Question 1 Which of the following is a crucial element of developing a guideline?
Creating a physician expert panel
Reviewing the literature with ratings of available evidence
Conducting an external review of a guideline
Developing evidence-based tables
Question 2 African American patients seem to have a negative reaction to which of the following asthma medications?
Inhaled corticosteroids
Long-term beta-agonist bronchodilators
Leukotriene receptor agonists
Oral corticosteroids
Question 3 Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?
The tumor size cannot be evaluated; the cancer has not spread to the lymph nodes; and the distant spread cannot be evaluated.
The cancer is in situ; it is spreading into the lymph nodes,
but the spread cannot be evaluated otherwise.
The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.
The cancer is about 5 cm in size; nearby lymph nodes cannot be evaluated; and there is no evidence of distant spreading.
Question 4 Sondra's peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?
Meclizine Diphenhydramine
Diamox Promethazine
Question 5 Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a:
Filiform/digitate wart
Dysplastic cervical lesion Condyloma acuminata Koilocytosis
Question 6 Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?
Dementia
Alzheimer's disease Parkinson's disease Delirium
Question 7 You have taught Jennifer, age 15, about using a flow meter
to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?
"Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow."
"Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow."
"Drive to the emergency room now."
"Call 911."
Question 8 A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
NSAIDs
Beets Vitamin A Red meat
Question 9 Which of the following is an example of tertiary prevention in a patient with chronic renal failure?
Fluid restriction Hemodialysis 4 days a week High-protein diet
Maintenance of blood pressure at 120/80
Question 10 Which of the following conditions is associated with cigarette smoking?
Glaucoma
Increased sperm quality Bladder cancer
Eczema
Question 11 A chronic cough lasts longer than: 3 weeks
1 month
6 months
1 year
Question 12 The 'freezing phenomenon' is a cardinal feature of?
Parkinson's disease
Alzheimer's disease A CVA
Bell's palsy
Question 13 When administered at the beginning of an attack, oxygen
therapy may help this kind of headache?
Tension Migraine Cluster Stress
Question 14 Which ethnic group has the highest lung cancer incidence and mortality rates?
African American men
Scandinavian men and women Caucasian women
Asian men
Question 15 The most significant precipitating event leading to otitis media with effusion is:
Pharyngitis Allergies
Viral upper respiratory infection (URI) Perforation of the eardrum
Question 16 Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:
Severe asthma
A common valvular lesion Severe hypertension
A prosthetic heart valve
Question 17 A 34-year-old patient was treated for a UTI and has not responded to antibiotic therapy. Which of the following actions should be taken next?
Send a urine specimen for microscopy and evaluate for
fungal colonies.
Increase the dose of antibiotic. Order a cytoscopy.
Order a different antibiotic.
Question 18 Which statement best describes a carotid bruit?
It is felt with the middle three fingers over the carotid artery.
A bruit becomes audible when the lumen is narrowed to 1
mm or less.
A low-pitched bruit is a medical emergency.
The higher the pitch of the bruit, the higher the degree of stenosis.
Question 19 Which statement is true regarding chloasma, the 'mask of pregnancy'?
It is caused by a decrease in the melanocyte-stimulating hormone during pregnancy.
This condition only occurs on the face.
Exposure to sunlight will even out the discoloration.
It is caused by increased levels of estrogen and progesterone.
Question 20 Simon presents with alopecia areata with well-circumscribed
patches of hair loss on the crown of his head. How do you respond when he asks you the cause?
"You must be under a lot of stress lately."
"It is hereditary. Did your father experience this also?" "The cause is unknown, but we suspect it is due to an
immunologic mechanism."
"We'll have to do some tests."
Question 21 A blood pressure (BP) of 150/90 is considered:
Stage 2 hypertension
Hypertensive
Normal in healthy older adults Acceptable if the patient has DM
Question 22 When teaching post MI patients about their NTG tablets, the clinician should stress that the tablets should remain in the light-resistant bottle in which they are packaged and should not be put in another pill box or remain in areas that are or could become warm and humid. Once opened, the bottle must be dated and discarded after how many months?
1 month 3 months
6 months
As long as the tablets are kept in this special bottle, they will last forever.
Question 23 Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?
He should stop smoking today.
He should stop smoking tomorrow. His quit date should be in 1 week.
He will be ready to quit after the first 30 days.
Question 24 When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?
Spores Leukocytes Pseudohyphae Epithelial cells
Question 25 The hallmark of an absence seizure is: No activity at all
A blank stare
Urine is usually voided involuntarily
The attack usually lasts several minutes
Question 26 Which medication used for scabies is safe for children 2 months and older?
Permethrin cream Lindane
Crotamiton lotion and cream Ivermectin
Question 27 The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?
Viral conjunctivitis Keratoconjunctivitis Bacterial conjunctivitis Allergic conjunctivitis
Question 28 Gabby, aged 22, has Bell's palsy on the right side of her
face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?
"Most patients have complete recovery in 3 to 6
months."
"Unfortunately, you'll probably have a small amount of residual damage."
"Don't worry, I'll take care of everything."
"You may have a few more episodes over the course of your lifetime but no permanent damage."
Question 29 How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate?
Every 3 months Every 6 months Annually
Whenever there is a problem
Question 30 Immunizations are an example of which type of prevention?
Primary
Secondary Tertiary
Question 31 The result of the patient's 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?
Repeat the test.
Refer to a nephrologist.
Measure the serum protein.
Obtain a blood urea nitrogen (BUN) and creatinine.
Question 32 Which cranial nerve is affected in a patient with a cerebrovascular accident who has di?culty chewing?
CN V CN VII CN IX CN X
Question 33 Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer?
Kidneys, ureter, bladder x-ray
Cystoscopy with biopsy Magnetic resonance imaging
Urine tumor marker (NMP22)
Question 34 The "B" in the ABCDEs of assessing skin cancer represents: Biopsy
Best practice Boundary
Border irregularity
Question 35 Which statement is true regarding driving and patients with a seizure disorder?
Once diagnosed with a seizure disorder, patients must never drive again.
After being seizure free for 6 months, patients may drive.
Each state has different laws governing driving for individuals with a seizure disorder.
These persons may drive but never alone.
Question 36 Which high-density lipoprotein (HDL) level is considered cardioprotective?
Greater than 30
Greater than 40
Greater than 50
Greater than 60
Question 37 The most common cause of CAP is?
Streptococcus pneumoniae
Klebsiella pneumoniae Legionella pneumoniae
Pseudomonas aeruginosa
Question 38 Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?
Serum calcium Electrocardiogram (ECG)
Thyroid-stimulating hormone test Complete blood cell count
Question 39 A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?
The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.
Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.
A throat culture should be performed to confirm the results of the rapid strep test.
The patient should be treated with antibiotics for strep
throat as the rapid strep test is not very sensitive.
Question 40 Patients with acute otitis media should be referred to a specialist in which of the following situations?
Concurrent vertigo or ataxia
Failed closure of a ruptured tympanic membrane If symptoms worsen after 3 or 4 days of treatment All of the above
Question 41 Which of the following tests is most useful in determining renal function in a patient suspected of CRF?
BUN and creatinine
Electrolytes
Creatinine clearance
Urinalysis
Question 42 Marci has a wart on her hand. She says she heard something about "silver duct tape therapy." What do you tell her about his?
It is an old wives' tale.
It is used as a last resort.
Salicylic acid is more effective.
It is a simple treatment that should be tried first.
Question 43 What is the first-line recommended treatment against Group A ?-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?
Penicillin
Quinolone
Cephalosporin
Macrolide
Question 44 Which of the following is an example of sensorineural hearing loss?
Perforation of the tympanic membrane Otosclerosis
Cholesteatoma Presbycusis
Question 45 Which of the following is "a linear crack extending from the epidermis to the dermis?"
An ulcer A fissure
Lichenification An excoriation
Question 46 A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?
The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.
The clinician can definitively diagnosis open-angle
glaucoma based on the subjective complaints of the patient.
Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist.
Early diagnosis is essential in order to reverse any
damage that has occurred to the optic nerve.
Question 47 The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?
IgA IgE IgG IgM
Question 48 A patient is seen with a sudden onset of flank pain accompanied by nausea, vomiting, and diaphoresis. In addition to nephrolithiasis, which of the following should be added to the list of differential diagnoses?
Pancreatitis
Peptic ulcer disease Diverticulitis
All of the above
Question 49 Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?
B-type natriuretic peptide
C-reactive protein Serum albumin
Erythrocyte sedimentation rate
Question 50 You are doing a cerumen extraction and touch the external meatus of your patient's ear. He winces and starts coughing. What is the name of this reflex?
Baker phenomenon Arnold reflex
Cough reflex Tragus reflex
