal dribbling while voiding. He expresses that he does not always feel that he is completely emptying his bladder when voiding. Irritative symptoms have included frequency, nocturna and urgency. He denies any hematuria or bone or back pain. Clinically, the nurse practitioner knows that diagnostics will include:                 Collect a Urinalysis, Prostate Specific Antigen test, Digital Rectal Examination and a Post-Void Residual.                 Imagining of the upper urinary tract for UTI or Urolithiasis.                 Refer patient for refractory urinary retention, pressure-flow studies and filling cystometrography. Question 89 In which stage of syphilis would the following clinical manifestations be found: destructive skin, bone and soft tissue lesions, aneurysms, heart failure, and neurosyphilis?                 Primary                                                   Secondary                                              Latent                 Tertiary Question 90 A criterion for a diagnosis of generalized anxiety disorder (GAD) is a period of excessive worrying that lasts for at least how many months?                 3                         6                         9                         12       Question 91 Which cells function to maintain bone matrix?                 Osteoclasts                                             Osteocytes                                              Osteoblasts                                              Osteophytes                  Question 92 A newborn baby displays jaundice 20 hours after birth. What action by the healthcare professional is most appropriate?                 Draw blood to measure total bilirubin.                 Teach the patient about phototherapy.                 Obtain consent for blood transfusions.                 Prepare to administer vitamin K. Question 93 A patient has defective secretion of the intrinsic factor leading to anemia. What treatment option does the healthcare professional discuss with the patient?                 Increasing iron sources in the diet such as red meat.                 Vitamin B 12 injections initially given once a week.                 Having relatives tested for bone marrow donation.                 Better control of the patient’s underlying disorder. Question 94 A patient is 8 hours postoperative after a long orthopedic procedure. The student asks why this patient is at particular risk of developing a thromboembolism. What response by the healthcare professional is best?                 Patients tend to have venous stasis from orthopedic operations.                 Anesthetic agents often cause an immune response against clotting factors.                 Endothelial damage occurs and repair is slowed by postoperative pain.                 Atherosclerotic build up causes turbulent blood flow leading to clots. Question 95 A patient has polycythemia vera and presents to the Emergency Department with plethora and neurological changes. The student asks the healthcare professional to explain the primary cause of these symptoms. What response by the professional is best?                 Decreased erythrocyte count                  Destruction of erythrocytes                   Increased blood viscosity                       Tissue destruction by macrophages              Question 96 What is the primary cause of respiratory distress syndrome (RDS) of the newborn?                 Immature immune system                      Small alveoli                                           Surfactant deficiency                             Anemia                                   Question 97 A person has a vascular anomaly associated with a congenital malformation of dermal capillaries and has been told this lesion does not fade with age. What treatment options can the healthcare professional discuss with this person?                 Surgical excision                                     Pulsed dye laser                                     Cool temperatures                                  Cosmetic tattooing                 Question 98 What is the link between major depression and cortisol secretion?                 Individuals with depression show suppression of plasma cortisol when given dexamethasone.                 Individuals with depression have a decreased plasma cortisol level, despite the administration of exogenous corticosteroids.                 Individuals with depression show that persistently elevated plasma cortisol levels can result in inflammation that is believed to trigger depression.                 Individuals with depression have normal plasma cortisol levels throughout the day when they take antidepressant medication as prescribed. Question 99 The disruption in cellular adhesion observed in bullous impetigo is caused by an exfoliative toxin related to which organism?                 Staphylococcus aureus                            Streptococcus pyogenes                           Escherichia coli                                       Candida albicans                          Question 100 A healthcare professional has educated a student on folic acid. Which statement by the student indicates that more teaching is needed?                 Folic acid absorption is dependent on the enzyme folacin.                 Folic acid is stored in the liver.                 Folic acid is essential for RNA and DNA synthesis within erythrocytes.                 Folic acid is absorbed in the upper small intestine.  

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