Question 1 Bronchiolitis tends to occur during the first years of life and is most often caused by what type of infection?                 Respiratory syncytial virus (RSV)                                Influenza virus                                       Adenoviruses                                          Rhinovirus                    Question 2 Mary, 47 presents to her primary care provider and reports nocturia x 6, urgency, frequency, voiding with laughing and coughing. She drinks one pot of coffee daily and does not drink much water daily. She reports this has impacting her quality of life and she frequently has embarrassing moments while out. Mary is possibly experiencing:                 The patient should have a full workup, that includes history, physical, and diagnostics which include a u/a, c/s, postvoid residual assessment. It is possible that she is experiencing overactive bladder concerns.                 The patient will need a full workup, that includes a history, physical and diagnostics which include a u/a, c/s, postvoid residual and urine cytology. It is possible that she is experiencing a urinary tract infection                 The patient may be experiencing urethritis, which can occur as a result of gastrointestinal bacteria spreading from the anus to the urethra.                 Because of her uncontrolled diabetes, she has an impaired immune system, which has resulted in her developing a urinary tract infection. Question 3 The APRN would expect to find elevated blood levels of which of the following markers for patients with a diagnosis of depression?                 Proinflammatory cytokines and pH                  Calcium and Cortisol                 Calcium and pH                 Proinflammatory cytokines and cortisol Question 4 A healthcare professional has taught a parent group about the causes of enuresis. What statement by a parent indicates the professional needs to give more information?                 A maturational lag may cause enuresis.                 Enuresis may be related to increased light sleep.                 Obstructive sleep apnea may be a symptom of enuresis.                 Elevated nocturnal levels of vasopressin may cause enuresis. Question 5 What is the first indication of nephrotic syndrome in children?                 Periorbital edema                                    Scrotal or labial edema                           Frothy urine                                            Ascites                Question 6 Abnormalities in brain development related to schizophrenia are thought to develop when?                   Prenatal                 Infancy                 Early Childhood                 Adolescent Question 7 A patient has a spinal cord injury at C4. What should the healthcare professional assess as the priority in this patient?                 Blood pressure                                        Respirations                                            Pulse                   Temperature                Question 9 Parents bring their 1-year-old child to the emergency department, reporting that the child has been irritable and pounding on her head, has projectile vomiting, and seems very sleepy for most of the last 3 days. What diagnostic testing does the healthcare professional prepare the child and parents for as the priority?                 Brain scanning with either CT or MRI                         Lumbar puncture with CSF cultures                            Developmental assessment                     Ophthalmologic assessment   Question 10 A child has iron deficiency anemia. In addition to iron supplements, what else does the healthcare professional educate the parents on giving the child?                 Vitamin A                                               Magnesium                                             Vitamin C                                                Zinc    Question 11 Why is nasal congestion a serious threat to young infants?                 Infants are obligatory nose breathers.                 Their nares are small in diameter.                 Infants become dehydrated when mouth breathing.                 Their epiglottis is proportionally greater than the epiglottis of an adult’s. Question 12 The health care professional is caring for a person who has a pathologic fracture. The patient asks the professional to explain the condition. What response by the professional is best?                 The outer surface of the bone is disrupted, but the inside is intact.                 A stable fracture where the cortex of the bone bends but doesn’t break.                 A fracture that happens at the site of an abnormality already in that bone.                 It was caused by the cumulative effects of stress on the bone over time. Question 13 A healthcare professional wants to volunteer for a community education project to help prevent spinal cord injury. What activity would the professional most likely volunteer for?                 Teaching school aged children bicycle safety                                    Teaching stretching to high school athletes                 Teaching adults good body mechanics for lifting                              Teaching older adults how to prevent trip-and-fall events Question 14 What diagnosis is given to parents when their infant’s hip maintains contact with the acetabulum but is not well seated within the hip joint?                 Dislocatable hip                                      Subluxated hip                                       Dislocated hip                                        Subluxable hip                        Question 15 What is the role of thromboxane A (TXA 2) in the secretion stage of hemostasis?                 Stimulates the synthesis of serotonin.                 Promotes vasodilation.                 Stimulates platelet aggregation.                 Promotes formation of cyclooxygenase. Question 16 A healthcare professional suspects a patient is brain dead. How would the professional assess for brain death?                 Determine if the patient can make voluntary movements.                 Perform tests to assess if the patient is in a coma.                 Remove the patient’s ventilator to see if spontaneous breathing occurs.                 Monitor the patient for eye movements that seem purposeful. uestion 17 A healthcare professional is educating a community men’s group on symptoms of benign prostatic hyperplasia (BPH). The professional relates that most symptoms are a result of which pathophysiologic condition?                 Infection of the prostate                         Obstruction of the urethra                      Ischemia of the urethra                           Compression of the urethra    Question 18 A woman who is positive for hepatitis B is in labor. What action by the healthcare professional is most appropriate?                 Draw blood for a drug screen.                 Encourage the mother to bottle feed.                 Immunize the newborn within 12 hours.                 Discuss poor infant survival. Question 19 In acute hypothermia, what physiologic change shunts blood away from the colder skin to the body core in an effort to decrease heat loss?                 Hypotension                                            Peripheral vasoconstriction                    Voluntary muscle movements                 Shivering Question 20 How is gonorrhea transmitted from a pregnant woman to her fetus?                 Unbound in the blood via the placenta                        Attached to immunoglobulin G (IgG) via the placenta                     By direct inoculation with the fetal scalp electrodes exposed to maternal body fluids                 Predominately through infected cervical and secretions during the birth process Question 21 A student reads in a chart that a child has been diagnosed with mixed precocious puberty and asks for an explanation. What explanation by the healthcare professional is most accurate?                 When a child develops some secondary sex characteristics of the opposite sex                   When a child does not develop any identifiable external sex organs                        When early puberty occurs due to multiple, integrated causative effects                 When early puberty has signs of physical and hormonal abnormalities     Question 22 A student reads in a chart that a baby was born with an encephalocele. The student asks the healthcare professional to explain this condition. What explanation by the healthcare professional is best?                 A herniation or protrusion of brain and meninges through a defect in the skull                   A protruding saclike cyst of meninges filled with spinal fluid and is a mild form of spina bifida                 Protrusion of a saclike cyst containing meninges, spinal fluid, and a portion of the spinal cord through a defect in the posterior arch of a vertebra                  Premature closure of one or more of the cranial sutures during the first 18 to 20 months of an infant’s life        Question 23 Cystic fibrosis is characterized by which symptom?                 Excessive mucus production                  Elevated blood glucose levels                 Low sodium content in perspiration                             Abnormally thin exocrine secretions            Question 24 A patient reports frequent nightmares. For which of these should the healthcare professional assess the patient?                 A recent major loss                                 Family history of nightmares                 History of traumatic event                     Poor nutrition and weight loss                     Question 25 A student is learning about pelvic inflammatory disease (PID). What information does the student clarify with a study partner as being correct?                 An episode of mild PID can decrease the possibility of a successful pregnancy by 80%.                 Such an inflammation may result in permanent changes to the ciliated epithelium of the fallopian tubes.                              PID has not been associated with an increased risk of an ectopic pregnancy.                 Contracting this infection increases the risk of cervical cancer. Question 26 What causes the vasomotor flushes (hot flashes) that are associated with declining ovarian function with age?                 Decreased estrogen levels                      Absence of estrogen                               Increased estrogen levels                        Rapid changes in estrogen levels                  Question 27 In the majority of children experiencing delayed puberty, what is the problem caused by?                 Disruption in the hypothalamus                                   Disruption of the pituitary                     Deficit in estrogen or testosterone                                Physiologic delays in maturation Question 28 A patient has been hospitalized for a large deep vein thrombosis and states he is the third person in his family to have this condition in the last 2 years. What response by the healthcare professional is most appropriate?                 This condition is not transmitted genetically.                                    We can test your blood for factor V Leiden.                                     Were they all men or both men and women?                                     Familial thromboses tend to be very severe.                      uestion 29 A healthcare professional is planning a community event to reduce risk of cerebrovascular accident (CVA) in high risk groups. Which group would the professional target as the priority?                 Insulin-resistant diabetes mellitus                                Hypertension                                          Polycythemia                                          Smoking                   Question 30 A preschool teacher notices a child who has burrows on the hands that are several millimeters to 1 cm long, papules, and vesicular lesions. What other assessment finding would help the teacher determine the type of infestation the child has?                 Ask the child if he or she has been around puppies or kittens.                 Check the child’s hair for the presence of small mites.                 Ask the child if itching occurs especially at night.                 Assess the child’s trunk and abdomen for petechiae. Question 31 Which condition is consistent with the cardiac defect of transposition of the great vessels?                 The aorta arises from the right ventricle.                 The pulmonary trunk arises from the right ventricle.                 The right ventricle pumps blood to the lungs.                 An intermittent murmur is present. Question 32 A patient has a temporary displacement of two bones in a joint causing the bone surfaces to partially lose contact with each other. What treatment does the health care professional prepare the patient for?                 Internal fixation                                      Reduction and immobilization                                     Calcium phosphate cement                     Low-density ultrasound         Question 33 Which statement by the professor best describes acute respiratory distress syndrome (ARDS)?                 An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation                                              A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and the presence of bilateral infiltrates on chest x-ray imaging                       A respiratory disorder involving an abnormal expression of a protein producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens                                 A pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency                                   Question 35 A child has Duchenne muscular dystrophy. What complication does the healthcare professional teach the parents is most important to control?                 Respiratory infection                              Joint contractures                                   Urinary tract infection                            Fractures from falling             Question 36 How should the healthcare professional reply when parents question why a computed tomographic (CT) scan of the head was not ordered for their 5-year-old child after a minor fall?                 Physicians are cautious about ordering CT scan on children younger than 10 years of age.                 CT scans are seldom conclusive when used to diagnosis head injuries in young children.                 The child’s symptoms will determine whether a CT scan is necessary and worth the expense.                 Research suggests that repeated CT scans can increase the risk of developing brain cancer uestion 37 An infant is brought to the emergency department by parents who report that the baby’s fontanels seem to be bulging outward. What action by the healthcare provider is most appropriate?                 Assess the baby for recent trauma to the head.                 Measure the head circumference and plot it on a growth chart.                 Prepare the baby for a lumbar puncture and blood cultures.                 Determine how much fluid the baby had in the last 24 hours. Question 38 What type of thoughts are characteristic of post traumatic stress disorder?                  disorganized                 intrusive                 anxious                 disturbing Question 39 When examining a male age 50 and older, the Nurse Practitioner should know that:                 It is not necessary to perform a DRE if the PSA is normal.                 It is not necessary to perform a PSA if the DRE is normal.                 The DRE and PSA should be performed.                 The Nurse Practitioner can use her discretion until age 60.     1 points   Question 40 A mother reports that her young teens have voracious appetites. The healthcare professional would explain that which hormone is linked to an increase in appetite during puberty?                 Inhibin                 Leptin                 Activin                                                    Follistatin                                Question 41 Which mother does the healthcare professional prepare to administer Rh immune globulin (Rho-GAM) to?                 Is Rh-positive and the fetus is Rh-negative                 Is Rh-negative and the fetus is Rh-positive                 Has type A blood and the fetus has type O                 Has type AB blood and the fetus has type B uestion 42 A patient reports small, vesicular lesions that last between 10 and 20 days. What treatment does the healthcare professional educate the patient about?                 Acyclovir (Zovirax)                                Three injections of penicillin                  One time dose of azithromycin                                    Test of cure                            Question 43 The student wants to know how the clinical manifestations and onset of juvenile idiopathic arthritis (JIA) differ from those of rheumatoid arthritis (RA) in adults. What answer by the healthcare professional is best?                 JIA begins insidiously with systemic signs of inflammation.                 JIA predominantly affects large joints.                 JIA has more severe joint pain than adult RA.                 JIA has a rapid onset of generalized aches as the first symptom. Question 44 Which of the following are positive clinical manifestations of schizophrenia?                   Social withdraw, blunted affect, and failure to respond to simple questions                 Hallucinations, delusions, and incoherent speech                 Hallucinations, blunted affect, and social withdraw                 Delusions, hallucinations, and failure to respond to simple questions 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    

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