28 Jan meatus of your patient’s ear.

Question 1.Question : 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.Question : 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.Question : 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.Question : 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

Diamox

Promethazine

Question 5.Question : 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.Question : Inattention and a sleep-wake cycle disturbance are the

hallmark symptoms of?

Dementia

Alzheimer’s disease

Parkinson’s disease

Delirium

Question 7.Question : 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.Question : 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?

Student Answer:

NSAIDs

NSAIDs

Beets

Vitamin A

Red meat

Question 9.Question : 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.Question : Which of the following conditions is associated with

cigarette smoking?

Glaucoma

Increased sperm quality

Bladder cancer

Eczema

Question 11.Question : A chronic cough lasts longer than:

3 weeks

1 month

6 months

1 year

Question 12.Question : The ‘freezing phenomenon’ is a cardinal feature of?

Parkinson’s disease

Alzheimer’s disease

A CVA

Bell’s palsy

Question 13.Question : When administered at the beginning of an attack, oxygen

therapy may help this kind of headache?

Tension

Migraine

Cluster

Stress

Question 14.Question : 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.Question : 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.Question : 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.Question : 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.

fungal colonies.

Increase the dose of antibiotic.

Order a cytoscopy.

Order a different antibiotic.

Question 18.Question : 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.Question : 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.Question : 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.Question : A blood pressure (BP) of 150/90 is considered:

Stage 2 hypertension

Stage 2 hypertension

Hypertensive

Normal in healthy older adults

Acceptable if the patient has DM

Question 22.Question : 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.Question : 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.Question : 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.Question : The hallmark of an absence seizure is:

Question 25.Question : 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.Question : Which medication used for scabies is safe for children 2

months and older?

Permethrin cream

Lindane

Crotamiton lotion and cream

Ivermectin

Question 27.Question : 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.Question : 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.Question : How often should drug levels be monitored when a seizure

Question 29.Question : 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.Question : Immunizations are an example of which type of prevention?

Primary

Secondary

Tertiary

Question 31.Question : 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.Question : Which cranial nerve is affected in a patient with a

cerebrovascular accident who has difficulty chewing?

CN V

CN VII

CN IX

CN X

Question 33.Question : 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)

Urine tumor marker (NMP22)

Question 34.Question : The “B” in the ABCDEs of assessing skin cancer represents:

Biopsy

Best practice

Boundary

Border irregularity

Question 35.Question : 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.Question : Which high-density lipoprotein (HDL) level is considered

cardioprotective?

Greater than 30

Greater than 40

Greater than 50

Greater than 60

Question 37.Question : The most common cause of CAP is?

Streptococcus pneumoniae

Klebsiella pneumoniae

Legionella pneumoniae

Pseudomonas aeruginosa

Question 38.Question : Sandra has palpitations that occur with muscle twitching,

Question 38.Question : 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.Question : 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.Question : 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.Question : 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.Question : 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.Question : 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.Question : Which of the following is an example of sensorineural

hearing loss?

Perforation of the tympanic membrane

Otosclerosis

Cholesteatoma

Presbycusis

Question 45.Question : Which of the following is “a linear crack extending from the

epidermis to the dermis?”

An ulcer

A fissure

Lichenification

An excoriation

Question 46.Question : A 65-year-old man presents to the clinician with complaints

Question 46.Question : 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.Question : 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.Question : 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.Question : 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?

making it a good diagnostic test?

B-type natriuretic peptide

C-reactive protein

Serum albumin

Erythrocyte sedimentation rate

Question 50.Question : 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