Which of the following is a characteristic of delirium?

The nurse practitioner (NP) is reviewing the chart of an 8-month-old infant scheduled to receive immunizations. Which vaccination would the NP question if noted in the infant’s chart?

A 65-year-old female patient who has had type 2 diabetes for 20 years is concerned about her kidneys. She has a history of three urinary tract infections (UTIs) within the past 8 months and is currently experiencing dysuria at the clinic today. The nurse practitioner will:

The nurse practitioner orders a 24-hour urine collection for a patient with suspected kidney disease. Additional testing will be required to detect what?

Which assessment finding is associated with a diagnosis of proximal hypospadias?

A 20-year-old female college athlete presents with weight loss and amenorrhea for 6 months. She had a period 7 months ago and denies sexual activity. The patient’s body mass index (BMI) has decreased to 16.4, her pulse is 52 beats/min and weak, and her blood pressure is 84/54 mmHg. What will the nurse practitioner assess next?

A 42-year-old female patient presents with difficulty conceiving despite following ovulation indicators and timing intercourse accordingly. The patient denies pain and fatigue and reports no changes in bowel movements. Based on the findings, the nurse practitioner suspects “false-positive” ovulation results and rules out which disorder before referring the patient to a fertility specialist for further evaluation?

Which oral antibiotic will the nurse practitioner prescribe for an 18-month-old infant with a symptomatic urinary tract infection (UTI)?

A patient newly diagnosed with diabetes mellitus has a body mass index (BMI) of 32.5, creatinine of 1.4 mg/dL, blood urea nitrogen (BUN) of 20.0 mg/dL, and fasting blood sugar (FBS) of 186 mg/dL. The patient also has a history of bladder cancer. Which is the most appropriate drug class for this patient?

Which lab results suggest a diagnosis of hypothyroidism?

The nurse practitioner (NP) is screening a 1-week-old newborn for congenital heart defects (CHDs) and measures 91% oxygenation in the right hand and 95% in the left hand. The NP will:

Which of the following findings is most likely in a young primigravida patient with pregnancy-induced hypertension?

Which of the following is used to confirm a diagnosis of Hashimoto thyroiditis?

Café au lait spots look like tan to light-brown stains that have irregular borders. They can be located anywhere on the body. Which of the following is a correct statement about café au lait spots?

A middle-aged male patient complains of a history of outbreaks of painful large nodules and pustules on both his axillae that resolve after treatment with antibiotics. On physical examination, the nurse practitioner (NP) notices large red nodules that are tender to palpation. In addition, several pustules are present along with multiple scars on the skin. The NP advises the patient that the condition is caused by a bacterial infection of the sweat glands in the axillae. Which of the following conditions is being described?

A 72-year-old female patient complains of a crusty, nonhealing, small ulcer on her upper lip that she has had for several years. Which of the following will the nurse practitioner recommend?

A red, raised serpiginous-shaped rash is noted by the nurse practitioner on the foot of an 11-year-old male patient. He complains of severe itch and keeps scratching the lesion. The patient reports that he frequently plays in the yard without wearing shoes. Which of the following is most likely?

The parent of a 12-month-old infant reports to the nurse practitioner that the child had a high fever for several days, which spontaneously resolved. After the fever resolved, the child developed a maculopapular rash. Which diagnosis is most likely?

A male patient complains of a dry cough for the past 6 weeks. It worsens when he is supine. He has episodes of nausea and heartburn, which he self-treats with an over-the-counter (OTC) antacid. He chews mints for his “bad breath.” Which of the following is a possible cause of this patient’s cough?

Which of the following pharmacologic agents is the best choice for an elderly patient with insomnia?

A 25-year-old male patient with schizophrenia comes in for a routine annual physical. He is a heavy smoker and has a body mass index (BMI) of 28. The patient has been on olanzapine (Zyprexa) for 10 years. Which of the following laboratory tests is recommended for monitoring the adverse effects of atypical antipsychotics?

A 28-year-old male patient who works as a nurse reports a history of a cold that resolved 2 weeks ago, except for a dry cough and pain over the right cheek that worsens when he bends over. He tells the employee health nurse practitioner that he is very allergic to both cephalexin (Keflex) and erythromycin. The patient’s vital signs are temperature of 99.2°F, pulse of 72 beats/min, and respirations of 12 breaths/min.

A female patient is planning to breastfeed her newborn infant for at least 6 months. She wants to know whether she should give the infant vitamins. Which of the following vitamin supplements is recommended by the American Academy of Pediatrics (AAP) during the first few days of life?

A 65-year-old female patient’s bone density result shows severe demineralization of cortical bone with a history of a recent hip fracture. Which of the following pharmacologic agents is considered first line for the treatment of this condition?

A young adult patient complains of a 2-week history of facial pressure that worsens when bending over. The patient complains of tooth pain in the upper molars on the right side of the face. On physical exam, lung and heart sounds are normal. Which diagnosis is most likely?

Erythromycin inhibits the cytochrome P450 (CYP450) system. Which of the following drugs should be administered carefully due to the p450 interaction with erythromycin?

An adult female patient who works as a kindergarten teacher is diagnosed with acute streptococcal pharyngitis. On exam, her throat is a bright-red color with tonsillar exudate and enlarged tender anterior cervical lymph nodes. The patient has an allergy to penicillins (history of severe angioedema). Which of the following is the best treatment option?

An 8-year-old child is seen as a walk-in appointment by the nurse practitioner (NP). The parent reports that the child has been febrile for 2 days and is not eating well because of painful sores inside the mouth. The child’s temperature is 101°F, pulse is 88 beats/min, and respirations are 14 breaths/min. During the physical exam, the NP notices several small blisters and shallow ulcers on the child’s pharynx and oral mucosa. The child has small, round red rashes on both palms and soles.

A 4-week-old boy is seen in the family practice clinic for a complaint of forceful vomiting that occurs immediately after feeding. The vomitus is composed of infant formula and is not bilious. The infant is bottle-fed with infant formula that was recommended by the pediatrician. The parent reports that the infant seems hungry and sucks on the bottle without any problems. His birth weight was 7 lb, 5 oz. The current weight is 7 lb. Which of the following clinical findings is an important clue regarding the possible cause of the infant’s vomiting?

An adult brings their 82-year-old mother to the ED. The adult reports finding their mother on the floor when checking on her that morning. The patient was awake and oriented but needed help getting up. The patient states that she thinks she passed out. She is being evaluated by a physician who orders an EKG and x-rays of both hips. Regarding laboratory testing, which of the following tests is important to perform initially?

The nurse practitioner (NP) is reviewing the laboratory results for an adult patient, which reveal macrocytosis and reticulocytopenia. The NP will likely rule out what disorder?

A 76-year-old male patient with a history of atherosclerotic cardiovascular disease (ASCVD) presents to the nurse practitioner (NP) with hyperlipidemia. Following current guidelines on the management of blood cholesterol, which medication should the NP prescribe?

The nurse practitioner notices a gray ring on the edge of both irises of an 80-year-old woman. The patient denies visual changes or pain. She reports that she has had the “ring” for many years. Which of the following causes is most likely?

The visual fields by confrontation test is used to evaluate for:

Which area of the breast is the most common site for female breast cancer?

Which of the following effects is seen in patients using the medroxyprogesterone injection (Depo-Provera) for more than 5 years?

The span of the normal adult liver is:

When assessing a patient suspected of having vertigo, the description provided by the patient that is most consistent with the diagnosis is a sensation of:

The nurse practitioner notes bony nodules located at the proximal interphalangeal joints on both hands of a 65-year-old female patient. Which of the following is most likely?

The nurse practitioner is viewing a plain chest radiograph (which follows). What is the diagnosis?

Which of the following statements is true about the Somogyi effect?

A nurse practitioner (NP) is giving dietary counseling to a 30-year-old male patient with alcoholism who has recently been diagnosed with folic acid/deficiency anemia. Which of the following foods will the NP recommend to this patient?

Which of the following is an instrumental activity of daily living (IADL)?

The nurse practitioner (NP) advises a patient who is taking a monoamine oxidase inhibitor (MAOI) to avoid foods that contain high levels of tyramine. Which food would the NP include in a list of examples?

A 65-year-old male patient has been taking a new prescription of rosuvastatin (Crestor) 40 mg daily for 6 weeks. During a follow-up visit, he reports feeling extremely fatigued and having dark-colored urine. He denies any generalized muscle soreness. The nurse practitioner (NP) orders several laboratory tests and instructs the patient to:

The enzyme-linked immunosorbent assay (ELISA) and Western blot tests are used to detect which of the following?

While reviewing some lab reports, the nurse practitioner notes that one of the results for a teenage male patient is abnormal. The liver function tests are all normal except for a slight elevation in the alkaline phosphatase level. The patient is a member of a soccer team and denies any recent injury. Which of the following statements is true about the patient’s slightly elevated alkaline phosphatase level?

Which of the following murmurs can radiate to the neck?

The nurse practitioner auscultates a child’s heart and hears a very soft murmur. Which grade would the nurse assign to the murmur?

Place an X on the anatomic location where sensorineural hearing loss occurs.

What is a potential adverse effect of long-term haloperidol therapy?

The nurse practitioner is reviewing the medical record of a 6-month-old infant with normocytic hemolytic anemia and notes an electrophoresis result of hemoglobin S with a 20% concentration of hemoglobin F (fetal hemoglobin). Which additional diagnosis is most likely?

Swim therapy (aqua therapy) for a 13-year-old patient with cerebral palsy is an example of which type of prevention?

While performing a routine physical exam on a 60-year-old male patient, the nurse practitioner notices a soft bruit over the carotid area on the left side of the neck. The patient has a history of hypertension. The patient is at higher risk for:

While examining the genitalia of a male patient, the nurse practitioner (NP) observes distended scrotal veins. The NP will:

A 23-year-old college student is seen in the school health clinic with complaints of a nonproductive cough, rhinorrhea, pharyngitis, and malaise for the past week. The patient also reports mildly erythematous rashes and myalgia. He has no significant medical history. Physical examination reveals a low-grade temperature of 99.9°F, respirations of 22 breaths/min, pulse of 90 beats/min, and scattered rales and wheezing of the lungs. Lab abnormalities suggest hemolysis, and patchy consolidations are noted on chest imaging. Which of the following diagnoses is most likely?

A 25-year-old male patient who was involved in a car crash is brought to the ED. He reports wearing a seat belt and being the driver of the vehicle. The patient is complaining of pain on his right lower leg. The right foot is abducted, and the ankle is swollen and bruised. There is a small laceration on the ankle. The patient complains of severe right ankle pain when standing. Which of the following tests would be the initial choice for evaluating for possible fractures on the right lower leg?

In addition to surgical repair of a compound fracture that has broken through the skin, which of the following treatment plans is important to consider?

Koilonychia is associated with which of the following conditions?

The major difference between the quasi-experimental design and the experimental design is which of the following?

A 36-year-old female patient complains of fatigue and headaches accompanied by widespread muscle and joint pain that started 6 months ago. She reports insomnia and feeling tired even with adequate sleep. She was diagnosed with major depression 1 year ago and is currently on escitalopram (Lexapro) 20 mg orally daily. She is also taking B-complex vitamins and melatonin at bedtime for sleep. During the physical exam, the nurse practitioner notes bilateral areas of tender points on the neck, jaw, shoulders, chest, upper back, and greater trochanter. The symptoms and physical exam findings are highly suggestive of which condition?

Which chronic illness disproportionately affects the Hispanic population compared with the non-Hispanic White population?

During an assessment of a young adolescent male patient with flu-like symptoms, the nurse practitioner (NP) notices several deep bruises on his buttocks. Which ethical concept does the NP follow in reporting the findings?

All of the following drug classes are approved for treating hypertension. Which of the following antihypertensive drug classes is associated with the largest number of research studies?

Which patient is the lowest priority for diabetes screening?

Phalen’s test is used to evaluate:

A 70-year-old female patient complains of left lower quadrant (LLQ) abdominal pain and fever for 2 days. Her blood pressure is 130/80 mmHg, pulse is 90 beats/min, respirations are 14 breaths/min, and temperature is 100.5°F. During the abdominal exam, the LLQ of the abdomen is tender to palpation. The nurse practitioner (NP) does not palpate a mass; neither is there guarding or rigidity. Rovsing’s sign is negative. Bowel sounds are present in all quadrants. The NP is familiar with the patient, who is alert and is asking appropriate questions about her condition. The NP suspects that the patient has acute diverticulitis. Which of the following treatment plans is appropriate for this patient?

When a domestic dog is suspected of being infected with the rabies virus, it can either be euthanized for a brain biopsy or it can be quarantined. What is the minimum number of days for which a dog suspected of rabies infection must be quarantined?

A 68-year-old female patient presents at the primary care clinic with complaints of “whitish-looking” papules in the vulvar region and a nonpruritic maculopapular rash on the soles of the feet. The patient is also experiencing alopecia and lymphadenopathy. Rapid plasma reagin (RPR) is 1:8. Which diagnosis is most likely?

A 24-year-old male patient presents with a history of major depression with occasional bouts of elevated mood. During the bouts of elevated mood, he reports racing thoughts and an intense desire for risky behaviors but denies hallucinations. He works a steady job and maintains a home. Which diagnosis is most likely?

Which finding is associated with the human papillomavirus (HPV)?

Which of the following heart sounds is considered a normal finding when heard in children?

A 36-year-old male patient presents to the nurse practitioner complaining of a history of cervical and upper back pain for many months. On examination, the range of motion of the patient’s spine is limited, especially with lateral flexion. The other joints in the patient’s body are normal. Only the spine seems to be affected. The patient reports that a laboratory test from a previous clinician showed increased erythrocyte sedimentation rate (ESR), negative antinuclear antigen (ANA), and negative rheumatoid factor (RF). Which of the following is best described?

Which of the following laboratory values may be elevated on the liver function panel of patients with alcohol use disorder?

A middle-aged patient newly diagnosed with type 2 diabetes wants to start an exercise program. Which statement would the nurse practitioner include in the teaching?

What is the diagnosis for the skin lesion shown in the following photograph?

A 74-year-old male patient presents with recurrent abdominal cramping and pain associated with diarrhea that occurs from four to five times per day. He reports that currently he is having an exacerbation. The stools are bloody, with mucus and pus. The patient reports that he has lost weight and is always fatigued. The patient denies recent travel or outdoor camping. Which of the following conditions is most likely?.

A 72-year-old female patient presents with complaints of a nonproductive cough, fatigue, shortness of breath, and weight gain. An S3 heart gallop is noted. Which diagnosis is most likely?

The nurse practitioner (NP) is reviewing the bilirubin level of a 3-day-old, full-term neonate and notes that it is 10 mg/dL. The infant has a slight yellow color to the skin, mucous membranes, and sclerae. The infant is feeding well, is not irritable, and has 8 to 10 wet diapers per day. What is the NP’s next action

During a sports participation exam, a 16-year-old patient is noted to have a few beats of horizontal nystagmus on extreme lateral gaze that disappear when the eyes move back toward midline. Which statement best describes this clinical finding?

Pulsus paradoxus is more likely to be associated with:

A 69-year-old patient presents with acute hearing loss. Upon physical examination, the nurse practitioner finds a cerumen impaction. Which type of hearing loss is expected?

A 17-year-old male patient reports “feeling something” on his left scrotum. On palpation, soft and movable blood vessels that feel like a “bag of worms” are noted underneath the scrotal skin. The testicle is not swollen or reddened. The most likely diagnosis is:

Which of the following drug classes is recommended for the treatment of postherpetic neuralgia?

The parent of a 4-month-old calls the office and reports that the infant has a fever of 101.4°F. The infant received immunizations yesterday. Which of the following statements is correct?

A 78-year-old female patient’s dual-energy x-ray absorptiometry (DEXA) scan yields a T score of -2.8. Which of the following pharmacologic options is preferred for treating this condition?

A parent brings in their 11-year-old daughter to see the nurse practitioner (NP). The parent complains that the school nurse found a few nits in the patient’s hair. The parent states that the school has a “no nits” policy regarding head lice and that the child cannot go back to school until all the nits have been removed. The child was treated with permethrin shampoo (Nix) twice about 3 months ago. During the physical exam, the NP sees a few nits that are about 2 inches away from the scalp. The child denies itchiness on her scalp. Which of the following is the best action for the NP to follow?

Which of the following situations is considered emergent?

A nurse practitioner discusses the condition of a patient in the hallway with another staff member. Which of the following statements is correct?

The nurse practitioner (NP) notices a gray ring on the edge of both irises of an 81-year-old female patient. The patient denies visual changes or pain. She reports that she has had the “ring” for many years. What would the clinical significance of this same finding be in a 35-year-old patient?

The nurse practitioner is reviewing a patient’s laboratory results and notes a normal ferritin level, high serum iron, elevated total iron-binding capacity, normal mean corpuscular hemoglobin concentration, and abnormal hemoglobin electrophoresis. Which diagnosis is most likely?

A patient newly diagnosed with diabetes reports severe hives and swollen lips after taking sulfamethoxazole-trimethoprim (Bactrim) for a bladder infection 2 months ago. Which of the following statements is correct?

When evaluating the blood pressure on both the arms and the legs of an infant who has a diagnosis of coarctation of the aorta, which of the following is the expected finding?

Which of the following antihypertensive medications should the nurse practitioner avoid when treating patients with emphysema?

A 76-year-old female patient presents to the primary care clinic for her annual check-up. The nurse practitioner (NP) notes that the patient’s height has decreased by an inch in the last year and that her back has a “hump-like” deformity. How will the NP document these findings?

Which activity presents the lowest legal risk for the nurse practitioner (NP)?

A patient reports a productive cough with excessive light-colored sputum. On physical examination, the nurse practitioner auscultates wheezing and crackles in all lobes. The patient has a 20-pack-year history of smoking. Which of the following conditions is most likely?

A 47-year-old male patient with a history of injection drug use and alcohol use disorder presents to the public health clinic with a recent history of fever, night sweats, fatigue, and weakness. The patient has recently noticed some thin red streaks on his nail beds and red bumps on some of his fingers that hurt. During the cardiac exam, the nurse practitioner hears a grade 3/6 murmur over the mitral area. The subcutaneous red-purple nodules are tender to palpation. The thin red lines on the nail beds resemble subungual splinter hemorrhages. Which of the following conditions is most likely?

Fetal TORCH infections can cause microcephaly, intellectual disability, hepatosplenomegaly, and intrauterine growth retardation. The acronym TORCH stands for:

A parent brings in their 11-year-old daughter to see the nurse practitioner (NP). The parent complains that the school nurse found a few nits in the patient’s hair. The parent states that the school has a “no nits” policy regarding head lice and that the child cannot go back to school until all the nits have been removed. The child was treated with permethrin shampoo (Nix) twice about 3 months ago. During the physical exam, the NP sees a few nits that are about 2 inches away from the scalp. The child denies itchiness on her scalp. Which of the following is the best action for the NP to follow?

A 28-year-old male patient is evaluated by the nurse practitioner for frequent episodes of psychotic delusions and paranoia. He has taken risperidone (Risperdal) in the past but states that the drug was not effective. Which medication will the nurse practitioner prescribe?

The anti-hepatitis C virus (HCV) test of a 60-year-old female patient is positive. Which test is appropriate for follow-up?

A middle-aged male patient has recently been diagnosed with renal insufficiency. He has a history of hypertension and has been on lisinopril (Accupril) for many years. Which of the following laboratory values should be carefully monitored?

A 10-year-old boy complains of a sudden onset of scrotal pain upon awakening that morning. He also complains of severe nausea and vomiting. During the physical examination, the nurse practitioner finds a tender, warm, and swollen left scrotum. The cremasteric reflex is negative, and the urine dipstick is negative for leukocytes, nitrites, and blood. The most likely diagnosis is:

In regard to the previous scenario, what type of follow-up should this patient receive?

A 20-year-old female patient reports that for several years, she has had random episodes of palpitations and shortness of breath that resolve spontaneously. She denies chest pain, arm pain, and syncope. Her past medical and family histories are negative for coronary artery disease, stroke, and lung disease. During the cardiac exam, the nurse practitioner notices a grade 3/6 murmur that is accompanied by a midsystolic click, which is best heard at the apical area. The apical pulse is 78 beats/min, blood pressure is 120/60 mmHg, and temperature is 98.6°F. The cardiac exam is highly suggestive of which of the following conditions?

When starting an elderly patient on a new prescription of levothyroxine (Synthroid), the nurse practitioner should keep in mind that the rationale for beginning with a lower dose in such patients relates to the effect of the drug on which system?

Which of the following individuals is most likely to have the highest number of risk factors for osteoporosis?

A 13-year-old boy wants to be treated for acne. He has a large number of closed and open comedones on his face. The patient has been self-treating with over-thecounter topical benzoyl peroxide and salicylic acid products. Which of the following would the nurse practitioner recommend next?

A bulla may describe as a

A middle-aged male patient reports to the local public health clinic complaining of a painless and shallow ulcer on the penile shaft for the past 2 weeks. He is sexually active and has had unprotected intercourse with two male partners over the past few months. The patient is tested for HIV, syphilis, gonorrhea, hepatitis B, and herpes types 1 and 2. The syphilis and HIV tests are both positive. The gonorrhea, hepatitis B, and herpes tests are negative. The nurse practitioner (NP) is aware of nationally notifiable infectious conditions. Which of the following is true regarding the reporting of any of these sexually transmitted infections (STIs)?

In how many months does a healthy infant triple its birth weight

A 15-year-old male patient who is 6 ft (1.83 m) tall and a basketball player is seen for complaints of painful lumps on his anterior knees. Upon inspection, the nurse practitioner notes a bonelike growth on the upper tibia midline below the kneecap on both knees. The patient has full range of motion (ROM) with no joint tenderness, redness, or swelling. Which of the following conditions is best described?

A middle school–aged patient is complaining of burning and itching that started in the left eye. Within 2 days it involved both eyes, and the child developed a runny nose and sore throat. During the physical exam, the child’s eyes appear injected bilaterally with no purulent discharge. The throat is red, the inferior nasal turbinates are swollen, and lymph nodes are palpable in front of each ear. Which diagnosis is most likely?

A 55-year-old male patient presents with a swollen, painful right testicle and burning on urination. Examination reveals edematous scrotum with tenderness and a positive Prehn sign. The patient states that he is heterosexual and has been in a monogamous relationship for the past 5 years. He denies practicing anal intercourse. The nucleic acid amplification test (NAAT) is negative. Which medication will the nurse practitioner prescribe?

Which of the following adverse effects are most likely to be seen with the atypical antipsychotic drugs?

A female adult patient presents with complaints of “bad burns” that are very painful. A large pot of boiling water tipped over and spilled on her arms and her anterior chest and abdomen. During the physical exam, the nurse practitioner notices brightred skin with numerous bullae on the left arm and hand and large patches of bright-red skin on the anterior chest and abdominal area. On a pain scale of 1 to 10, she reports the pain as 9. Her vital signs are stable with tachycardia (pulse is 100 beats/min). She does not appear to be in shock. Using the rule of nines, what are the total body surface area (TBSA) and the depth of the burns in this patient?

Which patient presents the lowest risk for urinary tract infection (UTI)?

A 6-year-old child is brought to the clinic by a parent as a walk-in patient. The parent reports that the child has recently begun swim lessons. Their symptoms began as redness on the left eye and spread to the second eye within 2 days. The child’s eyes are watery and crusted upon waking. Vital signs are temperature of 98.8°F, pulse of 90 beats/min, and respirations of 16 breaths/min. The eye exam reveals bilateral injected conjunctivae. When the lower eyelid is examined, the nurse practitioner (NP) notes that it is pink with a cobblestone appearance. There is ipsilateral preauricular adenopathy. What measure will the NP include in the treatment plan?

Which of the following antibiotic regimens is recommended as first-line treatment for communityacquired pneumonia in patients with no comorbidity?

. When examining a 10-year-old patient, where will the nurse practitioner (NP) auscultate the point of maximal impulse (PMI)?

Which of the following is a hematologic change associated with pernicious anemia?

A patient refuses a blood transfusion based on religious beliefs. In which manner would the nurse practitioner support the patient’s beliefs and practices, while also ensuring that the patient understands the components of informed consent?

Which cranial nerve (CN) is being evaluated when patients are instructed to shrug their shoulders?

A female patient diagnosed with emphysema 5 years ago has been taking budesonide with formoterol (Symbicort) twice daily. The nurse practitioner is concerned about the patient’s risk for bone fractures. Which assessment finding indicates that the patient should be prescribed supplements?

A 65-year-old male patient with a body mass index (BMI) of 30 and a history of asthma has hypertension that has been well controlled with hydrochlorothiazide (Dyazide) 12.5 mg PO daily. His total cholesterol is 230 mg/dL. How many risk factors for coronary artery disease (CAD) does the patient have?

According to the U.S. Preventive Services Task Force (USPSTF), which of the following tests should be used to screen for lung cancer?

A 21-year-old female patient complains of a 1-week episode of dysuria, frequency, and a strong odor to her urine. This is her second episode of the year. The previous urinary tract infection (UTI) occurred 3 months ago. What is the most appropriate follow-up for this patient?

In the majority of children, the first permanent teeth start to erupt at age 6 years. Which of the following are the first permanent teeth to erupt in this time period?

The nurse practitioner notes a high-pitched, blowing pansystolic murmur while assessing a 70-year-old male patient. It is grade 2/6 and is best heard at the apical area. Which of the following is most likely?

A 13-year-old girl has a throat culture that is positive for strep throat. She reports that her younger brother was recently diagnosed with strep throat and treated. The patient has a severe allergy to penicillin and reports that erythromycin makes her very nauseated. Which of the following antibiotics is the best choice?

A 76-year-old female patient reports that for the previous 4 months, she has noticed severe stiffness and aching in her neck and both shoulders and hips that is worsened by movement. She reports having a difficult time getting out of bed because of the severe stiffness and pain. It is difficult for her to put on a jacket or shirt or fasten her bra. Along with these symptoms, she also has a low-grade fever, fatigue, loss of appetite, and weight loss. Starting yesterday, the vision in her right eye has progressively worsened. She has annual eye exams and denies that she has glaucoma. Which of the following conditions is most likely?

Which of the following is a nonstimulant drug that may be prescribed for treatment of attention deficit hyperactivity disorder (ADHD)?

A female multigravida patient who is at 34 weeks’ gestation wants to know at what level her uterine fundus should be. The best answer is to advise the patient that her fundus is:

When the nurse practitioner is evaluating a patient for intermittent claudication, they would first:

A 40-year-old female nurse complains of a new-onset back pain secondary to her job on the medicalsurgical floor of a hospital. She reports lifting some patients while working the previous night shift. She reports to the workers’ compensation clinic where she was referred. She describes the pain as starting in her right buttock area and radiating down the back of her thigh. It becomes worse when she sits down for long periods. The nurse practitioner suspects:

A sexually active 16-year-old female patient is brought by her parent for a physical exam. During the exam, the nurse practitioner notices some bruises on both breasts. What area has the lowest priority for evaluation during this visit?

Which of the following agents are most likely to cause negative outcomes in the elderly population?

A 5-year-old patient is in the office for a school physical. The child is up-to-date on immunizations, and the parent denies a history of chickenpox infection. Which of the following immunizations are indicated at this visit?

What is the diagnosis for the skin lesion shown in the following photograph?

A 65-year-old patient with a history of chronic obstructive pulmonary disease related to a 45 packyear smoking history presents with lower back ache, frequency of urination, and “sometimes pink-tinged” urine. The urine dipstick test is heme positive. The nurse practitioner will order:

Which of the following accurately describes the role of health insurance marketplaces established under the Affordable Care Act (ACA)?

A 40-year-old male patient complains to the nurse practitioner of severe stabbing pains behind his left eye for the past 2 days. They are accompanied by some nasal congestion and rhinorrhea, which is clear in color. The patient denies pharyngitis and fever. Which of the following conditions is most likely?

Which of the following factors increases the risk of mortality for patients diagnosed with bacterial pneumonia? (Select all that apply.)

A middle-aged female patient who works in the housekeeping department of a hospital presents to the employee health clinic with a complaint of a needlestick to her left thumb. The needle was in one of the garbage bags from the ED. The patient had a little bleeding that stopped spontaneously. Which of the following is the next step?

. The nurse practitioner (NP) can treat which patient in the absence of parental consent?

An elderly patient has a positive polymerase chain reaction for varicella-zoster virus and has a recent history of breast cancer. What interventions should be included in the treatment plan? (Select all that apply.)

A 65-year-old male patient presents to the clinic complaining of random and recurrent episodes of dizziness with nausea. The patient describes it as the sensation of the room “moving” or “spinning.” It is worsened by sudden head movement. During the episodes, he becomes very nauseated. He also has tinnitus with hearing loss in his right ear. The patient has type 2 diabetes and is on a prescription of metformin 500 mg orally twice daily and an angiotensin-converting enzyme (ACE) inhibitor. The blood glucose level during his visit is 80 mg/dL. Which of the following conditions is most likely?

A 36-year-old female patient is seen by the nurse practitioner for a Pap smear and gynecologic exam. The patient is of Ashkenazi Jewish ethnicity. Her mother died of breast cancer at age 50 years, and her sister has recently been diagnosed with breast cancer. The breast exam is negative for a dominant mass, and the axillae do not contain any masses. Which of the following is an appropriate breast cancer screening regimen?

Which of the following viral infections is associated with occasional abnormal forms of lymphocytes during an acute infection?

An infant who does not have a history of reactive airway disease and allergy has both inspiratory and expiratory wheezing accompanied by fever and profuse, clear nasal discharge. Which of the following is most likely?

Three days after delivering a healthy baby girl, a woman calls the office with concern that her daughter’s vagina is swollen with a small amount of bleeding. The nurse practitioner will:

Which of the following drugs can increase the risk of bleeding in patients who are receiving anticoagulation therapy with warfarin sodium (Coumadin)?

An elderly man is diagnosed with conductive hearing loss in the left ear by the nurse practitioner. Which of the following is the expected result when performing a Rinne test on this patient?

A 3-year-old male toddler was seen in the office 8 days ago and prescribed amoxicillin 200 mg orally (suspension) three times daily x 10 days for strep throat. He presents for a follow-up visit with fatigue, reduced appetite, and dark-colored urine. A urine dipstick test reveals protein, albumin, and blood in the urine. Which test will the nurse practitioner order next?