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1. Nursing Paper

The first step of the EBP process is to develop a question from the nursing practice problem of interest.

Select a practice problem of interest to use as the focus of your research.

Start with the patient and identify the clinical problems or issues that arise from clinical care.

Following the PICOT format, write a PICOT statement in your selected practice problem area of interest, which is applicable to your proposed capstone project.

Conduct a literature search to locate research articles focused on your selected practice problem of interest. This literature search should include both quantitative and qualitative peer-reviewed research articles to support your practice problem.

The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts.

Suggestions for locating qualitative and quantitative research articles from credible sources:

  1. Use a library database such as CINAHL Complete for your search.
  2. Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.
  3. When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.

To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

2. CMIS 320 project

In this assignment you will perform the physical design and implementation using SQL Data Definition Language (DDL) and proceed with populating the Mom and Pop Johnson Video Store database via Data Manipulation Language (DML) SQL commands. 

For each of the steps below you may create a separate SQL script file and SPOOL file or you may want to put the SPOOL output for several steps, from the same SQL script file, in the same file.  Be sure your SPOOL file(s) contains your SQL statements along with the Oracle responses and/or displayed results.  Do NOT submit your SQL script files.  Only submit your output SPOOL files.

Assignment Details

1) Create Oracle database tables using SQL Data Definition Language (DDL) for each table listed in the metadata of Project 2.  You may need to use a combination of DROP TABLE, CREATE TABLE, and ALTER TABLE SQL statements.  Make sure that entity and referential integrity are enforced by declaring a primary key for each table (these may be composite keys) and declaring all appropriate foreign keys. Your CREATE TABLE and ALTER TABLE statements (if desired) must show integrity constraints, as appropriate, for NOT NULL, UNIQUE, PRIMARY KEY, FOREIGN KEY, REFERENCES, and CHECK constraints. Be sure to save your SQL script file used to create these tables with a .sql extension and your output SPOOL file with a .lst or .txt extension.  You should rerun and test your SQL script file until it runs without any errors (this is why you’ll want to include DROP TABLE statements).  Submit your SPOOL file showing that all SQL in your SQL script file worked properly.

2) Populate each of your tables with at least five valid rows of data each and show the SQL INSERT statements as you executed them. Populate other tables in your database, as necessary, to satisfy referential integrity. Save your SQL script file and SPOOL file with the correct extensions.  You should test and rerun your SQL script file until it runs without any errors.  Submit your SPOOL file showing that all SQL in your SQL script file worked properly.

3) Develop an SQL script file to perform the following queries and updates. You should test your SQL script file until it runs without any errors. 

  • Retrieve all of your customers’ names, account numbers, and addresses (street and zip code only), sorted by account number.
  • Retrieve all of the videos rented in the last 30 days and sort in chronological rental date order.  
  • Produce a list of your distributors and all their information sorted in order by company name.
  • Update a customer name to change their maiden name to a married name. You can choose which row to update.  Make sure that you use the primary key column in your WHERE clause to affect only a specific row.  You may want to include a ROLLBACK statement to undo your data update.
  • Delete a customer from the database. You can choose which row to delete. Make sure that you use the primary key column in your WHERE clause to affect only a specific row.  You may want to include a ROLLBACK statement to undo your data deletion. 

Submit your SPOOL file(s) showing that all SQL in your SQL script file worked properly.  Show the actual SQL statements executed and the results the SQL produced below the code by making sure that you have a SET ECHO STATEMENT in your SQL script file(s).  

3. Liberty HIEU 201 History of Western Civilization Evaluative Essay 1 & 2 Thesis Statement

Evaluative Essay Instructions

Purpose

  • To evaluate an historical theme using assigned sources for support.
  • To compose a properly formatted, scholarly paper, using the most recent edition of Turabian, Notes-Bibliography.

General Directions:

For this assignment, students will choose 1 historical theme from the list below to research throughout the course:

  • Religion/Philosophy
  • Literature
  • Law
  • Science/Medicine/Technology
  • Economy/Labor

Students will write 2 analytical essays on their chosen theme, using the primary sources and topic prompts within the additional documents.

In Week 3, students will submit a thesis statement for Evaluative Essay 1 to the instructor for review. This pre-submission of the thesis statement will not be required for Evaluative Essay 2.

Evaluative Essay 1 will cover the period from 3000 BC through AD 476. It is due in Week 4.

Evaluative Essay 2 will cover the period from 476-1640. It is due in Week 7.

Specific Requirements:

The evaluative essay will consider assigned sources on the chosen theme, and evaluate those sources using the topic prompt provided in the additional documents for this assignment.

Format, Length and Organization:

  • Length: 750-1100 words (roughly 3-4pages, double spaced – not counting footnotes)
  • Double spaced text, Times New Roman, size 12 font, standard margins and indentation (see Turabian: Notes-Bibliography)
  • The paper should have a title page, body, and bibliography page
  • Using Turabian Notes-Bibliography style, format footnotes for the paper.
  • Basic Organization (except literature topic, given in literature document): The paper will consist of an introduction, body and conclusion:
    • Introduction should be one paragraph and should introduce the main argument, ending with a strong thesis statement. The thesis statement is the ONE SENTENCE argument.
    • Body of the paper is a few paragraphs (3-4) developing and supporting the argument, showing comparison and contrast of the assigned documents, as well as further analysis and Biblical evaluation. The body of the paper should provide specific examples and details from the assigned sources.
    • Conclusion is the final paragraph, restating the argument and summarizing the main points of the paper, drawing conclusions for the reader. No new information.

Sources:

  • The textbook and lectures can be used for basic background information, but the majority of supporting details should be drawn from the assigned sources within each topic document.
  • For Biblical analysis, you can use your own Bible, or one of the following websites for finding and using Scripture verses. Please note that you need to use a standard translation (such as KJV or ESV) and not a paraphrase Bible (such as the Message).

            www.biblegateway.com

            Srong’s Exhaustive Concordance https://books.google.com/books?id=3TBGAQAAMAAJ&printsec=frontcover&dq=strong%27s+exhaustive+concordance+of+the+bible&hl=en&sa=X&ved=0ahUKEwifx7zyxZHXAhXFPCYKHQwRBc0Q6AEIKDAA#v=onepage&q&f=false

Source Citation Examples:

      Note that no citation is needed for common knowledge information, but specific examples, details, or arguments drawn from the assigned sources DO need proper source citation.

                             Martin Luther nailed the 95 Theses to the door of the Wittenburg Church in 1517. (common knowledge, no specific citation needed)

                             The Hebrew Old Testament is considered to be a book of folklore, myths and stories that is useful for some understanding of Hebrew history, but not always reliable as an historical source since it was written by religious devotees rather than historians.[1] – citation needed because this expresses a specific view or argument.

**If you are unsure of whether or not a citation is needed, it is better to include the citation than to leave it out. You can also contact your instructor for assistance.

4. Management Book Reactions:

Students will find two to three compelling items within the book and tie it back into what has been learned in the course. The book reactions should be a minimum of 2 pages (writing should run onto page three) double spaced with 1” margins and 12-point font. Feel free to agree or disagree with what was presented in the books, but make sure to support your argument with information. Long headers at the beginning of the submission will NOT count towards your page length.

5. I need an essay to be written over the specified case study. I have attached the case study along with the directions.

Instruction

Write a two- to three-page essay. Double spaced, 12-pt font. Identify and discuss 5 nutrition related problems or potential nutrition problems in the Davis family. Offer recommendations for dealing with the nutrition issue in the context of the current crisis situation. Use your text book, the PPT lectures, previous case studies and assignments, reliable websites, and your own critical thinking skills. No references required.

6. Your Smallville client has asked you to gather details to meet IT audit requirements to determine whether IT services meet the organization’s objectives. Prepare a report for your Smallville client on IT audit objectives, risk assessment, and what help you may need from them to complete this task. Review the Gail Industries Case Study.

Instruction

Write a 3- to 4-page report or create a 12- to 16-slide media-rich presentation with speaker notes in which you: Describe the reasons it is important to conduct periodic reviews of information systems to determine whether they continue to meet the organization’s objectives. Discuss the importance of the organization’s policies and practices as they relate to information systems and IT infrastructure. Identify strategic and operational objectives for planning for the audit. Evaluate different risk assessments techniques and monitoring tools to consider during an audit process. Note: You are preparing for a systems audit, not a financial audit. Frame your analysis around the systems, not the accounting or finance aspects directly. Format citations according to APA guidelines.

7. 10 page Term Paper Greenhouse Gas Emissions and Impact on Climate Change

Instruction

Details of the Paper: Prepare a 10-15 page paper in Microsoft Word (counts as 15% of the final grade) in APA format (see writing expectations in the Policies section) (350 words per page). At a minimum include the following: References (minimum of 10) You may use resources from the APUS Online Library, any library, government library, or any peer-reviewed reference (Wikipedia and any other publicly-reviewed source is not accepted). The paper must by at least 10 pages double-spaced, 1″ margin all around, black 12 point fonts (Times New Roman or Arial) with correct citations of all utilized references/sources, (pictures, graphics, etc are extra – allowed but extra for the minimum page count). The title page and references are also required but don’t count in the minimum page count. A minimum of 10 references are needed. The paper will be subjected to checking against plagiarism. The paper must follow acceptable originality criteria (no more than 15% max total, and 2% per individual source match are allowed). Save the file using the following file naming convention: ITMG481_Project_First_Last.doc(x) (where first and last are your first and last names resp.) and submit the file in this assignment area. Turnitin.com has been enabled for this assignment so remember that your submission’s file type must be either doc or docx Outline and Topic are attached. Paper needs to follow the outline provided as well as include the references already provided.

8. Service and Contracts

Description

  • Analyze how physicians and hospitals have negotiated service contracts with third party payers.
  • Discuss how fee for service versus managed care models of reimbursement have contributed risk avoidance in their contract negotiations.
  • Recommend future strategies for physicians and hospitals to effectively negotiate service delivery contracts. Base the recommendation on your research and readings.

The paper must be formatted as follows:

  • 3–5 pages of text, double spaced.
  • A minimum of 6–8 outside references required.
  • Citations must appear within the body of your paper to correspond with the references listed at the end of the paper (i.e., if the resource is included in your Reference List, the resource must be cited in your paper).
  • Use Times New Roman 12-point font.

9. Success Factors in Virtual Collaboration

Description

Overview

Write a 7–10 page analysis of how the practices of your own organization (or another organization with which you are familiar) influence the success of its virtual teams.

You will benefit from taking a close look at how your own organization fares in terms of addressing critical success factors for virtual teams, as well as from building an understanding of the skills needed to participate successfully in virtual team collaboration.

Preparation

In their seminal work, Mastering Virtual Teams (2011), Duarte and Snyder identify seven critical success factors in virtual team collaboration:

1. Human resource policies.
2. Training and development.
3. Standard organizational processes.
4. Communication and collaboration technology.
5. Organizational culture.
6. Leadership.
7. Competence (p. 10).

Note: You should be able to find a number of resources that address these critical success factors through your research for this assessment.

To prepare for this assessment, research the seven critical success factors in virtual team collaboration. Consider your own real-world experiences with these factors in the workplace.

Deliverable

This assessment incorporates multiple elements. Be sure to thoroughly address each before submitting the assessment.

Use the seven critical success factors to analyze how the practices of your own organization (or another organization with which you are familiar) influence the success of its virtual teams. Base your analysis on your own experience of being a member of a virtual team within the organization.

Note: If you have not participated in a virtual team, base your analysis on a hypothetical virtual team experience, using what you know of your organization’s practices.

In developing this case, it is helpful to assume that you have been tasked by executive management to conduct an audit of your organization’s ability to support virtual team collaboration. Your audit will include a detailed report in each of the seven critical success factors. Go beyond a description of the “as-is” state for each of these factors in your audit to evaluate and analyze each of the factors to identify strengths, weaknesses, opportunities, and threats that the current state presents to the organization in terms of its ability to support virtual team collaboration.

Remember that the executive management of your company is not interested in a report about the criteria themselves—they are not interested in reading about human resource policies in the abstract, for example—but about how the organization measures up to the criteria. Use the success factors to analyze the organization—do not fall into the trap of writing about the criteria. Use the criteria to describe, analyze, and evaluate the organization.

Explain how organizational practices influenced (or might influence) the virtual team’s performance. Address all of the following:

Human resource policies: Do the organization’s career development resources address the needs of virtual team members? Does the organizational reward system recognize the efforts and successes of those who work virtually? Are rewards given only for results, or are they also given for effort? Does the organization actively support work arrangements such as telecommuting?
Training and development: Is there access to technical training for virtual team members? Is there access to training in the area of working across cultures? Is there a program of ongoing training as needed? Is there a system for sharing what has been learned, such as a database?
Standard organizational processes: Are there standard technical processes used throughout the organization (with regard to virtual teams)? Are there standard soft processes used throughout the organization? Does the organization support the ability to adapt processes when necessary? Does the organizational culture support shared ways of doing business across teams?
Communication and collaboration technology: Are there consistent standards for electronic communication and collaboration tools across the organization? Does the organization possess or provide enough resources to purchase and support state-of-the-art electronic communication and collaboration technology? Do all employees (across departments and geographic location) have equal access to electronic communication and collaboration technology?
Organizational culture: Is there trust between the organization, its partners, and other external stakeholders? Are teamwork and collaboration standard practices? Are people from different cultures valued?
Leadership: Do leaders allocate enough resources for the training and technology needed by virtual teams? What level of expectation do leaders set for virtual team performance? Do leaders model exemplary behavior by working across boundaries and using technology effectively?
Competence: Are team leaders experienced with working in virtual environments? Are team members experienced with working in virtual team environments? Are team leaders experienced in working across both organizational and cultural boundaries? Are team members experienced in working across both organizational and cultural boundaries?
Support your analyses with real examples, as well as evidence from your research and readings.

Additional Requirements

Ensure written communication is free of errors that detract from the overall message and quality.
Your report should be 7–10 content pages, in addition to a title page and references page.
Use 12-point, Times New Roman.
Use at least three scholarly resources.
Follow APA rules for attributing sources that support your analysis and conclusions. As a reminder related to using APA rules to ensure academic honesty:
When using a direct quote (using exact or nearly exact wording), you must enclose the quoted wording in quotation marks, immediately followed by an in-text citation. The source must then be listed in your references page.
When paraphrasing (using your own words to describe a nonoriginal idea), the paraphrased idea must be immediately followed by an in-text citation and the source must be listed in your references page.

Suggested Resources
The following optional resources are provided to support you in completing the assessment or to provide a helpful context.
Purvanova, R. K. (2014). Face-to-face versus virtual teams: What have we really learned? The Psychologist-Manager Journal, 17(1), 2–29.

10. 9-4 Assignment: DMADV for New Housing at the University of Miami

Assignment

 Updated

Read the case study about using the DMADV approach for designing new housing at the University of Miami. Write a paper of two to four pages detailing the DMADV steps for designing a new product/process at your firm. Your approach to designing the new product/process at your firm should be similar to that in this case study. Cite your sources in the APA format.

For additional details, please refer to the Short Paper and Case Study Rubric document.

 9-5 Course Project: Submit for Grading

Assignment

For additional details, please refer to the Course Project Guidelines and Rubric document

11. Physics Word Problem

A man is 2,000 m from the base of a tower and is launching a rocket in the direction of the same tower. When the rocket takes off the change in the angle between the flight path and the land is represented by Φ(t) according to time. Knowing that Φ'(t) = Π/3, determine: 

 1. The height of the rocket when Φ = Π/3 radians. 

Please explain how you arrived at your answer. 

12. Which formula should be used to determine the total cost?

The wedding photographer for the Smith/Jones wedding charges $1,000 for her preparation and first 60 prints. The cost is $2.00 per photo for photos beyond the first 60. Which formula should be used to determine the total cost, C, as a function of the number of photos, p, that are purchased, assuming at least 60 are purchased? 

a. C = 1000 p + 2 

b. C = 1000(2p – 60) 

c. C = 1000 + 2(p – 60) 

Please explain your answer.

13.  Philip and Claire are married and file a joint

Question

Individual Tax Return Problem 4

Required:

         Use the following information to complete Phillip and Claire Dunphy’s 2017 ­federal income tax return. If any information is missing, use reasonable ­assumptions to fill in the gaps. Ignore the alternative minimum tax for this ­problem.

         Any required forms, schedules, and instructions can be found at the IRS website (www.irs.gov). The instructions can be helpful in completing the forms.

 Facts:

     Phillip and Claire are married and file a joint return. Phillip is self-employed as a real estate agent, and Claire is a flight attendant. Phillip and Claire have three ­dependent children. All three children live at home with Phillip and Claire for the entire year.

     The Dunphys provide you with the following additional information:

        The Dunphys do not want to contribute to the presidential election campaign.

        The Dunphys live at 3701 Brighton Avenue, Los Angeles, California 90018.

        Phillip’s birthday is 11/5/1971 and his Social Security number is 321-XX-5766.

        Claire’s birthday is 5/12/1974 and her Social Security number is 567-XX-1258.

        Haley’s birthday is 11/6/2005 and her Social Security number is 621-XX-7592.

        Alex’s birthday is 2/1/2007 and her Social Security number is 621-XX-8751.

        Luke’s birthday is 12/12/2011 and his Social Security number is 621-XX-9926.

         The Dunphys do not have any foreign bank accounts or trusts.

     Claire is a flight attendant for Western American Airlines (WAA), where she earned $57,000 in salary. WAA withheld federal income tax of $6,375, state income tax of $1,800, Los Angeles city income tax of $675, Social Security tax of $3,600, and Medicare tax of $825.

     Phillip and Claire received $300 of interest from State Savings Bank on a joint ­account. They also received a qualified dividend of $395 on jointly owned stock in Xila Corporation.

    Phillip’s full-time real estate business is named “Phillip Dunphy Realty.” His ­business is located at 645 Grove Street, Los Angeles, California 90018, and his ­employer identification number is 93-3488888. Phillip’s gross receipts during the year were $730,000. Phillip uses the cash method of accounting for his business. Phillip’s business expenses are as follows:

    Advertising                                    $ 5,000

    Professional dues                          800

    Professional journals                   200  

    Employee wages                              48,000

    Insurance on office contents                   1,120

    Accounting services                                    2,100

    Miscellaneous office expense                   500

    Utilities and telephone                              3,360

    Payroll taxes                                              3,600

    Depreciation To be calculated

    On March 20, Phillip moved his business out of the old offices at 1103 Allium Lane into a newly constructed and equipped office on Grove Street. Phillip sold the old office building and all its furnishings. Phillip’s expenditures for the new office building are as follows:

    Date Acquired              Asset     Cost

    3/20                               Land      $   300,000

    3/20                 Office building       2,500,000

    3/20                 Furniture                  200,000

    4/1             Computer system        350,000

    6/1                   Artwork                    150,000

    Phillip computes his cost recovery allowance using MACRS. He would like to use the §179 immediate expensing, but he has elected to not claim any bonus depreciation. Phillip has never claimed §179 or bonus depreciation before. The assets Phillip sold on March 20 are as follows:

    Date Acquired              Asset                    Sales Price      Original Cost      Accumulated Depreciation as of Beginning of the Year

    5/1/11                 Office building               $940,000                $900,000                   $129,825

    5/1/11              Land                                  200,000                   100,000                             0

    7/1/11              Furniture                           50,000                                  239,000                          206,998

    8/13/13            Furniture                           10,000                                  324,000                         222,782

    4/12/14            Office equipment            100,000                  120,000                           67,524     5/13/15           Computers                       30,000


[1] Marvin Perry, et.al., Western Civilization Vol. 1, MindTap edition, 2-1c. (Note that this is short-form)

    Phillip has never sold any assets relating to his business before this transaction.

   The Dunphys sold 60 shares of Fizbo Corporation common stock on September 3 for $65 a share (minus a $50 total commission). The Dunphys purchased the stock on November 8, 2016, for $90 a share. They also sold a painting for $13,000 on March 1. Claire purchased the painting for $20,050 on September 1, 2010, as an investment.

   The Dunphys filed their 2016 federal, state, and local returns on April 13, 2017. They paid the following additional 2016 taxes with their returns: federal income taxes of $630, state income taxes of $250, and city income taxes of $75.

   The Dunphys made timely estimated federal income tax payments of $17,000 each quarter during 2017. They also made estimated state income tax payments of $1,000 each quarter and estimated city income tax payments of $300 each quarter. The Dunphys made all fourth-quarter payments on December 31, 2017. They would like to receive a refund for any overpayments.

    Phillip and Claire have qualifying insurance for purposes of the Affordable Care Act (ACA).\

14. Facilities Management

As the manager of a resort hotel with 500 guest roomsyou are concerned with your monthly water and sewage bill.   The water company uses the graduated billing schedule listed below. Your operation is currently using 2,500,000 gallons of water per month. It is time to replace your 3.6 gallon per flush toilets and you initially decided to install 1.8 gallons per flush high efficiency toilets.  The toilet salesperson is recommending that you install anultra-high efficiency model that used 0.9 gallons per flush.  The ultra-high efficiency toilets will cost you $250more than the high efficiency toilets per toilet, installed. Based on information your chief engineer found, you estimate that on average every toilet in an occupied room is flushed 10 times per day.  Your average annual occupancy rate is 91.0747%.Assume 30.5 days per month when calculating your monthly water savings.  Based on the information above and the rate scale below,your ultimate goal is to determine if it is more cost effective to install the ultra-high efficiency toilets?

Water rates:  monthly charge of $150.00 per month plus usage charge base on the rates listed below.

            Amount of water used                                    Rate per 1000 gallons

            First 100,000 gallons                           $6.00

            Next 500,000 gallons                          $5.00

            Next 1,000,000 gallons                                   $4.00

            Anything over 1,600,000 gallons                    $2.00

Sewage rates: monthly charge of $200.00 per month plus usage charge based on the total water used.

            Amount of sewage produced =           Total water used minus deduct meter          

Rate per 1000 gallons is $10.00

            Deduct meter shows a monthly average of 125,000 gallons

Water and sewage rates are expected to rise at the same rate,2.0202% per month. The owners of the operation expect a monthly rate of return on their investment of at least 1.0%. Assume that the toilets will last for 30 years. Assume that you will take out a loan for the toilets.  You must pay 10% down make payments at the end of each month until the remainder has been paid off, 72 month.  The nominal annual interest rate for the loan is 3.99%. The equation for converting a nominal annual rate to a monthly rate is:

            imonthly = (1 + iannual)(1/12) -1

The equation to calculate the monthly payment is:

Monthly loan payment = (total cost – down payment) * (imonthly * (1 + imonthly)n) / ((1 + imonthly)n -1)

The equation for the effective monthly interest rate is:

ieffective = ((1 + inominal) / (1 + Inflation)) – 1

The present value equations are:

PV = FV * (1 + i)-n

PV = A * (((1 + ieffective)n – 1) / (ieffective * (1 + ieffective)n))

Give the above information answer the following questions. You must show ALL your work to receive credit.

1.   How much will your water usage drop each month (to the nearest gallon) if you install the ultra-high       efficiency toilets compared to the high efficiency toilets?

      (type your answer here)

2.   If your water usage is for the entire facility is projected to be 2,250,000 gallons if the high efficiency toilets are installed, how much water will be used each month by your entire facility if you install the ultra-high efficiency toilets?

      (type your answer here)

3.   If you install the ultra-high efficiency toilets, what will be your average monthly water and sewage bill (to the nearest dollar) for the entire facility?

      Water portion of the bill

      (Type stating amount here)

      100,000 x 6.00/1,000 =

      (Type stating amount – 100,000 here)

      500,000 x 5.00/1,000 =

      (Type stating amount – 600,000 here)

      1,000,000 x 4.00/1,000 =

      (Type stating amount – 1,600,000 here)

      (Type stating amount – 1,600,000 here) x 2.00/1,000 =

                    0

      Total water bill =

      Sewage bill =

      Total water and sewage bill =

4.   What is the projected savings on your water and sewage bill (to the nearest dollar) for the entire facilityin present value if you install the ultra-high efficiency toilets instead of the high efficiency toilets?  The projected monthly water and sewage bill if you add the high efficiency toilets will be $30,000. Make sure you calculate all interest rates to 4 significant digits, and write all percentages as decimals.

      Equation (variables only): PV =

            A =

            n =

            ieffective =

      PV =

      PV =

5.   How much more will it cost to install the ultra-high efficiency toilets compared to installing the high efficiency toilets in present value will it cost (to the nearest dollar) for the new toilets, installed?   Make sure you calculate all interest rates to 4 significant digits, and write all percentages as decimals.

a.   What will be increase in total price for all the toilets installed if you install the ultra-high efficiency toilets compared to installing the high efficiency toilets (to the nearest dollar)?

            (type your answer here)

b.   How much more will the down payment be on the loan if you install the ultra-high efficiency toilets compared to installing the high efficiency toilets (to the nearest dollar)?

            (type your answer here)

c.   How much more will your monthly loan payment (to the nearest dollar) be if you install the ultra-high efficiency toilets compared to installing the high efficiency toilets?

(type your answer here)

d.   How much will the total cost (to the nearest dollar) in present value for the toilets installed increase if you install the ultra-high efficiency toilets compared to installing the high efficiency toilets?

      Equation (variables only): PV =

            A =

            n =

            ieffective =

      PV =

      PV =

6.   What will be your net savings if you install the ultra-high efficiency toilets compared to installing the high efficiency toilets?

      (type your answer here)

7.   Should you install the high efficiency or ultra-high efficiency toilets?

      (type your answer here)

15. Political Science and Policy response

Question

Assume that you are a Senator within your home state in which determinate sentencing is currently being practiced; however, you have introduced a bill to switch to indeterminate sentencing. What are some of the strengths of indeterminate sentencing that you could use to persuade your fellow senators?

16. Globalization in the role of Mass Media in Healthcare and Higher Education

Question

Students will write a paper analyzing the issues of the Globalization in the role of Mass Media in Healthcare and Higher Education. This paper should be 2000-2500 words. It should examine relevant professional issues and real-life dilemmas encountered by members of the topic. The paper should cite at least seven (7) current sources. 

APA Guidelines 

Time New Roman

12 pt, Double Spaced

17. BUILDING AN ETHICS-BASED WORKPLACE CULTURE

Question

Assignment Overview

Ethics Program Implementation

As you can see by your reading, a lot of energy goes into the implementation of an organizational ethics program. And Lockheed Martin has clearly allotted considerable resources to assuring their program is successful. In this assignment we’ll be focusing on what the company did to ensure the implementation of a successful program that was flexible enough to accommodate the changing needs of the organization.

Case Assignment

Please address the following questions: 

On p. 83 Terris discusses the company’s ethics code.  Why is the code considered important to the company’s ethics program? 

Discuss the importance of ethics training and employee involvement.  What are some of the things Lockheed does to make the training process interesting and worthwhile? 

How does Lockheed measure success with respect to ethics in the workplace?

What are some of the things Lockheed does at the operational level to make their ethics program work?

Assignment Expectations

Write a 4- to 5-page paper, not including title page or references page addressing the issue and upload it by the end of this module.

Your paper should be double-spaced and in 12-point type size.

Your paper should have a separate cover page and a separate reference page.  Make sure you cite your sources. 

Use APA style, and proofread your paper.

Upload your paper by the end of the module.

18. BUS ADM 600

Question

The analysis of strategy in the case of Wal-mart 2005.

(20 points)

Please summarize its company strategies with supporting activities at the corporate, business, andfunctional level.

Please state how the corporate level of strategy is connected to the business level. 

Stakeholder Theory of the Firm: Theory and Application

(20 points)

Describe the stakeholder theory for a RTE breakfast cereal firm. Who are the major external stakeholders? Who are the major internal stakeholders?

Imagine you are the CEO of a ready-to-eat breakfast cereal company such as General Mills. Recent research has linked diabetes to an artificial sweetener that your company has been using for the last decade. Please discuss the likely preference of each stakeholder group. Discuss how you will go about deciding whether to continue with the same artificial sweetener or to seek alternative yet more costly replacements.

External Analysis: Please describe Porter’s 5-Forces Model in the following order: Power of Suppliers, Power of Buyers, Substitutes, Barriers to Entry, and Price Rivalry from the perspective of Coke and Pepsi concentrate producers.

(25 points, 5 points for each force)

For each force be sure to indicate if the power is HIGH, MODERATE or LOW.

Please be sure to defend your assessment of each force with evidence.

Internal Analysis: please list what resources and capabilities qualify as VRIO for the case of Wal-mart 2005? (20 points)

Please first describe the question of value, rarity, imitability, and organization.

Please list the resources and capabilities that you identify from Wal-mart under each of the question of VRIO model.

Internal Analysis: Please provide a Value-Chain analysis for the company of Coca-Cola.

(15 points)

Please list the primary activities in value chain for a soft drink company such as Coco-Cola.

Please indicate whether those primary activities were conducted internally or outsourced. If outsourced (at certain times or in certain regions), please state the rationale behind such decision.

BONUS QUESTION: Competitive Advantages – Value Chain and Economic Value Creation (10 points)

For Milwaukee Cheese Company, below are the breakdowns for its cheese production:

• Product priced at $20/pound 


• Raw materials cost $10/pound 


• Manufacturing cost $1/pound 


• Packaging cost $1/pound 


• Distribution cost $1/pound 


• Sales and Marketing cost $1/pound 


• Overhead allocation $1/pound 


• Production facility rent $3/pound 


• Employee pay $2/pound

Given the information above, please calculate Milwaukee Cheese Company’s Economic Value Creation. Please provide all of your work below in calculation.

19. Outline the cybersecurity issues and vulnerabilities of the petrochemical industry

Question

1. Outline the Cybersecurity issues and vulnerabilities of the petrochemical industry. Include in your answer specific actions required to improve the security profile of this industry.

2. Using Clarke’s assessment from chapter six of Cyber War: The Next Threats to National Security and What to Do About It, describe  America’s potential best scenario use of “Offensive Cyberwar” to attack other nation’s infrastructure. Feel free to provide ‘theoretical’ scenarios and war-gaming actions that would best serve our nation’s efforts for debilitating a foe’s national infrastructure.

 20. Starbuck Corporation Case Anaylsis

Question

This week, we will analyze a full-length case study, which is about Starbucks Corporation

With more than 25,000 stores in 75 countries and $21 billion in annual revenues, Starbucks is the largest roaster and retailer of specialty coffee in the world. Howard Schultz’s strategic leadership was critical in turning Starbucks around. He is now hoping that his second retirement from the company he built from the ground up will be his final one. In the meantime, Kevin Johnson,  the new CEO, faces several challenges. In particular, the question of maintaining core competencies and how to achieve future growth, both domestically and internationally is central to the case. The case also focuses on diversification, as Starbucks is branching out in new areas such as menu extensions including offering alcohol as well as rolling out coffee bars with high-end offerings such as a $12 cup of coffee.

 To-Do List – Week Six: All assignments are required.

  1. Read Overview of this case
  2. Reading Assignments:  Starbucks Corporation
  3. Full-length Case assignment: Read ‘Starbucks Corporation’ case, and think about the discussion

Discussion questions

  1. How did Starbucks create its uniqueness in the first place? Why was it so successful (until the mid-2000s)?
  2. Why and how did Starbucks lose its uniqueness and struggle in the mid-2000s?
  3. What strategic initiatives did Howard Schultz put in place to re-create Starbucks’ uniqueness after his return in 2008? Detail each strategic initiative. Explain why a specific strategic initiative was successful.
  4. Is Howard Schultz an effective strategic leader? Why or why not? Buttress your arguments.
  5. How is Starbucks trying to grow in the future? What are its biggest challenges?
  6. What recommendations would you give the new Starbucks CEO, Kevin Johnson, to address the challenges identified in Question 5? Be specific.

After reading the case, you are expected to submit a written analysis of the case which ranges from 3-5, typewritten, double-spaced pages. For the analysis, you should conduct additional research on the cases beyond the information provided in the case

*Note add references behind sentences that are used from other sites.

21. Sex Crime Statutes

Research your Louisiana government website to locate information on a recently adopted sex crime statue in this area.

Write a 550- to 700-word paper in which you do the following:

  • Provide a brief summary of the statute, including the intended category of sexual offense. Louisiana 
  • Explain how the statute could impact laws or enforcement in the area. 
  • Provide a brief history of other statutes that may have led to the creation of the current statute.
  • Describe the range of  punishments for violation of the law.
  • Explain whether the acts identified in the statute are acts that previously were considered      accepted practice.
  • Explain what made this statute a current precedent and if it was derived from a previous law.

Format your paper consistent with APA guidelines.

22. Analysis of Ground Rules

 Write a minimum of 3 pages with team experiences you have had in which a team was effective and another in which it was not. Write a description of these teams and their tasks, paying particular attention to the behavioral expectations for which the team members held each other accountable.

  • Describe how ground rules help an effective team perform and work well together.
  • Analyze prospective differences in ground rules for team members and tensions that may result.
  • Analyze how differences in unspoken ground rules and team members’ expectations cause conflict and damage performance.
  • Describe the effect of discussing ground rules as a method of team learning.
  • Analyze applications of change management principles.
  • Describe an effective team from a real-world experience, including the tasks of the team.
  • Describe the ground rules applied in an effective team.
  • Describe an ineffective team from a real-world experience, including the tasks of the team. Explain the spoken or unspoken ground rules that describe expectations for behavior in an ineffective team.

23. The Epic of Gilgamesh and Monkey

Compare the heroes as kings. Monkey as a king of the monkeys has some things in common with Gilgamesh as a king, e.g. a desire for immortality. When they are good kings,what virtues do they show?Is one of them better than the other? When they are not good kings, what feelings do they share? Who has the greatest flaws as a king?

Please use quotes from the text.

The paper should be in MLA guidelines and be around 1000-1250 words

24. Network Design Executive PowerPoint Presentation

In this assignment you are to submit the Network Design Executive PowerPoint Presentation for the term paper.

This is a persuasive Executive PowerPoint presentation of up to 15 slides that you will present to the Executive Committee of Fiction Corporation. 

The PowerPoint must include the following in accordance with Chapter 14 of the text:

1. Title page
2. Executive summary
3. Project goal
4. Project scope
5. Design requirements: 

a. Business goals
b. Technical goals
c. User communities and data stores

d. Network applications

6. Current state of the network
7. Logical design
8. Physical design
9. Results of network design testing
10. Implementation plan with a project schedule
11. Project budget with a return on investment calculation

Your assignment must follow these formatting requirements:

  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.

25. Managerial Accounting

Over the last 50 years the financial reporting systems have dramatically changed and will continue to change as the financial world faces changes such as globalization, changing regulations and the increased use of technology. The accounting profession must be ready to not only face these changes but to also adapt to them, providing relevant and reliable information to the many internal and external users of financial and managerial accounting reports.

It is important to understand the difference between managerial and financial accounting reports.

You are the chief executive officer of a multinational corporation that operates wholly owned subsidiaries in several countries. One of the company’s manufacturing plants is located in Europe. As CEO, respond to the following questions in 400-600 words:

  • What types of internal and external accounting reports will you use in the process of making decisions?  
  • How will the reports differ for a multi-national corporation?

26. Resistance and Communication – Walmart

Write a four to six (4-6) page paper in which you: (previous paper is attached)

  1. Diagnose the reasons for resistance to change.
  2. Interpret the potential causes of resistance in the organization (WALMART). Identify and describe three (3) potential causes of resistance to your change plan (better benefits and better training and development programs). Identify and describe three (3) potential sources of resistance to your change plan  (better benefits and better training and development programs).
  3. Create a plan for minimizing possible resistance to your change management plan.
  4. Elaborate on the relationship between resistance to change and communication.
  5. Evaluate three (3) communication strategies.
  6. Recommend one (1) communication strategy that would be applicable to your organization (WALMART). Diagnose why this communication strategy is best for your organization.
  7. Create a solid communication plan for your change initiative.
  8. Use at least four (4) quality academic resources in this assignment. Note: Wikipedia and other similar Websites do not qualify as academic resources.

Note: If you choose to submit a video presentation, please also submit a one (1) page summary of your presentation.

If you choose the written paper, your assignment must follow these formatting requirements:

  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
  • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

27. Fraud Prevention and Detection Plan

Scenario – You went back to your corporate controllership position with Dingwow Inc. Senior Management has assigned you as the team lead to develop a fraud prevention and detection plan for the company.

Use the Internet, to research the key elements of a fraud prevention and detection program, and prepare a plan.

Write an eight to nine (8 – 9) page paper in which you:

  1. Evaluate the key elements that should be included in the plan, including a justification as to how the element is likely to protect corporate assets and minimize risk based on your research.
  • Create an argument to be presented to the senior leadership in support of a fraud prevention and detection plan, indicating the consequences of failure to implement the plan. Provide support for your argument.
  • Create an approach to identify the roles and responsibilities of key personnel in the organization, indicating the significance of each role in the fraud prevention and detection equation. Provide support for your rationale.
  • Compare the roles of management, internal auditors, external auditors, governing bodies, and the board of directors, and assess how each can contribute to your fraud prevention and detection plan.
  • Evaluate the tools that you would propose to use to make your plan more effective in mitigating or eliminating fraud and how you would justify the risk / reward ratio of each tool recommended.
  • Prepare a fraud prevention and detection plan based on your findings, indicating how you would communicate the plan to employees throughout the organization.
  • Predict the future occurrences of corporate fraud and the likelihood that it will be detected by regulatory agencies based on your research. Provide support for your rationale.
  • Use at least five (5) quality resources in this assignment.

NOTE: Wikipedia and similar Websites do NOT qualify as quality resources.

Your assignment must follow these formatting requirements:

  • Be typed, double spaced, using Times New Roman font (size 12), with 1” margins on all sides; citations and references must follow APA
  • The cover page containing the title of the assignment, and the reference page are NOT included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

  • Create an approach to implementing a fraud detection plan.
  • Research and analyze the impact of fraud on financial reporting within a corporation.
  • Examine the role that corporate governance plays in preventing and detecting fraud.
  • Research and analyze the impact of fraud prevention and detection using forensic accounting practices.
  • Create strategies for communicating the prevention and detection of fraud.
  • Use technology and information resources to research issues in fraud prevention and detection.
  • Write clearly and concisely about fraud prevention and detection using proper writing mechanics.

28. Philosophical explication and analysis of the first chapter of “Being and Some Philosophers” by Etienne Gilson (refer to instructions for specifications).

Instruction

Prompt: The goal of this essay is to understand and explicate, in your own words, what Gilson has to say in the first chapter. This essay should explain the argument that Gilson makes and comment on the significance of his analysis. In your essay you will be expected to touch on the following three problems:

1. What does Gilson mean by the “existential neutrality” of our conceptual knowledge? How does this frame the problem that Gilson intends to study in “Being and some Philosophers”?

2. What is Parmenides’ answer to the question, “what is being”? How is Plato the heir and continuator of Parmenides?

3. How does plato give rise to the Neo-Platonic “metaphysics of the One”? What problems does such a metaphysics pose for a Christian thinker?

 Specifications:

This essay should be 6-8 pages (double spaced), 12 point in the “Times New Roman” font, with one inch margins, plagiarism free, and proofread. Helpful Tip: Gilson’s book is a philosophical analysis of the ways that various philosophers have understood the meaning of being in the Platonic tradition. His goal is to present not a history of metaphysics, but rather a thinking through of the views of several historical philosophers. 

29. ChE 230Problem Set 3

Optimization

  1. 75 Points. You are to optimize a series of two heat exchangers. The first heat exchanger uses low-pressure steam as a utility. The second heat exchanger uses medium-pressure steam. The third uses high-pressure steam. Together, the heat exchangers must bring a 1.5 kg/s stream of Dowtherm from 25C to 220C. Dowtherm has a heat capacity of 6.0 . Both types of steam enter as a saturated vapor and leave as a saturated liquid (so the utility stream does not change temperature). The following table summarizes the relevant properties:
  lps mps hps
Temp (C) 160 187 254
Cost $13.28/GJ $14.19/GJ $17.70/GJ

Heat exchangers are costed by their area. To determine the area, the following design equation must be used

Where  is the heat duty,  is the overall heat transfer coefficient (,  is the area of the heat exchanger, and  is the log-mean temperature difference.

See the following diagram for more information.

Description: Counter Flow Heat Exchanger LMTD

Heat exchangers are costed according to the following equation

 where A is area in m2.

Since there are two intermediate temperatures, this is a multivariable optimization. You are to optimize this system two ways:

Text Box: T_out=220℃
Text Box: T_2
Text Box: T_1
Text Box: T_in=25℃
Text Box: lps
Text Box: mps
Text Box: hps
  1. Set  , then minimize the EAOC with respect to using golden search. Once you get the optimal, keep that constant, and minimize the EAOC with respect to , again using golden search. Repeat this process once more to see if the optimal temperatures change. This is called a “greedy” optimization. (Greedy because you only look at one variable over all others at a time.) Was this technique effective for this system?
  2. Use a grid search to minimize the EAOC with respect to both temperatures simultaneously. You can then use solver or fmincon to see how closely the solutions match.

30. Self-Defense Essay for Criminal Law

Instruction

Instructions: You have been asked to give a lecture to a group of first-time gun owners about self-defense. Explain when force may be used in self-defense. What about deadly force? How will you instruct the session differently if you are in a stand-your-ground jurisdiction? -1000 word minimum, 1500 maximum length. -FORMAT: Set in APA or MLA format, typed in Times New Roman 12-point font, 1” margins, Double-spaced, Spell-checked, and Proofread. -Plagiarism will not be tolerated on any assignment. Always cite your sources. -No images. Create a successful academic prose that is readable, coherent, and grammatically appropriate for the college level. Begin by introducing the topic. (Introduction) You will then use a minimum of three (3) resources to gather facts about the topic. (Body) Finally, you will report your findings. (Conclusion)

31. Business

When a business is not focused on sustainability, value may be solely determined outside its customers’ interest in green behavior. Suppose a restaurant makes a great-tasting hamburger. Very few of its customers might care whether or not the restaurant engages in green business practices. However, what if there are two restaurants that make equally great-tasting burgers, but one is green while the other is not? Many customers may choose the green business, because the business adds value to its offerings by engaging in sustainable practices. In the case of sustainable products, meaning those products made with an effort to be environmentally and socially responsible, sustainability plays a large role in the customers’ decisions to buy, and tends to be central to the company’s brand.

Instruction

Identify a Saudi business that may not yet be focused on sustainability. Suppose this company decides it would like to deliver products that are more socially, environmentally, and economically superior. In a 4-5 page paper, not including the cover and reference pages, present the company with the total value proposition from a sustainability perspective. In that total value proposition, include a discussion of use values and nonuse values for the business’ green products. How should the business determine WTP, WTA, or consumer surplus? Your required readings this week provide insight which will aid you in your analysis. Make sure to cite and reference any information gleaned from those documents. Additionally, include two current and scholarly sources beyond the course materials and readings to support your analysis. Current sources are those published in the most recent five years. Scholarly sources come from peer’s reviewed journals. Use Saudi Electronic University academic writing standards and APA style guidelines, citing references as appropriate.

32. Capital Financing

Description

Does financial innovation in health care improve productivity and  consumer welfare the way technological innovation does? Why or why not?

33. Healthcare and Macroeconomics

Description

Which of the factors given below is more important in determining how much to spend on medical care:

  • How sick people are.
  • How much money is available.

Who should be determining which factor is more important? Why?

34. STAT 3502 C – Assignment 2 Carleton University Winter 2019

1. (5 points) Let X be a positive and continuous random variable for which E[X] exists. Show that: E[X] = Z ∞ 0 (1 − F(x))dx, where F is the cdf of X.

2. Customers arrive at a checkout counter in a department store according to a Poisson distribution. Let X be the number of customers arrivals during a one-hour period such that X ∼ P oisson(λ),

 (a) (4 points) Show that Var(X) = λ.

(b) Let λ = 7. During a given hour, what are the probabilities that:

i. (4 points) no more than three customers arrive?.

ii. (4 points) at least two customers arrive?.

 iii. (4 points) exactly five customers arrive?.

3. (6 points) Past experience shows that the number of accidents per month is modelled by a random variable N with p(n) = P(N = n) = 1/ (n + 1)(n + 2),

where n = 0, 1, 2, …. Calculate the probability of at least one accident during a particular month, given that there have been at most five accidents during that month.

4. (6 points) The annual rainfall (in inches) is normally distributed with µ = 40 and σ = 4. Assuming rainfalls are independent from year to year, what is the probability that starting with this year, it will take more than 10 years before a year occurs having a rainfall of over 50 inches?

 5. Headway time (HT) (in seconds) in a traffic flow (time elapsed between the passage by a fixed point of two successive cars) has pdf f(x) = αλα (λ + x) α+1 , where x ≥ 0, α > 0, and λ > 0.

 (a) (4 points) Check this actually is a pdf.

(b) (4 points) Compute HT’s cdf.

(c) Let α = 0.5 and λ = 10

 i. (4 points) What is the probability of HT above 7 sec.

ii. (4 points) What is the probability of HT between 2 and 6 sec?

iii. (5 points) Find an expression of the (100p)th percentile.

iv. (4 points) Find the HT’s median.

v. (4 points) 75% of the HT are below which value?

6. (6 points) * A baseball team has scheduled its opening game for April 1. If it rains on April 1, the game is postponed and will be played on the next day that it does not rain. The team purchases insurance against rain. The policy will pay 1000 for each day, up to 2 days, that the opening game is postponed. The insurance company determines that the number of consecutive days of rain beginning on April 1 is a Poisson random variable with mean 0.7. What is the standard deviation of the amount the insurance company will have to pay?

7. (6 points) Suppose you throw a die and say that you have success if you get 5 or 6. You want to get two such successes. What is the probability that you need exactly 10 tries for this?

8. Suppose that 25% of all students at a large public university receive financial aid. If 65 students are sampled,

(a) (5 points) What is the probability that at most 10 of them receive aid? (Use normal approximation to binomial).

(b) (5 points) What is the approximate probability that between 5 and 15 (inclusive) receive aid.

 9. In an assembly-line production of industrial robots, gearbox assembles can be installed in 1 minute each if holes have been properly drilled in the boxes and in 10 minutes if the holes must be redrilled. Twenty gearboxes are in stock, 2 with improperly drilled holes. Five gearboxes must be selected from the 20 that are available for installation in the next five robots.

 (a) (5 points) Find the probability that all 5 gearboxes will fit properly.

(b) (5 points) Find the mean, variance and standard deviation of the time it takes to install these 5 gearboxes. (Hint: Denote by X the number of improperly drilled gearboxes in the sample of 5, determine the distribution of X, and represent the total time as a function of X.)

10. (6 points) The number of years a certain type of TV functions is exponentially distributed with an average lifetime of 6 years. If Jones buys a used TV (3-year old, say), what is the probability that it will be working after an additional 6 years? (Comment: You will find that this probability is the same as the probability that the TV will function after 6 years from the beginning. That is, the TV does not actually get old. This is the so-called memoryless property of exponential distribution.)

Problems marked by a star are inspired from old actuarial exams.

35. ITS 835 Enterprise Risk Assessment

Final Research Paper

Write a research paper on the topic: What are the main drivers for successful ERM implementations in organizations?

Your research paper should be minimally 6 pages (double space, Font – Georgia with font size 12). The research paper needs to refer to the following sources

  • Rubino, M. (2018). A comparison of the Main ERM frameworks: Howq Limitations and Weakness can be Overcome Implementing IT GOvernance. Internation Journal of Business and Management, 13(12).
  • In addition the research paper needs to minimally refer to 3 peer reviewedq journal papers

The following case studies from your book need to be referenced in your research paper 

  • Chapter 30, “Alleged Corruption at Chessfield: Corporate Governance and theq Risk Oversight Role of the Board of Directors” 
  • Chapter 31, “Operational Risk Management Case Study: Bon Boulangerie”q
  • Chapter 34, “Turning Crisis into Opportunity: Building an ERM Program atq General Motors” 
  • In addition you need to refer to at least two other case studies that we haveq covered so far in the course

The research needs to minimally discuss the role of the following factors in successful ERM implementations 

  • Corporate governance
  • Risk frameworks such as COSO, ISO 31000q 
  • Information Technology
  • Operational factors

Please do not describe the case studies from the book but focus on elaborating on key points and examples from the case studies that support the research topic.

The bibliography should be included as a separate page and is not part of the 6 page requirement. Student assignments will be run through Safe Assignment. Please ensure to check the safe assignment result prior to submitting

36. HCM 4025

E-Prescribing

E-prescribing is the transmission of prescription or prescription-related information using electronic media between a prescriber, dispenser, pharmacy benefit manager, or health plan, either directly or through an intermediary, including an e-prescribing network.

In an effort to understand the benefits and cautions about e-prescribing, conduct thorough research. For your assignment, create a 4- to 5-page report in Microsoft Word document consisting of your research findings covering your responses to the following questions:

  • Evaluate three pros and three cons of e-prescribing.
  • Summarize the e-prescription standards as described by the National Council for Prescription Drug Programs.
  • Evaluate the projected cost and time savings as estimated by the United States Department of Health and Human Services.
  • Comment on the controversy surrounding the 2013 e-prescribing penalty.

Use the following resources, and 2 outside resources and your text book for this assignment.

Ratanawongsa, N., Lenny L. S. Chan, Fouts, M. M., & Murphy, E. J. (2017). The challenges of electronic health records and diabetes electronic prescribing: Implications for safety net care for diverse populations. Journal of Diabetes Research, 2017 doi:10.1155/2017/8983237

Juszczyk, D., Charlton, J., McDermott, L., Soames, J., Sultana, K., Ashworth, M., . . . Gulliford, M. C. (2016). Electronically delivered, multicomponent intervention to reduce unnecessary antibiotic prescribing for respiratory infections in primary care: A cluster randomized trial using electronic health records-REDUCE trial study original protocol. BMJ Open, 6(8) doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1136/bmjopen-2015-010892

Support your responses with examples in a 3-6 page APA formatted Word Document. Include an introduction and conclusion. Cite any sources in APA format.

37. M7a3

Assignment 3: Course Project Task XII

Final Submission

It’s now time to complete your dissertation paper. In the previous modules, you tried different statistical analyses as possible approaches for your final prospectus.

Now, submit your Final Prospectus Project including a cover page and the following subheadings:

An abstract of the prospectus project.

Introduction: A one-page overview of the background theory, definitions, and questions for the study.

Goals: A one-page summary of specific goals and hypotheses for the study.

Sampling and sample size: In one to two pages, describe your sample size and the sample. Address the following points:


Who, how, and how many?

How did you come to these decisions?

How does your proposed sample size relate to the planned power?

Operational definitions of variables included in your study, which are as follows.


Independent variables (IVs): What they are and how are they measured or defined in the actual research operations of your study? For example, what exactly are the treatments being compared? Give specifics of how they vary in such things as intensity, content, and length and cite supportive references for background information including the effect sizes. This will depend on the number and types of IVs and levels or categories of each.

Dependent variables (DVs): What they are and how are they measured in the actual research operations of your study? How was the measurement technique developed? What are the reliabilities, validities (citing supportive resources), and level of measurement of each measure? Is the resulting score a single item score or a composite score? How do you interpret the score? Are there norms available for interpreting the score? What were the known relationships between and among the measures prior to your data collection? Are there covariates (CVs) you plan to use? If so, how are these measured and what are all the details of these measures (repeat all the questions for the DVs)? This again will depend on the number of DVs. However, sufficient information should be given for each to answer all these questions. This could take several pages.

Procedures: Detail exactly how you plan to develop measurements (if not already developed) and to obtain participants or observations. How are your procedures compatible with ethical and legal standards of research including institutional review board (IRB) expectations? (This could be two pages long if no new development instrument is being developed, but it could be longer if you need to detail such things as these procedures and the establishment of reliability.)

Results: Detail your plans for using statistical analyses to evaluate each of your research questions or hypotheses. How will you assemble and prepare your data for SPSS analysis? Given your statistical analysis(es), how will you do such things as screen data, make any necessary modifications in the database, and compute composite scores, if necessary? How will you proceed with your statistical analysis(es)? Give sample outcome tables (with dummy data) that would be part of what you would be presenting if you were reporting this as actual study results. Depending on the study and the statistical methods used, this could be two to three pages long for each question or hypothesis. However, this is variable.

Discussion: Point out possible limitations or problems with your design and any ideas for ways to improve on them. (This could be, at most, two pages long.)

Appendix: Include copies of your test instruments and/or other supporting information.

Your Final Prospectus Project should be of 10–15 pages (plus Appendix, if included). Present it in Microsoft Word. Name your file R7034_M7_A3_LastName_FirstInitial.doc. Submit it to theSubmissions Area by the due date assigned.

Note: Your facilitator will assign you one research proposal submitted by a classmate for peer review in Module 8.

All written assignments and responses should follow APA rules for attributing sources.

Assignment 3 Grading Criteria Maximum Points Provided an introduction with an adequate summary of the introductory background theory, definitions, and questions for the study.8Identified and described specific goals and hypotheses for the study8Described and justified sampling and sample size.12Identified and operationally defined all variables to be used or measured in the study and addressed relevant questions for IVs and DVs12Analyzed and described a plan to develop measurements and explained how the procedures are compatible with IRB expectations16Identified and justified statistical analyses to be used to evaluate each of the research questions or hypotheses.16Provided a discussion of possible limitations or problems with the design.16Included flawless copies of test instruments, projected assignment activities with a timeline, and/or other supporting information.12Wrote in a clear, concise, and organized manner; demonstrated ethical scholarship in accurate representation and attribution of sources, displayed accurate spelling, grammar, and punctuation.4Total:104 

38. Research Paper

Develop a Complete Disaster Recovery Plan to be submitted to the executive board of your company. 

Only MS Word (.doc, .docx) and Adobe Acrobat (PDF) formats are acceptable.

Please note that this is a formal writing, all references (peer-reviewed) mostly must be cited appropriately within the text and clearly avoid plagiarism. 

The paper should have a minimum of 10 pages, 1.5 spacing and Times New Roman font. 

A minimum of 5 peer review references must be provided. Reference style is APA. 

With also 10 slides of PPT. Slides may also contain visuals and/or graph content to enhance your presentation. Include speaker notes of at least 50 words per slide. Use 12-point Times New Roman and APA citations and reference page.

39. Discussions

Discussion Topic 1

During the Great Recession of 2008–2009, (1) what actions would have been required of Congress and the President had a balanced budget amendment to the Constitution been ratified?  (2) What impact would that have had on the unemployment rate?

Discussion Topic 2 Explain how decr

Discussion Topic 2

Explain how decreased domestic investments that occur due to a budget deficit will affect future economic growth.

40. M7a2

Assignment 2: Prospectus Project Task XI

Planning Discriminant Analysis or Logistic Regression Analysis

In this project task, you will formulate a research question for your study that would be compatible with the use of either a discriminant analysis or logistic regression analysis of selected data.

For this assignment, write a response to the following points:

  • Identify one dependent variable (DV) or criterion variable and three predictor variables from your selected variable set that would fit the requirements of discriminant analysis or logistic regression analysis. Create new variables if you don’t have exactly what you would need to do this type of analysis.
  • State your research question in a manner compatible with the selected type of classification analysis.
  • Elaborate on your design for using discriminant analysis or logistic regression analysis for your study. Describe and justify the methods you propose for each of the following (discuss any possible concerns or limitations in the proposed methods):


    • Determining sufficient sample size: Specify considerations for the selected alpha level, desired power, desired effect size, and the validation checks you may plan.
    • Selecting a sample: How would you ensure representativeness?
    • Performing statistical analyses: Include the method to be used and validation checks.
    • Screening data and evaluating assumptions: Are any data transformations or modifications required? If yes, describe.
    • Interpreting the outcomes in relation to the stated hypothesis(es).

Present the response in Microsoft Word. Name the file R7034_M7_A2_LastName_FirstInitial.doc and submit it to the Discussion Area by the due date assigned.

Through the end of the module, review your partner’s research question description and design for using a discriminant analysis or logistic regression analysis. Post a response addressing the following points:

  • What are the challenges and strengths in the design of your partner?
  • How does the design promote sample representativeness?
  • What are your thoughts about the proposed sample size?
  • How will the methods for analyses serve the goals of the study?

All written assignments and responses should follow APA rules for attributing sources.

Assignment 2 Grading CriteriaMaximum PointsAccurately identified one DV or criterion variable and three predictor variables that would fit the requirements of discriminant analysis or logistic regression analysis.8Accurately identified and described the research question for design in a manner compatible with the selected type of classification analysis.8Determined a procedure for planning a sample size appropriate to the scope of the study and the alpha level8Identified and clearly described any concerns or limitations of the plan.8Determined a procedure for sample selection consistent with the underlying assumptions of representativeness and identified any concerns and limitations in the plan.8Identified and justified the classification analysis method to be used and described a technique for validating the results.8Determined a procedure for data screening and the evaluation of assumptions and described any data transformations or modifications required.8Justified a method for interpreting outcomes in relation to the stated hypothesis(es).8Evaluated and critiqued partner’s plans indicating strengths and limitations in the design, sample size, sample selection, and the chosen method of analysis.16Wrote in a clear, concise, and organized manner; demonstrated ethical scholarship in accurate representation and attribution of sources, displayed accurate spelling, grammar, and punctuation. 

41. Costing Method

  • Use the Internet to research the annual report of at least one (1) merchandising company. Determine which costing method (Last In First Out [LIFO], First In First Out [FIFO], or weighted average cost) that is used to record inventory by your selected company.
  • Identify the three (3) primary advantages and three (3) primary disadvantages of using the costing method (LIFO, FIFO, and weighted average) that is used to record inventory.
  • Provide support for your response.

42. HCM4012

Workforce Shortage

Click hereto read the health care workforce shortage and its implications on America’s hospitals, at the American Hospitals Association’s (AHA) website.

Select a hospital, which is not more than two hours away from your place of residence. Based on your readings and understanding, create a 5- to 6-page report in a Microsoft Word document, that includes:

A plan for a rural, medium-sized hospital to deal with short- and long-term workforce shortages.

Your plan should include the following elements:

  • Introduction
  • Problem description of the healthcare workforce shortage and its implications
    • The aspects that need immediate attention and aspects that need long-term attention
    • Provide a rationale on why these aspects need attention
    • A description of the financial implications for these issues
  • Evaluation of alternatives with an explanation of the risks associated with these problems
  • Your recommendations to solve these problems 
  • An explanation of the methods to measure the success of the plan 
  • A description of the next steps, if the plan failed 
  • Conclusion 
  • Reference list

To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Submission Details:

  • Your assignment should be addressed in an 5- to 6-page document.

43. Business Forum

WATCH: https://www.youtube.com/watch?v=fsU9N6A18sY

Please review this ted talk.

Based on what you read in the text, in at least 150 words, discuss three things you agree with or disagree with, or a mix of agree/disagree.

Use at least three key terms in bold from your text in your post.

44. M7a1

Assignment 1: SPSS Discriminant Analysis

While regression analysis evaluates the ability of multiple predictor variables to predict values on a single continuous variable, discriminant analysis evaluates the ability of multiple predictor variables to predict classification on a single categorical variable. Discriminant analysis can also be viewed as the reverse of a MANOVA: In MANOVA, the IVs are the groups and the DVs are the predictors. In DA, the IVs are the predictors and the DVs are the groups. (In order to avoid semantic confusion, it’s easier to refer to IVs as the predictors—or discriminating variables—and to DVs as the grouping variables.)

The emphases of MANOVA and DA are different. While MANOVA seeks to find a linear combination of variables that will maximize the test statistic, DA is used to establish the linear combination of dependent variables that maximally discriminates among groups. DA is used to predict membership in naturally occurring groups and to determine if a combination of variables can reliably predict group membership. Several variables are included in a study to see which ones best contribute to the discrimination between groups.

As with factor analysis, discriminant functions are identified through the analysis, but it remains for the researcher to provide a meaningful interpretation and labeling of these.

Use the Discussion Area to ask for help in completing the tasks from your classmates and the facilitator; likewise, offer your suggestions to those asking for help. Participating in this community of scholars will help you clarify processes, solve problems, and gain the immediate reinforcement you need to quickly solidify gains that you’re making in working with multiple variables and advanced statistics.

Open the Statistical Package for the Social Sciences (SPSS) data file created in
M6: Assignment 1. Use the following variables:

Create a Grouping Criterion Variable: Using the continuous data for Number of Previous Hospitalizations, transform this into categorical data by assigning patients to different categorical groups. You will add a new variable to your data file, which indicates which group each case falls into. For example, use the descriptive statistics and frequency information for the number of hospitalizations to decide your cut-offs for scores to define each group and then to assign patients to a group such as Group 1 (lower number of hospitalizations), Group 2 (medium number of hospitalizations), and Group 3 (higher number of hospitalizations) or you may consider quartiles, a median split, and dividing by standard deviation units. Justify your method.

Select five (or more, if justified) continuous variables to use as predictor variables for your analysis. Briefly justify your choices.

Conduct a discriminant analysis of these data. Use the same methods and choices found in the textbook’s sample study. Include tests for homogeneity of group variances.

Save the SPSS file as R7034_M7_A1_LastName_FirstInitial.sav.

Prepare a two- to three-page (plus Appendix for tables) response, which presents a summary report of the following information:

  • State a research question that could be studied using the specified variables for a discriminant analysis.
  • Report the results of prescreens for the missing data, multivariate outliers (Mahalanobis distance), univariate normality, and linearity (bivariate scatter plots). Indicate if any transformations or other decisions are required.
  • In your Appendix, report group descriptive statistics, analysis of variance (ANOVA) summary tables, summary of steps, eigenvalues, Wilks’ lambda table, standardized discriminant function coefficients, cannonical correlation or structure matrix, classification of results, and discriminant function means.
  • Summarize the results of the discriminant analysis, including an interpretation of discriminant functions. Compare the outcomes in terms of the research question.

Create your response in Microsoft Word. Name your file R7034_M7_A1_LastName_FirstInitial.doc. Submit your response to the Discussion Area by the due date assigned.

All written assignments and responses should follow APA rules for attributing sources.

Assignment 1 Grading CriteriaMaximum PointsCorrectly created a nominal variable for number of hospitalizations and assigned cases to each group.4Identified and justified choice of continuous variables to use as predictor variables for the DA.4Accurately interpreted the results of prescreens for the missing data, multivariate outliers, univariate normality, and linearity.8Conducted discriminant analysis and reported the results correctly for group descriptive statistics, ANOVA summary tables, summary of steps, eigenvalues, Wilks’ lambda table, standardized discriminant function coefficients, correlation coefficients or structure matrix, classification of results, and discriminant function means.36Presented an informative narrative summary of the analysis.24Participated actively in the Discussion Area by asking for or providing clarification of a response, addressing gaps, offering suggestions, and asking for help, as needed.8Wrote in a clear, concise, and organized manner; demonstrated ethical scholarship in accurate representation and attribution of sources, displayed accurate spelling, grammar, and punctuation.4Total:88 

45. PURPOSE-DRIVEN MARKETING Portfolio Essay

My Portfolio

  • MARKETING STRATEGY. Imagine you work at a large multi-brand company of your choosing (e.g., Apple, Nestle, Unilever). (a) BRAND DEVELOPMENT STRATEGIES. Imagine you are hired as a Brand Manager for any one brand at the company. Name the brand (e.g., iPhone). Using the slide titled “4 Brand Development Strategies,” detail 4 pathways to grow the Brand. (i) LINE EXTENSION. (ii) BRAND EXTENSION. (iii) MULTIBRAND. (iv) NEW BRAND. (v) Rank order the anticipated success of these 4 strategies and explain your reasoning. (b) BUSINESS GROWTH STRATEGIES. Flash forward a few years, imagine you are now promoted to a Vice President position for a region of your choosing. Name the region (e.g., USA). Using the slide titled “4 Strategies for Growing Businesses,” detail 4 pathways to grow the Company. (i) MARKET PENETRATION. (ii) PRODUCT DEVELOPMENT. (iii) MARKET DEVELOPMENT. (iv) DIVERSIFICATION. (v) Rank order the anticipated success of these 4 strategies and explain your reasoning.
  • PURPOSE-DRIVEN INNOVATION. Think of a purpose-driven innovation in each of the following market categories: (a) TRANSPORTATION, (b) FOOD AND BEVERAGES, and (c) PERSONAL CARE. Within each category, answer these questions. (i) CATEGORY INNOVATION. Describe the status quo in the product category, your purpose, and your innovation. (ii) TARGET MARKET. Identify the consumer segment who will be the most likely to value your category innovation. Use demographic, geographic, psychographic, and/or behavioral variables to define this segment. (iii) ANTICIPATED RESPONSE. Anticipate the response and resistance to your innovation from other relevant stakeholders (e.g., activists, employees, communities, governments, journalists). (iv) PROMOTION MIX. Explain how you would promote this innovation to ensure that it is a success. The slide entitled “Promotion Mix” could serve as a checklist of options.
  • MAKING THE PITCH. A key step in any marketing project is pitching your ideas to your colleagues, bosses, partners, and funders. Watch any 3 pitches from the TV show Shark Tank on YouTube. You just need to watch the pitch, not the investor negotiations. (a) LINKS. List weblinks for the 3 pitches you selected. (b) THE LEAST EFFECTIVE. In your opinion, which pitch was the least effective and why? If you were to redo the least effective pitch, what would you do differently? (c) THE MOST EFFECTIVE. Which pitch was the most effective and why? If you were to redo the most effective pitch to make it even better, what would you do differently? (d) PITCHING EXPERIENCE. Describe any experience you have had pitching a new idea to a tough audience and what you learned from the experience. (e) MY PITCH. As an entrepreneur, you are seeking venture capital for a new business idea. Please write a short elevator pitch.
  • CAREER ADVANCEMENT. Find 5 different job ads (internships or permanent jobs) in marketing or other business areas that interest you. Aim for as much variety as possible. At least one of these jobs should be at a global company (e.g., Nestle, P&G, Unilever, etc.). At least one of these jobs should be at a relatively small company in NYC. (a) JOB ADS. Provide web links to the descriptions of each of these 5 jobs. (b) VALUES-BASED SELECTION. Which of these jobs most closely aligns with your personal values and how? (c) LIKELY HURDLES. Identify all the educational, experiential, psychological, and practical hurdles you might face in securing these jobs. (d) MY NEXT STEPS. Enumerate the steps that you are going to take to overcome these hurdles and get these jobs in the next few months.
  • PROFESSIONAL DEVELOPMENT. (a) COURSE SLIDES. From all the slides discussed in the course so far, elaborate on 3 course slides that could be helpful for your personal or professional goals. Describe when, where, and/or how you might use the slide. (b) CHARACTER STRENGTHS. Describe 3 character strengths that you think you have improved upon during this course. Describe where you used to be, how you have progressed, and how you hope to develop next. (c) WELL-BEING PILLARS. Do the pillars of well-being exercise. Identify at least 3 actionable insights you learn about your current circumstances.

Directions for Portfolios

Each portfolio consists of five projects. The recommended word count is at minimum 1000 words per project (or 5000 per portfolio). The projects are purposefully open to customization. Students are free to make adaptations to match their specific career interests.

Evaluation criteria. The grade is determined as follows: 50% for completion + 50% for quality. What constitutes high quality in business is necessarily defined by competition. That said, here are some typical quality markers:

  1. readability; shorter sentences are generally clearer than longer ones
  2. logic; all of the assumptions and arguments make sense
  3. concepts and frameworks from the slides and beyond (e.g., Changing Minds)
  4. all concepts and frameworks are explained before they are applied
  5. several different sources of data and insights from appropriate sources
  6. useful examples to illustrate the key points
  7. no long quotes, which signal an inability to synthesize
  8. elegant presentation, including clear organization and consistent formatting
  9. conceptual illustrations (e.g., process maps, comparison tables)
  10. photographs or other images that provide evidence or animate key ideas

Examples. Students who have limited exposure to professional business reports are encouraged to review examples before producing their own.

Submission checklist. Consider these items before you submit:

  1. Does your cover page include your own name?
  2. Does your table of contents list page numbers for each project?
  3. Does each project begin on a new page?
  4. Are your sources cited in the text and referenced in a works cited page?
  5. Do your citations/references use a standard format (e.g., MLA)?
  6. Is most of the text in a readable 10-12 font size?
  7. Is your text single-spaced like most professional reports?
  8. Is each part clearly numbered (1, 2, 3…/a, b, c…/i, ii, iii…)?
  9. Is each part clearly titled to help guide the reader?
  10. Have you run a spelling and grammar check?

46. Movie Critical Review

Watch the following film and write a 2-page reaction paper/review.

Salt of the Earth: https://www.youtube.com/watch?v=n3VPWmqaOb4

47. Case Study

APA STYLE- 2 Pages

Synthesis: Suggest ways to improve/strengthen your chosen solution (may use information not contained within the scenario). Scenario: Security at All Pine Medical Center.

Questions:

a. Identify concepts and ideas from multiple sources that improve or strengthen your solution.

b. Identify any new found information and the impact that new information may or may not have on your solution.

c. Identify potential missing information and the impact that missing information may or may not have on your solution.

48. Macro Econ Discussion

Go to the internet and find a news article published within the last three months that discusses balancing the federal budget of the U.S. and fiscal policy, summarize key points and post in the Discussions area.  Discuss the current level of the Federal budget deficit and the implications of the deficit.  Support a proposal for addressing these concerns.

Reflection – the students also should include a paragraph in the initial response in their own words reflecting on specifically what they learned from the assignment and how they think they could apply what they learned in the workplace.

49. Research Paper

Develop a Complete Disaster Recovery Plan to be submitted to the executive board of your company. 

The paper should have a minimum of 10 pages and APA format. A minimum of 5 peer reviewed references in APA.

50. “Nike Sweatshops: Behind The Swoosh” (300 Words) Reflection

Watch the videos below and write a 300-word individual reflection discussing two most poignant/surprising things you learned from this video. You can focus on Jim Keady’s story and mission, any new perspectives this opens for you, and how the issue connects with international business (law) and corporate social responsibility. 

In this video, Jim Keady, a renowned speaker on social injustice, recounts his experience living in Indonesia for a month on Nike sweatshop worker wages. 

https://bryant.hosted.panopto.com/Panopto/Pages/Viewer.aspx?id=1fc54965-63f6-4294-82bc-3eee6c02db1c m

51. DB3

Using your Beyond the Book Guide, course materials, and online resources, assume the role of the office manager and provide the following information for your staff to ensure they understand the electronic record keeping systems used in the medical office.     What is a practice management system (PMS) used for in a medical office?  How is a PMS related to an electronic health record (EHR) system? Name 2 uses for computers and software programs in a medical office in addition to the electronic health record entries and explain what is meant by a computer back up and why it is important in a medical office.  What is meant by supply chain management and why is it important in a healthcare organization? 

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NR511 Midterm Exam 2018

Question

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?

NSAIDs

Beets

Vitamin A

Red meat

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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.

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

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:

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 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)

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, 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 b-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 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

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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?

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

 

Question 1: The most cost-effective screening test for determining HIV status is which of the following?

Western blot

Enzyme-linked immunosorbent assay

Venereal Disease Research Laboratory test

Viral load

Question 2.Question : Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process?

Erythrocyte sedimentation rate

White blood cell count

Polymorphonuclear cells

C-reactive protein (CRP)

Question 3.Question : Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?

GABA

Acetylcholine

Dopamine

Serotonin

Question 4.Question : Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:

Ecchymosis, edema, and erythema over the lateral epicondyle

Pain at the elbow with resisted movements at the wrist and forearm

Inability to supinate and pronate the arm

Inability to flex or extend the elbow against resistance

Question 5.Question : Which of the following statements concerning the musculoskeletal examination is true?

The uninvolved side should be examined initially and then compared to the involved side.

The part of the body that is causing the patient pain should be examined first.

When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain.

Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

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Question 6.Question : Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Decreased C-reactive protein

Hyperalbuminemia

Morning stiffness

Weight gain

Question 7.Question : Which causes the greatest percentage of mammalian bites?

Dogs

Cats

Humans

Rodents

Question 8.Question : A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states  she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first?

Transvaginal ultrasound

Endometrial biopsy

MRI

Abdominal computed tomography scan

Question 9.Question : A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate?

“Control of glucose will help postpone or delay complications.”

“Regularly checking blood sugar will help establish a routine.”

“Monitoring glucose will promote a sense of control.”

All of the above

Question 10.Question : A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3  months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next?

Serum calcium

TSH

Electrolytes

Urine specific gravity

Question 11.Question : Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?

Insulin

Metformin

Glucotrol

Precose

Question 12.Question : During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

An enlarged rubbery gland

A hard irregular gland

A tender gland

A boggy gland

Question 13.Question : Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step?

Remove the insect with tweezers.

Immobilize the insect with 2% lidocaine.

Sedate Eddie with diazepam.

Shine a light in the ear for the insect to “find its way out.”

Question 14.Question : What is the most common cause of microcytic anemia?

Anemia of chronic disease

Sideroblastic anemia

Iron-deficiency anemia

Thalassemia

Question 15.Question : An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses?

Benign prostatic hyperplasia (BPH)

Parkinson’s disease

Prostate cancer

All of the above

Question 16.Question : Early rheumatoid disease is characterized by:

Pain and swelling in both small and large peripheral joints

Rigid joints with diminished range of motion

Joint swelling and immobility on rising

A cardiac rub or pulmonary friction rub

Question 17.Question : A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do?

Make an immediate referral for an orthopedic evaluation without further assessment.

Tell her that it takes time for these bruises to improve, so she should be patient.

Obtain a wrist x-ray and place her wrist in a splint or  prescribe a splint.

Send her to the emergency room for reduction of this obvious wrist fracture.

Question 18.Question : The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:

1 month

3 months

6 months

12 months

Question 19.Question : A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?

The scrotum will be dark.

The scrotum will appear light pink or yellow.

The scrotum will appear milky white.

The internal structures will be clearly visible.

Question 20.Question : According to Kübler-Ross, the stages of grief occur in which order?

Anger, denial, depression, bargaining, acceptance

Anger, denial, bargaining, acceptance, depression

Denial, anger, depression, bargaining, acceptance

Denial, anger, bargaining, depression, acceptance

Question 21.Question : Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate?

A favorable prognostic trend

Disease progression

The need to be more aggressive with Reuben’s

medications

The eradication of the HIV

Question 22.Question : The exanthem of Lyme disease is:

Erythema infectiosum

Need homework help? Click Here!

Laterothoracic exanthem

Erythema migrans

Morbilli exanthem

Question 23.Question : You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is:

Articular

Inflammatory

Nonarticular

A and B

Question 24.Question : What is the recommended daily calcium intake for adults over the age of 50 with low bone mass?

1,200 mg/day

1,000 mg/day

1,300 mg/day

1,500 mg/day

Question 25.Question : When assessing a woman for infertility, which of the following tests should be done first?

Analysis of partner’s sperm

Magnetic resonance imaging (MRI)

Hysterosalpingogram

Estrogen level

Question 26.Question : Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

Superficial burns

Superficial partial-thickness burns

Deep partial-thickness burns

Full-thickness burns

Question 27.Question : A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination?

Human papillomavirus (HPV)

Endometrial hyperplasia

Vagismus

Polycystic ovarian syndrome

Question 28.Question : As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin?

Two

Three

Four

Five

Question 29.Question : Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?

Morning stiffness and limited mobility of the lumbar spine

Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

Fever, chills, and elevated erythrocyte sedimentation rate

Pathologic fractures, severe night pain, weight loss, and fatigue

Question 30.Question : A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?

Testosterone level

Prostate-specific antigen

Nocturnal penile tumescence and rigidity

Prolactin level

Question 31.Question : The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective?

“I’ll take my pill at least 30 minutes before breakfast.”

“I’ll take my Glucotrol before bedtime.”

“It is important to take my medication right after I eat.”

“Since I only like to eat two meals a day, I can take the pill between my meals.”

Question 32.Question : In the United States, what is the second most common connective tissue disease and the most destructive to the joints?

Osteoarthritis

Systemic lupus erythematosus (SLE)

Rheumatoid arthritis

Sjögren’s syndrome

Question 33.Question : The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?

Acetylcholine

Gamma-aminobutyric acid (GABA)

Dopamine

Serotonin

Question 34.Question : A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action?

Refer to a urologist immediately.

Obtain a computed tomography (CT) scan.

Instruct the patient to elevate the scrotum.

Prescribe ibuprofen.

Question 35.Question : Which of the following medications can cause hyperglycemia?

Prednisone

Metformin

Synthroid

Cephalexin

Question 36.Question : During treatment for anaphylaxis, what site is used for the initial injection of epinephrine?

IV

Abdomen

Upper lateral thigh

Deltoid

Question 37.Question : It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is  especially true during which time period?

Before the initiation of treatment

1 to 2 weeks after the initiation of treatment

When switching to a different medication

1 to 2 weeks after tapering off medications

Question 38.Question : What is the most common cause of secondary amenorrhea?

Pregnancy

Pituitary dysfunction

Inadequate estrogen levels

Genetic disorders

Question 39.Question : Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration?

Sertraline

Fluoxetine

Citoprolam

Imipramine

Question 40.Question : The goals of the 15-minute hour approach include:

Enhance self-esteem, expand behavioral repertoire, prevent dire consequences, and reestablish premorbid levels of functioning

Emerge with a higher level of functioning and commitment to long-term psychotherapy

Accept need for antidepressant therapy and psychiatric referral; share concerns with primary care clinician

Improve family functioning and sexual performance as well as accept need for antidepressant medication

Question 41.Question : John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing  localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

Valgus stress test

McMurray circumduction test

Lachman test

Varus stress test

Question 42.Question : The cardinal subjective symptom of sickle cell crisis is which of the following?

Pain

Nausea

Light-headedness

Palpitations

Question 43.Question : A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which of the following pelvic pathologies is the most common cause of dysmenorrhea?

Pelvic inflammatory disease

Endometriosis

Sexually transmitted infections

Ovarian cyst

Question 44.Question : Which arthropod bite can contain cytotoxic and haemolytic toxins that may destroy tissue?

Tick

Brown recluse spider

Wasp

Stinging caterpillar

Question 45.Question : Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equine compression. Which of the following is a sign or symptom of cauda equina compression?

Gastrocnemius weakness

A reduced or absent ankle reflex

Numbness in the lateral foot

Paresthesia of the perineum and buttocks

Question 46.Question : A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the following tests is essential before prescribing any oral contraceptive?

Pregnancy test

Complete blood cell count

Thyroid-stimulating hormone

Urine dip for protein

Question 47.Question : A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin?

Ketoacidosis

Cirrhosis

Hypoglycemic episodes

All of the above

Question 48.Question : The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants?

SSRIs are more effective than TCAs.

SSRIs take less time to work than TCAs.

SSRIs have a more favorable side-effect profile than

TCAs.

SSRIs are not lethal in overdose.

Question 49.Question : Which type of bone marrow transplant is obtained from an identical twin?

Autogenic

Autologous

Allogeneic

Syngeneic

Question 50.Question : Pink, cherry red tissues and skin may result from which type of poisoning?

Arsenic

Lead

Carbon monoxide

Strychnine

Question 51.Question : Basic human needs are identified as:

Autonomy and feeling valued by others

Exhilaration and productivity

Spirituality

Career success and material rewards

Question 52.Question : The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

Overweight

Mild obesity

Moderate obesity

Morbid obesity

Question 53.Question : A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular selfexamination (TSE). Which of the following should be examination (TSE). Which of the following should be included in the list of differential diagnoses?

Testicular cancer

Inguinal hernia

Varicocele

All of the above

Question 54.Question : What is the treatment of choice for a patient diagnosed with testicular cancer?

Radical orchidectomy

Lumpectomy

Radiation implants

All of the above

Question 55.Question : Which method is used to remove heavy metals, such as lead, that are ingested as poisons?

Chelation

Dialysis

Gastric lavage

Bowel irrigation

Question 56.Question : A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

“It is probably just a cyst because that is the most common breast mass.”

“We will order a mammogram and ultrasound to help establish a diagnosis.”

“We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”

“Because your lump is painful, it is most likely not cancer.”

Question 57.Question : A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate?

Fluconazole

Estrogen vaginal cream

Metronidazole

Doxycycline

Question 58.Question : The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs?

“You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.”

“You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication.”

“You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.”

“It is important to take NSAIDs on an empty stomach in order to increase absorption.”

Question 59.Question : A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting of a joint, is more likely related to which musculoskeletal injury?

A sprain

A strain

A partial fracture

A fracture

Question 60.Question : Which type of heat-related illness involves a core body temperature of at least 104.9°F, acute mental status temperature of at least 104.9°F, acute mental status changes, absent sweat, and tachypnea?

Heat cramps

Heat syncope

Heat exhaustion

Heat stroke

Question 61.Question : Which of the following may be used to evaluate a person’s suicide risk?

CAGE

SANE

SAD PERSONAS

DIGFAST

Question 62.Question : One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular structure?

Bone

Synovium

Tendons

Fascia

Question 63.Question : After returning from visiting his grandchildren in England, George, age 59, complains of a flulike illness, including fever, chills, and myalgia. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?

A viral syndrome

Lyme disease

Rocky Mountain spotted fever

Relapsing fever

Question 64.Question : A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expect as a manifestation of the disease?

Sinus bradycardia

Atrial fibrillation

Supraventricular tachycardia

U waves

Question 65.Question : Which of the following tests is essential for a 46-year-old woman who the clinician suspects is perimenopausal?

Pregnancy

Estrogen level

Progesterone level

LH level

Question 66.Question : After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?

Elevated TSH

Normal TSH

Low TSH

Undetectable TSH

Question 67.Question : A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment?

No treatment at this time

Diet and exercise for 6-week trial

Diet, exercise, and oral medication

Diet, exercise, and exogenous insulin

Question 68.Question : Which of the following should be considered in a patient presenting with erectile dysfunction?

Diabetes mellitus

Hypertension

Atherosclerosis

All of the above

Question 69.Question : Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel  syndrome?

Carpal tunnel syndrome commonly occurs in families.  Genetic factors are thought to account for about one-half the risk of developing carpal tunnel.

Only people with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.

An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.

Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.

Question 70.Question : A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea?

Ceftriaxone

Doxycycline

Acyclovir

Metronidazole

Question 71.Question : Which of the following statements is true regarding the treatment of carpal tunnel syndrome?

The goal of treat

NR511 Midterm Exam

NR511 Midterm Exam 2018

Question 1: The most cost-effective screening test for determining HIV status is which of the following?

Western blot

Enzyme-linked immunosorbent assay

Venereal Disease Research Laboratory test

Viral load

Question 2.Question : Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process?

Erythrocyte sedimentation rate

White blood cell count

Polymorphonuclear cells

C-reactive protein (CRP)

Question 3.Question : Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?

GABA

Acetylcholine

Dopamine

Serotonin

Need homework help? Click Here!

Question 4.Question : Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:

Ecchymosis, edema, and erythema over the lateral epicondyle

Pain at the elbow with resisted movements at the wrist and forearm

Inability to supinate and pronate the arm

Inability to flex or extend the elbow against resistance

Question 5.Question : Which of the following statements concerning the musculoskeletal examination is true?

The uninvolved side should be examined initially and then compared to the involved side.

The part of the body that is causing the patient pain should be examined first.

When possible, the patient should not be asked to perform active range-of-motion (ROM) exercises to avoid causing pain.

Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

Question 6.Question : Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Decreased C-reactive protein

Hyperalbuminemia

Morning stiffness

Weight gain

Question 7.Question : Which causes the greatest percentage of mammalian bites?

Dogs

Cats

Humans

Rodents

Question 8.Question : A 48-year-old woman is seen in the clinic with complaints of prolonged heavy menstrual periods. She is pale and states  she can no longer exercise. Pelvic exam reveals a single, very large mass. Which of the following diagnostic tests should the clinician order first?

Transvaginal ultrasound

Endometrial biopsy

MRI

Abdominal computed tomography scan

Question 9.Question : A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate?

“Control of glucose will help postpone or delay complications.”

“Regularly checking blood sugar will help establish a routine.”

“Monitoring glucose will promote a sense of control.”

All of the above

Question 10.Question : A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3  months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes. Which of the following tests should be ordered next?

Serum calcium

TSH

Electrolytes

Urine specific gravity

Question 11.Question : Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?

Insulin

Metformin

Glucotrol

Precose

Question 12.Question : During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

An enlarged rubbery gland

A hard irregular gland

A tender gland

A boggy gland

Question 13.Question : Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step?

Remove the insect with tweezers.

Immobilize the insect with 2% lidocaine.

Sedate Eddie with diazepam.

Shine a light in the ear for the insect to “find its way out.”

Question 14.Question : What is the most common cause of microcytic anemia?

Anemia of chronic disease

Sideroblastic anemia

Iron-deficiency anemia

Thalassemia

Question 15.Question : An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses?

Benign prostatic hyperplasia (BPH)

Parkinson’s disease

Prostate cancer

All of the above

Question 16.Question : Early rheumatoid disease is characterized by:

Pain and swelling in both small and large peripheral joints

Rigid joints with diminished range of motion

Joint swelling and immobility on rising

A cardiac rub or pulmonary friction rub

Question 17.Question : A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds. What should you do?

Make an immediate referral for an orthopedic evaluation without further assessment.

Tell her that it takes time for these bruises to improve, so she should be patient.

Obtain a wrist x-ray and place her wrist in a splint or  prescribe a splint.

Send her to the emergency room for reduction of this obvious wrist fracture.

Question 18.Question : The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:

1 month

3 months

6 months

12 months

Question 19.Question : A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?

The scrotum will be dark.

The scrotum will appear light pink or yellow.

The scrotum will appear milky white.

The internal structures will be clearly visible.

Question 20.Question : According to Kübler-Ross, the stages of grief occur in which order?

Anger, denial, depression, bargaining, acceptance

Anger, denial, bargaining, acceptance, depression

Denial, anger, depression, bargaining, acceptance

Denial, anger, bargaining, depression, acceptance

Question 21.Question : Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate?

A favorable prognostic trend

Disease progression

The need to be more aggressive with Reuben’s

medications

The eradication of the HIV

Question 22.Question : The exanthem of Lyme disease is:

Erythema infectiosum

Laterothoracic exanthem

Erythema migrans

Morbilli exanthem

Question 23.Question : You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is:

Articular

Inflammatory

Nonarticular

A and B

Question 24.Question : What is the recommended daily calcium intake for adults over the age of 50 with low bone mass?

1,200 mg/day

1,000 mg/day

1,300 mg/day

1,500 mg/day

Question 25.Question : When assessing a woman for infertility, which of the following tests should be done first?

Analysis of partner’s sperm

Magnetic resonance imaging (MRI)

Hysterosalpingogram

Estrogen level

Question 26.Question : Which type of burn injury results in destruction of the epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

Superficial burns

Superficial partial-thickness burns

Deep partial-thickness burns

Full-thickness burns

Question 27.Question : A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination?

Human papillomavirus (HPV)

Endometrial hyperplasia

Vagismus

Polycystic ovarian syndrome

Question 28.Question : As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin?

Two

Three

Four

Five

Question 29.Question : Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?

Morning stiffness and limited mobility of the lumbar spine

Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

Fever, chills, and elevated erythrocyte sedimentation rate

Pathologic fractures, severe night pain, weight loss, and fatigue

Question 30.Question : A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?

Testosterone level

Prostate-specific antigen

Nocturnal penile tumescence and rigidity

Prolactin level

Question 31.Question : The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective?

“I’ll take my pill at least 30 minutes before breakfast.”

“I’ll take my Glucotrol before bedtime.”

“It is important to take my medication right after I eat.”

“Since I only like to eat two meals a day, I can take the pill between my meals.”

Question 32.Question : In the United States, what is the second most common connective tissue disease and the most destructive to the joints?

Osteoarthritis

Systemic lupus erythematosus (SLE)

Rheumatoid arthritis

Sjögren’s syndrome

Question 33.Question : The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?

Acetylcholine

Gamma-aminobutyric acid (GABA)

Dopamine

Serotonin

Question 34.Question : A 14-year-old male is seen with complaints of severe testicular pain. The clinician suspects testicular torsion. Which of the following is the appropriate action?

Refer to a urologist immediately.

Obtain a computed tomography (CT) scan.

Instruct the patient to elevate the scrotum.

Prescribe ibuprofen.

Question 35.Question : Which of the following medications can cause hyperglycemia?

Prednisone

Metformin

Synthroid

Cephalexin

Question 36.Question : During treatment for anaphylaxis, what site is used for the initial injection of epinephrine?

IV

Abdomen

Upper lateral thigh

Deltoid

Question 37.Question : It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is  especially true during which time period?

Before the initiation of treatment

1 to 2 weeks after the initiation of treatment

When switching to a different medication

1 to 2 weeks after tapering off medications

Question 38.Question : What is the most common cause of secondary amenorrhea?

Pregnancy

Pituitary dysfunction

Inadequate estrogen levels

Genetic disorders

Question 39.Question : Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration?

Sertraline

Fluoxetine

Citoprolam

Imipramine

Question 40.Question : The goals of the 15-minute hour approach include:

Enhance self-esteem, expand behavioral repertoire, prevent dire consequences, and reestablish premorbid levels of functioning

Emerge with a higher level of functioning and commitment to long-term psychotherapy

Accept need for antidepressant therapy and psychiatric referral; share concerns with primary care clinician

Improve family functioning and sexual performance as well as accept need for antidepressant medication

Question 41.Question : John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing  localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

Valgus stress test

McMurray circumduction test

Lachman test

Varus stress test

Question 42.Question : The cardinal subjective symptom of sickle cell crisis is which of the following?

Pain

Nausea

Light-headedness

Palpitations

Question 43.Question : A 25-year-old woman is seen in the clinic complaining of painful menstruation. Which of the following pelvic pathologies is the most common cause of dysmenorrhea?

Pelvic inflammatory disease

Endometriosis

Sexually transmitted infections

Ovarian cyst

Question 44.Question : Which arthropod bite can contain cytotoxic and haemolytic toxins that may destroy tissue?

Tick

Brown recluse spider

Wasp

Stinging caterpillar

Question 45.Question : Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equine compression. Which of the following is a sign or symptom of cauda equina compression?

Gastrocnemius weakness

A reduced or absent ankle reflex

Numbness in the lateral foot

Paresthesia of the perineum and buttocks

Question 46.Question : A 21-year-old woman is seen in the clinic requesting birth control pills. Which of the following tests is essential before prescribing any oral contraceptive?

Pregnancy test

Complete blood cell count

Thyroid-stimulating hormone

Urine dip for protein

Question 47.Question : A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin?

Ketoacidosis

Cirrhosis

Hypoglycemic episodes

All of the above

Question 48.Question : The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants?

SSRIs are more effective than TCAs.

SSRIs take less time to work than TCAs.

SSRIs have a more favorable side-effect profile than

TCAs.

SSRIs are not lethal in overdose.

Question 49.Question : Which type of bone marrow transplant is obtained from an identical twin?

Autogenic

Autologous

Allogeneic

Syngeneic

Question 50.Question : Pink, cherry red tissues and skin may result from which type of poisoning?

Arsenic

Lead

Carbon monoxide

Strychnine

Question 51.Question : Basic human needs are identified as:

Autonomy and feeling valued by others

Exhilaration and productivity

Spirituality

Career success and material rewards

Question 52.Question : The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

Overweight

Mild obesity

Moderate obesity

Morbid obesity

Question 53.Question : A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular selfexamination (TSE). Which of the following should be examination (TSE). Which of the following should be included in the list of differential diagnoses?

Testicular cancer

Inguinal hernia

Varicocele

All of the above

Question 54.Question : What is the treatment of choice for a patient diagnosed with testicular cancer?

Radical orchidectomy

Lumpectomy

Radiation implants

All of the above

Question 55.Question : Which method is used to remove heavy metals, such as lead, that are ingested as poisons?

Chelation

Dialysis

Gastric lavage

Bowel irrigation

Question 56.Question : A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

“It is probably just a cyst because that is the most common breast mass.”

“We will order a mammogram and ultrasound to help establish a diagnosis.”

“We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”

“Because your lump is painful, it is most likely not cancer.”

Question 57.Question : A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate?

Fluconazole

Estrogen vaginal cream

Metronidazole

Doxycycline

Question 58.Question : The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs?

“You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.”

“You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication.”

“You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.”

“It is important to take NSAIDs on an empty stomach in order to increase absorption.”

Question 59.Question : A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting of a joint, is more likely related to which musculoskeletal injury?

A sprain

A strain

A partial fracture

A fracture

Question 60.Question : Which type of heat-related illness involves a core body temperature of at least 104.9°F, acute mental status temperature of at least 104.9°F, acute mental status changes, absent sweat, and tachypnea?

Heat cramps

Heat syncope

Heat exhaustion

Heat stroke

Question 61.Question : Which of the following may be used to evaluate a person’s suicide risk?

CAGE

SANE

SAD PERSONAS

DIGFAST

Question 62.Question : One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular structure?

Bone

Synovium

Tendons

Fascia

Question 63.Question : After returning from visiting his grandchildren in England, George, age 59, complains of a flulike illness, including fever, chills, and myalgia. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?

A viral syndrome

Lyme disease

Rocky Mountain spotted fever

Relapsing fever

Question 64.Question : A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expect as a manifestation of the disease?

Sinus bradycardia

Atrial fibrillation

Supraventricular tachycardia

U waves

Question 65.Question : Which of the following tests is essential for a 46-year-old woman who the clinician suspects is perimenopausal?

Pregnancy

Estrogen level

Progesterone level

LH level

Question 66.Question : After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?

Elevated TSH

Normal TSH

Low TSH

Undetectable TSH

Question 67.Question : A patient is 66 inches in height, weighing 200 pounds, and newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment?

No treatment at this time

Diet and exercise for 6-week trial

Diet, exercise, and oral medication

Diet, exercise, and exogenous insulin

Question 68.Question : Which of the following should be considered in a patient presenting with erectile dysfunction?

Diabetes mellitus

Hypertension

Atherosclerosis

All of the above

Question 69.Question : Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel  syndrome?

Carpal tunnel syndrome commonly occurs in families.  Genetic factors are thought to account for about one-half the risk of developing carpal tunnel.

Only people with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.

An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.

Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.

Question 70.Question : A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea?

Ceftriaxone

Doxycycline

Acyclovir

Metronidazole

Question 71.Question : Which of the following statements is true regarding the treatment of carpal tunnel syndrome?

The goal of treatment is to prevent flexion and extension movements of the wrist.

Splints are used in carpal tunnel syndrome, because they allow for free movement of the fingers and thumb while allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position.

Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.

All of the above

Question 72.Question : Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this patient?

Elevated uric acid level

Elevated blood urea nitrogen

Decreased urine pH

Decreased C-reactive protein

Question 73.Question : Which of the following data is indicative of testicular torsion?

Absent cremasteric reflex

Pain relieved on testicular elevation

Testicle very low in the scrotum

Swollen scrotum with “red dot sign”

Question 74.Question : A patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer her, the clinician must understand that exercise has what effect on the patient with type 2 diabetes?

Reduces postprandial blood glucose

Reduces triglycerides and increases high-density lipoprotein (HDL)

Reduces total cholesterol

All of the above

Question 75.Question : A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the vaginal bleeding. Which of the following tests should be the first priority?

Pregnancy test

Pelvic ultrasound

Endometrial biopsy

Platelet count

Question 76.Question : What is the most common cause of generalized musculoskeletal pain in women ages 20 to 55?

Chronic fatigue syndrome (CFS)

Anemia

Fibromyalgia syndrome (FMS)

Sports-related injuries

Question 77.Question : If the international normalized ratio (INR) result is above the therapeutic range in a patient with atrial fibrillation on warfarin, what might the clinician do?

Stop the warfarin for 1 week, and then repeat the INR.

Withhold one or more days of anticoagulant therapy.

Restart therapy at a lower dose immediately.

The prothrombin time and INR should be reevaluated within 1 month of the dosage adjustments.

Question 78.Question : A 32-year-old woman is seen in the clinic because she has been unable to get pregnant after 12 months of unprotected sex. In order to determine the cause of the infertility, the clinician should question her about which of these possible causes?

Pelvic inflammatory disease

Oral contraceptive use for 15 years

Early menarche

Diet high in soy protein

Question 79.Question : Which of the following statements concerning the treatment of fibromyalgia syndrome is true?

There is currently no cure for the disorder; however, patients should be made aware that symptom relief is possible.

Treatment is directed toward controlling discomfort, improving sleep, and maintaining function.

Fibromyalgia syndrome can be difficult to manage, requiring a variety of approaches and multiple medications.

All of the above

Question 80.Question : The clinician should prescribe an antibiotic that covers which of these organisms for a patient with acute prostatitis?

Gram-positive cocci

Gram-negative cocci

Gram-positive bacillus

Gram-negative bacillus

Question 81.Question : Which household solution should be used to clean a bathroom if sharing with a friend who has HIV?

100% bleach

50% bleach and 50% vinegar

Nine parts H2O to one part bleach

The friend must have his or her own bathroom.

Question 82.Question : Sandra is 42 years old and has just been diagnosed with leukemia. She is complaining of bone and joint pain. Which type of leukemia is most likely the culprit?

Acute lymphocytic leukemia

Acute myelogenous leukemia

Chronic myelogenous leukemia

Chronic lymphocytic leukemia

Question 83.Question : Which of the following is identified as an eating disorder in which a person craves food substitutes, such as clay, ice chips, and cotton, and is considered an objective finding associated with severe iron deficiency?

Ferritin

Porter’s syndrome

Hypochromasia

Pica

Question 84.Question : The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit?

High sensitivity thyroid-stimulating hormone (TSH) and free T4

Free T4 and serum calcium

Free T3 and T4

TSH and thyroxin antibodies

Question 85.Question : The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been effective?

“As long as I don’t need glasses, I don’t have to worry about going blind.”

“I know I need to have my eyes checked every year.”

“My optometrist checks my eyes.”

“I will see my eye doctor when my vision gets blurry.”

Question 86.Question : Triggering factors for acute exacerbations of which of the following conditions include exposure to ultraviolet (UV)-B and UV-A rays?

Rheumatoid arthritis

Scleroderma

SLE

Sjögren’s syndrome

Question 87.Question : Which of the following characteristics separates anaphylaxis from a vasovagal reaction?

Bradycardia

Extreme diaphoresis

Severe bronchoconstriction

Hypotension

Question 88.Question : Mr. Jackson is a 65-year-old man recently diagnosed with osteoarthritis. The clinician has explained to Mr. Jackson that the goals for managing osteoarthritis include controlling pain, maximizing functional independence and mobility,

minimizing disability, and preserving quality of life. Mr. Jackson explains to the clinician that his first choice would be to use complementary therapies to control his condition and asks what therapies are most effective in treating osteoarthritis. What would be the most  appropriate response from the clinician?

“Complementary therapies should be considered only if surgical interventions are not successful.”

“I am unfamiliar with the available complementary therapies for osteoarthritis and prefer to discuss more mainstream treatments, such as NSAIDs and physical therapy, to manage your condition.”

“I would be happy to discuss all the treatment options available to you. Complementary therapies, such as acupuncture, acupressure, and tai-chi, are being studied for use in the treatment of osteoarthritis and have shown promise when used with standard medical therapy.”

“It would be crazy to use complementary therapies to treat such a serious condition.”

Question 89.Question : One benefit of motivational interviewing (MI) is:

It assumes that ambivalence is a normal part of the change process.

It can be utilized during routine office visits.

It is a therapeutic technique which is not necessarily time intensive.

All are benefits of MI.

Question 90.Question : What percentage of burns is involved using the rule of nines if both front legs are burned?

9%

18%

24%

36%

Question 91.Question : Women are at the highest risk for developing postpartum depression for up to how long after childbirth?

2 weeks

1 month

3 months

6 months

Question 92.Question : Which statement about HIV postexposure prophylaxis (PEP) for health-care workers is the most accurate?

PEP should be started within hours of exposure.

PEP should be started within 72 hours of exposure.

Renal and hepatic function tests should be done 6 weeks after beginning PEP.

PEP will prevent potential hepatitis C infection if present.

Question 93.Question : The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an xray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane’s description of her injury. Which of the following clues in Diane’s examination or history would alert the clinician to the need for obtaining radiographs?

Inability to bear weight immediately after the injury

Development of marked ankle swelling and discoloration after the injury

Crepitation with palpation or movement of the ankle

All of the above

Question 94.Question : A vegetarian patient with gout asks the clinician about food he should avoid. The clinician should advise the patient to avoid which of the following foods?

Rice

Carrots

Spinach

Potatoes

Question 95.Question : A patient with a basilar skull fracture may experience an impaired downward gaze or diplopia from which affected cranial nerve?

CN II

CN III

CN IV

CN V

Question 96.Question : A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack?

Pheochromocytoma

Hyperthyroidism

Cardiac arrhythmias

All of the above

Question 97.Question : Which test is used to confirm a diagnosis of epididymitis?

Urinalysis

Gram stain of urethral discharge

Gram stain of urethral discharge

Complete blood cell count with differential

Ultrasound of the scrotum

Question 98.Question : BATHEing the patient refers to:

A technique used in primary care to get the patient to accept the need for psychological or psychiatric referral.

A technique used to facilitate cultural understandingc.

A technique used to perform psychotherapyd.

A technique that is a quick screen for psychiatric issues and interventions for psychological problems

 

 

 

 

 

Question 99. Question :BATHEing the patient is an advanced practice nursingintervention that allows the practitioner to:

Develop a therapeutic relationship without “owning” the patient’s problem

Conduct psychological counseling within the context of the primary care encounter

Focus on the “process” and not the assessment

Make the patient and family happier

 

Question 100. Question A 45-year-old woman is seen in the clinic with abnormaluterine bleeding and pain during intercourse. The clinicianshould consider which of the following diagnoses? Leiomyoma

Pregnancy

Ovarian cancer

All of the above

 

MN551 Unit 10 Final Exam

MN551 Unit 10 Final Exam

Question

  1. During an examination, the nurse observes a female patient’s vestibule and expects to see the:

A ) urethral meatus and vaginal orifice.

  1. B) vaginal orifice and vestibular (Bartholin) glands.
  2. C) urethral meatus and paraurethral (Skene) glands.
  3. D) paraurethral (Skene) and vestibular (Bartholin) glands.
  4. During a speculum inspection of the vagina, the nurse would expect to see what at the end of the vaginal canal?
  5. A) Cervix
  6. B) Uterus
  7. C) Ovaries
  8. D) Fallopian tubes
  9. The uterus is usually positioned tilting forward and superior to the bladder. This position is known as:
  10. A) anteverted and anteflexed.
  11. B) retroverted and anteflexed.

C retroverted and retroflexed.

D)superiorverted and anteflexed.

  1. An 11-year-old girl is in the clinic for a sports physical. The nurse notices that she has begun to develop breasts, and during the conversation the girl reveals that she is worried about her development. The nurse should use which of these techniques to best assist the young girl in understanding the expected sequence for development? The nurse should:
  2. A) use the Tanner’s table on the five stages of sexual development.
  3. B) describe her development and compare it with that of other girls her age.
  4. C) use Jacobsen’s table on expected development on the basis of height and weight data.
  5. D) reassure her that her development is within normal limits and should tell her not to worry about the next step.
  6. A woman who is 8 weeks pregnant is in the clinic for a checkup. The nurse reads on her chart that her cervix is softened and looks cyanotic. The nurse knows that the woman is exhibiting _____ sign and _____ sign.
  7. A) Tanner’s; Hegar’s
  8. B) Hegar’s; Goodell’s
  9. C) Chadwick’s; Hegar’s
  10. D) Goodell’s; Chadwick’s
  11. A woman who is 22 weeks pregnant has a vaginal infection. She tells the nurse that she is afraid that this infection will hurt the fetus. The nurse knows that which of these statements is true?
  12. A) If intercourse is avoided, then the risk for infection is minimal.
  13. B) A thick mucus plug forms that protects the fetus from infection.
  14. C) The acidic pH of vaginal secretions promotes the growth of pathogenic bacteria.
  15. D) The mucus plug that forms in the cervical canal is a good medium for bacterial growth.
  16. The changes normally associated with menopause occur generally because the cells in the reproductive tract are:

A)aging.

B)becoming fibrous.

C)estrogen dependent.

D)able to respond to estrogen.

  1. The nurse is reviewing the changes that occur with menopause. Which of these are changes associated with menopause?
  2. A) Uterine and ovarian atrophy along with thinning vaginal epithelium
  3. B) Ovarian atrophy, increased vaginal secretions, and increasing clitoral size
  4. C) Cervical hypertrophy, ovarian atrophy, and increased acidity of vaginal secretions
  5. D) Vaginal mucosa fragility, increased acidity of vaginal secretions, and uterine hypertrophy
  6. A 54-year-old woman who has just completed menopause is in the clinic today for a yearly physical examination. Which of these statements should the nurse include in patient education? “A postmenopausal woman:
  7. A) is not at any greater risk for heart disease than a younger woman is.”
  8. B) should be aware that she is at increased risk for dyspareunia because of decreased vaginal secretions.”
  9. C) has only stopped menstruating; there really are no other significant changes with which she should be concerned.”
  10. D) is likely to have difficulty with sexual pleasure as a result of drastic changes in the female sexual response cycle.”
  11. A woman is in the clinic for an annual gynecologic examination. The nurse should plan to begin the interview with the:
  12. A) menstrual history because it is generally nonthreatening.
  13. B) obstetric history because it is the most important information.
  14. C) urinary system history because there may be problems in this area as well.
  15. D) sexual history because it will build rapport to discuss this first.
  16. A patient has had three pregnancies and two live births. The nurse would record this information as gravida _____, para _____, AB _____.
  17. A) 2; 2; 1
  18. B) 3; 2; 0
  19. C) 3; 2; 1
  20. D) 3; 3; 1
  21. During the interview with a female patient, the nurse gathers data that indicate that the patient is perimenopausal. Which of these statements made by this patient leads to this conclusion?

A)”I have noticed that my muscles ache at night when I go to bed.”

  1. B) “I will be very happy when I can stop worrying about having a period.”
  2. C) “I have been noticing that I sweat a lot more than I used to, especially at night.”
  3. D) “I have only been pregnant twice, but both times I had breast tenderness as my first symptom.”
  4. A 50-year-old woman calls the clinic because she has noticed some changes in her body and breasts and wonders if they could be due to the hormone replacement therapy (HRT) she started 3 months ago. The nurse should tell her:
  5. A) “Hormone replacement therapy is at such a low dose that side effects are very unusual.”
  6. B) “Hormone replacement therapy has several side effects, including fluid retention, breast tenderness, and vaginal bleeding.”
  7. C) “It would be very unusual to have vaginal bleeding with hormone replacement therapy, and I suggest you come in to the clinic immediately to have this evaluated.”

D)”It sounds as if your dose of estrogen is too high; I think you may need to decrease the amount you are taking and then call back in a week.”

  1. A 52-year-old patient states that when she sneezes or coughs she “wets herself a little.” She is very concerned that something may be wrong with her. The nurse suspects that the problem is:
  2. A) dysuria.
  3. B) stress incontinence.
  4. C) hematuria.
  5. D) urge incontinence.
  6. During the interview a patient reveals that she has some vaginal discharge. She is worried that it may be a sexually transmitted infection. The nurse’s most appropriate response to this would be:
  7. A) “Oh, don’t worry. Some cyclic vaginal discharge is normal.”
  8. B) “Have you been engaging in unprotected sexual intercourse?”
  9. C) “I’d like some information about the discharge. What color is it?”
  10. D) “Have you had any urinary incontinence associated with the discharge?”
  11. A woman states that 2 weeks ago she had a urinary tract infection that was treated with an antibiotic. As a part of the interview, the nurse should ask, “Have you noticed:
  12. A) a change in your urination patterns?”
  13. B) any excessive vaginal bleeding?”
  14. C) any unusual vaginal discharge or itching?”
  15. D) any changes in your desire for intercourse?”
  16. Which statement would be most appropriate when the nurse is introducing the topic of sexual relationships during an interview?

A)”Now it is time to talk about your sexual history. When did you first have intercourse?”

  1. B) “Women often feel dissatisfied with their sexual relationships. Would it be okay to discuss this now?”
  2. C) “Often women have questions about their sexual relationship and how it affects their health. Do you have any questions?”
  3. D) “Most women your age have had more than one sexual partner. How many would you say you have had?”
  4. A 22-year-old woman has been considering using oral contraceptives. As a part of her history, the nurse should ask:
  5. A) “Do you have a history of heart murmurs?”
  6. B) “Will you be in a monogamous relationship?”
  7. C) “Have you thought this choice through carefully?”
  8. D) “If you smoke, how many cigarettes do you smoke per day?”
  9. A married couple has come to the clinic seeking advice on pregnancy. They have been trying to conceive for 4 months and have not been successful. What should the nurse do first?
  10. A) Ascertain whether either of them has been using broad-spectrum antibiotics.
  11. B) Explain that couples are considered infertile after 1 year of unprotected intercourse.
  12. C) Immediately refer the woman to an expert in pelvic inflammatory disease—the most common cause of infertility.
  13. D) Explain that couples are considered infertile after 3 months of engaging in unprotected intercourse and that they will need a referral to a fertility expert.
  14. A nurse is assessing a patient’s risk of contracting a sexually transmitted infection (STI). An appropriate question to ask would be:
  15. A) “You know that it’s important to use condoms for protection, right?”
  16. B) “Do you use a condom with each episode of sexual intercourse?”
  17. C) “Do you have a sexually transmitted infection?”
  18. D) “You are aware of the dangers of unprotected sex, aren’t you?”
  19. When the nurse is interviewing a preadolescent girl, which opening statement would be least threatening?
  20. A) “Do you have any questions about growing up?”
  21. B) “What has your mother told you about growing up?”
  22. C)  “When did you notice that your body was changing?”
  23. D) “I remember being very scared when I got my period. How do you think you’ll feel?”
  24. When the nurse is discussing sexuality and sexual issues with adolescents, a permission statement helps to convey that it is normal to think or feel a certain way. Which of these is the best example of a permission statement?
  25. A) “It is okay that you have become sexually active.”
  26. B) “Often girls your age have questions about sexual activity. Have you any questions?”
  27. C) “If it is okay with you, I’d like to ask you some questions about your sexual history.”
  28. D) “Often girls your age engage in sexual activity. It is okay to tell me if you have had intercourse.”
  29. The nurse is preparing to interview a postmenopausal woman. Which of these statements is true with regard to the history of a postmenopausal woman?
  30. A) The nurse should ask a postmenopausal woman if she ever has vaginal bleeding.
  31. B) Once a woman reaches menopause, the nurse does not need to ask any further history questions.
  32. C) The nurse should screen for monthly breast tenderness.
  33. D) Postmenopausal women are not at risk for contracting sexually transmitted infections and thus these questions can be omitted.
  34. During the examination portion of a patient’s visit, she will be in lithotomy position. Which statement below reflects some things that the nurse can do to make this more comfortable for her?
  35. A) Ask her to place her hands and arms behind her head.
  36. B) Elevate her head and shoulders to maintain eye contact.
  37. C) Allow her to choose to have her feet in the stirrups or have them resting side by side on the edge of the table.
  38. D) Allow her to keep her buttocks about 6 inches from the edge of the table to prevent her from feeling as if she will fall off.
  39. An 18-year-old patient is having her first pelvic examination. Which action by the nurse is appropriate?
  40. A) Invite her mother to be present during the examination.
  41. B) Avoid the lithotomy position this first time because it can be uncomfortable and embarrassing.
  42. C) Raise the head of the examination table and give her a mirror so that she can view the exam.
  43. D) Drape her fully, leaving the drape between her legs elevated to avoid embarrassing her with eye contact.
  44. The nurse has just completed an inspection of a nulliparous woman’s external genitalia. Which of these would be a description of a finding within normal limits?
  45. A) Redness of the labia majora
  46. B) Multiple nontender sebaceous cysts
  47. C) Discharge that is sticky and yellow-green
  48. D) Gaping and slightly shriveled labia majora
  49. The nurse is preparing for an internal genitalia examination of a woman. Which order of the examination is correct?
  50. A) Bimanual, speculum, rectovaginal
  51. B) Speculum, rectovaginal, bimanual
  52. C) Speculum, bimanual, rectovaginal
  53. D) Rectovaginal, bimanual, speculum
  54. During an internal examination of a woman’s genitalia, the nurse will use which technique for proper insertion of the speculum?
  55. A) Instruct the woman to bear down, open the speculum blades, and apply in a swift, upward movement.
  56. B) Insert the blades of the speculum on a horizontal plane, turning them to a 30-degree angle while continuing to insert them. Ask the woman to bear down after the speculum is inserted.
  57. C) Instruct the woman to bear down, turn the width of the blades horizontally, and insert the speculum at a 45-degree angle downward toward the small of the woman’s back.
  58. D) Lock the blades open by turning the thumbscrew. Once the blades are open, apply pressure to the introitus and insert the blades at a 45-degree angle downward to bring the cervix into view.
  59. The nurse is examining a 35-year-old female patient. During the history, the nurse notices that she has had two term pregnancies, and both babies were delivered vaginally. During the internal examination the nurse observes that the cervical os is a horizontal slit with some healed lacerations and that the cervix has some nabothian cysts that are small, smooth, and yellow. In addition, the nurse notices that the cervical surface is granular and red, especially around the os. Finally, the nurse notices the presence of stringy, opaque, odorless secretions. Which of these findings are abnormal?
  60. A) Nabothian cysts are present.
  61. B) The cervical os is a horizontal slit.
  62. C) The cervical surface is granular and red.
  63. D) Stringy and opaque secretions are present.
  64. A patient calls the clinic for instructions before having a Papanicolaou (Pap) smear. The most appropriate instructions from the nurse are:
  65. A) “If you are menstruating, please use pads to avoid placing anything into the vagina.”
  66. B) “Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment.”
  67. C) “If you suspect that you have a vaginal infection, please gather a sample of the discharge to bring with you.”
  68. D) “We would like you to use a mild saline douche before your examination. You may pick this up in our office.”
  69. During an examination, which tests will the nurse collect to screen for cervical cancer?
  70. A) Endocervical specimen, cervical scrape, and vaginal pool
  71. B) Endocervical specimen, vaginal pool, and acetic acid wash
  72. C) Endocervical specimen, KOH preparation, and acetic acid wash
  73. D) Cervical scrape, acetic acid wash, saline mount (“wet prep”)
  74. When performing the bimanual examination, the nurse notices that the cervix feels smooth and firm, is round, and is fixed in place (does not move). When cervical palpation is performed, the patient complains of some pain. The nurse’s interpretation of these results should be which of these?
  75. A) These findings are all within normal limits.
  76. B) The cervical consistency should be soft and velvety—not firm.
  77. C) The cervix should move when palpated; an immobile cervix may indicate malignancy.
  78. D) Pain may occur during palpation of the cervix.
  79. The nurse is palpating a female patient’s adnexa. The findings include a firm, smooth uterine wall; the ovaries are palpable and feel smooth and firm. The fallopian tube is firm and pulsating. The nurse’s most appropriate course of action would be to:
  80. A) tell the patient that her examination was normal.
  81. B) give her an immediate referral to a gynecologist.
  82. C) suggest that she return in a month for a recheck to verify the findings.
  83. D) tell the patient that she may have an ovarian cyst that should be evaluated further.
  84. A 65-year-old woman is in the office for routine gynecologic care. She had a complete hysterectomy 3 months ago after cervical cancer was detected. The nurse knows that which of these statements is true with regard to this visit?
  85. A) Her cervical mucosa will be red and dry looking.
  86. B) She will not need to have a Pap smear done.
  87. C) The nurse can expect to find that her uterus will be somewhat enlarged and her ovaries small and hard.
  88. D) The nurse should plan to lubricate the instruments and the examining hand well to avoid a painful examination.
  89. The nurse is preparing to examine the external genitalia of a school-age girl. Which of these positions would be most appropriate in this situation?
  90. A) In the parent’s lap
  91. B) In a frog-leg position on the examining table
  92. C) In the lithotomy position with the feet in stirrups
  93. D) Lying flat on the examining table with legs extended
  94. When assessing a newborn infant’s genitalia, the nurse notices that the genitalia are somewhat engorged. The labia majora are swollen, the clitoris looks large, and the hymen is thick. The vaginal opening is difficult to visualize. The infant’s mother states that she is worried about the labia being swollen. The nurse should reply:
  95. A) “This is a normal finding in newborns and should resolve within a few weeks.”

B “This could indicate an abnormality and may need to be evaluated by a physician.”

  1. C) “We will need to have estrogen levels evaluated to make sure that they are within normal limits.”
  2. D) “We will need to keep close watch over the next few days to see if the genitalia decrease in size.”
  3. During a vaginal examination of a 38-year-old woman, the nurse notices that the vulva and vagina are erythematous and edematous with thick, white, curdlike discharge adhering to the vaginal walls. The woman reports intense pruritus and thick white discharge from her vagina. The nurse knows that these history and physical examination findings are most consistent with which of these conditions?
  4. A) Candidiasis
  5. B) Trichomoniasis
  6. C) Atrophic vaginitis
  7. D) Bacterial vaginosis
  8. A 22-year-old woman is being seen at the clinic for problems with vulvar pain, dysuria, and fever. On physical examination, the nurse notices clusters of small, shallow vesicles with surrounding erythema on the labia. There is also inguinal lymphadenopathy present. The most likely cause of these lesions is:
  9. A) pediculosis pubis.
  10. B) contact dermatitis.
  11. C) human papillomavirus.
  12. D) herpes simplex virus type 2.
  13. When performing an external genitalia examination of a 10-year-old girl, the nurse notices that there is no pubic hair, and the mons and the labia are covered with fine vellus hair. These findings are consistent with stage _____ of sexual maturity, according to the Sexual Maturity Rating scale.
  14. A) 1
  15. B) 2
  16. C) 3
  17. D) 4
  18. A 46-year-old woman is in the clinic for her annual gynecologic examination. She voices a concern about ovarian cancer because her mother and sister died of it. The nurse knows that which of these statements is correct regarding ovarian cancer?
  19. A) Ovarian cancer rarely has any symptoms.
  20. B) The Pap smear detects the presence of ovarian cancer.
  21. C) Women at high risk for ovarian cancer should have annual transvaginal ultrasonography for screening.
  22. D) Women over age 40 years should have a thorough pelvic examination every 3 years.
  23. During a bimanual examination, the nurse detects a solid tumor on the ovary that is heavy and fixed, with a poorly defined mass. This finding is suggestive of:
  24. A) an ovarian cyst.
  25. B) endometriosis.
  26. C) ovarian cancer.
  27. D) an ectopic pregnancy.
  28. A 25-year-old woman comes to the emergency department with a sudden fever of 101° F and abdominal pain. Upon examination, the nurse notices that she has rigid, boardlike lower abdominal musculature. When the nurse tries to perform a vaginal examination, the patient has severe pain when the uterus and cervix are moved. The nurse knows that these signs and symptoms are suggestive of:
  29. A) endometriosis.
  30. B) uterine fibroids.
  31. C) ectopic pregnancy.
  32. D) pelvic inflammatory disease.
  33. During an external genitalia examination of a woman, the nurse notices several lesions around the vulva. The lesions are pink, moist, soft, and pointed papules. The patient states that she is not aware of any problems in that area. The nurse recognizes that these lesions may be:
  34. A) syphilitic chancre.
  35. B) herpes simplex virus type 2 (herpes genitalis).
  36. C) human papillomavirus (HPV), or genital warts.
  37. D) pediculosis pubis (crab lice).
  38. During an examination, the nurse would expect the cervical os of a woman who has never had children to appear:
  39. A) stellate.
  40. B) small and round.
  41. C) as a horizontal irregular slit.
  42. D) everted.
  43. A woman has just been diagnosed with HPV, or genital warts. The nurse should counsel her to receive regular examinations because this virus makes her at a higher risk for _____ cancer.
  44. A) uterine
  45. B) cervical
  46. C) ovarian
  47. D) endometrial
  48. During an internal examination, the nurse notices that the cervix bulges outside the introitus when the patient is asked to strain. The nurse will document this as:
  49. A) uterine prolapse, graded first degree.
  50. B) uterine prolapse, graded second degree.
  51. C) uterine prolapse, graded third degree.
  52. D) a normal finding.
  53. A 35-year-old woman is at the clinic for a gynecologic examination. During the examination, she asks the nurse, “How often do I need to have this Pap test done?” Which reply by the nurse is correct?

A)”It depends. Do you smoke?”

B)”This will need to be done annually until you are 65.”

C)”If you have 2 consecutive normal Pap tests, then you can wait 5 years between tests.”

D)”After age 30, if you have 3 consecutive normal Pap tests, then you may be screened every 2 to 3 years.”

  1. The nurse is palpating an ovarian mass during an internal examination of a 63-year-old woman. Which findings of the mass’s characteristics would suggest the presence of an ovarian cyst? Select all that apply.
  2. A) Heavy and solid
  3. B) Mobile and fluctuant

C)Mobile and solid

  1. D) Fixed
  2. E) Smooth and round
  3. F) Poorly defined

 

HealthCare Information Systems (7pgs)

Questions:

  1. How proper use of Information Systems can enhance Health Care?

 

Millennium development goals report

Instructions for developing the MDGs Report HLTH 4380 Fall 2018 In this Project, we will use the United Nations Millennium Declaration document called Millennium Development Goals (MDGs) adopted by world leaders at the dawn of the 21st century as our guide. The Millennium Development Goals (MDGs) are eight international development goals that were established following the Millennium Summit of the United Nations in 2000, and subsequent adoption of the United Nations Millennium Declaration. Although these Goals have universal appeal, they are readily applicable to mainly developing countries and Middle-income countries of the world. Of course they have some relevance to the United States, but you are not required to make any comparison with US or any other industrialized country. The idea of including this part of the project is for us to examine the global perspectives of public health and the extent to which world leaders (governments, civil society groups, NGOs) in low-resource settings are affected by the poor health vulnerabilities and efforts being made by countries to improve population health. The MDGs has eight goals with targets and indicators; and range from halving extreme poverty rates to halting the spread of HIV/AIDS and providing universal primary education by the target date of 2015. I have provided the eight goals below: 1. To eradicate extreme poverty and hunger 2. To achieve universal primary education 3. To promote gender equality and empower women 4. To reduce child mortality 5. To improve maternal health 6. To combat HIV/AIDS, malaria, and other diseases 7. To ensure environmental sustainability 8. To develop a global partnership for development These goals have been reviewed in July 2015, and a new development plan Agenda 2030 Sustainable Development Goals has been put in place. I have posted a copy of final review of the MDGs document on Blackboard (under MDG Assignment Resources). Your role is to select TWO GOALS from the MDGs and two specific countries outside the United States and other industrialized countries to assess the extent to which your selected countries did in achieving the goal by July 2015 (the target and indicators for that MDG goals you picked by July of 2015). You may include what the country need to do as part of your postMDG steps. The post MDG’s are Sustainable Development Goals (SDGs) MDG Expectation: Visit the web link of countries you have selected for this project. You can just google by typing “your selected country and MDG report.” For example, if I selected Ghana, I will google “Ghana MDG report” and you will find all MDG reports for Ghana in different years. Select the three most current reports of the respective country selected. The link below is for the assessment of UN member’s countries progress towards achievement of MDG’s. Assess (based on your chosen goals and targets for the MDG’s) whether the country (of your interest) is likely to meet those MDG’s (for that country) by 2015 according to your specific objective /goals. Critically evaluate whether your specific community or your country of interest will meet respective goals and objectives as well as the accompanying dates. Prepare a six page comparative analytic report that includes the information below (you may additional information for extra credit): • Short definition or description of your Goals (from the MDGs) for the two countries, and a briefly descriptions of each country’s background context. The context of each country is important for understanding why or why not the results achieved in the manner in they have been reported. • Most important issue each country addressed in each Goal. • Individuals most affected by this objective (age, gender, ethnicity, etc.) and a country of your interest. • Ethnic/racial groups most affected • Value of addressing this Goal and consequences of not meeting your objective • Most interesting data to use to gain more attention to this objective or Goal • Details of community and national efforts to address this issue and any local data that you may be able to secure. There is detailed information on the MDG’s and what countries are doing to achieve a specific goal. Make sure to select a peer reviewed publication and cite appropriately. Please, refer to this website for additional information on MDGs: http://www.healthpolicyinitiative.com/index.cfm?id=onlineCDs&groupID=7 3 Note that the MDG’s are primarily United Nations target to improve health and social wellbeing of populations of the world (mainly outside the United States). The US uses the Healthy People as a national guide for improving health and social outcomes. Healthy People are a set of goals and objectives spanning a 10-year period, designed to guide national health promotion and disease prevention efforts for the population in the United States. Prepare a critical and detailed six-page report to address those issues. You will utilize and cite, according to the APA Style and Format (6th edition). Make sure that you have at least seven additional references aside the Healthy People 2020 and MDGs documents. My suggestions when writing this paper is to avoid direct quoting from any source (even those you will cite those sources). I strongly recommend that you paraphrase and cite appropriately instead of direct quoting.

BSBSUS401 Implement & monitor environmentally sustainable work practices

What is the purpose of National Greenhouse & Energy Reporting Legislation?

 

  1. What is the purpose of Environment Protection & Biodiversity Conservation Legislation?
  2. What is the Kyoto Protocol?
  3. Who has the prime responsibility for environmental protection?
  4. How do organisations know how to behave ethically in regards to sustainability?

Activity 2.

What process might an assessor follow when analysing procedures to ensure compliance with

  1. environmental regulations?
  2. How might an assessor conduct an assessment?

Activity 3.

  1. What is resource efficiency?
  2. What is an Environmental Management System?
  3. How can a work group be engaged in disseminating environmental and resource efficiency information?

 

Activity 4.

  1. Explain the differences between qualitative and quantitative information.
  2. What do you think are the advantages of presenting analysed data in graphical format, rather than a written report?
  3. Your organisation is interested in analysing and organising information about the amount of paper it uses. Convert the data provided into a format that is easily used.

Activity 5.

  1. What are the goals of resource usage assessments? Give at least 6 examples.
  2. List the steps (in order) that need to be taken when carrying out a resource usage assessment.

Activity 6.

  1. Identify 5 benefits of environmental purchasing.

Activity 7.

  1. How can organisations ensure that work processes meet environmental requirements and identify areas in which changes need to be made? Give at least 6 examples.
  2. What is problem solving in the context of environmental work processes and what is its aim/s?

Activity 8.

  1. List at least 5 various ways that organisations can access stakeholder input.

Activity 9.

  1. What are the advantages of joining an industry association? List two examples.
  2. What are the advantages of joining an environmental program? Give 2 examples.
  3. What is the hierarchy of control?
  4. Rearrange the controls in their correct order, as specified in the hierarchy of control:

Administration, Elimination, Engineering, Personal Protective Equipment (PPE), and Substitution.

Activity 11.

  1. What are Key Performance Indicators (KPIs)?
  2. What five criteria should be met when creating targets?
  3. Identify what is wrong with the following targets and rewrite them so they conform to SMART criteria.
  4. The Absolute Advertising Agency will reduce its paper waste.
  5. The Fish Factory will reduce its energy consumption to zero in the next month.

Activity 12.

  1. Identify five things a business could do to reduce its energy consumption.
  2. Identify five things an organisation could do to reduce its waste.

Activity 13.

  1. Identify the four steps of the continuous improvement cycle.
  2. Identify five things an organisation can do to improve the performance of its employees.

Activity 14.

  1. Explain why it is a good idea to integrate environmental procedures and practices with pre-existing organisation procedures and practices.
  2. What needs to be done when existing procedures or work practices are changed or new procedures and work practices are introduced?

Activity 15.

Define the term “Engagement”.

Engagement is the emotional commitment the employee has to the organization and its goals. It relates to a state of involvement and participation.

 

  1. Why is it important to ensure that employees do not become disengaged?
  2. What are the benefits of having a diverse team?

Activity 16.

  1. List at least six people/groups who might make up an organisations stakeholders.
  2. Each stakeholder will have different areas of expertise. Complete the table by providing reasons that an organisation should seek suggestions & ideas about their environmental and resource efficiency management for each of the listed stakeholders.

 

Activity 17.

  1. A school is thinking about installing low-flush toilets in all of its bathrooms and air hand-driers to replace paper towel dispensers. Purchasing new toilets for the entire school will cost $22,000. It will need to employ plumbers to fit the toilets at a cost of $9,500. It is estimated that this will save the school $16,000 in water consumption fees. The hand driers will cost $13,500. The cost of employing electricians to install the hand driers will come to $4,400. As the school will no longer have to purchase paper towels, it will save $7,300 per year. It also estimates it will save $1,000 a year in cleaning costs, as the bathrooms will take less time to clean, and bins will need to be emptied less frequently. The school will incur additional electricity costs of $1,700 per year, however. Calculate the combined payback period for the installation of low flush toilets and air hand driers.

Activity 18.

  1. Determine whether the following statements are true or false.

Activity 19.

  1. Place the steps, which need to be observed when creating an environment report in their correct order.
  • Communicate with the audience to understand their concerns, questions, expectations & interests.
  • Create performance Indicators.
  • Decide how you are going to publish report.
  • Gather the data and evaluate it.
  • Identify the data you will need to produce the report.
  • Identify key environmental aspects that need to be covered by the report.
  • Identify the target audience for your report.
  • Make improvements to reporting procedures for future reports.
  • Obtain Feedback.
  • Produce, publish and distribute the report.
  1. Identify 5 benefits of creating and distributing an environmental report.

Activity20.

  1. Why is it important to carry out regular evaluations of environmental management systems/ strategies and improvement plans?

Activity 21.

  1. List 5 reasons that efficiency targets should be/ might need to be regularly reviewed.

Activity 22.

  1. Identify the characteristics of an effective reward system. Give 4 examples.

Question 1.

What methods can be used to convey information and identify sustainability improvements?

Question 2.

What are the essential features of a non-compliance form that could be used by employees to report any non-compliance issues?

Question 3.

What is the effect of environmental regulations and legislation on business?

Question 4.

What common environmental and energy efficiency issues can you think of?

Question5.

What benchmarks might be used for environmental & resource sustainability?

List at least 8 examples of techniques or tools that can be used to achieve efficiency.

Question 6.

Define the term “Sustainability” and explain how it relates to resource usage.

Question 7.

What are the steps in creating an Environment Management System (EMS)?

Question 8.

How do sustainable businesses foster ethical behaviours in staff and management?

Summative Assessment 2

Project 1.

 

Essay Question –write a response to the following quote from Unlimited Sustainable Development Solutions.

Organisations today are being asked to address an increasingly complex set of environmental issues. As noted in the quote:

“Sustainability is achieved when we understand the economic, environmental, and social consequences of our actions and make deliberate choices that allow all people to lead healthy, productive and enjoyable lives”.

Your response should include a discussion of:

  • Complex environmental issues.
  • Methods of measuring an organisation’s environmental impact.
  • Methods of managing an organisation’s environmental impact.
  • Methods of reducing an organisation’s environmental impact.

Project 2.

Youare the supervisor of a group of 15 workers in a business involved in an industry of your choice. You have been asked to plan and organise a number of work group activities in relation to measuring current resource use and devising strategies to improve usage.

  1. Identify a minimum of 3 appropriate work group activities and provide an overview of what is involved with each activity.
  2. Develop a plan to monitor resource use and improvements for environmental performance as a result of the activities undertaken by your work group.

 

 

Millennium development goals

Pick two MDGs

Evaluate the progress with a case study of two developing countries. 

 

HSA 505 Case Study 3 Missed Opportunities

HSA 505 Case Study 3 Missed Opportunities

 

Due Week 9 and worth 200 points

 

Read the case study titled “Missed Opportunities”, located in the online course shell.

 

Write a four to six (4-6) page paper in which you:

  1. Examine the pros and cons from the perspective of Crestview Hospital of the placement of its new billboard directly adjacent to Briarwood Medical Center. Interpret the reaction of customers and other community stakeholders to the billboard postings.
  2. Use competitive marketing entry strategies to suggest the action that Briarwood Hospital should undertake to counter the messages in the new Crestview Hospital Billboard postings.
  3. Recommend the marketing communication strategy or strategies that both Crestview and Briarwood Hospitals should employ. Justify why the Governing Board of both hospitals should take a proactive role in promoting and implementing effective marketing strategies.
  4. Assess the value of the various marketing research tool(s) that Briarwood and Crestview hospital could use to promote effective marketing communication strategies. Justify your response.
  5. Use at least five (5) quality academic resources. Note: Wikipedia and other Websites do not qualify as academic resources.

 

Your assignment must follow these formatting requirements:

  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
  • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

 

The specific course learning outcomes associated with this assignment are:

  • Evaluate marketing research tools involved in the marketing process.
  • Formulate competitive market entry strategies based on analysis of global markets that comply to initiatives in the health care industry.
  • Determine the marketing communications strategy used in health care services.
  • Use technology and information resources to research issues in health services strategic marketing.
  • Write clearly and concisely about health services strategic marketing using proper writing mechanics.

HSA 599 week 5 Case Study – GE Healthcare (A): Innovating for Emerging Markets

HSA 599 week 5 Case Study – GE Healthcare (A): Innovating for Emerging Markets

Read the case study titled “GE Healthcare (A): Innovating for Emerging Markets” located in the XanEdu case pack (Link Below)

Write a three to four (3-4) page paper in which you:

  • Determine two (2) emerging trends in the external environment that prompted General Electric (GE) Healthcare to develop a new strategy for the production and marketing of a low cost Electroencephalography (EEG) machine in bottom of the pyramid markets (BOP).
  • Examine two (2) internal barriers GE Healthcare faced when developing its BOP market in India and determine the manner in which they hindered GE Healthcare’s growth in this market segment.
  • Analyze two (2) of the significant external barriers that GE Healthcare faced when trying to meet its marketing goals in the Indian market. Propose two (2) ways to address these barriers.
  • Analyze the specific steps GE took in developing its strategy to grow its BOP market. Determine the manner in which those actions apply to the principles of strategic thinking and strategic planning.
  • Determine the manner in which GE Healthcare’s strategy to improve its position in BOP markets contributed to the organization’s value chain in both emerging and developed markets.

Your assignment must follow these formatting requirements:

Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.

Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

  • Differentiate between strategic management, strategic thinking, strategic planning, and managing strategic momentum.
  • Analyze the significance of the external environment’s impact on health care organizations.
  • Examine the role of internal environmental analysis in identifying the basis for sustained competitive advantage.
  • Examine the organizational value chain, including the components of the service delivery and support activities.
  • Examine barriers to new product development that comply with initiatives in the health care industry.
  • Use technology and information resources to research issues in the strategic management of health care organizations.
  • Write clearly and concisely about strategic management of health care organizations using proper writing mechanics.

Grading for this assignment will be based on answer quality, logic / organization of the paper, and language and writing skills, using the following rubric.

 

Week 2 – Healthy People 2020

After reviewing the Healthy People 2020 website, discuss the concept of MAP-IT.  Choose a health topic of your choice to briefly discuss how MAP-IT can be implemented in the community of your choice.
Topic: Affordable Medication Program

Length:  Minimum of two full pages of text in length.  Please ensure you cite your references in APA format. Please ensure you cite your references in APA format with a minimum of 3 references

 

https://www.healthypeople.gov/2020/tools-and-resources/Program-Planning

 

Influences of Health Care Research

Identify one innovation that has been developed in the past 20 years that has influenced the health care industry, such as: Telemedicine Organ transplants Write a 700- to 1,050-word paper that discusses the following: Explain how evidence-based research influences the health care industry. Compare external influences on health care research. Cite 3 peer-reviewed, scholarly, or similar references to support your paper. Format your paper according to APA guidelines.

Human Resource Management Overview

Assignment 1: Human Resource Management Overview

 Due Week 4 and worth 200 points

 

Using the course readings, articles, and your personal experiences, address the role of human resource management.

 Write a six to eight (6-8) page paper in which you:

1.Determine key roles that human resource management plays in the health care field..

2.Evaluate three to five (3-5) functions of human resource management in terms of their level of support to the health care field, and then select which one you believe is the primary function in furthering the health care field..

3.Analyze the role of human resource management in an organization’s strategic plan..

4.Use at least three (3) quality academic resources in this assignment.  Note: Wikipedia and other Websites do not qualify as academic resources..

 

Your assignment must follow these formatting requirements:

  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions..
  • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length..

 

The specific course learning outcomes associated with this assignment are:

  • Appraise the aspects of managing human resources (HR) in health care organizations. .
  • Use technology and information resources to research issues in health care human resources management..
  • Write clearly and concisely about health care human resources management using proper writing mechanics..

 

MN568 Unit 10 Final latest 2017 

MN568 Unit 10 Final latest 2017

Question 1 2 / 2 points

Which statement about confusion is true?

Question options:

  1. a) Confusion is a disease process.
  2. b) Confusion is always temporary.
  3. c) Age is a reliable predictor of confusion.
  4. d) Polypharmacy is a major contributor to confusion in older adults.

Question 2 0 / 2 points

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?

Question options:

  1. a) Meclizine
  2. b) Diphenhydramine
  3. c) Diamox
  4. d) Promethazine

Question 3 2 / 2 points

The hallmark of an absence seizure is:

Question options:

  1. a) No activity at all
  2. b) A blank stare
  3. c) Urine is usually voided involuntarily
  4. d) The attack usually lasts several minutes

Question 4 2 / 2 points

How often should drug levels be monitored when a seizure medication has controlled the seizures, and the drug level is adequate?

Question options:

  1. a) Every 3 months
  2. b) Every 6 months
  3. c) Annually
  4. d) Whenever there is a problem

Question 5 2 / 2 points

Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)?

Question options:

  1. a) A teenage male
  2. b) A 65-year-old male
  3. c) A 25-year-old female
  4. d) A 60-year-old female

Question 6 2 / 2 points

Which of the following is a specific test to MS?

Question options:

  1. a) Magnetic resonance imaging (MRI)
  2. b) Computed tomography (CT) scan
  3. c) A lumbar puncture
  4. d) There is no specific test.

Question 7 2 / 2 points

Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

Question options:

  1. a) Cholinesterase inhibitors
  2. b) Anxiolytics
  3. c) Antidepressants
  4. d) Atypical antipsychotics

Question 8 2 / 2 points

Which hematoma occurs along the temporal cranial wall and results from tears in the middle meningeal artery?

Question options:

  1. a) Epidural hematoma
  2. b) Subdural hematoma
  3. c) Subarachnoid hematoma
  4. d) Intraparenchymal hemorrhage

Question 9 2 / 2 points

Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty chewing?

Question options:

  1. a) CN V
  2. b) CN VII
  3. c) CN IX
  4. d) CN X

Question 10 2 / 2 points

Which statement best describes a carotid bruit?

Question options:

  1. a) It is felt with the middle three fingers over the carotid artery.
  2. b) A bruit becomes audible when the lumen is narrowed to 1 mm or less.
  3. c) A low-pitched bruit is a medical emergency.
  4. d) The higher the pitch of the bruit, the higher the degree of stenosis.

Question 11 2 / 2 points

Which patient is more likely to have a cluster headache?

Question options:

  1. a) A female in her reproductive years
  2. b) A 40-year-old African American male
  3. c) A 55-year-old female who drinks 10 cups of coffee daily
  4. d) A 45-year-old male awakened at night

Question 12 2 / 2 points

Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?

Question options:

  1. a) Dementia
  2. b) Alzheimer’s disease
  3. c) Parkinson’s disease
  4. d) Delirium

Question 13 2 / 2 points

Which type of meningitis is more benign, self-limiting, and caused primarily by a virus?

Question options:

  1. a) Purulent meningitis
  2. b) Chronic meningitis
  3. c) Aseptic meningitis
  4. d) Herpes meningitis

Question 14 2 / 2 points

Which is the most sensitive neuroimaging test to evaluate patients with encephalitis?

Question options:

  1. a) MRI
  2. b) CT
  3. c) Electroencephalogram (EEG)
  4. d) An initial lumbar puncture

Question 15 2 / 2 points

What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?

Question options:

  1. a) A stabbing pain on one small area of the body
  2. b) A vesicular skin lesion on one side of the body
  3. c) A pain that is worse upon awakening
  4. d) A lesion on the exterior ear canal

Question 16 1 / 1 point

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?

Question options:

  1. a) “Most patients have complete recovery in 3 to 6 months.”
  2. b) “Unfortunately, you’ll probably have a small amount of residual damage.”
  3. c) “Don’t worry, I’ll take care of everything.”
  4. d) “You may have a few more episodes over the course of your lifetime but no permanent damage.”

Question 17 2 / 2 points

Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary. You tell him:

Question options:

  1. a) “L-dopa is neuroprotective.”
  2. b) “The primary goal of therapy is to replace depleted stores of dopamine.”
  3. c) “This is the only drug that can provide symptomatic benefit.”
  4. d) “This is the initial monotherapy drug.”

Question 18 2 / 2 points

Which of the following signs is seen in a patient with more advanced PD?

Question options:

  1. a) Resting tremor
  2. b) Bradykinesia
  3. c) Rigidity
  4. d) Postural instability

Question 19 2 / 2 points

Which of the following is the most commonly experienced symptom of migraine?

Question options:

  1. a) Light sensitivity
  2. b) Pulsatile pain
  3. c) Sound sensitivity
  4. d) Experiencing an aura

Question 20 2 / 2 points

Which of the following characteristics differentiates peripheral vertigo from central vertigo?

Question options:

  1. a) The duration of central vertigo is shorter than that of peripheral vertigo.
  2. b) There is an auditory-associated symptom with peripheral vertigo and a visual-associated symptom with central vertigo.
  3. c) Central vertigo is positional, and peripheral vertigo is not.
  4. d) The onset of central vertigo is more sudden than that of peripheral vertigo.

Question 21 2 / 2 points

Carotid endarterectomy should be considered only for symptomatic patients with greater than what percentage of stenosis?

Question options:

  1. a) Greater than 25%
  2. b) Greater than 50%
  3. c) Greater than 75%
  4. d) Only for 100% occlusion

Question 22 2 / 2 points

What antiplatelet agent is most widely used for secondary prevention of stroke?

Question options:

  1. a) Aspirin
  2. b) Ticlopidine
  3. c) Clopidogrel
  4. d) Aspirin and clopidogrel

Question 23 2 / 2 points

Which adjunctive diagnostic test should be used in the work-up of a patient with suspected Creutzfeldt-Jakob disease or transient epileptic amnesia?

Question options:

  1. a) MRI
  2. b) CT
  3. c) Cerebrospinal fluid analysis
  4. d) EEG

Question 24 2 / 2 points

Which herbal preparation may cause delirium and should be avoided in an elderly patient?

Question options:

  1. a) Sam-e
  2. b) Saint John’s Wort
  3. c) Melatonin
  4. d) Saw Palmetto

Question 25 0 / 2 points

Which of the following activities is part of the functional activities questionnaire?

Question options:

  1. a) Asking the patient to unravel a Rubik’s cube
  2. b) Determining if the patient can drive on the highway
  3. c) Asking the patient about a news event from the current week
  4. d) Seeing if the patient can keep his or her home clean

Question 26 2 / 2 points

About 90% of all headaches are?

Question options:

  1. a) Tension
  2. b) Migraine
  3. c) Cluster
  4. d) Without pathological cause

Question 27 2 / 2 points

Which statement is true regarding driving and patients with a seizure disorder?

Question options:

  1. a) Once diagnosed with a seizure disorder, patients must never drive again.
  2. b) After being seizure free for 6 months, patients may drive.
  3. c) Each state has different laws governing driving for individuals with a seizure disorder.
  4. d) These persons may drive but never alone.

Question 28 2 / 2 points

Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon. Which medication might help given intravenously once a month?

Question options:

  1. a) Glatiramer acetate
  2. b) Natalizumab
  3. c) Fingolimod
  4. d) Glucocorticoids

Question 29 2 / 2 points

The ‘freezing phenomenon’ is a cardinal feature of?

Question options:

  1. a) Parkinson’s disease
  2. b) Alzheimer’s disease
  3. c) A CVA
  4. d) Bell’s palsy

Question 30 2 / 2 points

A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as?

Question options:

  1. a) Spinothalamic dysfunction
  2. b) Ratcheting
  3. c) Cogwheeling
  4. d) Hand tremors

Question 31 2 / 2 points

Clinical features of insidious onset, slow progression, and a lack of other findings to explain the symptoms are fairly diagnostic of which condition?

Question options:

  1. a) Guillain-Barré syndrome
  2. b) Parkinson’s disease
  3. c) Alzheimer’s disease
  4. d) Huntington’s disease

Question 32 1 / 1 point

Which condition is characterized by the impaired ability to learn new information along with either a cognitive disturbance in language, function, or perception?

Question options:

  1. a) Guillain-Barré syndrome
  2. b) Parkinson’s disease
  3. c) Alzheimer’s disease
  4. d) Delirium

Question 33 2 / 2 points

A score of 20 to 25 on this test indicates early-stage Alzheimer’s disease:

Question options:

  1. a) SLUMS
  2. b) MoCA
  3. c) FAST
  4. d) MMSE

Question 34 2 / 2 points

Intravenous thrombolytic therapy following an ischemic CVA should be given within how many hours of symptom onset?

Question options:

  1. a) 1 hour
  2. b) 3 hours
  3. c) 6 hours
  4. d) 12 hours

Question 35 2 / 2 points

When administered at the beginning of an attack, oxygen therapy may help this kind of headache?

Question options:

  1. a) Tension
  2. b) Migraine
  3. c) Cluster
  4. d) Stress

Question 36 2 / 2 points

The effectiveness of benzodiazepines in treating anxiety disorders suggests that which of the following neurotransmitters plays a role in anxiety?

Question options:

  1. a) Acetylcholine
  2. b) Gamma-aminobutyric acid (GABA)
  3. c) Dopamine
  4. d) Serotonin

Question 37 2 / 2 points

The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least:

Question options:

  1. a) 1 month
  2. b) 3 months
  3. c) 6 months
  4. d) 12 months

Question 38 1 / 1 point

A patient presents to the clinician after experiencing four episodes in the last month of sweating, palpitations, chest pain, nausea, and shaking. Each episode lasted about 10 minutes. The patient is now becoming very fearful of future events and has been reluctant to leave the house. The clinician suspects panic disorder but wants to rule out any possible medical causes. Which of the following medical conditions can mimic the symptoms of a panic attack?

Question options:

  1. a) Pheochromocytoma
  2. b) Hyperthyroidism
  3. c) Cardiac arrhythmias
  4. d) All of the above

Question 39 2 / 2 points

Which of the following is considered first-line treatment for panic disorders?

Question options:

  1. a) Benzodiazepines
  2. b) Selective serotonin reuptake inhibitors (SSRIs)
  3. c) Tricyclic antidepressants
  4. d) Cognitive behavioral therapy

Question 40 1 / 1 point

Which of the following symptoms is not part of the diagnostic criteria for post-traumatic stress disorder (PTSD)?

Question options:

  1. a) Hypersomnolence
  2. b) Blunted feelings
  3. c) Loss of interest in significant activities
  4. d) Intrusive recurrent recollections of the event

Question 41 2 / 2 points

Which of the following neuroendocrine abnormalities is implicated in depression?

Question options:

  1. a) Decrease in adrenal size
  2. b) Increased cortisol and corticotrophin-releasing hormone
  3. c) An exaggerated response of thyrotropin (TRH) to infusion of thyroid-releasing hormone
  4. d) Increased inhibitory response of glucocorticoids to dexamethasone

Question 42 2 / 2 points

The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants?

Question options:

  1. a) SSRIs are more effective than TCAs.
  2. b) SSRIs take less time to work than TCAs.
  3. c) SSRIs have a more favorable side-effect profile than TCAs.
  4. d) SSRIs are not lethal in overdose.

Question 43 2 / 2 points

After discontinuing fluoxetine, how long must a person wait before starting a monoamine oxidase inhibitor?

Question options:

  1. a) 2 weeks
  2. b) 3 weeks
  3. c) 4 weeks
  4. d) 5 weeks

Question 44 2 / 2 points

It is important to educate patients with depression and their family members about reporting signs of increasing depression and suicidal thoughts. This is especially true during which time period?

Question options:

a) Before the initiation of treatment

b) 1 to 2 weeks after the initiation of treatment

c) When switching to a different medication

d) 1 to 2 weeks after tapering off medications

Question 45 2 / 2 points

A patient is experiencing extrapyramidal side effects from his antipsychotic medications. The clinician would most likely take which of the following approaches to treating these side effects?

Question options:

a) Give the patient a “drug holiday” until the symptoms resolve and then restart the medication.

b) Switch the patient to a different antipsychotic.

c) Treat the patient with anticholinergics.

d) Treat the patient with anticonvulsants.

Question 46 1 / 1 point

According to Kübler-Ross, the stages of grief occur in which order?

Question options:

a) Anger, denial, depression, bargaining, acceptance

b) Anger, denial, bargaining, acceptance, depression

c) Denial, anger, depression, bargaining, acceptance

d) Denial, anger, bargaining, depression, acceptance

Question 47 1 / 1 point

The clinician is educating a patient about the effects of marijuana. The patient stated she has been smoking for years and believes the use does not interfere with her life. What is a significant long-term sequelae of marijuana use that the clinician should educate this patient about?

Question options:

a) Memory impairment

b) Sexual dysfunction

c) Dry mouth

d) There are no long-term consequences of marijuana use.

Question 48 2 / 2 points

Cocaine acts as a stimulant by blocking the reuptake of which neurotransmitter?

Question options:

a) GABA

b) Acetylcholine

c) Dopamine

d) Serotonin

Question 49 2 / 2 points

What blood alcohol level corresponds with the signs of stupor and confusion?

Question options:

a) 0.05

b) 0.1

c) 0.2

d) 0.3

Question 50 2 / 2 points

Rapid eye movement (REM) sleep occurs how frequently during non-REM sleep?

Question options:

a) Every 30 minutes

b) Every 60 minutes

c) Every 90 minutes

d) Every 180 minutes

Question 51 2 / 2 points

Which of the following is a laboratory finding commonly found in patients with anorexia nervosa?

Question options:

a) Hypercholesterolemia

b) Hypermagnesmia

c) Leukocytosis

d) Decreased TRH

Question 52 2 / 2 points

Which of the following is the only drug for bulimia approved by the U.S. Food and Drug Administration?

Question options:

a) Sertraline

b) Fluoxetine

c) Citoprolam

d) Imipramine

Question 53 2 / 2 points

Which of the following would be important to monitor in a child receiving methylphenidate for treatment of attention deficit-hyperactivity disorder (ADHD)?

Question options:

a) Liver function

b) Vision

c) Growth parameters

d) Renal function

Question 54 2 / 2 points

It is important for the clinician to discuss the long-term effects of sexual assault with survivors. Which of the following is the most common long-term effect of sexual assault?

Question options:

a) Depression

b) Obsessive-compulsive disorder

c) Substance abuse

d) PTSD

Question 55 2 / 2 points

Women are at the highest risk for developing postpartum depression for up to how long after childbirth?

Question options:

a) 2 weeks

b) 1 month

c) 3 months

d) 6 months

Question 56 2 / 2 points

Which is the most prevalent psychiatric condition in the United States?

Question options:

a) Depression

b) Anxiety

c) Substance-related addictions

d) Gambling

Question 57 1 / 1 point

What is recorded as clinical category two of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision)?

Question options:

a) Clinical disorder or focus of clinical attention

b) Personality or environmental problems

c) Environmental and psychosocial stressors

d) Global assessment of functioning

Question 58 2 / 2 points

Which of the following may be used to evaluate a person’s suicide risk?

Question options:

a) CAGE

b) SANE

c) SAD PERSONAS

d) DIGFAST

Question 59 2 / 2 points

Assessing for adherence with prescribed medications and developing a plan for what to do if they are stopped is a major treatment issue for which of the following diagnostic groups?

Question options:

a) ADHD

b) Bipolar

c) Depression

d) Anxiety

Question 60 1 / 1 point

Bipolar disorder requires differential diagnosis from all of the following except?

Question options:

a) Substance abuse and medication effects

b) Medical and neurological disorders

c) Cluster B personality disorders and depression

d) Obsessive-compulsive disorder

Question 61 1 / 1 point

The use of benzodiazepines in the patient with generalized anxiety disorder and comorbid depression can exacerbate depressive symptoms.

Question options:

a) True

b) False

Question 62 1 / 1 point

Depressive episodes associated with bipolar disorder are treated the same as major depressive disorder.

Question options:

a) True

b) False

Question 63 1 / 1 point

Women in abusive relationships have a greater chance of being killed by their batterers when they leave the relationship than women who stay.

Question options:

a) True

b) False

Question 64 1 / 1 point

Adults must show childhood onset of symptoms to receive a diagnosis of ADHD.

Question options:

a) True

b) False

Question 65 1 / 1 point

Parkinson’s disease and dementing illnesses may commonly manifest depressive symptoms.

Question options:

a) True

b) False

Question 66 1 / 1 point

The best predictor of suicide risk is a history of suicide attempts.

Question options:

a) True

b) False

Question 67 1 / 1 point

A no-suicide contract can prevent a suicide attempt.

Question options:

a) True

b) False

Question 68 1 / 1 point

Depression is the most chronic disabling and economically catastrophic medical disorder of the severe mental illnesses.

Question options:

a) True

b) False

Question 69 1 / 1 point

Clozapine (Clozaril) requires laboratory monitoring at specified frequencies with results reported to a national registry.

Question options:

a) True

b) False

Question 70 1 / 1 point

When combined with certain other medications, serotonin-specific antidepressants can have significant liver P450-interaction effects.

Question options:

a) True

b) False

Question 71 1 / 1 point

A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her examination?

Question options:

a) Human papillomavirus (HPV)

b) Endometrial hyperplasia

c) Vagismus

d) Polycystic ovarian syndrome

Question 72 2 / 2 points

A 20-year-old woman is seen in the clinic because her boyfriend was found to have gonorrhea. Which of the following is the treatment of choice for gonorrhea?

Question options:

a) Ceftriaxone

b) Doxycycline

c) Acyclovir

d) Metronidazole

Question 73 1 / 1 point

A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease has she most probably been exposed to?

Question options:

a) Gonorrhea

b) HPV

c) Chlamydia

d) Trichomonas

Question 74 1 / 1 point

A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear.Which of the following diagnoses is associated with this finding?

Question options:

a) Trichomonas

b) Bacterial vaginosis

c) HPV

d) Herpes simplex virus

Question 75 2 / 2 points

Which of the following medications is the treatment of choice for trichomonas?

Question options:

a) Metronidazole

b) Ceftriaxone

c) Diflucan

d) Doxycycline

Question 76 1 / 1 point

A 36-year-old woman is seen with complaints of vaginal itching, burning, and discharge. On potassium hydroxide (KOH) wet mount of vaginal discharge, the clinician notices hyphae. Which of the following treatments would be appropriate?

Question options:

a) Fluconazole

b) Estrogen vaginal cream

c) Metronidazole

d) Doxycycline

Question 77 2 / 2 points

Mandy presents with a cauliflower-like wart in her anogenital region. You suspect it was sexually transmitted and document this as a:

Question options:

a) Filiform/digitate wart

b) Dysplastic cervical lesion

c) Condyloma acuminata

d) Koilocytosis

Question 78 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 79 2 / 2 points

Of the following types of cellulitis, which is a streptococcal infection of the superficial layers of the skin that does not involve the subcutaneous layers?

Question options:

a) Necrotizing fasciitis

b) Periorbital cellulitis

c) Erysipelas

d) “Flesh-eating” cellulitis

Question 80 2 / 2 points

The forced vital capacity is decreased in:

Question options:

a) Asthma

b) Chronic bronchitis

c) Emphysema

d) Restrictive disease

Question 81 2 / 2 points

The most common cause of CAP is?

Question options:

a) Streptococcus pneumoniae

b) Klebsiella pneumoniae

c) Legionella pneumoniae

d) Pseudomonas aeruginosa

Question 82 2 / 2 points

Which of the following is a possible consequence of sleep apnea?

Question options:

a) Asthma

b) Increased white blood cells

c) Insulin resistance

d) Hyperactivity

Question 83 2 / 2 points

The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?

Question options:

a) IgA

b) IgE

c) IgG

d) IgM

Question 84 2 / 2 points

A 60-year-old man presents with an enlarged scrotum. The clinician uses a penlight to transilluminate the scrotum. In a patient with a hydrocele, what would the clinician expect to find?

Question options:

a) The scrotum will be dark.

b) The scrotum will appear light pink or yellow.

c) The scrotum will appear milky white.

d) The internal structures will be clearly visible.

Question 85 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 86 2 / 2 points

A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system?

Question options:

a) The cancer involves the seminal vesicles.

b) There is metastatic disease to regional lymph nodes.

c) The cancer is confined to the capsule.

d) There is metastasis to distant organs.

Question 87 1 / 1 point

A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects?

Question options:

a) Risk of osteoporosis

b) May have hot flushes

c) May have impotence

d) All of the above

Question 88 1 / 1 point

A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE).Which of the following should be included in the list of differential diagnoses?

Question options:

a) Testicular cancer

b) Inguinal hernia

c) Varicocele

d) All of the above

Question 89 1 / 1 point

What is the treatment of choice for a patient diagnosed with testicular cancer?

Question options:

a) Radical orchidectomy

b) Lumpectomy

c) Radiation implants

d) All of the above

Question 90 1 / 1 point

A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?

Question options:

a) Every month

b) Every 3 to 4 months

c) Every 6 to 12 months

d) Every year

Question 91 2 / 2 points

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?

Question options:

a) “You must be under a lot of stress lately.”

b) “It is hereditary. Did your father experience this also?”

c) “The cause is unknown, but we suspect it is due to an immunologic mechanism.”

d) “We’ll have to do some tests.”

Question 92 2 / 2 points

Which of the following is “a linear crack extending from the epidermis to the dermis?”

Question options:

a) An ulcer

b) A fissure

c) Lichenification

d) An excoriation

Question 93 2 / 2 points

A bulla is:

Question options:

a) A vesicle larger than 1 cm in diameter

b) An elevated solid mass with a hard texture; the shape and borders can be regular or irregular

c) A superficial elevated lesion filled with purulent fluid

d) Thinning of the skin (epidermis and dermis) that appears white or translucent

Question 94 1 / 1 point

A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds.What should you do?

Question options:

a) Make an immediate referral for an orthopedic evaluation without further assessment.

b) Tell her that it takes time for these bruises to improve, so she should be patient.

c) Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint.

d) Send her to the emergency room for reduction of this obvious wrist fracture.

Question 95 1 / 1 point

Osteoarthritis is primarily a noninflammatory condition.

Question options:

a) True

b) False

Question 96 1 / 1 point

The presence of a positive rheumatoid factor is always indicative of rheumatoid arthritis.

Question options:

a) True

b) False

Question 97 2 / 2 points

Which of the following medications can cause hyperglycemia?

Question options:

a) Prednisone

b) Metformin

c) Synthroid

d) Cephalexin

Question 98 2 / 2 points

Which of the following is diagnostic for diabetes mellitus?

Question options:

a) A1C 7.0 on one occasion

b) Fasting blood sugar (FBS) of 100 mg/dL on two occasions

c) Random glucose of 200 mg/dL on two occasions

d) Two-hour post-load plasma glucose of 300 mg/dL on one occasion

Question 99 2 / 2 points

Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?

Question options:

a) Insulin

b) Metformin

c) Glucotrol

d) Precose

Question 100 1 / 1 point

A 35-year-old woman presents with symptoms of hypoglycemia.There is no history of diabetes mellitus. Which of the following should be included in the differential diagnosis?

Question options:

a) Anxiety disorder

b) Pheochromocytoma

c) Psychosis

d) All of the above

MN568 Unit 8 Exam latest 2017

MN568 Unit 8 Exam latest 2017

Question 1 2 / 2 points

Osteoarthritis is primarily a noninflammatory condition.

Question options:

a) True

b) False

Question 2 2 / 2 points

Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?

Question options:

a) Insulin

b) Metformin

c) Glucotrol

d) Precose

Question 3 2 / 2 points

After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

Question options:

a) Suggest she use a heating pad to improve circulation.

b) Refer to a podiatrist for a foot care treatment plan.

c) Send her for acupuncture treatments.

d) All of the above

Question 4 2 / 2 points

Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?

Question options:

a) Morning stiffness and limited mobility of the lumbar spine

b) Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

c) Fever, chills, and elevated erythrocyte sedimentation rate

d) Pathologic fractures, severe night pain, weight loss, and fatigue

Question 5 2 / 2 points

John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain.The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

Question options:

a) Valgus stress test

b) McMurray circumduction test

c) Lachman test

d) Varus stress test

Question 6 2 / 2 points

The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort.Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs?

Question options:

a) “You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.”

b) “You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication.”

c) “You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.”

d) “It is important to take NSAIDs on an empty stomach in order to increase absorption.”

Question 7 2 / 2 points

The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an x-ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane’s description of her injury. Which of the following clues in Diane’s examination or history would alert the clinician to the need for obtaining radiographs?

Question options:

a) Inability to bear weight immediately after the injury

b) Development of marked ankle swelling and discoloration after the injury

c) Crepitation with palpation or movement of the ankle

d) All of the above

Question 8 2 / 2 points

The clinician finds numerous nodules on the thyroid of a 65-year-old woman. The clinician suspects thyroid cancer. Which of the following data would be most significant for this patient?

Question options:

a) A history of tonsillectomy in the 1940s

b) Recent exposure to mumps

c) Vegetarian diet

d) Allergy to iodine

Question 9 2 / 2 points

A vegetarian patient with gout asks the clinician about food he should avoid. The clinician should advise the patient to avoid which of the following foods?

Question options:

a) Rice

b) Carrots

c) Spinach

d) Potatoes

Question 10 2 / 2 points

One of the most frequent presenting signs/symptoms of osteoporosis is:

Question options:

a) Goiter

b) Abnormal serum calcium

c) Elevated urine biochemical markers

d) Bony fracture

Question 11 2 / 2 points

After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?

Question options:

a) Elevated TSH

b) Normal TSH

c) Low TSH

d) Undetectable TSH

Question 12 2 / 2 points

Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Question options:

a) Decreased C-reactive protein

b) Hyperalbuminemia

c) Morning stiffness

d) Weight gain

Question 13 2 / 2 points

The clinician prescribes glipizide (Glucotrol) for a diabetic patient. Which statement made by the patient would indicate that your teaching has been effective?

Question options:

a) “I’ll take my pill at least 30 minutes before breakfast.”

b) “I’ll take my Glucotrol before bedtime.”

c) “It is important to take my medication right after I eat.”

d) “Since I only like to eat two meals a day, I can take the pill between my meals.”

Question 14 2 / 2 points

The presence of a positive rheumatoid factor is always indicative of rheumatoid arthritis.

Question options:

a) True

b) False

Question 15 2 / 2 points

Which of the following statements is true regarding the treatment of carpal tunnel syndrome?

Question options:

a) The goal of treatment is to prevent flexion and extension movements of the wrist.

b) Splints are used in carpal tunnel syndrome, because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position.

c) Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.

d) All of the above

Question 16 2 / 2 points

Which of the following medications can cause hyperglycemia?

Question options:

a) Prednisone

b) Metformin

c) Synthroid

d) Cephalexin

Question 17 2 / 2 points

Janet is a 30-year-old who has recently been diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?

Question options:

a) Gastrocnemius weakness

b) A reduced or absent ankle reflex

c) Numbness in the lateral foot

d) Paresthesia of the perineum and buttocks

Question 18 2 / 2 points

You are performing muscle strength testing on a patient presenting with musculoskeletal pain and find that the patient has complete ROM with gravity eliminated. Which numeric grade of muscle strength would you give this patient?

Question options:

a) 1

b) 2

c) 3

d) 4

e) 5

Question 19 2 / 2 points

A diabetic patient asks the clinician why he needs to check his blood sugar at home even when he feels good. Which of the following responses would be most appropriate?

Question options:

a) “Control of glucose will help postpone or delay complications.”

b) “Regularly checking blood sugar will help establish a routine.”

c) “Monitoring glucose will promote a sense of control.”

d) All of the above

Question 20 2 / 2 points

Which of the following is diagnostic for diabetes mellitus?

Question options:

a) A1C 7.0 on one occasion

b) Fasting blood sugar (FBS) of 100 mg/dL on two occasions

c) Random plasma glucose greater than or equal to 200 in a person with symptoms of hyperglycemia

d) Two-hour post-load plasma glucose of 300 mg/dL on one occasion

Question 21 2 / 2 points

A patient with type 2 diabetes asks the clinician why she needs to exercise. In order to answer her, the clinician must understand that exercise has what effect on the patient with type 2 diabetes?

Question options:

a) Reduces postprandial blood glucose

b) Reduces triglycerides and increases high-density lipoprotein (HDL)

c) Reduces total cholesterol

d) All of the above

Question 22 0 / 2 points

A 35-year-old woman presents with symptoms of hypoglycemia.There is no history of diabetes mellitus. Which of the following should be included in the differential diagnosis?

Question options:

a) Anxiety disorder

b) Pheochromocytoma

c) Psychosis

d) All of the above

Question 23 2 / 2 points

The clinician has been doing diabetic teaching for a patient with type 1 diabetes. Which of the following statements by the patient would indicate that teaching has been effective?

Question options:

a) “As long as I don’t need glasses, I don’t have to worry about going blind.”

b) “I know I need to have my eyes checked every year.”

c) “My optometrist checks my eyes.”

d) “I will see my eye doctor when my vision gets blurry.”

Question 24 2 / 2 points

A 70-year-old female has fallen 2 weeks ago and developed immediate pain in her left wrist. She thought she just bruised it but is worried because it has not improved. She has used Tylenol® and ice at home, and that has helped slightly. You examine her and find she has moderate swelling and ecchymosis but no overtly obvious deformity. Her ROM is uncomfortable and severely diminished due to the pain. No crepitus is heard or felt. Her fingers are warm; her pulse is strong; and capillary refill is less than 2 seconds.What should you do?

Question options:

a) Make an immediate referral for an orthopedic evaluation without further assessment.

b) Tell her that it takes time for these bruises to improve, so she should be patient.

c) Obtain a wrist x-ray and place her wrist in a splint or prescribe a splint.

d) Send her to the emergency room for reduction of this obvious wrist fracture.

Question 25 2 / 2 points

A patient with type 1 diabetes comes to the clinic complaining of feeling nervous and clammy. He states that he took his insulin this morning but was late for work and did not eat breakfast. Which action should the clinician take first?

Question options:

a) Check his blood sugar.

b) Have him drink 4 ounces of juice.

c) Call 911.

d) Ask him about his usual eating habits.

Question 26 2 / 2 points

The clinician suspects that a client seen in the office has hyperthyroidism. Which of the following tests should the clinician order on the initial visit?

Question options:

a) High sensitivity thyroid-stimulating hormone (TSH) and free T4

b) Free T4 and serum calcium

c) Free T3 and T4

d) TSH and thyroxin antibodies

Question 27 2 / 2 points

A 25-year-old patient presents to the clinic with fatigue, cold intolerance, weight gain, and constipation for the past 3 months. On physical examination, the clinician notices a sinus bradycardia; muscular stiffness; coarse, dry hair; and a delay in relaxation in deep tendon reflexes.Which of the following tests should be ordered next?

Question options:

a) Serum calcium

b) TSH

c) Electrolytes

d) Urine specific gravity

Question 28 2 / 2 points

Mrs. Gray is a 55-year-old woman who presents with tightness, pain, and limited movement in her right shoulder. She denies any history of trauma. Her examination reveals a 75% reduction in both active and passive ROM of the right shoulder. Mrs. Gray also is experiencing tenderness with motion and pain at the deltoid insertion. Her medical history is significant for type 1 diabetes mellitus and hypertension. Her social history reveals that she is a secretary and that she is right-handed. Based on her examination and medical history, you suspect adhesive capsulitis, or “frozen shoulder.” Which clue in Mrs. Gray’s history supports this diagnosis?

Question options:

a) History of hypertension

b) Her affected shoulder is also her dominant arm.

c) Her history of diabetes mellitus

d) Her work as a secretary predisposes her to repetitive motions.

Question 29 2 / 2 points

What is the recommended daily calcium intake for adults over the age of 50 with low bone mass?

Question options:

a) 1,200 mg/day

b) 1,000 mg/day

c) 1,300 mg/day

d) 1,500 mg/day

Question 30 2 / 2 points

A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram changes should the clinician expect as a manifestation of the disease?

Question options:

a) Sinus bradycardia

b) Atrial fibrillation

c) Supraventricular tachycardia

d) U waves

Question 31 2 / 2 points

You have detected the presence of crepitus on examination of a patient with a musculoskeletal complaint. Additionally, there is limited range of motion (ROM) with both active and passive movement. These findings suggest that the origin of the musculoskeletal complaint is:

Question options:

a) Articular

b) Inflammatory

c) Nonarticular

d) A and B

Question 32 2 / 2 points

Which of the following statements concerning the treatment of fibromyalgia syndrome is true?

Question options:

a) There is currently no cure for the disorder; however, patients should be made aware that symptom relief is possible.

b) Treatment is directed toward controlling discomfort, improving sleep, and maintaining function.

c) Fibromyalgia syndrome can be difficult to manage, requiring a variety of approaches and multiple medications.

d) All of the above

Question 33 2 / 2 points

Mrs. Thomas was seen in the office complaining of pain and point tenderness in the area of her elbow. The pain has increased following a day of gardening one week ago. A physical finding that differentiates the diagnosis and is most consistent with lateral epicondylitis (tennis elbow) is:

Question options:

a) Ecchymosis, edema, and erythema over the lateral epicondyle

b) Pain at the elbow with resisted movements at the wrist and forearm

c) Inability to supinate and pronate the arm

d) Inability to flex or extend the elbow against resistance

Question 34 2 / 2 points

Mrs. Allen is a 60-year-old woman who has been diagnosed with osteoporosis. She is very concerned about the risk of breast cancer associated with hormone replacement therapy and is wondering what other treatments are available to her. The clinician explains that bisphosphonates are another class of drugs used in the prevention and treatment of osteoporosis. What teaching should the clinician give Mrs. Allen in regard to taking bisphosphonates?

Question options:

a) Taking bisphosphonates can result in hypercalcemia, so calcium intake should be decreased while taking this class of drugs.

b) There is potential for upper GI irritation, so these medications are contraindicated in people with abnormalities of the esophagus or delayed esophageal emptying.

c) This class of drugs can be taken at any time of the day without regard to meals.

d) None of the above

Question 35 2 / 2 points

The clinician suspects that a client has patellar instability. In order to test for this, the client is seated with the quadriceps relaxed, and the knee is placed in extension. Next the patella is displaced laterally, and the knee flexed to 30°. If instability is present, this maneuver displaces the patella to an abnormal position on the lateral femoral condyle, and the client will perceive pain. Testing for patellar instability in this way is known as:

Question options:

a) Apprehension sign

b) Bulge sign

c) Thumb sign

d) None of the above

Question 36 2 / 2 points

Normal estrogen function is important for preventing osteoporosis in both men and women. Estrogen works to prevent osteoporosis in which of the following ways?

Question options:

a) By decreasing the erosive activity of osteoclasts

b) By promoting osteoclastogenesis

c) By inhibiting osteoclast apoptosis

d) All of the above

Question 37 2 / 2 points

Which of the following tests should you order to confirm Mr.W’s diagnosis?

Question options:

a) Bone scan

b) Computed tomography (CT) scan

c) X-ray of the foot

d) Culture of the ulcer

Question 38 2 / 2 points

One of the initial steps in assessing patients with musculoskeletal complaints is to determine whether the complaint is articular or nonarticular in origin. Which of the following is an example of an articular structure?

Question options:

a) Bone

b) Synovium

c) Tendons

d) Fascia

Question 39 2 / 2 points

Mr. S presents in the clinic with pain, tenderness, erythema, and swelling of his left great toe. The clinician suspects acute gout. Which of the following should the clinician expect in the initial test results for this patient?

Question options:

a) Elevated uric acid level

b) Elevated blood urea nitrogen

c) Decreased urine pH

d) Decreased C-reactive protein

Question 40 2 / 2 points

Urine-free cortisol is one of four diagnostic tests recommended for Cushing’s syndrome.

Question options:

a) True

b) False

Question 41 2 / 2 points

Joyce is seen in the clinic complaining of vague symptoms of nervousness and irritability. She says that her hair will not hold a permanent wave anymore. On physical examination, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis should include which of the following conditions?

Question options:

a) Myxedema

b) Thyrotoxicosis

c) Cushing’s syndrome

d) Pan-hypopituitarism

Question 42 0 / 2 points

How often should the clinician examine the feet of a person with diabetes?

Question options:

a) Once a year

b) Every 6 months

c) Every 3 months

d) Every visit

Question 43 2 / 2 points

A BMI of 29 kg/m2 is considered obesity.

Question options:

a) True

b) False

Question 44 2 / 2 points

Jennifer is an 18-year-old who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited ROM in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

Question options:

a) Posterior dislocations are more common than anterior dislocations.

b) There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.

c) Recurrent dislocations are uncommon and would require great force to result in injury.

d) Surgery is most commonly the treatment of choice.

Question 45 2 / 2 points

The clinician should question the patient with suspected gout about use of which of these medications?

Question options:

a) Low-dose aspirin

b) Thiazide diuretics

c) Ethambutol

d) All of the above

Question 46 2 / 2 points

Metformin is the first line of pharmacologic treatment for type 2 DM.

Question options:

a) True

b) False

Question 47 2 / 2 points

Mrs. Anderson is a 35-year-old woman who has been recently diagnosed with carpal tunnel syndrome. She has two young children and asks the clinician what the chances are that they also will develop carpal tunnel syndrome. Which of the following responses would be correct regarding the risk of developing carpal tunnel syndrome?

Question options:

a) Carpal tunnel syndrome commonly occurs in families. Genetic factors are thought to account for about one-half the risk of developing carpal tunnel.

b) Only people with occupations that require repeated flexion extension of the wrist, use of hand tools that require forceful gripping, or use of hand tools that vibrate are at risk for developing carpal tunnel.

c) An underlying musculoskeletal disorder must be present for a person to develop carpal tunnel.

d) Carpal tunnel syndrome only occurs in the presence of a hormonal imbalance.

Question 48 2 / 2 points

Fruit juice with added sugar is the treatment of choice for anyone experiencing hypoglycemia.

Question options:

a) True

b) False

Question 49 2 / 2 points

The patient is prescribed radioactive iodine (RAI) and asks the clinician how this drug works. The clinician’s response should include which of the following data?

Question options:

a) RAI prevents the peripheral conversion of T4 to T3.

b) RAI binds free T4.

c) RAI destroys thyroid tissue.

d) RAI reduces freely circulating iodine.

Question 50 2 / 2 points

Lifestyle modification is the treatment of choice for metabolic syndrome.

Question options:

a) True

b) False

MN568 Unit 6 Exam latest 2017

MN568 Unit 6 Exam latest 2017

Question 1 2 / 2 points

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?

Question options:

a) Pancreatitis

b) Peptic ulcer disease

c) Diverticulitis

d) All of the above

Question 2 2 / 2 points

Which of the following would be an appropriate treatment for a patient with mild BPH?

Question options:

a) Refer to a urologist for surgery.

b) Prescribe a trial of tamsulosin.

c) Recommend cranberry supplements.

d) Reevaluate symptoms in 1 to 3 months.

Question 3 2 / 2 points

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?

Question options:

a) Repeat the test.

b) Refer to a nephrologist.

c) Measure the serum protein.

d) Obtain a blood urea nitrogen (BUN) and creatinine.

Question 4 2 / 2 points

Which is the most potent and irritating dose of tretinoin?

Question options:

a) 0.05% liquid formulation

b) 0.1% cream

c) 1% foam

d) 0.02% cream

Question 5 2 / 2 points

Which of the following clinical manifestations are consistent with a patient in ARF?

Question options:

a) Pruritis

b) Glycosuria

c) Irritability

d) Hypotension

Question 6 2 / 2 points

Which of the following is an infraorbital fold skin manifestation in a patient with atopic dermatitis?

Question options:

a) Keratosis pilaris

b) Dennie’s sign

c) Keratoconus

d) Pityriasis alba

Question 7 2 / 2 points

The patient with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6 months. The clinician should assess this patient for which of these side effects?

Question options:

a) Erectile dysfunction

b) Glaucoma

c) Hypotension

d) Headache

Question 8 2 / 2 points

When using the microscope for an intravaginal infection, you see something translucent and colorless. What do you suspect?

Question options:

a) A piece of hair or a thread

b) Hyphae

c) Leukocytes

d) Spores

Question 9 2 / 2 points

Your patient is in her second trimester of pregnancy and has a yeast infection. Which of the following is a treatment that you usually recommend/order in nonpregnant patients, but is listed as a Pregnancy category D?

Question options:

a) Vagistat vaginal cream

b) Monistat combination pack

c) Terazol vaginal cream

d) Diflucan, 150 mg

Question 10 2 / 2 points

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?

Question options:

a) NSAIDs

b) Beets

c) Vitamin A

d) Red meat

Question 11 2 / 2 points

Which of the following tests is most useful in determining renal function in a patient suspected of CRF?

Question options:

a) BUN and creatinine

b) Electrolytes

c) Creatinine clearance

d) Urinalysis

Question 12 2 / 2 points

Eighty percent of men have noticeable hair loss by what age?

Question options:

a) 35

b) 50

c) 70

d) 85

Question 13 0 / 2 points

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?

Question options:

a) Spores

b) Leukocytes

c) Pseudohyphae

d) Epithelial cells

Question 14 2 / 2 points

Which of the following information is essential before prescribing Bactrim DS to a 24-year-old woman with a UTI?

Question options:

a) Last menstrual period

b) Method of birth control

c) Last unprotected sexual contact

d) All of the above

Question 15 2 / 2 points

What is the treatment of choice for a patient diagnosed with testicular cancer?

Question options:

a) Radical orchidectomy

b) Lumpectomy

c) Radiation implants

d) All of the above

Question 16 2 / 2 points

Which test is used to confirm a diagnosis of epididymitis?

Question options:

a) Urinalysis

b) Gram stain of urethral discharge

c) Complete blood cell count with differential

d) Ultrasound of the scrotum

Question 17 2 / 2 points

Sally, age 25, presents with impetigo that has been diagnosed as infected with Staphylococcus. The clinical presentation is pruritic tender, red vesicles surrounded by erythema with a rash that is ulcerating. Her recent treatment has not been adequate. Which type of impetigo is this?

Question options:

a) Bullous impetigo

b) Staphylococcal scalded skin syndrome (SSSS)

c) Nonbullous impetigo

d) Ecthyma

Question 18 2 / 2 points

An example of ecchymosis is:

Question options:

a) A hematoma

b) A keloid

c) A bruise

d) A patch

Question 19 2 / 2 points

An 82-year-old man is seen in the primary care office with complaints of dribbling urine and difficulty starting his stream. Which of the following should be included in the list of differential diagnoses?

Question options:

a) Benign prostatic hyperplasia (BPH)

b) Parkinson’s disease

c) Prostate cancer

d) All of the above

Question 20 0 / 2 points

A 30-year-old man is seen with a chief complaint of loss of libido. Which of the following laboratory tests would help establish a diagnosis?

Question options:

a) Testosterone level

b) Prostate-specific antigen

c) Nocturnal penile tumescence and rigidity

d) Prolactin level

Question 21 2 / 2 points

A 35-year-old man presents with complaints of painful erections, and he notices his penis is crooked when erect. What is the most likely diagnosis?

Question options:

a) Peyronie’s disease

b) Damage to the pudendal artery

c) Scarring of the cavernosa

d) All of the above

Question 22 2 / 2 points

A 78-year-old man is diagnosed with C2 prostate cancer, and he asks the clinician what that means. In order to answer the patient, the clinician must have which of these understandings of the Jewett rating system?

Question options:

a) The cancer involves the seminal vesicles.

b) There is metastatic disease to regional lymph nodes.

c) The cancer is confined to the capsule.

d) There is metastasis to distant organs.

Question 23 0 / 2 points

During a DRE on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

Question options:

a) An enlarged rubbery gland

b) A hard irregular gland

c) A tender gland

d) A boggy gland

Question 24 2 / 2 points

Tinea unguium is also known as:

Question options:

a) Onychomycosis

b) Tinea versicolor

c) Tinea manuum

d) Tinea corporis

Question 25 2 / 2 points

The patient is diagnosed with acute renal failure (ARF).Which of the following data obtained from the history should alert the provider that this is a case of prerenal azotemia?

Question options:

a) Recent heat stroke

b) Nephrolithiasis

c) Recent infection where gentamicin was used in treatment

d) All of the above

Question 26 2 / 2 points

Which of the following statements is accurate when you are removing a seborrheic keratosis lesion using liquid nitrogen?

Question options:

a) Do not use lidocaine as it may potentiate bleeding.

b) Pinch the skin taut together.

c) Use gel foam to control bleeding.

d) This should be performed by a dermatologist only.

Question 27 2 / 2 points

A patient is diagnosed with urge incontinence. Before prescribing Detrol XL, the provider should question the patient about which of these contraindications to this medication?

Question options:

a) Diarrhea

b) Parkinson’s disease

c) Closed-angle glaucoma

d) Breast cancer

Question 28 2 / 2 points

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?

Question options:

a) “You must be under a lot of stress lately.”

b) “It is hereditary. Did your father experience this also?”

c) “The cause is unknown, but we suspect it is due to an immunologic mechanism.”

d) “We’ll have to do some tests.”

Question 29 2 / 2 points

A 58-year-old patient has been receiving leuprolide as treatment for prostate cancer. The clinician should instruct the patient about which of these side effects?

Question options:

a) Risk of osteoporosis

b) May have hot flushes

c) May have impotence

d) All of the above

Question 30 2 / 2 points

Josh, aged 22, has tinea versicolor. Which description is the most likely for this condition?

Question options:

a) There are round, hypopigmented macules on his back.

b) Josh has red papules on his face.

c) There are crusted plaques in Josh’s groin area.

d) There are white streaks on his neck.

Question 31 2 / 2 points

The most common precancerous skin lesion found in Caucasians is:

Question options:

a) A skin tag

b) Actinic keratosis

c) A melanoma

d) A basal cell lesion

Question 32 2 / 2 points

Which scalp problem can be caused by a fever and certain drugs?

Question options:

a) Telogen effluvium (TE)

b) Trichotillomania

c) Psoriasis

d) Alopecia areata

Question 33 2 / 2 points

A 46-year-old man presents with urinary hesitancy and low back pain. He has no history of UTI. Digital rectal examination (DRE) reveals a normal prostate, and a diagnosis of prostatodynia is made. Which is the appropriate treatment?

Question options:

a) Terazosin 2 mg PO once a day

b) Ice pack to the scrotal area

c) Saw palmetto 320 mg per day

d) All of the above

Question 34 2 / 2 points

A 30-year-old patient presents with pain on urination. The urine microscopy of unspun urine shows greater than 10 leukocytes/mL, and a dipstick is positive for nitrites. What is the probable diagnosis?

Question options:

a) Lower urinary tract infection

b) Chlamydia infection

c) Candidiasis

d) Pyelonephritis

Question 35 2 / 2 points

Which of the following foods should be limited in a patient with CRF?

Question options:

a) Milk

b) Bananas

c) Soy sauce

d) All of the above

Question 36 2 / 2 points

An example of a primary skin lesion is a/an:

Question options:

a) Bulla

b) Scale

c) Excoriation

d) Fissure

Question 37 2 / 2 points

A 76-year-old man is seen in the office for complaints of urinary incontinence. The clinician should explore which of these causes of incontinence in men?

Question options:

a) Urethral polyps

b) Urinary tract infection (UTI)

c) Anticholinergic medication

d) All of the above

Question 38 2 / 2 points

A patient is seen in the clinic with a chief complaint of hematuria. To make a differential diagnosis, which of the following questions should be asked?

Question options:

a) “Do you have a history of liver disease?”

b) “What medications are you currently taking?”

c) “Have you noticed swelling in your ankles?”

d) All of the above

Question 39 2 / 2 points

A 78-year-old man is diagnosed with Stage D bladder cancer and asks the provider what that means. Which is the best response?

Question options:

a) “There is no such thing as Stage D cancer.”

b) “You have cancer that has spread to the surrounding tissue.”

c) “Your cancer has spread to other organs.”

d) “Your cancer can be cured by removing your bladder.”

Question 40 2 / 2 points

Treatment for epididymitis includes which of the following?

Question options:

a) Warm sitz baths

b) Scrotal elevation

c) Masturbation

d) All of the above

Question 41 2 / 2 points

A patient is seen in the office complaining of severe flank pain. The clinician should assess this patient for which risk factor for kidney stones?

Question options:

a) Hypertension

b) Constipation

c) Tubal ligation

d) Diabetes

Question 42 2 / 2 points

A 63-year-old man is seen in the clinic with a chief complaint of nocturia. Which of the following should be included in the differential diagnosis?

Question options:

a) Psychogenic nocturia

b) Urethral polyp

c) Irritative posterior urethral lesion

d) Benign prostatic hypertrophy

Question 43 0 / 2 points

A patient with testicular cancer is being followed after completing treatment 1 year ago. He has been symptom-free with no evidence of disease. How often should he have a CT scan?

Question options:

a) Every month

b) Every 3 to 4 months

c) Every 6 to 12 months

d) Every year

Question 44 2 / 2 points

Mark has necrotizing fasciitis of his left lower extremity.Pressure on the skin reveals crepitus due to gas production by which anaerobic bacteria?

Question options:

a) Staphylococcal aureus

b) Clostridium perfringens

c) S. pyrogenes

d) Streptococcus

Question 45 2 / 2 points

Ian, age 62, presents with a wide, diffuse area of erythematous skin on his lower left leg that is warm and tender to palpation.There is some edema involved. You suspect:

Question options:

a) Necrotizing fasciitis

b) Kaposi’s sarcoma

c) Cellulitis

d) A diabetic ulcer

Question 46 2 / 2 points

Why do people of African descent have a lower incidence of non-melanoma skin cancer?

Question options:

a) They have an increased number of melanocytes.

b) Their darker skin protects from ultraviolet radiation.

c) Their skin is thicker.

d) Their immune system is stronger.

Question 47 2 / 2 points

A 23-year-old sexually active man is seen in the clinic with unilateral painful testicular swelling, and he is diagnosed with epididymitis.In order to prescribe the correct drug, the clinician must understand that which of these is the most common causative organism?

Question options:

a) Escherichia coli

b) Staphylococcus aureus

c) Chlamydia trachomatis

d) Pseudomonas aeruginosa

Question 48 2 / 2 points

When instructing your elderly client about treating her xerosis, what do you tell her?

Question options:

a) A daily hot bath may help the associated pruritus.

b) Rub the skin briskly to make sure it is completely dry after bathing.

c) Only take short tepid showers.

d) Use a gel that is alcohol-based after bathing to soften the skin.

Question 49 2 / 2 points

Which of the following instructions should be given to the patient with nephrolithiasis?

Question options:

a) Take ibuprofen, 600 mg every 8 hours.

b) Take Tums? for stomach upset.

c) Drink more black tea.

d) Increase intake of vegetables, like spinach.

Question 50 2 / 2 points

The 56-year-old man with chronic prostatitis should be treated with trimethoprim 80 mg-sulfamethoxazole 400 mg (TMP-SMX, Bactrim) for how long?

Question options:

a) 3 to 7 days

b) 14 to 21 days

c) 3 to 6 weeks

d) 6 to 12 weeks

 

MN568 Unit 4 Exam

MN568 Unit 4 Exam latest 2017

Question 1 0 / 2 points

Mr. J. K., 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had intermittent heartburn for several months and takes Tums® with temporary relief. He has been waking during the night with a burning sensation in his chest. Which additional information would lead you to believe that gastroesophageal reflux disease (GERD) is the cause of his pain?

Question options:

a) The pain seems better when he smokes to relieve his nerves.

b) Coffee and fried foods don’t bother him,

c) He wakes at night coughing with a bad taste in his mouth.

d) All of the above

Question 2 2 / 2 points

A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis?

Question options:

a) Very early

b) 3 to 4 hours after perforation

c) Late in inflammation

d) Appendicitis never presents with vague pain.

Question 3 2 / 2 points

A patient is seen with complaints of diarrhea. Which of the following should be included in the patient’s differential diagnosis?

Question options:

a) Gastroenteritis

b) Inflammatory bowel disease

c) Lactase deficiency

d) All of the above

Question 4 0 / 2 points

If chest pain can be alleviated with time, analgesics, and heat applications, what might the differential diagnosis be?

Question options:

a) Peptic ulcer

b) Hiatal hernia

c) Costochondritis

d) Pericarditis

Question 5 2 / 2 points

A patient is seen in the office with complaints of six to seven liquid bowel movements per day. Which of the following assessment findings would lead the NP to a diagnosis of inflammatory bowel disease?

Question options:

a) Intermittent constipation with periods of diarrhea

b) Wakens at night with diarrhea

c) History of international travel

d) All of the above

Question 6 2 / 2 points

In which type of arterioventricular (AV) block does the pulse rate (PR) interval lengthen until a beat is dropped?

Question options:

a) First-degree AV block

b) Second-degree Mobitz I AV block

c) Second-degree Mobitz II AV block

d) Third-degree AV block

Question 7 2 / 2 points

For the best therapeutic effect after a myocardial infarction (MI), thrombolytics should be administered within the first 3 hours (ideally 30 minutes) of symptom onset. Studies have shown, however, that thrombolytic therapy can be of benefit up to how many hours after the initial presentation of MI symptoms?

Question options:

a) 6 hours

b) 8 hours

c) 10 hours

d) 12 hours

Question 8 2 / 2 points

Which of the following is associated with celiac disease (celiac sprue)?

Question options:

a) Malabsorption

b) Constipation

c) Rectal bleeding

d) Esophageal ulceration

Question 9 2 / 2 points

A 46-year-old female patient is seen in the clinic with abdominal pain. Which of the following tests is essential for this patient?

Question options:

a) CBC with differential

b) Urine human chorionic gonadotropin

c) Barium enema

d) Computed tomography of the abdomen

Question 10 2 / 2 points

Which high-density lipoprotein (HDL) level is considered cardioprotective?

Question options:

a) Greater than 30

b) Greater than 40

c) Greater than 50

d) Greater than 60

Question 11 2 / 2 points

A 28-year-old patient is seen with complaints of diarrhea.Which of the following responses to the history questions would help the primary care physician (PCP) establish the diagnosis of irritable bowel syndrome?

Question options:

a) Feels relief after a bowel movement

b) Sometimes is constipated

c) Does not defecate in the middle of the night

d) All of the above

Question 12 2 / 2 points

Which heart sound may be heard with poorly controlled hypertension, angina, and ischemic heart disease?

Question options:

a) A physiologic split S2

b) A fixed split S2

c) S3

d) S4

Question 13 2 / 2 points

A patient is diagnosed with GERD, and his endoscopic report reveals the presence of Barrett’s epithelium. Which of the following should the PCP include in the explanation of the pathology report?

Question options:

a) This is a premalignant tissue.

b) This tissue is resistant to gastric acid.

c) This tissue supports healing of the esophagus.

d) All of the above

Question 14 0 / 2 points

A patient is seen with dark-colored urine, and the urine dipstick reveals a high level of bilirubin. Which of the following could be a cause of this problem?

Question options:

a) Increased breakdown of red blood cells

b) Inadequate hepatocyte function

c) Biliary obstruction

d) All of the above

Question 15 2 / 2 points

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?

Question options:

a) B-type natriuretic peptide

b) C-reactive protein

c) Serum albumin

d) Erythrocyte sedimentation rate

Question 16 2 / 2 points

Your patient with permanent afib asks when he can discontinue his warfarin. You tell him:

Question options:

a) When your internalized normalized ratio reaches 3.0, you can stop taking your warfarin permanently.

b) When you no longer feel ill

c) One month after your symptoms dissipate

d) You’ll probably be on it indefinitely.

Question 17 2 / 2 points

Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?

Question options:

a) Serum calcium

b) Electrocardiogram (ECG)

c) Thyroid-stimulating hormone test

d) Complete blood cell count

Question 18 2 / 2 points

Which of the following statements about dabigatran is true?

Question options:

a) It is difficult to keep the patient in therapeutic range.

b) Anticoagulation cannot be immediately reversed.

c) It allows for the use of tPA if the patient has a stroke despite anticoagulation.

d) None of the statements are true.

Question 19 2 / 2 points

A 25-year-old accountant is seen in the clinic complaining of crampy abdominal pain after meals. She is often constipated and takes laxatives, which are followed by a couple of days of diarrhea. She temporarily feels better after a bowel movement. She states she is embarrassed by flatulence and has abdominal distension. She has had no weight loss or blood in her stool. This problem has gone on for about 6 months. What should the next step be?

Question options:

a) Obtain a complete history.

b) Order a barium enema.

c) Schedule a Bernstein’s test.

d) Prescribe a trial of antispasmodics.

Question 20 2 / 2 points

A 35-year-old female patient is seen in the clinic complaining of abdominal pain. Which of the following should be included in the history and physical examination?

Question options:

a) Digital rectal exam

b) Pelvic exam

c) Sexual history

d) All of the above

Question 21 2 / 2 points

A 28-year-old patient is seen in the clinic with colicky abdominal pain particular with meals. She has frequent constipation, flatulence, and abdominal distension. Which of the data make a diagnosis of diverticulitis unlikely?

Question options:

a) Her age

b) Frequent constipation

c) Flatulence

d) Colicky abdominal pain

Question 22 2 / 2 points

Nitroglycerine (NTG) is given for a patient having ischemic chest pain. One tablet or one spray should be used under the tongue every 5 minutes for three doses. What should be done if the pain has not been relieved after three doses?

Question options:

a) 911 should be called, and the patient should be transported immediately to the emergency department.

b) One more dose of NTG may be tried.

c) The person should be given two aspirin to chew.

d) A portable defibrillator should be located to ascertain the cardiac rhythm.

Question 23 2 / 2 points

A patient is seen in the clinic with right upper quadrant pain that is radiating to the middle of the back. The NP suspects acute cholelithiasis. The NP should expect which of the following laboratory findings?

Question options:

a) Decreased alanine aminotransferase and decreased aspartate aminotransferase

b) Elevated alkaline phosphatase

c) Elevated indirect bilirubin

d) Decreased white blood cells

Question 24 2 / 2 points

A patient is diagnosed with giardia after a backpacking trip in the mountains. Which of the following would be an appropriate treatment?

Question options:

a) Vancomycin

b) Penicillin

c) Metronidazole

d) Bactrim

Question 25 2 / 2 points

A 21-year-old student presents with complaints of fatigue, headache, anorexia, and a runny nose, all of which began about 2 weeks ago. She started taking vitamins and over-the-counter cold preparations but feels worse.The smell of food makes her nauseated. Her boyfriend had mononucleosis about a month ago, and she wonders if she might have it also. Examination reveals cervical adenopathy and an enlarged liver and spleen. Which of the following labs would be most helpful in the differential diagnosis at this point?

Question options:

a) Stool culture

b) Liver enzymes

c) Antihepatitis D virus

d) Thyroid-stimulating hormone test

Question 26 2 / 2 points

Statins are approved for which age group?

Question options:

a) Children over the age of 2

b) Children over the age of 6

c) Children over the age of 10

d) Only adolescents and adults

Question 27 2 / 2 points

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?

Question options:

a) 1 month

b) 3 months

c) 6 months

d) As long as the tablets are kept in this special bottle, they will last forever.

Question 28 2 / 2 points

Mary has hypertension and previously had a stroke. Which hypertensive drug would you order for her?

Question options:

a) Angiotensin converting enzyme inhibitor

b) Calcium channel blocker

c) Angiotensin II receptor blocker

d) Beta blocker

Question 29 2 / 2 points

What value on the ankle-brachial index diagnoses peripheral artery disease?

Question options:

a) Less than 0.25

b) Less than 0.50

c) Less than 0.90

d) Greater than 1

Question 30 2 / 2 points

Which group would most benefit from statins?

Question options:

a) Those with a low density lipoprotein-cholesterol greater than 100 mg/dL

b) Individuals with clinical arteriosclerotic cardiovascular disease

c) Individuals with a 10-year risk greater than 10%

d) Individuals of all ages with diabetes mellitus (DM)

Question 31 2 / 2 points

Which type of angina do you suspect in Harvey, who complains of chest pain that occurs during sleep and most often in the early morning hours?

Question options:

a) Stable angina

b) Unstable angina

c) Variant (Prinzmetal’s angina)

d) Probably not angina but hiatal hernia

Question 32 2 / 2 points

The American College of Cardiology/American Heart Association states which of the following regarding the use of non-statin lipid-lowering agents?

Question options:

a) Nicotinic acid derivatives are effective for lowering LDL and triglycerides (TGs).

b) Bile acid sequestrates increase HDL.

c) Cholesterol absorption inhibitors decrease LDL.

d) There is no sufficient evidence to use non-statin lipid-drugs.

Question 33 2 / 2 points

A patient comes to the office complaining of constipation.The patient lists all of the following medications. Which drug could be responsible for the constipation?

Question options:

a) Multivitamin

b) Magnesium hydroxide

c) Pepto-Bismol

d) Ibuprofen

Question 34 2 / 2 points

You just started Martha on HTN therapy. The Eighth Joint National Committee recommends that if her goal BP is not reached in what length of time, you should increase the initial drug or add a second drug to it?

Question options:

a) 1 month

b) 3 months

c) 6 months

d) 1 year

Question 35 2 / 2 points

The patient with GERD should be instructed to eliminate which of these activities?

Question options:

a) Swimming

b) Weight lifting

c) Golfing

d) Walking

Question 36 2 / 2 points

A patient has acute pancreatitis with seven of the diagnostic criteria from Ranson’s criteria. In order to plan care, the NP must understand that this criteria score has which of the following meanings?

Question options:

a) A high mortality rate

b) An increased chance of recurrence

c) A 7% chance of the disease becoming chronic

d) All of the above

Question 37 2 / 2 points

A Delta wave on the ECG may be present in which condition?

Question options:

a) Prinzmetal’s angina

b) Bundle branch block

c) Wolff-Parkinson-White syndrome

d) Aortic stenosis

Question 38 2 / 2 points

Lifestyle modifications to manage hypertension (HTN) include:

Question options:

a) Maintaining a body mass index of 17

b) Restricting dietary sodium to 2 grams per day

c) Engaging in exercise or physical activity for 90 minutes a day

d) Limiting beer intake to 24 ounces per day

Question 39 2 / 2 points

Which pain characteristic is usually indicative of cardiac pathology?

Question options:

a) Fleeting

b) Moving

c) Diffuse

d) Localized

Question 40 2 / 2 points

Which ECG change is typical of cardiac ischemia?

Question options:

a) T-wave inversion

b) ST-segment elevation

c) Significant Q wave

d) U-wave

Question 41 0 / 2 points

A 29-year-old Englishman is seen in the office with complaints of pain in his chest and belly. He has been suffering the pain for 2 weeks and gets temporary relief from Alka-Seltzer®. The burning pain wakes him at night and radiates up to his chest. Which factor favors a diagnosis of gastric ulcer?

Question options:

a) His gender

b) His age

c) His use of Alka-Seltzer

d) His ethnic origin

Question 42 2 / 2 points

Which murmurs are usually ‘watch and wait’?

Question options:

a) Systolic murmurs

b) Diastolic murmurs

c) They both are dangerous and need immediate attention.

d) You can ‘watch and wait’ for both of them.

Question 43 2 / 2 points

A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her physical examination is remarkable for left lower quadrant tenderness. At this time, which of the following should be considered in the differential diagnosis?

Question options:

a) Endometriosis

b) Colon cancer

c) Diverticulitis

d) All of the above

Question 44 2 / 2 points

George, age 64, has cardiovascular disease (CVD), a total cholesterol of 280 mg/dL, and a systolic BP of 158. He is being treated for hypertension.You are doing a Framingham Risk Assessment on him. Which assessment factor would give him the highest number of points on the scale?

Question options:

a) His age

b) His cholesterol level

c) His systolic BP

d) The fact that he is on antihypertensive medication

Question 45 2 / 2 points

The nurse practitioner (NP) suspects a patient has a peptic ulcer. Which of the following items on the history would lead the NP to this conclusion?

Question options:

a) Use of NSAIDs

b) Cigarette smoker

c) Ethanol consumption

d) All of the above

Question 46 2 / 2 points

In the CHADS2 Index for the stroke risk score for AF, the‘A’ stands for:

Question options:

a) Anticoagulation

b) Autoimmune disease

c) Age

d) Antihypertension

Question 47 2 / 2 points

Jamie, age 55, has just started on a statin after having his liver function tests (LFTs) come back normal. He now asks you how often he has to have the LFTs repeated. What do you tell him?

Question options:

a) Initially in 6 weeks

b) Every 3 months

c) Every 6 months

d) It’s no longer necessary for his statin regimen.

Question 48 0 / 2 points

Which of the following dietary instructions should be given to a patient with GERD?

Question options:

a) Eliminate coffee.

b) Drink peppermint tea to relieve stomach distress.

c) Recline and rest after meals.

d) Limit the amount of antacids.

Question 49 2 / 2 points

Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:

Question options:

a) Severe asthma

b) A common valvular lesion

c) Severe hypertension

d) A prosthetic heart valve

Question 50 2 / 2 points

You are assessing Sigred for metabolic syndrome. Which of her parameters is indicative of this syndrome?

Question options:

a) Her waist is 36 inches.

b) Her triglyceride level is 140 mg/dL.

c) Her BP is 128/84.

d) Her fasting blood sugar (BS) is 108 mg/dL.

MN568 Unit 2 Exam

MN568 Unit 2 Exam latest 2017

Question 1 0 / 2 points

Acute angle-closure glaucoma involves a sudden severe rise in intraocular pressure. Which of the following ranges represents normal intraocular pressure?

Question options:

a)  0 to 7 mm Hg

b)  8 to 21 mm Hg

c)  22 to 40 mm Hg

d)  40 to 80 mm Hg

Question 2 0 / 2 points

Which obstructive lung disease is classified as reversible?

Question options:

a) Asthma

b)  Chronic bronchitis

c)  Emphysema

d)  COPD

Question 3 0 / 2 points

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?

Question options:

a) The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.

b) The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.

c) Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist.

d) Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.

Question 4 2 / 2 points

Heart valve damage resulting from acute rheumatic fever is a long-term sequelae resulting from infection with which of the following pathogens?

Question options:

a) Coxsackievirus

b) Cytomegalovirus

c) Francisella tularensis

d) Group A streptococcus

Question 5 2 / 2 points

The presence of hairy leukoplakia in a person with no other symptoms of immune suppression is strongly suggestive of which type of infection?

Question options:

a) HSV type 2

b) HIV

c) Pneumonia

d) Syphilis

Question 6 0 / 2 points

Your patient is on Therabid for his asthma. You want to maintain his serum levels between:

Question options:

a) 0 to 5 mcg/mL

b) 5 to 10 mcg/mL

c) 5 to 15 mcg/mL

d) 10 to 20 mcg/mL

Question 7 0 / 2 points

African American patients seem to have a negative reaction to which of the following asthma medications?

Question options:

a) Inhaled corticosteroids

b) Long-term beta-agonist bronchodilators

c) Leukotriene receptor agonists

d) Oral corticosteroids

Question 8 2 / 2 points

Which of the following statements is true concerning the use of bilberry as a complementary therapy for cataracts?

Question options:

a) The body converts bilberry to vitamin A, which helps to maintain a healthy lens.

b) Bilberry blocks an enzyme that leads to sorbitol accumulation that contributes to cataract formation in diabetes.

c) Bilberry boosts oxygen and blood delivery to the eye.

d) Bilberry is a good choice for patients with diabetes as it does not interact with antidiabetic drugs.

Question 9 2 / 2 points

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?

Question options:

a) He should stop smoking today.

b) He should stop smoking tomorrow.

c) His quit date should be in 1 week.

d) He will be ready to quit after the first 30 days.

Question 10 2 / 2 points

The forced vital capacity is decreased in:

Question options:

a) Asthma

b) Chronic bronchitis

c) Emphysema

d) Restrictive disease

Question 11 2 / 2 points

A patient with hypertension comes in and insists that one of his new medications is causing him to cough. When looking at his list of medications, you think the cough must be from:

Question options:

a) Metoprolol

b) Clopidogrel

c) Tadalafil

d) Captopril

Question 12 0 / 2 points

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?

Question options:

a) “Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow.”

b) “Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow.”

c) “Drive to the emergency room now.”

d) “Call 911.”

Question 13 2 / 2 points

Which of the following statements regarding pulmonary function is true?

Question options:

a) Cigarette smoking accelerates the decline in pulmonary function tenfold.

b) Smoking cessation can reverse most pathological changes.

c) Cigarette smoking decreases mucus production.

d) There is a normal age-related decline in pulmonary function.

Question 14 0 / 2 points

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?

Question options:

a) Baker phenomenon

b) Arnold reflex

c) Cough reflex

d) Tragus reflex

Question 15 0 / 2 points

Nathan, a 32-year-old policeman, has a 15-pack-a-year history of smoking and continues to smoke heavily. During every visit, he gets irate when you try to talk to him about quitting. What should you do?

Question options:

a) Hand him literature about smoking cessation at every visit.

b) Wait until he is ready to talk to you about quitting.

c) Document in the record that he is not ready to quit.

d) Continue to ask him at every visit if he is ready to quit.

Question 16 2 / 2 points

Which immunoglobulin mediates the type 1 hypersensitivity reaction involved in allergic rhinitis?

Question options:

a) IgA

b) IgE

c) IgG

d) IgM

 

Question 17 2 / 2 points

Which of the following conditions is associated with cigarette smoking?

Question options:

a) Glaucoma

b) Increased sperm quality

c) Bladder cancer

d) Eczema

 

 

 

Question 18 0 / 2 points

Which ethnic group has the highest lung cancer incidence and mortality rates?

Question options:

a) African American men

b) Scandinavian men and women

c) Caucasian women

d) Asian men

Question 19 2 / 2 points

Which information should be included when you are teaching your patient about the use of nicotine gum?

Question options:

a) The gum must be correctly chewed to a softened state and then placed in the buccal mucosa.

b) Patients should not eat for 30 minutes prior to or during the use of the gum.

c) Initially, one piece is chewed every 30 minutes while awake.

d) Acidic foods and beverages should be encouraged during nicotine therapy.

Question 20 2 / 2 points

Julie has a postnasal drip along with her cough. You assess her for:

Question options:

a) Asthma

b) Sinusitis

c) Allergic or vasomotor rhinitis

d) Influenza

Question 21 2 / 2 points

Cydney presents with a history of asthma. She has not been treated for a while. She complains of daily but not continual symptoms, greater than 1 week and at nighttime. She has been using her rescue inhaler. Her FEV1 is 60% to 80% predicted. How would you classify her asthma severity?

Question options:

a) Mild intermittent

b) Mild persistent

c) Moderate persistent

d) Severe persistent

Question 22 2 / 2 points

A chronic cough lasts longer than:

Question options:

a) 3 weeks

b) 1 month

c) 6 months

d) 8 weeks

Question 23 0 / 2 points

Severe pain associated with acute otitis media signifies perforation of the tympanic membrane.

Question options:

a) True

b) False.

Question 24 0 / 2 points

As diabetic retinopathy progresses, the presence of ‘cotton wool’ spots can be detected. Cotton wool spots refer to:

Question options:

a) Nerve fiber layer infarctions

b) Blood vessel proliferation

c) Venous beading

d) Retinal hemorrhage

Question 25 2 / 2 points

Which of the following is a possible consequence of sleep apnea?

Question options:

a) Asthma

b) Increased white blood cells

c) Insulin resistance

d) Hyperactivity

Question 26 2 / 2 points

Marta is taking TB drugs prophylactically. How do you instruct her to take them?

Question options:

a) Take them on an empty stomach to facilitate absorption.

b) Take them with aspirin (ASA) to prevent flushing.

c) Take them with ibuprofen to prevent a headache.

d) Take them with food to prevent nausea.

Question 27 0 / 2 points

Sam, age 78, presents to the clinic with respiratory symptoms. His pulmonary function tests are as follows: a normal total lung capacity, a decreased PaO2, and an increased PaCO2. On assessment, you auscultate coarse crackles and forced expiratory wheezes. What is your diagnosis?

Question options:

a) Asthma

b) Emphysema

c) Chronic bronchitis

d) Influenza

Question 28 0 / 2 points

Which subtype of cataracts is characterized by significant nearsightedness and a slow indolent course?

Question options:

a) Nuclear cataracts

b) Cortical cataracts

c) Posterior cataracts

d) Immature cataracts

Question 29 0 / 2 points

Otitis media is considered chronic when:

Question options:

a) Inflammation persists more than 3 months with intermittent or persistent otic discharge.

b) There are more than six occurrences of otitis media in a 1-year period.

c) Otitis media does not resolve after two courses of antibiotics.

d) All of the above

Question 30 0 / 2 points

Which of the following is an example of sensorineural hearing loss?

Question options:

a) Perforation of the tympanic membrane

b) Otosclerosis

c) Cholesteatoma

d) Presbycusis

Question 31 0 / 2 points

A patient presents with the following signs and symptoms: gradual onset of low-grade fever, marked fatigue, severe sore throat, and posterior cervical lymphadenopathy. Based on the signs and symptoms alone, which of the following conditions is most likely the cause?

Question options:

a) Gonorrhea

b) Mononucleosis

c) Influenza

d) Herpes zoster

Question 32 0 / 2 points

You are using the CURB-65 clinical prediction tool to decide whether Mabel, whom you have diagnosed with community-acquired pneumonia (CAP), should be hospitalized or treated at home. Her score is 3. What should you do?

Question options:

a) Consider home treatment.

b) Plan for a short inpatient hospitalization.

c) Closely supervise her outpatient treatment.

d) Hospitalize and consider admitting her to the intensive care unit.

Question 33 2 / 2 points

The most significant precipitating event leading to otitis media with effusion is:

Question options:

a) Pharyngitis

b) Allergies

c) Viral upper respiratory infection (URI)

d) Perforation of the eardrum

Question 34 2 / 2 points

Patients with acute otitis media should be referred to a specialist in which of the following situations?

Question options:

a) Concurrent vertigo or ataxia

b) Failed closure of a ruptured tympanic membrane

c) If symptoms worsen after 3 or 4 days of treatment

d) All of the above

Question 35 2 / 2 points

Marci has been started on a tuberculosis (TB) regimen.Because isoniazid (INH) may cause peripheral neuropathy, you consider ordering which of the following drugs prophylactically?

Question options:

a) Pyridoxine

b) Thiamine

c) Probiotic

d) Phytonadione

Question 36 2 / 2 points

The barrel chest characteristic of emphysema is a result of:

Question options:

a) Chronic coughing

b) Hyperinflation

c) Polycythemia

d) Pulmonary hypertension

Question 37 0 / 2 points

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?

Question options:

a) The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.

b) Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.

c) A throat culture should be performed to confirm the results of the rapid strep test.

d) The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.

Question 38 0 / 2 points

Your patient states he has a strep throat infection. Which of the following symptoms makes you consider a viral etiology instead?

Question options:

a) Fever

b) Headache

c) Exudative pharyngitis

d) Rhinorrhea

Question 39 0 / 2 points

Which statement about adenocarcinoma of the lung is accurate?

Question options:

a) It is the least common type of lung cancer, representing approximately 5% to 10% of cases.

b) It is the most prevalent carcinoma of the lungs in both sexes and in nonsmokers, representing 35% to 40% of all tumors.

c) It is more common in men than in women and occurs almost entirely in cigarette smokers.

d) It is aggressive, with rapid growth and early local and distant metastases via the lymphatic and blood vessels.

Question 40 0 / 2 points

A patient presents to the clinician complaining of ear pain.On examination, the clinician finds that the patient has tenderness on traction of the pinna as well as when applying pressure over the tragus. These findings are classic signs of which condition?

Question options:

a) Otitis media

b) Meniere’s disease

c) Tinnitus

d) Otitis externa

Question 41 2 / 2 points

Supplemental oxygen for how many hours per day has been shown to improve the mortality associated with COPD?

Question options:

a) 3 to 5 hours

b) 6 to 10 hours

c) 11 to 14 hours

d) 15 to 18 hours

Question 42 0 / 2 points

Which of the following medications used in the treatment of glaucoma works by constricting the pupils to open the angle and allow aqueous fluid to escape?

Question options:

a) Pilocarpine

b) Timolol

c) Brinzolamide

d) Acetazolamide

Question 43 2 / 2 points

You are in the park playing with your children when you see that your friend is screaming for help. Her toddler has fallen and there is a stick lodged in his eye. The child is kicking and screaming and grabbing for the stick. You:

Question options:

a) instruct his mother to hold him securely and not allow him to touch the stick, then carefully remove the stick from the eye.

b) stabilize the foreign object and accompany the mother and child to the local ER.

c) find a water fountain, hold the child to the water, and flush the eye.

d) call 911.

Question 44 2 / 2 points

You have a patient who is a positive for Strep on rapid antigen testing (rapid strep test). You order amoxacillin after checking for drug allergies (patient is negative) but he returns 3 days later, reporting that his temperature has gone up, not down (101.5 F in office). You also note significant adenopathy, most notably in the posterior and anterior cervical chains, some hepatomegaly, and a diffuse rash. You decide:

Question options:

a) to refer the patient.

b) that he is having an allergic response and needs to be changed to a macrolide antibiotic.

c) that his antibiotic dosage is not sufficient and should be changed.

d) that he possibly has mononucleosis concurrent with his strep infection.

Question 45 2 / 2 points

Fluctuations and reductions in estrogen may be a contributing factor in which type of rhinitis?

Question options:

a) Vasomotor rhinitis

b) Rhinitis medicamentosum

c) Atrophic rhinitis

d) Viral rhinitis

Question 46 2 / 2 points

In which of the following situations would referral to a specialist be needed for sinusitis?

Question options:

a) Recurrent sinusitis

b) Allergic sinusitis

c) Sinusitis that is refractory to antibiotic therapy

d) All of the above

Question 47 0 / 2 points

The clinician is assessing a patient complaining of hearing loss. The clinician places a tuning fork over the patient’s mastoid process, and when the sound fades away, the fork is placed without restriking it over the external auditory meatus. The patient is asked to let the clinician know when the sound fades away. This is an example of which type of test?

Question options:

a) Weber test

b) Schwabach test

c) Rinne test

d) Auditory brainstem response (ABR) test

Question 48 0 / 2 points

Sinusitis is considered chronic when there are episodes of prolonged inflammation with repeated or inadequately treated acute infection lasting greater than:

Question options:

a) 4 weeks

b) 8 weeks

c) 12 weeks

d) 16 weeks

Question 49 2 / 2 points

Most nosocomial pneumonias are caused by:

Question options:

a) Fungi

b) Viruses

c) Gram-negative bacteria

d) Pneumococcal pneumonia

Question 50 2 / 2 points

Joyce is taking a long-acting beta agonist for her asthma.What additional medication should she be taking?

Question options:

a) Inhaled corticosteroid

b) Leukotriene receptor antagonist

c) Systemic corticosteroid

d) Methyl xanthenes

 

NR 511 Week 4 Midterm Exam Version 4 

NR 511 Week 4 Midterm Exam Version 4

 

 Question 1. Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. 

She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

Posterior dislocations are more common than anterior dislocations.

There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.

Recurrent dislocations are uncommon and would require a greater force to result in injury.

Surgery is most commonly the treatment of choice.

 

Question.2 In the United States, what is the second most common connective tissue disease and the most destructive to the joints?  

Osteoarthritis

Systemic lupus erythematosus (SLE)

Rheumatoid arthritis

Sjögren’s syndrome

 

Question.3 Which of the following laboratory findings should the clinician expect in a patient with untreated Graves’ disease?

a.Elevated thyroid-stimulating hormone (TSH)

b.Elevated T4

c.Elevated TRH

d.All of the above

 

Question.4 Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?  

Benzodiazepinesb.

Antipsychoticsc.

Anticonvulsantsd.

Antidepressants

 

Question.5 When may confidentiality be overridden?

When personal information is available on the computer

When a clinician needs to share information with a billing company

When an insurance company wants to know the results of a breast cancer gene testX

When a patient has a communicable disease

 

 

 

Question.6 What percentage of burns is involved using the rule of nines if both front legs are burned?

 

9%

18%

24%

36%

Question.7 The clinician should question the patient with suspected gout about use of which of these medications that may be a risk factor?

 

Low-dose aspirin

Thiazide diuretics

Ethambutol

All of the above

 

Question.8 Women are at the highest risk for developing postpartum depression for up to how long after childbirth?

 

2 weeks

1 month

3 months

6 months

 

 

Question.9 Which ethical principle reflects respect for all persons and their self-determination?

 

Autonomy

Beneficence

Justice

Veracity

 

Question.10 George, aged 59, complains of a flulike illness, including fever, chills, and myalgia after returning from visiting his grandchildren in New England. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?

 

a. A viral syndromes
b. Lyme disease
c. Rocky Mountain spotted fever
d. Relapsing fever

Question.11 A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?  

Pregnancy test.

Endometrial biopsy

Pelvic ultrasound

Platelet count

Question.12 Which of the following statements is true regarding the treatment of carpal tunnel syndrome?  

a. The goal of treatment is to prevent flexion and extension movements of the wrist.
b. Splints are used in carpal tunnel syndrome because they allow for free movement of the fingers and thumb while maintaining the wrist in a neutral position.
c. Corticosteroid injections are discouraged in the treatment of carpal tunnel syndrome because of the risks for median nerve damage, scarring, and infection.
d. All of the above

Question.13 During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

a. An enlarged rubbery gland

b. A hard irregular gland

c. A tender gland
d. A boggy gland

Question.14 Which drug commonly prescribed …. partial- and full-thickness thermal injuries?  

Clotrimazole cream (Lotrimen)

Mafenide acetate (Sulfamylon)

Silver nitratex

Silver sulfadiazine (Silvadene)

Question.15 A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

“It is probably just a cyst, because that is the most common breast mass.

“We will order a mammogram and ultrasound to help establish a diagnosis.”

“We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”

“Because your lump is painful, it is most likely not cancer.”

 

Question.16 After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

Suggest she use a heating pad to improve circulation

Refer to a podiatrist for a foot care treatment plan

Send her for acupuncture treatments

All of the above

 

Question.17 Which of the following medications is the treatment of choice for trichomonas?  

Metranidazole

Ceftriaxone

Diflucan

Doxycycline

 

Question.18 Most adult poisonings are:

intentional and self-inflicted.

accidental.

caused by someone wishing to do harm to the person.

not attributed to any reason.

 

Question.19 Which solution should be used when irrigating lacerated tissue over a wound on the arm?  

Dilute povidone-iodine solutionx

Hydrogen peroxide (H2O2)

Saline solution infused with an antibiotic

Saline irrigation or soapy water

Question.20 A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?  

 

Sinus bradycardia

Atrial fibrillation

Supraventricular tachycardia

U waves

Question.21 What is usually the first sign or symptom that a patient would present with that would make you suspect herpes zoster?  

A stabbing pain on one small area of the body

A vesicular skin lesion on one side of the body

A pain that is worse upon awakening

A lesion on the exterior ear canal

 

Question.22 Which patient is more likely to have a cluster headache?

A female in her reproductive years

A 40-year-old African American male

A 55-year-old female who drinks 10 cups of coffee daily

A 45-year-old male awakened at night

 

Question.23 If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?  

Permanent tissue damage may occur, resulting in necrosis to that body part.

The area will be super sensitive.

The area is prone to a repeat frostbite.

The area is as susceptible as any other area.

Question.24 The current goal of treatment for a patient with HIV infection is which of the following?

Viral suppression of HIV to undetectable levels in the peripheral blood

Compete eradication of the virus

Encouraging the person to have no contact with uninfected individuals

Complete abstinence

Question.25 The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?  

Overweight

Mild obesity

Moderate obesity

Morbid obesity

Question.26 The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs to manage his pain?

 

You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.

You should start with the lowest dose that is effective in managing your pain in order to avoid developing tolerance to the medication.

You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.

It is important to take NSAIDs on an empty stomach in order to increase absorption.

Question.27 In the consensus model for Advanced Practice Registered Nurse (APRN) regulation, the “C” of LACE represents?  

Commitment

Consensusx

Certification

Collaboration

Question.28 Which of the following statements is true concerning the management of the client with a herniated disc?  

Muscle relaxants and narcotics can be used to control moderate painbut should be discontinued after 3 weeks of use.

An epidural injection is helpful in reducing leg pain that has persisted for at least 3 weeks after the herniation occurred.

Intolerable pain for more than a 3-month period is an indication for surgical intervention.

All of the above

 

 

Question.29 Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?  

Superficial burns

Superficial partial-thickness burns

Deep partial-thickness burns

Full-thickness burns

Question.30 CPT coding offers the uniformed language used for reporting medical services and procedures performed by physician and non physician practitioners. Clinicians are paid based on calculated resource costs that are calculated based on practice components. Which of the following are part of the components used to calculate the per CPT code payment rate?

a. Clinician education loans

b. Clinician practice liability and malpractice expense

c. Clinician reported cost reduction efforts

d. Clinician volume of patients treated

Question.31 Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point?  

10%

x 20%

30%

50%

 

 

Question.32 A bulla is:  

A vesicle larger than 1 cm in diameter.

An elevated solid mass with a hard texture, and the shape and borders can be regular or irregular.

A superficial elevated lesion filled with purulent fluid.

Thinning of the skin (epidermis and dermis) that appears white or translucent.

Question.33 Clinicians who learn how to code and document Evaluation and Management (E&M) and clinician services will be more successful in gaining timely payment for care delivery. Which or the following Centers for Medicare and Medicaid Services (CMS) practices are designed to financially penalize clinicians who do not bill according to CMS guidelines?  

Audits and probes

Add-on codes

Modifier codes

HAC guidelines

Question 34. Which characteristic of delirium helps to distinguish delirium from dementia?

Abrupt onset

Impaired attention

Affective changes

Delusions

Question.35 Which of the following statements is true concerning the musculoskeletal exam?  

The uninvolved side should be examined initially and compared to the involved side.

The part of the body that is causing the patient pain should be examined first.

The patient should not be asked to perform active range-of-motion (ROM) exercises whenever possible to avoid causing pain.

Radiographs should always be obtained prior to examination so as not to cause further injury to the patient.

Question.36 A 22-year-old male is seen in the clinic because he found a hard lump in his testicle when performing testicular self-examination (TSE). Which of the following should be included in the list of differential diagnoses?

Testicular cancer

Inguinal hernia

Varicocele

All of the above

Question.37 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.38 Which of the following is a role of the advanced practice nurse in palliative cancer care?  

 Detecting cancer in asymptomatic patients or those with specific symptoms

Arranging for follow-up care, including psychosocial and spiritual support

Identifying and managing complications of care

All of the above

Question.39 Immunizations are an example of which type of prevention?  

 Primary

Secondary

Tertiary

Question.40 Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines? 

Propranolol

Timolol

Ergotamine

Topiramate

Question.41 A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?  

Human papillomavirus (HPV)

Endometrial hyperplasia

Vagismus

Polycystic ovarian syndrome

Question. 42 How often should the clinician examine the feet of a person with diabetes?

Once a year

Every 6 months

Every 3 months

Every visit

   

Question.43 A 45-year-old woman is seen in the clinic with complaints of a vaginal discharge. The clinician identifies clue cells on the vaginal smear. Which of the following diagnoses is associated with this finding?

Trichomonas

 Bacterial vaginosis

Human papillomavirus (HPV)

Herpes simplex virus (HSV)

 

Question.44 After 6 months of synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies? 

 Elevated thyroid-stimulating hormone (TSH)

Normal TSH

Low TSH

Undetectable TSH

Question.45 The main mechanism for avoiding a lawsuit involves:

Good liability insurance

A collaborating physician

Good documentation

Open communication skills

 

  

Question.46 The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least: 

1 month.

3 months.

6 months.

12 months.

 

Question. 47 What is the treatment of choice for a patient diagnosed with testicular cancer?

Radical orchidectomy

Lumpectomy

Radiation implants

All of the above

 

Question. 48 Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression? Gastrocnemius weakness

A reduced or absent ankle reflex

Numbness in the lateral foot

 Paresthesia of the perineum and buttocks

Question.49 Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

Cholinesterase inhibitors

Anxiolytics

Antidepressants

Atypical antipsychotics

 

Question.50 Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Decreased C-reactive protein

Hyperalbuminemia

Morning stiffness

Weight gain

 

NAPSRx Final Exam

NAPSRx Final Exam

 

1. How are drugs sorted into therapeutic groups and classes?

A. first by the conditions that they are used to treat. and then by their mechanisms of action

B. first by their mechanisms of action. and then by their therapeutic effects

C. first by their side effects. and then by their therapeutic effects

D. first by their toxicity. and then by their effectiveness

 

 

 

2. Bone marrow transplants…

A. require that the patient first undergo chemotherapy or radiation to kill the diseased stem cells and promote white blood cell production.

B. are a type of stem cell therapy. unless patient’s own cells are reinjected.

C. are always a type of stem cell therapy.

D. can help people with leukemia. a condition in which the body does not produce enough white blood cells.

 

 

 

3. What does AMA stand for?

A. American Medical Academy

B. American Medical Accreditation

C. American Medical Association

D. Association of Medical Assistants

 

 

 

4. What section of a drug’s package insert describes situations in which the drug should not be used because the risks outweigh the therapeutic benefits?

A. adverse reactions

B. contraindications

C. overdosage

D. warning/precautions

 

 

 

5 What is tertiary care?

A. adding medications together to achieve a better clinical effect

B. highly specialized medical and surgical care provided by a large medical center for unusual or complex medical problems

C. receiving medical or surgical care that does not require an overnight stay in the treatment facility

D. seeing a physician for routine checkups and general healthcare

 

 

 

6. Which of the following is NOT one of the stages in the classic approach to brand development strategy covered in your manual?

A. brand personality

B. brand positoning

C. brand quality

D. brand values

 

 

 

7 What are vasodilators used to do?

A. decrease vascular resistance and increase blood flow

B. mimic pathogens to stimulate the immune system

C. narrow the blood vessels

D.stimulate the CNS to make the heart beat faster

 

 

 

8. What is the name of the condition that occurs after a specific dose of a drug is given at such regular intervals that absorption and elimination (and therefore drug plasma concentration) have become fairly constant?

A. homeostasis

B. steady state

C. titration

D. tolerance

 

 

 

9. Which statement is TRUE about ocular administration?

A. Ocular administration is primarily for drugs that must cross the blood-brain barrier.

B. Ocular administration is used primarily to treat the eye.

C. Ocular administration is used when a drug must enter the bloodstream immediately.

D. Ocular administration is used when a drug must produce immediate effects on the brain or spinal cord.

 

 

 

10. Which entities invest’s the most money in pharmaceutical R&D?

A. Canadian pharmaceutical companies

B. the NIH

C. the U.S. Government

D. U.S. pharmaceutical companies

 

 

 

11. How are most drugs excreted?

A. via the bloodstream

B. via the heart

C. via the kidneys

D. via the skin

 

 

 

12. Over the last few decades, what has happened to legal limitations on sales’ reps discussions about off label uses? 

A. Limitations have decreased.

B. Limitations have increased significantly.

C. Limitations have increased slightly.

D. Limitations have remained about the same.

 

 

 

13. Answer: Branding name

 

 

 

14. What does it mean if two drugs are at parity?

A. Both drugs are essentially in a neutral position.

B. Both drugs are generics.

C. Both drugs have exclusive preferred status.

D. The two drugs are bioequivalent.

 

 

 

15 Who is most likely to benefit from electronic sampling programs?

A. Everyone would benefit equally from electronic sampling programs

B. physicians in hospitals who are too busy to see representatives

C. physicians in rural areas who are not as frequently visited by representatives

D. physicians in urban areas who are too busy to see representatives

 

 

 

16. When referring to medication dosage, which abbreviation means “one-half’:

A. MS

B. OH

C. SM

D. SS

 

 

 

17 What is an internist?

A. a physician who practices internal medicine

B. a physician’s intern

C. a type of oncologist who specializes in chemotherapy

D. an internal sales representative

 

 

 

18. Which of the following is a type of white blood cell?

A. erythrocytes

B. insulin

C. Lymphocytes

D.HCs

 

 

 

19. Why are novice sales representatives often placed in charge of negotiating MCO formularies?

A. to become more familiar with the healthcare industry

B. to become more familiar with their territories

C. P&T committees are more receptive to new faces.

D. They are not. This job is usually reserved for more experienced reps.

 

 

 

20. What distinguishes pharmacodynamics from pharmacokinetics?

A. Pharmacodynamics studies a drug’s ex vivo effects.

B. Pharmacodynamics studies how drugs affect the body.

C. Pharmacodynamics studies the how the body affects drugs.

D. Pharmacodynamics studies the time required for a drug’s absorption.

 

 

 

21 What proportion of the drugs tested on human subjects are eventually approved by the FDA?

A. about 20%

B. about 60%

C. about 70%

D. about 95%

 

 

 

22. According to a study discussed in your manual, how do most physicians prefer to receive their drug samples?

A. by borrowing them from hospitals

B. by ordering them over the Internet

C. by trading them for services

D. directly from sales representatives

 

 

 

23. Which of the following is an example of a central value?

A. I buy Advil to show that I’m a modern consumer.

B. I like Advil because we were both born in the 80s.

C. I prefer Advil because I like the flavor.

D. I prefer Advil because it’s easier to swallow.

 

 

 

24. Which of the following specialties likely has the MOST emergency calls?

A. cardiology

B. psychiatry

C. urology

D. All specialists have the same number of emergency calls.

 

 

 

25. What affects the rate of active transport?

A. the availability of carriers. but not energy

B. the availability of energy. but not carriers

C. the availability of carriers and energy

D. neither the availability of carriers nor the availability of energy

 

 

 

26. Over the last few decades, what has happened to the FDA approval time for new drugs?

A. It has been lengthened to ensure safer drug products.

B. It has been lengthened to limit DTC marketing

C. It has been shortened to improve drug quality

D. It has been shortened to reduce the cost of new drug development.

 

 

 

27. Which of the following would NOT help improve compliance?

A. patients liking their providers

B. patients using only one pharmacist

C. pharmacists understanding how generics differ from brand name drugs

D.  support groups

 

 

 

28. Which entity chooses a drug’s trade name?

A. the drug’s inventor

B. the drug’s manufacturer

C. the FDA

D. the United States Pharmaceutical Council

 

 

 

29. What type of stem cells are obtained from embryos and can develop into any cell type?

A. multipotent

B.  pluripotent

C. totipotent

D. All stem cells can develop into any cell type.

 

 

 

30. As the price a patient pays for a prescription increases, what happens to the likelihood that the patient will fill it?

A. It decreases.

B. It increases.

C. It remains unaffected because the prescription is needed.

D. It remains unaffected because the prescription’s increased cost is offset by its perceived value.

 

 

 

31. Most involuntary movements come from which type of muscle tissue?

A. cardiac and smooth

B. only skeletal

C. skeletal and cardiac

D. skeletal and smooth

 

 

 

32. Which of the following is NOT one of the body’s major organ systems?

A. the cardiovascular system

B. the cellular system

C. the gastrointestinal system

D.  the musculoskeletal system

 

 

 

33. How do most drugs exert their primary physiological effects?

A.  by activating synapses between different types of tissues

B. by binding to cell receptors that are sensitive to their presence

C. by inhibiting synapses between different types of tissues

D.  through genetic mutation

 

 

 

34. What is the most reliable source of information for determining therapeutically equivalent drug products?

A. AMA guide

B. Blue Book

C. FDA drug list

D.  Orange Book

 

 

 

35. What does subcutaneous mean?

A. beneath the intervention

B. beneath the muscle tissue

C. beneath the outer skin

D. beneath the suture

 

 

 

36. What should a sales representative do if all of the prime spaces in a drug cabinet are coccupied?

A. ask staff for permission to move some of the other products in the cabinet

B. ask staff for permission to throw away expired products in the cabinet

C. ask the doctor if he still needs some of the other products in the cabinet

D. surreptitiously move your largest competitors’ products out of the way

 

 

 

37. It is inappropriate for physicians’ prescribing behaviors to be educated by their personal tastes and idiosyncrasies

A. TRUE

B. FALSE

 

 

 

38.The FDA defines API as the active__ ingredient in a drug, which produces the desired change in the body.

A. pharmaceutical

B. positive

C. potent

D.  primary

 

 

 

39. What are the 2 legal classifications of wholesalers?

A. distributors and supply chains

B. pharmacists and NAMs

C. primary and secondary wholesale distributors

D. retailers and institutions

 

 

 

40.What term describes the usage of a medication for purposes other than the FDA-approved indications on the labeling?

A. contraindicative indication

B. off-indication usage

C or D. off-label

 

 

 

41. What is the acronym for pharmacokinetics?

A. KN

B. PC

C. PK

D. pT

 

 

 

42. The dosage range of a drug that is both safe and beneficial is known as the therapeutic window.

A. TRUE

B. FALSE

 

 

 

43. What is typically NOT a characteristic of a pharmaceutical sales rep?

A. Pharmaceutical sales reps are authentic and real.

B. Pharmaceutical sales reps are creative.

C. Pharmaceutical sales reps are focused.

D. Pharmaceutical sales reps are not concerned about competitors.

 

 

 

44. What entity grants drug patents?

A. the FDA

B. the FDA if the drug is over-the-counter and the U.S. Patent and Trademark Office if the drug is prescription

C. the FDA if the drug is prescription and the U.S. Patent and Trademark Office if the drug is over-the-counter

D. the U.S. Patent and Trademark Office

 

 

 

45. Which of the following refers to all active and inert pharmaceutical ingredients in a drug, including fillers and colors?

A. formulation

B. mycoplasma

C. peptide

D. saccharide

 

 

 

46. What is the difference between potency and efficacy?

A. Doctors prefer more potent drugs.

B. Drug manufacturers prefer more potent drugs.

C. Potency refers to the drug’s effectiveness. while efficacy refers to its strength.

D. Potency refers to the drug’s strength, while efficacy refers to its effectiveness.

 

 

 

47. What is the minimum level of education required for a nurse practitioner?

A. a certification program

B. an associate’s degree    

C. a bachelor’s degree

D. a graduate degree

 

 

 

48. How many names must a drug have?

A. at most three

B. at least three

C. at most five

D. at least five

 

 

 

49. How has a longer development time increased the cost of bringing a new drug to market?

Answer: Increasing the cost of capital

 

 

 

50. Senior citizens consume over times as many pharmaceuticals as people under 65.

A. three

B. five

C. ten

D. fifteen

 

 

 

51. What agency regulates the distribution and use of narcotics?

A. DEA

B. FTC

C. OIG

D.TSA

 

 

 

52. What is passive diffusion?

A. a type of pinocytosis

B. membrane transport via vesicles

C. the use of energy to help a substance pass from a low concentration gradient to a high one

D. when a substance freely moves through a membrane from a high concentration gradient to a low one

 

 

 

53. What are the MAIN categories of drugs under FDA jurisdiction?

A. active drugs and active placebos

B. biopharmaceuticals and nutraceuticals

C. non-prescription and nutraceuticals

D. prescription and non prescription

 

 

 

54. Answer: Oxytocin

 

 

 

55. What are all metabolites?

A. active substances

B. inactive substances

C. injections

D. products of metabolism

 

 

 

56. When a drug is administered orally, where does first-pass metabolism occur?

A. intestine

B. liver

C. pancreas

D. stomach

 

 

 

57. What is the medical term for swelling?

A. assay

B. edema

C. instillation

D. protease

 

 

 

58. Which of the following is NOT part of the Seven Step Cascade of Emotion?

A. be a consultant. not a rep

B. identify what your product does

C. reflect

D. visualize the power of 10

 

 

 

59. Which part of a clinical research paper is frequently referred to as the road map?

A. abstract

B. findings

C. letter to the editor

D . methods

 

 

 

60. Which of the following is a main active ingredient in lung surfactants?

A. animal lung extract

B.  germicides

C.  sympathomimetic drugs

D.  theophylline

 

 

 

61. What does parenteral mean?

A. child prescriptions

B. injection

C. oral

D. tablet

 

 

 

62. Which term denotes a type of substance that enhances the action of a drug or antigen?

A. adjuvant

B. indicated

C. ligase

D peptide

 

 

 

63. If a sales representative’s product is placed on the second tier of a standard three-tier formulary, which of the following is most likely true?

A. It has not been reviewed by the P&T committee.

B. It is in a neutral position unless it is at parity with other drugs.

C. It probably has exclusive preferred status if it is not at parity with any other drugs.

D. It will essentially sell itself if it is granted exclusive preferred status.

 

 

 

64. Which of the following is NOT one of the four basic transport mechanisms?

A. active transport

B. homeostasis

C. passive diffusion

D. pinocytosis

 

 

 

65. Which statement accurately describes a relationship between drug agonists and antagonists?

A. Agonists and antagonists can be used together.

B. Agonists and antagonists should not be used together.

C. Antagonist drugs activate receptors. while agonists block access to receptors.

D. Antagonists are endogenous whereas agonists are man-made.

 

 

 

 

 

66. What is the study of the effects and movement of drugs in the human body?

A. anatomy

B. antology

C. clinical pharmacology

D. pathology

 

 

 

67. According to your manual, what is a common complaint that physicians have about traditional sampling methods?

A. that drug sample supply is too unpredictable

B. that patients are less likely to take free samples because they think they are lower quality

C. that patients do not like seeing drug representatives in their offices

D. that they receive too many drug samples

 

 

 

68. Which of these entities is formed by two or more hospitals or other healthcare entities to negotiate reduced rates with its aggregated purchasing power?

A. GPO

B. In-state wholesaler

C. PPO

D. RPO

 

 

 

69. What is another name for a drug derived from a biologic compound?

A. large molecule 

B. oligonucleotide

C. orgaanism

D. small molecule

 

 

 

70. What is the most common policy regarding pharmaceutical reps dispensing drug samples in hospitals?

A. By federal law. drug sampling is permitted in all hospitals.

B. By federal law. it is up to individual physicians. not the hospital.

C. Drug sampling is encouraged. but not required.

D. Drug sampling is often forbidden.

 

 

 

71 Which of the following would help you build trust with a physician?

A. asking if he or she is having any problems with the managed care coverage of your products

B. repeating a question you already asked

C. surprising the office staff with a new poster in the break room

D. None of these would help you build trust with a physician.

 

 

 

72. What term denotes the difference between the usual effective dose and the dose that induces severe or life-threatening side effects?

A. dose-response relationship

B. margin of safety

C. the placebo effect

D. therapeutic window

 

 

 

73. What are excipients?

A. a type of cell receptor to which antagonists bind to decrease the effects of the body’s natural agonists

B. another term for generic equivalents

C. sites of action besides the target sites of action

D. the inert ingredients in a drug formulation

 

 

 

74. What is another term for the AWP?

A. dock-to-dock price

B. float price

C. list price

D. non-stock price

 

 

 

75. Which of these is the most likely use for a uterotonic agent?

A. to induce labor

B. to make the urine more alkaline

C. to supplement oral food intake

D. to treat hyperthyroidism

 

 

 

76. As of November 2013, which of these countries has legalized DTC advertising of prescription drugs?

A. Canada

B. Japan

C. Spain

D. none of these

 

 

 

77. Why are oral drugs often taken on an empty stomach?

A.  to be more wholly absorbed by the stomach

B. to minimize absorption by the intestine

C.  to minimize nausea

 

D. to pass through the stomach more quickly

 

 

78. What is one factor that differentiates community health centers from hospitals?

A.  Community health center formularies are more restrictive.

B. Community health centers have higher reimbursement rates.

C. Newer brand name drugs are easier to access at community health centers.

D. None of these

 

 

 

79. How does drug sampling provide a social benefit?

A. Doctors donate their unused drug samples to charities.

B. Doctors often use drug samples to treat patients who otherwise could not afford it.

C. It allows patients to try out different prescription medications before consulting with physicians.

D.  Drug sampling provides a social benefit in all of these ways.

 

 

 

80. Which medical term denotes the use of a stethoscope to listen to the heart?

A. auscultation

B. cardioversion

C. catheterization

D. echocardiography

 

 

 

81. What do enteric coatings do?

A. facilitate vomiting

B. help drugs dissolve in the stomach

C. help drugs enter the bloodstream more quickly

D. prevent dissolution in the stomach

 

 

 

82. What is the duration of exclusivity for orphan drugs?

A.  6 months

B. 1 year

C.  7 years

D.  15 years

 

 

 

83. What do National Account Managers do?

A. act as the sales reps’ primary point of contact with the rest of the corporation

B. manage the FDA approval process

C. negotiate contracts with MCOs and PBMs

D.  sell only to pharmacies

 

 

 

84. What does it usually mean if a drug recall is voluntary?

A. Pharmacies may choose whether to return the drug or dispense it.

B. The FDA has determined that the drug is perfectly safe. but ineffective.

C. The manufacturer has recalled the product on its own. but negotiated with the FDA beforehand.

D. The manufacturer has recalled the product without negotiating with the FDA.

 

 

 

85. Which phase of clinical trials is also known as the pivotal phase?

A. Phase I

B. Phase III

C Phase IV

D. Phase IX

 

 

 

86. During which phase of clinical trials is the new drug’s safety and effectiveness first tested in the target group?

A. preclinical

B. Phase I

C. Phase II

D. Phase III

 

 

 

87. How do antacids work?

A. by increasing blood flow to the stomach

B. by lowering gastric pH

C. by raising gastric pH

D. by suppressing cholesterol formation by the liver

 

 

 

88. What is one of the biggest time wasters for a pharmaceutical sales rep?

A. Caterers

B. Pharcists

C. receptionists

D. travel time

 

 

 

89. What happens when equilibrium is reached?

A.  equal numbers of molecules cross the membrane in both directions

B.  molecules stop moving

C. the concentration gradient decreases indefinitely

D. the concentration gradient increases indefinitely

 

 

 

90. What are the most common vectors used in gene therapy?

A.  autologous antigens

B. liposomes

C. naked DNA

D. viruses

 

 

 

91. What is the percentage fee that the dispenser pays the wholesaler for distribution?

A. margin fee

B. recharge

C. standard fee

D. upcharge

 

 

 

92. What is the difference between a chronic (or continuing) reaction, and a delayed reaction?

A. Chronic reactions are exaggerated. whereas delayed reactions are idiosyncratic.

B. Chronic reactions occur only during treatment. whereas delayed reactions only occur during withdrawal.

C. Chronic reactions persist for a long time. whereas delayed reactions take some time to develop.

D. Delayed reactions are always idiosyncratic. but chronic reactions are not.

 

 

 

93 What is clinical effect?

A. federally funded research condition

B. the effect of maximum dosage

C. the response produced by a medication

D. the use of treatment drugs in chemotherapy

 

 

 

94. Which of the following is an example of noncompliance?

A. a patient forgetting to take a drug at a specified time of day

B. a patient taking a drug. but only because it has been court-mandated

C. a pharmacist dispensing a generic equivalent of a drug instead of the brand name

D. a physician refusing to prescribe a drug because he or she does not trust the clinical studies on it

 

 

 

95. What is the average circulation time of blood?

A. about a minute

B. about 5 minutes

C. about 5 to 10 minutes depending on the patient’s age and health conditions

D. about 10 minutes

 

 

 

96. What is one way in which pharmaceutical selling is different from selling in most other industries?

A. In pharmaceutical sales. the decisions-makers. consumers. and payers are usually the same entity.

B. Pharmaceutical selling takes less time because doctors are so busy.

C. Representatives do NOT sell to the end user of the product.

D. Representatives DO sell to the end user of the product.

 

 

 

97. From what types of entities do primary wholesale distributors buy most of their drugs?

A. brokerages

B. buying clubs

C. manufacturers

D. physicians

 

 

 

98.What is the Office of the Inspector General (01G)?

A. a department in pharmaceutical companies

B. an arm of the Department of Health and Human Services

C. an arm of the European Medicines Agency

 

 D an arm of the FDA

 

 

 

99. What are doctors required to consider when deciding whether or not to prescribe a particular drug?

A. quantity of life over quality of life

B. that no drugs with adverse effects should ever be used

C. the inferiority of OTC drugs

D. the severity of the disorder being treated and the effect it has on the patient’s quality of life

 

 

 

100. Which entity assigns a new drug its generic names?

A. the drug’s inventor

B. the Food and Drug Administration

C. the United States Adopted Name Council

D. the United States Pharmaceutical Council

 

 

 

101. Drugs can be used days beyond their expiration date.

A.  2-7 days. depending on the most current monograph.

B.  2-90 days. depending on state laws

C. 7-90 days. depending on the type of drug and its therapeutic class.

D. none of these

 

 

 

102. What is necessary for a drug to be excreted extensively via the kidneys?

A. The drug must be water-soluble. and not bind too tightly to proteins in the bloodstream.

B. The drug must have a phospholipid bilayer and be non-water-soluble.

C. The drug must have a phospholipid bilayer and bind well to proteins in the bloodstream.

D. The drug must not be water-soluble.

 

 

 

103. Which organization or individual initiates the clinical trial and finances the study?

A. clinical research organization

B. investigator

C. researcher

D. sponsor

 

 

 

104. The name describes the atomic or molecular structure of a drug.

A. chemical

B.  generic

C. pharmaceutical

D. proprietary

 

 

 

105. Under PhRMA Code, is it acceptable or unacceptable for a pharmaceutical sales rep to take a physician and the physician’s spouse to a fundraising dinner?

A. acceptable if only the physician attends

B. acceptable if only the physician attends. and the total is under $100

C. acceptable if the total is under $100

D. unacceptable

 

 

 

106. The Hatch-Waxman Act is considered the most significant drug-related affecting the pharmaceutical industry since 1962.

A. experiment

B. legislation

C. process

D. research

 

 

 

107. What term denotes the the extent, quality, or degree to which a substance is poisonous or harmful to the body?

A. caliber

B. chronicity

C. indication

D. toxicity

 

 

 

108. What issue has MOST encouraged consumers’ desire to see more OTC medications?

A. a weaker patients’ rights movement

B. lack of insurance coverage

C. less reliance on the Internet

D. proliferation of herbal remedies

 

 

 

109. What is the degree to which a medication produces a therapeutic effect?

A. diffusion

B. efficacy

C. protease

D. vector

 

 

 

110. What is the most important benefit of electronic prescribing?

A. Choice

B. cost

C. inquiries

D.  safety  

 

 

 

111. When does the FDA regulate generic drugs?

A. only if they are branded generics

B. only if they have been contested

C.  always

D never

 

 

 

112. Which phase of trials largely determines the clinical dose?

A. preclinical trials

B. Phase II trials

C. Phase III trials

D. Phase IV trials

 

 

 

113. What is an advantage of inactivated vaccines over attenuated vaccines?

A.  Inactivated vaccines are less expensive to prepare.

B. Inactivated vaccines have a higher probability of eliciting the desired immunological response.

C. Inactivated vaccines have a more stable shelf life.

D.  Inactivated vaccines only require a single dose.

 

 

 

114. Which medical term denotes a low supply of oxygen due to low blood flow?

A. potentiation

B. ischemia

C. TID

D. titration

 

 

 

115. What are the two main types of prescription drug marketing?

A. (1) marketing to insurance companies. and (2) marketing to pharmacies

B. (1) PBM marketing. and (2) marketing to governments

C. (1) professional physician promotions. and (2) direct-to-consumer advertising

D. (1) publicly-funded marketing. and (2) physician-funded marketing

 

 

 

116. What is the site of delivery for subcutaneous injections?

A. fatty tissue beneath the surface of the skin

B.  lymphatic tissue

C. muscle tissue

D. the stomach, via a special type of needle

 

 

 

117. What must be contained in the Description section of a pharmaceutical package insert?

A. adverse effects

B. mechanism of action

C. pharmacokinetics

D. the proprietary name and the established name

 

 

 

118. What is the study of a medication’s effects as it travels through the body?

A. pharmacodynamics

B. pharmacogenetics

C. pharmacogenomics

D. pharmacokinetics

 

 

 

119. Customers purchase products from people they like, trust, and respect. This is called the 

A. closing of the sale

B. first time advantage

C. likeability factor

D. power of knowledge

 

 

 

120. What is penicillin’s primary mechanism of action?

A. It disturbs bacterial cell wall synthesis.

B It inhibits the production of viruses.

C. It prevents proper DNA replication.

D. It sends a messenger to the bone marrow to produce extra white blood cells

 

 

 

121. According to your manual, how has the U.S. healthcare marketplace changed in the last few decades?

A. Fewer and fewer prescription drugs have been made available as OTCs.

B. Managed care has been increasingly replaced by more patient-centered approaches.

C. The aging Baby Boomer generation has begun demanding more personalized attention.

D. There has been decreased emphasis on preventive health.

 

 

 

122. How does pharmaceutical marketing help narrow the treatment gap?

A. It encourages patients to take more active roles in their healthcare.

B. It makes doctors more skeptical of the pharmaceutical industry.

C. It makes patients more skeptical of their doctors’ opinions.

D. all of these

 

 

 

123. What do immunosuppressive agents do?

A. decrease risk of infection

B. increase risk of infection

C. reduce the risk of rejection of foreign bodies

D. treat psoriasis

 

 

 

124. What types of drugs are EGFR inhibitors?

A. antineoplastics

B. cardiovascular agents

C. CNS agents

D. mitotic inhibitors

 

 

 

125. Which of the following means outside of the living body?

A. en vivo

B. ex vitro

C. ex vivo

D. intra vivo

 

 

 

126. The FDA requirements for nutraceuticals and medicinal herbs are just as stringent as for pharmaceuticals.

A. TRUE

B. FALSE

 

 

 

127. What is the estimated net gain of private-sector healthcare’s contributions to increased U.S. life expectancy?

A. $5-10 billion

B. $40-50 billion

C. $800-900 billion

D.$ 2-5 trillion 

 

 

 

128. Which statement is TRUE regarding post-approval drug monitoring?

A. All side effects are determined during clinical trials.

B. Drug manufacturers are only required to report adverse effects if they are severe or life-threatening.

C. Drug manufacturers are only required to report adverse effects if they have been proven in clinical studies.

D. The FDA can choose to withdraw their approval if new evidence arises.

 

 

 

129. Which term denotes when tolerance to one medication causes increased tolerance to another medication?

A. cell tolerance

B. cross-tolerance

C. indicated tolerance

D. minimized tolerance

 

 

 

130. Patents expire __ years from the date of filing.

A. ten

B. fifteen

C. twenty

D. thirty

 

 

 

131. After a trade-name drug’s patent expires, how may generic versions of it be sold?

A. only under the branded generic name

B. only under the generic name

C. only under the original trade name

D. under the original trade name or a generic name

 

 

 

132. What is required for a new pharmaceutical to be considered a viable therapy?

A. It causes no serious adverse effects.

B. It causes no side effects.

C. It has an active placebo.

D. It is more effective and/or causes fewer serious adverse effects than other drugs on the market.

 

 

 

133. Under the AMA guidelines, who is ultimately responsible for minimizing conflicts of interest?

A.  doctors

B. lawyers and office managers

C. pharmaceutical companies

D. sales representatives

 

 

 

134. The act of dispensing a pharmaceutical alternative for the product prescribed is

A. alternative licensure

B. equivalence practice

C.  necessitated substitution

D. pharmaceutical substitution

 

 

 

135. What does it mean if a drug is said to have a wide margin of safety?

A. Its safety levels have yet to be adequately verified.

B. Its safety varies widely among different types of patients.

C. There is a greater chance of severe or life-threatening side effects.

D. There is a lower chance of severe or life-threatening side effects.

 

 

 

136. Which of the following is the correct medical acronym for effective dose?

A. DE

B. ED

C. EFD

D. eff D

 

 

 

137. Why is one group of subjects given an active drug, while another group only receives a placebo?

A. to assess patients’ expectations

B. to assess the drug’s effectiveness

C. to assess the professionalism of the study staff

D. to assess the subjects’ demographics

 

 

 

138. A generic version is likely to have some inactive ingredients that are different from those of the original drug.

A. TRUE

B. FALSE

 

 

 

139. Which of the following is an example of a functional value?

A.  I drink Coca-Cola because I am a citizen of the world.

B.  I drink Coca-Cola because I like looking like a traditionalist.

C.  I drink Coca-Cola because I like the taste.

D.  I drink Coca-Cola because it is an international brand.

 

 

 

140. Where are most drugs metabolized?

A.  interstitial spaces

B.  liver

C. stomach

D . the bloodstream

 

 

 

141. What is essential to the ethical requirement that subjects be selected fairly?

A. Selection criteria should be well-supported by documented evidence.

B. Studies should make every attempt to conduct research on subjects who are underprivileged and in need of medical attention.

C. Subjects should be selected based on scientific objectives.

D. all of these

 

 

 

142. Which of the following is the most appropriate salutation for a cover letter if you cannot find a contact name?

A. Dear Personnel Department.

B. Dear Sir or Madam,

C. Dear Sir

D.To Whom It May Concern.

 

 

 

143. What is part of becoming an indispensable pharmaceutical sales rep?

A. asking for feedback

B. giving the doctors anything they ask for to prescribe your products

C. keeping your market share goals the same each term

D. not bothering busy doctors in hospitals

 

 

 

144. Which of the following is NOT typically included in the indications and usage section of the package insert information?

A. diseases or conditions that the drug is approved to treat

B. the drug’s active metabolites

C. the drug’s recommended usual dosage

D. the drug’s usual dosage range

 

 

 

145. Which term denotes the practice of classifying physicians and other potential prescribers by anticipated prescription volume?

A. conditioning

B. deciling

C. detailing

D. private labeling

 

146. What makes a drug eligible for fast track approval from the FDA?

A. It is a generic that has already been approved as a branded drug.

B. It is a new drug.

C. It is less expensive than what is currently on the market.

D. It treats patients with a serious. life-threatening condition.

 

147. In the gastrointestinal tract, help break up tablets to ensure full release of the active pharmaceutical ingredient.

A. binders

B. disintegrants

C. dispersing agents

D. lubricants

 

148. According to your manual, what does the PDRP do?

A. It educates patients on their treatment options.

B. It expands sales representatives’ access to patient information.

C. It improves communication between sales representatives and patients in doctors’ offices.

D. It limits sales representatives’ abilities to see individual physicians’ prescribing data.

 

149. What are the components of the central nervous system?

A. the brain and sense organs

B. the brain and spinal cord

C. the brain. spinal cord. and peripheral nervous system

D. the spinal cord and sense organs

 

150. Which term denotes the origin or cause of a medical condition?

A. cytology

B. discovery

C. etiology

D. pathology

 

151. Patients diagnosed with Type 1 diabetes…

A.  …do not produce enough insulin because they do not have enough B cells.

B.  …have an autoimmune disease.

C.  …produce enough insulin. but it is not as effective.

D.  …rely on insulin from porcine sources.

 

152. Which DTC pharmaceutical marketing tactic is permitted in European countries?

A. disease state ads

B. branded billboards and disease state ads

C. branded highway billboards

D. branded radio ads

 

153. What is one way in which psychologists DIFFER from psychiatrists?

A. Psychologists are more concerned with subconscious memories than conscious ones.

B. Psychologists deal more with emotional than physical issues.

C. Psychologists deal more with physical issues than emotional ones.

D. Psychologists do not have graduate degrees.

 

154. What are PBMs?

A. governmental organizations that provide healthcare

B. organizations that design marketing campaigns

C. organizations that negotiate between pharmaceutical companies and large drug purchasers

D. organizations that write FDA new drug applications

 

155. How does the Hatch-Waxman Act protect research-based drug manufacturers?

A. by limiting the competition

B. by making it easier to bring generic drugs to market

C. by providing a 30-month cooling off period

D. by requiring the FDA to only look at bioavailability studies when approving an ANDA 

 

156. What is the process of adjusting drug doses to achieve the maximum positive therapeutic effects while minimizing adverse or side effects?

A.homeostatic maximization

B.steady state administration

C.Sustained release

D.Titration

 

 

 

157. Which of the following is studied more in pharmacodynamics than in pharmacokinetics?

A. absorption. Distribution metabolism and excretion

B. dose-response effects

C. the transportation of the drug to the specific site for drug-receptor interaction

D. the way the human body deals with a drug after it has been administered

 

 

 

158. How does the healthy human immune system use MHC markers?

A. Substances with MHC markers are discerned as foreign and targeted for destruction.

B. Substances with MHC markers as discerned as foreign and quarantined in the liver.

C. Substances with MHC markers as discerned as foreign and quarantined in the pancreas.

D. Substances without MHC markers are discerned as foreign and targeted for destruction.

 

 

 

159. What is a behind-the-counter drug?

A. an OTC drug that must be closely monitored by the pharmacist

B. another term for a generic prescription drug

C. another term for a prescription drug

D. another term for an OTC drug

 

 

 

160. When do MSLs meet with clinicians?

A. at nearly any stage of the product’s life cycle

B. only after the district’s sales representatives

C. only prior to launch

D. MSLs do not meet with physicians.

NAPSRx Final Exam

NAPSRx Final Exam

 

1. How are drugs sorted into therapeutic groups and classes?

A. first by the conditions that they are used to treat. and then by their mechanisms of action

B. first by their mechanisms of action. and then by their therapeutic effects

C. first by their side effects. and then by their therapeutic effects

D. first by their toxicity. and then by their effectiveness

 

 

 

2. Bone marrow transplants…

A. require that the patient first undergo chemotherapy or radiation to kill the diseased stem cells and promote white blood cell production.

B. are a type of stem cell therapy. unless patient’s own cells are reinjected.

C. are always a type of stem cell therapy.

D. can help people with leukemia. a condition in which the body does not produce enough white blood cells.

 

 

 

3. What does AMA stand for?

A. American Medical Academy

B. American Medical Accreditation

C. American Medical Association

D. Association of Medical Assistants

 

 

 

4. What section of a drug’s package insert describes situations in which the drug should not be used because the risks outweigh the therapeutic benefits?

A. adverse reactions

B. contraindications

C. overdosage

D. warning/precautions

 

 

 

5 What is tertiary care?

A. adding medications together to achieve a better clinical effect

B. highly specialized medical and surgical care provided by a large medical center for unusual or complex medical problems

C. receiving medical or surgical care that does not require an overnight stay in the treatment facility

D. seeing a physician for routine checkups and general healthcare

 

 

 

6. Which of the following is NOT one of the stages in the classic approach to brand development strategy covered in your manual?

A. brand personality

B. brand positoning

C. brand quality

D. brand values

 

 

 

7 What are vasodilators used to do?

A. decrease vascular resistance and increase blood flow

B. mimic pathogens to stimulate the immune system

C. narrow the blood vessels

D.stimulate the CNS to make the heart beat faster